WO1996030016A2 - Low dose ridogrel formulations and their use for the treatment of inflammatory bowel diseases - Google Patents

Low dose ridogrel formulations and their use for the treatment of inflammatory bowel diseases Download PDF

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Publication number
WO1996030016A2
WO1996030016A2 PCT/EP1996/001229 EP9601229W WO9630016A2 WO 1996030016 A2 WO1996030016 A2 WO 1996030016A2 EP 9601229 W EP9601229 W EP 9601229W WO 9630016 A2 WO9630016 A2 WO 9630016A2
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WO
WIPO (PCT)
Prior art keywords
ridogrel
pharmaceutically acceptable
body weight
inflammatory bowel
bowel diseases
Prior art date
Application number
PCT/EP1996/001229
Other languages
French (fr)
Other versions
WO1996030016A3 (en
Inventor
Maria-Helena Joris Jozef Verlinden
Original Assignee
Janssen Pharmaceutica N.V.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Janssen Pharmaceutica N.V. filed Critical Janssen Pharmaceutica N.V.
Priority to EP96910921A priority Critical patent/EP0817631A2/en
Priority to AU53974/96A priority patent/AU5397496A/en
Priority to JP8528894A priority patent/JPH10511097A/en
Publication of WO1996030016A2 publication Critical patent/WO1996030016A2/en
Publication of WO1996030016A3 publication Critical patent/WO1996030016A3/en
Priority to MXPA/A/1997/007394A priority patent/MXPA97007394A/en
Priority to NO974486A priority patent/NO974486L/en

