US20200237651A1 - Topical montelukast for treatment of atopic dermatitis - Google Patents

Topical montelukast for treatment of atopic dermatitis Download PDF

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US20200237651A1
US20200237651A1 US16/738,482 US202016738482A US2020237651A1 US 20200237651 A1 US20200237651 A1 US 20200237651A1 US 202016738482 A US202016738482 A US 202016738482A US 2020237651 A1 US2020237651 A1 US 2020237651A1
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ingredient
montelukast
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active
oil
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Avi Avramoff
Helena Shifrin
Irena Oleinik
Ron Schlinger
Tzviel Sheskin
Vered Rosenberger
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Taro Pharmaceutical Industries Ltd
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Taro Pharmaceutical Industries Ltd
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Assigned to TARO PHARMACEUTICAL INDUSTRIES LTD. reassignment TARO PHARMACEUTICAL INDUSTRIES LTD. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: OLEINIK, IRENA, SHESKIN, TZVIEL, AVRAMOFF, AVI, ROSENBERGER, VERED, SCHLINGER, RON, SHIFRIN, HELENA
Priority to US18/295,654 priority patent/US20230248641A1/en
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    • 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
    • A61K9/0014Skin, i.e. galenical aspects of topical compositions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • 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
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/20Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing sulfur, e.g. dimethyl sulfoxide [DMSO], docusate, sodium lauryl sulfate or aminosulfonic acids
    • 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
    • A61K47/42Proteins; Polypeptides; Degradation products thereof; Derivatives thereof, e.g. albumin, gelatin or zein
    • 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
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/10Dispersions; Emulsions
    • A61K9/107Emulsions ; Emulsion preconcentrates; Micelles
    • A61K9/1075Microemulsions or submicron emulsions; Preconcentrates or solids thereof; Micelles, e.g. made of phospholipids or block copolymers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients

Definitions

  • Atopic dermatitis is an increasingly common pruritic, chronic, inflammatory skin disorder.
  • AD Atopic dermatitis
  • AD and asthma There are pathogenic mechanisms that are in common to both AD and asthma.
  • the exaggerated inflammatory response (including increased production of IgE and eosinophilia) to environmental triggers, including irritants and allergens is characteristic of both AD and asthma.
  • Total IgE levels are elevated in both AD and asthma.
  • Genetic studies have demonstrated common chromosomal linkages between AD and asthma.
  • Leukotrienes are a class of potent biological inflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway Leukotrienes are divided into two groups according to their chemical structure: those with a sulphur linkage (cysteinyl LTs: LTC 4 , LTD 4 , LTE 4 ), and those that lack one (LTB 4 ). Eosinophils, basophils and mast cells are the most important sources of LTs. Epidermal cells are able to transform neutrophil derived LTA 4 into LTB 4 and LTC 4 . Thus the epidermis can also contribute significantly to LT synthesis.
  • cysteinyl leukotrienes mediate asthma and allergic rhinitis and when the LT receptors are antagonized, symptoms resolve.
  • Leukotrienes are important pro inflammatory mediators that are capable of inducing airway smooth muscle constriction, airway hyper responsiveness, eosinophil migration, vascular permeability, edema, and chemotaxis.
  • a role for LTs in AD has been suggested in the literature.
  • the cysteinyl LTs increase vascular permeability and dilate skin blood vessels.
  • LTC 4 has been found in the skin of AD patients using the suction blister technique.
  • LT receptors There are at least two types of LT receptors: cysLT1 and cysLT2.
  • Montelukast (Singulair®, Merk-Frosst), zafirlukast (Accolate®, Zeneca), and pranlukast (Ultair®, SmithKline Beecham) are LT receptor antagonists that demonstrate high-affinity binding to the cysLT1 receptor.
  • Montelukast is currently indicated for the prophylaxis and chronic treatment of asthma in adults and pediatric patients 12 months of age and older and for the relief of symptoms of seasonal allergic rhinitis in adults and pediatric patients 2 years of age and older.
  • Montelukast is generally a safe drug during long term treatment; side effects are minimal.
  • the stratum corneum is the outmost layer of the skin which is being continually replaced. By so doing the skin is well adapted to its requirements for repairing damage from wear and tear.
  • SC stratum corneum
  • environmental and individual factors interact in a complex manner to induce skin abnormalities and dryness.
  • Application of moisturizers to the skin induces changes in its superficial as well as deep layers.
  • the chemical and physical characteristics of the individual ingredients of the formulation determnnine the performance of the drug product.
  • Montelukast sodium exerts additional challenge to be formulated in a semi solid formulation even for experienced formulators.
  • Sodium montelukast chemically known as [sodium 1-(1-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)-phenyl)(3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl) thio)-methyl)-cyclo-propane) acetate is a photosensitive compound requiring special handling precautions to protect specimens from light especially in a solution.
  • the present invention provides a topical formulation comprising 1-(1-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)-phenyl)(3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl) thio)-methyl)-cyclo-propane) acetate (montelukast) or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis.
  • the present invention provides a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof and at least one oil for the treatment of atopic dermatitis wherein the formulation is waterless.
  • the present invention relates to a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis.
  • the salt is an alkali metal salt, such as sodium or potassium; an alkaline earth salt; or an ammonium salt.
  • montelukast encompasses polymorph crystal forms and any other form of montelukast that has one or more of the pharmaceutical activities of montelukast.
  • the topical formulation may comprise about 0.01% w/w to about 10% w/w montelukast or a pharmaceutically acceptable salt.
  • the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is between about 0.5% w/w to about 5% w/w.
  • the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is between about 5% w/w to about 10% w/w
  • the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is 5% w/w.
  • the topical formulation of montelukast or a pharmaceutically acceptable salt can be a gel.
  • a gel may be prepared by providing a gelling agent and adding an excipient such as water in case of a hydrous gel.
  • the gel may include a variety of additional components such as, but not limited to solvents, emulsifiers, thickeners, stabilisers, gelling agents, chelating agents, surfactants, emollients, permeation enhancers, preservatives, antioxidants, lubricants, pH adjusters.
  • the topical formulations of Montelukast or a pharmaceutically acceptable salt thereof provide topical penetration of the active agent through the epidermis and into the dermis.
  • the topical formulations described above comprise penetration enhancers, which facilitate the penetration of the active agent and preferably dissolve the active ingredient present in the formulations of the invention
  • permeation enhancers include, for example: polyols and esters, including polyethylene glycol, polyethylene glycol monolaurate, and butanediol; sulfoxides, including dimethylsulfoxide and decylmethylsulfoxide; ethers, including diethylene glycol monoethyl ether (e.g., Transcutol® P) and diethylene glycol monomethyl ether; fatty acids, including lauric acid, oleic acid, and valeric acid; fatty acid esters, including isopropyl myristate, isopropyl palmitate, methyl propionate, and ethyl oleate; nitrogenous compounds including urea, dimethyl acetamide, dimethylformamide 2-pyrrolidone, ethanolamine, methyl-2-pyrrolidone, diethanolamine, and triethanolamine; terpenes; alkanones; organic acids,
  • the pH of the topical gel formulation of montelukast or a pharmaceutically acceptable salt is less than 6.
  • the pH is in the range from 4 to 6. In a more preferred embodiment, the pH is in the range of 5 to 6.
  • the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a gelling agent.
  • suitable gelling agents for use in the present invention may include, but are not limited to hyaluronic acid and its salts such as Sodium Hyaluronate, cellulose derivatives such as hydroxypropyl cellulose (HPC), Hydroxyethyl cellulose (Natrosol 250 HEC HHX), carbomers such as sodium carbomer.
  • suitable topically acceptable solvents may also be used in the topical composition.
  • suitable topically acceptable solvents for use in the present invention include, but are not limited to lower alcohols, ethanol, isopropanol, benzyl alcohol, propanol, methanol, other C4-C10 mono alcohols and mixtures thereof.
  • the solvents suitable for use in the formulation of the present invention may include albumin, gelatin, citric acid, ethylenediaminesodiumtetraacetate, dextrin, dimethylsulfoxide, dimethylacetamide, dimethylformamide, 2-pyrrolidone, N-(2-hydroxyethyl) pyrrolidone, N-methylpyrrolidone, 1-dodecylazacycloheptan-2-one and other n-substituted-alkyl-azacycloalkyl-2-ones(azones), sodium hydrosulfite and mixtures thereof.
  • the topical formulation of the invention comprises a polar aprotic solvent, preferably selected from anyone or more of the following: dimethylsulfoxide, dimethyl acetamide, dimethylformamide or N-methylpyrrolidone.
  • the topical formulation of montelukast or a pharmaceutically acceptable salt may further comprise an antioxidant such butylated hydroxy anisole or butylated hydroxy toluene; preservatives such as a paraben which include a methyl paraben or propyl paraben.
  • the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a triglyceride.
  • a triglyceride may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • MCT medium chain triglyceride
  • the topical formulation described above comprises an occlusive ingredient, such as petroleum jelly/white petrolatum; a wax; an oil; a silicone; a film forming polymer, such as hyaluronic acid, hydroxypropyl cellulose (HPC) or a poly (meth) acrylate, (e.g. Eudragit®); or any combination thereof, and said formulation is therefore an occlusive formulation.
  • an occlusive ingredient such as petroleum jelly/white petrolatum; a wax; an oil; a silicone; a film forming polymer, such as hyaluronic acid, hydroxypropyl cellulose (HPC) or a poly (meth) acrylate, (e.g. Eudragit®); or any combination thereof, and said formulation is therefore an occlusive formulation.
  • the pharmaceutically acceptable inactive ingredients of the formulation described above may further comprise an oil, such as castor oil or a castor oil derivative (e.g. trihydroxystearin), fractionated coconut oil, or olive oil; an occlusive ingredient, such as petroleum jelly/white petrolatum, a wax, an oil, a silicone, glycerin; an MCT of e.g. hexanoic acid, octanoic acid, decanoic acid or dodecanoic acid; an antioxidant, such as butylated hydroxyanisole; or any combination thereof.
  • an oil such as castor oil or a castor oil derivative (e.g. trihydroxystearin), fractionated coconut oil, or olive oil
  • an occlusive ingredient such as petroleum jelly/white petrolatum, a wax, an oil, a silicone, glycerin
  • an MCT e.g. hexanoic acid, octanoic acid, decanoic acid or dodecanoic acid
  • an antioxidant
  • the topical formulation described above may comprise a colloidal solution/suspension, wherein the active agent is in the form of microparticles that are suspended in said formulation, i.e. particles having a diameter of about 1-100 ⁇ m.
  • the topical formulation may comprise a microparticle or nanoparticle comprising or encapsulating the active agent, wherein said microparticle or nanoparticle is selected from the group consisting of (a) a solid lipid nanoparticle; (b) a liposome; and (c) a polymeric microparticle or nanoparticle.
  • the solid lipid nanoparticle comprises a lipid selected from the group consisting of cholesterol, a triglyceride, a phospholipid, a fat and a wax.
  • the solid lipid nanoparticle or liposome comprises a phospholipid selected from the group consisting of a lecithin, such as egg or soybean lecithin; a phosphatidylcholine such as egg phosphatidylcholin; a hydrogenated phosphotidylcholine; a lysophosphatidylcholine; dipalmitoylphosphatidylcholine; distearoylphosphatidylcholine; dimyristoylphosphatidylcholine; dilauroylphosphatidylcholine; a glycerophospholipid such as phosphatidylglycerol, phosphatidylserine, phosphatidylethanolamine, lysophosphatidylethanolamine, phosphatidylinositol, phosphatidylinositol phosphate, phosphatidylinositol bisphosphate and phosphatidylinosito
  • a galactolipid and a sulfolipid a glycosphingolipid, e.g. a cerebroside (a glucocerebroside and a galactocerebroside), and a glycosylphosphatidylinositol; a plasmalogen; a phosphosphingolipid such as a ceramide phosphorylcholine, a ceramide phosphorylethanolamine and a ceramide phosphorylglycerol; and a mixture thereof.
  • a glycosphingolipid e.g. a cerebroside (a glucocerebroside and a galactocerebroside), and a glycosylphosphatidylinositol; a plasmalogen; a phosphosphingolipid such as a ceramide phosphorylcholine, a ceramide phosphorylethanolamine and a ceramide phosphorylglycerol; and a mixture thereof.
  • the phospholipid may further be admixed with one or more nonphosphorous-containing molecules selected from the group consisting of a fatty amine, such as octylamine, laurylamine, N-tetradecylamine, hexadecylamine, stearylamine, oleylamine, tallow amine, hydrogenated tallow amine, and cocoamine; a fatty acid; a fatty acid amide; an ester of a fatty acid such as isopropyl myristate, hcxadecyl stearate, and cetyl palmitate; cholesterol; a cholesterol ester; a diacylglycerol; a glycerol ester, such as glycerol ricinoleate; and a mixture thereof.
  • a fatty amine such as octylamine, laurylamine, N-tetradecylamine, hexadecylamine, stearylamine,
  • the polymeric microparticle or nanoparticle comprises a polymer selected from the group consisting of a silicone; poly(lactic-co-glycolic acid (PLGA); polylactic acid (PLA); chitosan; gelatine; ethylcellulose; polycaprolactone; a polyalkyl cyanoacrylate; and any combination thereof.
  • a silicone poly(lactic-co-glycolic acid (PLGA); polylactic acid (PLA); chitosan; gelatine; ethylcellulose; polycaprolactone; a polyalkyl cyanoacrylate; and any combination thereof.
  • a triglyceride may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • MCT medium chain triglyceride
  • topical formulations described above provide topical penetration of the active agent through the epidermis and into the dermis.
  • the topical formulations described above comprise penetration enhancers, which facilitate the penetration of the active agent and preferably dissolve the active ingredient present in the formulations of the invention.
  • the topical gel formulation comprises
  • the gel formulation may also comprise pH adjusting agents and occlusive agents.
  • concentration of above category of ingredient/ingredients may be determined based on knowledge by the person skill in the art.
  • Examples of specific gel formulation include:
  • the present invention relates to a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, at least one oil for the treatment of atopic dermatitis wherein the formulation is waterless.
  • the waterless topical formulation comprising Montelukast or a pharmaceutically acceptable salt may further a topically acceptable solvent and an amphiphilic compound.
