WO2001000675A1 - Compositions insuliniques acylees insolubles exemptes de protamine - Google Patents

Compositions insuliniques acylees insolubles exemptes de protamine Download PDF

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WO2001000675A1
WO2001000675A1 PCT/US2000/015037 US0015037W WO0100675A1 WO 2001000675 A1 WO2001000675 A1 WO 2001000675A1 US 0015037 W US0015037 W US 0015037W WO 0100675 A1 WO0100675 A1 WO 0100675A1
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insulin
crystals
human insulin
protein
acid
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PCT/US2000/015037
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English (en)
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Mark Laurence Brader
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Eli Lilly And Company
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Priority to AU54542/00A priority Critical patent/AU5454200A/en
Priority to EP00939458A priority patent/EP1196446A1/fr
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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K14/00Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/575Hormones
    • C07K14/62Insulins
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides

Definitions

  • This invention is in the field of human medicine. More particularly, this invention is in the field of pharmaceutical treatment of the diseases of diabetes and hyperglycemia .
  • a rapid acting meal time insulin provided by bolus injections and a long-acting, so- called, basal insulin, administered by injection once or twice daily to control blood glucose levels between meals.
  • An ideal basal insulin will provide an extended and "flat" time action - that is, it will control blood glucose levels for at least 12 hours, and preferably for 24 hours or more, without significant risk of hypoglycemia .
  • an ideal basal insulin should be mixable with a soluble mealtime insulin, and should not cause irritation or reaction at the site of administration.
  • long-acting insulin formulations have been obtained by formulating normal insulin as microcrystalline suspensions for subcutaneous injection.
  • Examples of commercial insulin preparations used for basal insulin therapy include NPH (Neutral Protamine Hagedorn) insulin, protamine zinc insulin (PZI) , and ultralente (UL) .
  • NPH Neutral Protamine Hagedorn
  • PZI protamine zinc insulin
  • UL ultralente
  • These formulations are suspension formulations whereby prolonged insulin activity is achieved by the slow dissolution of solid insulin particles at the subcutaneous site resulting in sustained insulin absorption into the bloodstream. Dissolution of the solid insulin particles at the subcutaneous site is thus the rate-controlling step in determining the pharmacodynamics and pharmacokinetics .
  • the therapeutic characteristics of insulin suspension formulations critical to their efficacy include; the time of onset of insulin activity, the duration of insulin effect, the time and magnitude of maximal effect (i.e. peak), and the overall pharmacokinetic profile.
  • the solid insulin particles of NPH and PZI formulations incorporate protamine which is essential to stabilizing these particular formulations .
  • the term "protamine” refers to a mixture of strongly basic proteins obtained from fish sperm.
  • the solid insulin particles of the ultralente formulation do not contain protamine.
  • Ultralente insulin is a microcrystalline complex of insulin and zinc formulated in an aqueous diluent containing methylparaben, sodium acetate, and sodium chloride.
  • One advantage of the ultralente formulation is the absence of protamine which can cause allergic reactions and injection site inflammation [Galloway J. and deShazo, R.
  • Ultralente insulin is currently available commercially incorporating reco binant human insulin and was formerly available commercially incorporating pork insulin, beef insulin, or mixtures thereof.
  • the availability of recombinant human insulin in the 1980s resulted in the human ultralente product superceding the animal ultralente products and the latter ceased to be commercially available.
  • the advantage of human ultralente is that its manufacture does not rely on a source of animal pancreases, and the immunogenicity of the human insulin amino acid sequence is less than that of pork insulin and substantially less than that of beef insulin (Ottesen J. et al . Diabetologia (1994) 37:1178-1185).
  • Immunogenicity results in the generation of antibodies to insulin which delay the effect of regular insulin administered to control meal glycemia. Immunogenicity has been recognized as a particular problem with beef insulin suspension formulations [Galloway J. & Chance R. Horm. Met. Res. 26:591-598 (1994)].
  • Human ultralente while lacking in immunogenicity, provides only intermediate time action that is not suitably flat for effective basal insulin therapy.
  • a single daily injection of human ultralente does not provide adequate basal glycemic control and, due to its substantial phar acokinetic peak, can result in undesirably high levels of insulin in the blood which may cause life-threatening hypoglycemia .
  • solid insulin preparations that do not require phenolic preservatives or protamine as stabilizing agents are preferred since protamine and phenolic preservatives are likely to act as irritants in the lung and are, therefore, undesirable in insulin preparations for inhalation. It is a further object of the present invention to provide solid acylated insulin compositions and solid mixture compositions of acylated insulins and insulin that do not contain phenolic preservatives and do not contain protamine that may be used as pulmonary hypoglycemic agents.
  • WO95/07931, 23 March 1995 Their extended time action is caused by binding of the fatty acyl portion of these molecules to serum albumin.
  • the fatty acyl chain lengths of these molecules is such as to take advantage of the fatty acid binding capability of serum albumin.
  • the fatty acid chains used in fatty acid-acylated insulins are typically longer than about ten carbon atoms, and chain lengths of fourteen and sixteen carbon atoms are optimal for binding to serum albumin and extending time action.
  • ultralente insulin which is insoluble
  • the aforementioned fatty acid-acylated insulins are soluble at the usual therapeutic concentrations of insulin.
  • ultralente-like compositions that include an acylated insulin and zinc can be prepared and that ultralente-like compositions that include a mixture of an acylated insulin and insulin and zinc can be prepared.
  • the insoluble compositions are expected to provide flexibility of control over the duration and shape of the glucodynamic response profile. They are thought to function as controlled release compositions, wherein, the release rate is controlled by the proportion and nature of the derivatized protein.
  • compositions of acylated insulins and mixtures of acylated insulins with insulin there are no examples known to me of compositions of acylated insulins and mixtures of acylated insulins with insulin, as those terms are to be understood in the context of the present disclosure.
  • the closest art relates to crystals comprised of proinsulin and insulin [Steiner, D. F., Nature 243:528-530
  • Steiner produced crystals comprised of proinsulin and insulin with mole ratios of about 1:11, 1:5, 1:2, and 1:1, respectively (i.e., 0.5, 1, 2, and 3 moles of proinsulin per 6 moles total insulin and proinsulin) in 0.095 M sodium citrate, pH 6.0, 0.03 M NaCl, 0.012 M ZnC12 , and 16% acetone.
  • the proportion of proinsulin greatly affected the rate of crystallization.
  • the crystals differed greatly from those of pure insulin under the same conditions, and were characterized as rhombohedral crystals with rounded borders. There was great variability within and between preparations.
  • Dorschug, M., et al . disclosed crystals comprised of insulin, des(PheBl) insulin, des(ThrB30) human insulin, or des(AlaB30) beef insulin, and at least one insulin having a basic modification at the C-terminal end of the B chain ("modified insulin").