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    • 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
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4406Non condensed pyridines; Hydrogenated derivatives thereof only substituted in position 3, e.g. zimeldine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the present invention relates to the use of ridogrel at low dosages in the treatment of inflammatory bowel diseases and to corresponding low dose ridogrel formulations.
  • EP-0,221,601 describes (E)-5-[[[(3-pyridinyl)[3-(trifluoromethyl)phenyl] methylene]amino)oxy]pentanoic acid (generically known as ridogrel) for use in various pathological conditions. This document also generically discloses pharmaceutical compositions comprising ridogrel.
  • EP-0,448,274 describes a tablet formulation comprising 400 mg of ridogrel for use in ulcerative and inflammatory conditions of the gastrointestinal tract.
  • ridogrel in the treatment of inflammatory bowel diseases as described in the prior-art shows limited clinical efficacy and displays undesired side-effects.
  • the use as described in claim 1 solves this problem by administering ridogrel at low doses, thereby unexpectedly increasing the clinical efficacy in inflammatory bowel diseases and reducing adverse side-effects.
  • Ridogrel as defined herein refers to (E)-5-[[[(3-pyridinyl)[3-(trifluoromethyl) phenyl]methylene]amino]oxy]pentanoic acid and can be prepared in accordance with the procedures described in EP-0,221,601. Ridogrel can also be used according to this invention as a pharmaceutically acceptable acid or base addition salt thereof. When a pharmaceutically acceptable acid or base addition salt is used, the dose referred to hereinabove and hereinunder is based upon the amount of ridogrel as such.
  • the pharmaceutically acceptable acid addition salts as mentioned hereinabove are meant to comprise the acid addition salt forms which can conveniently be obtained by treating the base form of the compounds of formula (I) with appropriate acids such as inorganic acids, for example, hydrohalic acid, e.g. hydrochloric or hydrobromic, sulfuric. nitric, phosphoric and the like acids; or organic acids, such as, for example, acetic, hydroxyacetic, propanoic, lactic, pyruvic.
  • acids such as inorganic acids, for example, hydrohalic acid, e.g. hydrochloric or hydrobromic, sulfuric. nitric, phosphoric and the like acids; or organic acids, such as, for example, acetic, hydroxyacetic, propanoic, lactic, pyruvic.
  • acids to form acid addition salts are hydrochloric acid, which forms a ( 1 : 1 ) salt with ridogrel and nitric acid, which also forms a (1: 1) salt with ridogrel.
  • said acid addition salt forms can be converted in the free base forms by treatment with an appropriate base.
  • the compounds of formula (I) which are acidic may form base addition salt forms.
  • the pharmaceutically acceptable base addition salts as mentioned hereinabove are meant to comprise the base addition salts forms which can conveniently be obtained by treating the acid form of the compounds of formula (I) with appropriate bases.
  • bases may include lithium, sodium, potassium, calcium, aluminium, gold and silver salts.
  • salts with pharmaceutically acceptable amines such as ammonia, primary, secondary and tertiary amines, such as alkyl amines, hydroxyalkylamines, N-methylglucamine and the like.
  • said base addition salt forms can be converted in the free acid forms by treatment with an appropriate acid.
  • Preferred counter ions in a base addition salt form are lithium and sodium.
  • the present invention relates to the use of ridogrel or a pharmaceutically acceptable acid or base addition salt thereof for the manufacture of a medicament for treating inflammatory bowel diseases, wherein ridogrel or its pharmaceutically acceptable acid or base addition salt form is administered in a daily dose from 0.01 mg/kg body weight to 1 mg/kg body weight, suitably to 0.5 mg/kg body weight (the dose based upon the amount of ridogrel present as such).
  • the invention relates to a method of treating humans suffering from inflammatory bowel diseases, said method comprising the administration to said humans of ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof in an amount from 0.01 mg/kg body weight to 1 mg/kg body weight, suitably to 0.5 mg/kg body weight.
  • ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof is used in a daily dose from 0.02 mg/kg body weight to 0.1 mg/kg body weight, more particularly in a dose of about 0.05 mg/kg body weight.
  • the above cited dose ranges in mg/kg body weight correspond to a dose range from about 1 mg/day to about 50 mg/day, in particular from about 2 mg/day to 10 mg/day, more in particular of about 5 mg/day.
  • Inflammatory bowel diseases include, for example, ulcerative colitis, Crohn's disease and the like.
  • ridogrel is used in the treatment of ulcerative colitis. Ulcerative colitis is characterized by the presence of lesions in the mucous membranes of the colon.
  • thromboxane plays an active role in the development of these lesions.
  • Ridogrel has been described to show both thromboxane synthetase inhibitory activity and thromboxane receptor antagonistic activity.
  • ridogrel is a mere thromboxane synthetase inhibitor, lacking thromboxane receptor antagonistic activity.
  • the treatment of inflammatory bowel diseases includes both the treatment of the acute disease state, thereby inducing remission of the disease or improvement of the lesions or clinical condition, as well as the use in maintenance therapy.
  • a satisfactory treatment of inflammatory bowel diseases, in particular ulcerative colitis, is characterized by a good clinical efficacy and a low occurrence of adverse events.
  • the following findings are desirable:
  • Adverse events that may occur are e.g. nausea, vomiting, diarrhoea, abdominal cramps, oedema, paraesthesia, hematoma, ecchymoses, and the like.
  • Ridogrel or its pharmaceutically acceptable acid or base addition salt form is suitably administered systemically, such as orally, rectally, intraperitoneally or parenterally.
  • ridogrel is administered orally or rectally.
  • ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof is administered once daily (o.d.) or twice daily (b.i.d.), preferably formulated in an appropriate pharmaceutical composition.
  • the invention relates to a pharmaceutical composition comprising a pharmaceutically acceptable carrier and ridogrel or its pharmaceutically acceptable acid or base addition salt form in an amount effective to be used as defined hereinabove.