  • the waterless formulation may be an ointment. In another embodiment, the waterless formulation may be a solution. In another embodiment, the waterless formulation may be a gel.
  • the waterless formulations may include a variety of additional components such as, but not limited to solvents, emulsifiers, chelating agents, surfactants, emollients, permeation enhancers, preservatives, antioxidants, lubricants, pH adjusters.
  • the ointment may comprise an amphiphilic compound.
  • suitable amphiphilic compounds include, but are not limited to vegetable oils, animal fats, and semisolid hydrocarbons obtained from petroleum.
  • examples of amphiphilic compound include polypropylene glycol-15 stearyl ether, propylene glycol monostearate (monosteol), Poloxylhydrogenated Castor oil, oleyl alcohol, polyoxyglycerides, propylene carbonate
  • oils such as poloxylhydrogenated castor oil (e.g. trihydroxystearin), fractionated coconut oil, or olive oil
  • an occlusive ingredient such as petroleum jelly/white petrolatum, a wax, an oil, a silicone, glycerin
  • an MCT of e.g.
  • hexanoic acid, octanoic acid, decanoic acid or dodecanoic acid lubricants such as Cyclomethicone and Dimethicone 5225C, Cyclomethicone, polypropylene glycol-15 stearyl ether; an antioxidant, such as butylated hydroxy anisole or butylated hydroxyl toluene; or any combination thereof.
  • the topical formulation may comprise an occlusive ingredient selected from the group of siloxanes such as cyclomethicone, dimethicones; petroleum jelly/white petrolatum.
  • the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a triglyceride.
  • a triglyceride may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • MCT medium chain triglyceride
  • the topical waterless formulation comprises:
  • the gel formulation may further comprise a gelling agent.
  • concentration of above category of ingredient/ingredients may be determined based on knowledge by the person skill in the art.
  • the waterless formulation of montelukast or a pharmaceutically acceptable salt can be:
  • API is milled to ⁇ 5 micron size. Homogenous distribution of crystals in ointment was observed
  • each one of the topical formulations described above further comprises an additional active agent, such as an anti-pruritic agent, such as pramoxine; an antihistamine; an anti-inflammatory agent, such as a corticosteroid (e.g., an anti-pruritic agent, such as pramoxine; an antihistamine; an anti-inflammatory agent, such as a corticosteroid (e.g., an anti-pruritic agent, such as pramoxine; an antihistamine; an anti-inflammatory agent, such as a corticosteroid (e.g.
  • hydrocortisone or desoximetasone), or a glucocorticosteroid an antibacterial agent, such as dapson (diaminodiphenyl sulfone) or minocycline; a vitamin, such as vitamin B, C, D or E; a non-steroidal anti-inflammatory drug (NSAID); a peripheral analgesic agent; or a different leukotriene receptor antagonist, such as zafirlukast or pranlukast, or a pharmaceutically acceptable derivative thereof.
  • the present invention provides a topical formulation comprising a pharmaceutically acceptable carrier and a microparticle(s) or nanoparticle(s) comprising an active agent selected from the group consisting of a leukotriene receptor antagonist, such as an antagonist specific to cysLT1, and a pharmaceutically acceptable derivative thereof.
  • a leukotriene receptor antagonist such as an antagonist specific to cysLT1
  • the active agent may be montelukast, zafirlukast or pranlukast, or a pharmaceutically acceptable derivative thereof.
  • the active agent is montelukast, e.g. montelukast sodium.
  • the microparticles or nanoparticles of this topical formulation may be as defined above.
  • each one of the topical formulations described above is formulated as a gel, solution, suspension, lotion, paste, cream, ointment, aerosol, dusting powder or a patch.
  • the present invention provides a topical fonnulation for use in the treatment of atopic dermatitis, wherein said topical formulation is any one of the topical formulations defined herein above.
  • the present invention is directed to a method for the treatment of atopic dermatitis in a patient in need thereof, comprising administering to the patient any one of the topical formulations defined herein above.
  • the use or method comprises topically exposing the patient to said formulation once or twice daily; for example, the use or method comprises exposing the patient to a formulation that comprises about 0.5% to about 5% montelukast sodium.
  • topical formulation comprises microparticles or nanoparticles encapsulating the active agent, they provide targeting of the active agent to hair follicles.
  • the topical formulation described above comprises a formulation selected from the group consisting of:
  • Ingredient % W/W Montelukast sodium 2.0 Emulsifiers 0.75 (c.g. Poloxamer188/polysorbate 20) Lipids/Hard fat/Triglycerides 15 (e.g. Compritol, Cocoa butter, Phosphatidylcholine) Water Up to 100; (b) a liposomal formulation comprising Sphingomyelin/cholesterol e.g. in the molar ratio of 2:1; phosphatidyl choline/cholesterol e.g. in the molar ratio of 3:1; phosphatidyl ethanolamine/phosphatidyl choline/cholesterole.g.
  • a polymer selected from the group consisting of a silicone; poly(lactic-co-glycolic acid (PLGA); polylactic acid (PLA); chitosan; gelatine; ethylcellulose; polycaprolactone; a polyalkyl cyanoacrylate and any combination thereof.
  • the particles in the topical formulation comprising encapsulating nanoparticles, have a size (diameter) of up to about 1000 nm.
  • particulate drug carriers can be formulated (e.g. oil in water or water in oil emulsions, liposomes, microparticles and nanoparticles of polymers (synthetic or natural), solid lipid nanoparticles in which sodium montelukast is encapsulated (dissolved or suspended))
  • Waterless formulations in which sodium montelukast can be dissolved or suspended are another route for preparation of stable formulations.
  • the waterless formulations typically contain at least one oil.
  • Crystals of less than 5 micron are homogenously dispersed in the ointment formulation
  • Example 11 Colloidal Particle Formulation/SLN (Solid Lipid Nanoparticle) Dispersion
  • Various techniques can be used to produce polymer nanoparticles in which montelukast would be encapsulated, such as solvent evaporation, salting-out, dialysis, supercritical fluid technology, micro-emulsion, nano-emulsion, surfactant-free emulsion, and interfacial polymerization.
  • solvent evaporation such as solvent evaporation, salting-out, dialysis, supercritical fluid technology, micro-emulsion, nano-emulsion, surfactant-free emulsion, and interfacial polymerization.
  • the choice of method depends on a number of factors, such as, particle size, particle size distribution, area of application, etc.
  • the produced polymeric nanoparticles would be suspended in a cream or a gel formulation.
  • Typical polymers that are in use for the production of pharmaceutical nanoparticles are silicon, PLGA, PLA, chitosan, gelatine, ethylcellulose, polycaprolactone and poly alkyl cyanoacrylates.
  • Example 13 Solution Formulation (Substantially Anhydrous)
  • Example 14 Montelukast in a Cream Formulation
  • Montelukast sodium topical gel (Example 1, RD #14152) and Montelukast sodium topical cream (Example 14, RD #14153) formulations for the treatment of Atopic dermatitis (Efficacy studies).
  • mice Balb/c mice were used for the study. The animals were sensitized on Day 1 by application of 100 ⁇ l of 1% DNCB in acetone: olive oil (Figaro) 3:1 on shaved dorsal back skin and 10l of 1% DNCB on right ear from day 1 to day 4. On day 6, animals were weighed using digital weighing balance.
  • mice were challenged by application of 100 ⁇ l of 0.5% DNCB in acetone: olive oil (3:1) on dorsal back skin and 20 ⁇ L of 0.5% DNCB on right ear on day 8, day 10, day 12, day 14. Normal control animals were sensitized and challenged with acetone and olive oil alone. 200 mg of Montelukast sodium topical gel and Montelukast sodium topical cream were topically applied in around 5-6 cm 2 area on the back skin of the mice for 9 days from day 6 to day 14. Respective placebo items were topically applied in around 5-6 cm 2 area on the back skin of the mice for 9 days from day 6 to day 14.
  • Bethametasone valerate cream was used as the reference item 0.40 mg of reference item was applied topically per animal on the back skin for 9 days from day 6 to day 14. All the vials of test items were opened and test items were topically applied under yellow sodium lamp light. The animals were kept under yellow sodium lamp light up to 4 hours after application.
  • clinical scoring has been performed to determine the efficacy of tested formulations with appropriate controls as a part of the study.
  • back skin severity scores were assessed as following criteria 1) Erythema (0-3), 2) Excoriation/Erosion (0-3), 3) Scarring/Dryness in each symptoms was scored by following criteria no lesion, 0; mild, 1; moderate, 2; severe, 3. Total maximum cumulative score was 9 as defined as the sum of these individual scores.
  • the % clinical score (Erythema, Excoriation/erosion, Scarring/dryness and Total cumulative) of the disease control group, the placebo groups, Montelukast sodium topical cream group and the Montelukast sodium topical gel group were compared.
  • FIG. 1 the % clinical score of Montelukast sodium topical gel for erythema was lower i.e 78% as compared to the disease control which showed a score of 100%.
  • the % clinical score of the gel for erythema was also lower as compared to its placebo.
  • Bethametasone valerate cream showed a % clinical score of 100% which was lower among all the treatment groups.
  • Montelukast sodium topical gel group showed 50% clinical score for excoriation/erosion as compared to its placebo, the disease control, the montelukast sodium topical cream group and its placebo and the Bethametasone valerate cream group.
  • the total cumulative score of the group treated with Montelukast sodium topical gel was 77% as compared to the disease control and the placebo group.
  • Montelukast sodium topical gel was effective for erythema as compared to the placebo and the disease control groups. ( FIG. 2 )
  • DNCB induced atopic dermatitis of the skin in mice reproduces biochemical and histopathological parameter characteristic of atopic dermatitis in humans.
  • Tissue collection The animals were sacrificed by CO 2 asphyxiation. The back skin was collected and was preserved in 50 ml falcon tube containing 10% formalin for histologic analysis or was stored in micro centrifuge tube at ⁇ 70° C. for cytokine analysis.
  • Cytokine estimation For determination of cytokines levels, the skin samples were removed from ⁇ 70° C. and kept on ice. The 20% w/v tissue homogenate was prepared by adding cocktail protease inhibitor to the tubes containing weighed skin tissues. The skin tissue homogenate was prepared in 5 ml cryovials using a homogenizer under constant cooling using an ice bath. Each skin tissue was homogenized for 30-90 seconds with approximately 19000 to 26000 rpm. After every run, the homogenizer probe was washed first with 70% v/v isopropyl alcohol followed by PBS (pH 7.4). The probe was then wiped with a dry tissue paper before the next run. Homogenized samples were centrifuged at 10,000 rpm for 10 min at 4° C.
  • the resulting supernatant was separated in micro centrifuge tube and snap frozen in liquid nitrogen and stored in ⁇ 70° C.
  • Cytokines like IL-4, TNF- ⁇ and IFN- ⁇ were estimated in skin homogenate supernatant using mouse ELISA kits (R&D systems). Cytokine levels were normalized to the amount of total proteins as determined by Bicinchoninic acid assay.
  • the Ki67 is a cellular marker for proliferation and is associated with cell proliferation.
  • the immunohistochemistry in FIG. 4 demonstrates strong Ki67 staining in the back skin sections of disease control groups as compared to the normal control groups. Weak Ki67 staining was observed in the group treated with Betamethasone valerate cream as compared to the disease control group. Placebos of Montelukast sodium topical gel and Montelukast sodium topical cream showed strong staining of Ki67 comparable to the disease control group. However, Montelukast sodium gel showed moderate Ki67 staining as compared to its placebo. Also, it also showed moderate staining as compared to the disease control group. Thus, cell proliferation was less pronounced in the group treated with Montelukast sodium topical gel as compared to its placebo and the disease control group.
  • the in vitro skin permeation studies were determined using vertical static Franz cells. Two pieces of excised heat-separated human skin were used in this study. A total of 10 cells were used for each formulation with an average application of 14.07 ⁇ 2.5 mg/cm 2 .
  • 4.5 ml receptor solution was used in this study.
  • the receptor solution was a mixture 30% Ethanol in Phosphate buffer saline. The receptor solution was sampled at 6 time points in addition to to. After 24 hours, the skin surface was washed using pre-developed washing procedure), the skin surface was then tape stripped ( ⁇ 10 time). Both, the tape strips and skin were extracted with 3 ml and 2 ml in 80% ethanol in water, respectively, for 24 hours under agitation. Wash, tape, skin and permeation samples were analyzed to determined mass balance. Total recoveries only were corrected for the assay.
  • Montelukast is combined with anti-pruritic/anti histamines/anti-inflammatory/anti-bacterial agents/vitamines (e.gpramoxine, hydrocortisone, desoximetasone, dapsone, minocycline vitamine E/B/C/D etc.,) and tested as described above.
  • anti-pruritic/anti histamines/anti-inflammatory/anti-bacterial agents/vitamines e.gpramoxine, hydrocortisone, desoximetasone, dapsone, minocycline vitamine E/B/C/D etc.

