WO1989003384A1 - Prostaglandin derivatives for the treatment of glaucoma or ocular hypertension - Google Patents
Prostaglandin derivatives for the treatment of glaucoma or ocular hypertension Download PDFInfo
- Publication number
- WO1989003384A1 WO1989003384A1 PCT/SE1988/000515 SE8800515W WO8903384A1 WO 1989003384 A1 WO1989003384 A1 WO 1989003384A1 SE 8800515 W SE8800515 W SE 8800515W WO 8903384 A1 WO8903384 A1 WO 8903384A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- glaucoma
- 2alpha
- epi
- ocular hypertension
- alkyl
- Prior art date
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- 208000010412 Glaucoma Diseases 0.000 title claims abstract description 17
- 206010030043 Ocular hypertension Diseases 0.000 title claims abstract description 14
- 238000011282 treatment Methods 0.000 title claims abstract description 13
- 150000003180 prostaglandins Chemical class 0.000 title description 12
- 239000000203 mixture Substances 0.000 claims abstract description 15
- 238000004519 manufacturing process Methods 0.000 claims abstract 2
- FPABVZYYTCHNMK-YNRDDPJXSA-N PGF2alpha isopropyl ester Chemical compound CCCCC[C@H](O)\C=C\[C@H]1[C@H](O)C[C@H](O)[C@@H]1C\C=C/CCCC(=O)OC(C)C FPABVZYYTCHNMK-YNRDDPJXSA-N 0.000 claims description 14
- -1 11 epi PGF2alpha ester Chemical class 0.000 claims description 13
- PXGPLTODNUVGFL-ZWAKLXPCSA-N 11-epi-prostaglandin F2alpha Chemical compound CCCCC[C@H](O)\C=C\[C@H]1[C@@H](O)C[C@H](O)[C@@H]1C\C=C/CCCC(O)=O PXGPLTODNUVGFL-ZWAKLXPCSA-N 0.000 claims description 8
- 230000004410 intraocular pressure Effects 0.000 claims description 8
- 125000000217 alkyl group Chemical group 0.000 claims description 6
- 125000004432 carbon atom Chemical group C* 0.000 claims description 6
- 230000001603 reducing effect Effects 0.000 claims description 6
- 239000000243 solution Substances 0.000 claims description 4
- 239000003755 preservative agent Substances 0.000 claims description 3
- 125000003118 aryl group Chemical group 0.000 claims description 2
- 239000002674 ointment Substances 0.000 claims description 2
- 229920000642 polymer Polymers 0.000 claims description 2
- 239000004094 surface-active agent Substances 0.000 claims description 2
- 239000003981 vehicle Substances 0.000 claims 2
- 239000002502 liposome Substances 0.000 claims 1
- 239000002504 physiological saline solution Substances 0.000 claims 1
- PXGPLTODNUVGFL-BRIYLRKRSA-N (E,Z)-(1R,2R,3R,5S)-7-(3,5-Dihydroxy-2-((3S)-(3-hydroxy-1-octenyl))cyclopentyl)-5-heptenoic acid Chemical compound CCCCC[C@H](O)C=C[C@H]1[C@H](O)C[C@H](O)[C@@H]1CC=CCCCC(O)=O PXGPLTODNUVGFL-BRIYLRKRSA-N 0.000 abstract description 7
- PXGPLTODNUVGFL-UHFFFAOYSA-N prostaglandin F2alpha Natural products CCCCCC(O)C=CC1C(O)CC(O)C1CC=CCCCC(O)=O PXGPLTODNUVGFL-UHFFFAOYSA-N 0.000 abstract 1
- 230000007794 irritation Effects 0.000 description 10
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- 229940094443 oxytocics prostaglandins Drugs 0.000 description 5
- 206010020565 Hyperaemia Diseases 0.000 description 4
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- 239000006196 drop Substances 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 230000000622 irritating effect Effects 0.000 description 4
- 239000000126 substance Substances 0.000 description 4
- XEKOWRVHYACXOJ-UHFFFAOYSA-N Ethyl acetate Chemical compound CCOC(C)=O XEKOWRVHYACXOJ-UHFFFAOYSA-N 0.000 description 3
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 description 3
- 239000003889 eye drop Substances 0.000 description 3
- QCHFTSOMWOSFHM-WPRPVWTQSA-N (+)-Pilocarpine Chemical compound C1OC(=O)[C@@H](CC)[C@H]1CC1=CN=CN1C QCHFTSOMWOSFHM-WPRPVWTQSA-N 0.000 description 2
- WADSJYLPJPTMLN-UHFFFAOYSA-N 3-(cycloundecen-1-yl)-1,2-diazacycloundec-2-ene Chemical compound C1CCCCCCCCC=C1C1=NNCCCCCCCC1 WADSJYLPJPTMLN-UHFFFAOYSA-N 0.000 description 2
- CSCPPACGZOOCGX-UHFFFAOYSA-N Acetone Chemical compound CC(C)=O CSCPPACGZOOCGX-UHFFFAOYSA-N 0.000 description 2
- 201000004569 Blindness Diseases 0.000 description 2
- 208000024304 Choroidal Effusions Diseases 0.000 description 2
- QCHFTSOMWOSFHM-UHFFFAOYSA-N SJ000285536 Natural products C1OC(=O)C(CC)C1CC1=CN=CN1C QCHFTSOMWOSFHM-UHFFFAOYSA-N 0.000 description 2
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 2
- 239000013543 active substance Substances 0.000 description 2
- 229960000686 benzalkonium chloride Drugs 0.000 description 2
- CADWTSSKOVRVJC-UHFFFAOYSA-N benzyl(dimethyl)azanium;chloride Chemical compound [Cl-].C[NH+](C)CC1=CC=CC=C1 CADWTSSKOVRVJC-UHFFFAOYSA-N 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
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- 229940012356 eye drops Drugs 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 210000005036 nerve Anatomy 0.000 description 2
- 210000003733 optic disk Anatomy 0.000 description 2
- 230000036407 pain Effects 0.000 description 2