  • modified insulins are disclosed, for example, in European Patent Application No. 132,769.
  • Globin or protamine sulfate were stated to be auxiliary compounds that could be used in the crystal preparations. There are no examples of the use of protamine, nor any suggestion that the inventors appreciated the effect of adding such compounds.
  • the modified insulins used in Dorschug, et al . are different than the derivatives used in the present invention.
  • the present invention is based on the surprising discovery that it is possible to prepare ultralente-like crystals with acylated insulins as well as ultralente-like co-crystals containing a mixture of acylated insulin and insulin.
  • the ultralente-like crystals described in this invention were prepared and characterized by HPLC .
  • the present invention provides microcrystalline compositions of acylated insulins and microcrystalline mixture compositions of acylated insulin and insulin to provide therapeutic basal insulin activity without the use of insulin from animal sources, avoiding the immunogenicity of beef insulin, and without the use of protamine.
  • the present invention also provides easily filterable microcrystalline compositions of acylated insulins and microcrystalline compositions of acylated insulin and insulin mixtures.
  • the present invention provides insoluble compositions comprising a derivatized protein selected from the group consisting of acylated insulin derivatives and acylated insulin analog derivatives, a protein selected from the group consisting of insulin and insulin analogs, and a divalent metal cation.
  • the insoluble compositions of the present invention are in the form of microcrystals, or in the form of mixtures of microcrystals and amorphous precipitates. These insoluble compositions are useful for treating diabetes and hyperglycemia, and provide the advantages of having flatter and longer time action than NPH insulin.
  • the extent of protraction of the time action can be finely controlled over a very great range of time-action, from that nearly the same as NPH insulin to much greater than that of NPH insulin.
  • the present invention is distinct from previous fatty acid-acylated insulin technology in that the extension of time action of the present invention does not rely necessarily on albumin-binding, though albumin binding may further protract the time action of certain of the compositions of the present invention.
  • the microcrystals of the present invention are useful for treating diabetes and for controlling blood glucose in a patient in need thereof.
  • the invention provides aqueous suspension formulations comprising an insoluble composition and an aqueous solvent.
  • One such aqueous suspension formulation is comprised of a microcrystalline composition of the present invention and an aqueous solvent.
  • the formulations of the present invention have superior pharmacodynamics compared with human insulin NPH, and their time-action can be purposefully selected over a wide range, from just slightly extended compared with human insulin NPH to very greatly extended compared with human insulin NPH.
  • the invention provides a method of treating diabetes or hyperglycemia comprising, administering to a patient in need thereof a sufficient quantity of an insoluble composition of the present invention to regulate blood glucose levels in the patient.
  • co-crystal means a microcrystal of the present invention.
  • insoluble composition refers to matter in either a microcrystalline state or in an amorphous precipitate state, or both. The presence of microcrystals or amorphous precipitate can be ascertained by visual and microscopic examination. Solubility depends on solvent, and a particular composition may be insoluble in one solvent, but soluble in another.
  • microcrystal means a solid that is comprised primarily of matter in a crystalline state, wherein the individual crystals are predominantly of a single crystallographic composition and are of a microscopic size, typically of longest dimension within the range 1 micron to 100 microns.
  • microcrystalline refers to the state of being a microcrystal.
  • amorphous precipitate refers to insoluble protein or derivatized protein that is not crystalline in form. The person of ordinary skill can distinguish crystals from amorphous precipitate.
  • the amorphous precipitates of the present invention have advantageous pharmacological properties in their own right, and also are intermediates in the formation of the microcrystals of the present invention.
  • protein may have its common meaning, that is, a polymer of amino acids.
  • protein as used herein, also has a narrower meaning, that is, a protein selected from the group consisting of insulin and insulin analogs.
  • un-derivatized protein also refers to a protein selected from the group consisting of insulin and insulin analogs.
  • total protein refers to the combined amount of protein (insulin or insulin analog) and derivatized protein (derivatized insulin or a derivatized insulin analog) .
  • derivatized protein refers to a protein selected from the group consisting of derivatized insulin and derivatized insulin analogs that is derivatized by a functional group such that the derivatized protein is less soluble in an aqueous solvent than is the un-derivatized protein.
  • derivatized proteins are known in the art, and the determination of solubility of proteins and derivatized proteins is well known to the skilled person.
  • Examples of derivatized insulin and insulin analogs include benzoyl, p-tolyl-sulfonamide carbonyl, and indolyl derivatives of insulin and insulin analogs [Havelund, S., et al .
  • alkyloxycarbonyl derivatives of insulin [Geiger, R., et al . , U.S. Patent No. 3,684,791, issued 15 August 1972; Brandenberg, D. , et al . , U.S. 3,907,763, issued 23 September 1975] ; aryloxycarbonyl derivatives of insulin [Brandenberg, D., et al . , U.S. 3,907,763, issued 23 September 1975]; alkylcarba yl derivatives [Smyth, D. G., U.S. Patent No.
  • acylated protein refers to a derivatized protein selected from the group consisting of insulin and insulin analogs that is acylated with an organic acid moiety that is bonded to the protein through an amide bond formed between the acid group of an organic acid compound and an amino group of the protein.
  • the amino group may be the ⁇ -amino group of an N-terminal amino acid of the protein, or may be the ⁇ -amino group of a Lys residue of the protein.
  • An acylated protein may be acylated at one or more of the three amino groups that are present in insulin and in most insulin analogs.
  • Mono-acylated proteins are acylated at a single amino group.
  • Di-acylated proteins are acylated at two amino groups.
  • Tri-acylated proteins are acylated at three amino groups.
  • the organic acid compound may be, for example, a fatty acid, an aromatic acid, or any other organic compound having a carboxylic acid group that will form an amide bond with an amino group of a protein, and that will cause the aqueous solubility of the derivatized protein to be lower than the solubility of the un-derivatized protein.
  • fatty acid-acylated protein refers to a an acylated protein selected from the group consisting of insulin and insulin analogs that is acylated with a fatty acid that is bonded to the protein through an amide bond formed between the acid group of the fatty acid and an amino group of the protein.
  • the amino group may be the ⁇ -amino group of an N-terminal amino acid of the protein, or may be the ⁇ -amino group of a Lys residue of the protein.
  • a fatty acid-acylated protein may be acylated at one or more of the three amino groups that are present in insulin and in most insulin analogs.
  • Mono-acylated proteins are acylated at a single amino group.
  • Di-acylated proteins are acylated at two amino groups. Tri-acylated proteins are acylated at three amino groups.
  • Fatty acid-acylated insulin is disclosed in a Japanese patent application 1-254,699. See also, Hashimoto, M. , et al . , Pharmaceu tical Research, 6:171-176 (1989), and Lindsay, D. G., et al., Biochemical J. 121:737-745 (1971). Further disclosure of fatty acid- acylated insulins and fatty acylated insulin analogs, and of methods for their synthesis, is found in Baker, J. C, et al , U.S. 08/342,931, filed 17 November 1994 and issued as U.S. Patent No.