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Abstract

A topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis.

Description

  • This application claims priority to the U.S. Provisional Patent Application No. 62/331,528 filed on May 4, 2016, the disclosure of which is incorporated by reference herein.
  • BACKGROUND
  • Atopic dermatitis is an increasingly common pruritic, chronic, inflammatory skin disorder. There has been a striking rise in the incidence of Atopic dermatitis (AD) during the past two decades, which is not simply due to an increased recognition of the disease. Population studies suggest that in most countries, AD now affects at least 10-20% of children at some point during childhood. In particular, higher prevalence has been recorded in urban regions than in rural regions of development countries, and the disease is more common in higher social class groups, suggesting that environmental factors associated with more industrialized and urban living determine expression of AD.
  • There are pathogenic mechanisms that are in common to both AD and asthma. The exaggerated inflammatory response (including increased production of IgE and eosinophilia) to environmental triggers, including irritants and allergens is characteristic of both AD and asthma. Total IgE levels are elevated in both AD and asthma. Genetic studies have demonstrated common chromosomal linkages between AD and asthma.
  • Leukotrienes (LTs) are a class of potent biological inflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway Leukotrienes are divided into two groups according to their chemical structure: those with a sulphur linkage (cysteinyl LTs: LTC4, LTD4, LTE4), and those that lack one (LTB4). Eosinophils, basophils and mast cells are the most important sources of LTs. Epidermal cells are able to transform neutrophil derived LTA4 into LTB4 and LTC4. Thus the epidermis can also contribute significantly to LT synthesis. It has been shown that cysteinyl leukotrienes (cysLTs) mediate asthma and allergic rhinitis and when the LT receptors are antagonized, symptoms resolve. Leukotrienes are important pro inflammatory mediators that are capable of inducing airway smooth muscle constriction, airway hyper responsiveness, eosinophil migration, vascular permeability, edema, and chemotaxis. A role for LTs in AD has been suggested in the literature. There is evidence of enhanced LT production in the pathogenesis of AD. The cysteinyl LTs increase vascular permeability and dilate skin blood vessels. LTC4 has been found in the skin of AD patients using the suction blister technique. Patients with AD have activated circulating basophils and increased basophil releasability of LTC4. Cysteinyl LT release from basophils and eosinophils isolated from AD patients is increased compared to healthy controls. Enhanced spontaneous and stimulated release ability of LTC4 from leukocytes of patients with AD compared with normal controls has been reported. Increased production of LTs has been reported in the skin of atopic patients after allergen specific challenge.
  • There are at least two types of LT receptors: cysLT1 and cysLT2. Montelukast (Singulair®, Merk-Frosst), zafirlukast (Accolate®, Zeneca), and pranlukast (Ultair®, SmithKline Beecham) are LT receptor antagonists that demonstrate high-affinity binding to the cysLT1 receptor. Montelukast is currently indicated for the prophylaxis and chronic treatment of asthma in adults and pediatric patients 12 months of age and older and for the relief of symptoms of seasonal allergic rhinitis in adults and pediatric patients 2 years of age and older. Montelukast is generally a safe drug during long term treatment; side effects are minimal. Asthma and allergic rhinitis have numerous pathophysiological elements in common with AD, and together these three diseases are referred to as the “atopic triad”. As outlined above there are pathogenic mechanisms that are central to both AD and asthma. Evidence in the literature provides a pathophysiological rationale for the use of cysLT receptor blockers in the treatment of AD however the exact mechanism of action of Icukotriene receptor antagonists in AD is not known. Intradermal LTD4 causes a wheal-and-flare response that could be blocked by a LTD4 antagonist. Montelukast has been shown to decrease eosinophils by 15%. LTD4 stimulates proliferation of eosinophil hematopoietic progenitor cells, and this increase can be suppressed by Montelukast.
  • The major function of the skin is to protect the body against physical and chemical injury and to prevent loss of body water and other substances. The stratum corneum (SC) is the outmost layer of the skin which is being continually replaced. By so doing the skin is well adapted to its requirements for repairing damage from wear and tear. However, in Atopic Dermatitis environmental and individual factors interact in a complex manner to induce skin abnormalities and dryness. Application of moisturizers to the skin induces changes in its superficial as well as deep layers. The chemical and physical characteristics of the individual ingredients of the formulation determnnine the performance of the drug product.
  • Moreover, in topical treatments of dermatological conditions the efficacy is likely to depend on the dosage, where compliance is a great challenge faced in the management of the diseases.
  • Montelukast sodium exerts additional challenge to be formulated in a semi solid formulation even for experienced formulators.
  • Sodium montelukast (Singulair), chemically known as [sodium 1-(1-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)-phenyl)(3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl) thio)-methyl)-cyclo-propane) acetate is a photosensitive compound requiring special handling precautions to protect specimens from light especially in a solution.
  • In the montelukast molecule there are number of functional groups that impair the chemical stability of this substance. Montelukast is known to be prone to the formation of several types of impurities:
    • 1. a sulfoxide impurity: [1-[((RS)[1-[3-[(E)-2-(7-Chloroquinolin-2-yl)ethenyl)phenyl)-3-[2-(1-hydroxy-1-methylethyl)phenyl)propyl]sulfinyl]methyl]cyclopropyl]acetic acid;
    • 2. a diol impurity: 2-(2-(3-(S)-(3 (E)-(2-(7-Chloro-2-quinolinyl)-ethenyl)phenyl)-3-hydroxypropyl)phenyl)-2-propanol;
    • 3. a methyl styrene impurity: [1-[[[(1R)-1-[3-[(E)-2-(7-Chloroquinolin-2-yl)etheny[ ]phenyl]-3-[2-(1 methylethenyl)phenyl]propyl]sulfanyl]melhyl]cyclopropyl]acetic acid (USP imp F);
    • 4. a cis-isomer impurity: [1-[[[(1R)-1-[3-[(Z)-2-(7-Chloroquinolin-2-yl)etheny]phlenyl]-3-[2-(1-hydroxy-1-methylethyl)phenyl]propyl]sulfanyl]methyl]cyclopropyl]acetic acid;
    • 5. a Michael adduct impurity (1): 1-[[((1R)-1-[3-[(1R)-1 [[[1-(Carboxymethyl)cyclapropyl]methyl]sulfanyl]-2-(7-chloroquinolin-2-yl)ethyl]phenyl]-3-[2-(1-hydroxy-1-methylethyl)phenyl]propyl]suifanyl]methyl]cyclopropyllacetic acid;
    • 6. a Michael adduct impurity (2): 1-[[[(1R)-1-[3-[(1 S)-1-[[[1-(Carboxymethyi)cyclopropyl]methyl]sulfanyl]-2-(7-chloroquinolin-2-yl)ethyl]phenyl]-3-[2-(1-hydroxy-1-methylethyl)phenyl]propyl]sulfanyl]methyl]cyclopropyl]acetic acid;
    • 7. a methyl ketone impurity: [1-({((1R)-3-(2-acetylphenyl)-1-[3-[(E)-2-(7-chloroquinolin-2-yl)ethenyl)phenyl]propyl]sulfanyl]methyl]cyclopropyl]acetic acid.
    SUMMARY OF THE INVENTION
  • In one aspect, the present invention provides a topical formulation comprising 1-(1-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)-phenyl)(3-(2-(1-hydroxy-1-methylethyl)phenyl)propyl) thio)-methyl)-cyclo-propane) acetate (montelukast) or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis.
  • In one aspect, the present invention provides a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof and at least one oil for the treatment of atopic dermatitis wherein the formulation is waterless.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the United States Patent Office upon request and payment of the necessary fee.
  • FIG. 1 describes the % Clinical Score (Erythema, Excoriation/Erosion, Scaring/Dryness and Total Cumulative) compared to Disease Control after Montelukast Topical Gel (Example 1) (RD #14152) Treatment (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n=10
  • FIG. 2—Photographs (representative) of Animal's Back Skin after Montelukast Topical cream (Example 14) and Montelukast Topical Gel Treatment (Example 1) (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n=10
  • FIG. 3 describes the Levels of Cytokines (IL-4, TNF-α and IFN-γ) ng/gm of Protein in Back Skin Homogenate after Montelukast Topical Cream (Example 14, RD #14153) and Montelukast Topical Gel (Example 1, RD #14152) Treatment (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n=10
  • FIG. 4—Images (representative) of Ki67 Immunohistochemistry of Back Skin section at 100× magnification after Montelukast Topical Cream (Example 14, RD #14153) and Montelukast Topical Gel (Example 1, RD #14152) Treatment (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n=10
  • DETAILED DESCRIPTION OF THE INVENTION
  • The present invention relates to a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis. In certain embodiments the salt is an alkali metal salt, such as sodium or potassium; an alkaline earth salt; or an ammonium salt.
  • Furthermore, the term “montelukast” as used herein encompasses polymorph crystal forms and any other form of montelukast that has one or more of the pharmaceutical activities of montelukast.
  • In certain embodiments, the topical formulation may comprise about 0.01% w/w to about 10% w/w montelukast or a pharmaceutically acceptable salt.
  • In certain embodiments, the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is between about 0.5% w/w to about 5% w/w.
  • In certain embodiments, the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is between about 5% w/w to about 10% w/w
  • In preferred embodiments, the concentration of montelukast or a pharmaceutically acceptable salt in the topical formulation is 5% w/w.
  • In one embodiment of the present invention, the topical formulation of montelukast or a pharmaceutically acceptable salt can be a gel. In one embodiment, a gel may be prepared by providing a gelling agent and adding an excipient such as water in case of a hydrous gel. The gel may include a variety of additional components such as, but not limited to solvents, emulsifiers, thickeners, stabilisers, gelling agents, chelating agents, surfactants, emollients, permeation enhancers, preservatives, antioxidants, lubricants, pH adjusters.
  • In one embodiment, the topical formulations of Montelukast or a pharmaceutically acceptable salt thereof provide topical penetration of the active agent through the epidermis and into the dermis.
  • In some embodiments, the topical formulations described above comprise penetration enhancers, which facilitate the penetration of the active agent and preferably dissolve the active ingredient present in the formulations of the invention
  • There are numerous penetration enhancers that can be used in accordance with the present invention. Various useful permeation enhancers include, for example: polyols and esters, including polyethylene glycol, polyethylene glycol monolaurate, and butanediol; sulfoxides, including dimethylsulfoxide and decylmethylsulfoxide; ethers, including diethylene glycol monoethyl ether (e.g., Transcutol® P) and diethylene glycol monomethyl ether; fatty acids, including lauric acid, oleic acid, and valeric acid; fatty acid esters, including isopropyl myristate, isopropyl palmitate, methyl propionate, and ethyl oleate; nitrogenous compounds including urea, dimethyl acetamide, dimethylformamide 2-pyrrolidone, ethanolamine, methyl-2-pyrrolidone, diethanolamine, and triethanolamine; terpenes; alkanones; organic acids, including salicylic acid, citric acid, and succinic acid; and any mixtures thereof. A penetration enhancer can be used in concentrations ranging from about 1-15% by weight, preferably about 2-12% by weight, and more preferably about 3-10% by weight, of the total composition.
  • In certain embodiments of the invention, the pH of the topical gel formulation of montelukast or a pharmaceutically acceptable salt is less than 6. Typically the pH is in the range from 4 to 6. In a more preferred embodiment, the pH is in the range of 5 to 6.
  • In one embodiment of the present invention, the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a gelling agent. Examples of suitable gelling agents for use in the present invention may include, but are not limited to hyaluronic acid and its salts such as Sodium Hyaluronate, cellulose derivatives such as hydroxypropyl cellulose (HPC), Hydroxyethyl cellulose (Natrosol 250 HEC HHX), carbomers such as sodium carbomer.
  • In one embodiment, suitable topically acceptable solvents may also be used in the topical composition. Suitable topically acceptable solvents for use in the present invention include, but are not limited to lower alcohols, ethanol, isopropanol, benzyl alcohol, propanol, methanol, other C4-C10 mono alcohols and mixtures thereof. In another embodiment, the solvents suitable for use in the formulation of the present invention may include albumin, gelatin, citric acid, ethylenediaminesodiumtetraacetate, dextrin, dimethylsulfoxide, dimethylacetamide, dimethylformamide, 2-pyrrolidone, N-(2-hydroxyethyl) pyrrolidone, N-methylpyrrolidone, 1-dodecylazacycloheptan-2-one and other n-substituted-alkyl-azacycloalkyl-2-ones(azones), sodium hydrosulfite and mixtures thereof. In some embodiments, the topical formulation of the invention comprises a polar aprotic solvent, preferably selected from anyone or more of the following: dimethylsulfoxide, dimethyl acetamide, dimethylformamide or N-methylpyrrolidone.
  • In another embodiment of the present invention, the topical formulation of montelukast or a pharmaceutically acceptable salt may further comprise an antioxidant such butylated hydroxy anisole or butylated hydroxy toluene; preservatives such as a paraben which include a methyl paraben or propyl paraben.
  • In one aspect of the invention, the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a triglyceride. In a preferred embodiment, if a triglyceride is present, it may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • In certain embodiments, the topical formulation described above comprises an occlusive ingredient, such as petroleum jelly/white petrolatum; a wax; an oil; a silicone; a film forming polymer, such as hyaluronic acid, hydroxypropyl cellulose (HPC) or a poly (meth) acrylate, (e.g. Eudragit®); or any combination thereof, and said formulation is therefore an occlusive formulation.
  • The pharmaceutically acceptable inactive ingredients of the formulation described above may further comprise an oil, such as castor oil or a castor oil derivative (e.g. trihydroxystearin), fractionated coconut oil, or olive oil; an occlusive ingredient, such as petroleum jelly/white petrolatum, a wax, an oil, a silicone, glycerin; an MCT of e.g. hexanoic acid, octanoic acid, decanoic acid or dodecanoic acid; an antioxidant, such as butylated hydroxyanisole; or any combination thereof.
  • The topical formulation described above may comprise a colloidal solution/suspension, wherein the active agent is in the form of microparticles that are suspended in said formulation, i.e. particles having a diameter of about 1-100 μm. Alternatively, the topical formulation may comprise a microparticle or nanoparticle comprising or encapsulating the active agent, wherein said microparticle or nanoparticle is selected from the group consisting of (a) a solid lipid nanoparticle; (b) a liposome; and (c) a polymeric microparticle or nanoparticle.
  • In certain embodiments, the solid lipid nanoparticle comprises a lipid selected from the group consisting of cholesterol, a triglyceride, a phospholipid, a fat and a wax.
  • In certain embodiments, the solid lipid nanoparticle or liposome comprises a phospholipid selected from the group consisting of a lecithin, such as egg or soybean lecithin; a phosphatidylcholine such as egg phosphatidylcholin; a hydrogenated phosphotidylcholine; a lysophosphatidylcholine; dipalmitoylphosphatidylcholine; distearoylphosphatidylcholine; dimyristoylphosphatidylcholine; dilauroylphosphatidylcholine; a glycerophospholipid such as phosphatidylglycerol, phosphatidylserine, phosphatidylethanolamine, lysophosphatidylethanolamine, phosphatidylinositol, phosphatidylinositol phosphate, phosphatidylinositol bisphosphate and phosphatidylinositol triphosphate; sphingomyelin; cardiolipin; a phosphatidic acid; a glycolipid such as a glyceroglycolipid, e.g. a galactolipid and a sulfolipid, a glycosphingolipid, e.g. a cerebroside (a glucocerebroside and a galactocerebroside), and a glycosylphosphatidylinositol; a plasmalogen; a phosphosphingolipid such as a ceramide phosphorylcholine, a ceramide phosphorylethanolamine and a ceramide phosphorylglycerol; and a mixture thereof.
  • The phospholipid may further be admixed with one or more nonphosphorous-containing molecules selected from the group consisting of a fatty amine, such as octylamine, laurylamine, N-tetradecylamine, hexadecylamine, stearylamine, oleylamine, tallow amine, hydrogenated tallow amine, and cocoamine; a fatty acid; a fatty acid amide; an ester of a fatty acid such as isopropyl myristate, hcxadecyl stearate, and cetyl palmitate; cholesterol; a cholesterol ester; a diacylglycerol; a glycerol ester, such as glycerol ricinoleate; and a mixture thereof.
  • In certain embodiments, the polymeric microparticle or nanoparticle comprises a polymer selected from the group consisting of a silicone; poly(lactic-co-glycolic acid (PLGA); polylactic acid (PLA); chitosan; gelatine; ethylcellulose; polycaprolactone; a polyalkyl cyanoacrylate; and any combination thereof.
  • In any one of the topical formulations described above, if a triglyceride is present, it may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • The topical formulations described above provide topical penetration of the active agent through the epidermis and into the dermis.
  • In some embodiments, the topical formulations described above comprise penetration enhancers, which facilitate the penetration of the active agent and preferably dissolve the active ingredient present in the formulations of the invention.
  • In certain embodiments, the topical gel formulation comprises
  • Category of ingredient
    Active (Montelukast or a salt thereof)
    Water miscible organic solvent
    Penetration enhancer
    Antioxidant
    Chelating Agent
    Water
    Preservative
    Gelling agent
  • The gel formulation may also comprise pH adjusting agents and occlusive agents. The concentration of above category of ingredient/ingredients may be determined based on knowledge by the person skill in the art.
  • Examples of specific gel formulation include:
  • (a) Formula 1
  • Category Ingredient % W/W
    Active Montelukast sodium 5.00
    Water miscible Alcohol 96% 25.00
    organic solvent
    Penetration DMSO 10.00
    enhancer
    Antioxidant BHT 0.10
    Chelating Agent EDTA 0.10
    Water Purified water 57.90
    Preservative Methyl paraben 0.30
    Preservative Propyl paraben 0.10
    Gelling agent Hydroxyethylcellulose 1.50
    (Mw 90,000 to 1,300,000)
    pH adjusting HCl (10% solution) q.s.
    agent
  • b) Formula 2
  • Category of ingredient Ingredient % W/W
    Occlusive ingredient Dimethicone 1
    Occlusive ingredient Cyclomethicone 4
    Active Montelukast sodium 3
    Emulsifier Silicone Glycerol emulsifier 1.5
    Occlusive ingredient Cetearyl Ethylhexanoate 2.5
    Water miscible Glycerin 3.0
    organic solvent
    Solvent Water Up to 100
    Gelling agent Sodium Carbomer 2.5
    Lubricant Sodium Hyaluronate 1.0
  • c) Formula 3
  • Ingredient % W/W
    Montelukast sodium   1%
    Alcohol 25%
    BHT 0.10%
    Purified water 60.00
    DMSO 10.00% 
    Methyl paraben 0.30%
    Propyl paraben 0.10%
    Carbopol 947P (polymers of acrylic acid) 0.40%
    EDTA 0.10%
    Sepineo 600 (Acrylamide/Sodium Acryloyldimethyl   3%
    Taurate copolymer/isohexadecane and Polysorbate 80
  • d) Formula 4
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium   1%
    Water miscible Alcohol 25%
    organic solvent
    Antioxidant BHT 0.10%
    Water Purified water 60.00
    Penetration DMSO 10.00% 
    enhancer
    Preservative Methyl paraben 0.30%
    Preservative Propyl paraben 0.10%
    Gelling agent Carbopol 947P (polymers of acrylic 0.40%
    acid)
    Chelating agent EDTA 0.10%
    Emulsifier/Thickener/ Sepineo 600 (Acrylamide/Sodium   3%
    Stabilizer Acryloyldimethyl Taurate copolymer/
    isohexadecane and Polysorbate 80
    pH adjusting agent Citric acid buffer To pH 5.6
  • e) Formula 5
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium   1%
    Water miscible Alcohol 25%
    organic solvent
    Antioxidant BHT 0.10%
    Water Purified water 60.00
    Penetration DMSO 10.00% 
    enhancer
    Preservative Methyl paraben 0.30%
    Preservative Propyl paraben 0.10%
    Gelling agent Carbopol 947P 0.40%
    (polymers of acrylic
    acid)
    Chelating agent EDTA 0.10%
    Emulsifier/Thickener/ Sepineo 600   3%
    Stabilizer (Acrylamide /Sodium
    Acryloyldimethyl
    Taurate copolymer/
    isohexadecane and
    Polysorbate 80
    pH adjusting agent Phosphate Buffer pH 5.6
  • In one embodiment, the present invention relates to a topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, at least one oil for the treatment of atopic dermatitis wherein the formulation is waterless.
  • In one embodiment of the present invention, the waterless topical formulation comprising Montelukast or a pharmaceutically acceptable salt may further a topically acceptable solvent and an amphiphilic compound.
  • In another embodiment, the waterless formulation may be an ointment. In another embodiment, the waterless formulation may be a solution. In another embodiment, the waterless formulation may be a gel. The waterless formulations may include a variety of additional components such as, but not limited to solvents, emulsifiers, chelating agents, surfactants, emollients, permeation enhancers, preservatives, antioxidants, lubricants, pH adjusters.
  • In one embodiment, the ointment may comprise an amphiphilic compound. The examples of suitable amphiphilic compounds include, but are not limited to vegetable oils, animal fats, and semisolid hydrocarbons obtained from petroleum.
  • In one embodiment, examples of amphiphilic compound include polypropylene glycol-15 stearyl ether, propylene glycol monostearate (monosteol), Poloxylhydrogenated Castor oil, oleyl alcohol, polyoxyglycerides, propylene carbonate Examples of oils, such as poloxylhydrogenated castor oil (e.g. trihydroxystearin), fractionated coconut oil, or olive oil; an occlusive ingredient, such as petroleum jelly/white petrolatum, a wax, an oil, a silicone, glycerin; an MCT of e.g. hexanoic acid, octanoic acid, decanoic acid or dodecanoic acid; lubricants such as Cyclomethicone and Dimethicone 5225C, Cyclomethicone, polypropylene glycol-15 stearyl ether; an antioxidant, such as butylated hydroxy anisole or butylated hydroxyl toluene; or any combination thereof.
  • In certain embodiments, the topical formulation may comprise an occlusive ingredient selected from the group of siloxanes such as cyclomethicone, dimethicones; petroleum jelly/white petrolatum.
  • In one aspect of the invention, the topical formulation of montelukast or a pharmaceutically acceptable salt may comprise a triglyceride. In a preferred embodiment, if a triglyceride is present, it may be a medium chain triglyceride (MCT) of e.g. hexanoic acid; octanoic acid; decanoic acid or dodecanoic acid.
  • In certain embodiments, the topical waterless formulation comprises:
  • Category of ingredient
    Active (Montelukast or a salt thereof)
    Water miscible organic solvent
    Amphiphilic compound
    Occlusive ingredient
    Oil
    Antioxidant
  • The gel formulation may further comprise a gelling agent.
  • The concentration of above category of ingredient/ingredients may be determined based on knowledge by the person skill in the art.
  • In one embodiment, the waterless formulation of montelukast or a pharmaceutically acceptable salt can be:
      • a solution comprising
  • Category of Ingredient Ingredient % W/W
    Topically acceptable solvent Alcohol (Dehydrated) 34.5
    Amphiphilic compound Poloxylhydrogenated Castor 2.5
    Active Montelukast sodium 3
    oil Fractionated Coconut oil 60

