Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
  • C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
  • C07D487/04—Ortho-condensed systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2072—Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
  • A61K9/2086—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
  • A61K9/209—Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
  • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
  • A61K9/5084—Mixtures of one or more drugs in different galenical forms, at least one of which being granules, microcapsules or (coated) microparticles according to A61K9/16 or A61K9/50, e.g. for obtaining a specific release pattern or for combining different drugs
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/20—Hypnotics; Sedatives

Definitions

• the present invention relates generally to compositions and methods for the treatment of insomnia and related conditions.
• the invention is more particularly related to controlled-release sedative-hypnotic compositions with particularly short half-lives, and methods for using such compositions to promote rapid sleep onset and sleep maintenance.
• insomnia refers to the perception of inadequate or non-restful sleep by a patient. Insomnia is a frequent complaint, reported by 32% of the adult population surveyed in the Los Angeles area (Bixler et al, Amer. Journal of Psychiati ⁇ 136:1257-1262, 1979), and 13% of the population surveyed in San Marino, Italy (Lugaresi et al., Psychiatric Annals 17:446-453, 1987). Fully 45% of the surveyed adult population of Alachua County, Florida, reported trouble getting to sleep or staying asleep (Karacan et al., Social Science and Medicine 10:239-244, 1976). The prevalence of insomnia has also been shown to be related to the age and sex of the individuals, being higher in older individuals and in females.
• insomnia central nervous system
• CNS central nervous system
• These compounds are typically long acting (on the order of 8-50 hours) due to long terminal half-lives, and have a well-known spectrum of side effects, including lethargy, confusion, depression and next day hangover effects.
• chronic use has been associated with a high potential for addiction involving both physical and psychological dependence.
• the pharmaceutical treatment of insomnia shifted away from barbiturates and other CNS depressants toward the benzodiazepine class of sedative- hypnotic agents. This class of compounds produces a calming effect that results in a sleeplike state in humans and animals, with a greater safety margin than prior hypnotics.
• benzodiazepines The therapeutic actions of benzodiazepines are believed to be mediated by binding to a specific receptor on benzodiazepine GABA complexes in the brain. As a result of this binding, synaptic transmission is altered at neurons containing the benzodiazepine GABA complex.
• the clinical usefulness of different benzodiazepine hypnotics relates largely to their pharmacokinetic differences with regard to this binding and, in particular, to the half-lives of the parent compound and its active metabolites.
• many benzodiazepines possess side effects that limit their usefulness in certain patient populations.
• the present invention provides compositions and methods for promoting sleep.
• a controlled-release formulation comprising (a) a sedative-hypnotic compound, or a precursor thereof that is metabolized to generate a sedative-hypnotic compound in vivo, and (b) at least one release retardant such that, upon administration of the formulation to a patient, the patient has a "pulsed" plasma profile of the sedative-hypnotic compound.
• a "pulsed" plasma profile means that, following administration of the sedative-hypnotic formulation the patient has in the following order:
• Tmax a time to a first maximum plasma concentration (Tmax,) of the sedative-hypnotic compound ranging from 0.1 to 2 hours following administration;
• a time to a minimum plasma concentration (Tmin) of the sedative- hypnotic compound ranging from 2 to 4 hours, wherein the plasma concentration of the sedative-hypnotic compound at Tmin is less than 80% of the plasma concentration at Tmax,, with the proviso that, in a preferred embodiment, the plasma concentration of the sedative- hypnotic compound at Tmin does not fall below a minimum effective concentration to maintain sleep;
• Tmax 2 a time to a second maximum plasma concentration (Tmax 2 ) of the sedative-hypnotic ranging from 3 to 5 hours following administration, wherein the plasma concentration of the sedative-hypnotic compound at Tmax 2 is from 80% to 150% of the plasma concentration at Tmax,;
• Sedative-hypnotic compounds of this invention have particularly short plasma half-lives - that is, less than 2 hours and, more preferably, on the order of about 1 hour.
• a representative sedative-hypnotic compound is N-methyl-N-(3- ⁇ 3-[2-thienylcarbonyl]- pyrazolo-[l,5-a]-pyrimidin-7-yl ⁇ -phenyl)acetamide (also referred to herein as "NBI-34060").
• Representative release retardants include, but are not limited to, hydroxypropylmethyl cellulose, ethyl cellulose, poly (ethylacrylate methylmethacrylate), methacrylic acid copolymer (Type A, Type B, Type C), hydroxypropyl cellulose, carbomer, polyethylene glycol, polyvinylpyrrolidone, gelatin, corn starch, stearyl alcohol, carnuba wax, white wax, glyceryl monostearate, glyceryl distearate, guar gum, xanthan gum and chitosan.
• the present invention provides methods for promoting sleep in a mammal, including a human (collectively referred to herein as a "patient") and particularly in the context of treating chronic insomnia, comprising administering to a patient a controlled-release formulation as described above.
• a controlled-release formulation as described above.
• Such formulations may, for example, be administered orally, or by any other route that provides a plasma profile as described herein, and have been found to minimize next day residual effects.
• Figure 1 is a graph illustrating the plasma level over time following administration of a formulation of the present invention that provides for a "pulsed" plasma profile according this invention.
