WO2003024489A2 - Combination of a nsaid and a pde-4 inhibitor - Google Patents

Combination of a nsaid and a pde-4 inhibitor Download PDF

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Publication number
WO2003024489A2
WO2003024489A2 PCT/EP2002/010424 EP0210424W WO03024489A2 WO 2003024489 A2 WO2003024489 A2 WO 2003024489A2 EP 0210424 W EP0210424 W EP 0210424W WO 03024489 A2 WO03024489 A2 WO 03024489A2
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WO
WIPO (PCT)
Prior art keywords
inn
acid
methyl
alpha
ester
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PCT/EP2002/010424
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French (fr)
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WO2003024489A3 (en
Inventor
Thomas Klein
Hans-Peter Kley
Armin Hatzelmann
Manfrid Eltze
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Altana Pharma Ag
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Publication date
Priority to EA200400410A priority Critical patent/EA008108B1/en
Priority to US10/489,920 priority patent/US20040242597A1/en
Application filed by Altana Pharma Ag filed Critical Altana Pharma Ag
Priority to AU2002337105A priority patent/AU2002337105B2/en
Priority to BR0212606-0A priority patent/BR0212606A/en
Priority to IL16027102A priority patent/IL160271A0/en
Priority to KR1020047004047A priority patent/KR100949528B1/en
Priority to MXPA04002562A priority patent/MXPA04002562A/en
Priority to SI200230534T priority patent/SI1429807T1/en
Priority to HU0401582A priority patent/HU229442B1/en
Priority to DK02772313T priority patent/DK1429807T3/en
Priority to DE60218497T priority patent/DE60218497T2/en
Priority to JP2003528583A priority patent/JP4588998B2/en
Priority to CA2459757A priority patent/CA2459757C/en
Priority to EP02772313A priority patent/EP1429807B1/en
Priority to NZ532278A priority patent/NZ532278A/en
Publication of WO2003024489A2 publication Critical patent/WO2003024489A2/en
Publication of WO2003024489A3 publication Critical patent/WO2003024489A3/en
Priority to IL160271A priority patent/IL160271A/en
Priority to ZA2004/02654A priority patent/ZA200402654B/en
Priority to NO20041596A priority patent/NO331756B1/en
Priority to HK04109770A priority patent/HK1066730A1/en
Priority to US12/003,129 priority patent/US8242146B2/en

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    • 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • 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
    • 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the invention relates to the combination of certain known active compounds for therapeutic purposes.
  • the substances used in the combination according to the invention are known active compounds from the PDE4-inhibitor class and active compounds from the non-steroidal anti-inflammatory drug (NSAID) class.
  • NSAID non-steroidal anti-inflammatory drug
  • NSAIDs nonsteroidal anti-inflammatory drugs
  • Gl gastro-intestinal
  • celecoxib selectively increased coronary heart flow at doses consistent with its inhibitory potency on PDE4 and 5, but had no effect on left ventricular pressure and heart rate, thereby excluding inhibition of PDE3.
  • diclofenac 3-100 mg/kg, p.o.
  • ED 50 56 mg/kg
  • spectrophotometric determination of fecal hemoglobin 56 mg/kg
  • NSAIDs with preferential COX-2 selectivity possess PDE4 and PDE5 inhibitory potency on isolated enzymes, an effect which was confirmed in the Langendorff heart by an increase in coronary flow. It seems that the intrinsic PDE4 - but not the intrinsic PDE5 - inhibitory component of NSAIDs with preferential COX-2 selectivity most likely contribute to the gastrointestinal safety of these drugs. Furthermore, gastrointestinal side effects of conventional NSAIDs can be atten- tuated or even prevented, if these class of compounds is applied in combination with a compound from the class of selective PDE4 inhibitors.
  • the invention thus relates to the combined use of a PDE4 inhibitor and a conventional NSAID in the treatment of an inflammatory disease and/or an inflammation-associated disorder while minimizing gastrointestinal side effects, such as gastric erosions and ulcer, which are frequently associated with the use of conventional NSAIDs.
  • Combined use in the context of the invention means the simultaneous, sequential or separate administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand.
  • Simultaneous administration includes - aside from the simultaneous uptake of two separate dosage forms containing the conventional NSAID in the one and the PDE4 inhibitor in the other dosage form - pharmaceutical compositions containing both active ingredients in one single dosage form (fixed unit dose form).
  • Simultaneous administration also includes the oral administration of the PDE4 inhibitor during i. v. administration (e. g. by infusion) of the conventional NSAID, or shortly after intramuscular or intravenous injection of the conventional NSAID.
  • Sequential administration in the context of the invention means the administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand in separate dosage forms within less than 12 hours, more preferably within less than one hour, most preferably within 5 minutes or less, including regimen where the PDE4 inhibitor is administered first.
  • Separate administration within the context of the invention means the administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand in separate dosage forms within 12 hours or more, including administration regimen where the PDE4 inhibitor is administered first, and including regimen where e. g. the conventional NSAID is administered twice or three times daily and the PDE4 inhibitor is administered once or twice daily.
  • Sequential and separate administration also include the oral administration of the PDE4 inhibitor and the i. v. administration (e. g. by infusion) or intramuscular or intravenous injection of the conventional NSAID.
  • Combined use in the context of the invention also includes a pharmaceutical product comprising both the conventional NSAID and the PDE4 inhibitor as discrete separate dosage forms, in separate containers or e. g. in blisters containing both types of drugs in discrete solid dosage units, preferably in a form in which the dosage units which have to be taken together or which have to be taken within one day are grouped together in a manner which is convenient for the patient.
  • Said pharmaceutical product itself or as a part of a kit may contain instructions for the simultaneous, sequential or separate administration of the discrete separate dosage units, to a patient in need thereof.
  • PDE4 inhibitor is meant a phosphodiesterase inhibitor, which selectively inhibits the type 4 phosphodiesterase when compared to other known types of phosphodiesterase, e.g. type 1, 2, 3, 5 etc., whereby the compound has a lower IC 50 (more potent) for the type 4 phosphodiesterase, such as where the IC 50 for PDE4 inhibition is about factor 100 lower compared to IC S0 for inhibition of other known type of phosphodiesterase, e.g. type 1 , 2, 3, 5 etc.
  • NSAID a cyclooxygenase inhibitor which inhibits both, the constitutive form (COX-1) and the inducible form (COX-2) of the cyclooxygenase and does not contain any of the following residues: -S(0) 2 NH 2 , -S(0) 2 CH 3 , -S(0) 2 N(H)C(0)CH 2 CH 3 and -N(H)-S(0) 2 -CH 3 .
  • PDE4 inhibitors within the meaning of the present invention are those which are named expressis verbis as an example or described and/or claimed generically in the following patent applications and patents: EP0428302, EP0731099, W09212961 , W09319749, WO9402465, WO9500516, WO9501338, WO9611690, WO9603399, W09636625, W09636626, W09723457, W09728131 , W09735854, W09743288, WO9807715, WO9808841 , WO9809946, WO9821207, WO9821209, W09822453, W09831674, WO9905111, WO9905112, WO9905113, WO9931090, W09957115, W09964414, WO0001695, WO0026208, WO0042017, WO0042018, WO0042019, WO0042020, WO0042034, WO
  • Preferred PDE4 inhibitors which are selected from the above-defined PDE4 inhibitors are the compounds with the research codes CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8- methoxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1-oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code:
  • PDE4-inhibitors are cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclo- hexane-1-carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-di- chloropyrid-4-yl)-benzamide [INN: ROFLUMILAST].
  • NSAIDs within the meaning of the present invention are glycolic acid [o-(2,6-dichloroani- lino)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole- 3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALI- CYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyIoxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hydratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-(
  • Preferred conventional NSAIDs which are selected from the above-defined group of conventional NSAIDs are 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]- benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-meth- oxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN] and 4-hydroxy-2-methyl-N-2-pyridyl-2H- 1,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM].
  • ACETYLSALICYLIC ACID 2-[(2,6-d
  • An particularly preferred conventional NSAID is 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC].
  • a pharmaceutically acceptable derivative of an active ingredient means a pharmaceutically acceptable salt or solvate (e. g. hydrate), a pharmaceutically acceptable solvate of such salt, a pharmaceutically acceptable N-oxide or a pharmaceutically acceptable salt or solvate of the latter.
  • Suitable pharmacologically tolerable salts are on the one hand in particular water-soluble and water-insoluble acid addition salts with acids such as, for example, hydrochloric acid, hydrobromic acid, phosphoric acid, nitric acid, sulfuric acid, acetic acid, citric acid, D-gluconic acid, benzoic acid, 2-(4-hydroxybenzoyl)-benzoic acid, butyric acid, sulfosalicylic acid, maleic acid, lauric acid, malic acid, fumaric acid, succinic acid, oxalic acid, tartaric acid, embonic acid, stearic acid, toluenesulfonic acid, methanesulfonic acid or 1-hydroxy-2-naphthoic acid, the acids being employed in salt preparation - depending on whether it is a mono- or polybasic acid and depending on which salt is desired - in an equimolar quantitative ratio or one differing therefrom.
  • the active compounds mentioned can also be present
  • salts with bases are also suitable.
  • examples of salts with bases which may be mentioned are alkali metal (lithium, sodium, potassium) or calcium, aluminum, magnesium, titanium, ammonium, meglumine or guanidinium salts, where here too the bases are employed in salt preparation in an equimolar quantitative ratio or one differing therefrom.
  • Certain of the active ingredients used in the present invention are capable of existing in stereoisomeric forms.
  • the invention encompasses all stereoisomers of the active ingredients and mixtures thereof including racemates. Tautomers and mixtures thereof of the active ingredients are also part of the present invention.
  • a pharmaceutical composition comprising, in admixture, a first active ingredient which is a PDE4-inhibitor selected from CDC- 998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2-(trifluoromethyI)quinoIine-5- ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenz- yl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl- 3,4,6J-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4-carboxamide [
  • a pharmaceutical composition comprising, in admixture, a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-di- chlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic
  • a pharmaceutical composition comprising, in admixture, a first active ingredient which selected from 3-Cyclopropylmeth- oxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its Pharmaceutically acceptable derivatives, and a second active ingredient which is selected from 2-[(2,6-dichlo- rophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives.
  • the invention provides a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is a PDE4-inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine- 1-oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethyIamino)-8- isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyI-3,4,6,7-tetrahydropyrro- lo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-
  • a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYL- SALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p- isobutyl
  • a PDE4-inhibitor selected from cis-[
  • a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is selected from 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is selected from 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives, for simultaneous, sequential or separate use in therapy.
  • a preparation of a first active ingredient which is selected from 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives
  • a preparation of a second active ingredient which is selected from 2-[(2,6-dichlorophenyl)amino
  • the invention provides a kit comprising a preparation of a first active ingredient which is a PDE4-inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichlo- ro-4-[8-methoxy-2-(trifluoromethyI)quinoline-5-ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo- diazepin-3(R)-yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(
  • the invention provides a kit comprising a preparation of a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4- (3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cycloprop- ylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichloro- phenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenyl
  • a ninth aspect - which is another embodiment of the seventh aspect - the invention provides a kit comprising a preparation of a first active ingredient which is selected from 3-Cyclopropy!methoxy-4- difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is selected from 2-[(2,6- dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives, and instructions for the simultaneous, sequential or separate administration of the preparations to a patient in need thereof.
  • the pharmaceutical composition of the present invention may be prepared by mixing the first active ingredient with the second active ingredient.
  • the first active ingredient and the second active ingredient can a) in a first step be mixed as such, afterwards be processed with pharmaceutically acceptable auxiliaries and/or excipients and finally pressed to tablets or caplets or b) in a first step separately be processed with pharmaceutically acceptable auxiliaries and/or excipients to give granules or pellets containing each only one of the two active ingredients; the pellets or granules for their part then can be mixed in an appropriate ratio and either be pressed - optionally with further pharmaceutically acceptable auxiliaries and/or excipients - to give for example, tablets or cap- lets, or can be filled in more or less loose form in capsules.
  • a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is a PDE4- inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2- (trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1-oxide [Research Code: SCH351591], 3-[3-(cy- clopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4- carboxamide [Research-Code:
  • a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1- carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4- yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, with a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYL- SALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p- isobutylpheny
  • a PDE4-inhibitor selected from cis-[4-
  • a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is selected from 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yI)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, with a second active ingredient which is selected from 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives.