- 229960001416 pilocarpine Drugs 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 230000001953 sensory effect Effects 0.000 description 2
- 239000002904 solvent Substances 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- KIUKXJAPPMFGSW-DNGZLQJQSA-N (2S,3S,4S,5R,6R)-6-[(2S,3R,4R,5S,6R)-3-Acetamido-2-[(2S,3S,4R,5R,6R)-6-[(2R,3R,4R,5S,6R)-3-acetamido-2,5-dihydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-2-carboxy-4,5-dihydroxyoxan-3-yl]oxy-5-hydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-3,4,5-trihydroxyoxane-2-carboxylic acid Chemical compound CC(=O)N[C@H]1[C@H](O)O[C@H](CO)[C@@H](O)[C@@H]1O[C@H]1[C@H](O)[C@@H](O)[C@H](O[C@H]2[C@@H]([C@@H](O[C@H]3[C@@H]([C@@H](O)[C@H](O)[C@H](O3)C(O)=O)O)[C@H](O)[C@@H](CO)O2)NC(C)=O)[C@@H](C(O)=O)O1 KIUKXJAPPMFGSW-DNGZLQJQSA-N 0.000 description 1
- TWBNMYSKRDRHAT-RCWTXCDDSA-N (S)-timolol hemihydrate Chemical compound O.CC(C)(C)NC[C@H](O)COC1=NSN=C1N1CCOCC1.CC(C)(C)NC[C@H](O)COC1=NSN=C1N1CCOCC1 TWBNMYSKRDRHAT-RCWTXCDDSA-N 0.000 description 1
- PAWDOGUJCZVISQ-UHFFFAOYSA-N 2-(diethylamino)ethyl 4-amino-3-butoxybenzoate;3',6'-dihydroxyspiro[2-benzofuran-3,9'-xanthene]-1-one Chemical compound CCCCOC1=CC(C(=O)OCCN(CC)CC)=CC=C1N.O1C(=O)C2=CC=CC=C2C21C1=CC=C(O)C=C1OC1=CC(O)=CC=C21 PAWDOGUJCZVISQ-UHFFFAOYSA-N 0.000 description 1
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 206010023644 Lacrimation increased Diseases 0.000 description 1
- 206010067013 Normal tension glaucoma Diseases 0.000 description 1
- 208000022873 Ocular disease Diseases 0.000 description 1
- 206010030348 Open-Angle Glaucoma Diseases 0.000 description 1
- 239000004372 Polyvinyl alcohol Substances 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- PMZURENOXWZQFD-UHFFFAOYSA-L Sodium Sulfate Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=O PMZURENOXWZQFD-UHFFFAOYSA-L 0.000 description 1
- 206010047141 Vasodilatation Diseases 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
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- 210000002159 anterior chamber Anatomy 0.000 description 1
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- 238000009412 basement excavation Methods 0.000 description 1
- 229910052799 carbon Inorganic materials 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 239000000064 cholinergic agonist Substances 0.000 description 1
- 230000001886 ciliary effect Effects 0.000 description 1
- 238000004440 column chromatography Methods 0.000 description 1
- 125000001511 cyclopentyl group Chemical group [H]C1([H])C([H])([H])C([H])([H])C([H])(*)C1([H])[H] 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000005786 degenerative changes Effects 0.000 description 1
- 230000001627 detrimental effect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000004406 elevated intraocular pressure Effects 0.000 description 1
- 239000003480 eluent Substances 0.000 description 1
- NBEMQPLNBYYUAZ-UHFFFAOYSA-N ethyl acetate;propan-2-one Chemical compound CC(C)=O.CCOC(C)=O NBEMQPLNBYYUAZ-UHFFFAOYSA-N 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000002440 hepatic effect Effects 0.000 description 1
- 229920002674 hyaluronan Polymers 0.000 description 1
- 229960003160 hyaluronic acid Drugs 0.000 description 1
- 125000002887 hydroxy group Chemical group [H]O* 0.000 description 1
- 230000004317 lacrimation Effects 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 208000018769 loss of vision Diseases 0.000 description 1
- 231100000864 loss of vision Toxicity 0.000 description 1
- 201000002978 low tension glaucoma Diseases 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 229920000609 methyl cellulose Polymers 0.000 description 1
- 239000001923 methylcellulose Substances 0.000 description 1
- 235000010981 methylcellulose Nutrition 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- PVWOIHVRPOBWPI-UHFFFAOYSA-N n-propyl iodide Chemical compound CCCI PVWOIHVRPOBWPI-UHFFFAOYSA-N 0.000 description 1
- 239000012074 organic phase Substances 0.000 description 1
- CMHHMUWAYWTMGS-UHFFFAOYSA-N oxybuprocaine Chemical compound CCCCOC1=CC(C(=O)OCCN(CC)CC)=CC=C1N CMHHMUWAYWTMGS-UHFFFAOYSA-N 0.000 description 1
- 229960003502 oxybuprocaine Drugs 0.000 description 1
- 230000008289 pathophysiological mechanism Effects 0.000 description 1
- 235000010482 polyoxyethylene sorbitan monooleate Nutrition 0.000 description 1
- 229920000136 polysorbate Polymers 0.000 description 1
- 229920000053 polysorbate 80 Polymers 0.000 description 1
- 229920002451 polyvinyl alcohol Polymers 0.000 description 1
- 235000019422 polyvinyl alcohol Nutrition 0.000 description 1
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 description 1
- 230000003389 potentiating effect Effects 0.000 description 1
- 230000002335 preservative effect Effects 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- BHMBVRSPMRCCGG-OUTUXVNYSA-N prostaglandin D2 Chemical compound CCCCC[C@H](O)\C=C\[C@@H]1[C@@H](C\C=C/CCCC(O)=O)[C@@H](O)CC1=O BHMBVRSPMRCCGG-OUTUXVNYSA-N 0.000 description 1