• Figures 2A and 3A illustrate predicted plasma concentrations with a sedative- hypnotic compound having a half-life of 1.3 hours (NBI-34060), while Figures 2B and 3B illustrate the corresponding calculated dissolution curves of the same.
• Figures 4A and 5A illustrate the predicted plasma concentrations achieved with a sedative-hypnotic compound outside the scope of this invention, having a half-life of 2.3 hours, while Figures 4B and 5B illustrate the corresponding calculated dissolution curves of the same.
• Figure 6 represents a representative large-scale synthesis of NBI-34060. DETAILED DESCRIPTION OF THE INVENTION
• the present invention is generally directed to a controlled- release sedative-hypnotic formulation that is characterized by a pulsed release of the active compound(s) over a period of up to eight hours.
• Formulations as provided herein are particularly useful for administering compounds intended to be active during sleep. As discussed in more detail below, such formulations are preferably orally active, but may be administered by other suitable routes.
• the sedative-hypnotic formulations provided herein generally comprise at least one sedative-hypnotic compound having a particularly short plasma half-life of less than 2 hours, and at least one release retardant that controls the rate of compound release following administration to a patient. It has been found, within the context of the present invention, that short acting sedative-hypnotic compounds are particularly useful for promoting rapid sleep onset and/or sleep maintenance through the use of a formulations that generates a "pulsed" release profile as described herein. Such formulations may be used, for example, as single dose nocturnal formulations, which can promote sleep for 7-8 hours, and which do not result in significant next-day residual effects (also referred to as "hangover" effect).
• short acting sedative-hypnotic compounds are particularly suited for use within the controlled-release formulations described herein.
• a short- acting sedative-hypnotic compound is a compound that has a detectable sedative effect in any standard assay, with a mean plasma half-life of the compound of less than 2 hours, typically ranging from 0.25 to 1.5 hours, and preferably, in one embodiment, on the order of about 1.3 hours. Such compounds generally show a relationship between hypnotic effect and plasma levels.
• a formulation may comprise an active sedative-hypnotic compound or a precursor thereof that is metabolized to generate an active sedative-hypnotic compound in vivo. Both types of formulation are specifically contemplated by the present invention.
• a sedative-hypnotic effect of a compound may be readily established using, for example, standard tests that monitor the effects of a dmg on motor activity, muscle relaxation and motor coordination (see, e.g., Beer et al., CNS Drug Reviews 3:201-224, 1997; Sanger et al., Eur. J. Pharmacol. 313:35-42, 1996, and references cited therein).
• a sedative-hypnotic compound should have a statistically significant sedative effect within at least one, and preferably all, of the following assays:
• a preferred short-acting sedative-hypnotic compound of this invention is N- methyl-N-(3- ⁇ 3-[2-thienylcarbonyl]-pyrazolo-[l,5-a]-pyrimidin-7-yl ⁇ -phenyl)acetamide (NBI-34060).
• the molecular formula of NBI-34060 is C 20 H, o N 4 O 2 S, and the molecular weight is 376.44 Daltons.
• NBI-34060 has a half-life of approximately 1.3 hours. The structural formula is shown below:
• NBI-34060 occurs as an off-white to yellow, non-free flowing powder with little static charge.
• NBI-34060 may be prepared using chemical synthesis techniques known to to those skilled in this field.
• NBI-34060 may generally be made by the synthetic procedures disclosed in U.S. Patent Nos. 4,521,422 and 4,900,836 (incorporated herein by reference). These patents, particularly U.S. Patent No. 4,521,422, disclose a genus encompassing certain aryl and heteroaryl[7-(aryl and heteroaryl)-pyrazolo[l,5-a]pyrimidin-3-yl]methanones. Such compounds may generally be classified as "substituted pyrazolopyrimidines" having the following Genus I:
• zaleplon Wyeth-Ayerst
• Sonata is a sedative-hypnotic compound recently approved by the FDA as sedative-hypnotic (see U.S. Patent No. 4,626,538).
• Sonata has a half-life of approximately 1 hour when administered orally in tablet form. Sonata has about 1/20 the binding specificity of NBI-34060 at the GABA complex.
• NBI-34060 a potent sedative, anxiolytic and anti-convulsant agent, and possesses an improved profile of side effects, as compared to benzodiazepine agents.
• NBI-34060 shows a reduced tolerance to sedation, a lowered potential for abuse and a reduced tendency to potentiate the deleterious effects of ethanol.
• NBI-34060 appears to be substantially devoid of next-day hangover effects and to have a considerably reduced amnesic potential compared to currently marketed sedative- hypnotic agents.
• release retardants Any of a variety of release retardants may be used within the formulations described herein.
• the critical feature of a release retardant is the ability to generate a release profile of the sedative-hypnotic compound that provides a "pulsed" plasma level of the compound. As mentioned above, such a release profile yields, in sequential order, the characteristics noted below following administration to a patient:
• Tmax a time to a first maximum plasma concentration (Tmax,) of the sedative-hypnotic compound ranging from 0.1 to 2 hours following administration;
• a time to a minimum plasma concentration (Tmin) of the sedative- hypnotic compound ranging from 2 to 4 hours, wherein the plasma concentration of the sedative-hypnotic compound at Tmin is less than 80% of the plasma concentration at Tmax,, with the proviso that, in a preferred embodiment, the plasma concentration of the sedative- hypnotic compound at Tmin does not fall below a minimum effective concentration to maintain sleep;
• Tmax 2 a time to a second maximum plasma concentration (Tmax 2 ) of the sedative-hypnotic ranging from 3 to 5 hours following administration, wherein the plasma concentration of the sedative-hypnotic compound at Tmax 2 is from 80% to 150% of the plasma concentration at Tmax,;
• Tmax refers to the "time to maximum plasma concentration” and represents time that elapses between administration of the formulation and a maximal plasma concentration of sedative-hypnotic compound (i.e., a peak in a graph of plasma concentration vs. time).
