US20230117905A1

US20230117905A1 - Pharmaceutical composition comprising 3-beta-hydroxy-5-alpha-pregnan-20-one with improved storage and solubility properties

Info

Publication number: US20230117905A1
Application number: US18/056,475
Authority: US
Inventors: Torbjörn Bäckström; Anders Carlsson
Original assignee: Asarina Pharma AB
Current assignee: Asarina Pharma AB
Priority date: 2010-01-14
Filing date: 2022-11-17
Publication date: 2023-04-20
Also published as: CA2786330C; ZA201204574B; US20120322781A1; EP2523666A4; JP5687287B2; CN102753181A; ES2566765T3; JP2013517269A; PL2523666T3; AU2011205821B2; EP2523666A1; WO2011087441A1; EP2523666B8; DK2523666T3; AU2011205821A1; HUE027298T2; RU2012133627A; CN102753181B; US9687496B2; BR112012017136B1

Abstract

It is provided a pharmaceutical composition comprising 3-beta-hydroxy-5-alpha-pregnan-20-one, at least one sterol or an ester thereof and a mixture of acylglycerols with a solid fat content of less than 25% at 25° C. and 0% at 37° C. In addition it is provided a method for preparing the pharmaceutical composition.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of copending application Ser. No. 14/626,490, filed on Feb. 19, 2015, which is a Divisional of application Ser. No. 13/522,081, filed on Aug. 17, 2012 (now abandoned), which was filed as PCT International Application No. PCT/SE2011/050036 on Jan. 14, 2011, which claims the benefit under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 61/295,027, filed on Jan. 14, 2010, and under 35 U.S.C. § 119(a) to Patent Application No. 1050029-6, filed in SWEDEN on Jan. 14, 2010, all of which are hereby expressly incorporated by reference into the present application.

TECHNICAL FIELD

The present invention relates generally to an improved formulation of 3-beta-hydroxy-5-alpha-pregnan-20-one.

BACKGROUND ART

3-beta-hydroxy-5-alpha-pregnan-20-one is a steroid in the pregnane family and a modulator of GABA_A-receptor activity which is indicated for the treatment of sex/stress steroid induced disorders conditions (WO99/45931). 3-beta-hydroxy-5-alpha-pregnan-20-one is poorly soluble in many therapeutically acceptable solvents, which makes it difficult to administer the compound to a patient.
In animal studies, 3-beta-hydroxy-5-alpha-pregnan-20-one has been intravenously administered to rats in a formulation containing cyclodextrin (WO99/45931).
Grant et al (JPET 326:354-362, 2008) has administered 3-beta-hydroxy-5-alpha-pregnan-20-one to monkeys by using a formulation with hydroxypropyl β-cyclodextrin.
Formulations with cyclodextrins are not suitable for administration to human patients. One reason for this is, because 3-beta-hydroxy-5-alpha-pregnan-20-one is poorly soluble, the formulation results in a large therapeutic volume that can only be administered intravenously.
Since 3-beta-hydroxy-5-alpha-pregnan-20-one is poorly soluble in water there is still no pharmaceutically acceptable formulation for this compound.

Definitions

As used in the present application, the following terms have the specified meanings unless otherwise specified.
By “acylglycerol” is meant all types and combinations of fatty acids esterified to glycerol.
By “medium-chain acylglycerol” is meant a mixture of acylglycerols where the total combined percentage of octanoic (caprylic) acid and decanoic (capric) acid is at least 95%.
By “solid fat content” is meant the percentage of solid as determined by pulse NMR (nuclear magnetic resonance).
“Room temperature” denotes a temperature of between 18° C. and 25° C.
“UC1010” denotes 3-beta-hydroxy-5-alpha-pregnan-20-one.
“Sterol or ester thereof” denotes steroids with at least one hydroxyl group and esters of said steroids where at least one hydroxyl group has been used for the synthesis of an ester.
Steroids, such as sterols, are usually described by the number of carbon atoms in the compound. Thus, for example, cholesterol is a C27 sterol, which indicates that the compound consists of 27 carbon atoms.
Unless stated otherwise, concentrations are stated as mg/g, that is, mg per gram of pharmaceutical composition.

BRIEF DESCRIPTION OF FIGURES

FIG. 1 shows mean plasma concentrations of 3-beta-hydroxy-5-alpha-pregnan-20-one (ng/mL) in rabbits following subcutaneous administration of 3-beta-hydroxy-5-alpha-pregnan-20-one in sesame oil with cholesterol (1:1) in two doses: 1 mg/kg (squares) and 5 mg/kg (circles).

FIG. 2 shows 3-beta-hydroxy-5-alpha-pregnan-20-one concentration in filtrate (0.2 μm) from a suspension of 3-beta-hydroxy-5-alpha-pregnan-20-one in relation to cholesterol:3-beta-hydroxy-5-alpha-pregnan-20-one ratio.

FIG. 3 a, 3 b, 4 a and 4 b show photographs of suspensions of 3-beta-hydroxy-5-alpha-pregnan-20-one.

SUMMARY OF INVENTION

An object of the present invention is to provide an improved formulation of 3-beta-hydroxy-5-alpha-pregnan-20-one in a pharmaceutically acceptable carrier.
Another object of the present invention is to provide a formulation of 3-beta-hydroxy-5-alpha-pregnan-20-one with enhanced storage properties.
Yet another object is to provide a formulation of 3-beta-hydroxy-5-alpha-pregnan-20-one with improved pharmacokinetics.
Yet another object of the present invention is to provide a formulation of 3-beta-hydroxy-5-alpha-pregnan-20-one with increased solubility in a pharmacologically acceptable carrier.
These and other objects are met by a first general aspect of the present invention which provides a pharmaceutical formulation comprising 3-beta-hydroxy-5-alpha-pregnan-20-one, at least one sterol or an ester thereof and a mixture of acylglycerols with a solid fat content of less than about 25% at 25° C. and about 0% at 37° C.
In a second general aspect of the present invention there is provided methods for preparing a pharmaceutical composition.
In a third general aspect of the present invention there is provided a pharmaceutical composition obtainable according to a method according to the invention.
In a fourth general aspect of the present invention there is provided use of a pharmaceutical composition for the treatment of conditions of the central nervous system.