- 150000003163 prostaglandin D2 derivatives Chemical group 0.000 description 1
- 229940127293 prostanoid Drugs 0.000 description 1
- 150000003814 prostanoids Chemical class 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 210000001525 retina Anatomy 0.000 description 1
- 210000003786 sclera Anatomy 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
- 239000000741 silica gel Substances 0.000 description 1
- 229910002027 silica gel Inorganic materials 0.000 description 1
- 210000002460 smooth muscle Anatomy 0.000 description 1
- 235000017557 sodium bicarbonate Nutrition 0.000 description 1
- 229910000030 sodium bicarbonate Inorganic materials 0.000 description 1
- 235000002639 sodium chloride Nutrition 0.000 description 1
- 229910052938 sodium sulfate Inorganic materials 0.000 description 1
- 235000011152 sodium sulphate Nutrition 0.000 description 1
- 208000010110 spontaneous platelet aggregation Diseases 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 238000004809 thin layer chromatography Methods 0.000 description 1
- 229960004605 timolol Drugs 0.000 description 1
- 210000001585 trabecular meshwork Anatomy 0.000 description 1
- 230000009466 transformation Effects 0.000 description 1
- 230000024883 vasodilation Effects 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
- 230000004393 visual impairment Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/557—Eicosanoids, e.g. leukotrienes or prostaglandins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
- A61P27/06—Antiglaucoma agents or miotics
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
- C07C405/00—Compounds containing a five-membered ring having two side-chains in ortho position to each other, and having oxygen atoms directly attached to the ring in ortho position to one of the side-chains, one side-chain containing, not directly attached to the ring, a carbon atom having three bonds to hetero atoms with at the most one bond to halogen, and the other side-chain having oxygen atoms attached in gamma-position to the ring, e.g. prostaglandins ; Analogues or derivatives thereof
Definitions
- Prostaglandin derivatives for the treatment of glaucoma or ocular hypertension are prostaglandin derivatives for the treatment of glaucoma or ocular hypertension.
- the invention is concerned with the use of derivatives of a specific diastereomer of prostaglandin F 2alpha , viz. 11 epi, for the treatment of glaucoma or ocular hypertension.
- the invention furthermore also relates to ophthalmological compositions containing an active amount of these prostaglandin derivatives.
- Glaucoma is an ocular disorder characterized by elevated intraocular pressure, excavation of the optic nerve head and gradual loss of the vision field.
- An abnormally high intraocular pressure will have a generally detrimental effect on the eye; and there are clear indications that this is probably the main factor causing degenerative changes of the retina in glaucoma patients.
- the pathophysiological mechanism underlying open-angle glaucoma is still unknown. If not treated successfully the disease will usually proceed to blindness sooner or later, its course towards that stage being characterized by a slow but progressive loss of vision.
- the intraocular pressur IOP (abbr. of intraocular pressure) is usually defined by the formula
- P e is the pressure in the episcleral veins, generally considered to be around 9 mm Hg; F is a measure of aqueous humor flow rate; and R is the resistance to aqueous humor outflow through the trabecular meshwork and adjacent tissue into Schlemm's canal.
- This uveoscleral path has been described by e.g. Bill (1975).
- the pressure gradient along this path is very insignificant as compared to the gradient in the first mentioned case over the interior wall of Schlemm's canal and adjacent tissue.
- the flow-limiting step along the uveoscleral path is believed to reside in the flow from the anterior chamber into the suprachoroidal space.
- IOP P e + (F t - F u ) x R (2)
- F t represents the total outflow of aqueous humor
- F u represents that portion thereof which goes via the uveoscleral path.
- the IOP will normally be within the range of from 12 to 22 mm Hg. At higher values, e.g. exceeding 22 mm Hg, there is a risk that the eye may be affected.
- the so-called low-tension glaucoma lesions will occur at intraocular pressure levels which are generally regarded as physiological. Possibly this may be due to an increased pressure sensitivity of the eye of such an individual.
- the opposite type of phenomenon is known, i.e. some individuals may have an abnormally high intraocular pressure without any noticeable distinct defects in their vision field or optic nerve head. Such conditions are usually named "ocular hypertension".
- Glaucoma treatments may be given by means of drugs, laser or surgery.