  • the present invention further provides the use of a pharmaceutical composition, or pharmaceutical product according to the invention in the manufacture of a medicament for the treatment of an inflammatory disease and/or an inflammation associated disorder.
  • the present invention provides a method of an effective treatment of an inflammatory disease and/or an inflammation associated disorder which can be treated with a conventional NSAID while minimizing gastrointestinal side effects comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
  • the present invention provides a method of minimizing gastrointestinal side effects frequently associated with the use of conventional NSAIDs comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
  • Said methods also include a pharmaceutical product or kit containing a conventional NSAID and a written description which discloses that said conventional NSAID can be administered together with a PDE4 inhibitor (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs.
  • said methods include a pharmaceutical product or kit containing a PDE4 inhibitor and a written description which discloses that said PDE4 inhibitor can be administered together with a conventional NSAID (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs.
  • Inflammatory diseases which may be mentioned in particular are arthritis, including but not limited to rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus and juvenile arthritis; gastrointestinal conditions such as inflammatory bowel disease, Crohn's disease, irritable bowel syndrome and ulcera- tive colitis; asthma, bronchitis and skin related disorders such as psoriasis, eczema, burns and dermatitis.
  • “Inflammation associated disorders” which may be mentioned are, for example, pain, migraine, fever and headaches.
  • the active ingredients may, and indeed will, as part of the pharmaceutical composition, the pharmaceutical product or preparation, be used in admixture with one or more pharmaceutically acceptable auxiliaries and/or excipients.
  • excipients or auxiliaries are suitable for the desired pharmaceutical composition, product or preparation.
  • solvents for example, antioxidants, dispersants, emulsifiers, antifoams, flavor corrigents, preservatives, solubilizers, colorants or permeation promoters and complexing agents (e.g. cyclodextrins).
  • combined use is preferably understood as meaning the oral administration of both active ingredients.
  • Further methods of administration which may be mentioned are the parenteral (for example intravenous injection or infusion or intramuscular or intraarticu- lar injection) and the topical administration of the active ingredients.
  • the pharmaceutical compositions or products according to the invention are preferably in the form of tablets, coated tablets, chewing tablets, lemonade tablets, dragees, capsules, caplets, suppositories, emulsions, (sterile parenteral) suspensions or solutions, the active ingredient content advantageously being between 0.1 and 95% and by appropriate choice of the excipients and the auxiliaries, it being possible to achieve a pharmaceutical administration form precisely tailored to the active ingredient(s) and/or to the desired onset of action (e.g. a sustained release form or an enteric form).
  • the compounds according to the invention also can be used in form of pharmaceutical compositions or products which are suitable for topical application.
  • suitable pharmaceutical formulations which may be mentioned in this connection are, for example, ointments, fatty ointments, creams, pastes or gels.
  • the pharmaceutical compositions or products for topical application can preferably also be in form of a patch (e.g. as TTS).
  • the dosages administered will, of course, vary with the first and second active ingredients employed, the mode of administration, the treatment desired and the disorder indicated. However, in general, satisfactory results will be obtained when the total daily dosage of first active ingredient(s), the PDE4 inhibitor(s), when taken oral is in the range from 1 - 2000 ⁇ g/kg of body weight. In the case of the especially preferred PDE4 inhibitor ROFLUMILAST, the daily dosage is in a range from 2 - 20 ⁇ g/kg of body weight.
  • the total daily dosage of the second active ingredient(s), the conventional NSAIDs also can vary within a wide range.
  • the daily doses are in a range from 100 - 2000 ⁇ g/kg.
  • ASS acetylsalicylic acid; diclofenac, 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid; indomethacin, 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid; nimesulide, 4'-nitro-2'-phenoxyme- thansulfonamide; CGP28238, 6-(2,4-difluorophenoxy)-5-methylsulfonylamino-1-indanone; L-745337 5-methanesulfonamido-6-(2,4-difluorophenylthio)-1-indanone); celecoxib, (4-[5-(4-methylphenyl)-3-(tri- fluoromethyl)-1 H-pyrazol-1-yl]benzenesulfonamide.
  • celecoxib selectively increased coronary heart flow at doses consistent with its inhibitory potency on PDE4 and 5, but had no effect on left ventricular pressure and heart rate, thereby excluding inhibition of PDE3.
  • mice Male NMRI mice (Charles River Laboratories, Sulzfeld, Germany) weighting 23-25 g were housed in groups of 5 under standard conditions at a temperature of 22°C +/-2°C and a 12h light-dark cycle. If not otherwise stated animals had free access to tap water and standard food pellets.
  • Diclofenac was administrated at doses from 1-100 mg/kg p.o.; rolipram, roflumliast and RP73401 were given at doses from 1-100 mg/kg p.o.
  • Preventive treatment Diclofenac was given at time point Oh. At time points -24, -16, Oh, +7h one of the selective PDE4 inhibitors was administered.
  • Diclofenac was given at time point Oh. At time points +1h and +7h one of the selective PDE4 inhibitors was administered. The drugs used were dissolved in 4% aqueos methyl cellulose. The animals were food reduced 24h prior diclofenac administration. For each experiment 5 animals were used for one experimental point. Following 24h administration of drugs animals were weighted and stool was collected quantitatively and homogenized as described below:
  • the modified method of Welch (Clin. Chem. 29/12, 2022-2025, 1983) was used.
  • the amount of hemoglobin was determined by the heme catalyzed oxidation of tolidine in the presence of hydrogen peroxide.
  • Feces was homogenized in destilled water in a concentration with 1g feces/6.6ml H20 with an ultra-turrax (IKA-Werke, Germany). 500 ⁇ l aliquots from two different areas of the stool were taken to minimize error due to inhomogenous distribution of blood in the feces and heated 10 min at 95°C to inactivate peroxidases and than diluted with 500 ⁇ l of acetic acid/H20 (30/70 vol/vol).
  • Hemoglobin was extracted in 2.5 ml of acetic acid/H20 (30/70 vol/vol) by the addition of 4.5 ml ethyl acetate. The sample was rigorously shacked and the supernatant was used following a centrifugation step for optical detection of hemoglobin.
  • Tolidine was prepared freshly from a stock solution (0.4g tolidine in 10ml ethanol) by mixing equal volumes of stock solution, H20 and acetic acid and equilibrated at room temperature. 20 ⁇ l of extracted supernatant was diluted to 100 ⁇ l ethyl acetate in a 96er crystall plate and incubated with 50 ⁇ l of the working solution.
  • Table 2 shows the % reduction of the ⁇ OD 6go /min when a PDE4 inhibitor was administered (preventive or curative) compared to the ⁇ OD 690 /min obtained without the administration of a PDE4-inhibitor.

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Abstract

The invention relates to the combined administration of PDE4-inhibitors and NSAIDs for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointesti-nal side effects, such as gastric erosions and ulcer, which are frequently associated with the use of NSAIDs.

Description

Combination
Field of application of the invention
The invention relates to the combination of certain known active compounds for therapeutic purposes.
The substances used in the combination according to the invention are known active compounds from the PDE4-inhibitor class and active compounds from the non-steroidal anti-inflammatory drug (NSAID) class.
Known technical background
In the International Patent Application WO01/58441 the treating of an inflammatory disease by administering a phosphodiesterase 4 inhibitor in combination with an inhibitor of prostaglandin synthesis, NSAIDS being exemplary, is disclosed.
Description of the invention
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is often associated with the development of gastro-intestinal (Gl) side effects such as gastric erosions and ulcer, which limit their widespread clinical use.
Investigations into the role of several NSAIDs in inhibiting the phosphodiesterase 4 and 5 in vitro showed that in partially purified or recombinant PDE4 and PDE5, NSAIDs with preferential COX-2 selectivity (for example, nimesulide [INN], CGP28238 [Research Code], L-745337 [Research Code], and the highly selective drug celecoxib [INN]) possess PDE4 and PDE5 activity in the μM range, whereas conventional NSAIDs (for example, acetylsalicylic acid, diclofenac [INN] or indometacin [INN]) show only minor effects.
In isolated guinea pig Langendorff hearts, celecoxib selectively increased coronary heart flow at doses consistent with its inhibitory potency on PDE4 and 5, but had no effect on left ventricular pressure and heart rate, thereby excluding inhibition of PDE3. In mice, diclofenac (3-100 mg/kg, p.o.) induced gastrointestinal bleeding (ED50 = 56 mg/kg), assessed by spectrophotometric determination of fecal hemoglobin. Treatment with diclofenac (10-100 mg/kg, p.o. t = 0 h) in the presence of the selective PDE5 inhibitor sildenafil (3-100 mg/kg, p.o. t = - 48 h to +7 h) demonstrated no protection from NSAID-induced blood loss, whereas treatment in the presence of several selective PDE4 inhibitors significantly reduced the amount of detectable hemoglobin.
In summary, one can say that NSAIDs with preferential COX-2 selectivity possess PDE4 and PDE5 inhibitory potency on isolated enzymes, an effect which was confirmed in the Langendorff heart by an increase in coronary flow. It seems that the intrinsic PDE4 - but not the intrinsic PDE5 - inhibitory component of NSAIDs with preferential COX-2 selectivity most likely contribute to the gastrointestinal safety of these drugs. Furthermore, gastrointestinal side effects of conventional NSAIDs can be atten- tuated or even prevented, if these class of compounds is applied in combination with a compound from the class of selective PDE4 inhibitors.
The invention thus relates to the combined use of a PDE4 inhibitor and a conventional NSAID in the treatment of an inflammatory disease and/or an inflammation-associated disorder while minimizing gastrointestinal side effects, such as gastric erosions and ulcer, which are frequently associated with the use of conventional NSAIDs.
"Combined use" in the context of the invention means the simultaneous, sequential or separate administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand.
Simultaneous administration includes - aside from the simultaneous uptake of two separate dosage forms containing the conventional NSAID in the one and the PDE4 inhibitor in the other dosage form - pharmaceutical compositions containing both active ingredients in one single dosage form (fixed unit dose form).
Simultaneous administration also includes the oral administration of the PDE4 inhibitor during i. v. administration (e. g. by infusion) of the conventional NSAID, or shortly after intramuscular or intravenous injection of the conventional NSAID.
Sequential administration in the context of the invention means the administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand in separate dosage forms within less than 12 hours, more preferably within less than one hour, most preferably within 5 minutes or less, including regimen where the PDE4 inhibitor is administered first.
Separate administration within the context of the invention means the administration of the conventional NSAID on the one hand and of the PDE4 inhibitor on the other hand in separate dosage forms within 12 hours or more, including administration regimen where the PDE4 inhibitor is administered first, and including regimen where e. g. the conventional NSAID is administered twice or three times daily and the PDE4 inhibitor is administered once or twice daily.
Sequential and separate administration also include the oral administration of the PDE4 inhibitor and the i. v. administration (e. g. by infusion) or intramuscular or intravenous injection of the conventional NSAID.
"Combined use" in the context of the invention also includes a pharmaceutical product comprising both the conventional NSAID and the PDE4 inhibitor as discrete separate dosage forms, in separate containers or e. g. in blisters containing both types of drugs in discrete solid dosage units, preferably in a form in which the dosage units which have to be taken together or which have to be taken within one day are grouped together in a manner which is convenient for the patient. Said pharmaceutical product itself or as a part of a kit may contain instructions for the simultaneous, sequential or separate administration of the discrete separate dosage units, to a patient in need thereof.
By the expression "PDE4 inhibitor" is meant a phosphodiesterase inhibitor, which selectively inhibits the type 4 phosphodiesterase when compared to other known types of phosphodiesterase, e.g. type 1, 2, 3, 5 etc., whereby the compound has a lower IC50 (more potent) for the type 4 phosphodiesterase, such as where the IC50 for PDE4 inhibition is about factor 100 lower compared to ICS0 for inhibition of other known type of phosphodiesterase, e.g. type 1 , 2, 3, 5 etc.
By "conventional NSAID" is meant a cyclooxygenase inhibitor which inhibits both, the constitutive form (COX-1) and the inducible form (COX-2) of the cyclooxygenase and does not contain any of the following residues: -S(0)2NH2, -S(0)2CH3, -S(0)2N(H)C(0)CH2CH3 and -N(H)-S(0)2-CH3.