• the formulations of this invention display two Tmax values: “Tmax,” is the “time to first maximum plasma concentration”, while “Tmax 2 " is the “time to second maximum plasma concentration.
• Tmax is the “time to first maximum plasma concentration”
• Tmax 2 is the “time to second maximum plasma concentration.
• Tmin time to minimum plasma concentration
• From Tmin to Tmax 2 the plasma concentration increases from the dip concentration to that of Tmax 2 . This increase in plasma concentration of the sedative-hypnotic compound is believed to be particular beneficial in the context of treating insomnia.
• Sleep is controlled by two biological processes, the homeostatic and circadian.
• the homestatic drive manifests itself as an increased drive for sleep.
• This drive for sleep accumulates across the period of wakefulness (typically daytime) and dissipates across the sleep period.
• the circadian rhythm of sleep-wake shows a biphasic curve with the greatest drive for sleep occurring between midnight and 5AM in the morning, and between 2PM and 4PM in the afternoon. It is believed that major circadian influences are an alerting pulse in the evening and in the morning. It is the interaction of these processes which give rise to the 24-hour sleep schedule.
• sleep onset in the evening occurs primarily as a function of homeostatic drive.
• homeostatic drive dissipates significantly and wakefulness begins to intmde into the sleep period. This propensity to increased wakefulness is further increased by the rise in the circadian alerting pulse at about 5AM.
• the formulations of the present invention address both of these issues by use of a particularly short acting sedative-hypnotic compound which has a single pulse at sleep onset, and a second pulse at the time of the decline in homeostatic processes and rise in the circadian pulse.
• the increase in plasma concentration from the dip or Tmin value to that of Tmax 2 has been found to be particularly beneficial in preventing subsequent awakening of the patient.
• the pulse from the concentration at Tmin to Tmax 2 has been found to be particularly beneficial for sleep maintenance.
• this increase in plasma concentration is more beneficial than merely maintaining a constant plasma concentration of the sedative-hypnotic compound.
• the plasma concentration dip between Tmax, and Tmax 2 the patient is exposed to a lower overall dosage, thereby decreasing subsequent effects, such as unwanted hangover effect.
• a lower plasma concentration at Tmin decreases incidents of nighttime falls and/or amnesia, particularly in the elderly.
• the plasma concentration of the sedative- hypnotic at Tmax is generally in excess of 5 ng/mL, and normally in the range of 5 ng/mL to 20 ng/mL, typically in the range of 7.5 ng/mL to 15 ng/mL, and preferably in the range of 10 ng/mL to 13 ng/mL.
• concentration values expressed as "ng/mL" are for NBI-34060.
• This plasma concentration is arbitrarily assigned a value of 100% at Tmax, for comparison purposes to plasma concentrations at subsequent times post-administration.
• Tmax generally ranges in time from 0.1 to 2 hours following administration of the sedative-hypnotic compound, typically from 0.25 to 1 hour and, in one embodiment, is on the order of about 30 minutes and, in another embodiment, on the order of about 1 hour. It is generally desirable to have the time to Tmax, to be as short as practical such that the patient falls asleep quickly after administration of the sedative-hypnotic.
• a "dip" in plasma concentration of the sedative-hypnotic compound occurs at Tmin, which occurs after Tmax, and prior to Tmax 2 .
• This dip results in a plasma concentration of the sedative-hypnotic compound that is generally less than 80%, preferably less than 70%, and typically less than 60% of the plasma concentration at Tmaxi.
• the concentration at Tmin is less than 50%, or less than 40%, of the plasma concentration at Tmax,.
• the phrase "less than 80% of the plasma concentration at Tmax” means that the plasma concentration of the sedative-hypnotic compound is less than 8 ng/mL at Tmin.
• the plasma concentration at Tmin does not result in a plasma concentration of the sedative-hypnotic compound less than a nominal level necessary to maintain sleep. Typically, this lower level is in excess of 3 ng/mL, typically in excess of 4 ng/mL, and preferably in excess of 5 ng/mL.
• Tmin generally ranges from 2 to 4 hours following administration of the sedative-hypnotic compound, and typically from about 2.5 to 3.5 hours and, in one embodiment, is on the order of about 3 hours. .
• Tmax 2 occurs after Tmin, with the increase in plasma concentration from Tmin to Tmax representing the increase, as discussed above, of sedative-hypnotic compound to which the patient is exposed.
• the plasma concentration at Tmax 2 is generally in the range of 80% to 150% of the plasma concentration at Tmax,, typically in the range of 90% to 140%, preferably in the range of 100% to 130% and, in one embodiment, is about 100% of the plasma concentration at Tmax,.