DETAILED DESCRIPTION

The inventors have found that the addition of a sterol surprisingly increases the solubility and improves the pharmacokinetics of 3-beta-hydroxy-5-alpha-pregnan-20-one in acylglycerols.
Generally, the pharmaceutical composition comprises 3-beta-hydroxy-5-alpha-pregnan-20-one, at least one sterol or an ester thereof and a mixture of acylglycerols with a solid fat content of less than about 25% at 25° C. and about 0% at 37° C.
In particular a sterol with a hydroxyl group bound to the third carbon atom of the sterol structure is useful in the invention. The sterol may be cholesterol or beta-sitosterol, but also other sterols such as stigmasterol, brassicasterol or avenasterol may be used. In particular, cholesterol may be used.
In addition, cholesteryl esters can be used. Examples of such esters are sodium cholesteryl sulphate, cholesteryl bensoate, cholesteryl acetate, cholesteryl caprylate, cholesteryl decanoate, cholestyl palmitate, cholesteryl oleate and cholesteryl stearate.
The sterol or ester thereof can be a C18-C30 sterol or an ester thereof, a C21-C27 sterol or an ester thereof, or a C27-C29 sterol or ester thereof.
The pharmaceutical composition can, in a first embodiment, be such that 3-beta-hydroxy-5-alpha-pregnan-20-one is essentially dissolved in the composition. Thus 3-beta-hydroxy-5-alpha-pregnan-20-one can be dissolved or essentially dissolved according to this embodiment of the invention.
The weight ratio of sterol (or ester thereof) to 3-beta-hydroxy-5-alpha-pregnan-20-one can, in this embodiment, be in the range of about 1:10 to 10:1. The sterol or ester thereof may be added in an amount that is similar to the amount of 3-beta-hydroxy-5-alpha-pregnan-20-one by weight. Because 3-beta-hydroxy-5-alpha-pregnan-20-one and a sterol have similar molecular weights this results in almost equimolar amounts of 3-beta-hydroxy-5-alpha-pregnan-20-one to sterol.
Thus, the weight ratio of sterol to 3-beta-hydroxy-5-alpha-pregnan-20-one can be in the range of from 1:5 to 5:1. In particular, the weight ratio of sterol to 3-beta-hydroxy-5-alpha pregnan-20-one can be from 1:3 to 3:1.
Suitable concentrations of 3-beta-hydroxy-5-alpha pregnan-20-one are between 0.1 mg/g and 75 mg/g. The concentration of 3-beta-hydroxy-5-alpha pregnan-20-one can also be between 1 mg/g and 50 mg/g, between 5 mg/g and 30 mg/g or between 10 mg/g and 25 mg/g.
Alternatively, in a second embodiment, the pharmaceutical composition comprises a suspension of 3-beta-hydroxy-5-alpha-pregnan-20-one. In this case the pharmaceutical composition will comprise 3-beta-hydroxy-5-alpha-pregnan-20-one in particles as well as 3-beta-hydroxy-5-alpha-pregnan-20-one dissolved in the composition. The sterol increases the soluble fraction of 3-beta-hydroxy-5-alpha-pregnan-20-one in such a suspension compared to a suspension without a sterol. One advantage with a suspension is that the formulation can contain a high concentration of 3-beta-hydroxy-5-alpha-pregnan-20-one. An additional advantage with a composition that comprises a suspension is that it results in slow release of 3-beta-hydroxy-5-alpha-pregnan-20-one.
When the pharmaceutical composition comprises a suspension, the particles are preferably of a range of sizes that is not engulfed by macrophages. Macrophages do primarily engulf particles of a size that is 2-3 micrometer (Champion et al, Pharm Res 2008; 25(8):1815-1821).
In this second embodiment, the weight ratio of sterol (or ester thereof) to 3-beta-hydroxy-5-alpha pregnan-20-one can be in the range of about 1:10 to 10:1. The weight ratio of sterol to 3-beta-hydroxy-Salpha pregnan-20-one can be in the range of from 1:5 to 5:1. In particular, the weight ratio of sterol to 3-beta-hydroxy-5-alpha-pregnan-20-one can be from 1:4 to 3:1 or from 1:3 to 3:1.
Suitable concentrations of 3-beta-hydroxy-5-alpha-pregnan-20-one are, in this second embodiment, between 0.1 mg/g and 750 mg/g. The concentration of 3-beta-hydroxy-5-alpha-pregnan-20-one can also be between 1 mg/g and 300 mg/g, between 1 mg/g and 100 mg/g, between 1 mg/g and 50 mg/g, between 5 mg/g and 30 mg/g or between 10 mg/g and 25 mg/g.
The following applies to the invention in general.
Generally, the mixture of acylglycerols is characterized in that it has a solid fat content of less than about 25% at 25° C. and about 0% at 37° C. Thus, the solid fat content is, for practical purposes, 0% at 37° C. The solid fat content is at most 0.01% at 37° C.
The mixture of acylglycerols can be a vegetable oil. Thus, it can be a vegetable oil selected from the group consisting of sesame oil, peanut oil, olive oil, and castor oil, or mixtures thereof.
In particular the mixture of acylglycerols can be a medium-chain acylglycerol, that is, a mixture of acylglycerols wherein the total combined percentage of fatty acids with 8 carbon atoms (octanoic acid) and 10 carbon atoms (decanoic acid) is at least 95%. The medium-chain acylglycerol can be various mixtures of monoacylglycerols, diacylglycerols and triacylglycerols.
The medium-chain acylglycerol can consist of from about 50% to about 65% of monoacylglycerols, about 25% to about 35% of diacylglycerols, less than about 5% of triacylglycerols and less than about 2.5% of glycerol. An example of such a medium chain acylglycerol is Akoline MCM.
The medium-chain acylglycerol can be such that it comprises at least about 95% triacylglycerols. Akomed R MCT is an example of such a medium-chain acylglycerol.
The mixture of acylglycerols can comprise a mixture of a vegetable oil and a medium-chain acylglycerol. The mixture of acylglycerols can comprises a mixture of castor oil and a medium-chain acylglycerol where castor oil is present in an amount of between 40% and 60% by weight. The mixture of acylglycerols can consist of about 48% by weight of castor oil and about 52% by weight of a medium-chain acylglycerol. In particular the mixture of acylglycerols can consist of about 48% by weight castor oil and about 52% by weight of a medium-chain acylglycerol.
The pharmaceutical composition may comprise additional excipients known to a person skilled in the art such as antioxidants, preservatives, surfactants, coloring, flavoring, or thickening agents.
The pharmaceutical composition can be administered to the patient by different means. Thus, it may be administered orally, parenterally or topically. Thus, the pharmacological composition may be administered subcutaneously, intramuscularly, intravenously, nasally, transdermally or vaginally.
In a second general aspect of the present invention there is provided methods for preparing a pharmaceutical composition of 3-beta-hydroxy-5-alpha-pregnan-20-one.
One method, in which 3-beta-hydroxy-5-alpha-pregnan-20-one is dissolved or essentially dissolved in the composition, comprises the steps of a) dissolving 3-beta-hydroxy-5-alpha-pregnan-20-one in ethanol, b) adding a mixture of acylglycerols with a solid fat content of less than about 25% at 25° C. and about 0% at 37° C. and a sterol or ester thereof, c) mixing until a homogeneous liquid is obtained and d) evaporating the ethanol.
When the mixture of acylglycerol is a solid or a semi-solid at room temperature, such as a medium-chain acylglycerol, the method may comprise a further step, which is the melting of the medium-chain acylglycerol before mixing it with the ethanol-drug preparation. The melting step enables the homogeneous mixing of this type of acylglycerol with other components. Once melted and mixed with the other components, the preparation remains in a liquid state for at least the time periods indicated in Table 1.
When the formulation comprises a suspension, the formulation is advantageously prepared according to a method that comprises the following steps: 1) dissolving or suspending the sterol or ester thereof in the mixture of acylglycerols, 2) suspending 3-beta-hydroxy-5-alpha-pregnan-20-one in the acylglycerol-sterol mixture, 3) gently mixing. Surprisingly, this procedure leads to suspended particles comprising 3-beta-hydroxy-5-alpha-pregnan-20-one of smaller size.
In a third general aspect of the present invention there is provided pharmaceutical compositions obtainable by the methods according to the second aspect of the invention.
In a fourth general aspect of the present invention there is provided the use of the pharmaceutical composition according to the invention for the treatment or prevention of conditions of the central nervous system.
The pharmaceutical composition can be used to treat or prevent conditions of the central nervous system. Examples of such conditions that can be treated are epilepsy, menstruation cycle dependent epilepsy, depression, stress related depression, migraine, tiredness and in particular stress related tiredness, premenstrual syndrome, premenstrual dysphoric disorder, menstrual cycle linked mood changes, stress related memory changes, menstrual cycle linked memory changes, Alzheimer's dementia, menstrual cycle linked difficulties in concentration, menstrual cycle linked sleep disorders and tiredness, substance abuse, menstrual cycle linked alcoholism, or combinations thereof.
In particular the pharmaceutical composition can be used to treat steroid induced mood disorders, in particular premenstrual dysphoric disorder.
The pharmaceutical composition can also be used for treating or preventing side effects of oral contraceptives and postmenopausal therapy.
The pharmaceutical composition can also be used for control or termination of steroid-induced anesthesia.