  • the invention relates to a pharmaceutical composition comprising from 0.5 to 5 mg ridogrel per dosage unit form and a pharmaceutically acceptable carrier.
  • Solid pharmaceutical compositions such as tablets, capsules, suppositories and the like, suitably comprise ridogrel in an amount from 0.5 to 5 mg per dosage unit form, in particular from 1 to 5 mg per dosage unit form.
  • the active ingredient is preferably ridogrel as such.
  • Liquid pharmaceutical compositions such as oral solutions, oral suspensions, oral syrups, injectable solutions, rectal enema's or rectal solutions, rectal foams and the like, suitably comprise ridogrel in an amount from 0.1 to 1 mg ml, preferably from 0.5 to 1 mg/ml.
  • ridogrel is preferably present as the sodium salt of the ridogrel.
  • Dosage unit form refers to physically discrete units suitable as unitary dosages, each unit containing a predetermined quantity of ridogrel.
  • dosage unit forms are tablets (including scored or coated tablets), capsules, pills, powder packets, wafers, injectable solutions or suspensions, teaspoonfuls, tablespoonfuls and the like, and segregated multiples thereof.
  • compositions there may be cited all compositions usually employed for systemically administering drugs.
  • an effective amount of ridogrel is combined in intimate admixture with a pharmaceutically acceptable carrier, which carrier may take a wide variety of forms depending on the form of preparation desired for administration.
  • Solid compositions according to the present invention will preferably comprise pharmaceutically acceptable carriers and excipients, such as fillers e.g. lactose, sucrose, mannitol, maize starch, microcrystalline cellulose or calcium hydrogen phosphate; lubricants e.g. stearic acid, polyethylene glycol, magnesium stearate, talc or silica; disintegrants e.g.
  • compositions comprise by weight based on the total weight of the composition from 60% to 90% fillers, from 3% to 10% disintegrants and from 0.5% to 5% binding agents.
  • ridogrel is blended with suitable excipients and granulated.
  • ridogrel is granulated with the filler or fillers before admixture of the other excipients.
  • Liquid compositions may comprise any of the usual pharmaceutical media such as water, glycols, oils, alcohols and the like. interesting liquid compositions are aqueous solutions or suspensions, in particular for rectal administration.
  • Liquid oral compositions may comprise, apart from ridogrel or a pharmaceutically acceptable acid or preferably base addition salt form and water, flavouring substances; sweeteners; suspending agents, e.g. cellulose derivatives; wetting agents, e.g.
  • the carrier will usually comprise sterile water, at least in large part, though other ingredients, for example, to aid solubility, may be included.
  • injectable solutions for example, may be prepared in which the carrier comprises saline solution, glucose solution or a mixture of saline and glucose solution.
  • injectable suspensions may also be prepared in which case appropriate liquid carriers, suspending agents and the like may be employed.
  • convenuonal compositions such as suppositories or enemas may be used.
  • rectal solutions may be used for rectal administration.
  • Said rectal solutions comprise apart from the active ingredient ridogrel or its pharmaceutically acceptable acid or preferably base addition salt, water (suitably demineralised, preferably free of pyrogenics), a suitable buffer, such as the combination of disodium hydrogen phosphate and sodium dihydrogen phosphate, a thickening and stabilising agent such as for example hydroxyethyl cellulose, and an agent to make the solution isotonic, such as sodium chloride.
  • a suitable buffer such as the combination of disodium hydrogen phosphate and sodium dihydrogen phosphate
  • a thickening and stabilising agent such as for example hydroxyethyl cellulose
  • an agent to make the solution isotonic such as sodium chloride.
  • solid form preparations which are intended to be converted, shortly before use, to liquid form preparations.
  • Particular pharmaceutical compositions are controlled release formulations, from which the active ingredient is gradually released after administration.
  • micronized form of ridogrel is used in the present compositions.
  • These micronized forms may be prepared by micronization techniques known in the art, e.g. by milling in appropriate mills and sieving through appropriate sieves.
  • ridogrel may be administered in combination with another agent effective in the treatment of inflammatory bowel diseases, e.g. sulphasalazine, mesalazine, olsalazine, balsalazide, a corticosteroid and the like.
  • Another agent effective in the treatment of inflammatory bowel diseases e.g. sulphasalazine, mesalazine, olsalazine, balsalazide, a corticosteroid and the like.
  • the combined use includes the simultaneous, separate or sequential administration of the therapeutic agents.
  • the invention relates to a product containing (a) ridogrel and (b) sulphasalazine, mesalazine or a corticosteroid, as a combined preparation for simultaneous, separate or sequential use in the treatment of inflammatory bowel diseases.
  • compositions 1. 1 mg oral tablet
  • Tablets having the composition shown hereinunder were prepared according to art-known formulation procedure.
  • Croscarmellose sodiumO 2 mg 2.00 %
  • Croscarmellose sodium is the British Approved Name of sodium carboxymethyllcellulose.
  • Hypromellose 2910 15 mPa.s is the British Approved Name for methylhydroxypropylcellulose, the four digit number (2910) is an indication of the substitution on cellulose, i.e. the first two digits represent the approximate percentage composition of methoxyl groups, and the third and fourth digits the approximate percentage composition of hydroxypropyl groups.
  • the grade used in this example is indicated by the viscosity of a 2 % solution at 20°C, i.e. 15 mPa.s
  • Hypromellose 2910 15 mPa.s 2 2 mg 2.00 % w/w)
  • colloidal anhydrous silica 0.3 mg 0.30 % ( ⁇ w/w)
  • the percentages are based on the total weight of the tablet.
  • the pH of the final solution should range between about 6.5 and 8.5, preferably the pH should be between 7.2 and 7.6.
  • the solutions are packaged in enema bottles containing 40 ml or 80 ml of the above described solution.
  • Analogous solutions containing 2.5 mg to 10 mg of ridogrel in 40 ml of rectal solution or 2.5 mg to 10 mg of ridogrel in 80 ml of rectal solution can be prepared according to the above described preparation.