    or a gel formulation comprising
  • Category of ingredient Ingredient % W/W
    Topically acceptable solvent Alcohol (Dehydrated) 31
    Amphiphilic compound Poloxylhydrogenated Castor 2.5
    Active Montelukast sodium 3
    oil Fractionated Coconut oil 60
    Gelling agent Hydroxy propyl cellulose 3.5

    or an ointment comprising
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium 0.5-5
    Occlusive ingredient Petroleum jelly/white petrolatum 80
    Oil Trihydroxystearin 1-3
    oil Olive oil 12-18.5

    or an ointment comprising
  • Category of ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast sodium 0.5-5
    Water miscible Glycerine 65-75
    organic solvent
    Oil Medium chain triglycerides 20
    Antioxidant Antioxidant 0-0.5

    or an ointment comprising
  • Category of %
    ingredient Ingredient W/W{grave over ( )}
    Active Montelukast Sodium 5
    Antioxidant BHT 0.08
    Occlusive ingredient Cyclomethicone 94.52
    Amphiphilic compound Cyclomethicone and Dimethicone 0.40

    or an ointment comprising
  • Category of
    ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast Sodium 5
    Antioxidant BHT 0.08
    Occlusive Petrolatum White 55.92
    ingredient
    Amphiphilic PPG-15 Stearyl Ether 16
    compound
    Oil Medium Chain Triglycerides 20
    Amphiphilic Monosteol 3
    compound
  • API is milled to <5 micron size. Homogenous distribution of crystals in ointment was observed
  • or an ointment comprising
  • Category of
    ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast Sodium 5
    Antioxidant BHT 0.08
    Occlusive Petrolatum White 49.92
    ingredient/
    Oil Mineral Oil 45
  • In certain embodiments, each one of the topical formulations described above further comprises an additional active agent, such as an anti-pruritic agent, such as pramoxine; an antihistamine; an anti-inflammatory agent, such as a corticosteroid (e.g. hydrocortisone or desoximetasone), or a glucocorticosteroid; an antibacterial agent, such as dapson (diaminodiphenyl sulfone) or minocycline; a vitamin, such as vitamin B, C, D or E; a non-steroidal anti-inflammatory drug (NSAID); a peripheral analgesic agent; or a different leukotriene receptor antagonist, such as zafirlukast or pranlukast, or a pharmaceutically acceptable derivative thereof.
  • In another aspect, the present invention provides a topical formulation comprising a pharmaceutically acceptable carrier and a microparticle(s) or nanoparticle(s) comprising an active agent selected from the group consisting of a leukotriene receptor antagonist, such as an antagonist specific to cysLT1, and a pharmaceutically acceptable derivative thereof.
  • The active agent may be montelukast, zafirlukast or pranlukast, or a pharmaceutically acceptable derivative thereof. In certain embodiments the active agent is montelukast, e.g. montelukast sodium. The microparticles or nanoparticles of this topical formulation may be as defined above.
  • In certain embodiments, each one of the topical formulations described above is formulated as a gel, solution, suspension, lotion, paste, cream, ointment, aerosol, dusting powder or a patch.
  • In an additional aspect, the present invention provides a topical fonnulation for use in the treatment of atopic dermatitis, wherein said topical formulation is any one of the topical formulations defined herein above.
  • In a further aspect, the present invention is directed to a method for the treatment of atopic dermatitis in a patient in need thereof, comprising administering to the patient any one of the topical formulations defined herein above.
  • In certain embodiments, the use or method comprises topically exposing the patient to said formulation once or twice daily; for example, the use or method comprises exposing the patient to a formulation that comprises about 0.5% to about 5% montelukast sodium.
  • In case the topical formulation comprises microparticles or nanoparticles encapsulating the active agent, they provide targeting of the active agent to hair follicles.
  • In certain embodiments, the topical formulation described above comprises a formulation selected from the group consisting of:
  • (a) a solid lipid nanoparticle (SLN) dispersion comprising
  • Ingredient % W/W
    Montelukast sodium 2.0
    Emulsifiers 0.75
    (c.g. Poloxamer188/polysorbate 20)
    Lipids/Hard fat/Triglycerides 15
    (e.g. Compritol, Cocoa butter,
    Phosphatidylcholine)
    Water Up to 100;