• the phrase "80% to 150% of the plasma concentration at Tmax” means a plasma concentration ranging from 8 ng/mL to 15 ng/mL.
• Tmax 2 generally ranges from 3 hours to 5 hours following administration of the sedative-hypnotic compound, typically from 3.5 to 4.5 and, in one embodiment, is on the order of about 4 hours.
• the plasma concentration is at a level in excess of the amount necessary to maintain sleep.
• concentration levels are in excess of 3 ng/mL, typically in excess of 4 ng/mL, and preferably in excess of 5 ng/mL.
• the plasma concentration at 6 hours is at least 20% of that at Tmax 2 , typically at least 30%, and, in one embodiment, is on the order of about 40%.
• the maximum plasma concentration that may be achieved at 6 hours following administration is dependent, at least in part, on the desired plasma concentration of the sedative-hypnotic compound at 8 hours (as discussed below).
• the plasma concentration of the sedative- hypnotic compound is at a level that is not sufficient to maintain sleep, and generally at a level of less than 2 ng/mL.
• the plasma concentration at 8 hours is less than 20% of the concentration at Tmax 2 , and preferably less than 15%.
• Such a low level of the sedative-hypnotic compound at 8 hours post-administration reduces hangover effect. It should be noted, however, that in order to achieve such low plasma levels at 8 hours post- administration, while still maintaining the pulsed plasma profile disclosed above, the sedative-hypnotic agent must have a particularly short half-life as discussed above.
• Suitable release retardants include, but are not limited to, acrylic or other polymers, alkylcelluloses, shellac, zein, hydrogenated vegetable oil, hydrogenated castor oil and mixtures of any of the foregoing.
• release retarding polymers that are commercially available.
• aqueous dispersions of ethyl cellulose e.g., Aquacoat? , available from FMC Corp. (Philadelphia, PA) or Surelease? , available from Coloron, Inc. (West Point, PA) and acrylic resin lacquers (e.g., Eudragit? dispersions (Rohm Pharma)) are readily available.
• biodegradable, biocompatible polymers such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, polyorthoesters, polylactic acid and others known to those of ordinary skill in the art, may also be used.
• Preferred release retardants include hydroxypropylmethyl cellulose, ethyl cellulose, poly (ethylacrylate methylmethacrylate), methacrylic acid copolymer (Type A, Type B, Type C), hydroxypropyl cellulose, carbomer, polyethylene glycol, polyvinylpyrrolidone, gelatin, corn starch, stearyl alcohol, camuba wax, white wax, glyceryl monostearate, glyceryl distearate, guar gum, xanthan gum and chitosan.
• One or more release retardants may be combined with the hypnotic compound, and/or the hypnotic compound (e.g., in combination with a binder and pelletized) may be coated by a material comprising one or more release retardants in a pharmaceutically acceptable solvent, such as water, methanol or ethanol. Such coating may be achieved using standard techniques, such as spraying using any spray equipment known in the art, followed by curing. Methods for using release retardants to obtain a desired release profile are well known in the art and are amply described in the patent and scientific literature (see, e.g., US Patent Nos. 5,672,360, 5,698,220 and 5,788,987; and EP 908,177 Al).
• the physical properties of the coating may be further improved through the use of one or more other components, such as plasticizers, diluents, lubricants, binders, granulating aids, flavorants, glidants and colorants, which may be selected and used according to standard practice (see Handbook of Pharmaceutical Excipients (Eds, A Wade, and P. J. Weiler, second edition, American Pharmaceutical Association, The Pharmaceutical Press, London, 1994); Pharmaceutical Dosage Forms: Tablets, Lieberman, Lachman and Schwartz, ed., 2 nd edition (Marcel Dekker, Inc.); Remington's Pharmaceutical Sciences, Arthur Osol, ed., pages 1553-1593 (1980)).
• plasticizers plasticizers, diluents, lubricants, binders, granulating aids, flavorants, glidants and colorants
• Formulations may take any suitable form, including solutions, capsules, tablets, pellets, patches, aerosols and powders. Such formulations may be intended for administration by any known means, including buccal, sublingual, transmembrane, muccusal, transdermal, intranasal, inhalation and rectal administration. Preferably, the formulation is adapted for oral delivery. It will be apparent that other formulation components may be desirable depending on the mode of administration.
• Formulations used for parenteral, intradermal, subcutaneous or topical application can include, for example, a sterile diluent (such as water), saline solution, fixed oil, polyethylene glycol, glycerin, propylene glycol or other synthetic solvent; antimicrobial agents (such as benzyl alcohol and methyl parabens); antioxidants (such as ascorbic acid and sodium bisulfite) and chelating agents (such as ethylenediaminetetraacetic acid (EDTA)); buffers (such as acetates, citrates and phosphates).
• a sterile diluent such as water
• saline solution fixed oil
• polyethylene glycol, glycerin, propylene glycol or other synthetic solvent such as water
• antimicrobial agents such as benzyl alcohol and methyl parabens
• antioxidants such as ascorbic acid and sodium bisulfite
• chelating agents such as ethylenediaminetetraacetic acid (ED
• suitable carriers include physiological saline or phosphate buffered saline (PBS), and solutions containing thickening and solubilizing agents, such as glucose, polyethylene glycol, polypropylene glycol and mixtures thereof.