  • fatty acid-acylated protein includes pharmaceutically acceptable salts and complexes of fatty acid-acylated proteins.
  • fatty acid-acylated protein also includes preparations of acylated proteins wherein the population of acylated protein molecules is homogeneous with respect to the site or sites of acylation.
  • N ⁇ -mono-acylated protein, Bl-N ⁇ - ono-acylated protein, Al-N ⁇ -mono-acylated protein, Al , Bl-N ⁇ -di-acylated protein, NE, Al-N ⁇ , di-acylated protein, N ⁇ , Bl-N ⁇ , di-acylated protein, and N ⁇ ,Al, Bl-N ⁇ , tri-acylated protein are all encompassed within the term "fatty acid-acylated protein" for the purpose of the present invention.
  • the term also refers to preparations wherein the population of acylated protein molecules has heterogeneous acylation.
  • fatty acid-acylated protein includes mixtures of mono-acylated and di-acylated proteins, mixtures of mono-acylated and tri-acylated proteins, mixtures of di- acylated and tri-acylated proteins, and mixtures of mono- acylated, di-acylated, and tri-acylated proteins.
  • insulin refers to human insulin, whose amino acid sequence and special structure are well known. Human insulin is comprised of a twenty-one amino acid A-chain and a thirty-amino acid B-chain which are cross-linked by disulfide bonds. A properly cross-linked insulin contains three disulfide bridges: one between position 7 of the A-chain and position 7 of the B-chain, a second between position 20 of the A-chain and position 19 of the B-chain, and a third between positions 6 and 11 of the A-chain.
  • insulin analog means proteins that have an A-chain and a B-chain that have substantially the same amino acid sequences as the A-chain and B-chain of human insulin, respectively, but differ from the A-chain and B-chain of human insulin by having one or more amino acid deletions, one or more amino acid replacements, and/or one or more amino acid additions that do not destroy the insulin activity of the insulin analog.
  • Animal insulins are analogs of human insulin, and therefore, are insulin analogs, as defined herein.
  • Four such animal insulins are rabbit, pork, beef, and sheep insulin.
  • the amino acid substitutions that distinguish these animal insulins from human insulin are presented below for the reader's convenience.
  • Monomeric insulin analogs are structurally very similar to human insulin, and have activity similar or equal to human insulin, but have one or more amino acid deletions, replacements or additions that tend to disrupt the contacts involved in dimerization and hexamerization which results in their greater tendency to dissociate to less aggregated states.
  • Monomeric insulin analogs are rapid-acting analogs of human insulin, and are disclosed, for example, in Chance, R. E., et al . , U.S. patent No.
  • monomeric insulin analogs is described as human insulin wherein Pro at position B28 is substituted with Asp, Lys, Leu, Val, or Ala, and wherein Lys at position B29 is Lys or is substituted with Pro, and also, AlaB26-human insulin, des (B28-B30)- human insulin, and des (B27) -human insulin.
  • the monomeric insulin analogs employed as derivatives in the present crystals, or employed un-derivatized in the solution phase of suspension formulations, are properly cross-linked at the same positions as is human insulin.
  • Another group of insulin analogs consists of insulin analogs that have one or more amino acid deletions that do not significantly disrupt the activity of the molecule.
  • This group of insulin analogs is designated herein as "deletion analogs.”
  • insulin analogs with deletion of one or more amino acids at positions B1-B3 are active.
  • insulin analogs with deletion of one or more amino acids at positions B28-B30 are active.
  • Examples of “deletion analogs” include des (B30) -human insulin, desPhe (Bl ) -human insulin, des (B27 ) -human insulin, des (B28-B30) -human insulin, and des (B1-B3 ) -human insulin.
  • the deletion analogs employed as derivatives in the present crystals, or employed un-derivatized in the solution phase of suspension formulations are properly cross-linked at the same positions as is human insulin.
  • an insulin analog may be insulin or an insulin analog that has one or more of its amidated residues replaced with other amino acids for the sake of chemical stability.
  • Asn or Gin may be replaced with a non-amidated amino acid.
  • Preferred amino acid replacements for Asn or Gin are Gly, Ser, Thr, Asp or Glu. It is preferred to replace one or more Asn residues.
  • AsnAl ⁇ , AsnA21, or AsnB3 , or any combination of those residues may be replaced by Gly, Asp, or Glu, for example.
  • GlnA15 or GlnB4 , or both, may be replaced by either Asp or Glu.
  • Preferred replacements are Asp at B21, and Asp at B3.
  • a "pharmaceutically acceptable salt” means a salt formed between any one or more of the charged groups in a protein and any one or more pharmaceutically acceptable, non-toxic cations or anions.
  • Organic and inorganic salts include, for example, those prepared from acids such as hydrochloric, sulfuric, sulfonic, tartaric, fumaric, hydrobromic, glycolic, citric, maleic, phosphoric, succinic, acetic, nitric, benzoic, ascorbic, p-toluenesulfonic, benzenesulfonic, naphthalenesulfonic, propionic, carbonic, and the like, or for example, ammonium, sodium, potassium, calcium, or magnesium.
  • acids such as hydrochloric, sulfuric, sulfonic, tartaric, fumaric, hydrobromic, glycolic, citric, maleic, phosphoric, succinic, acetic, nitric, benzoic, ascorbic, p-toluenesulfonic, benzenesulfonic, naphthalenesulfonic, propionic, carbonic, and the like, or for example, ammoni
  • acylate means to form the amide bond between a fatty acid and an amino group of a protein.
  • a protein is “acylated” when one or more of its amino groups is combined in an amide bond with the acid group of a fatty acid.
  • fatty acid means a saturated or unsaturated, straight chain or branched chain fatty acid, having from one to eighteen carbon atoms.
  • Cl to C18 fatty acid refers to a saturated, straight chain or branched chain fatty acid having from one to eighteen carbon atoms .
  • divalent metal cation refers to the ion or ions that participate to form a complex with a multiplicity of protein molecules.
  • the transition metals, the alkaline metals, and the alkaline earth metals are examples of metals that are known to form complexes with insulin.
  • the transition metals are preferred.
  • Zinc is particularly preferred.
  • Other transition metals that may be pharmaceutically acceptable for complexing with insulin proteins include copper, cobalt, and iron.
  • complex has two meanings in the present invention.
  • the term refers to a complex formed between one or more atoms in the proteins that form the complex and one or more divalent metal cations.
  • the atoms in the proteins serve as electron-donating ligands.
  • the proteins typically form a hexamer complex with divalent transition metal cations.