- the purpose is to achieve a reduction of either the flow (F) or the resistance (R), which will result in a lower IOP according to formula (1) above; or alternatively the purpose may be to increase the flow via the uveoscleral path - which too will be a means of lowering the pressure as can be seen from formula (2).
- Cholinergic agonists like for instance pilocarpine reduce the intraocular pressure mainly by increasing the outflow through Schlemm's canal.
- Interest in prostaglandins as IOP- reducing substances has been growing substantially for quite some time; the mechanism underlying their effect probably being an increased uveoscleral outflow (Crawford et al. 1987, and Nilsson et al. 1987). These substances on the other hand do not appear to have any effect on either the formation of aqueous humor or the conventional outflow through Schlemm's canal (Crawford et al. 1987).
- prostaglandins and derivatives thereof are described in for example US 4599353 and EP 87103714.9.
- prostaglandins and derivatives as suitable as drugs for treating glaucoma or ocular hypertension, a limiting factor is their property of causing superficial irritation and vasodilatation in the conjunctiva. It is probable moreover that prostaglandins have an irritant effect on the sensory nerves of the cornea. Thus local side effects will arise in the eye already when the amounts of prostaglandin administered are quite small - that is, already when the doses are lower than those that would be desirable for achieving maximum pressure reduction. It has thus been found for instance that for this reason it is clinically impossible to use PGF 2alpha -1-isopropyl ester in the amount that would give maximum pressure reduction.
- Prostaglandins being naturally occurring autacoids are very potent pharmacologically and affect both sensory nerves and smooth muscle of the blood vessels. Since the effects caused by administrations of PGF2 2alpha and its esters to the eye comprise in addition to pressure reduction also irritation and hyperemia (increased blood flow) the doses currently practicable in clinical tests are necessarily very low.
- the irritation experienced when PGF 2alpha or its esters are applied consists mainly in a feeling of grittiness or of having a foreign body in one's eye, this being usually accompanied by increased lacrimation.
- a diastereomer of prostaglandin PGF 2alpha viz. 11 epi, will lower the eye pressure without causing any substantial irritation.
- the present invention thus relates to 1-alkyl or 1-alkylaryl esters of 11 epi PGF 2alpha to be used for treating glaucoma or ocular hypertension.
- the alkyl chain of the 1-alkyl esters comprises 1-10, preferably 1-7, and especially 1-5 carbon atoms.
- the 1-alkylaryl esters have an aryl group monosubstituted by a lower alkyl chain. This lower alkyl chain has 1-5 carbon atoms.
- the 11 epi PG 2alpha -1-isopropyl ester is used.
- compositions for the treatment of glaucoma or ocular hypertension said compositions containing an effective intraocular pressure reducing amount of at least one 11 epi PGF 2alpha -1-ester defined as above, in an ophthalmologically compatible vehicle.
- effective amount here means that the composition contains about 0.1-10 ⁇ g, especially 1-10 ⁇ g of the active substance.
- the ophthalmologically compatible vehicle which may be employed for preparing compositions of this invention comprises aqueous solutions as e.g. physiological salines, oil solutions or ointments.
- the vehicle furthermore may contain ophthalmologically compatible preservatives such as e.g. benzalkonium chloride, surfactants like e.g. Tween ® 80, liposorces or polymers, for example methyl cellulose, polyvinyl alcohol, polyvinyl pyrrolidone and hyaluronic acid; these may be used for the purpose of increasing the viscosity.
- ophthalmologically compatible preservatives such as e.g. benzalkonium chloride, surfactants like e.g. Tween ® 80, liposorces or polymers, for example methyl cellulose, polyvinyl alcohol, polyvinyl pyrrolidone and hyaluronic acid; these may be used for the purpose of increasing the viscosity.
- the invention moreover relates to a method for treating glaucoma or ocular hypertension.
- the method consists in contacting a composition as aforesaid with the eye in order to reduce eye pressure and to maintain said pressure on a reduced level.
- the composition contains 0.1-10 ⁇ g, especially
- the treatment may advantageously be carried out in that one drop of the composition, corresponding to about 30 ⁇ l, is administered about 1 to 4 times to the patient's eye.
- PGF 2alpha -1-isopropyl ester or 11 epi PGF 2alpha -1-isopropyl ester produced according to Example 1 was mixed with an eye drop solution containing 0.5 % Tween 80 as a micelle-forming substance plus 0.01 % benzalkonium chloride as a preservative to 50 ⁇ g/ml concentration. Healthy volunteers received in one of their eyes one drop (30 ⁇ l) containing 1.5 ⁇ g of either PGF 2alpha - 1-isopropyl ester or 11 epi PGF 2alpha -1-isopropyl ester, and in the other eye one drop of the vehicle without any added prostaglandin compound, this other eye being the contralateral control eye.
- Eye pressures were measured 2, 4, 6 and 8 hours after administration of 11 epi PG 2alpha -1-isopropyl ester, and 4 and hours after administration of PFG 2alpha -1-isopropyl ester. With prostaglandin eye drops the maximum pressure reducing effect in the eye is expected to be achieved 6-8 hours after administration of the preparation.