• PBS physiological saline or phosphate buffered saline
• thickening and solubilizing agents such as glucose, polyethylene glycol, polypropylene glycol and mixtures thereof.
• other pharmaceutically active ingredients and/or suitable excipients such as salts, buffers and stabilizers may, but need not, be present within the composition.
• any method that provides for controlled release of the active component with the desired kinetics may be used.
• one or more drug-rich regions may be deposited within a polymer matrix to provide one or more bursts of sedative release. Additional active component may be incorporated into the matrix to provide for maintenance of plasma levels.
• Methods for generating drug-rich regions and for incorporating a dmg into a matrix are well known, and include methods employing three dimensional printing as described in WO 98/36739.
• Controlled release may also be achieved, for example, using ion exchange microspheres. Such microspheres may be overloaded, resulting in an initial pulse of active component, followed by subsequent release of active component bound to the ion exchange material. It will be apparent that an active component for use within such formulations should be in a salt form, and that the ionic exchange material should be one that, when ionized, contains a suitable charge for interacting with the active component (i.e., a negative charge for use with a positively charged active component, and a positive charge for use with a negatively charged active component). Those of ordinary skill in the art will be readily able to select a suitable ion exchange material.
• Ion exchange microspheres may be produced using well known procedures, such as spray drying, coacervation and emulsification. The preparation of such formulations is described, for example, in Davis et al., Microsphere and Dmg Therapy (Elsevier, 1984); Kwon et al, J. Colloid Interface Sci. 143:501, 1991; Cremers et al, J. Controlled Rel. 11:167, 1990; Codde et al., Anti-cancer Res. 70: 1715-1718, 1990 and WO 94/27576.
• a formulation having a release profile as provided herein contains multiple different units in a single, multiple-unit dosage form. Each unit typically displays a different release profile.
• a formulation may contain two or three units.
• the first unit may be an immediate release ("IR") unit, which releases active component rapidly upon administration in order to generate the plasma concentration at Tmax,.
• IR immediate release
• An optional component may be a sustained release unit which provides extended release of the active component to ensure that that the plasma concentration of the sedative-hypnotic compound does not fall below the minimum effective concentration to maintain sleep at Tmin.
• the second unit may be a delayed release unit in which active component is released, at in least in part, in a burst akin to the first IR unit, but at a specified period of time following administration in order to generate the plasma concentration at Tmax 2 .
• additional delayed/controlled release units may also be employed, provided the plasma profile of this invention results.
• the individual units may comprise powder, granule and/or pellet formulations, and are preferably formulated as pellets.
• the multiple-unit dosage form can be, for example, a compressed tablet or hard gelatin capsule.
• a first unit formulated for immediate release dosage may comprise a surface- active agent such as sodium lauryl sulfate, sodium monoglycerate, sorbitan monooleate, polyoxyethylene sorbitan monooleate, glyceryl monostearate, glyceryl monooleate, glyceryl monobutyrate, any one of the Pluronic line of surface-active polymers, or any other suitable material with surface active properties or any combination of the above.
• the surface-active agent is sodium lauryl sulfate.
• the concentration of surface-active agent in this unit can range from about 0.05 to about 10.0% (W/W).
• a first unit in pellet form may be made via any suitable process that generates a reasonably round unit.
• This process can be, for example, simple granulation, followed by sieving; extrusion and marumerization; rotogranulation; or any agglomeration process which results in a pellet of reasonable size and robustness.
• This immediate release unit may alternatively be formulated as a granule or powder, although the preferred form is a pellet due to mixing and de-mixing considerations.
• Materials to be admixed along with the dmg and surfactant for a first pellet should possess sufficient binding properties to allow agglomeration to occur.
• Such materials can be, but are not limited to, microcrystalline cellulose (such as Avicel), co starch, pregelatinized starch (such as Starch 1500 or National 1551), potato starch, sodium carboxymethylated starch, sodium carboxymethylated cellulose, hydroxypropylmethyl cellulose, hydroxypropylcellulose, hydroxyethylcellulose, ethylcellulose, as well as any cellulose ether.
• any binder material such as gums (e.g., guar gum) natural binders and derivatives such as alginates, chitosan, gelatin and gelatin derivatives, are also useful.
• Synthetic polymers such as polyvinylpyrrolidone (PVP), acrylic acid derivatives (Eudragit, Carbopol, etc.) and polyethylene glycol (PEG) are also useful as binders and matrix formers for the purpose of this invention. It may be useful to have these materials present in the range of from about 1.0 to about 60.0% (W/W) either in total, or individually in combination with one another. Preferably, such materials should be present in the range of from about 30 to about 50 percent (W/W).
• any suitable tablet disintegrant can be utilized here, such as cross-linked sodium carboxymethylcellulose (Ac-Di-Sol), cross-linked sodium carboxymethyl starch (Explotab, Primojel), cross-linked PVP (Plasdone XL) or any other material possessing tablet disintegrant properties.
• the optional unit when present, generally has a sustained or prolonged release profile.
• This unit should have all of the ingredients as mentioned above, but in different ratios, depending on the desired release profile.
• the process for manufacturing such units may be as described above described above for the intermediate-release pellet.