Abstract

The present invention relates to the use of ridogrel for the manufacture of a medicament for treating inflammatory bowel diseases, wherein ridogrel is administered in a daily dose from 0.01 mg/kg body weight to 0.5 mg/kg body weight; pharmaceutical compositions comprising ridogrel.

Description

LOW DOSE RIDOGREL FORMULATIONS AND
THEIR USE FOR THE TREATMENT OF INFLAM¬ MATORY BOWEL DISEASES
The present invention relates to the use of ridogrel at low dosages in the treatment of inflammatory bowel diseases and to corresponding low dose ridogrel formulations.
EP-0,221,601 describes (E)-5-[[[(3-pyridinyl)[3-(trifluoromethyl)phenyl] methylene]amino)oxy]pentanoic acid (generically known as ridogrel) for use in various pathological conditions. This document also generically discloses pharmaceutical compositions comprising ridogrel. EP-0,448,274 describes a tablet formulation comprising 400 mg of ridogrel for use in ulcerative and inflammatory conditions of the gastrointestinal tract.
Casellas et al., 1992, Gastroenterology 102 (4, Suppl.), p. A601, and Casellas et al., 1993, Gastroenterology _Q (4, Suppl.), p. A677 describe the clinical effect of the administration of ridogrel, 300 mg b.i.d., in ulcerative colitis.
The use of ridogrel in the treatment of inflammatory bowel diseases as described in the prior-art shows limited clinical efficacy and displays undesired side-effects. The use as described in claim 1 solves this problem by administering ridogrel at low doses, thereby unexpectedly increasing the clinical efficacy in inflammatory bowel diseases and reducing adverse side-effects.
Ridogrel as defined herein refers to (E)-5-[[[(3-pyridinyl)[3-(trifluoromethyl) phenyl]methylene]amino]oxy]pentanoic acid and can be prepared in accordance with the procedures described in EP-0,221,601. Ridogrel can also be used according to this invention as a pharmaceutically acceptable acid or base addition salt thereof. When a pharmaceutically acceptable acid or base addition salt is used, the dose referred to hereinabove and hereinunder is based upon the amount of ridogrel as such.
The pharmaceutically acceptable acid addition salts as mentioned hereinabove are meant to comprise the acid addition salt forms which can conveniently be obtained by treating the base form of the compounds of formula (I) with appropriate acids such as inorganic acids, for example, hydrohalic acid, e.g. hydrochloric or hydrobromic, sulfuric. nitric, phosphoric and the like acids; or organic acids, such as, for example, acetic, hydroxyacetic, propanoic, lactic, pyruvic. oxalic, malonic, succinic, maleic, fumaric, malic, tartaric, citric, methanesulfonic, ethanesulfonic, benzenesulfonic, p-toluenesulfonic, cyclamic, salicylic, p-aminosalicylic, pamoic and the like acids. Preferred acids to form acid addition salts are hydrochloric acid, which forms a ( 1 : 1 ) salt with ridogrel and nitric acid, which also forms a (1: 1) salt with ridogrel. Conversely, said acid addition salt forms can be converted in the free base forms by treatment with an appropriate base. The compounds of formula (I) which are acidic may form base addition salt forms. The pharmaceutically acceptable base addition salts as mentioned hereinabove are meant to comprise the base addition salts forms which can conveniently be obtained by treating the acid form of the compounds of formula (I) with appropriate bases. Examples of such salts may include lithium, sodium, potassium, calcium, aluminium, gold and silver salts. Also contemplated are salts with pharmaceutically acceptable amines such as ammonia, primary, secondary and tertiary amines, such as alkyl amines, hydroxyalkylamines, N-methylglucamine and the like. Conversely, said base addition salt forms can be converted in the free acid forms by treatment with an appropriate acid.
Preferred counter ions in a base addition salt form are lithium and sodium.
The present invention relates to the use of ridogrel or a pharmaceutically acceptable acid or base addition salt thereof for the manufacture of a medicament for treating inflammatory bowel diseases, wherein ridogrel or its pharmaceutically acceptable acid or base addition salt form is administered in a daily dose from 0.01 mg/kg body weight to 1 mg/kg body weight, suitably to 0.5 mg/kg body weight (the dose based upon the amount of ridogrel present as such).
Alternatively, the invention relates to a method of treating humans suffering from inflammatory bowel diseases, said method comprising the administration to said humans of ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof in an amount from 0.01 mg/kg body weight to 1 mg/kg body weight, suitably to 0.5 mg/kg body weight.
In particular, ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof is used in a daily dose from 0.02 mg/kg body weight to 0.1 mg/kg body weight, more particularly in a dose of about 0.05 mg/kg body weight. For adult human beings, the above cited dose ranges in mg/kg body weight correspond to a dose range from about 1 mg/day to about 50 mg/day, in particular from about 2 mg/day to 10 mg/day, more in particular of about 5 mg/day. Inflammatory bowel diseases include, for example, ulcerative colitis, Crohn's disease and the like. In particular, ridogrel is used in the treatment of ulcerative colitis. Ulcerative colitis is characterized by the presence of lesions in the mucous membranes of the colon. It is generally believed that thromboxane plays an active role in the development of these lesions. Ridogrel has been described to show both thromboxane synthetase inhibitory activity and thromboxane receptor antagonistic activity. Unexpectedly, it has been shown that at the doses of the present invention, however, ridogrel is a mere thromboxane synthetase inhibitor, lacking thromboxane receptor antagonistic activity.
The treatment of inflammatory bowel diseases includes both the treatment of the acute disease state, thereby inducing remission of the disease or improvement of the lesions or clinical condition, as well as the use in maintenance therapy. A satisfactory treatment of inflammatory bowel diseases, in particular ulcerative colitis, is characterized by a good clinical efficacy and a low occurrence of adverse events. In particular, after 8 weeks of treatment, the following findings are desirable:
- an endoscopic improvement in more than 45% of the patients, preferably in more than 50% of the patients;
- a complete endoscopic cure in more than 10% of the patients, preferably in more than 30% of the patients;
- a median percentage of days with bloody stools during the last 2 weeks of treatment of below 50%, preferably below 10%;
- a percentage of patients wherein the investigator's global evaluation of the effect of the treatment is good or excellent of more than 40%, preferably more than 60%; and - an occurrence of adverse events in less than 40% of the patients. Adverse events that may occur are e.g. nausea, vomiting, diarrhoea, abdominal cramps, oedema, paraesthesia, hematoma, ecchymoses, and the like.
Ridogrel or its pharmaceutically acceptable acid or base addition salt form is suitably administered systemically, such as orally, rectally, intraperitoneally or parenterally. Preferably, ridogrel is administered orally or rectally. Suitably, ridogrel or a pharmaceutically acceptable acid or base addition salt form thereof is administered once daily (o.d.) or twice daily (b.i.d.), preferably formulated in an appropriate pharmaceutical composition. Hence, the invention relates to a pharmaceutical composition comprising a pharmaceutically acceptable carrier and ridogrel or its pharmaceutically acceptable acid or base addition salt form in an amount effective to be used as defined hereinabove. In particular, the invention relates to a pharmaceutical composition comprising from 0.5 to 5 mg ridogrel per dosage unit form and a pharmaceutically acceptable carrier.
Solid pharmaceutical compositions such as tablets, capsules, suppositories and the like, suitably comprise ridogrel in an amount from 0.5 to 5 mg per dosage unit form, in particular from 1 to 5 mg per dosage unit form. In solid pharmaceutical compositions the active ingredient is preferably ridogrel as such. Liquid pharmaceutical compositions such as oral solutions, oral suspensions, oral syrups, injectable solutions, rectal enema's or rectal solutions, rectal foams and the like, suitably comprise ridogrel in an amount from 0.1 to 1 mg ml, preferably from 0.5 to 1 mg/ml. In liquid pharmaceutical compositions ridogrel is preferably present as the sodium salt of the ridogrel.
Dosage unit form as used herein refers to physically discrete units suitable as unitary dosages, each unit containing a predetermined quantity of ridogrel. Examples of such dosage unit forms are tablets (including scored or coated tablets), capsules, pills, powder packets, wafers, injectable solutions or suspensions, teaspoonfuls, tablespoonfuls and the like, and segregated multiples thereof.
As appropriate compositions there may be cited all compositions usually employed for systemically administering drugs. To prepare the pharmaceutical compositions of this invention, an effective amount of ridogrel is combined in intimate admixture with a pharmaceutically acceptable carrier, which carrier may take a wide variety of forms depending on the form of preparation desired for administration. Solid compositions according to the present invention will preferably comprise pharmaceutically acceptable carriers and excipients, such as fillers e.g. lactose, sucrose, mannitol, maize starch, microcrystalline cellulose or calcium hydrogen phosphate; lubricants e.g. stearic acid, polyethylene glycol, magnesium stearate, talc or silica; disintegrants e.g. rice, potato or maize starch, sodium starch glycolate or croscarmellose sodium ; binding agents e.g. pregelatinised maize starch, polyvinylpyrrolidone or hydroxypropyl-methylcellulose and wetting agents e.g. sodium dioctylsulfosuccinate and Polysorbates. Interesting solid compositions comprise by weight based on the total weight of the composition from 60% to 90% fillers, from 3% to 10% disintegrants and from 0.5% to 5% binding agents. For the preparation of solid compositions according to the invention, ridogrel is blended with suitable excipients and granulated. Preferably, ridogrel is granulated with the filler or fillers before admixture of the other excipients. Most preferably the fillers employed will be lactose monohydrate and maize starch, especiallly in combination with calcium hydrogen phosphate. Because of their ease in administration, tablets and capsules represent the most advantageous oral dosage unit form. Liquid compositions may comprise any of the usual pharmaceutical media such as water, glycols, oils, alcohols and the like. Interesting liquid compositions are aqueous solutions or suspensions, in particular for rectal administration. Liquid oral compositions may comprise, apart from ridogrel or a pharmaceutically acceptable acid or preferably base addition salt form and water, flavouring substances; sweeteners; suspending agents, e.g. cellulose derivatives; wetting agents, e.g. polyoxyethylene derivatives of sorbitan esters; buffer systems; stabilizing agents; preservatives; solubility enhancers and the like. For parenteral compositions, the carrier will usually comprise sterile water, at least in large part, though other ingredients, for example, to aid solubility, may be included. Injectable solutions, for example, may be prepared in which the carrier comprises saline solution, glucose solution or a mixture of saline and glucose solution. Injectable suspensions may also be prepared in which case appropriate liquid carriers, suspending agents and the like may be employed. For rectal administration, convenuonal compositions such as suppositories or enemas may be used. Preferably, rectal solutions may be used. Said rectal solutions comprise apart from the active ingredient ridogrel or its pharmaceutically acceptable acid or preferably base addition salt, water (suitably demineralised, preferably free of pyrogenics), a suitable buffer, such as the combination of disodium hydrogen phosphate and sodium dihydrogen phosphate, a thickening and stabilising agent such as for example hydroxyethyl cellulose, and an agent to make the solution isotonic, such as sodium chloride.