  • suspension refers to a mixture of a liquid phase and a solid phase that consists of insoluble or sparingly soluble particles that are larger than colloidal size. Mixtures of ultralente-like microcrystals and an aqueous solvent form suspensions. Mixtures of amorphous precipitate and an aqueous solvent also form a suspension.
  • the term "suspension formulation” means a pharmaceutical composition wherein an active agent is present in a solid phase, for example, a microcrystalline solid, an amorphous precipitate, or both, which is finely dispersed in an aqueous solvent.
  • the finely dispersed solid is such that it may be suspended in a fairly uniform manner throughout the aqueous solvent by the action of gently agitating the mixture, thus providing a reasonably uniform suspension from which a dosage volume may be extracted.
  • Examples of commercially available insulin suspension formulations include, for example, NPH, PZI, and ultralente.
  • a small proportion of the solid matter in a microcrystalline suspension formulation may be amorphous.
  • the proportion of amorphous material is less than 10%, and most preferably, less than 1% of the solid matter in a microcrystalline suspension.
  • a small proportion of the solid matter in an amorphous precipitate suspension may be microcrystalline.
  • Ultralente-like crystals refers to crystals of the present invention that are morphologically similar or identical to the ultralente crystals described in Schlichtkrull U.S. Patent 2,799,622, issued July 16, 1957, U.S. Patent 2,819, 999, issued Jan. 14, 1958, and Insulin Crystals, by Schlichtkrull, Ejnar Munksgaard Publishers, Copenhagen (1958) .
  • Ultralente-like crystals are comprised of an insulin derivative and optionally insulin or an insulin analog, and zinc.
  • the crystals of the present invention have rhombohedral morphology or an irregular morphology.
  • seed crystals is well known to one of ordinary skill in the art. It refers to a preparation of insulin-related crystals involving lyophilization as described in Schlichtkrull, U. S. Patent 2,819,999 issued Jan. 14, 1958.
  • aqueous solvent refers to a liquid solvent that contains water.
  • An aqueous solvent system may be comprised solely of water, may be comprised of water plus one or more miscible solvents, and may contain solutes.
  • miscible solvents are the short-chain organic alcohols, such as, methanol, ethanol, propanol, short-chain ketones, such as acetone, and polyalcohols , such as glycerol .
  • an “isotonicity agent” is a compound that is physiologically tolerated and imparts a suitable tonicity to a formulation to prevent the net flow of water across cell membranes that are in contact with an administered formulation.
  • Glycerol which is also known as glycerin, is commonly used as an isotonicity agent.
  • Other isotonicity agents include salts, e . g. , sodium chloride, and monosaccharides, e . g. , dextrose and lactose.
  • the term "preservative” refers to a compound added to a pharmaceutical formulation to act as an anti-microbial agent. A parenteral formulation must meet guidelines for preservative effectiveness to be a commercially viable multi-use product.
  • preservatives known in the art as being effective and acceptable in parenteral formulations are benzalkonium chloride, benzethonium, chlorohexidine, phenol, m-cresol, benzyl alcohol, methylparaben, chlorobutanol, o-cresol, p-cresol, chlorocresol, phenylmercurie nitrate, thimerosal, benzoic acid, and various mixtures thereof. See, e . g. , Wall pruner, K.-H.,
  • phenolic preservative includes the compounds phenol, m-cresol, o-cresol, p-cresol, chlorocresol , methylparaben, and mixtures thereof.
  • Certain phenolic preservatives, such as phenol and m-cresol are known to bind to insulin-like molecules and thereby to induce conformational changes that increase either physical or chemical stability, or both [Birnbaum, D. T., et al . , Pharmaceutical . Res . 14:25-36 (1997); Rahuel-Clermont , S., et al . , Biochemistry 36:5837-5845 (1997)].
  • buffer or “pharmaceutically acceptable buffer” refers to a compound that is known to be safe for use in insulin formulations and that has the effect of controlling the pH of the formulation at the pH desired for the formulation.
  • the pH of the formulations of the present invention is from about 6.0 to about 8.0.
  • the formulations of the present invention have a pH between about 6.8 and about 7.8.
  • Pharmaceutically acceptable buffers for controlling pH at a moderately acidic pH to a moderately basic pH include such compounds as phosphate, acetate, citrate, arginine, TRIS, and histidine.
  • TRIS arginine
  • TRIS arginine
  • TRIS is also known in the art as trimethylol aminomethane, tromethamine, and tris (hydroxymethyl) aminomethane.
  • Other buffers that are pharmaceutically acceptable, and that are suitable for controlling pH at the desired level are known to the chemist of ordinary skill.
  • administer means to introduce a formulation of the present invention into the body of a patient in need thereof to treat a disease or condition.
  • treating refers to the management and care of a patient having diabetes or hyperglycemia, or other condition for which insulin administration is indicated for the purpose of combating or alleviating symptoms and complications of those conditions. Treating includes administering a formulation of present invention to prevent the onset of the symptoms or complications, alleviating the symptoms or complications, or eliminating the disease, condition, or disorder.
  • the insoluble compositions of the present invention may comprise crystals with rhombohedral morphology or with an irregular morphology, or they may comprise amorphous precipitates.
  • a preferred group of insulin analogs for preparing derivatized insulin analogs used to form crystals and co- crystals consists of animal insulins, deletion analogs, and pl-shifted analogs.
  • a more preferred group consists of animal insulins and deletion analogs. Deletion analogs are yet more preferred.
  • Another preferred group of insulin analogs for use in the crystals and co-crystals of the present invention consists of the monomeric insulin analogs.
  • Particularly preferred are those monomeric insulin analogs wherein the amino acid residue at position B28 is Asp, Lys, Leu, Val, or Ala, the amino acid residue at position B29 is Lys or Pro, the amino acid residue at position B10 is His or Asp, the amino acid residue at position Bl is Phe, Asp or deleted alone or in combination with a deletion of the residue at position B2 , the amino acid residue at position B30 is Thr, Ala, Ser, or deleted, and the amino acid residue at position B9 is Ser or Asp; provided that either position B28 or B29 is Lys.
  • pi-shifted insulin analogs include, for example, ArgB31, ArgB32-human insulin, GlyA21, ArgB31,ArgB32-human insulin, ArgAO , ArgB31 , ArgB32- human insulin, and ArgAO , GlyA21 , rgB31 , ArgB32-human insulin.
  • Another preferred group of insulin analogs consists of LysB28, ProB29-human insulin (B28 is Lys; B29 is Pro) ; AspB28-human insulin (B28 is Asp) , AspBl-human insulin, ArgB31 , ArgB32-human insulin, ArgAO-human insulin, AspBl, GluBl3-human insulin, AlaB26-human insulin, GlyA21- human insulin, des (ThrB30) -human insulin, and GlyA21 , ArgB31 , ArgB32-human insulin.