• this unit may have a controlling coat applied to the surface of the pellet such that the release of the dmg from the pellet can be further controlled and released over a period such that the plasma concentration of the dmg does not fall below the minimum effective concentration to maintain sleep at Tmin.
• the materials used for this purpose can be, but are not limited to, ethylcellulose, hydroxypropylmethylcellulose, hydroxypropylcellulose, hydroxyethylcellulose, methylcellulose, nitrocellulose, carboxymethylcellulose, and any other cellulose ether, as well as copolymers of ethacrylic acid and methacrylic acid (Eudragit), or any other acrylic acid derivative (Carbopol, etc.) can be used.
• an enteric coating material can also be employed, either singularly, or in combination with one or more of the above non-pH sensitive coatings.
• Enteric coating materials include, but are not limited to, hydroxypropylmethylcellulose phthalate and the phthalate esters of all the cellulose ethers, as well as phthalate esters of the acrylic acid derivatives (Eudragit) and cellulose acetate phthalate. These coating materials can be employed in coating the surfaces in a range of from about 1.0% (W/W) to about 25% (W/W). Preferably these coating materials should be in a range of from about 2.0 to about 12.0 percent (W/W).
• a second unit in the controlled-release formulation may be qualitatively similar to the first unit, and may be produced by a manufacturing process as described above. However, such a unit may have an internal component (e.g., an enteric or pH sensitive material) that breaks down in the pH of the lower GI tract.
• This material can comprise a substance such as, but not limited to, cellulose acetate phthalate, hydroxypropylmethylcellulose phthalate, any additional cellulose ether phthalates, any of the acrylic acid derivative phthalates (Eudragit), as well as any enteric coating material, such as shellac, zein or others.
• the concentration of such materials in the unit should be from about 1.0 to about 15.0% (W/W), preferably the concentration of materials should be from about 2.0 to about 10.0 percent (W/W).
• Suitable coating materials may be similar to the coating for the optional unit, except that it may have a considerable pH sensitivity associated with it. More specifically, it is desirable to coat this unit with any of the pH sensitive or enteric coating materials listed above, either singularly, or in combination with any coating material mentioned above.
• the coating level of this unit should range from about 1.0 to about 15.0% (W/W), preferably the concentration of materials should be from about 2.0 to about 12.0 percent (W/W).
• each of the above units should have its own dissolution profile associated with the formulation assigned to it.
• the exact ratios of each of the pellets may need to be adjusted.
• the amount of first unit in the formulation ranges from about 30% to about 70%).
• the amount of optional unit in the dosage form preferably ranges from about 0 to about 20%).
• the amount of second unit preferably ranges of from about 30% to about 70%.
• the release profile of the formulations may be adjusted by, for example, varying the thickness of the coating, changing the particular release retardant used, altering the relative amounts of coating components, including additional ingredients or by modifying the method of manufacture. The variation of such parameters to adjust the release profile is well known in the art.
• plasma concentration, Tmax and Tmin may be determined using well known techniques. Briefly, blood samples are taken from a patient over the course of the dosing interval. The samples are then tested to determine the plasma level of the hypnotic compound. Any suitable assay may be used to determine plasma levels, such as ELISA, RIA, or chromatography (e.g., gas-liquid chromatography or high pressure liquid chromatography) linked to any suitable detection system such as UV, fluorescence, mass spectrometry or an electrochemical system).
• a formulation may comprise active sedative-hypnotic compound or may comprise a precursor thereof. In either case, the plasma levels assessed are those of active sedative-hypnotic compound.
• assays are designed to detect the sedative-hypnotic contained within the formulation.
• an active metabolite is assayed. Active metabolites may be identified using well known techniques. To assess sedative activity, any of a variety of standard assays may be used.
• sedative activity may be assessed using tests such as EEG measurements, subjective reporting, visual analogue scales, critical flicker fusion, Salford tracking, sway tests, sleep efficiency, time to sleep onset, time to awakenings number of awakenings and/or sleep architecture.
• tests such as EEG measurements, subjective reporting, visual analogue scales, critical flicker fusion, Salford tracking, sway tests, sleep efficiency, time to sleep onset, time to awakenings number of awakenings and/or sleep architecture.
• a preferred method for assaying plasma levels is an HPLC procedure. This method also permits detection of the primary inactive metabolite N-[3-[3-(2- thienylcarbonyl)-pyrazolo-[l,5-a]-pyrimidin-7-yl)-phenylacetamide and is sufficiently sensitive to detect NBI-34060 in samples obtained from patients treated with low doses for up to 4-6 half-lives. Briefly, a plasma sample (e.g., 100 ?1) is diluted (e.g., 1 :4) and combined with internal standard. The mixture is vortexed and centrifuged to obtain a clear supernatant.
• Samples are then evaporated to dryness and reconstituted with a buffer suitable for HPLC (e.g., phosphate buffer pH 6.8).
• a buffer suitable for HPLC e.g., phosphate buffer pH 6.8
• the samples e.g., 50 ⁇ l
• a Hewlett Packard Zorbax, C8, 4.6 x 150 mm column the following chromatographic conditions may be used:
• FIG. 1 illustrates a representative release profile of the formulations described herein.
• Tmax occurs at approximately 1 hour post- administration
• Tmin occurs at approximately 2 hours post-administration
• Tmax 2 occurs at approximately 3 hours post-administration. Further representative release profiles are set forth below in the Examples.