PDE4 inhibitors within the meaning of the present invention are those which are named expressis verbis as an example or described and/or claimed generically in the following patent applications and patents: EP0428302, EP0731099, W09212961 , W09319749, WO9402465, WO9500516, WO9501338, WO9611690, WO9603399, W09636625, W09636626, W09723457, W09728131 , W09735854, W09743288, WO9807715, WO9808841 , WO9809946, WO9821207, WO9821209, W09822453, W09831674, WO9905111, WO9905112, WO9905113, WO9931090, W09957115, W09964414, WO0001695, WO0026208, WO0042017, WO0042018, WO0042019, WO0042020, WO0042034, WO0130766, WO0130777, WO0151470, WO0206239, WO0206270, WO0205616 and WO0206238 and additionally the following compounds identified by their research codes: CDC-998, D-4396, IC-485, CC-1088 and KW-4490. Substances having good oral availability are preferred here. Preferred PDE4 inhibitors which are selected from the above-defined PDE4 inhibitors are the compounds with the research codes CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8- methoxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1-oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code:
V 11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)- yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1-(4-fluorobenzyl)- 5-hydroxy-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-dichloropyridin-4-yl)- 2-[5-fluoro-1-(4-fluorobenzyl)-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino- 1 ,3-bis(cyclopropylmethyl)xanthine [INN:CIPAMFYLLINE], Tetrahydro-5-[4-methoxy-3-[(1S,2S,4R)-2- norbornyloxy]phenyI]-2(1 H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclopentyloxy)-4-methoxyphenyl]- 1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyl)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichloropy- rid-4-yl)-3-cyclopentyloxy-4-methoxybenzamide [INN: PICLAMILASTJ, cis-[4-Cyano-4-(3-cyclopentyl- oxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy- 4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST].
Particularly preferred PDE4-inhibitors are cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclo- hexane-1-carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-di- chloropyrid-4-yl)-benzamide [INN: ROFLUMILAST].
Conventional NSAIDs within the meaning of the present invention are glycolic acid [o-(2,6-dichloroani- lino)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole- 3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALI- CYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyIoxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hydratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1- hydroxyethoxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyl)pyrrol-2-acetamido- acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzoyl)-1 H pyrrolizine- 1-carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7- trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2-propyl-1 H- pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyl sali- cylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yl)methoxy]-2-methylpropionic acid [INN: BIN- DARIT], [2-amino-3-(p-bromobenzoyi)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chloro-4-cyclohex- ylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BUCO- LOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-di- phenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methy!propyl)benzeneacetic acid [INN: BU- TIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1 ) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1 -cinnamoyl-5-meth- oxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl-4-cinnamoyloxy-2H-1 ,2- benzothiazine-3-carboxamide-1 ,1 -dioxide [INN: CINNOXICAM], 6-chloro-5-cyclohexyl-1-indancarb- oxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyIoxy]-2-methylpropionic acid [INN: CLOBU- ZARIT], 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)-p-isobutylhy- dratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hydroxy-3-bi- phenyicarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3-thiopheneacetic acid [INN: ELTE- NAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyrano[3,4-b]in- dole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2-hydroxy- ethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hydroxymethyl)- 1 ,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenylylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phenyl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chloro- phenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy-1 ,1-dimeth- ylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4,-difluorobiphenylyl)-4-oxo-2-methyl- butanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFE- NAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPRO- FEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fluoro-4- biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro- 5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phenyl]propionic acid [INN: FURPRO- FEN], 2-[2-[1-(p-chlorobenzoyI)-5-methoxy-2-methylindol-3-yl]acetamido]-2-deoxy-D-glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4-nitrooxybutyIester [Research Code: HCT- 1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methylacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-ehlorobenzoyl)-5- methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2- methyl-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2,6,10-dodecatrienyl ester [INN: INDOMETACIN FAR- NESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H-benzo[4,5]- cyclohepta[1,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H-1,2-dihydropyrrolo[1 ,2-a]pyrrole-1-carboxylic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1- phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno- [2,3-e]-1 ,2-thiazine-3-carboxamide 1 ,1 -dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclopentan-1-yl- methyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-methyl- N-(5-methyl-2-thiazolyl)-2H-1 ,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELOXICAM], 5-ami- nosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro-1 H- pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5-isoxazoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-meth- oxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)anilino]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSALAZINE], alpha-methyl-4-[(2-oxocyclo- hexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)propionic acid 2-pyridyl-m ethyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyl)-1-(p-fluorophenyl)pyrazole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H- (1 )benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'-theno- yl)phenol [INN: PRIFELONE], aIpha-cyano-1-methyl-beta-oxopyrrole-2-propionanilide [INN: PRINOMI- DE], 3-[4-(2-hydroxyethyl)-1 -piperazinyl]-propyl-D,L-4-benzamido-N,N-dipropylglutaramat 1 -(p-chloro- benzoyl)-5-methoxy-2-methylindole-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1-methyl- ethyl)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphenothiazi- ne-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2- methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMISTEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SULIN- DAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)propionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,aipha-trifluoro-m-toIuidino)nicotinate [INN: TALNIF- LUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarb- oxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]- 1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4-methoxyphenyl)- N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thienyl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3-[4-(2-hydroxyethyl)-1-piperazinyl]carbonylmethyl-2-benzo- thiazolin one [INN: TIARAMIDE], 2-(2-methyl-5H-[1]benzopyrano[2,3-b]pyridin-7-yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2-(2-methyl-4- quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl-4,5,6,7-tetrahydrothieno[2,3- c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-meth- y|-5-(4-methylbenzoyl)-1 H-pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha-methyl-4-(2- methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphen- yl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohexyl]phenyl]propio- nic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN] and 2-[4-(2-thiazolyloxy)phenyl]-propionic acid [INN: ZOLIPROFEN].
Preferred conventional NSAIDs which are selected from the above-defined group of conventional NSAIDs are 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]- benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-meth- oxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN] and 4-hydroxy-2-methyl-N-2-pyridyl-2H- 1,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM].
An particularly preferred conventional NSAID is 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC].
In the context of the present invention, unless otherwise stated, a pharmaceutically acceptable derivative of an active ingredient means a pharmaceutically acceptable salt or solvate (e. g. hydrate), a pharmaceutically acceptable solvate of such salt, a pharmaceutically acceptable N-oxide or a pharmaceutically acceptable salt or solvate of the latter.
Suitable pharmacologically tolerable salts here are on the one hand in particular water-soluble and water-insoluble acid addition salts with acids such as, for example, hydrochloric acid, hydrobromic acid, phosphoric acid, nitric acid, sulfuric acid, acetic acid, citric acid, D-gluconic acid, benzoic acid, 2-(4-hydroxybenzoyl)-benzoic acid, butyric acid, sulfosalicylic acid, maleic acid, lauric acid, malic acid, fumaric acid, succinic acid, oxalic acid, tartaric acid, embonic acid, stearic acid, toluenesulfonic acid, methanesulfonic acid or 1-hydroxy-2-naphthoic acid, the acids being employed in salt preparation - depending on whether it is a mono- or polybasic acid and depending on which salt is desired - in an equimolar quantitative ratio or one differing therefrom. Furthermore, the active compounds mentioned can also be present as pure enantiomers or as enantiomer mixtures in any mixing ratio.
On the other hand, salts with bases are also suitable. Examples of salts with bases which may be mentioned are alkali metal (lithium, sodium, potassium) or calcium, aluminum, magnesium, titanium, ammonium, meglumine or guanidinium salts, where here too the bases are employed in salt preparation in an equimolar quantitative ratio or one differing therefrom.
Certain of the active ingredients used in the present invention are capable of existing in stereoisomeric forms. The invention encompasses all stereoisomers of the active ingredients and mixtures thereof including racemates. Tautomers and mixtures thereof of the active ingredients are also part of the present invention.
In accordance with the present invention, there is provided in a first aspect a pharmaceutical composition comprising, in admixture, a first active ingredient which is a PDE4-inhibitor selected from CDC- 998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2-(trifluoromethyI)quinoIine-5- ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenz- yl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl- 3,4,6J-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4-carboxamide [Research-
Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1-(4-fluorobenzyl)-5-hydroxy-1 H-indol-3-yl]-2-oxoacet- amide [Research-Code: AWD-12-281], N-(3,5-dichloropyridin-4-yl)-2-[5-fluoro-1-(4-fluorobenzyI)-1 H- indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino-1 ,3-bis(cyclopropylmethyl)xanthi- ne [INN:CIPAMFYLLINE], Tetrahydro-5-[4-methoxy-3-[(1 S,2S,4R)-2-norbornyloxy]phenyl]-2(1 H)-pyri- midone [INN: ATIZORAM], β-[3-(CycIopentyloxy)-4-methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H- isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenyl- carbonyl)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichIoropyrid-4-yl)-3-cyclopentyl- oxy-4-methoxybenzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)- cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5- dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6- dichloroanilino)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-meth- yl-1 H-indole-3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACE- TYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenyIacetate [Research Code: AF-2259], (4-allyloxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methy!allyl)amino]hydra- tropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/mi- nus)-4-(1-hydroxyethoxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyl)pyrrol-2- acetamido-acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzoyl)-1 H pyrrolizine-1-carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]- ethyl-N-(7-trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2- propyl-1 H-pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamido- phenyl salicylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2- yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yl)methoxy]-2-methylpropionic acid [INN: BINDARIT], [2-amino-3-(p-bromobenzoyl)phenyl]acetic acid [INN: BROMFENAC], 3-(3- chloro-4-cyclohexylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BUCOLOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylpropyl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinna- moyl-5-methoxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl-4-cinnamo- yloxy-2H-1,2-benzothiazine-3-carboxamide-1 ,1-dioxide [INN: CINNOXICAM], 6-chloro-5-cyclohexyl-1- indancarboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-methylpropionic acid [INN: CLOBUZARIT], 5-methoxy-2-methyl-3-indoIylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)-p- isobutylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETO- PROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hy- droxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3-thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyra- no[3,4-b]indole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2- hydroxyethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hy- droxymethyl)-1 ,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenylylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phen- yl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chlorophenyI)-2-phenyI-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-aIpha-[[(2-hydroxy- 1 ,1-dimethylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)-4- oxo-2-methylbutanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPROFEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/mi- nus)-2-(2-fluoro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phenyl]propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-yl]acetamido]-2-deoxy-D- glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpro- pionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methylacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlo- robenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5- methoxy-2-methyI-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2,6,10-dodecatrienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H- benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H-1 ,2-dihydropyrrolo[1 ,2-a]pyrroIe-1-carb- oxylic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlo- rophenyl)-1-phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyri- dyl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclo- pentan-1-ylmethyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]pro- pionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hy- droxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELO- XICAM], 5-aminosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3- dihydro-1 H-pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5-isoxa- zoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)anili- no]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSALAZINE], alpha-methyl-4- [(2-oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)pro- pionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyl)-1-(p-fluorophenyl)pyrazole- 3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxa- mide 1 ,1-dioxide [INN: PIROXICAM], 3-chIoro-4-(3-pyrrolin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H-(1)benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'- thenoyl)phenol [INN: PRIFELONE], alpha-cyano-1-methyl-beta-oxopyrrole-2-propionaniIide [INN: PRI- NOMIDE], 3-[4-(2-hydroxyethyl)-1-piperazinyl]-propyl-D,L-4-benzamido-N,N-dipropylglutaramat 1-(p- chlorobenzoyl)-5-methoxy-2-methylindoIe-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyI-1-(1- methylethyl)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphen- othiazine-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]meth- oxy]-2-methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALM- ISTEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carb- oxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyI-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SULINDAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)- propionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,alpha-trifluoro-m-toluidino)nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarboxyIic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl- 2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1 -(4- methoxyphenyl)-N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thien- yl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3-[4-(2-hydroxyethyl)-1-piperazinyl]carbonyl- methyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2-methyl-5H-[1]benzopyrano[2,3-b]pyridin-7-yi)- propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2- (2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl-4,5,6,7-tetrahy- drothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)-1 H-pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha- methyl-4-(2-methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluo- romethylphenyl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohex- yl]phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propio- nic acid [INN: ZALTOPROFEN], 2-[4-(2-thiazolyloxy)phenyl]-propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives.