EXAMPLES

The invention will now be described with non-limiting examples.
In order to find a pharmaceutical composition comprising 3-beta-hydroxy-5-alpha-pregnan-20-one, several different vehicles and combinations of vehicles were evaluated. 3-beta-hydroxy-5-alpha-pregnan-20-one was dissolved in various vehicles and was evaluated by eye for physical stability at room temperature over time. A formulation that did not undergo any visible changes in appearance and remained clear on storage in room temperature without signs of haziness, precipitation, sedimentation, phase separation into two or more liquid phases or change of colour, within 30 days was considered as “stable”.
In addition, the particle size and solubility of 3-beta-hydroxy-5-alpha-pregnan-20-one in formulations comprising a suspension of 3-beta-hydroxy-5-alpha-pregnan-20-one were evaluated.

General Procedure for Examples 1-49

The following procedure was adopted for the preparation of 3-beta-hydroxy-5-alpha-pregnan-20-one-containing formulations.
The desired amount of 3-beta-hydroxy-5-alpha-pregnan-20-one and sterol (for example cholesterol) was weighed in a 100 ml or 250 ml round-bottomed flask. To every gram of the mixture of 3-beta-hydroxy-5-alpha-pregnan-20-one and sterol a volume of about 30 ml of absolute ethanol was added. The mixture was treated in an ultrasonication bath (not exceeding 50° C.) until a clear liquid was obtained. This was normally accomplished within 10 minutes.
The additional lipid ingredients indicated in the “Vehicle” column in Table 1 was then added up to 20 g. The resulting mixture was gently shaken by hand until a clear, homogeneous liquid was obtained. When the lipid was a solid at room temperature it was melted in the warm ultrasonication bath to a liquid form before addition.
Compounds from the following suppliers were used (product numbers within brackets): Cholesterol from Sigma (C8503), olive oil and peanut oil from Apoteket, Sweden (26 36 16 and 26 66 01, respectively), sesame oil from Fluka (85067), and castor oil from Sigma (259853). Akomed R medium-chain triacylglycerol (MCT) and Akoline medium-chain monoacylglycerol (MCM) were both from AarhusKarlshamns Sweden AB, Karlshamn, Sweden.
The alcohol was evaporated from the liquid on a rotary evaporator at a pressure of about 25 mbar and a temperature of about 40° C. until the weight of the flask was essentially constant. The remaining ethanol content was essentially less than 1%. The aim was to obtain a liquid with the appearance of clear oil at room temperature. The oily liquid was then transferred to clear glass vials and stored at room temperature until evaluation.
The samples were evaluated by observing the samples in the glass vials and recording signs of haziness, precipitation, sedimentation, phase separation into two or more liquid phases, or change of colour after 1 or 2 days after preparation and after 30 days after preparation. In some cases, other time intervals were used (indicated in Table 1). Where indicated, the entire sample was placed in a refrigerator (2-8° C.) to provoke precipitation.