    (b) a liposomal formulation comprising Sphingomyelin/cholesterol e.g. in the molar ratio of 2:1; phosphatidyl choline/cholesterol e.g. in the molar ratio of 3:1; phosphatidyl ethanolamine/phosphatidyl choline/cholesterole.g. in the molar ratio of 3:4:2 as representative examples; and
    (c) a formulation of polymeric nanocapsules based on a polymer selected from the group consisting of a silicone; poly(lactic-co-glycolic acid (PLGA); polylactic acid (PLA); chitosan; gelatine; ethylcellulose; polycaprolactone; a polyalkyl cyanoacrylate and any combination thereof.
  • In certain embodiments, in the topical formulation comprising encapsulating nanoparticles, the particles have a size (diameter) of up to about 1000 nm.
  • EXAMPLES Example 1 Montelukast in a Gel Formulation
  • Category Ingredient % W/W
    Active Montelukast sodium 5.00
    Water miscible Alcohol 96% 25.00
    organic solvent
    Penetration DMSO 10.00
    enhancer
    Antioxidant BHT 0.10
    Chelating Agent EDTA 0.10
    Water Purified water 57.90
    Preservative Methyl paraben 0.30
    Preservative Propyl paraben 0.10
    Gelling agent Hydroxyethylcellulose 1.50
    (Mw 90,000 to 1,300,000)
    pH adjusting HCl (10% solution) q.s.
    agent
  • Example 2 Montelukast in a Gel Formulation
  • Category of ingredient Ingredient % W/W
    Occlusive ingredient Dimethicone 1
    Occlusive ingredient Cyclomethicone 4
    Active Montelukast sodium 3
    Emulsifier Silicone Glycerol emulsifier 1.5
    Occlusive ingredient Cetearyl Ethylhexanoate 2.5
    Water miscible Glycerin 3.0
    organic solvent
    Solvent Water Up to 100
    Gelling agent Sodium Carbomer 2.5
    Lubricant Sodium Hyaluronate 1.0
  • Example 3 Montelukast in a Gel Formulation
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium   1%
    Water miscible Alcohol 25%
    organic solvent
    Antioxidant BHT 0.10%
    Water Purified water 60.00
    Penetration DMSO 10.00% 
    enhancer
    Preservative Methyl paraben 0.30%
    Preservative Propyl paraben 0.10%
    Gelling agent Carbopol 947P (polymers of acrylic 0.40%
    acid)
    Chelating agent EDTA 0.10%
    Emulsifier/Thickener/ Sepineo 600(Acrylamide/Sodium   3%
    Stabi1izer Acryloyldimethyl Taurate copolymer/
    isohexadecane and Polysorbate 80

    pH was adjusted to 5.6 with citric/phosphate buffer
  • Example 4 Montelukast in a Gel Formulation
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium   5%
    Water miscible Alcohol 22.4%
    organic solvent
    Antioxidant BHT 0.10%
    Water Purified water 56.00
    Penetration DMSO 10.00% 
    enhancer
    Preservative Methyl paraben 0.30%
    Preservative Propyl paraben 0.10%
    Gelling agent Carbopol 947P   3%
    (polymers of acrylic
    acid)
    Chelating agent EDTA 0.10%
    Emulsifier/Thickener/ Sepineo 600(Acrylamide/   3%
    Stabilizer Sodium Acryloyldimethyl
    Taurate copolymer/
    isohexadecane and
    Polysorbate 80

    Crystals of montelukast are present in the formula
  • Example 5: Montelukast in a Gel Formulation
  • Category of ingredient Ingredient % W/W
    Active Montelukast sodium   3%
    Water miscible Alcohol 22.4%
    organic solvent
    Antioxidant BHT 0.10%
    Water Purified water 57.5%
    Penetration DMSO 10.00% 
    enhancer
    Preservative Methyl paraben 0.30%
    Preservative Propyl paraben 0.10%
    Gelling agent Carbopol 947P  1.5%
    (polymers of acrylic
    acid)
    Chelating agent EDTA 0.10%
    Emulsifier/Thickener/ Sepineo 600(Acrylamide/   3%
    Stabilizer Sodium Acryloyldimethyl
    Taurate copolymer/
    isohexadecane and
    Polysorbate 80
    pH adjusting agent Phosphate buffer or pH adjusted to 5.6
    citrate buffer

