WO2003020285A1 - Präparat zur behandlung weiblicher inkontinenz - Google Patents
Präparat zur behandlung weiblicher inkontinenz Download PDFInfo
- Publication number
- WO2003020285A1 WO2003020285A1 PCT/EP2002/009775 EP0209775W WO03020285A1 WO 2003020285 A1 WO2003020285 A1 WO 2003020285A1 EP 0209775 W EP0209775 W EP 0209775W WO 03020285 A1 WO03020285 A1 WO 03020285A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- estradiol
- preparation
- treatment
- incontinence
- bladder
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
- A61K31/565—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
Definitions
- the invention relates to a preparation for the treatment of pathological irritation of the bladder in women.
- urinary incontinence is an objectively demonstrable involuntary loss of urine. This loss of urine can lead to considerable social, hygienic and psychological impairments.
- the main forms of urinary incontinence are stress incontinence and urge incontinence.
- Stress incontinence means involuntary loss of urine when the intra-abdominal pressure is increased. It is in most cases due to a weak pelvic floor, e.g. B. after several heavy births, but it can also be the result of an innervation disorder of the pelvic floor with a neuromotor lesion, a congenital urethra that is too short, an epispadia or rarely the result of an operative injury to the external sphincter.
- Urge incontinence describes the involuntary loss of urine when there is a strong urge to urinate.
- the etiology of urge incontinence in women is unclear.
- An imbalance between afferent and inhibitory impulses must be seen as the cause of urge incontinence.
- This form of hyperactive voiding disorder is based on an increased acetylcholine secretion from parasympathetic neurons. Acetylcholine changed the membrane conductivity of smooth muscle cells for Ca 2+ and thereby initiates bladder muscle contractions.
- Anticholinergics have proven their worth in the treatment of urge incontinence, the function of which is to inhibit cholinergic receptors of the vesica detrusor.
- the use of anticholinergics has strong central effects such as dry mouth, dizziness, confusion as well
- Estrogens are usually used to treat symptoms that occur during menopause due to the decrease in estrogen production.
- the application of estrogens in postmenopausal women leads to a significant improvement in the micturition problem, which is characterized by recurrent infections, stress and urge incontinence.
- glycogen Through the incorporation of glycogen into the vaginal epithelium, estrogens promote the colonization of the vagina with lactobacilli, and thus ultimately the restoration of a normal vaginal flora.
- Estrogens therefore have a positive influence on the sensitivity and motor skills of the urethrovesical unit, so that they are used to treat urogenital age atrophy (UGA). Furthermore, various direct effects of estrogens on the bladder muscles are suspected.
- the invention relates to the use of 17 ⁇ -estradiol in preparations for the treatment of pollakiuria, imperative urge to urinate and urge incontinence.
- the invention relates to the use of 17-ß-estradiol in preparations together with formulations and additives customary in pharmacy.
- 17-ß-estradiol can also be combined with other active ingredients, in particular spasmolytics (phosphodiesterase inhibitors) and anticholinergics.
- active ingredients in particular spasmolytics (phosphodiesterase inhibitors) and anticholinergics.
- anticholinergics in particular tortureodin, oxybutynin, trospium chloride and the like come into question.
- the ratio of 17-ß-estradiol to the spasmolytic or anticholinergic should be in the ratio of 30: 70 to 70: 30 mol percent.
- the pharmaceutical agent also has a supportive effect in hormone replace therapy (HRT) in the perimenopausal phase.
- HRT hormone replace therapy
- Usual forms of administration such as. B. powders, tablets, capsules, suppositories or aqueous or oily dispersions, provided as well as transdermal application forms.
- tissue strips are obtained as part of transurethral bladder tumor resections (TURB) or as part of radical surgical interventions in the bladder.
- the tissue strips were transferred to Ringer's solution immediately after resection.
- the electro-caustically modified tissue edges were manually resected and the strips cut to a length of 10 x 3 x 5 mm.
- the strips could be preserved for up to 24 hours in oxygenated Ringer's solution.
- FIG. 1 shows the dose-response relationship of the acetylcholine-induced contraction of the bladder.
- the logarithmic concentration of acetylcholine was plotted against the mean contraction (expressed in% of the maximum contraction).
- the threshold concentration was 10 nM
- the EC 50 concentration was approx. 5 ⁇ M
- saturating effects were observed in minimal polar concentrations.
- FIG. 2 shows the dose-response relationship of the 17-ß-estradiol-induced inhibition of the ACH contraction, where the logarithmic concentration of 17-ß-estradiol is plotted against the mean contraction (% of the control contraction by 100 ⁇ M ACH).
- a maximum inhibition of approximately 50% by 17-ß-estradiol in millimolar concentration could be observed.