Example 1

3-beta-hydroxy-5-alpha-pregnan-20-one (UC1010) (5 mg/g) and peanut oil was mixed into an emulsion with ethanol as described above in the concentrations shown in Table 1, and the ethanol was evaporated. The final weight of the preparation was 20 g. The mixture then had the form of an oily liquid. After one day when the sample was evaluated there were signs of precipitation. At 30 days the precipitate has formed a bottom sediment. Thus, the formulation was not stable.

Example 2

Example 2 was carried out essentially as Example 1 with the difference that cholesterol (5.5 mg/g) was added. When the sample was evaluated after one day the appearance of the sample had not changed. It was still unchanged after 30 days and after four months. After five months there was a slight precipitation. Example 2 compared with Example 1 shows how the addition of 5.5 mg/g cholesterol to a solution of 5 mg/g 3-beta-hydroxy-5-alpha-pregnan-20-one in peanut oil substantially increases the solubility so that, instead of precipitating, no precipitation occurred and the sample was stable for four months. However, a slight sedimentation occurred after 5 months.

Examples 3 to 49

Examples 3 to 49 were carried out essentially as described above with the variations with regard to 3-beta-hydroxy-5-alpha-pregnan-20-one concentration, acylglycerol mixture used, sterol used and sterol concentration that are shown in Table 1.
The data from examples 1 to 49 is presented in Table 1. The effect of addition of cholesterol is, for example, evident in examples 8 and 12, where the addition of cholesterol (10 mg/g) substantially increased solubility so that the sample did not precipitate but instead was stable for 12 months.
In Table 1, “Weighed amount of UC1010 (mg/g)” is the amount of 3-beta-hydroxy-5-alpha-pregnan-20-one per gram of final total composition including sterol (when a sterol is present). “Vehicle” denotes the carrier being tested. The amount of sterol is stated as “mg/g”, that is, the weight of sterol per weight of final total composition, including 3-beta-hydroxy-5-alpha-pregnan-20-one. “Appearance at preparation” describes the change of appearance of the mixture during preparation; usually the preparation is initially an emulsion or a solution whereas it has an oily appearance after evaporation of the ethanol; “Unchanged” denotes a sample that was stable and where thus 3-beta-hydroxy-5-alpha-pregnan-20-one remained in solution, without visible signs of haziness, precipitation, sedimentation, phase separation into two or more liquid phases or change of colour. This is also indicated by an asterisk (*) in the table.

TABLE 1

		Weighed			Appearance after	Appearance after
		amount of			1-2 days or other	30 days or other
	Batch	UC1010		Appearance at	time period that	time period that is
Example	name	(mg/g)	Vehicle	preparation	is indicated	indicated	Comments