In a second aspect - which is an embodiment of the first aspect - there is provided a pharmaceutical composition comprising, in admixture, a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-di- chlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 4-hydroxy-2- methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM] and their pharmaceutically acceptable derivatives.
In a third aspect - which is another embodiment of the first aspect - there is provided a pharmaceutical composition comprising, in admixture, a first active ingredient which selected from 3-Cyclopropylmeth- oxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its Pharmaceutically acceptable derivatives, and a second active ingredient which is selected from 2-[(2,6-dichlo- rophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives.
In a forth aspect the invention provides a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is a PDE4-inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine- 1-oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethyIamino)-8- isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyI-3,4,6,7-tetrahydropyrro- lo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(3,5-di- chloro-4-pyridinyl)-2-[1-(4-fluorobenzyl)-5-hydroxy-1H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-dichloropyridin-4-yl)-2-[5-fluoro-1-(4-fluorobenzyI)-1 H-indol-3-yI]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino-1 ,3-bis(cycIopropylmethyl)xanthine [INN:CIPAMFYLLINE], Tetrahydro-5-[4-methoxy-3-[(1S,2S,4R)-2-norbornyloxy]phenyl]-2(1 H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclopentyloxy)-4-methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyl)-3-ureidobenzo-furan-6- y| ester [INN: LIRIMILAST], N-(3,5-dichloropyrid-4-yl)-3-cyclopentyloxy-4-methoχybenzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyI)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroanili- no)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole- 3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALI- CYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyloxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hydratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hy- droxyethoxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1 -dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyl)pyrrol-2-acetamido- acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzoyl)-1 H pyrrolizine- 1-carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7- trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2-propyl-1 H- pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyl salicylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yI)methoxy]-2-methylpropionic acid [INN: BIN- DARIT], [2-amino-3-(p-bromobenzoyl)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chloro-4-cyclohex- ylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BUCO- LOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-di- phenylhydrazide) [INN: BUMADIZONE], alpha-ethyI-4-(2-methylpropyl)benzeneacetic acid [INN: BUTI- BUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1 ) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinnamoyI-5-meth- oxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl-4-cinnamoyloxy-2H-1 ,2- benzothiazine-3-carboxamide-1 ,1 -dioxide [INN: CINNOXICAM], 6-chloro-5-cyclohexyl-1-indancarb- oxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-methylpropionic acid [INN: CLOBU- ZARIT], 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)-p-isobutylhy- dratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hydroxy-3-bi- phenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3-thiopheneacetic acid [INN: ELTE- NAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyrano[3,4-b]in- dole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2-hydroxy- ethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hydroxymethyl)- 1 ,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenylylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phenyI]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chloro- phenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy-1,1-dimeth- ylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2\4'-difluorobiphenyIyl)-4-oxo-2-methyl- butanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLU- FENAMIC ACID], (plus)-2-(p-fiuorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXA- PROFEN], 2-fluoro-a)pha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fIuo- ro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3- dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyI)phenyl]propionic acid [INN: FUR- PROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methyIindol-3-yl]acetamido]-2-deoxy-D-glucose
[INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yI)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methyIacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlorobenzoyl)-5- methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2- methyl-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2,6,10-dodecatrienyl ester [INN: INDOMETACIN FAR- NESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H-benzo[4,5]- cyclohepta[1 ,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H-1 ,2-dihydropyrrolo[1 ,2-a]pyrrole-1-carboxylic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1- phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyridyI-2H-thie- no[2,3-e]-1 ,2-thiazine-3-carboxamide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclopentan-1-yl- methyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-methyl- N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide 1,1-dioxide [INN: MELOXICAM], 5-ami- nosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro-1 H- pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5-isoxazoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-meth- oxy-alpha-methyl-2-naphthaIineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)anilino]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisaIicylic acid [INN: OLSALAZINE], a!pha-methyl-4-[(2-oxocyclo- hexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)propionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyI)-1-(p-fluorophenyl)pyrazole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yI)hydratropic acid [INN: PIRPROFEN], 2-[5H- (1)benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'-theno- y|)phenol [INN: PRIFELONE], alpha-cyano-1-methyl-beta-oxopyrroIe-2-propionanilide [INN: PRINOMI- DE], 3-[4-(2-hydroxyethyl)-1-piperazinyl]-propyl-D,L-4-benzamido-N,N-dipropyIglutaramat 1-(p-chloro- benzoyl)-5-methoxy-2-methylindole-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1-methyl- ethyl)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphenothiazi- ne-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2- methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMISTEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SULIN- DAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)propionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,alpha-trifluoro-m-toluidino)nicotinate [INN: TALNIF- LUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarb- oxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]- 1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4-methoxyphenyl)- N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thienyl)propionic acid [INN: TIAPROFENIC ACID], 5-chIoro-3-[4-(2-hydroxyethyl)-1-piperazinyl]carbonylmethyl-2-benzo- thiazolin one [INN: TIARAMIDE], 2-(2-methyl-5H-[1]benzopyrano[2,3-b]pyridin-7-yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2-(2-methyl-4- quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyI-4,5,6J-tetrahydrothieno[2,3- c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-meth- yl-5-(4-methyIbenzoyl)-1 H-pyrro!e-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha-methyl-4-(2- methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphen- yl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohexyl]phenyl]propio- nic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN], 2-[4-(2-thiazolyloxy)phenyl]-propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives, for simultaneous, sequential or separate use in therapy.
In a fifth aspect - which is an embodiment of the forth aspect - the invention provides a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYL- SALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p- isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indo- le-3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1 -dioxide [INN: PIROXICAM] and their pharmaceutically acceptable derivatives, for simultaneous, sequential or separate use in therapy.
In a sixth aspect - which is another embodiment of the forth aspect - the invention provides a pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is selected from 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is selected from 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives, for simultaneous, sequential or separate use in therapy.
In a seventh aspect, the invention provides a kit comprising a preparation of a first active ingredient which is a PDE4-inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichlo- ro-4-[8-methoxy-2-(trifluoromethyI)quinoline-5-ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo- diazepin-3(R)-yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1 - (4-fluorobenzyl)-5-hydroxy-1 H-indoI-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-di- chloropyridin-4-yl)-2-[5-fluoro-1-(4-fluorobenzyl)-1 H-indoI-3-yl]-2-oxoacetamide [Research-Code:
AWD-12-343], 8-Amino-1,3-bis(cycIopropylmethyl)xanthine [INN:ClPAMFYLLINE], Tetrahydro-5-[4- methoxy-3-[(1S,2S,4R)-2-norbornyloxy]phenyl]-2(1 H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclopent- yloxy)-4-methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC- 801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyI)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichloropyrid-4-yl)-3-cyclopentyloxy-4-methoxybenzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cydohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichIoropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroanilino)phenyl]ace- tate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyI-1 H-indole-3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyloxy-3- chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylalIyl)amino]hydratropic acid [INN: ALMI- NOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hydroxyeth- oxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1 -dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyI)pyrrol-2-acetamido-acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzoyl)-1 H pyrrol izine-1-carb- oxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7- trifluoromethyl-4-quinolyI)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2-propyl-1 H- pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyI salicylate acetate [INN: BENORILATE], 2-(8-methyI-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yl)methoxy]-2-methylpropionic acid [INN: BINDARIT], [2-amino-3-(p-bromobenzoyl)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chloro-4-cyclo- hexylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BU- COLOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1,2- diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylpropyl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1 ) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinnamoyl- 5-methoxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl-4-cinnamoyIoxy- 2H-1 ,2-benzothiazine-3-carboxamide-1,1-dioxide [INN: CINNOXICAM], 6-chIoro-5-cyclohexyl-1-indan- carboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-methylpropionic acid [INN: CLO- BUZARiη, 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)-p-iso- butylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoyIhydratropic acid [INN: DEXKETO- PROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hy- droxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3-thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyra- no[3,4-b]indole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2- hydroxyethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyI-4-(hy- droxymethyl)-1 ,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenylylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phen- yl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chlorophenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy- 1 ,1 -dimethylethyI)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)-4- oxo-2-methylbutanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPROFEN], 2-f!uoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/mi- nus)-2-(2-fluoro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phenyl]propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyI)-5-methoxy-2-methylindol-3-yl]acetamido]-2-deoxy-D- glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpro- pionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methylacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlo- robenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5- methoxy-2-methyl-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2,6,10-dodecatrienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H- benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H-1 ,2-dihydropyrrolo[1,2-a]pyrrole-1-carboxy- lic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlo- rophenyl)-1-phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyrid- yl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclo- pentan-1 -ylmethyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]pro- pionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hy- droxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1 ,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELO- XICAM], 5-aminosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3- dihydro-1 H-pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5-isoxa- zoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)ani- lino]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSALAZINE], alpha-methyl-4- [(2-oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)pro- pionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyl)-1-(p-fluorophenyI)pyrazole- 3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxa- mide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H-(1 )benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'- thenoyl)phenol [INN: PRIFELONE], alpha-cyano-1-methyl-beta-oxopyrroIe-2-propionanilide [INN: PRI- NOMIDE], 3-[4-(2-hydroxyethyl)-1-piperazinyl]-propyl-D,L-4-benzamido-N,N-dipropylglutaramat 1-(p- chlorobenzoyl)-5-methoxy-2-methylindole-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1- methylethyl)-4-phenyl-2(1H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphe- nothiazine-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]meth- oxy]-2-methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMI- STEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carb- oxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SULINDAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)- propionic acid [Research Code: TA-60], phthalidyl 2-(aIpha,alpha,alpha-trifluoro-m-toluidino)nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarboxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl- 2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4- methoxyphenyl)-N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thien- yl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3-[4-(2-hydroxyethyl)-1-piperazinyl]carbonyl- methyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2-methyl-5H-[1]benzopyrano[2,3-b]pyridin-7-yl)- propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2- (2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl-4,5,6J-tetrahy- drothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)-1 H-pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha- methyl-4-(2-methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoro- methylphenyl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohexyl]- phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN], 2-[4-(2-thiazolyloxy)pheny!]-propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives, and instructions for the simultaneous, sequential or separate administration of the preparations to a patient in need thereof.
In a eigth aspect - which is an embodiment of the seventh aspect - the invention provides a kit comprising a preparation of a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4- (3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cycloprop- ylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichloro- phenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 4-fιydroxy-2-meth- yl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM] and their pharmaceutically acceptable derivatives, and instructions for the simultaneous, sequential or separate administration of the preparations to a patient in need thereof.
In a ninth aspect - which is another embodiment of the seventh aspect - the invention provides a kit comprising a preparation of a first active ingredient which is selected from 3-Cyclopropy!methoxy-4- difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is selected from 2-[(2,6- dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives, and instructions for the simultaneous, sequential or separate administration of the preparations to a patient in need thereof.
It has been found that the choice of active ingredients according to the invention is advantageous because it results in a beneficial antiinflammatory effect while simultaneously minimizing gastrointestinal side effects which are inevitably associated with the use of the conventional NSAIDs. The pharmaceutical composition of the present invention may be prepared by mixing the first active ingredient with the second active ingredient.
In the above-mentioned mixing process the first active ingredient and the second active ingredient can a) in a first step be mixed as such, afterwards be processed with pharmaceutically acceptable auxiliaries and/or excipients and finally pressed to tablets or caplets or b) in a first step separately be processed with pharmaceutically acceptable auxiliaries and/or excipients to give granules or pellets containing each only one of the two active ingredients; the pellets or granules for their part then can be mixed in an appropriate ratio and either be pressed - optionally with further pharmaceutically acceptable auxiliaries and/or excipients - to give for example, tablets or cap- lets, or can be filled in more or less loose form in capsules.