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- Health & Medical Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Organic Chemistry (AREA)
- Animal Behavior & Ethology (AREA)
- Pharmacology & Pharmacy (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Medicinal Chemistry (AREA)
- General Health & Medical Sciences (AREA)
- Ophthalmology & Optometry (AREA)
- Life Sciences & Earth Sciences (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Chemical & Material Sciences (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Epidemiology (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicinal Preparation (AREA)
Abstract
Use of derivatives of a diastereomer of prostaglandin F2alpha, viz. 11 epi, for the manufacture of compositions for the treatment of glaucoma or ocular hypertension.
Description
Prostaglandin derivatives for the treatment of glaucoma or ocular hypertension
The invention is concerned with the use of derivatives of a specific diastereomer of prostaglandin F2alpha, viz. 11 epi, for the treatment of glaucoma or ocular hypertension. The invention furthermore also relates to ophthalmological compositions containing an active amount of these prostaglandin derivatives.
Glaucoma is an ocular disorder characterized by elevated intraocular pressure, excavation of the optic nerve head and gradual loss of the vision field. An abnormally high intraocular pressure will have a generally detrimental effect on the eye; and there are clear indications that this is probably the main factor causing degenerative changes of the retina in glaucoma patients. However, the pathophysiological mechanism underlying open-angle glaucoma is still unknown. If not treated successfully the disease will usually proceed to blindness sooner or later, its course towards that stage being characterized by a slow but progressive loss of vision.
The intraocular pressur IOP (abbr. of intraocular pressure) is usually defined by the formula
IOP = Pe + F x R (1)
where Pe is the pressure in the episcleral veins, generally considered to be around 9 mm Hg; F is a measure of aqueous humor flow rate; and R is the resistance to aqueous humor outflow through the trabecular meshwork and adjacent tissue into Schlemm's canal.
Another path along which the aqueous humor may flow, in addition to the Schlemm's canal path, is via the ciliary muscle into the suprachoroidal space and then out of the eye through the sclera. This uveoscleral path has been described
by e.g. Bill (1975). The pressure gradient along this path is very insignificant as compared to the gradient in the first mentioned case over the interior wall of Schlemm's canal and adjacent tissue. The flow-limiting step along the uveoscleral path is believed to reside in the flow from the anterior chamber into the suprachoroidal space.
A more complete formula is the following:
IOP = Pe + (Ft - Fu) x R (2)
where Pe and R have the same meanings as above; Ft represents the total outflow of aqueous humor; and Fu represents that portion thereof which goes via the uveoscleral path.
In humans the IOP will normally be within the range of from 12 to 22 mm Hg. At higher values, e.g. exceeding 22 mm Hg, there is a risk that the eye may be affected. In a special form of glaucoma, the so-called low-tension glaucoma, lesions will occur at intraocular pressure levels which are generally regarded as physiological. Possibly this may be due to an increased pressure sensitivity of the eye of such an individual. Also the opposite type of phenomenon is known, i.e. some individuals may have an abnormally high intraocular pressure without any noticeable distinct defects in their vision field or optic nerve head. Such conditions are usually named "ocular hypertension".
Glaucoma treatments may be given by means of drugs, laser or surgery. In the case of drug treatments, the purpose is to achieve a reduction of either the flow (F) or the resistance (R), which will result in a lower IOP according to formula (1) above; or alternatively the purpose may be to increase the flow via the uveoscleral path - which too will be a means of lowering the pressure as can be seen from formula (2). Cholinergic agonists like for instance pilocarpine reduce the intraocular pressure mainly by increasing the outflow through Schlemm's canal.
Interest in prostaglandins as IOP- reducing substances has been growing substantially for quite some time; the mechanism underlying their effect probably being an increased uveoscleral outflow (Crawford et al. 1987, and Nilsson et al. 1987). These substances on the other hand do not appear to have any effect on either the formation of aqueous humor or the conventional outflow through Schlemm's canal (Crawford et al. 1987).
The use of prostaglandins and derivatives thereof is described in for example US 4599353 and EP 87103714.9.
With respect to the practical usefulness of some of the previously described prostaglandins and derivatives as suitable as drugs for treating glaucoma or ocular hypertension, a limiting factor is their property of causing superficial irritation and vasodilatation in the conjunctiva. It is probable moreover that prostaglandins have an irritant effect on the sensory nerves of the cornea. Thus local side effects will arise in the eye already when the amounts of prostaglandin administered are quite small - that is, already when the doses are lower than those that would be desirable for achieving maximum pressure reduction. It has thus been found for instance that for this reason it is clinically impossible to use PGF2alpha-1-isopropyl ester in the amount that would give maximum pressure reduction. Prostaglandins being naturally occurring autacoids are very potent pharmacologically and affect both sensory nerves and smooth muscle of the blood vessels. Since the effects caused by administrations of PGF22alpha and its esters to the eye comprise in addition to pressure reduction also irritation and hyperemia (increased blood flow) the doses currently practicable in clinical tests are necessarily very low. The irritation experienced when PGF2alpha or its esters are applied consists mainly in a feeling of grittiness or of having a foreign body in one's eye, this being usually accompanied by increased lacrimation.
We have now found, surprisingly, that a diastereomer of prostaglandin PGF2alpha, viz. 11 epi, will lower the eye pressure without causing any substantial irritation. In this stereoisomer the hydroxyl at carbon atom 11 lies above the cyclopentane ring. This isomer of PGF2alpha has been known heretofore; it is a metabolite of PGD2 (Liston and Roberts 1985, Pugliese et al. 1985). The 11 epi PGF2alpha-1-isopropyl ester which as far as we know has not been described heretofore will give rise to hyperemia in the conjunctiva to about the same extent as the PGF2alpha-1-isopropyl ester, but this will not involve any hazard or inconvenience as long as irritation problems are absent.