1	ACA09	5	Peanut oil	Emulsion to oil	Signs of	Bottom sediment
	0630-1				precipitation
2	ACA09	5	Peanut oil +	Emulsion to oil	Unchanged *	Slight sedimentation
	0629-6		cholesterol (5.5 mg/g)			after 5 months
3	ACA09	10	Peanut oil	Emulsion to	Precipitation in
	0629-4			suspension	almost the entire
					sample volume
4	ACA09	10	Peanut oil +	Emulsion to oil	Bottom sediment
	0629-3		cholesterol (10 mg/g)	(precipitation
				after a few
				hours)
5	ACA09	20	Peanut oil +	Emulsion to oil	Bottom sediment
	0629-5		cholesterol (20 mg/g)	(precipitation
				after a few
				hours)
6	ACA09	10	Olive oil +	Emulsion to oil	Bottom sediment
	0629-8		cholesterol (10 mg/g)
7	ACA09	3	Sesame oil +	Emulsion to oil	Unchanged *	Slight sedimentation
	0709-2		cholesterol (3 mg/g)			after 13 months
8	ACA09	5	Sesame oil	Emulsion to oil	Precipitation	Bottom sediment
	0702-2
9	ACA09	5	Sesame oil +	Emulsion to oil	Unchanged *	Precipitation of
	0822-B		cholesterol (2.5 mg/g)			crystals after 2
						months
10	ACA09	5	Sesame oil +	Emulsion to oil	Unchanged *	A few particles on the
	0702-1		cholesterol (5 mg/g)			bottom
11	ACA09	5	Sesame oil +	Emulsion to oil	Unchanged *	Precipitation of
	0822-A		cholesterol (5 mg/g)			crystals after 2
						months
12	ACA09	5	Sesame oil +	Emulsion to oil	Unchanged *	Unchanged after 12
	0822-C		cholesterol (10 mg/g)			months *
13	ACA09	10	Sesame oil +	Emulsion to oil	Precipitation of
	0822-E		cholesterol (5 mg/g)		crystals
14	ACA09	10	Sesame oil +	Emulsion to oil	Precipitation of
	0822-D		cholesterol (10 mg/g)		crystals
15	ACA09	11	Sesame oil +	Emulsion to oil	Precipitation of
	0822-F		cholesterol (20 mg/g)		crystals
16	ACA09	10	Sesame oil +	Emulsion to oil	Unchanged *	Crystals on the
	0716-7		β-sitosterol (10 mg/g)			bottom an on the
						walls of the vial
17	ACA09	10	Akomed R MCT	Solution to oil	Precipitation of
	1024-1				crystals within an
					hour
18	ACA09	10	Akomed R MCT +	Solution to oil	Slight precipitation
	1024-2		cholesterol (10 mg/g)		of crystals on the
					bottom after 2
					days
19	ACA09	15	Akomed R MCT +	Solution to oil	Slight precipitation
	1025-1		cholesterol (15 mg/g)		of crystals on the
					bottom after 24
					hours
20	ACA09	10	50% Akomed R	Solution to oil	Unchanged *	Unchanged after 10
	1024-3		MCT, 50% Akoline			months *
			MCM
21	ACA09	10	50% Akomed R	Solution to oil	Unchanged *	Unchanged after 10
	1024-4		MCT, 50% Akoline			months *
			MCM +
			cholesterol (10 mg/g)
22	ACA09	15	50% Akomed R	Solution to oil	Slight precipitation
	1025-2		MCT, 50% Akoline		of crystals on the
			MCM		bottom after 1
					week
23	ACA09	15	50% Akomed R	Solution to oil	Unchanged *	Unchanged after 10
	1025-3		MCT, 50% Akoline			months *
			MCM +
			cholesterol (15 mg/g)
24	ACA09	20	50% Akomed R	Solution to oil	Slight precipitation
	1026-1		MCT, 50% Akoline		of crystals on the
			MCM		bottom after 24
					hours
25	ACA09	20	50% Akomed R	Solution to oil	Unchanged *	Very slight
	1026-2		MCT, 50% Akoline			precipitation after
			MCM +			2.5 months
			cholesterol (20 mg/g)
26	ACA09	25	50% Akomed R	Solution to oil	Slight precipitation
	1101-1		MCT, 50% Akoline		of crystals on the
			MCM +		bottom after 3
			cholesterol (25 mg/g)		days
27	ACA09	30	50% Akomed R	Solution to oil	First sign of
	1102-1		MCT, 50% Akoline		precipitation after
			MCM +		2 days
			cholesterol (30 mg/g)
28	ACA09	15	Castor oil	Solution to oil	Slight precipitation
	1025-4				of crystals on the
					bottom after 26
					days
29	ACA09	20	Castor oil	Solution to oil	Slight precipitation
	1026-3				of crystals on the
					bottom after 3
					days
30	ACA09	20	Castor oil +	Solution to oil	Unchanged *	Unchanged after 10
	1101-2		cholesterol (20 mg/g)			months *
31	ACA09	25	Castor oil +	Solution to oil	Unchanged *	Unchanged after 1	Unchanged
	1109-1		cholesterol (25 mg/g)			month, very slight	after 1 week
						precipitation after 2	refrigerated *
						months
32	ACA09	30	Castor oil +	Solution to oil	Slight precipitation		Small crystals
	1109-2		cholesterol (31 mg/g)		of crystals on the		on the
					bottom after 8		bottom after
					days		1 week
							refrigerated -
							unchanged
							after 2 days *
33	ACA09	40	Akoline MCM	Solution to oil	Massive
	1122-1				precipitation
					within an hour
34	ACA09	40	Akoline MCM +	Solution to oil	Unchanged after	Precipitation after 1
	1122-2		cholesterol (40 mg/g)		24 hours *	week
35	ACA09	25	50% Castor oil, 50%	Solution to oil	Unchanged *	Unchanged after 10	After 1 week
	1101-4		Akoline MCM +			months *	refrigerated,
			cholesterol (25 mg/g)				the entire
							sample was
							solidified,
							Slight
							precipitation
							after melting
36	ACA09	30	50% Castor oil, 50%	Solution to oil	Unchanged *	Unchanged after 1	After 1 week
	1102-2		Akoline MCM +			month, very slight	refrigerated,
			cholesterol (30 mg/g)			precipitation after	the entire
						approx 2 months	sample was
							solidified,
							Slight
							precipitation
							after melting
37	ACA09	34	48% Castor oil, 52%	Solution to oil	Unchanged after	Precipitation in entire	Unchanged *
	1108-1		Akoline MCM +		15 days *	sample after 1 month	after 1 week
			cholesterol (34 mg/g)				refrigerated
38	ACA09	38	50% Castor oil, 50%	Solution to oil	Slight precipitation		Small crystals
	1108-2		Akoline MCM +		of crystals on the		on the
			cholesterol (38 mg/g)		bottom after 9		bottom after
					days		1 week
							refrigerated -
							unchanged
							after 2 days
39	ACA09	40	50% Castor oil, 50%	Solution to oil	Massive
	1120-3		Akoline MCM +		precipitation after
			cholesterol (20 mg/g)		24 hours
40	ACA09	40	50% Castor oil, 50%	Solution to oil	Massive
	1120-1		Akoline MCM +		precipitation after
			cholesterol (40 mg/g)		24 hours
41	ACA09	40	47.3% Castor oil,	Solution to oil	Unchanged after	Starts to precipitate
	1122-3		47.3% Akoline		24 hours *
			MCM, 5.4% benzyl
			alcohol +
			cholesterol (40 mg/g)
42	ACA09	40	50% Castor oil, 50%	Solution to oil	Very slight
	1120-2		Akoline MCM +		precipitation of
			cholesterol (60 mg/g)		crystal sin the
					entire sample after
					24 h
43	ACA09	45	45% Castor oil, 55%	Solution to oil	Slight precipitation		Crystals on
	1108-3		Akoline MCM +		of crystals on the		the bottom
			cholesterol (45 mg/g)		bottom after 9		after 1 week
					days		refrigerated
44	ACA09	45	50% Castor oil, 50%	Solution to oil	Slight precipitation
	1121-1		Akoline MCM +		of crystal sin the
			cholesterol (67.5 mg/g)		entire sample after
					24 h
45	ACA09	50	50% Castor oil, 50%	Solution to oil	Very slight
	1121-2		Akoline MCM +		precipitations of
			cholesterol (75 mg/g)		crystal sin the
					entire sample after
					24 h
46	ACA09	5	Olive oil	Emulsion to oil	Unchanged after	Crystals at the bottom
	1216-2				4 days, first signs	after 9 months
					of precipitation
					after 5 days
47	ACA09	5	Olive oil +	Emulsion to oil	Unchanged after	Unchanged after 8
	1216-1		cholesterol (10 mg/g)		3 weeks *	months
48	ACA09	7.5	Olive oil	Emulsion to oil	Precipitation after
	1221-2				approx. 1 hour
49	ACA09	7.5	Olive oil +	Emulsion to oil	Unchanged after	Crystals at the bottom
	1221-1		cholesterol (7.5 mg/g)		1 day, very slight	after 8 months
					precipitation after
					1 week