Also included are solid form preparations which are intended to be converted, shortly before use, to liquid form preparations. Particular pharmaceutical compositions are controlled release formulations, from which the active ingredient is gradually released after administration.
It may be advantageous that a micronized form of ridogrel is used in the present compositions. These micronized forms may be prepared by micronization techniques known in the art, e.g. by milling in appropriate mills and sieving through appropriate sieves.
Optionally, ridogrel may be administered in combination with another agent effective in the treatment of inflammatory bowel diseases, e.g. sulphasalazine, mesalazine, olsalazine, balsalazide, a corticosteroid and the like. The combined use includes the simultaneous, separate or sequential administration of the therapeutic agents. In a further aspect, the invention relates to a product containing (a) ridogrel and (b) sulphasalazine, mesalazine or a corticosteroid, as a combined preparation for simultaneous, separate or sequential use in the treatment of inflammatory bowel diseases.
Experimental part
Pharmaceutical compositions 1. 1 mg oral tablet
Tablets having the composition shown hereinunder were prepared according to art- known formulation procedure.
Ridogrel l mg 1.00 %
Calcium hydrogen phosphate dihydrate 0.94 mg 0.94 %
Lactose monohydrate 56.01 mg 56.01 %
Maize starch 24 mg 24.00 %
Croscarmellose sodiumO) 2 mg 2.00 %
Sodium lauryl sulphate 0.25 mg 0.25 %
Hypromellose 2910 15 mPa. s(2) 2 mg 2.00 %
Microcrystalline cellulose 10 mg 10.00 %
Croscarmellose sodium 1 3 mg 3.00%
Colloidal anhydrous silica 0.3 mg 0.30 %
Magnesium stearate 0.5 mg 0.50 %
( 1 ) Croscarmellose sodium is the British Approved Name of sodium carboxymethyllcellulose.
(2) Hypromellose 2910 15 mPa.s is the British Approved Name for methylhydroxypropylcellulose, the four digit number (2910) is an indication of the substitution on cellulose, i.e. the first two digits represent the approximate percentage composition of methoxyl groups, and the third and fourth digits the approximate percentage composition of hydroxypropyl groups. The grade used in this example is indicated by the viscosity of a 2 % solution at 20°C, i.e. 15 mPa.s
2. 5 mg oral tablet
Tablets having the composition shown hereinunder were prepared according to art- known formulation procedure. Ridogrel 5 mg 5.00 % ( [W/Vxf)
Calcium hydrogen phosphate dihydrate 4.7 mg 4.70 % ( 'w/w)
Lactose monohydrate 48.25 mg 48.25 % ( ^w/w)
Maize starch 24 mg 24.00 % ( [v//w)
Croscarmellose sodium* 2 mg 2.00% ( 'w/w)
Sodium lauryl sulphate 0.25 mg 0.25 % ( [Vxt/W)
Hypromellose 2910 15 mPa.s2 2 mg 2.00 % w/w)
Microcrystalline cellulose 10 mg 10.00 % < ^w/w)
Croscarmellose sodium* 3 mg 3.00 % (w/w)
Colloidal anhydrous silica 0.3 mg 0.30 % ( ^w/w)
Magnesium stearate 0.5 mg 0.50 % ( ^w/w)
The percentages are based on the total weight of the tablet.
3. Oral solution 0.25 mg/ml
The rectal solution of 1 litre having the composition as shown hereinunder were prepared as follows ( the amounts shown hereinunder are given for the preparation of 1 ml of rectal solution) :
800 ml of demineralised water was basified by adding approximately 1.6 ml of a aqueous sodium hydroxide solution (0.1 N). Said solution was heated to a temperature ranging from 60 to 70 °C. The 6.5 g hydroxy ethylcellulose was added to the solution while stirring vigorously. Said mixture is stirred for about 10 minutes at the above- mentioned temperature after which the heating is stopped. The stirring is continued until the hydroxy ethylcellulose is dissolved completely. Subsequently 250 mg ridogrel is added to the solution as well as 2.085 g disodium hydrogen phosphate anhydrous and 477 mg of sodium dihydrogen phosphate. Furthermore the 3.5 g of sodium chloride are added and 200 ml of deminieralised water is added.
The pH of the final solution should range between about 6.5 and 8.5, preferably the pH should be between 7.2 and 7.6.
The solutions are packaged in enema bottles containing 40 ml or 80 ml of the above described solution.
It is important use the correct amount and grade of hydroxy ethyl cellulose in view of stability of the obtained solutions. 0016 PCI7EP96/01229
Composition :
Ridogrel 0.25 mg 0.025 %
Hydroxy ethylcellulose (4800-6000 mPa.s) 6.5 mg 0.65 %
Disodium Hydrogen Phosphate anhydrous 2.085 mg 0.285 %
Sodium Dihydrogen Phosphate
Monohydrate germ poor 0.477 mg 0.0477 %
Sodium Hydroxide q.s to dissolve the Ridogrel
Sodium Chloride 3.5 mg 0.35 %
Purified water qs ad 1000 μl q.s. ad 100 %
Analogous solutions containing 2.5 mg to 10 mg of ridogrel in 40 ml of rectal solution or 2.5 mg to 10 mg of ridogrel in 80 ml of rectal solution can be prepared according to the above described preparation.
Clinical example
Three groups of patients suffering from mild to severe ulcerative colitis were treated orally for eight weeks with 5 mg ridogrel o.d. (group 1), 25 mg ridogrel b.i.d. (group 2) and 150 mg ridogrel b.i.d. (group 3). The following findings were recorded:
Group 1 Group 2 Group 3
(5 mg/day) (50 mg/day) (300 mg/day)
1. Primary parameters
Endoscopic improvement 55% 46% 42% Complete endoscopic cure 36% 17% 8%
2. Secondary parameters Median percentage of days with bloody stools during the last 2 weeks of treatment 0% 43% 92%
Percentage of patients wherein the investigator's global evaluation of the effect of the treatment was good or excellent 64% 46% 25%
3. Adverse events
Occurrence of adverse events 36% 38% 54% Conclusion
Both the treatment with 5 mg ridogrel o.d. and 25 mg ridogrel b.i.d. show improved clinical efficacy when compared with the 150 mg ridogrel b.i.d. treatment. Also the occurrence of adverse events is significantly less with the 5 mg ridogrel o.d. and 25 mg ridogrel b.i.d. treatment compared with the 150 mg ridogrel b.i.d. treatment.
Both the 5 mg ridogrel o.d. and 25 mg ridogrel b.i.d. treatment meet the definitions of a satisfactory treatment of ulcerative colitis as set forth hereinbefore.