Therefore, in a tenth aspect of the present invention, there is provided a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is a PDE4- inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2- (trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1-oxide [Research Code: SCH351591], 3-[3-(cy- clopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4- carboxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1-(4-fluorobenzyl)-5-hydroxy- 1H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-dichloropyridin-4-yl)-2-[5-fluoro- 1-(4-fluorobenzyl)-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino-1 ,3-bis(cy- clopropylmethyI)xanthine [INN:CIPAMFYLLINE], Tetrahydro-5-[4-methoxy-3-[(1S,2S,4R)-2-norbornyl- oxy]phenyl]-2(1 H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclopentyloxy)-4-methoxyphenyl]-1 ,3-dihydro- 1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-di- chlorophenylcarbonyI)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichloropyrid-4-yl)-3- cyclopentyloxy-4-methoxybenzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-meth- oxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluorometh- oxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, with a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroanilino)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-meth- oxy-2-methyl-1 H-indoIe-3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyloxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]- hydratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hydroxyethoxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcar- bonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyl)pyr- rol-2-acetamido-acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzo- yl)-1 H pyrrolizine-1-carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-pipe- razinyl]ethyl-N-(7-trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9- methyl-2-propyl-1 H-pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyI salicylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodi- benz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1H-indazol-3-yl)methoxy]-2- methylpropionic acid [INN: BINDARIT], [2-amino-3-(p-bromobenzoyl)phenyl]acetic acid [INN: BROM- FENAC], 3-(3-chloro-4-cyclohexylbenzoyI)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclo- hexylbarbituric acid [INN: BUCOLOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylprop- yl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CAR- PROFEN], 1-cinnamoyl-5-methoxy-2-methylindoIe-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2- methyl-4-cinnamoyloxy-2H-1 ,2-benzothiazine-3-carboxamide-1 ,1 -dioxide [INN: CINNOXICAM], 6-chIo- ro-5-cyclohexyl-1-indancarboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-methyl- propionic acid [INN: CLOBUZARIT], 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DE- BOXAMET], (S)-(+)-p-isobutylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hydroxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)~3- thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl- 1 ,3,4,9-tetrahydropyrano[3,4-b]indole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]- amino]benzoic acid 2-(2-hydroxyethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyi-4-(hydroxymethyl)-1 ,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-bi- phenylacetic acid [INN: FELBINAC], 3-(4-biphenyIylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4- dichlorophenoxy)phenyl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chlorophenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy-1 ,1-dimethylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)-4-oxo-2-methylbutanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha- trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyI-5- benzoxazoleacetic acid [INN: FLUNOXAPROFEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fluoro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'- furoyl)phenyl]propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methylindol- 3-yl]acetamido]-2-deoxy-D-glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yI)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methyl- acetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2, 6,10-dode- catrienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDO- PROFEN], 2-(10-methoxy-4H-benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H-1 ,2-dihydro- pyrrolo[1 ,2-a]pyrrole-1-carboxylic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6-[2-(hydroxymeth- yl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1-phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro- 4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide 1 ,1-dioxide [INN: LOR- NOXICAM], 2-[4-(2-oxocyclopentan-1-ylmethyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3- methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1 ,2-benzothiazine-3-carboxami- de 1 ,1-dioxide [INN: MELOXICAM], 5-aminosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4- chlorophenyl)-7-phenyl-2,3-dihydro-1 H-pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis- (4-methoxyphenyl)-5-isoxazoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)anilino]nicotinic acid [INN: NIFLUMIC ACID], S.δ'-azodisalicylic acid [INN: OLSA- LAZINE], alpha-methyl-4-[(2-oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)propionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chIorophenyl)-1- (p-fluorophenyl)pyrazole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1,2- benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H-(1)benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPRO- FEN], 2,6-di-tert-butyl-4-(2'-thenoyl)phenol [INN: PRIFELONE], alpha-cyano-1-methyl-beta-oxopyrrole- 2-propionanilide [INN: PRINOMIDE], 3-[4-(2-hydroxyethyl)-1-piperazinyl]-propyl-D,L-4-benzamido- N,N-dipropylglutaramat 1-(p-chlorobenzoyl)-5-methoxy-2-methylindole-3-acetate (ester) [INN: PRO- GLUMETACIN], 7-methyl-1-(1-methylethyI)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphenothiazine-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chloro- phenyl)-4-methyl-5-oxazolyl]methoxy]-2-methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMISTEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACE- DIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4- yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsul- finyl)benzylidene]indene-3-acetic acid [INN: SULINDAC], p-2-thenoylhydratropic acid [INN: SUPRO- FEN] 2-(4-(3-methyl-2-butenyl)phenyl)propionic acid [Research Code: TA-60], phthalidyl 2-(al- pha,alpha,alpha-trifluoro-m-toluidino)nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2- oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarboxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyI-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide [INN: TENO- XICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4-methoxyphenyl)-N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thienyl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3- [4-(2-hydroxyethyl)-1-piperazinyl]carbonylmethyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2-meth- yl-5H-[1]benzopyrano[2,3-b]pyridin-7-yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TIL- NOPROFEN ARBAMEL], 1-Cyclohexyl-2-(2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGA- DINE], 2-amino-6-benzyl-4,5,6,7-tetrahydrothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tol- yl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)-1 H-pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha-methyl-4-(2-methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphenyl)-anthranilic acid n-butyl ester [INN: UFENA- MATE], 2-[4-[3-(hydroxyimino)cyclohexyl]phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihy- dro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN], 2-[4-(2-thiazolyIoxy)phenyl]- propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives.
In an eleventh aspect - which is an embodiment of the tenth aspect - there is provided a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1- carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4- yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, with a second active ingredient which is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYL- SALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p- isobutylphenylpropionic acid [INN: IBUPROFEN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyI-1 H-indole- 3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM] and their pharmaceutically acceptable derivatives.
In an twelfth aspect - which is another embodiment of the tenth aspect - there is provided a process for the preparation of a pharmaceutical composition which comprises mixing a first active ingredient which is selected from 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yI)-benzamide [INN: ROFLUMILAST] and its pharmaceutically acceptable derivatives, with a second active ingredient which is selected from 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] and its pharmaceutically acceptable derivatives. The present invention further provides the use of a pharmaceutical composition, or pharmaceutical product according to the invention in the manufacture of a medicament for the treatment of an inflammatory disease and/or an inflammation associated disorder.
In a further aspect the present invention provides a method of an effective treatment of an inflammatory disease and/or an inflammation associated disorder which can be treated with a conventional NSAID while minimizing gastrointestinal side effects comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
In a still further aspect the present invention provides a method of minimizing gastrointestinal side effects frequently associated with the use of conventional NSAIDs comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
Said methods also include a pharmaceutical product or kit containing a conventional NSAID and a written description which discloses that said conventional NSAID can be administered together with a PDE4 inhibitor (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs. Likewise, said methods include a pharmaceutical product or kit containing a PDE4 inhibitor and a written description which discloses that said PDE4 inhibitor can be administered together with a conventional NSAID (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs.
"Inflammatory diseases" which may be mentioned in particular are arthritis, including but not limited to rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus and juvenile arthritis; gastrointestinal conditions such as inflammatory bowel disease, Crohn's disease, irritable bowel syndrome and ulcera- tive colitis; asthma, bronchitis and skin related disorders such as psoriasis, eczema, burns and dermatitis. "Inflammation associated disorders" which may be mentioned are, for example, pain, migraine, fever and headaches.
The active ingredients may, and indeed will, as part of the pharmaceutical composition, the pharmaceutical product or preparation, be used in admixture with one or more pharmaceutically acceptable auxiliaries and/or excipients.
The person skilled in the art is familiar on the basis of his/her expert knowledge with which excipients or auxiliaries are suitable for the desired pharmaceutical composition, product or preparation. In addition to solvents, gel-forming agents, tablet excipients and other active compound carriers, it is possible to use, for example, antioxidants, dispersants, emulsifiers, antifoams, flavor corrigents, preservatives, solubilizers, colorants or permeation promoters and complexing agents (e.g. cyclodextrins).
Within the meaning of the present invention, "combined use" is preferably understood as meaning the oral administration of both active ingredients. Further methods of administration, which may be mentioned are the parenteral (for example intravenous injection or infusion or intramuscular or intraarticu- lar injection) and the topical administration of the active ingredients.
For oral administration the pharmaceutical compositions or products according to the invention are preferably in the form of tablets, coated tablets, chewing tablets, lemonade tablets, dragees, capsules, caplets, suppositories, emulsions, (sterile parenteral) suspensions or solutions, the active ingredient content advantageously being between 0.1 and 95% and by appropriate choice of the excipients and the auxiliaries, it being possible to achieve a pharmaceutical administration form precisely tailored to the active ingredient(s) and/or to the desired onset of action (e.g. a sustained release form or an enteric form).
For the treatment of diseases of the arthritic type or skin related disorders, the compounds according to the invention also can be used in form of pharmaceutical compositions or products which are suitable for topical application. For the production of those pharmaceutical compositions or products, the compounds according to the invention (= active ingredients) are preferably mixed with suitable pharmaceutical excipients and further processed to give suitable pharmaceutical formulations. Suitable pharmaceutical formulations which may be mentioned in this connection are, for example, ointments, fatty ointments, creams, pastes or gels. The pharmaceutical compositions or products for topical application can preferably also be in form of a patch (e.g. as TTS).
For the above-mentioned therapeutic uses the dosages administered will, of course, vary with the first and second active ingredients employed, the mode of administration, the treatment desired and the disorder indicated. However, in general, satisfactory results will be obtained when the total daily dosage of first active ingredient(s), the PDE4 inhibitor(s), when taken oral is in the range from 1 - 2000 μg/kg of body weight. In the case of the especially preferred PDE4 inhibitor ROFLUMILAST, the daily dosage is in a range from 2 - 20 μg/kg of body weight.
The total daily dosage of the second active ingredient(s), the conventional NSAIDs also can vary within a wide range. In the case of the especially preferred NSAIDs Diclofenac the daily doses are in a range from 100 - 2000μg/kg.
Pharmacology
Investigations into the role of several NSAIDs in inhibiting the phosphodiesterase 4 and 5 in vitro (Table 1 below) showed that in partially purified or recombinant PDE4 and PDE5, NSAIDs with preferential COX-2 selectivity (for example, nimesulide [INN], CGP28238 [Research Code], L-745337 [Research Code], and the highly selective drug celecoxib [INN]) possess PDE4 and PDE5 activity in the μM range, whereas conventional NSAIDs (for example, acetylsalicylic acid, diclofenac [INN] or indo- metacin [INN]) show only minor effects:
Table 1 (IC50, μM)
Figure imgf000027_0001
ASS, acetylsalicylic acid; diclofenac, 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid; indomethacin, 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid; nimesulide, 4'-nitro-2'-phenoxyme- thansulfonamide; CGP28238, 6-(2,4-difluorophenoxy)-5-methylsulfonylamino-1-indanone; L-745337 5-methanesulfonamido-6-(2,4-difluorophenylthio)-1-indanone); celecoxib, (4-[5-(4-methylphenyl)-3-(tri- fluoromethyl)-1 H-pyrazol-1-yl]benzenesulfonamide.
In isolated guinea pig Langendorff hearts, celecoxib selectively increased coronary heart flow at doses consistent with its inhibitory potency on PDE4 and 5, but had no effect on left ventricular pressure and heart rate, thereby excluding inhibition of PDE3.