The present invention thus relates to 1-alkyl or 1-alkylaryl esters of 11 epi PGF2alpha to be used for treating glaucoma or ocular hypertension. The alkyl chain of the 1-alkyl esters comprises 1-10, preferably 1-7, and especially 1-5 carbon atoms. The 1-alkylaryl esters have an aryl group monosubstituted by a lower alkyl chain. This lower alkyl chain has 1-5 carbon atoms. In an embodiment currently preferred, the 11 epi PG2alpha -1-isopropyl ester is used.
Furthermore, the invention relates to compositions for the treatment of glaucoma or ocular hypertension, said compositions containing an effective intraocular pressure reducing amount of at least one 11 epi PGF2alpha-1-ester defined as above, in an ophthalmologically compatible vehicle. The term "effective amount" here means that the composition contains about 0.1-10 μg, especially 1-10 μg of the active substance.
The ophthalmologically compatible vehicle which may be employed for preparing compositions of this invention comprises aqueous solutions as e.g. physiological salines, oil solutions or ointments. The vehicle furthermore may contain ophthalmologically compatible preservatives such as e.g. benzalkonium chloride, surfactants like e.g. Tween® 80, liposorces or polymers, for example methyl cellulose, polyvinyl
alcohol, polyvinyl pyrrolidone and hyaluronic acid; these may be used for the purpose of increasing the viscosity. Furthermore, it is also possible to use soluble or insoluble drug inserts when the drug is to be administered.
The invention moreover relates to a method for treating glaucoma or ocular hypertension. The method consists in contacting a composition as aforesaid with the eye in order to reduce eye pressure and to maintain said pressure on a reduced level. The composition contains 0.1-10 μg, especially
1-10 μg, of the active substance i.e. the 11 epi PGF2alpha ester; the treatment may advantageously be carried out in that one drop of the composition, corresponding to about 30 μl, is administered about 1 to 4 times to the patient's eye.
The invention is illustrated by means of the following non-limitative examples .
Experiments
1. Synthesis of 11 epi PGF2alpha-1-isopropyl ester
20 mg (0,056 mmol) of 11 epi PGF2alpha (Cayman Chemicals, US) were dissolved in acetone at room temperature. To this solution were added 54.5 mg (0.336 mmol) of diazabicycloundecene (DBu) and 76.15 mg (0.448 mmol) of propyl iodide, whereupon the mixture was left to stand at room temperature for 8 hours. The solvent was removed in vacuo, the residue then being dissolved in 50 ml of ethyl acetate, washed with 20 ml of water, 20 ml of 3 % citric acid and 5 % sodium hydrogen carbonate; thereafter the organic phase was dried over sodium sulfate. The solvent was removed in vacuo and
the residue was purified by means of column chromatography on silica gel, with ethyl acetate - acetone (1:1) as the eluent. The yield of the product was about 76 %, and its purity was tested by means of thin layer chromatography and NMR.
2. Preparation of eye drops containing 11 epi PGF2alpha- 1-isopropyl ester
PGF2alpha-1-isopropyl ester or 11 epi PGF2alpha-1-isopropyl ester produced according to Example 1 was mixed with an eye drop solution containing 0.5 % Tween 80 as a micelle-forming substance plus 0.01 % benzalkonium chloride as a preservative to 50 μg/ml concentration. Healthy volunteers received in one of their eyes one drop (30 μl) containing 1.5 μg of either PGF2alpha- 1-isopropyl ester or 11 epi PGF2alpha-1-isopropyl ester, and in the other eye one drop of the vehicle without any added prostaglandin compound, this other eye being the contralateral control eye. Feelings of irritation and hyperemia in the conjunctiva were then recorded during a period of two hours. Eye pressures were measured 2, 4, 6 and 8 hours after administration of 11 epi PG2alpha -1-isopropyl ester, and 4 and hours after administration of PFG 2alpha-1-isopropyl ester. With prostaglandin eye drops the maximum pressure reducing effect in the eye is expected to be achieved 6-8 hours after administration of the preparation.
Eye pressure was measured by means of applanation tonometry, either with Godmann's applanation tonometer or with a pneumatonometer (Digilab Mode -30RT), after anesthesia of the cornea with oxybuprocaine drops or with a mixture of oxybuprocaine and fluorescein. Results could be read only after measurements were complete.
Feelings of irritation in the eye i.e. grittiness were classified by scores ranging from 0 to 3 where 0 = no irritation, 1 = slightly irritating, 2 = moderately irritating and 3 = highly irritating. Hyperemia in the conjunctiva was assessed only visually.
The results of the tests performed on healthy volunteers with 11 epi PGF2alpha-1-isopropyl ester and PGF2alpha- 1-isopropyl ester are set forth in Tables I and II.
Application of 1.5 μg of 11 epi PGF2alpha administered as the 1-isopropyl ester in a particular vehicle and application of 1.5 μg PGF2alpha administered as the
1-isopropyl ester in the same vehicle resulted in 1-2 mm Hg pressure reduction in normotensive individuals 4 to 8 hours after application, as compared to the control eye (Table I). The pressure reduction was statistically significant on a P<0.05 to P<0.02 level.