• a hypnotic formulation is generally formulated and administered to exert a therapeutically useful effect while minimizing undesirable side effects.
• the number and degree of acceptable side effects depend upon the condition for which the composition is administered.
• the concentration of active component in the composition will depend on absorption, inactivation and excretion rates thereof, the dosage schedule and the amount administered, as well as other factors that may be readily determined by those of skill in the art.
• the sedative-hypnotic formulations provided herein may be used for therapy of conditions such as insomnia, anxiety and convulsions. Patients afflicted with such conditions may be readily diagnosed using standard clinical criteria. It will be apparent to those of ordinary skill in the art that formulations comprising other active components, with similar release profiles, may further be used to treat any condition in which such a release profile is desirable. Typically, such conditions are those in which sustained nocturnal release of a dmg is desired. Formulations as provided herein may be administered to a patient, alone or in combination with other therapies, to treat or prevent such conditions.
• Appropriate dosages and a suitable duration and frequency of administration will be determined by such factors as the nature of the hypnotic compound used, the type and severity of the patient's condition and the method of administration.
• an appropriate dosage and treatment regimen provides the formulation in an amount sufficient to provide therapeutic and/or prophylactic benefit (i.e., an amount that ameliorates the symptoms or treats, delays or prevents progression of the condition).
• the precise dosage and duration of treatment may be determined empirically using known testing protocols or by testing the compositions in model systems known in the art and extrapolating therefrom.
• Known testing protocols include, but are not limited to, EEG measurements, subjective reporting, visual analogue scales, critical flicker fusion, Salford tracking, sway tests, sleep efficiency, time to sleep onset, time to awakenings number of awakenings and sleep architecture. Dosages may also vary with the severity of the condition to be alleviated. In general, the use of the minimum dosage that is sufficient to provide effective therapy is preferred. Patients may generally be monitored for therapeutic effectiveness using assays (which my be analytical or behavioral/psychometric) that are suitable for the condition being treated or prevented. Such assays will be apparent to those of ordinary skill in the art, and for any particular subject, specific dosage regimens may be adjusted over time according to the individual need. For NBI-34060, a suitable clinical dose is generally 1-100 mg, preferably 5- 60 mg and more preferably 25-50 mg, with the total dose dependent on the formulation used and the clinical result to be achieved.
• Each unit may be formulated as a pellet by combining the dmg substance and other pellet forming excipients. All components are dispensed, weighed, screened and added to an appropriate-sized blender. The ingredients are mixed and water or other suitable solvents are added until a uniform, wet mass is formed. The wet mass is extmded through a perforated screen using appropriate extmsion equipment. The extmdate is further processed on a spheronizer, which transforms the extmdate into uniform, spherical pellets. The pellets are tray dried in a suitable oven or, alternatively, using other suitable fluidized bed drying equipment.
• the coating excipients are dispensed, weighed, and added to an appropriate-sized container. The mixture is stirred until a uniform dispersion is formed. Using appropriate fluidized bed coating equipment, the pellets are placed in the fluidized bed apparatus. The pellets are coated with the coating suspension and simultaneously dried.
• the various units are filled in the correct ratios into hard gelatin capsules using appropriate capsule filling equipment.
• the pellet of Example 1 is combined with the pellet of Example 13 in a 1 :1 ratio.
• Pellets from Examples 1 and 13 are mixed in an appropriate dry blender. Additional ingredients are added, such as MCC and magnesium stearate, to facilitate tablet compression and lubrication. The mixture is blended and the mix is compressed on a suitable tablet press.
• Example 30 Representative IR/Delay Release IR Formulation This Example illustrates a preferred sedative-hypnotic formulation of the present invention, in tablet form, utilizing a dual IR formulation - that is, 20 mg IR and 20 mg IR with a 2 hour delay.
• Examples 31 Representative Plasma Profiles IR/Delay Release IR Formulation
• This Example illustrates simulated plasma profiles of representative sedative- hypnotic compound of the present invention having a half-life of 1.3 hours, compared to a sedative-hypnotic compound having a half-life of 2.3 hours.
• commercially available plasma profiling sofltware (GastroPlusTM) (Simulations Plus Inc., CA) was used to simulate the effects of varying controlled release profiles and pharmacokinetic parameters based on in vivo plasma concentrations of NBI-34060 as measured in 12-healty male human subjects.
• Adjustment in half-life from 1.3 to 2.3 hours was made by changing clearance (CL) in a one-compartment pharmacokinetic model, with volume of distribution (Vd) held at 159.25 L (or 2.275 L/kg, assuming 70 kg subject weight).
• CL clearance
• Vd volume of distribution
• Two oral plasma concentration-time files were created (NBI-Target-Hi.opd and NBI-Target-Lo.opd) with plasma concentration-time points serving as targets (shown as a square in Figures 2, 3, 4 and 5).
• the requirements for Tmax 2 for the high target was set at 100% of Tmax,.
• Figures 2A and 3A illustrate the plasma concentrations achieved with a sedative-hypnotic compound of the present invention, having a half-life of 1.3 hours , with Figure 2A depicting the "Target High" profile (50 mg dosage) and Figure 3A depicting the target low profile (45 mg dosage).