In mice, diclofenac (3-100 mg/kg, p.o.) induced gastrointestinal bleeding (ED50 = 56 mg/kg), assessed by spectrophotometric determination of fecal hemoglobin. Treatment with diclofenac (10-100 mg/kg, p.o. t = 0 h) in the presence of the selective PDE5 inhibitor sildenafil (3-100 mg/kg, p.o. t = - 48 h to +7 h) demonstrated no protection from NSAID-induced blood loss, whereas treatment in the presence of several selective PDE4 inhibitors significantly reduced the amount of detectable hemoglobin. Influence of PDE4 inhibition on diclofenac induced blood loss in mice
Methods
In vivo experiments
Male NMRI mice (Charles River Laboratories, Sulzfeld, Germany) weighting 23-25 g were housed in groups of 5 under standard conditions at a temperature of 22°C +/-2°C and a 12h light-dark cycle. If not otherwise stated animals had free access to tap water and standard food pellets. Diclofenac was administrated at doses from 1-100 mg/kg p.o.; rolipram, roflumliast and RP73401 were given at doses from 1-100 mg/kg p.o. Preventive treatment: Diclofenac was given at time point Oh. At time points -24, -16, Oh, +7h one of the selective PDE4 inhibitors was administered. Curative treatment: Diclofenac was given at time point Oh. At time points +1h and +7h one of the selective PDE4 inhibitors was administered. The drugs used were dissolved in 4% aqueos methyl cellulose. The animals were food reduced 24h prior diclofenac administration. For each experiment 5 animals were used for one experimental point. Following 24h administration of drugs animals were weighted and stool was collected quantitatively and homogenized as described below:
Detection of hemoglobin in feces
The modified method of Welch (Clin. Chem. 29/12, 2022-2025, 1983) was used. The amount of hemoglobin was determined by the heme catalyzed oxidation of tolidine in the presence of hydrogen peroxide. Feces was homogenized in destilled water in a concentration with 1g feces/6.6ml H20 with an ultra-turrax (IKA-Werke, Germany). 500μl aliquots from two different areas of the stool were taken to minimize error due to inhomogenous distribution of blood in the feces and heated 10 min at 95°C to inactivate peroxidases and than diluted with 500μl of acetic acid/H20 (30/70 vol/vol). Hemoglobin was extracted in 2.5 ml of acetic acid/H20 (30/70 vol/vol) by the addition of 4.5 ml ethyl acetate. The sample was rigorously shacked and the supernatant was used following a centrifugation step for optical detection of hemoglobin. Tolidine was prepared freshly from a stock solution (0.4g tolidine in 10ml ethanol) by mixing equal volumes of stock solution, H20 and acetic acid and equilibrated at room temperature. 20μl of extracted supernatant was diluted to 100μl ethyl acetate in a 96er crystall plate and incubated with 50μl of the working solution. The reaction was initiated by the injection of 25μl hydrogen peroxide (6%) in a Wallac Victor spectro-photometer (Turku, Finnland). The increase of OD 690 was monitored by a kinetic analysis and expressed as ΔOD690/min. Results
Table 2 shows the % reduction of the ΔOD6go/min when a PDE4 inhibitor was administered (preventive or curative) compared to the ΔOD690/min obtained without the administration of a PDE4-inhibitor.
Table 2: [% reduction of ΔOD69o/min]
Figure imgf000029_0001

Claims

Patent Claims
1. A pharmaceutical composition comprising, in admixture, a first active ingredient which is a PDE4- inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-meth- oxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1-oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethyIamino)-8-isopropyl-3H-purine [Research-Code: V- 11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6J-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)- yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1-(4-fluoro- benzyl)-5-hydroxy-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-dichloro- pyridin-4-yl)-2-[5-fluoro-1 -(4-fluorobenzyl)-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD- 12-343], 8-Amino-1 ,3-bis(cyclopropylmethyl)xanthine [INN:CIPAMFYLLINE], Tetrahydro-5-[4- methoxy-3-[(1S,2S,4R)-2-norbornyloxy]phenyl]-2(1 H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclo- pentyloxy)-4-methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyl)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichloropyrid-4-yl)-3-cyclopentyloxy-4-methoxybenzamide [INN: Pl- CLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1 -carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzami- de [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroanilino)phen- yl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3- acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenyIacetate [Research Code: AF- 2259], (4-allyloxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hydra- tropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hydroxyethoxy)-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methyl- benzoyl)pyrrol-2-acetamido-acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihydro-5-(4- methoxybenzoyl)-1 H pyrrolizine-1 -carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha- trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7-trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENI- NE], 5-(dimethylamino)-9-methyl-2-propyl-1 H-pyrazolo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyl salicylate acetate [INN: BENORILATE], 2-(8-meth- yl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benz- yl-1 H-indazol-3-yl)methoxy]-2-methyIpropionic acid [INN: BINDARIT], [2-amino-3-(p-bromobenzo- yl)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chloro-4-cyclohexylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cycIohexylbarbituric acid [INN: BUCOLOM], 4-butoxy-N-hydroxy- benzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylpropyl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-bi- phenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)- benzoic acid, calcium salt, compound with urea (1 :1) [INN: CARBASALATE CALCIUM], (plus/mi- nus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinnamoyl-5-methoxy- 2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl-4-cinnamoyloxy-2H-1 ,2- benzothiazine-3-carboxamide-1 ,1 -dioxide [INN: CINNOXICAM], 6-chloro-5-cyclohexyl-1-indan- carboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-methylpropionic acid [INN: CLOBUZARIT], 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)- p-isobutylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hydroxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3- thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyrano[3,4-b]indole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoro- methyl)phenyl]amino]benzoic acid 2-(2-hydroxyethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hydroxymethyl)-1,2-diphenyl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenylylcarbonyl)propio- nic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phenyl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chlorophenyl)-2-phenyl-5- thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy-1 ,1-dimethylethyl)amino]- methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)-4-oxo-2-methylbutanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPRO- FEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fluo- ro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3- dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phenyl]propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-yl]acetamido]-2-deoxy-D- glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenyl- propionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-methylacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBU- FEN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid, 3,7,11-trimethyl-2,6,10-dodeca- trienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: IN- DOPROFEN], 2-(10-methoxy-4H-benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)-acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)-5-benzoyl-3H- 1 ,2-dihydropyrrolo[1 ,2-a]pyrrole-1 -carboxylic acid [INN: KETOROLAC], 2,3-dihydro-5-hydroxy-6- [2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxyphenyl)-4-chlo- roanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1-phenylpyrazole-4-acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carbox- amide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclopentan-1-ylmethyl)phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-methyl-N-(5-methyl- 2-thiazolyl)-2H-1 ,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELOXICAM], 5-aminosali- cylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro-1 H-pyrroli- zin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyI)-5-isoxazoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-meth- oxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)anilino]nicoti- nic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSALAZINE], alpha-methyl-4-[(2- oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobutylphenyl)pro- pionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyl)-1-(p-fluorophenyl)py- razole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin- 3-carboxamide 1,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H-(1)benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'-thenoyl)phenol [INN: PRIFELONE], alpha-cyano-1-methyl-beta-oxopyrrole-2- propionanilide [INN: PRINOMIDE], 3-[4-(2-hydroxyethyl)-1-piperazinyl]-propyl-D,L-4-benzamido- N,N-dipropylglutaramat 1-(p-chlorobenzoyl)-5-methoxy-2-methylindole-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1-methylethyl)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZO- NE], 7-methoxy-alpha,10-dimethylphenothiazine-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p- chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2-methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cystei- ne salicylate (ester), acetate (ester) [INN: SALMISTEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2- fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2- methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SULINDAC], p-2-thenoyIhydra- tropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)propionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,alpha-trifluoro-m-toluidino)nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarboxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]- 1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4-methoxy- phenyl)-N-methyl-1H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thienyl)- propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3-[4-(2-hydroxyethyl)-1-piperazinyl]carbonyl- methyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2-methyl-5H-[1]benzopyrano[2,3-b]pyridin-7- yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclo- hexyl-2-(2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl- 4,5,6,7-tetrahydrothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)-1 H-pyrrole-2-acetic acid [INN: TOLME- TIN], hydroxybis[alpha-methyl-4-(2-methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphenyl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4- [3-(hydroxyimino)cyclohexyl]phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10- oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN], 2-[4-(2-thiazolyloxy)phenyl]- propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives.
2. A pharmaceutical composition according to claim 1 , wherein the first and/or second active ingredient is in the form of a pharmaceutically acceptable salt, solvate, ester, N-oxide or solvate of an salt, ester or N-oxide.
3. A pharmaceutical composition according to claim 1 or 2, which is a fixed oral combination.
4. A pharmaceutical composition according to claim 1 , 2 or 3, wherein the first active ingredient is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1- carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5- dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST], and the second active ingredient is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6- dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN] and 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1,1-dioxide [INN: PIROXICAM].
5. A pharmaceutical composition according to claim 4, wherein the first active ingredient is 3-Cyclo- propylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] or a pharmaceutically acceptable salt, solvate, N-oxide or solvate of an salt or N-oxide thereof.
6. A pharmaceutically composition according to claim 4, wherein the second active ingredient is 2-(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] or a pharmaceutically acceptable salt, ester, solvate or solvate of an salt or ester thereof.
7. Use of a pharmaceutical composition according to claim 1 in the manufacture of a medicament for the treatment of an inflammatory disease and/or an inflammation associated disorder.
8. A process for the preparation of a pharmaceutical composition as defined in claim 1 which comprises mixing the first active ingredient with the second active ingredient.
9. A pharmaceutical product comprising, in combination, a preparation of a first active ingredient which is a PDE4 inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-di- chloro-4-[8-methoxy-2-(trifluoromethyl)quinoline-5-ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)-4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-methyl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1,4]- benzo-diazepin-3(R)-yl]pyridine-4-carboxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyri- dinyl)-2-[1 -(4-fluorobenzyl)-5-hydroxy-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12- 281], N-(3,5-dichloropyridin-4-yl)-2-[5-fluoro-1-(4-fluorobenzyl)-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino-1 ,3-bis(cyclopropylmethyl)xanthine [INN:CIPAMFYLLI- NE], Tetrahydro-5-[4-methoxy-3-[(1S,2S,4R)-2-norbornyloxy]phenyl]-2(1 H)-pyrimidone [INN: ATI- ZORAM], β-[3-(Cyclopentyloxy)-4-methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propan- amide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyl)-3-ureido- benzo-furan-6-yl ester [INN: LIRIMILAST], N-(3,5-dichloropyrid-4-yl)-3-cyclopentyioxy-4-methoxy- benzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexa- ne-1 -carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difIuoromethoxy-N-(3,5-dichlo- ropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, and a preparation of a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroanilino)phenyl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzo- yl)-5-methoxy-2-methyl-1H-indole-3-acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobut- yl)phenylacetate [Research Code: AF-2259], (4-allyloxy-3-chlorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hydratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoyl- phenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hydroxyethoxy)-2-methyl-N-2-pyridyl-2H- 1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p-methylbenzoyl)pyrrol-2-acetamido-acetate [INN: AMTOLMETIN- GUACIL], (plus/minus)-2,3-dihydro-5-(4-methoxybenzoyl)-1 H pyrrolizine-1 -carboxylic acid [INN: ANIROLAC], 2-[4-(alpha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7-trifluoromethyl-4- quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2-propyl-1 H-pyrazo- lo[1 ,2-a][1 ,2,4]benzo-triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyl salicylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propio- nic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yl)methoxy]-2-methylpropionic acid [INN: BINDARiη, [2-amino-3-(p-bromobenzoyl)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chlo- ro-4-cyclohexylbenzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BUCOLOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2-diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylpropyl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1:1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinnamoyl-5-methoxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2- pyridyl)-2-methyl-4-cinnamoyloxy-2H-1,2-benzothiazine-3-carboxamide-1,1 -dioxide [INN: CINNO- XICAM], 6-chloro-5-cyclohexyl-1-indancarboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)- benzyloxy]-2-methylpropionic acid [INN: CLOBUZARIT], 5-methoxy-2-methyl-3-indolylacetohy- droxamic acid [INN: DEBOXAMET], (S)-(+)-p-isobutylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhydratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benz- eneacetic acid [INN: DICLOFENAC], 2',4,-Difluoro-4-hydroxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-dichloroanilino)-3-thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl- anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-aceto- phenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyrano[3,4-b]indole-1 -acetic acid [INN: ETODOLAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2-hydroxyethoxy)-ethyl ester [INN: ETOFENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hydroxymethyl)-1 ,2-diphen- yl-3,5-pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-bi- phenylylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phenyl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p- chlorophenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy- 1,1-dimethylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)- 4-oxo-2-methylbutanoic acid [INN: FLOBUFEN],, N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPROFEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fluoro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phenyl]- propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-yl]- acetamido]-2-deoxy-D-glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4-nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-meth- ylacetate [Research Code: IDPH-8261], (pIus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1H-indole-3-acetic acid, 3,7,11-trimethyl- 2,6,10-dodecatrienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindolinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H-benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)- acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)- 5-benzoyl-3H-1 ,2-dihydropyrrolo[1 ,2-a]pyrrole-1 -carboxylic acid [INN: KETOROLAC], 2,3-dihydro- 5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxy- phenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1-phenylpyrazole-4- acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]-1,2- thiazine-3-carboxamide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclopentan-1-ylmethyl)- phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-meth- yl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELOXICAM], 5-aminosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro- 1 H-pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5-isoxazole- acetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN], 2-[3-(trifluoromethyl)- anilino]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSALAZINE], alpha- methyl-4-[(2-oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPROFEN], 2-(p-isobut- ylphenyl)propionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chlorophenyl)-1-(p-fluo- rophenyl)pyrazole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-pyridyl-2H-1 ,2- benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrrolin-1-yl)hydra- tropic acid [INN: PIRPROFEN], 2-[5H-(1)benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRA- NOPROFEN], 2,6-di-tert-butyl-4-(2'-thenoyl)phenol [INN: PRIFELONE], alpha-cyano-1-methyl- beta-oxopyrrole-2-propionanilide [INN: PRINOMIDE], 3-[4-(2-hydroxyethyl)-1 -piperazinyl]-propyl- D,L-4-benzamido-N,N-dipropylglutaramat 1-(p-chlorobenzoyl)-5-methoxy-2-methylindole-3-ace- tate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1-methylethyl)-4-phenyl-2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphenothiazine-2-acetic acid [INN: PROTIZI- NIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2-methylpropionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMISTEINE], N-acetyl-L- cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2-amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzylidene]indene-3-acetic acid [INN: SU- LINDAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2-butenyl)phenyl)pro- pionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,alpha-trifluoro-m-toluidino)- nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carboxamide [INN: TENIDAP], 2-thiophenecarboxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2- methyl-N-2-pyridyl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chloro- phenyl)-N-hydroxy-1-(4-methoxyphenyl)-N-methyl-1 H-pyrazoIe-3-propionamide [INN: TEPOXA- LIN], alpha-(5-benzoyl-2-thienyl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3-[4-(2-hy- droxyethyl)-1-piperazinyl]carbonylmethyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2-methyl- 5H-[1]benzopyrano[2,3-b]pyridin-7-yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2-(2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl-4,5,6,7-tetrahydrothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-tolyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)-1 H- pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha-methyl-4-(2-methylpropyl)benzene ace- tato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphenyl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohexyl]phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN] and 2-[4-(2-thiazolyloxy)phenyl]-propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives, for simultaneous, sequential or separate use in therapy.