  • Especially preferred insulin analogs include LysB28, ProB29-human insulin, des (ThrB30 ) -human insulin, AspB28-human insulin, and AlaB26-human insulin.
  • Another especially preferred insulin analog is GlyA21, ArgB31, ArgB32-human insulin [Dorschug, M. , U. S. Patent No. 5,656,722, 12 August 1997].
  • the most preferred insulin analog is LysB28, ProB29-human insulin.
  • the preferred derivatized proteins are acylated proteins, and the preferred acylated proteins for the microcrystals and formulations of the present invention are fatty acid-acylated insulin and fatty acid-acylated insulin analogs.
  • Fatty acid-acylated human insulin is highly preferred.
  • Fatty acid-acylated insulin analogs are also highly preferred.
  • the particular group used to derivatize insulin or an insulin analog may be any chemical moiety that does not significantly reduce the biological activity of the protein, is not toxic when bonded to the protein, and most importantly, reduces the aqueous solubility, raises the lipophilicity, or decreases the solubility of zinc complexes of the derivatized protein.
  • One preferred group of acylating moieties consists of fatty acids that are straight chain and saturated.
  • This group consists of methanoic acid (CD, ethanoic acid (C2), propanoic acid (C3), n-butanoic acid (C4), n-pentanoic acid (C5), n-hexanoic acid (C6), n-heptanoic acid (C7), n- octanoic acid (C8), n-nonanoic acid (C9), n-decanoic acid (CIO), n-undecanoic acid (CH) , n-dodecanoic acid (C12), n- tridecanoic acid (C13), n-tetradecanoic acid (C14), n- pentadecanoic acid (C15) , n-hexadecanoic acid (C16) , n- heptadecanoic acid (C17), and n-octadecanoic acid (C18).
  • CD methanoic acid
  • Adjectival forms are formyl (Cl), acetyl (C2), propionyl (C3), butyryl (C4), pentanoyl (C5), hexanoyl (C6), heptanoyl (C7), octanoyl (C8), nonanoyl (C9), decanoyl (CIO), undecanoyl (CH), dodecanoyl (C12), tridecanoyl (C13), tetradecanoyl (C14) or myristoyl, pentadecanoyl (C15), hexadecanoyl (C16) or palmitic, heptadecanoyl (C17), and octadecanoyl (C18) or stearic.
  • a preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having an even number of carbon atoms - that is, C2 , C4 , C6, C8, CIO, C12 , C14, C16, and C18 saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having an odd number of carbon atoms - that is, Cl, C3 , C5, C7 , C9, CH, C13, C15, and C17 saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having more than 5 carbon atoms - that is, C6, C7 , C8, C9 , CIO, CH, C12, C13, C14, C15, C16, C17, and C18 saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having less than 9 carbon atoms - that is, Cl, C2 , C3 , C4 , C5, C6, C7 , and C8 saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having between 6 and 8 carbon atoms - that is, C6, C7 , and C8, saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having more than between 4 and 6 carbon atoms - that is, C4 , C5, and C6, saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having more than between 2 and 4 carbon atoms - that is, C2 , C3 , and C4 , saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having less than 6 carbon atoms - that is, Cl, C2 , C3 , C4 , and C5 saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having less than 4 carbon atoms - that is, Cl, C2 , and C3 saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having more than 9 carbon atoms - that is, CIO, CH, C12 , C13 , C14, C15, C16, C17, and C18 saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having an even number of carbon atoms and more than 9 carbon atoms - that is, CIO, C12 , C14, C16, and C18 saturated fatty acids.
  • fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having 12, 14, or 16 carbon atoms, that is, C12 , C14, and C16 saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having 14 or 16 carbon atoms, that is, C14 and C16 saturated fatty acids. Fatty acids with 14 carbons are particularly preferred. Fatty acids with 16 carbons are also particularly preferred.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of saturated fatty acids having between 4 and 10 carbon atoms, that is C4 , C5, C6, C7, C8, C9, and CIO saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of saturated fatty acids having an even number of carbon atoms between 4 and 10 carbon atoms, that is C4, C6, C8, and CIO saturated fatty acids.
  • Another preferred group of fatty acids for forming the fatty acid-acylated proteins used in the microcrystals of the present invention consists of fatty acids having 6, 8, or 10 carbon atoms. Fatty acids with 6 carbons are particularly preferred. Fatty acids with 8 carbons are also particularly preferred. Fatty acids with 10 carbons are particularly preferred. The skilled person will appreciate that narrower preferred groups are made by combining the preferred groups of fatty acids described above.
  • a branched fatty acid has at least two branches.
  • the length of a "branch" of a branched fatty acid may be described by the number of carbon atoms in the branch, beginning with the acid carbon.
  • the branched fatty acid 3-ethyl- 5-methylhexanoic acid has three branches that are five, six, and six carbons in length.
  • the "longest" branch is six carbons.
  • 2,3,4,5- tetraethyloctanoic acid has five branches that are 4, 5, 6, 7, and 8 carbons long.
  • the "longest” branch is eight carbons.
  • a preferred group of branched fatty acids are those having from three to ten carbon atoms in the longest branch.
  • Carbons 2-methyl-butyric acid, 3-methyl-butyric acid, 2, 2-dimethyl-propionic acid, 6 Carbons : 2-methyl-pentanoic acid, 3-methyl- pentanoic acid, 4-methyl-pentanoic acid, 2 , 2-dimethyl- butyric acid, 2 , 3-dimethyl-butyric acid, 3 , 3-dimethyl- butyric acid, 2-ethyl-butyric acid.
  • acylating moieties consists of cyclic alkyl acids having from 5 to 24 carbon atoms, wherein the cyclic alkyl moiety, or moieties, have 5 to 7 carbon atoms .
  • cyclic alkyl acids A representative number of such cyclic alkyl acids will be mentioned to assure the reader's comprehension of the range of such acids that may be used as acylating moieties of the proteins in the present invention: cyclopentyl-formic acid, cyclohexyl-formic acid, 1- cyclopentyl-acetic acid, 2-cyclohexyl-acetic acid, 1,2- dicyclopentyl-acetic acid, and the like.
  • a preferred group of derivatized proteins consists of mono-acylated proteins. Mono-acylation at the ⁇ -amino group is most preferred. For insulin, mono-acylation at LysB29 is preferred. Similarly, for certain insulin analogs, such as, LysB28 , ProB29-human insulin analog, mono- acylation at the ⁇ -amino group of LysB28 is most preferred.
  • Mono-acylation at the ⁇ -amino group of the B-chain (Bl) is also preferred.
  • Mono-acylation at the ⁇ -amino group of the A-chain (Al) is also preferred.
  • acylated proteins consists of di- acylated proteins.