Examples 50-75

Examples 50 to 75 were carried out essentially as examples 1-49. Akoline Medium-Chain Monoglyceride (MCM) (Batch 8192270 and 8218940) and Akomed R Medium-Chain Triglyceride (MCT) (Batch 4765) were obtained from AarhusKarlshamns Sweden AB, Karlshamn, Sweden. Absolute ethanol (>99%) was obtained from VWR International.
The procedure for making and evaluating lipid-based formulations was as follows: The batch sizes were either 20 g or 100 g of final formulation. The desired amounts of 3-beta-hydroxy-5-alpha-pregnan-20-one and cholesterol were weighed in a round-bottomed flask, 250 or 1000 ml depending on the batch size.
To every gram of 3-beta-hydroxy-5-alpha-pregnan-20-one and cholesterol mixture a volume of about 15 to 30 ml of absolute ethanol was added. The smaller volume of alcohol per gram of solute was used when preparing the largest batch size of 100 g of final formulation. The mixture was treated in an ultrasonication bath (not exceeding 55° C.) until a clear solution was obtained.
This was normally accomplished within a few minutes. The glycerides were then added and the resulting mixture was treated in the ultrasonication bath for a few seconds until a clear, homogeneous liquid was obtained. The alcohol was evaporated from the liquid on a rotary evaporator at a pressure of about 20 mbar and a temperature of about 40° C. until weight of the flask was more or less constant. Normally, the remaining ethanol content was 0.5% (w/w) or less. The evaporation time was 0.5-1.5 h, depending on the batch size. The aim was to obtain a practically uncolored liquid with the appearance of a clear oil at room temperature. The liquid was transferred to clear glass vials, which were stored at room temperature until evaluation.
Some selected formulations were portioned and stored at 2-8° C. for limited period of time.
The evaluation comprised observation of the physical stability at room temperature over time. The samples were observed for haziness, precipitation of particles, aggregates or crystals, and subsequent sedimentation and/or phase separation into two or more liquid phases, and/or change of colour.
It was possible to dissolve up to 25 mg of 3-beta-hydroxy-5-alpha-pregnan-20-one per gram of final formulation based on 50% MCT and 50% MCM (examples 68 and 69) without any noticeable change in appearance when stored at room temperature for more than 1 month. One of the samples (example 69) also withstood storage at 2-8° C. and repeated temperature cycling.
In order to check the robustness and reproducibility of the formulations and the procedure for the preparation thereof, a scaling up of the batch size from 20 g to 100 g of final formulation was performed. The compositions corresponding to examples 60 and 69 were selected for this procedure. From the behavior during preparation and the initial observations of the resulting formulations (examples 74 and 75) it can be concluded that the adopted procedure is both robust and reproducible for making up to 100 g of formulation.

TABLE 2

		Amount				Appearance after
		of			Appearance after 1-2	about 1 month (if not
	Batch	UC1010		Appearance at	days at room	otherwise stated) at
Example	name	(mg/g)	Vehicle	preparation	temperature	room temperature	Comments