    Crystals of montelukast are present in the formula
  • To protect montelukast from light and increase its stability particulate drug carriers can be formulated (e.g. oil in water or water in oil emulsions, liposomes, microparticles and nanoparticles of polymers (synthetic or natural), solid lipid nanoparticles in which sodium montelukast is encapsulated (dissolved or suspended))
  • Waterless formulations in which sodium montelukast can be dissolved or suspended are another route for preparation of stable formulations. Typically the waterless formulations contain at least one oil.
  • Example 6: Non Aqueous Solution Formulation (Waterless Formulation)
  • Category of Ingredient Ingredient % W/W
    Topically acceptable Alcohol (Dehydrated) 34.5
    Amphiphilic compound Poloxylhydrogenated Castor 2.5
    Active Montelukast sodium 3
    oil Fractionated Coconut oil 60
  • Example 7: Ointment (Waterless Formulation)
  • Category of
    ingredient Ingredient % W/W
    Active Montelukast sodium 0.5-5
    Occlusive Petroleum jelly/white 80
    ingredient petrolatum
    Oil Trihydroxystearin 1-3
    oil Olive oil 12-18.5
  • Example 8: Ointment (Waterless Formulation)
  • Category of
    ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast sodium 0.5-5
    Water miscible Glycerine 65-75
    organic solvent
    Oil Medium chain 20
    triglycerides
    Antioxidant Antioxidant 0-0.5
  • Example 9: Ointment (Waterless Formulation)
  • Category of
    ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast Sodium 5
    Antioxidant BHT 0.08
    Occlusive Petrolatum White 55.92
    ingredient
    Amphiphilic PPG-15 Stearyl Ether 16
    compound
    Oil Medium Chain Triglycerides 20
    Amphiphilic Monosteol 3
    compound
  • Example 10: Ointment (Waterless Formulation)
  • Category of
    ingredient Ingredient % W/W{grave over ( )}
    Active Montelukast Sodium 5
    Antioxidant BHT 0.08
    Occlusive Petrolatum White 49.92
    ingredient/
    Oil Mineral Oil 45
  • Crystals of less than 5 micron are homogenously dispersed in the ointment formulation
  • Example 11: Colloidal Particle Formulation/SLN (Solid Lipid Nanoparticle) Dispersion
  • Ingredient % W/W{grave over ( )}
    Montelukast sodium 2.0
    Emulsifiers (Poloxamer188/polysorbate 20) 0.75
    Lipids/Hard fat/Triglicerides (Compritol, 15
    Cocoa butter, Phosphatidylcholine)
    Water Up to 100
  • Colloidal Gel Formulation of Polymeric Nanocapsules
  • Various techniques can be used to produce polymer nanoparticles in which montelukast would be encapsulated, such as solvent evaporation, salting-out, dialysis, supercritical fluid technology, micro-emulsion, nano-emulsion, surfactant-free emulsion, and interfacial polymerization. The choice of method depends on a number of factors, such as, particle size, particle size distribution, area of application, etc.
  • The produced polymeric nanoparticles would be suspended in a cream or a gel formulation. Typical polymers that are in use for the production of pharmaceutical nanoparticles are silicon, PLGA, PLA, chitosan, gelatine, ethylcellulose, polycaprolactone and poly alkyl cyanoacrylates.
  • Example 12: Lipid Nano Emulsion
  • Ingredient % W/W
    Soybean oil 10-20
    Lecithin 1
    Glycerol 2
    Montelukast 1
    Water Up to 100
  • Example 13: Solution Formulation (Substantially Anhydrous)
  • Ingredient % W/W
    Montelukast sodium 5%
    Alcohol (96%) 66.45
    BHT 0.1%
    Propylene glycol 28.45
  • Example 14: Montelukast in a Cream Formulation
  • Ingredient % W/W
    Montelukast sodium 5%
    Propylene glycol  10%
    DMSO  10%
    Methylparaben 0.3%
    Propylparaben 0.1%
    BHT 0.1%
    MCT  10%
    Glyceryl Stearate & 5%
    PEG-100 Stearate
    Purified water 59.1% 
    Natrosol 250 HEC 0.30% 
    HHX
    EDTA 0.1%
    HCl (10% sol) q.s.
  • Crystals of Montelukast are Present in the Formula Example 15. Animal Model of Atopic Dermatitis with Repeated DNCB Patch in BALB/c Mice
  • The following is the animal model which is being used to test the efficacy of the formulation of the present invention for atopic dermatitis. Repeated 2,4-dinitrochlorobenzene, (DNCB) applications is a common animal model of AD which possesses benefits of reproducibility.
  • Montelukast sodium topical gel (Example 1, RD #14152) and Montelukast sodium topical cream (Example 14, RD #14153) formulations for the treatment of Atopic dermatitis (Efficacy studies).
  • Balb/c mice were used for the study. The animals were sensitized on Day 1 by application of 100 μl of 1% DNCB in acetone: olive oil (Figaro) 3:1 on shaved dorsal back skin and 10l of 1% DNCB on right ear from day 1 to day 4. On day 6, animals were weighed using digital weighing balance.
  • After 4 hr of treatment, animals were challenged by application of 100 μl of 0.5% DNCB in acetone: olive oil (3:1) on dorsal back skin and 20 μL of 0.5% DNCB on right ear on day 8, day 10, day 12, day 14. Normal control animals were sensitized and challenged with acetone and olive oil alone. 200 mg of Montelukast sodium topical gel and Montelukast sodium topical cream were topically applied in around 5-6 cm2 area on the back skin of the mice for 9 days from day 6 to day 14. Respective placebo items were topically applied in around 5-6 cm2 area on the back skin of the mice for 9 days from day 6 to day 14. Bethametasone valerate cream was used as the reference item 0.40 mg of reference item was applied topically per animal on the back skin for 9 days from day 6 to day 14. All the vials of test items were opened and test items were topically applied under yellow sodium lamp light. The animals were kept under yellow sodium lamp light up to 4 hours after application.
  • In one embodiment of the present invention, clinical scoring has been performed to determine the efficacy of tested formulations with appropriate controls as a part of the study. On day 15, back skin severity scores were assessed as following criteria 1) Erythema (0-3), 2) Excoriation/Erosion (0-3), 3) Scarring/Dryness in each symptoms was scored by following criteria no lesion, 0; mild, 1; moderate, 2; severe, 3. Total maximum cumulative score was 9 as defined as the sum of these individual scores.
  • TABLE 1
    Erythema (0-3), Excoriation/Erosion (0-3), Scaring/Dryness (0-3) and Total Cumulative Score (0-9)
    after Montelukast Topical Cream (Example 14, RD # 14153) or Gel (Example 1, RD #
    14152) Treatment (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n = 10
    MEAN ± SEM
    Group Excoriation/ Scarring/ Total cumulative
    No Dose Groups Erythema Erosion Dryness score
    1 Normal Control 0.00 ± 0.00 0.00 ± 0.00 0.00 ± 0.00 0.00 ± 0.00
    2 Disease Control   2.70 ± 0.21***   1.60 ± 0.27***   1.70 ± 0.15***   6.00 ± 0.45***
    3 Placebo of Montelukast 2.40 ± 0.16 1.60 ± 0.27 1.90 ± 0.10 5.90 ± 0.43
    Sodium gel of Example 1
    4 Montelukast sodium 2.10 ± 0.18 0.80 ± 0.25$ 1.70 ± 0.15 4.60 ± 0.43$
    gel of Example 1
    5 Placebo of Montelukast 2.20 ± 0.25 1.20 ± 0.20 1.90 ± 0.10 5.30 ± 0.30
    Sodium cream of
    Example 14
    6 Montelukast sodium 2.40 + 0.16 1.40 ± 0.27 2.20 ± 0.20 6.00 ± 0.45
    cream of Example 14
    7 Betamethasone valerate 1.20 ± 0.20### 1.20 ± 0.25 1.70 ± 0.15 4.10 ± 0.28###
    cream IP
    Data were analyzed by 2-tailed Student's t-test
    Normal Control vs Disease control group
    (*= p < 0.05,
    **= p < 0.01,
    ***= p < 0.001)
    Disease control group vs Betamethasone Valerate cream
    (#= p < 0.05,
    ##= p < 0.01,
    ###= p < 0.001)
    Placebo of Montelukast Sodium gel vs Montelukast Sodium gel
    ($= p < 0.05,
    $$= p < 0.01,
    $$$= p < 0.001)
    Placebo of Montelukast Sodium cream vs Montelukast Sodium cream
    (@= p < 0.05,
    @@= p < 0.01,
    @@@= p < 0.001.
  • As seen in Table 1, there was a significant increase in erythema, excoriation, dryness and total cumulative score in disease control group (DNCB) as compared to the normal control group. Montelukast sodium topical gel showed significant inhibition in excoriation as compared to its placebo. Also, the excoriation/erosion score of Montelukast sodium topical gel was lower than that of the Betamethasone valerate cream indicating that the gel reduced the excoriation or the erosion more than the Bethametasone valerate cream. A significant inhibition in the total cumulative score of Montelukast sodium topical gel was seen as compared to its placebo. Betamethasone valerate cream showed significant inhibition in erythema and total cumulative score but did not show significant inhibition in excoriation as compared to the disease control group.
  • In one embodiment of the present invention, the % clinical score (Erythema, Excoriation/erosion, Scarring/dryness and Total cumulative) of the disease control group, the placebo groups, Montelukast sodium topical cream group and the Montelukast sodium topical gel group were compared. (FIG. 1). As seen in FIG. 1, the % clinical score of Montelukast sodium topical gel for erythema was lower i.e 78% as compared to the disease control which showed a score of 100%. The % clinical score of the gel for erythema was also lower as compared to its placebo. Bethametasone valerate cream showed a % clinical score of 100% which was lower among all the treatment groups. Montelukast sodium topical gel group showed 50% clinical score for excoriation/erosion as compared to its placebo, the disease control, the montelukast sodium topical cream group and its placebo and the Bethametasone valerate cream group. The total cumulative score of the group treated with Montelukast sodium topical gel was 77% as compared to the disease control and the placebo group. Montelukast sodium topical gel was effective for erythema as compared to the placebo and the disease control groups. (FIG. 2)
  • In one embodiment of the present invention, DNCB induced atopic dermatitis of the skin in mice reproduces biochemical and histopathological parameter characteristic of atopic dermatitis in humans.
  • Tissue collection—The animals were sacrificed by CO2 asphyxiation. The back skin was collected and was preserved in 50 ml falcon tube containing 10% formalin for histologic analysis or was stored in micro centrifuge tube at −70° C. for cytokine analysis.
  • Cytokine estimation—For determination of cytokines levels, the skin samples were removed from −70° C. and kept on ice. The 20% w/v tissue homogenate was prepared by adding cocktail protease inhibitor to the tubes containing weighed skin tissues. The skin tissue homogenate was prepared in 5 ml cryovials using a homogenizer under constant cooling using an ice bath. Each skin tissue was homogenized for 30-90 seconds with approximately 19000 to 26000 rpm. After every run, the homogenizer probe was washed first with 70% v/v isopropyl alcohol followed by PBS (pH 7.4). The probe was then wiped with a dry tissue paper before the next run. Homogenized samples were centrifuged at 10,000 rpm for 10 min at 4° C. The resulting supernatant was separated in micro centrifuge tube and snap frozen in liquid nitrogen and stored in −70° C. Cytokines like IL-4, TNF-α and IFN-γ were estimated in skin homogenate supernatant using mouse ELISA kits (R&D systems). Cytokine levels were normalized to the amount of total proteins as determined by Bicinchoninic acid assay.
  • TABLE 2
    Levels of Cytokines (IL-4, TNF-α and IFN-γ) ng/gm of Protein in Back Skin
    Homogenate after Montelukast Topical Cream and Montelukast Topical Gel Treatment
    (from day 6 to 14) in DNCB-induced Atopic Dermatitis in Balb/c Mice on day 15, n = 10
    Ng/gm of protein in back skin homogenate
    Group (MEAN ± SD)
    No Dose Groups IL-4 TNF-α IFN-γ
    1 Normal Control  0.00 ± 0.00 0.00 ± 0.00 0.00 ± 0.00
    2 Disease Control   19.14 ± 7.67***   8.28 ± 3.36*** 1.40 ±0.58**
    3 Placebo of Montelukast Sodium 17.79 ± 9.25 6.68 ± 4.34 1.74 ± 0.27
    topical gel of Example 1
    4 Montelukast sodium topical gel of 18.99 ± 6.64 4.37 ± 1.94 1.29 ± 0.31$$
    Example 1
    5 Placebo of Montelukast Sodium 16.82 ± 3.80 5.28 ± 3.49 1.75 ± 0.74
    cream of Example 14
    6 Montelukast sodium topical cream 18.20 ± 9.72 4.42 ± 3.62 1.67 ± 0.68
    of Example 14
    7 Betamethasone valerate cream IP   3.06 ± 1.35### 4.96 ± 4.53 0.73 ± 0.26##
    Data were analyzed by 2-tailed Student's t-test
    Normal Control vs Disease control group
    (*= p < 0.05,
    **= p < 0.01,
    ***= p < 0.001)
    Disease control group vs Betamethasone Valerate cream
    (#= p < 0.05,
    ##= p < 0.01,
    ###= p < 0.001)
    Placebo of Montelukast Sodium gel vs Montelukast Sodium gel
    ($= p < 0.05,
    $$= p < 0.01,
    $$$=p < 0.001)
    Placebo of Montelukast Sodium cream vs Montelukast Sodium cream
    (@= p < 0.05,
    @@= p < 0.01,
    @@@= p < 0.001)
  • As seen in Table 2, the topical application of dinitrochloro benzene increased the levels of cytokines such as IL-4, TNF-α and IFN-γ in the disease control group as compared to the normal control group. Montelukast sodium topical gel showed significant inhibition in IFN-γ levels in skin homogenate as compared to its placebo. Betamethasone Cream showed significant inhibition in IL-4 and IFN-γ levels in skin homogenate but did not show significant inhibition in TNF-α level as compared to disease control group. (FIG. 3)
  • Immunohistochemistry (Ki67) Evaluation—
  • Images were captured from hcmatoxylin and eosin (H and E) stained skin sections at a magnification of 100× using ZEISS AxioA1 microscope. The unstained sections were processed for immunohistochemistry of Ki67 marker using Ki67 Immunohistochemistry Kit (Eton Bioscience, Inc). The images were captured using ZEISS AxioA1 microscope at 100× magnification.
  • The Ki67 is a cellular marker for proliferation and is associated with cell proliferation. The immunohistochemistry in FIG. 4 demonstrates strong Ki67 staining in the back skin sections of disease control groups as compared to the normal control groups. Weak Ki67 staining was observed in the group treated with Betamethasone valerate cream as compared to the disease control group. Placebos of Montelukast sodium topical gel and Montelukast sodium topical cream showed strong staining of Ki67 comparable to the disease control group. However, Montelukast sodium gel showed moderate Ki67 staining as compared to its placebo. Also, it also showed moderate staining as compared to the disease control group. Thus, cell proliferation was less pronounced in the group treated with Montelukast sodium topical gel as compared to its placebo and the disease control group.
  • Example 16. In Vitro Skin Permeation Studies
  • The in vitro skin permeation studies were determined using vertical static Franz cells. Two pieces of excised heat-separated human skin were used in this study. A total of 10 cells were used for each formulation with an average application of 14.07±2.5 mg/cm2. 4.5 ml receptor solution was used in this study. The receptor solution was a mixture 30% Ethanol in Phosphate buffer saline. The receptor solution was sampled at 6 time points in addition to to. After 24 hours, the skin surface was washed using pre-developed washing procedure), the skin surface was then tape stripped (<10 time). Both, the tape strips and skin were extracted with 3 ml and 2 ml in 80% ethanol in water, respectively, for 24 hours under agitation. Wash, tape, skin and permeation samples were analyzed to determined mass balance. Total recoveries only were corrected for the assay.
  • Results indicated that more than 80% of the applied formulations were recovered on the skin surface. Formulation Montelukast sodium gel (example 1) and substantially anhydrous topical solution (example 13) showed higher depositions in the stratum corneum (SC) and skin compared to the cream formulation (example 14). Specifically, between about 0.5% to about 1% of Montelukast was deposited within the skin including the SC in the gel formulation and the anhydrous solution.
  • The safety, tolerability, pharmacokinetics and bioavailability of topical montelukast are assessed according to methods well known in the art, for example according to
    • Cheng H, Leff J A, Amin R, Gertz B J, De Smet M, Noonan N, Rogers J D, Malbecq W, Meisner D, Somers G. Pharmacokinetics, bioavailability, and safety of montelukast sodium (MK-0476) in healthy males and females. Pharm Res. 1996 March; 13(3):445-8.
    Example 17. Combination Product
  • Montelukast is combined with anti-pruritic/anti histamines/anti-inflammatory/anti-bacterial agents/vitamines (e.gpramoxine, hydrocortisone, desoximetasone, dapsone, minocycline vitamine E/B/C/D etc.,) and tested as described above.