  • the di-acylation may be, for example, at the ⁇ -amino group of Lys and at the ⁇ -amino group of the B- chain, or may be at the ⁇ -amino group of Lys and at the ⁇ - amino group of the A-chain, or may be at the ⁇ -amino group the A-chain and at the ⁇ -amino group of the B-chain.
  • Another group of acylated proteins consists of tri-acylated proteins. Tri-acylated proteins are those that are acylated at the ⁇ -amino group of Lys, at the ⁇ -amino group of the B-chain, and at the ⁇ -amino group of the A- chain.
  • Aqueous compositions containing water as the major solvent are preferred.
  • Aqueous suspensions wherein water is the solvent are highly preferred.
  • compositions of the present invention further comprises a divalent metal cation.
  • the transition metals are preferred. Zinc is particularly preferred.
  • Other transition metals that may be pharmaceutically acceptable for complexing with insulin proteins include copper, cobalt and iron.
  • the primary role of divalent metal cations such as zinc in the present invention is to facilitate formation of hexamers of the protein.
  • Zinc facilitates the formation of hexamers of insulin, animal insulins and insulin analogs.
  • Zinc likewise promotes the formation of hexamers of derivatized insulin, insulin analogs and animal insulins.
  • composition of the present invention may further comprise a buffer, preferably a pharmaceutically acceptable buffer.
  • buffers include TRIS and acetate .
  • compositions of the present invention may further comprise a preservative.
  • preservatives include phenol, m-cresol and methylparaben.
  • the most preferred preservative is methylparaben.
  • compositions of the present invention may further comprise an isotonicity agent.
  • Preferred isotonicity agents include glycerol and sodium chloride, with sodium chloride most preferred.
  • the composition of the present invention may further comprise additional pharmaceutically acceptable excipients designed for various purposes, such as maintaining formulation stability, maintaining particle resuspendability, preventing particle clumping, and the like. Such excipients are known to one skilled in the art or may be determined experimentally and are described in references such as Remington's Pharmaceutical Sciences, 17 , th Edition, Mack Publishing Company, Easton, PA, USA (1985) and Handbook of Pharmaceutical Excipients, 2 nd Edition, American Pharmaceutical Association, Washington, D.C., USA (1995).
  • compositions of the present invention are used to treat patients who have diabetes or hyperglycemia.
  • the formulations of the present invention will typically provide derivatized protein at concentrations of from about 1 mg/mL to about 10 mg/mL.
  • Present formulations of insulin products are typically characterized in terms of the concentration of units of insulin activity (units/mL) , such as U40, U50, U100, and so on, which correspond roughly to about 1.4, 1.75, and 3.5 mg/mL preparations, respectively.
  • the dose, route of administration, and the number of administrations per day will be determined by a physician considering such factors as the therapeutic objectives, the nature and cause of the patient's disease, the patient's gender and weight, level of exercise, eating habits, the method of administration, and other factors known to the skilled physician.
  • a daily dose would be in the range of from about 1 nmol/kg body weight to about 6 nmol/kg body weight (6 nmol is considered equivalent to about 1 unit of insulin activity) .
  • a dose of between about 2 and about 3 nmol/kg is typical of present insulin therapy.
  • the physician of ordinary skill in treating diabetes will be able to select the therapeutically most advantageous means to administer the formulations of the present invention. Parenteral routes of administration are preferred.
  • Typical routes of parenteral administration of suspension formulations of insulin are the subcutaneous and intramuscular routes.
  • the compositions and formulations of the present invention may also be administered by nasal, buccal, pulmonary, or occular routes.
  • the compositions of the present invention are considered particularly advantageous for pulmonary delivery.
  • Methylparaben is the preferred preservative in formulations of the present invention.
  • Insulin or insulin analogs used to prepare derivatized proteins can be prepared by any of a variety of recognized peptide synthesis techniques including classical (solution) methods, solid phase methods, semi-synthetic methods, and more recent recombinant DNA methods. For example, see Chance, R. E., et al . , U.S. Patent No. 5,514,646, 7 May 1996; EPO publication number 383,472, 7 February 1996; Brange, J. J. V., et al . EPO publication number 214,826, 18 March 1987; and Belagaje, R. M. , et al . , U.S. Patent No. 5,304,473, 19 April 1994, which disclose the preparation of various proinsulin and insulin analogs.
  • acylated insulins are prepared using methods known in the art.
  • the publications listed above to describe derivatized proteins contain suitable methods to prepare derivatized proteins.
  • acylated proteins are derivatives of commonly employed acylating agents, and include activated esters of fatty acids, fatty acid halides, activated amides of fatty acids, such as, activated azolide derivatives [Hansen, L. B., WIPO Publication No. 98/02460, 22 January 1998], and fatty acid anhydrides.
  • activated esters especially N-hydroxysuccinimide esters of fatty acids, is a particularly advantageous means of acylating a free amino acid with a fatty acid.
  • activated fatty acid ester means a fatty acid which has been activated using general techniques known in the art [Riordan, J. F. and Vallee, B. L., Methods in Enzymology, XXV:494-499 (1972); Lapidot, Y., et al . , J. Lipid Res. 8:142-145
  • HOBT Hydroxybenzotriazide
  • N-hydroxysuccinimide N-hydroxysuccinimide
  • derivatives thereof are particularly well known for forming activated acids for peptide synthesis.
  • various protecting groups may be used to block the ⁇ -amino groups during the coupling.
  • the selection of a suitable protecting group is known to one skilled in the art and includes p- methoxybenzoxycarbonyl (pmZ) .
  • the ⁇ -amino group is acylated in a one-step synthesis without the use of amino-protecting groups.
  • a process for selective acylation at the N ⁇ -amino group of Lys is disclosed and claimed by Baker, J. C, et al . , U.S. Patent No. 5,646,242, 8 July 1997.
  • a process for preparing a dry powder of an acylated protein is disclosed and claimed by Baker, J.
  • a measured amount of the derivatized protein is dissolved in a volume of 0.1 N HCl.
  • a separate solution is prepared by dissolving a measured amount of the protein in a volume of 0.1 N HCl.
  • the two solutions are combined to form a mixture of the derivatized protein and protein. This mixture solution is stirred gently for about 5 to 10 minutes.
  • a solution of zinc as one of its soluble salts for example Zn(II)Cl 2 , to provide from about 0.3 moles of zinc per mole of derivatized insulin to about 1.0 moles, or to as much as 2.0 moles, of zinc per mole of total protein (protein + derivatized protein) .
  • the resulting solution is stirred gently for about 5 to 10 minutes.
  • an aqueous solution containing sodium chloride and sodium acetate whereupon a precipitate forms.
  • the pH of this solution is adjusted to within the range 8 to 10 with gentle stirring, whereupon the precipitate dissolves to yield a clear solution.
  • the pH may then be adjusted to within the range 8 to 9.