Claims

0016 PCI7EP96/01229-10-Claims
1. The use of ridogrel for the manufacture of a medicament for treating inflammatory bowel diseases, wherein ridogrel is administered in a daily dose from 0.01 mg/kg body weight to 1 mg/kg body weight.
2. The use according to claim 1 wherein the daily dose of ridogrel is from 0.02 mg/kg body weight to 0.1 mg/kg body weight.
3. The use according to claim 1 wherein ridogrel is administered orally or rectally.
4. The use according to claim 1 wherein ridogrel is administered in combination with sulphasalazine, mesalazine or a corticosteroid.
5. The use of ridogrel for the manufacture of a medicament for treating inflammatory bowel diseases in adult human beings, wherein ridogrel is administered in a dose from 1 mg/day to 50 mg/day.
6. A pharmaceutical composition comprising from 0.5 to 10 mg ridogrel per dosage unit form and a pharmaceutically acceptable carrier.
7. A solid pharmaceutical composition comprising from 0.5 to 10 mg ridogrel per dosage unit form and a pharmaceutically acceptable carrier .
8. A solid pharmaceutical composition according to claim 7 consisting essentially of ridogrel 1 mg 1.00 %
Calcium hydrogen phosphate dihydrate 0 0..9944 mmgg 0.94 %
Lactose monohydrate 56.01 mg 56.01 %
Maize starch 24 mg 24.00 % Croscarmellose sodium 2 mg 2.00 %
Sodium lauryl sulphate 0.25 mg 0.25 %
Hypromellose 2910 15 mPa.s mg 2.00 %
Microcrystalline cellulose 10 mg 10.00 %
Croscarmellose sodium 3 mg 3.00% Colloidal anhydrous silica 0.3 mg 0.30 %
Magnesium stearate 0.5 mg 0.50 %
9. A liquid pharmaceutical composition comprising from 0.1 to 1 mg/ml ridogrel and a pharmaceutically acceptable carrier .
10. A process for preparing a composition as claimed in claim 6 characterized in that ridogrel is intimately mixed with the pharmaceutically acceptable carriers.
PCT/EP1996/001229 1995-03-28 1996-03-18 Low dose ridogrel formulations and their use for the treatment of inflammatory bowel diseases WO1996030016A2 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
EP96910921A EP0817631A2 (en) 1995-03-28 1996-03-18 Low dose ridogrel formulations and their use for the treatment of inflammatory bowel diseases
AU53974/96A AU5397496A (en) 1995-03-28 1996-03-18 Low dose ridogrel formulations and their use for the treatme nt of inflammatory bowel diseases
JP8528894A JPH10511097A (en) 1995-03-28 1996-03-18 Low-dose lidogrel formulations and their use for the treatment of inflammatory bowel disease
MXPA/A/1997/007394A MXPA97007394A (en) 1995-03-28 1997-09-26 Formulations of low dose ridogrel and its use the treatment of inflamator intestinal diseases
NO974486A NO974486L (en) 1995-03-28 1997-09-29 Low-dose "Ridogrel" formulations and their use in the treatment of intestinal inflammation