10. A pharmaceutical product according to claim 9, wherein the first and/or second active ingredient is in the form of a pharmaceutically acceptable salt, solvate, ester, N-oxide or solvate of an salt, ester or N-oxide.
11. A pharmaceutical product according to claim 9 or 10, wherein the first active ingredient is a PDE4- inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1 -carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropy- rid-4-yl)-benzamide [INN: ROFLUMILAST], and the second active ingredient is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichlorophen- yl)amino]benzeneacetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], ], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-methoxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN] and 4-hy- droxy-2-methyl-N-2-pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM].
12. A pharmaceutical product according to claim 11 , wherein the first active ingredient is 3-Cycloprop- ylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] or a pharmaceutically acceptable salt, solvate, N-oxide or solvate of an salt or N-oxide thereof.
13. A pharmaceutical product according to claim 11 , wherein the second active ingredient is 2-[(2,6- dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC] or a pharmaceutically acceptable salt, ester, solvate or solvate of an salt or ester thereof.
14. Use of a pharmaceutical product according to claim 9 in the manufacture of a medicament for the treatment of an inflammatory disease and/or an inflammation associated disorder.
5. A kit comprising a preparation of a first active ingredient which is a PDE4-inhibitor selected from CDC-998, SH-636, D-4396, IC-485, CC-1088 and 3,5-dichloro-4-[8-methoxy-2-(trifluoromethyl)- quinoline-5-ylcarboxamido]pyridine-1 -oxide [Research Code: SCH351591], 3-[3-(cyclopentyloxy)- 4-methoxybenzyl]-6-(ethylamino)-8-isopropyl-3H-purine [Research-Code: V-11294A], N-[9-meth- yl-4-oxo-1-phenyl-3,4,6,7-tetrahydropyrrolo[3,2,1-jk][1 ,4]benzo-diazepin-3(R)-yl]pyridine-4-carb- oxamide [Research-Code: CI-1018, N-(3,5-dichloro-4-pyridinyl)-2-[1-(4-fluorobenzyl)-5-hydroxy- 1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-281], N-(3,5-dichloropyridin-4-yl)-2-[5- fluoro-1-(4-fluorobenzyl)-1 H-indol-3-yl]-2-oxoacetamide [Research-Code: AWD-12-343], 8-Amino- 1 ,3-bis(cyclopropylmethyl)xanthine [INN:CIPAMFYLLINE], Tetrahydro-5-[4-methoxy-3-
[(1S,2S,4R)-2-norbornyloxy]phenyl]-2(1H)-pyrimidone [INN: ATIZORAM], β-[3-(Cyclopentyloxy)-4- methoxyphenyl]-1 ,3-dihydro-1 ,3-dioxo-2H-isoindole-2-propanamide [Research-Code: CDC-801], Methanesulfonic acid 2-(2,4-dichlorophenylcarbonyl)-3-ureidobenzo-furan-6-yl ester [INN: LIRIMI- LAST], N-(3,5-dichloropyrid-4-yl)-3-cyclopentyloxy-4-methoxybenzamide [INN: PICLAMILAST], cis-[4-Cyano-4-(3-cyclopentyIoxy-4-methoxyphenyl)cyclohexane-1 -carboxylic acid [INN: CILOMILAST], 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] and their pharmaceutically acceptable derivatives, a preparation of a second active ingredient which is a conventional NSAID selected from glycolic acid [o-(2,6-dichloroani!ino)phen- yl]acetate(ester) [INN: ACECLOFENAC]; 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3- acetic acid carboxymethyl ester [INN: ACEMETACIN]; 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-methoxyphenyl-alpha-methyl-4-(isobutyl)phenylacetate [Research Code: AF-2259], (4-allyloxy-3-chIorophenyl)acetic acid [INN: ALCLOFENAC], p-[(2-methylallyl)amino]hy- dratropic acid [INN: ALMINOPROFEN], 2-amino-3-benzoylphenylacetic acid [INN: AMFENAC], (plus/minus)-4-(1-hydroxyethoxy)-2-methyl-N-2-pyridyI-2H-1 ,2-benzothiazine-3-carboxamide ethylcarbonate (ester), 1 ,1-dioxide [INN: AMPIROXICAM], 2-methoxyphenyl-1-methyl-5-(p- methylbenzoyl)pyrrol-2-acetamido-acetate [INN: AMTOLMETINGUACIL], (plus/minus)-2,3-dihy- dro-5-(4-methoxybenzoyl)-1 H pyrrolizine-1 -carboxylic acid [INN: ANIROLAC], 2-[4-(al- pha,alpha,alpha-trifluoro-m-tolyl)-1-piperazinyl]ethyl-N-(7-trifluoromethyl-4-quinolyl)anthranilate [INN: ANTRAFENINE], 5-(dimethylamino)-9-methyl-2-propyl-1 H-pyrazolo[1 ,2-a][1 ,2,4]benzo- triazine-1 ,3(2H)-dione [INN: AZAPROPAZONE], 4-acetamidophenyl salicylate acetate [INN: BENORILATE], 2-(8-methyl-10,11-dihydro-11-oxodibenz[b,f]oxepin-2-yl)propionic acid [INN: BERMOPROFEN], 2-[(1-benzyl-1 H-indazol-3-yl)methoxy]-2-methylpropionic acid [INN: BINDARiη, [2-amino-3-(p-bromobenzoyI)phenyl]acetic acid [INN: BROMFENAC], 3-(3-chloro-4-cyclohexyl- benzoyl)propionic acid [INN: BUCLOXIC ACID], 5-butyl-1-cyclohexylbarbituric acid [INN: BUCO- LOM], 4-butoxy-N-hydroxybenzeneacetamide [INN: BUFEXAMAC], butylmalonic acid mono(1 ,2- diphenylhydrazide) [INN: BUMADIZONE], alpha-ethyl-4-(2-methylpropyl)benzeneacetic acid [INN: BUTIBUFEN], 2-(4-biphenylyl)butyric acid, trans-4-phenylcyclohexylamine salt (1 :1) [INN: BUTIXIRATE], 2-(acetyloxy)-benzoic acid, calcium salt, compound with urea (1 :1 ) [INN: CARBASALATE CALCIUM], (plus/minus)-6-chloro-alpha-methylcarbazole-2-acetic acid [INN: CARPROFEN], 1-cinnamoyl-5-methoxy-2-methylindole-3-acetic acid [INN: CINMETACIN], N-(2-pyridyl)-2-methyl- 4-cinnamoyloxy-2H-1 ,2-benzothiazine-3-carboxamide-1 ,1-dioxide [INN: CINNOXICAM], 6-chloro- 5-cycIohexyl-1-indancarboxylic acid [INN: CLIDANAC], 2-[4-(p-chlorophenyl)benzyloxy]-2-meth- ylpropionic acid [INN: CLOBUZARIT], 5-methoxy-2-methyl-3-indolylacetohydroxamic acid [INN: DEBOXAMET], (S)-(+)-p-isobutylhydratropic acid [INN: DEXIBUPROFEN], (+)-(S)-m-benzoylhy- dratropic acid [INN: DEXKETOPROFEN], 2-[(2,6-dichlorophenyl)amino]benzeneacetic acid [INN: DICLOFENAC], 2',4'-Difluoro-4-hydroxy-3-biphenylcarboxylic acid [INN: DIFLUNISAL], 4-(2,6-di- chIoroanilino)-3-thiopheneacetic acid [INN: ELTENAC], N-beta-phenethyl-anthranilic acid [INN: ENFENAMIC ACID] salicylic acid acetate, ester with beta-hydroxy p-acetophenetidide [INN: ETERSALATE], 1 ,8-diethyl-1 ,3,4,9-tetrahydropyrano[3,4-b]indole-1 -acetic acid [INN: ETODO- LAC], 2-[[3-(trifluoromethyl)phenyl]amino]benzoic acid 2-(2-hydroxyethoxy)-ethyl ester [INN: ETO- FENAMATE], p-chlorobenzoic acid, ester with 4-butyl-4-(hydroxymethyl)-1 ,2-diphenyl-3,5- pyrazolidinedione [INN: FECLOBUZONE], 4-biphenylacetic acid [INN: FELBINAC], 3-(4-biphenyl- ylcarbonyl)propionic acid [INN: FENBUFEN], [o-(2,4-dichlorophenoxy)phenyl]acetic acid [INN: FENCLOFENAC], (plus/minus)-m-phenoxyhydratropic acid [INN: FENOPROFEN], 4-(p-chloro- phenyl)-2-phenyl-5-thiazoleacetic acid [INN: FENTIAZAC], (plus/minus)-alpha-[[(2-hydroxy-1 ,1- dimethylethyl)amino]methyl]-benzyl alcohol [INN: FEPRADINOL], 4-(2',4'-difluorobiphenylyl)-4- oxo-2-methylbutanoic acid [INN: FLOBUFEN], N-(alpha,alpha,alpha-trifluoro-m-tolyl)anthranilic acid [INN: FLUFENAMIC ACID], (plus)-2-(p-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid [INN: FLUNOXAPROFEN], 2-fluoro-alpha-methyl-4-biphenylacetic acid [INN: FLURBIPROFEN], (plus/minus)-2-(2-fluoro-4-biphenylyl)propionic acid 1 (acetoxy)ethyl ester [INN: FLURBIPROFEN AXETIL], 2-ethyl-2,3-dihydro-5-benzofuranacetic acid [INN: FUROFENAC], 2-[4-(2'-furoyl)phen- yl]propionic acid [INN: FURPROFEN], 2-[2-[1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-yl]- acetamido]-2-deoxy-D-glucose [INN: GLUCAMETACIN], 2-(2-fluorobiphenyl-4-yl)propionic acid 4- nitrooxybutylester [Research Code: HCT-1026], (p-isobutylphenyl)acetic acid [INN: IBUFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], methyl 4-(3-thienyl)phenyl-alpha-meth- ylacetate [Research Code: IDPH-8261], (plus/minus)-2-[p-(1-oxo-2-isoindolinyl)phenyl]butyric acid [INN: INDOBUFEN], 1-(4-chlorobenzoyI)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid, 3,7,1 1-trimethyl- 2,6,10-dodecatrienyl ester [INN: INDOMETACIN FARNESIL], p-(1-oxo-2-isoindoIinyl)hydratropic acid [INN: INDOPROFEN], 2-(10-methoxy-4H-benzo[4,5]cyclohepta[1 ,2-b]thiophen-4-ylidene)- acetic acid [Research Code: IX-207-887], m-benzoylhydratropic acid [INN: KETOPROFEN], (DL)- 5-benzoyl-3H-1 ,2-dihydropyrrolo[1 ,2-a]pyrroIe-1 -carboxylic acid [INN: KETOROLAC], 2,3-dihydro- 5-hydroxy-6-[2-(hydroxymethyl)cinnamyl]benzofuran [Research Code: L-651896], N-(2-carboxy- phenyl)-4-chloroanthranilic acid [INN: LOBENZARIT], 3-(p-chlorophenyl)-1-phenylpyrazole-4- acetic acid [INN: LONAZOLAC], 6-chloro-4-hydroxy-2-methyI-N-2-pyridyl-2H-thieno[2,3-e]-1 ,2- thiazine-3-carboxamide 1 ,1-dioxide [INN: LORNOXICAM], 2-[4-(2-oxocyclopentan-1-ylmethyl)- phenyl]-propionate [INN: LOXOPROFEN], 2(R)-[4-(3-methyl-2-thienyl)phenyl]propionic acid [Research Code: M-5010], N-(2,3-xylyl)anthranilic acid [INN: MEFENAMIC ACID], 4-hydroxy-2-me- thyl-N-(5-methyl-2-thiazolyl)-2H-1 ,2-benzothiazine-3-carboxamide 1 ,1-dioxide [INN: MELOXICAM], 5-aminosalicylic acid [INN: MESALAZINE], (2,2-dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3- dihydro-1 