50	ACA10	30	50% Akoline	Solution to oil	Signs of precipitation	Precipitation
	0129-1		MCM, 50%		after 1 day
			Akomed R
			MCT +
			cholesterol
			(30 mg/g)
51	ACA10	30	50% Akoline	Solution to oil	Signs of precipitation	Precipitation
	0129-2		MCM, 50%		after 1 day
			Akomed R
			MCT +
			cholesterol
			(45 mg/g)
52	ACA10	28	50% Akoline	Solution to oil	Unchanged	Precipitation	Signs of
	0129-3		MCM, 50%				precipitation
			Akomed R				after 1 day in
			MCT +				the
			cholesterol				refrigerator,
			(56 mg/g)				substantial
							precipitation
							after 2 days
53	ACA10	30	67% Akoline	Solution to oil	Signs of slight	Precipitation
	0130-1		MCM, 33%		precipitation after 2 days
			Akomed R
			MCT +
			cholesterol
			(30 mg/g)
54	ACA10	30	67% Akoline	Solution to oil	Unchanged	Precipitation
	0130-2		MCM, 33%
			Akomed R
			MCT +
			cholesterol
			(45 mg/g)
55	ACA10	30	67% Akoline	Solution to oil	Unchanged	Precipitation
	0130-3		MCM, 33%
			Akomed R
			MCT +
			cholesterol
			(60 mg/g)
56	ACA10	20	50% Akoline	Solution to oil	Unchanged	Unchanged after 29	Withstand 3
	0203-B		MCM, 50%			weeks	days in the
			Akomed R				refrigerator,
			MCT +				but not 4 days,
			cholesterol				due to
			(40 mg/g)				solidification of
							MCM
57	ACA10	20	50% Akoline	Solution to oil	Unchanged	Unchanged after 29	Withstand 3
	0203-C		MCM, 50%			weeks	weeks in the
			Akomed R				refrigerator
			MCT +
			cholesterol
			(60 mg/g)
58	ACA10	20	50% Akoline	Solution to oil	First signs of	Precipitation
	0204-1		MCM, 50%		precipitation after a few
			Akomed R		hours, large star-shaped
			MCT +		crystals after 2 days
			cholesterol
			(100 mg/g)
59	ACA10	20	30% Akoline	Solution to oil	Unchanged after 3 days	Precipitation
	0204-2		MCM, 70%
			Akomed R
			MCT +
			cholesterol
			(40 mg/g)
60	ACA10	20	30% Akoline	Solution to oil	Unchanged	Unchanged after 7	Withstand 6
	0206-1		MCM, 70%			weeks	days in the
			Akomed R				refrigerator,
			MCT +				but had
			cholesterol				precipitated
			(60 mg/g)				after about 2
							weeks without
							concomitant
							solidification of
							MCM
							Massive
							precipitation
							after 28 weeks
61	ACA10	20	30% Akoline	Solution to oil	First signs of	Precipitation
	0206-2		MCM, 70%		precipitation after about
			Akomed R		30 min
			MCT +
			cholesterol
			(100 mg/g)
62	ACA10	20	15% Akoline	Solution to oil	Precipitation	Precipitation
	0206-3		MCM, 85%
			Akomed R
			MCT +
			cholesterol
			(40 mg/g)
63	ACA10	20	15% Akoline	Solution to oil	Unchanged after 1 days	Precipitation
	0206-4		MCM, 85%
			Akomed R
			MCT +
			cholesterol
			(60 mg/g)
64	ACA10	20	15% Akoline	Solution to oil	Signs of precipitation	Precipitation
	0206-5		MCM, 85%		directly after evaporation
			Akomed R
			MCT +
			cholesterol
			(100 mg/g)
65	ACA10	20	100%	Solution to oil	Precipitation at the	Precipitation
	0213-A		Akomed R		bottom
			MCT +
			cholesterol
			(40 mg/g)
66	ACA10	20	100%	Solution to oil	Precipitation in the whole	Precipitation in the
	0213-C		Akomed R		sample	whole sample
			MCT +
			cholesterol
			(60 mg/g)
67	ACA10	20	100%	Solution to oil	Precipitation directly after	Precipitation in the
	0213-B		Akomed R		evaporation	whole sample
			MCT +
			cholesterol
			(80 mg/g)
68	ACA10	25	50% Akoline	Solution to oil	Unchanged	Unchanged	A portion of
	0301-1		MCM, 50%				the sample
			Akomed R				was placed in
			MCT +				the
			cholesterol				refrigerator:
			(50 mg/g)				partial
							solidification
							after 1 day,
							but clear
							solution after
							melting at RT.
							After another 1
							day in the
							fridge the
							sample started
							to precipitate
							Massive
							precipitation
							after 25 weeks
69	ACA10	25	50% Akoline	Solution to oil	Unchanged	Unchanged after 25	A portion of
	0301-2		MCM, 50%			weeks	the sample
			Akomed R				was placed in
			MCT +				the
			cholesterol				refrigerator:
			(75 mg/g)				partial
							solidification,
							but clear
							solution after
							melting at RT.
							The sample
							withstood
							repeated
							cycles during
							several weeks
							without
							precipitation!
70	ACA10	25	50% Akoline	Solution to oil	Very small amount of	Precipitation	A portion of
	0301-3		MCM, 50%		needle-shaped crystals		the sample
			Akomed R		after 1 day		was placed in
			MCT +				the
			cholesterol				refrigerator:
			(100 mg/g)				partial
							solidification
							and very slight
							precipitation
							after melting at
							RT
71	ACA10	30	50% Akoline	Solution to oil	Unchanged after 3 days,	Precipitation	A portion of
	0301-4		MCM, 50%		slight tendency to		the sample
			Akomed R		precipitation after 5 days		was placed in
			MCT +				the
			cholesterol				refrigerator:
			(60 mg/g)				partial
							solidification
							and slight
							precipitation
							after melting at
							RT
72	ACA10	30	50% Akoline	Solution to oil	Unchanged after 3 days,	Precipitation	A portion of
	0301-5		MCM, 50%		precipitation after 5 days		the sample
			Akomed R				was placed in
			MCT +				the
			cholesterol				refrigerator:
			(90 mg/g)				partial
							solidification
							and substantial
							precipitation
							after melting at
							RT
73	ACA10	30	50% Akoline	Solution to	—	—	—
	0301-6		MCM, 50%	crystals
			Akomed R	(precipitated
			MCT +	during
			cholesterol	evaporation;
			(120 mg/g)	discarded)
74	ACA10	25	50% Akoline	Solution to oil	Unchanged	Unchanged	Batch size 100 g
	0320		MCM, 50%				Very slight
			Akomed R				precipitation
			MCT +				after 23 weeks
			cholesterol
			(75 mg/g)
75	ACA10	20	30% Akoline	Solution to oil	Unchanged	Unchanged	Batch size 100 g
	0321		MCM, 70%				Slight
			Akomed R				precipitation
			MCT +				after 23 weeks
			cholesterol
			(60 mg/g)

Example 76

The objective of the study was to investigate the comparative pharmacokinetics in plasma of a 3-beta-hydroxy-5-alpha-pregnan-20-one formulation comprising sesame oil and cholesterol following subcutaneous administration to New Zealand White rabbits. Two groups of three female rabbits each received single doses 1 mg/kg (formulation as in example 7) or 5 mg/kg (formulation as in example 10). Following subcutaneous injection into the dorsal neck region of the animals, blood samples were taken at 0.25, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours post dose. Concentrations of 3-beta-hydroxy-5-alpha-pregnan-20-one in plasma were measured by a validated LC-MS/MS method. Data are presented in FIG. 1 , and show mean plasma concentration (ng/mL) of 3-beta-hydroxy-5-alpha-pregnan-20-one for the two doses: 1 mg/kg (squares) and 5 mg/kg (circles).