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EP95200768.0 1995-03-28
EP95200768 1995-03-28

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WO1996030016A3 WO1996030016A3 (en) 1997-01-30

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CA (1) CA2215160A1 (en)
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Cited By (9)

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WO1998015265A1 (en) * 1996-10-04 1998-04-16 Danbiosyst Uk Limited Colonic delivery of weak acid drugs
WO2002072069A1 (en) * 2001-03-12 2002-09-19 Novo Nordisk A/S Novel tablets and capsules and a process for its preparation
WO2017046343A1 (en) * 2015-09-17 2017-03-23 Nogra Pharma Limited Compositions for rectal administration in the treatment of ulcerative colitis and methods of using same
US9682050B2 (en) 2012-04-18 2017-06-20 Nogra Pharma Limited Methods of treating lactose intolerance
US9682923B2 (en) 2012-02-09 2017-06-20 Nogra Pharma Limited Methods of treating fibrosis
US9901557B2 (en) 2009-02-16 2018-02-27 Nogra Pharma Limited Methods of treating hair related conditions
US9913817B2 (en) 2008-12-05 2018-03-13 Nogra Pharma Limited Methods for preventing or reducing colon carcinogenesis
US10016381B2 (en) 2005-07-22 2018-07-10 Nogra Pharma Limited Compounds and their salts specific to the PPAR receptors and the EGF receptors and their use in the medical field
US11905232B2 (en) 2019-02-08 2024-02-20 Nogra Pharma Limited Process of making 3-(4′-aminophenyl)-2-methoxypropionic acid, and analogs and intermediates thereof

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DIGESTIVE DISEASE WEEK AND THE 93RD ANNUAL MEETING OF THE AMERICAN GASTROENTEROLOGICAL ASSOCIATION, SAN FRANCISCO, CALIFORNIA, USA, MAY 9-15, 1992. GASTROENTEROLOGY, 102 (4 PART 2). 1992. A601., XP000612207 CASELLAS F ET AL: "IN-VIVO QUANTIFICATION OF INTRACOLONIC EICOSANOID RELEASE IN ACTIVE CHRONIC ULCERATIVE COLITIS AFTER INHIBITION OF THROMBOXANE SYNTHETASE BY RIDOGREL" cited in the application *
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WO1998015265A1 (en) * 1996-10-04 1998-04-16 Danbiosyst Uk Limited Colonic delivery of weak acid drugs
WO2002072069A1 (en) * 2001-03-12 2002-09-19 Novo Nordisk A/S Novel tablets and capsules and a process for its preparation
US10016381B2 (en) 2005-07-22 2018-07-10 Nogra Pharma Limited Compounds and their salts specific to the PPAR receptors and the EGF receptors and their use in the medical field
US9913817B2 (en) 2008-12-05 2018-03-13 Nogra Pharma Limited Methods for preventing or reducing colon carcinogenesis
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Also Published As

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AU5397496A (en) 1996-10-16
IL117670A (en) 2000-02-29
CA2215160A1 (en) 1996-10-03
NO974486D0 (en) 1997-09-29
JPH10511097A (en) 1998-10-27
HUP9900309A2 (en) 1999-05-28
MX9707394A (en) 1997-11-29
HUP9900309A3 (en) 1999-11-29
IL117670A0 (en) 1996-07-23
NO974486L (en) 1997-09-29
EP0817631A2 (en) 1998-01-14
AR002727A1 (en) 1998-04-29
ZA962461B (en) 1997-09-29
WO1996030016A3 (en) 1997-01-30

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