H-pyrrolizin-5-yl)-acetic acid [Research Code: ML-3000], 3,4-bis(4-methoxyphenyl)-5- isoxazoleacetic acid [INN: MOFEZOLAC], 4-(6-methoxy-2-naphthyl)-2-butanone [INN: NABUMETONE], (plus)-6-methoxy-alpha-methyl-2-naphthaiineacetic acid [INN: NAPROXEN], 2-[3-(trifluo- romethyl)anilino]nicotinic acid [INN: NIFLUMIC ACID], 5,5'-azodisalicylic acid [INN: OLSA- LAZINE], alpha-methyl-4-[(2-oxocyclohexylidene)methyl]benzene acetic acid [INN: PELUBIPRO- FEN], 2-(p-isobutylphenyl)propionic acid 2-pyridyl-methyl ester [INN: PIMEPROFEN], 4-(p-chloro- phenyl)-1-(p-fluorophenyl)pyrazole-3-acetic acid [INN: PIRAZOLAC], 4-hydroxy-2-methyl-N-2-py- ridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM], 3-chloro-4-(3-pyrro- lin-1-yl)hydratropic acid [INN: PIRPROFEN], 2-[5H-(1 )benzopyrano]2,3-b]pyridin-7-yl]propionic acid [INN: PRANOPROFEN], 2,6-di-tert-butyl-4-(2'-thenoyI)phenol [INN: PRIFELONE], alpha- cyano-1-methyl-beta-oxopyrrole-2-propionanilide [INN: PRINOMIDE], 3-[4-(2-hydroxyethyl)-1- piperazinyl]-propyl-D,L-4-benzamido-N,N-dipropylglutaramat 1-(p-chlorobenzoyl)-5-methoxy-2- methylindole-3-acetate (ester) [INN: PROGLUMETACIN], 7-methyl-1-(1-methylethyl)-4-phenyl- 2(1 H)quinazolinone [INN: PROQUAZONE], 7-methoxy-alpha,10-dimethylphenothiazine-2-acetic acid [INN: PROTIZINIC] ACID], 2-[[2-(p-chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2-methyl- propionic acid [INN: ROMAZARIT], o-hydroxybenzamide [SALICYLAMIDE], 2-hydroxybenzoic acid [SALICYLIC ACID], N-acetyl-L-cysteine salicylate (ester), acetate (ester) [INN: SALMI- STEINE], N-acetyl-L-cysteine salicylate (ester) [INN: SALNACEDIN], 2-hydroxybenzoic acid 2-carboxyphenyl ester [INN: SALSALATE], 4-[1-(2-fluorobiphenyl-4-yl)ethyl]-N-methylthiazole-2- amine [Research Code: SM-8849], (Z)-5-fluoro-2-methyl-1-[p-(methylsulfinyl)benzyIidene]indene- 3-acetic acid [INN: SULINDAC], p-2-thenoylhydratropic acid [INN: SUPROFEN] 2-(4-(3-methyl-2- butenyl)phenyl)propionic acid [Research Code: TA-60], phthalidyl 2-(alpha,alpha,alpha-trifluoro- m-toluidino)nicotinate [INN: TALNIFLUMATE], (Z)-5-chloro-3-(2-thenoyl)-2-oxoindole-1-carbox- amide [INN: TENIDAP], 2-thiophenecarboxylic acid, ester with salicylic acid [INN: TENOSAL], 4-hydroxy-2-methyl-N-2-pyridyl-2H-thieno[2,3-e]-1 ,2-thiazine-3-carboxamide [INN: TENOXICAM], 5-(4-chlorophenyl)-N-hydroxy-1-(4-methoxyphenyl)-N-methyl-1 H-pyrazole-3-propionamide [INN: TEPOXALIN], alpha-(5-benzoyl-2-thienyl)propionic acid [INN: TIAPROFENIC ACID], 5-chloro-3- [4-(2-hydroxyethyl)-1-piperazinyl]carbonylmethyl-2-benzo-thiazolin one [INN: TIARAMIDE], 2-(2- methyl-5H-[1]benzopyrano[2,3-b]pyridin-7-yl)-propionic acid N,N-dimethylcarbamoylmethyl ester [INN: TILNOPROFEN ARBAMEL], 1-Cyclohexyl-2-(2-methyl-4-quinolyl)-3-(2-thiazolyl)guanidine [INN: TIMEGADINE], 2-amino-6-benzyl-4,5,6J-tetrahydrothieno[2,3-c]pyridine [INN: TINORIDINE], N-(3-chloro-o-toIyl)anthranilic acid [INN: TOLFENAMIC ACID], 1-methyl-5-(4-methylbenzoyl)- 1 H-pyrrole-2-acetic acid [INN: TOLMETIN], hydroxybis[alpha-methyl-4-(2-methylpropyl)benzene acetato-0]-aluminium [Research Code: U-18573-G], N-(3-trifluoromethylphenyl)-anthranilic acid n-butyl ester [INN: UFENAMATE], 2-[4-[3-(hydroxyimino)cyclohexyl]phenyl]propionic acid [INN: XIMOPROFEN], 2-(10,11-dihydro-10-oxo-dibenz[b,f]thiepin-2-yl-propionic acid [INN: ZALTOPROFEN] and 2-[4-(2-thiazolyloxy)phenyl]-propionic acid [INN: ZOLIPROFEN] and their pharmaceutically acceptable derivatives, and instructions for simultaneous, sequential or separate administration to the patient in need thereof.
16. A kit according to claim 15, wherein the first and/or the second active ingredient is in the form of a pharmaceutically acceptable salt, solvate, ester, N-oxide or solvate of an salt, ester or N-oxide.
17. A kit according to claim 15 or 16, wherein the first active ingredient is a PDE4-inhibitor selected from cis-[4-Cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexane-1-carboxylic acid [INN: CILOMILAST] and 3-Cyclopropylmethoxy-4-difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST],and the second active ingredient is a conventional NSAID selected from 2-(acetyloxy)benzoic acid [ACETYLSALICYLIC ACID], 2-[(2,6-dichlorophenyl)amino]benzene- acetic acid [INN: DICLOFENAC], alpha-p-isobutylphenylpropionic acid [INN: IBUPROFEN], 1-(4- chlorobenzoyl)-5-methoxy-2-methyl-1 H-indole-3-acetic acid [INN: INDOMETACIN], (plus)-6-meth- oxy-alpha-methyl-2-naphthalineacetic acid [INN: NAPROXEN] and 4-hydroxy-2-methyl-N-2- pyridyl-2H-1 ,2-benzothiadiazin-3-carboxamide 1 ,1-dioxide [INN: PIROXICAM].
18. A kit according to claim 17, wherein the first active ingredient is 3-Cyclopropylmethoxy-4- difluoromethoxy-N-(3,5-dichloropyrid-4-yl)-benzamide [INN: ROFLUMILAST] or a pharmaceutically acceptable salt, solvate, N-oxide or solvate of an salt or N-oxide thereof.
19. A kit according to claim 17, wherein the second active ingredient is 2-[(2,6-dichlorophenyl)- aminojbenzeneacetic acid [INN: DICLOFENAC] or a pharmaceutically acceptable salt, ester, solvate or solvate of an salt or ester thereof.
20. A method of an effective treatment of an inflammatory disease and/or an inflammation associated disorder which can be treated with a conventional NSAID while minimizing gastrointestinal side effects comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
21. A method according to claim 20 wherein the inflammatory disease is inflammatory bowel disease, Crohn's disease, irritable bowel syndrome or ulcerative colitis.
22. A method of minimizing gastrointestinal side effects frequently associated with the use of conventional NSAIDs comprising the simultaneous, sequential or separate administration of i) a first amount of a conventional NSAID or a pharmaceutically acceptable derivative therof; and ii) a second amount of a PDE4 inhibitor or a pharmaceutically acceptable derivative thereof, wherein the sum of the first and the second amount is a therapeutically effective amount, to a patient in need thereof.
23. A method according to claim 20 or 22 which comprises a pharmaceutical product or kit containing a conventional NSAID and a written description which discloses that said conventional NSAID can be administered together with a PDE4 inhibitor (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs.
24. A method according to claim 20 or 22 which comprises a pharmaceutical product or kit containing a PDE4 inhibitor and a written description which discloses that said PDE4 inhibitor can be administered together with a conventional NSAID (a) for the treatment of an inflammatory disease and/or an inflammation associated disorder while minimizing gastrointestinal side effects or (b) for the attenuation of gastrointestinal side effects frequently associated with the use of conventional NSAIDs.
PCT/EP2002/010424 2001-09-19 2002-09-17 Combination of a nsaid and a pde-4 inhibitor WO2003024489A2 (en)

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DE60218497T DE60218497T2 (en) 2001-09-19 2002-09-17 COMBINATION OF A NSAID AND A PDE-4 INHIBITOR
DK02772313T DK1429807T3 (en) 2001-09-19 2002-09-17 Combination of an NSAID and a PDE4 inhibitor
AU2002337105A AU2002337105B2 (en) 2001-09-19 2002-09-17 Combination of a NSAID and a PDE-4 inhibitor
BR0212606-0A BR0212606A (en) 2001-09-19 2002-09-17 Combination
IL16027102A IL160271A0 (en) 2001-09-19 2002-09-17 Pharmaceutical compositions containing pde4-inhibitors and nsaid
KR1020047004047A KR100949528B1 (en) 2001-09-19 2002-09-17 Combination of a nsaid and a pde-4 inhibitor
MXPA04002562A MXPA04002562A (en) 2001-09-19 2002-09-17 Combination.
SI200230534T SI1429807T1 (en) 2001-09-19 2002-09-17 Combination of a nsaid and a pde-4 inhibitor
JP2003528583A JP4588998B2 (en) 2001-09-19 2002-09-17 Concomitant medication
EA200400410A EA008108B1 (en) 2001-09-19 2002-09-17 Combination of a nsaid and a pde-4 inhibitors
HU0401582A HU229442B1 (en) 2001-09-19 2002-09-17 Combination of nsaid and pde-4 inhibitors and their use
US10/489,920 US20040242597A1 (en) 2001-09-19 2002-09-17 Combination
CA2459757A CA2459757C (en) 2001-09-19 2002-09-17 Combination
EP02772313A EP1429807B1 (en) 2001-09-19 2002-09-17 Combination of a nsaid and a pde-4 inhibitor
NZ532278A NZ532278A (en) 2001-09-19 2002-09-17 Combination of a PDE inhibitor and an NSAID
IL160271A IL160271A (en) 2001-09-19 2004-02-08 Pharmaceutical compositions containing pde4-inhibitors and
ZA2004/02654A ZA200402654B (en) 2001-09-19 2004-04-05 Combination of a nsaid and a pde-4 inhibitor
NO20041596A NO331756B1 (en) 2001-09-19 2004-04-19 Pharmaceutical composition, product and kit comprising an NSAID and a PDE-4 inhibitor and use thereof
HK04109770A HK1066730A1 (en) 2001-09-19 2004-12-09 Combination of a nsaid and a pde-4 inhibitor
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