- the inhibition could only be measured on the female detrusor, which indicates a receptor-mediated process, since no estrogen receptors could be detected on the male detrusor. For these reasons, the experiments shown in the results of measurements on
- the inhibition of the basal, ie the non-cholinergic, pre-stimulated current was assessed as the pure Ca 2+ -antagonistic effect and the concentration-dependent antagonization of the ACH pre-stimulated current was designated as the anticholinergic effect.
- the current-voltage relationship in FIG. 3 shows a shift in the peak Ca 2+ current by +20 mV. In addition to the additional inhibition of the peak current, the rightward shift increases the activation threshold for the Ca 2+ current. 17-ß-estradiol inhibits both basal and cholinergic stimulated Ca 2+ flow.
Landscapes
- Health & Medical Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE2001143009 DE10143009A1 (de) | 2001-09-03 | 2001-09-03 | Präparat zur Behandlung weiblicher Inkontinenz |
DE10143009.4 | 2001-09-03 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2003020285A1 true WO2003020285A1 (de) | 2003-03-13 |
Family
ID=7697474
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2002/009775 WO2003020285A1 (de) | 2001-09-03 | 2002-09-02 | Präparat zur behandlung weiblicher inkontinenz |
Country Status (2)
Country | Link |
---|---|
DE (1) | DE10143009A1 (de) |
WO (1) | WO2003020285A1 (de) |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP3429338B2 (ja) * | 1992-07-27 | 2003-07-22 | 杏林製薬株式会社 | 新規なアリールグリシンアミド誘導体及びその製造法 |
DE19935209A1 (de) * | 1999-07-27 | 2001-02-08 | Truss Michael C | Verwendung von Substanzen, die den intrazellulären Gehalt von zyklischem Adenosinmonophosphat (cAMP) erhöhen oder die Aktivität cAMP-bindender Proteine stimulieren, zur Behandlung von Erkrankungen der Harnblase |
-
2001
- 2001-09-03 DE DE2001143009 patent/DE10143009A1/de not_active Withdrawn
-
2002
- 2002-09-02 WO PCT/EP2002/009775 patent/WO2003020285A1/de not_active Application Discontinuation
Non-Patent Citations (9)
Title |
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ALTWEIN ET AL.: "Urologie", 1993, ENKE, STUTTGART, XP002225882 * |
BLOM M W ET AL: "The effects of estraderm TTS, alone and in combination with naproxen on urge incontinence in elderly females.", THERAPIE (PARIS), no. SUPPL., 1995, 1st Congress of the European Association for Clinical Pharmacology and Therapeutics;Paris, France; September 27-30, 1995, pages 328, XP002225880, ISSN: 0040-5957 * |
DATABASE BIOSIS [online] BIOSCIENCES INFORMATION SERVICE, PHILADELPHIA, PA, US; 1995, YASAY G D ET AL: "Mechanoinhibitory effect of estradiol in guinea pig urinary bladder smooth muscles.", XP002225883, Database accession no. PREV199698591857 * |
FEIGE ET AL.: "Frauenheilkunde", 1997, URBAN & SCHWARZENBERG, MÜNCHEN WIEN, XP002225881 * |
LOSE G ET AL: "Oestradiol-releasing vaginal ring versus oestriol vaginal pessaries in the treatment of bothersome lower urinary tract symptoms.", BJOG: AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. ENGLAND AUG 2000, vol. 107, no. 8, August 2000 (2000-08-01), pages 1029 - 1034, XP009003358, ISSN: 1470-0328 * |
LOSE G: "MEDICAL TREATMENT OF FEMALE URGE INCONTINENCE", ANNALS OF MEDICINE, vol. 22, no. 6, 1990, pages 449 - 454, XP009003318, ISSN: 0785-3890 * |
PHARMACOLOGY (BASEL), vol. 51, no. 5, 1995, pages 273 - 280, ISSN: 0031-7012 * |
PUNNONEN R ET AL: "Conservative treatment of urinary incontinence in women with special reference to the use of oestrogens.", MATURITAS. NETHERLANDS DEC 1981, vol. 3, no. 3-4, December 1981 (1981-12-01), pages 309 - 313, XP009003357, ISSN: 0378-5122 * |
STOTHERS LYNN: "A cost effectiveness and utility analysis of the estradiol vaginal ring for treatment of menopausal voiding dysfunction.", JOURNAL OF UROLOGY, vol. 159, no. 5 SUPPL., May 1998 (1998-05-01), 93rd Annual Meeting of the American Urological Association, Inc.;San Diego, California, USA; May 30-June 4, 1998, pages 302, XP009003353, ISSN: 0022-5347 * |
Also Published As
Publication number | Publication date |
---|---|
DE10143009A1 (de) | 2003-03-20 |
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