This pressure reduction may appear to be a small one, but it is a well-known fact that normotensive individuals will generally show fairly little reaction in response to pressure reducing drugs. This is true also of e.g. pilocarpine and timolol. As can be seen from Table II, irritation after application of 1.5 μg 11 epi PGF2alpha was felt to be considerably less than the irritation felt upon application of 1.5 μg PGF2alpha when each had been administered in the form of its 1-isopropyl ester. This is very important from a clinical point of view, since it may thus be espected that the drug will be used in doses high enough to bring about a maximal reduction of eye pressure.
References
Bill, A (1975). Blood circulation and fluid dynamics in the eye. Physiol. Rev. 55: 383-417.
Crawford, K, Kaufman, P L, och True Gabel, B'A (1987). Pilocarpine antagonizes PGF2a-induced ocular hypotension: Evidence for enhancement of uveoscleral outflow by PGF2a. Invest. Ophthalmol. Vis Sci p. 11.
Liston, T och Roberts, L J (1985) . Transformation of prostaglandin D2 to 9alpha, 11beta-(15S)-trihydroxyprosta-(5Z,13E)-dien-1-oic acid (9alpha, 11beta-prostaglandin F2): A unique biologically active prostaglandin produced enzymatically in vivo in humans. Proc Natl Acad Sci US 82 p. 6030-6034.
Nilsson, S F E, Stjernschantz, J, och Bill, A (1987) . PGF2a increases uveoscleral outflow. Invest. Ophthalmol. Vis Sci Suppl p. 284.
Pugliese G et al (1985). Hepatic Transformation of Prostaglandin D2 to a New Prostanoid, 9alpha, 11beta-Prostaglandin F2, That Inhibits Platelet Aggregation and Constricts Blood Vessels. J Biol Chem 260(27) p. 14621-14625.
TABLE I I
Time after application
Prostaglandin 15' 30' 45' 60' 120'
xxx) xxx)
11 epi-PGF2alpha-1- 0.4 ± 0.2 0.2 ± 0.2 0.0 ± 0.0 0.0 ± 0.0 0.0 ± 0.0 isopropyl ester
PGF2alpha-1- 1.5 ± 0.4 1.7 ± 0.2 1.8 ± 0.2 1.3 ± 0.2 0.5 ± 0.2 isopropyl ester
xxx) p < 0.01
Feeling of pain (grittiness) in the eye of normotensive individuals after local application of 1.5 μg 11 epi PGF2alpha-1-isopropyl ester or 1.5 μg PGF2alpha-1-isopropyl ester calculated as free acid. A scale of scores ranging from 0 to 3 was used for pain assessment.
Claims
1. 1-alkyl or 1-alkylaryl esters of 11 epi PGF2alpha for use in the treatment of glaucoma or ocular hypertension.
2. 11 epi PGF2alpha-1-alkyl esters according to claim 1, characterized in that the alkyl chain has 1-10, preferably 1-7, and especially 1-5 carbon atoms.
3. 11 epi PG2alpha -1-alkylaryl esters according to claim 1, characterized in that the aryl group is monosubstituted by a lower alkyl group having 1-5 carbon atoms.
4 11 epi PGF2alpha-1-isopropyl ester for use in the treatment of glaucoma or ocular hypertension.
5. Composition for the local treatment of glaucoma or ocular hypertension, characterized by containing an effective intraocular pressure reducing amount of an
11 epi PGF2alpha-1-ester according to any of claims 1-4 in an ophthalmologically compatible vehicle.
6. Composition according to claim 5, characterized in that the ophthalmologically compatible vehicle is a physiological saline, an oil solution or an ointment, and that it optionally contains ophthalmologically compatible preservatives, surfactants, liposomes or polymers.
7. The use of 1-alkyl or 1-alkylaryl esters of 11 epi PGF2alpha for the manufacture of a composition for the local treatment of glaucoma or ocular hypertension.
8. The use according to claim 7 in which the 11 epi
PGF2alpha ester is an 1-alkyl ester with 1-10, preferably 1-7, carbon atoms in the alkyl chain.
9. The use according to claim 8 in which the 11 epi
PGF2alpha ester is the 1-isopropylester.