  • the solution is stirred gently for about 5 to 10 minutes then filtered through a 0.22 micron, low-protein binding filter.
  • the pH of the resulting solution is adjusted to about 5.5 with a small volume of 1 N HCl.
  • a small quantity ( ⁇ 1%) of ultralente "seed" crystals may be added.
  • the resulting suspension is stirred gently to ensure homogeneity, then allowed to stand undisturbed at 25°C whereupon microcrystals are formed within a period from about 4 hours to about 10 days.
  • the microcrystals may then be formulated, for storage and administration to a patient, by combining the resulting preparation with an aqueous solution containing sodium chloride, sodium acetate, and zinc ions such that the final concentrations are approximately 0.08 mg/mL zinc ions, 1.6 mg/mL sodium acetate, 7 mg/mL sodium chloride, 1 mg/mL methylparaben, the final pH value is about 7.4, and the final total protein concentration is about 3.5 mg/mL.
  • the microcrystals may be separated from the mother liquor and introduced into a different solvent, for storage and administration to a patient.
  • aqueous solvent is as follows: water for injection containing 1 mg/mL methylparaben, 0.08 mg/mL zinc ions, 1.6 mg/mL sodium acetate, 7 mg/mL sodium chloride, at a pH value of 7.4.
  • a solution is prepared containing about 14 mg/mL of acylated insulin, 7% sodium chloride, 0.1 M sodium acetate, and a quantity of zinc chloride adequate to give 0.3 to 0.9% of zinc ions by weight of the acylated insulin.
  • the pH is adjusted to 5.5.
  • Most of the acylated insulin then precipitates in the amorphous state which then converts to crystals upon standing at about 20°C.
  • a quantity of phenolic preservative calculated to give a preservative concentration appropriate to confer antimicrobial properties to the solution upon final dilution to the desired acylated insulin concentration.
  • Methylparaben is the preferred preservative.
  • the pH of the formulation is adjusted to 7.4 with small quantities of sodium chloride and hydrochloric acid.
  • the dilution step is performed to adjust the acylated insulin concentration to a desired value. Typically, 3.5 mg/mL is a preferred concentration.
  • the crystallization step is an important aspect of the present invention and depends upon establishing appropriate conditions. Conditions considered important to this process are as follows: a total protein concentration of about 1 to 30 mg/mL and preferably from about 10 mg/mL to about 20 mg/mL and more preferably about 14 mg/mL; a zinc ion concentration of about 0.04 to about 0.2 mg/mL and preferably about 0.15 mg/mL; a sodium acetate concentration of about 4 to 12 mg/mL and preferably about 8 mg/mL; a sodium chloride concentration of about 40 to 100 mg/mL and preferably about 70 mg/mL; and a pH value of about 5.1 to 5.9 and preferably about 5.5.
  • HPLC HPLC was used to confirm the presence of the expected proteins in the acidified suspension, re-dissolved precipitate, and supernatant and also to determine protein concentrations.
  • the retention times of peaks in the chromatograms of the re-dissolved precipitates were compared with the retention times observed for the proteins and derivatized proteins used to make the formulations. The agreement between retention times was always good, showing that the proteins and derivatized proteins were actually incorporated into the microcrystals.
  • Concentrations of protein and derivatized protein were determined by comparing the appropriate peak areas to the areas of a standard. A 0.22 mg/mL solution of derivatized insulin was used as the standard for the purpose of determining the retention time.
  • the present invention may be better understood with reference to descriptions of the following preparations. These example preparations are intended to be representative of specific embodiments of the invention, and are not intended as limiting the scope of the invention.
  • An acidic solution of B29-N ⁇ -pentanoyl-human insulin was prepared by dissolving 16.5 mg of a dry powder of B29-N ⁇ -pentanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 15.0 mg of a dry powder of human insulin (as zinc crystals) in 100 microliters of 0.1 N HCl.
  • the two solutions were combined to form a mixture of B2 -N ⁇ -pentanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 10 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) .
  • the resulting solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 2 mL of an aqueous solution containing 70 mg/mL sodium chloride and 13.6 mg/mL sodium acetate whereupon a precipitate formed.
  • the pH of this solution was adjusted to within the range 8 to 10 with a small quantity of 1 N NaOH, whereupon, with gentle stirring, the precipitate dissolved to yield a clear solution.
  • the pH was then adjusted to 8.3 with a small quantity of 1 N HCl.
  • the solution was then stirred gently for about 5 minutes then filtered through a 0.22 micron, low-protein binding filter.
  • the pH of the resulting solution was then adjusted to 5.51 with a small quantity of 1 N HCl and 1 N NaOH.
  • Ultralente seed crystals were prepared by placing 1 mL of U100 Humulin U in an ultrasonicating bath and sonicating it for about 10 minutes. A small quantity (10 microliters) of the ultralente seed crystals were added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed. HPLC analysis showed less than 17% of the total protein remained in the supernatant .
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 47% B29-N ⁇ -pentanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -pentanoyl-human insulin was prepared by dissolving 7.6 mg of B29-N ⁇ - pentanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 23.3 mg of a dry powder of human insulin (as zinc crystals) in 100 microliters of 0.1 N HCl. The two solutions were combined to form a mixture of B29-N ⁇ -pentanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 10 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) . The resulting solution was stirred gently for about 5 to 10 minutes.
  • Ultralente seed crystals were prepared by placing 1 mL of U100 Humulin U in an ultrasonicating bath and sonicating it for about 10 minutes. A small quantity (10 microliters) of the ultralente seed crystals were added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed. HPLC analysis showed less than 10% of the total protein remained in the supernatant.
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 21% B29-N ⁇ -pentanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -pentanoyl-human insulin was prepared by dissolving 14.6 mg of a dry powder of B29-N ⁇ -pentanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 2.3 mg of a dry powder of human insulin (as zinc crystals) in 50 microliters of 0.1 N HCl.
  • the two solutions were combined to form a mixture of B29-N ⁇ -pentanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 10 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) .
  • the resulting solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 1 mL of an aqueous solution containing 70 mg/mL sodium chloride and 13.6 mg/mL sodium acetate whereupon a precipitate formed.
  • the pH of this solution was adjusted to within the range 8 to 10 with a small quantity of 1 N NaOH, whereupon, with gentle stirring, the precipitate dissolved to yield a clear solution.
  • the pH was then adjusted to 8.1 with a small quantity of 1 N HCl.
  • the solution was then stirred gently for about 5 minutes then filtered through a 0.22 micron, low-protein binding filter.
  • the pH of the resulting solution was then adjusted to 5.45 with a small quantity of 1 N HCl and 1 N NaOH.
  • Ultralente seed crystals were prepared by placing 1 mL of U100 Humulin U in an ultrasonicating bath and sonicating it for about 10 minutes. A small quantity (10 microliters) of the ultralente seed crystals were added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed. HPLC analysis showed less than 4% of the total protein remained in the supernatant .