Claims (17)

1. A topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof, a gelling agent and water for the treatment of atopic dermatitis.
2. The topical formulation of claim 1, wherein the concentration of Montelukast tor its pharmaceutically acceptable salt is between about 0.5% w/w to about 5% w/w or between about 5% w/w to about 10% w/w.
3. The topical formulation of claim 1, wherein the concentration of montelukast or a pharmaceutically acceptable salt is 5% w/w.
4. The topical formulation of claim 1, wherein between about 0.5% to about 1% of Montelukast is deposited within the skin following topical application.
5. The topical formulation of claim 1, wherein the pH of the formulation is less than 6
6. The topical formulation of claim 1, wherein the pH is in the range 5 to 6.
7. The topical formulation of claim 1, wherein the formulation further comprises a water miscible organic solvent.
8. The topical formulation of claim 1, wherein the formulation further comprises a penetration enhancer.
9. The topical formulation of claim 1, wherein the formulation further comprises an antioxidant.
10. The topical formulation of claim 1, wherein the formulation further comprises a preservative.
11. The topical formulation of claim 1 comprising:
a)
Category Ingredient Active Montelukast sodium Water miscible Alcohol 96% organic solvent Penetration DMSO enhancer Antioxidant BHT Chelating Agent EDTA Water Purified water Preservative Methyl paraben Preservative Propyl paraben Gelling agent Hydroxyethylcellulose (Mw90,000 to 1,300,000) pH adjusting HCl (10% solution) agent
b)
Category of ingredient Example of Ingredient Occlusive ingredient Dimethicone Occlusive ingredient Cyclomethicone Active Montelukast sodium Emulsifier Silicone Glycerol emulsifier Occlusive ingredient Cetearyl Ethylhexanoate Water miscible Glycerin organic solvent Solvent Water Gelling agent Sodium Carbomer Lubricant Sodium Hyaluronate
c)
Category of ingredient Example of Ingredient Active Montelukast sodium Water miscible Alcohol organic solvent Antioxidant BHT Water Purified water Penetration DMSO enhancer Preservative Methyl paraben Preservative Propyl paraben Gelling agent Carbopol 947P(polymers of acrylic acid) Chelating agent EDTA Emulsifier/ Sepineo 600(Acrylamide/Sodium Thickener/Stabilizer Acryloyldimethyl Taurate copolymer/ isohexadecane and Polysorbate 80)
d)
Category of ingredient Example of Ingredient Active Montelukast sodium Water miscible Alcohol organic solvent Antioxidant BHT Water Purified water Penetration DMSO enhancer Preservative Methyl paraben Preservative Propyl paraben Gelling agent Carbopol 947P(polymers of acrylic acid) Chelating agent EDTA Emulsifier/ Sepineo 600(Acrylamide/Sodium Thickener/Stabilizer Acryloyldimethyl Taurate copolymer/ isohexadecane and Polysorbate 80) pH adjusting Phosphate or citric acid Buffer agent
12. A topical formulation as in claim 11 selected from any one of the following
a)
Category Ingredient % W/W Active Montelukast sodium 5.00 Water miscible Alcohol 96% 25.00 organic solvent Penetration DMSO 10.00 enhancer Antioxidant BHT 0.10 Chelating Agent EDTA 0.10 Water Purified water 57.90 Preservative Methyl paraben 0.30 Preservative Propyl paraben 0.10 Gelling agent Hydroxyethylcellulose 1.50 (Mw 90,000 to 1,300,000) pH adjusting HCl (10% solution) q.s. agent
b)
Category of ingredient Ingredient % W/W Occlusive ingredient Dimethicone 1 Occlusive ingredient Cyclomethicone 4 Active Montelukast sodium 3 Emulsifier Silicone Glycerol emulsifier 1.5 Occlusive ingredient Cetearyl Ethylhexanoate 2.5 Water miscible Glycerin 3.0 organic solvent Solvent Water Up to 100 Gelling agent Sodium Carbomer 2.5 Lubricant Sodium Hyaluronate 1.0
c)
Category of ingredient Ingredient % W/W Active Montelukast sodium   1% Water miscible Alcohol 25% organic solvent Antioxidant BHT 0.10% Water Purified water 60.00 Penetration DMSO 10.00%  enhancer Preservative Methyl paraben 0.30% Preservative Propyl paraben 0.10% Gelling agent Carbopol 947P (polymers of acrylic 0.40% acid) Chelating agent EDTA 0.10% Emulsifier/ Sepineo 600(Acrylamide/Sodium   3% Thickener/Stabilizer Acryloyldimethyl Taurate copolymer/ isohexadecane and Polysorbate 80
d)
Category of ingredient Ingredient % W/W Active Montelukast sodium   1% Water miscible organic solvent Alcohol 25% Antioxidant BHT 0.10% Water Purified water 60.00 Penetration enhancer DMSO 10.00%  Preservative Methyl paraben 0.30% Preservative Propyl paraben 0.10% Gelling agent Carbopol 947P 0.40% (polymers of acrylic acid) Chelating agent EDTA 0.10% Emulsifier/Thickener/Stabilizer Sepineo 600   3% (Acrylamide/Sodium Acryloyldimethyl Taurate copolymer/ isohexadecane and Polysorbate 80 pH adjusting agent Phosphate Buffer pH 5.6
13. The topical formulation of claim 1, wherein the montelukast is homogeneously suspended in the formulation or wherein montelukast crystals are present in the formulation.
14. A topical formulation comprising Montelukast or a pharmaceutically acceptable salt thereof and at least one oil for the treatment of atopic dermatitis wherein the formulation is waterless.
15. A topical formulation as in claim 14 wherein the formulation further comprises a topically acceptable solvent, and an amphiphilic compound and further an occlusive ingredient
16. A topical formulation as in claim 15 selected from any of the following:
a solution comprising
Category of ingredient Example Topically acceptable solvent Alcohol (Dehydrated) Amphiphilic compound Poloxylhydrogenated Castor oil Active Montelukast sodium Oil Fractionated Coconut oil
or a gel formulation comprising
Category of ingredient Example of ingredient Topically acceptable solvent Alcohol (Dehydrated) Amphiphilic compound Poloxylhydrogenated Castor oil Active Montelukast sodium Oil Fractionated Coconut oil Gelling agent Hydroxypropylcellulose
or an ointment comprising
Category of ingredient Example of Ingredient Active Montelukast sodium Occlusive ingredient Petroleum jelly/white petrolatum Oil Trihydroxystearin Oil Olive oil
or an ointment comprising
Category of ingredient Example of Ingredient Active Montelukast sodium Water miscible organic solvent Glycerine Oil Medium chain triglycerides Antioxidant Antioxidant
or an ointment comprising
Category of ingredient Example of Ingredient Active Montelukast Sodium Antioxidant BHT Occlusive ingredient Cyclomethicone 5, NF Occlusive ingredient Cyclomethicone and Dimethicone 5225C
or an ointment comprising
Category of ingredient Example of Ingredient Active Montelukast Sodium Antioxidant BHT Occlusive ingredient Petrolatum White USP Amphiphilic compound Propylene Glycol-15 Stearyl Ether Oil Medium Chain Triglycerides Amphiphilic compound Monosteol(propylene glycol monostearate)
or an ointment comprising
Category of ingredient Example of Ingredient Active Montelukast Sodium Antioxidant BHT Occlusive ingredient/ Petrolatum White USP Oil Mineral Oil
17. A topical formulation as in claim 16 selected from any one of the following:
a solution comprising
Category of Ingredient Ingredient % W/W Topically acceptable Alcohol (Dehydrated) 34.5 Amphiphilic compound Poloxylhydrogenated Castor 2.5 Active Montelukast sodium 3 oil Fractionated Coconut oil 60
or a gel formulation comprising
Category of ingredient Ingredient % W/W Topically acceptable solvent Alcohol (Dehydrated) 31 Amphiphilic compound Poloxylhydrogenated Castor 2.5 Active Montelukast sodium 3 oil Fractionated Coconut oil 60 Gelling agent Hydroxy propyl cellulose 3.5
or an ointment comprising
Category of ingredient Ingredient % W/W Active Montelukast sodium 0.5-5 Occlusive Petroleum jelly/white 80 ingredient petrolatum Oil Trihydroxystcarin 1-3 oil Olive oil 12-18.5
or an ointment comprising
Category of ingredient Ingredient % W/W{grave over ( )} Active Montelukast sodium 0.5-5 Water miscible Glycerine 65-75 organic solvent Oil Medium chain 20 triglycerides Antioxidant Antioxidant 0-0.5
or an ointment comprising
Category of ingredient Ingredient % W/W{grave over ( )} Active Montelukast Sodium 5 Antioxidant BHT 0.08 Occlusive Cyclomethicone 94.52 ingredient Amphiphilic Cyclomethicone and 0.40 compound Dimethicone
or an ointment comprising
Category of ingredient Ingredient % W/W{grave over ( )} Active Montelukast Sodium 5 Antioxidant BHT 0.08 Occlusive Petrolatum White 55.92 ingredient Amphiphilic PPG-15 Stearyl Ether 16 compound Oil Medium Chain Triglycerides 20 Amphiphilic Monosteol 3 compound
or an ointment comprising
Category of ingredient Ingredient % W/W{grave over ( )} Active Montelukast Sodium 5 Antioxidant BHT 0.08 Occlusive Petrolatum White 49.92 ingredient/ Oil Mineral Oil 45
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