• Figures 2B and 3B illustrate the corresponding calculated dissolution curves for the formulations of Figures 2A and 3A, respectively.
• Figures 4A and 5A illustrate the plasma concentrations achieved with a sedative-hypnotic compound outside the scope of this invention, having a half-life of 2.3 hours.
• Figure 4A depicts the "Target High” profile (41 mg dosage)
• Figure 5 A depicts the target low profile (35 mg dosage).
• Figures 4B and 5B illustrate the correspond calculated dissolution curves for the formulations of Figures 4A and 5A, respectively.
• the pulsed plasma concentration profile of this invention could not be achieved with a sedative- hypnotic compound having a half-life of 2.3 hours.
• NBI-34060 may be made according to known techniques, such as those disclosed in U.S. Patent No. 4,521 ,422.
• an appropriately substituted pyrazole (a) is reacted with an appropriately substituted 3-dimethylamino-2- propen-1-one (b) as represented by the following reaction scheme:
• Genus I is as described above, yields NBI-34060 when R 2 , R 5 and R 6 are hydrogen, R 3 is thienyl, and R 7 is 2-(N(Me)COCH 3 )-phenyl.
• Step 1 ?-Dimethylamino-l-(2-thienyl)-2-propen-l-one
• the pH of the aqueous mother liquors are adjusted to 7.6 with concentrated hydrochloric acid (Mallinckrodt).
• a second crop of material precipitats. This material (2.155 kg) is found to have a lower purity than the first crop of product.
• the two crops of product are combined and slurried with 20 L of ethyl acetate/hexanes (1 : 1). The solid is collected and washed with 4 L of hexanes. The material is slurried washed with 15 L of dichloromethane, filtered, then washed a second time with 12 L of dichloromethane.
• Step 5 N-r3-r3-(Dimethylamino)- 1 -oxo-2-propenyl]phenyl]acetamide
• Step 6 N-r3-r3-(Dimethylamino)- 1 -oxo-2-propenyllphenyll-N-methylacetamide
• N-[3-[3-(Dimethylamino)-l-oxo-2-propenyl]phenyl]acetamide (3.77 kg) is suspended in dimethylformamide (20 L; Van Waters) and the mixture chilled in an ice bath.
• Sodium hydride (808 g, 60% dispersion; Aldrich) is added to the suspension under a nitrogen atmosphere. The temperature of the reaction mixture is maintained below 10?C during the addition of the hydride. After the addition is complete the mixture is stirred for 1 hour, then methyl iodide (2.46 kg) is added slowly while maintaining the temperature below 10?C.
• reaction mixture is stirred overnight and allowed to come to room temperature. HPLC analysis of the reaction mixture shows 91.7% product and -2.3% of the starting material. The addition of methyl iodide (53 g; Aldrich) and continued stirring (5 hours) does not change this ratio.
• the reaction mixture is quenched by the addition of 1 L of water. The mixture is triturated with hexanes (2 X 4 L) which are discarded. Most of the DMF is removed under reduced pressure. The residue is diluted with water (6 L) and product is extracted with methylene chloride (20 L; Barton). The solution is dried over sodium sulfate, filtered and the solvent evaporated to give a solid.
• This material is triturated with hexanes (15 L) and ethyl acetate (15 L). The slurry was cooled to room temperature, filtered and washed with hexanes (0.5 L). This material is found to be only -91% product by HPLC (area %). The material is purified by column chromatography. The material is dissolved in methylene chloride and passed through a pad of silica (-18 kg). The polarity of the eluant is gradually increased by adding ethyl acetate (Barton). Eventually the column is flushed with ethyl acetate.
• Step 7 N-Methyl-N-r3-r3-(2-thienylcarbonyl)-pyrazolo[ 1 ,5-a]pyrimidin-7-yllphenv ⁇ acetamide
• a fifty liter flask is charged with 1.936 kg of (3-amino-lH-pyrazol-4-yl)-2- thienylmethanone, 2.450 kg of N-[3-[3-(dimethylamino)-l-oxo-2-propenyl]phenyl]-N- methylacetamide and 33.3 kg of acetic acid (Van Waters).
• the reaction mixture is heated at reflux for 6 hours.
• the reaction mixture is evaporated to a residue under reduced pressure while maintaining the temperature at approximately 45?C.
• the residue is dissolved in methylene chloride (8 L; Spectrum) then precipitated by the addition of 32 L of methyl-t- butyl ether.
• the solid is isolated by filtration and the cake washed with a small portion (3.6 L) of methyl-t-butyl ether (Van Waters).
• the solid is suspended in a mixture of hexanes (20 L) and ethyl acetate (20 L) and heated at reflux for 5 minutes. The mixture was allowed to cool to room temperature and the solid is isolated by filtration.
• the cake is washed with a small portion (6 L) of hexanes/ethyl acetate (1 : 1).
• the material is dissolved in hot methylene chloride (17 L) then the product is precipitated by the addition of hexanes (17 L).
• the mixture was allowed to cool to room temperature and the solid is collected by filtration.
• the solid may be further purified by crystallization from any one of a variety of known solvents and/or washing techniques.

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• 2000
  • 2000-08-28 DK DK00961399T patent/DK1206248T3/da active
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  • 2000-08-28 ES ES00961399T patent/ES2199857T3/es not_active Expired - Lifetime
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