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 85% B29-N ⁇ -pentanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -octanoyl-human insulin was prepared by dissolving 7.6 mg of a dry powder of
  • B29-N ⁇ -octanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 24.9 mg of a dry powder of human insulin (as zinc crystals) in 100 microliters of 0.1 N HCl. The two solutions were combined to form a mixture of B29-N ⁇ -octanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 10 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) . The resulting solution was stirred gently for about 5 to 10 minutes.
  • Ultralente seed crystals were prepared by placing 1 mL of U100 Humulin U in an ultrasonicating bath and sonicating it for about 10 minutes. A small quantity (10 microliters) of the ultralente seed crystals were added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed. HPLC analysis showed less than 2% of the total protein remain in the supernatant .
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 18% B29-N ⁇ -octanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -octanoyl-human insulin was prepared by dissolving 12.2 mg of a dry powder of B29-NE-octanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 20.0 mg of a dry powder of human insulin (as zinc crystals) in 100 microliters of 0.1 N HCl.
  • the two solutions were combined to form a mixture of B29-N ⁇ -octanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 10 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) .
  • the resulting solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 2 mL of an aqueous solution containing 70 mg/mL sodium chloride and 13.6 mg/mL sodium acetate whereupon a precipitate formed.
  • the pH of this solution was adjusted to within the range 8 to 10 with a small quantity of 1 N NaOH, whereupon, with gentle stirring, the precipitate dissolved to yield a clear solution.
  • the pH was then adjusted to 8.4 with a small quantity of 1 N HCl.
  • the solution was then stirred gently for about 5 minutes then filtered through a 0.22 micron, low-protein binding filter.
  • the pH of the resulting solution was then adjusted to 5.51 with a small quantity of 1 N HCl and 1 N NaOH.
  • Ultralente seed crystals were prepared by placing 1 mL of U100 Humulin U in an ultrasonicating bath and sonicating it for about 10 minutes. A small quantity (10 microliters) of the ultralente seed crystals were added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed. HPLC analysis showed less than 1% of the total protein remained in the supernatant .
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 36% B29-N ⁇ -octanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -decanoyl-human insulin was prepared by dissolving 5.1 mg of a dry powder of
  • B29-N ⁇ -decanoyl-human insulin in 200 microliters of 0.1 N HCl.
  • a separate solution was prepared by dissolving 26.7 mg of a dry powder of human insulin (as zinc crystals) in 100 microliters of 0.1 N HCl. The two solutions were combined to form a mixture of B29-N ⁇ -decanoyl-human insulin and human insulin. This mixture solution was stirred gently for about 5 to 10 minutes.
  • To this solution was added 40 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) . The resulting solution was stirred gently for about 5 to 10 minutes.
  • microcrystals were separated from the mother liquor, then analyzed by HPLC.
  • HPLC analysis showed that the microcrystals contained 17% B29-N ⁇ -decanoyl-human insulin.
  • An acidic solution of B29-N ⁇ -butanoyl-human insulin was prepared by dissolving 33.3 mg of a dry powder of B29-N ⁇ -butanoyl-human insulin in 400 microliters of 0.1 N HCl. This solution was stirred gently for about 5 to 10 minutes. To this solution was added 40 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) . The resulting solution was stirred gently for about 5 to 10 minutes. To this solution was added 2 mL of an aqueous solution containing 70 mg/mL sodium chloride and 13.6 mg/mL sodium acetate whereupon a precipitate formed.
  • An acidic solution of B29-N ⁇ -pentanoyl-human insulin was prepared by dissolving 16.0 mg of a dry powder of B29-N ⁇ -pentanoyl-human insulin in 200 microliters of 0.1 N HCl. This solution was stirred gently for about 5 to 10 minutes. To this solution was added 20 microliters of a solution of 0.15 M zinc chloride (prepared by dissolving zinc oxide in HCl) . The resulting solution was stirred gently for about 5 to 10 minutes. To this solution was added 1 mL of an aqueous solution containing 70 mg/mL sodium chloride and 13.6 mg/mL sodium acetate whereupon a precipitate formed.
  • a 100 microliter volume of seed crystals (0.3 mg/mL human zinc insulin crystals of approximate size 3 microns containing 0.8 mg/mL methyl paragon and 0.29 mg/mL citric acid in water) was added and the resulting suspension was stirred gently to ensure uniformity. The resulting preparation was allowed to stand undisturbed at a controlled temperature of 25°C for 3 days whereupon microcrystals formed.

Abstract

La présente invention concerne des cristaux de type ultra-lent constitués de dérivés d'insuline ou de dérivés d'analogues insuliniques, et éventuellement d'insuline non dérivée ou d'analogues insuliniques non dérivés. L'invention concerne également des compositions insolubles renfermant lesdits cristaux de type ultra-lent, ces compositions étant aptes à être administrées par voie parentérale et non parentérale pour traiter l'hyperglycémie et le diabète.
PCT/US2000/015037 1999-06-29 2000-06-15 Compositions insuliniques acylees insolubles exemptes de protamine WO2001000675A1 (fr)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9260503B2 (en) 2011-06-15 2016-02-16 Novo Nordisk A/S Multi-substituted insulins
US10040839B2 (en) 2014-02-28 2018-08-07 Novo Nordisk A/S Insulin derivatives and the medical uses hereof

Citations (3)

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Publication number Priority date Publication date Assignee Title
EP0646379A1 (fr) * 1993-08-13 1995-04-05 Eli Lilly And Company Formulation d'insuline
WO1998042367A1 (fr) * 1997-03-20 1998-10-01 Novo Nordisk A/S Procede de preparation d'une poudre therapeutique par co-precipitation d'insuline et d'un activateur de l'absorption
WO1998042368A1 (fr) * 1997-03-20 1998-10-01 Novo Nordisk A/S Formulation de poudre therapeutique destinee a etre administree dans les voies respiratoires et contenant de l'insuline cristalline

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EP0646379A1 (fr) * 1993-08-13 1995-04-05 Eli Lilly And Company Formulation d'insuline
WO1998042367A1 (fr) * 1997-03-20 1998-10-01 Novo Nordisk A/S Procede de preparation d'une poudre therapeutique par co-precipitation d'insuline et d'un activateur de l'absorption
WO1998042368A1 (fr) * 1997-03-20 1998-10-01 Novo Nordisk A/S Formulation de poudre therapeutique destinee a etre administree dans les voies respiratoires et contenant de l'insuline cristalline

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9260503B2 (en) 2011-06-15 2016-02-16 Novo Nordisk A/S Multi-substituted insulins
US10040839B2 (en) 2014-02-28 2018-08-07 Novo Nordisk A/S Insulin derivatives and the medical uses hereof

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