10. Treatment of glaucoma or ocular hypertension by contacting the eye with a composition containing an effective intraocular pressure reducing amount of an 1-alkyl or 1-alkylaryl ester of 11 epi PGF2alpha.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE8888908778T DE3872701T2 (en) | 1987-10-07 | 1988-10-06 | PROSTAGLANDIN DERIVATIVES FOR TREATING GLAUCOMA OR EYE PRESSURE. |
AT88908778T ATE78031T1 (en) | 1987-10-07 | 1988-10-06 | PROSTAGLANDIN DERIVATIVES FOR THE TREATMENT OF GLAUCOMA OR OCULAR PRESSURE. |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SE8703854-3 | 1987-10-07 | ||
SE8703854A SE8703854D0 (en) | 1987-10-07 | 1987-10-07 | PROSTAGLAND INGREDIENTS FOR TREATMENT OF GLAUCOME OR OCULAR HYPERTENSION |
Publications (1)
Publication Number | Publication Date |
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WO1989003384A1 true WO1989003384A1 (en) | 1989-04-20 |
Family
ID=20369771
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/SE1988/000515 WO1989003384A1 (en) | 1987-10-07 | 1988-10-06 | Prostaglandin derivatives for the treatment of glaucoma or ocular hypertension |
Country Status (6)
Country | Link |
---|---|
EP (1) | EP0344235B1 (en) |
JP (1) | JP2852057B2 (en) |
AT (1) | ATE78031T1 (en) |
DE (1) | DE3872701T2 (en) |
SE (1) | SE8703854D0 (en) |
WO (1) | WO1989003384A1 (en) |
Cited By (20)
Publication number | Priority date | Publication date | Assignee | Title |
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US4994274A (en) * | 1989-07-27 | 1991-02-19 | Allergan, Inc. | Intraocular pressure reducing 11,15-diacyl prostaglandins and method of using |
US5011856A (en) * | 1990-03-12 | 1991-04-30 | Allergan, Inc. | Use of prostaglandin F3 α as an ocular hypotensive agent |
WO1992008697A2 (en) * | 1990-11-09 | 1992-05-29 | Schering Aktiengesellschaft, Berlin Und Bergkamen | 9-HALOGEN-11β-HYDROXY PROSTAGLANDIN DERIVATIVE, PROCESS FOR PRODUCING IT AND ITS USE AS A MEDICAMENT |
EP0521009A1 (en) * | 1990-03-19 | 1993-01-07 | Allergan, Inc. | 5-trans-prostaglandin-2-alpha as an ocular hypotensive agent |
US5238961A (en) * | 1990-06-14 | 1993-08-24 | Allergan, Inc. | Pgf 1-alcohols and their use as ocular hypotensives |
WO1994011002A1 (en) * | 1992-11-12 | 1994-05-26 | Allergan, Inc. | 8-epi prostaglandins |
EP0628545A1 (en) * | 1993-06-14 | 1994-12-14 | Ono Pharmaceutical Co., Ltd. | 13,14-Dihydro-PGF2BETA and its isopropyl ester |
US5446041A (en) * | 1989-07-27 | 1995-08-29 | Allergan, Inc. | Intraocular pressure reducing 11-acyl prostaglandins |
US6262105B1 (en) | 1997-02-04 | 2001-07-17 | Murray A. Johnstone | Method of enhancing hair growth |
US7351404B2 (en) | 2002-02-04 | 2008-04-01 | Allergan, Inc. | Method of enhancing hair growth |
USRE43372E1 (en) | 1999-03-05 | 2012-05-08 | Duke University | C16 unsaturated FP-selective prostaglandins analogs |
US8758733B2 (en) | 2002-02-04 | 2014-06-24 | Allergan, Inc. | Topical treatment for chemotherapy induced eyelash loss or hypotrichosis using prostamide F2 alpha agonists |
US8859616B2 (en) | 2011-01-21 | 2014-10-14 | Allergan, Inc. | Compounds and methods for enhancing hair growth |
US8906962B2 (en) | 2000-03-31 | 2014-12-09 | Duke University | Compositions and methods for treating hair loss using non-naturally occurring prostaglandins |
US9149484B2 (en) | 2009-11-09 | 2015-10-06 | Allergan, Inc. | Compositions and methods for stimulating hair growth |
US9216183B2 (en) | 2002-02-04 | 2015-12-22 | Allergan, Inc. | Topical treatment for chemotherapy induced eyelash loss or hypotrichosis using prostamide F2 alpha agonists |
US9346837B2 (en) | 2000-03-31 | 2016-05-24 | Duke University | Cosmetic and pharmaceutical compositions and methods using 2-decarboxy-2-phosphinico derivatives |
US9750750B2 (en) | 2009-11-09 | 2017-09-05 | Allergan, Inc. | Compositions and methods for stimulating hair growth |
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US10272040B2 (en) | 2010-08-12 | 2019-04-30 | Nanyang Technological University | Liposomal formulation for ocular drug delivery |
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EP0093380A2 (en) * | 1982-05-03 | 1983-11-09 | The Trustees Of Columbia University In The City Of New York | Use of eicosanoids and their derivatives for treatment of ocular hypertension and glaucoma |
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- 1988-10-06 EP EP88908778A patent/EP0344235B1/en not_active Expired - Lifetime
- 1988-10-06 AT AT88908778T patent/ATE78031T1/en not_active IP Right Cessation
- 1988-10-06 DE DE8888908778T patent/DE3872701T2/en not_active Expired - Lifetime
- 1988-10-06 WO PCT/SE1988/000515 patent/WO1989003384A1/en active IP Right Grant
- 1988-10-06 JP JP63508064A patent/JP2852057B2/en not_active Expired - Lifetime
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DE2166721A1 (en) * | 1970-09-11 | 1975-05-15 | Upjohn Co | PROSTANIC ACID DERIVATIVES AND THEIR PRODUCTION |
EP0093380A2 (en) * | 1982-05-03 | 1983-11-09 | The Trustees Of Columbia University In The City Of New York | Use of eicosanoids and their derivatives for treatment of ocular hypertension and glaucoma |
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Also Published As
Publication number | Publication date |
---|---|
EP0344235B1 (en) | 1992-07-08 |
DE3872701D1 (en) | 1992-08-13 |
SE8703854D0 (en) | 1987-10-07 |
DE3872701T2 (en) | 1992-12-03 |
EP0344235A1 (en) | 1989-12-06 |
JP2852057B2 (en) | 1999-01-27 |
ATE78031T1 (en) | 1992-07-15 |
JPH02501483A (en) | 1990-05-24 |
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