Example 77

Suspensions of 3-beta-hydroxy-5-alpha-pregnan-20-one were prepared for investigation of solubility as follows: cholesterol was first dissolved at room temperature in sesame oil at 10 and 20 mg/ml, respectively. Suspensions of 3-beta-hydroxy-5-alpha-pregnan-20-one in sesame oil with different amounts of cholesterol were prepared on a magnetic stirrer at about 500 rpm using a conventional Teflon coated stir bar, at room temperature for several days, with occasional cycling to 2-8° C. At this time, the particles have become substantially smaller. Thereafter, samples of the respective suspensions were filtered through a 0.2 μm filter and analyzed with regard to concentration of 3-beta-hydroxy-5-alpha-pregnan-20-one. The results are presented in Table 3 and FIG. 2 where it can be seen that increasing the amounts of cholesterol increases the soluble fraction of 3-beta-hydroxy-5-alpha-pregnan-20-one. FIG. 2 shows data for a 3-beta-hydroxy-5-alpha-pregnan-20-one concentration of 10 mg/g. FIG. 3 a and 3 b show microscopy pictures taken at 5× enlargement of suspensions with a 3-beta-hydroxy-5-alpha-pregnan-20-one concentration of 10 mg/g and a cholesterol:3-beta-hydroxy-5-alpha-pregnan-20-one ratio of 1:1 immediately upon mixing (3a) and after several days of stirring (3b).

	TABLE 3

	3-beta-hydroxy-5-alpha-pregnan-
	20-one concentration in filtrate
	(mg/ml)

The weight ratio	Initial 3-beta-	Initial 3-beta-
cholesterol to 3-	hydroxy-5-alpha-	hydroxy-5-alpha-
beta-hydroxy-5-	pregnan-20-one	pregnan-20-one
alpha-pregnan-	concentration	concentration
20-one	10 mg/g	40 mg/g

0:1	1	—
1:4	—	1.4
1:2	—	1.9
1:1	1.8	—
2:1	2.2	—

Example 78

Micronized 3-beta-hydroxy-5-alpha-pregnan-20-one (10 mg/g) with a mean particle size of 6 micrometer was suspended in sesame oil with cholesterol (20 mg/g) and stirred as in example 77. Photos were taken immediately upon suspension (FIG. 4 a ) and after 19 hours of stirring (FIG. 4 b ).

CONCLUSION

It has been shown that the presence of a sterol such as cholesterol improves the possibilities to formulate 3-beta-hydroxy-5-alpha-pregnan-20-one in a pharmaceutical composition comprising acylglycerols, either as an oily solution or an oily suspension.

Claims

1.-16. (canceled)

17. A pharmaceutical composition, comprising:

3-beta-hydroxy-5-alpha-pregnan-20-one;

a sterol or an ester thereof; and

a mixture of acylglycerols;

and

wherein at room temperature the composition is a liquid oil composition.

18. The pharmaceutical composition according to claim 17, wherein 3-beta-hydroxy-5-alpha-pregnan-20-one is present in an amount of up to 75 mg/g of the composition.

19. The pharmaceutical composition according to claim 17, wherein 3-beta-hydroxy-5-alpha-pregnan-20-one is present in an amount of up to 50 mg/g of the composition.

20. The pharmaceutical composition according to claim 17, wherein a weight ratio of said sterol or ester thereof to said 3-beta-hydroxy-5-alpha-pregnan-20-one is 1:10 to 10:1.

21. The pharmaceutical composition according to claim 20, wherein a weight ratio of said sterol or ester thereof to said 3-beta-hydroxy-5-alpha-pregnan-20-one is 1:5 to 5:1.

22. The pharmaceutical composition according to claim 21, wherein a weight ratio of said sterol or ester thereof to said 3-beta-hydroxy-5-alpha-pregnan-20-one is 1:3 to 3:1.

23. The pharmaceutical composition according to claim 17, wherein the weight ratio of said sterol or ester thereof to said 3-beta-hydroxy-5-alpha-pregnan-20-one is 1:5 to 2:1.

24. The pharmaceutical composition according to claim 17, wherein the sterol or ester thereof is cholesterol or an ester thereof.

25. The pharmaceutical composition according to claim 17, wherein the concentration of said cholesterol or ester thereof is no more than about 30 mg/ml.

26. The pharmaceutical composition according to claim 17, wherein the mixture of acylglycerols has a total combined percentage of (i) fatty acids with eight carbon atoms and (ii) fatty acids with ten carbon atoms of at least 95%.

27. The pharmaceutical composition according to claim 17, wherein the mixture of acylglycerols comprises a medium-chain acylglycerol.

28. The pharmaceutical composition according to claim 17, wherein the mixture of acylglycerols comprises medium-chain triacylglycerol (MCT).

29. The pharmaceutical composition according to claim 25, wherein said medium-chain acylglycerol comprises at least about 95% triacylglycerols.

30. The pharmaceutical composition according to claim 17, wherein the mixture of acylglycerols comprises sesame oil.

31. The pharmaceutical composition according to claim 27, wherein the mixture of acylglycerols, in addition to the medium-chain acylglycerol, further comprises a vegetable oil.

32. The pharmaceutical composition according to claim 31, wherein the vegetable oil is selected from the group consisting of sesame oil, peanut oil, olive oil and castor oil.

33. The pharmaceutical composition according to claim 17, wherein the 3-beta-hydroxy-5-alpha-pregnan-20-one is suspended in a solution comprising the sterol or ester thereof and the mixture of acylglycerols.

34. The pharmaceutical composition according to claim 17, wherein at least some of the 3-beta-hydroxy-5-alpha-pregnan-20-one is dissolved in a solution comprising the sterol or ester thereof and the mixture of acylglycerols.

35. The pharmaceutical composition according to claim 17, wherein said composition is formulated for parenteral administration.

36. A method of treating a condition of the central nervous system, comprising: administering the pharmaceutical composition according to claim 17 to a subject in need thereof.

37. The method according to claim 36, wherein the condition of the central nervous system is selected from the group consisting of epilepsy, menstruation cycle dependent epilepsy, depression, stress related depression, migraine, tiredness and in particular stress related tiredness, premenstrual syndrome, premenstrual dysphoric disorder, menstrual cycle linked mood changes, stress related memory changes, menstrual cycle linked memory changes, Alzheimer's dementia, menstrual cycle linked difficulties in concentration, menstrual cycle linked sleep disorders and tiredness, substance abuse, menstrual cycle linked alcoholism, side effects of oral contraceptives and postmenopausal therapy or combinations thereof.

38. A method of terminating steroid induced anesthesia, comprising: administering the pharmaceutical composition according to claim 17 to a subject in need thereof.