Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/13—Amines
  • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
  • A61K31/137—Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
• • 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
  • A61K31/16—Amides, e.g. hydroxamic acids
  • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
  • A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
  • A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
  • A61K47/6949—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit inclusion complexes, e.g. clathrates, cavitates or fullerenes
  • A61K47/6951—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit inclusion complexes, e.g. clathrates, cavitates or fullerenes using cyclodextrin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/007—Pulmonary tract; Aromatherapy
  • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
  • A61K9/008—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy comprising drug dissolved or suspended in liquid propellant for inhalation via a pressurized metered dose inhaler [MDI]
• • 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
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
  • A61P11/06—Antiasthmatics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
  • A61P11/08—Bronchodilators
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B82—NANOTECHNOLOGY
  • B82Y—SPECIFIC USES OR APPLICATIONS OF NANOSTRUCTURES; MEASUREMENT OR ANALYSIS OF NANOSTRUCTURES; MANUFACTURE OR TREATMENT OF NANOSTRUCTURES
  • B82Y5/00—Nanobiotechnology or nanomedicine, e.g. protein engineering or drug delivery

Definitions

• pMDIs pressure metered dose inhalers
• HFA hydro fluoro alkanes
• HFA 227 or HFA 134a an HFA (hydro fluoro alkanes) or mixture of HFAs, such as HFA 227 or HFA 134a.
• Polymeric and surfactant stabilisers impart solubility to drug suspension in HFA by absorbing to the surface of the drug particles, and thus triggering a mechanism of steric stabilisation.
• the stabilisers For the stabilisers to be efficient, they need to be soluble in the dispersing medium to a suitable level, at least in excess of 0.5 %w/w, although this limit is excipient dependent.
• the mode of action of solubilisers is simpler, as these act as solvents for the drug substance.
• drugs can be brought into solution in the HFA-solubiliser mix.
• cyclodextrins their mode of action is different. Cyclodextrins are able to form complexes with the drug molecules, and it is this complex that is solubilised in the HFAs.
• Cyclodextrins have been used extensively for the formulation of pharmaceutical dosage forms, in particular to increase the solubility of otherwise poorly soluble drugs, or to impart controlled release properties. More rarely have cyclodextrins been used for the formulation of inhalation products in HFAs. The only example found to date is WO03/066031. Use of cyclodextrins in HFA formulations is rare because most cyclodextrins, in particular natural cyclodextrins, are insoluble in HFAs. In WO03/066031, cyclodextrins are used to stabilise drug suspensions.
• co-solvent one hydrophilic additive, such as PEG: poly ethylene glycol
• co-solvents solubilise the cyclodextrins, and thus make them useful as stabilisers.
• the present invention has identified the correct cyclodextrins that do not require any co- solvents, and thus constitutes a major improvement to the invention of WO03/066031.
• modified cyclodextrins are naturally soluble in HFA propellants. These are partially or fully acylated alpha ( ⁇ ), beta ( ⁇ ) or gamma ( ⁇ ) cyclodextrins. It has been found that the solubilised modified cyclodextrins were very good stabilisers for drug suspensions, and that due to the ability of cyclodextrin to act as complexing agents for drug molecules, they can also be used to form solution pMDIs.
• the invention provides HFA formulations comprising a partially or fully acylated alpha ( ⁇ ), beta ( ⁇ ) or gamma ( ⁇ ) cyclodextrin.
• the formulations are in the form of a suspension.
• the invention provides stable dispersions for the pulmonary or nasal delivery of one or more active molecule, for local or systemic administration. It comprises a physical mixture of modified cyclodextrin with one or more active ingredients in a propellant or propellant mixture.
• the invention provides a method for making a suspension formulation wherein modified cyclodextrins are first solubilised in HFA 134 or HFA 227, or a mixture of both, to the required concentration levels, from 0.001%w/w to 20 %w/w, preferably from 0.001 %w/w to 10 % w/w, most preferably from 0.001 %w/w to 5 % w/w.
• the active ingredient (drug) is then added to the cyclodextrin-HFA solution and filled into a pMDI canister.
• known amounts of drug can be added to individual canisters and the cyclodextrin-HFA solution added to the known weight cans.
• the drug suspension thus formed can be homogenised by appropriate means: stirrer, ultrasonic energy etc.
• the invention concerns the formation of pMDI solution formulations.
• the drug and the cyclodextrin are first solubilised in a common solvent.
• the solution is allowed to equilibrate over a couple of days.
• the complex is formed, it is extracted by, for example spray drying, freeze drying or supercritical fluid extraction.
• the solid formed is then solubilised in the HFA, or mixture thereof by virtue of the solubility of the modified cyclodextrin.
• the modified cyclodextrin is a partially or fully substituted alpha ( ⁇ ), beta ( ⁇ ) or gamma ( ⁇ ) cyclodextrin as shown on Figure 1, with R' an acyl group of the general formula: R-CO-.
• substituting group can be taken from the following selection: Acetyl, Acryloyl, Alanyl, Aminocarbonyl, ⁇ -Alanyl, aklyl Azelaoyl, Benzoyl, tert-Butoxy, Butynyl, Caproyl, Crotomoyl, Formyl, alkyl Glutaryl, Glycoloyl, Glycyl, Glyoxyloyl, Heptadecanoyl, Hydroperoxy, Hydroxyamino, Isobutynyl, Isovalenyl, Lactoyl, Lenyl, Levulinoyl, alkyl Malonyl, Mandeloyl, Methacryloyl, Myristoyl, Monanoyl, alkyl Oxalyl, Palmitoyl, alkyl Pimeloyl, Pivaloyl, Propanyl, Salicyloyl, Seryl, Sorboyl, Stearoyl, alkyl,
• the acetyl group is: Formyl, Acetyl, and Propanyl.
• the drug is any pharmaceuticaly active ingredient used in inhalation delivery. It can be micronised if needed for targeted delivery, such as in the treatment of respiratory diseases. It may be selected from any therapeutic or diagnostic agent.
• the pharmacologically active agents in accordance with the present invention include glucocorticosteroids such as: budesonide, fluticasone (e.g. as propionate ester), mometasone (e.g.
• furcate ester beclomethasone (e.g. as 17-propionate or 17,21- dipropionate esters), ciclesonide, triamcinolone (e.g. as acetonide), flunisolide, zoticasone, flumoxonide, rofleponide, butixocort (e.g. as propionate ester), prednisolone, prednisone, tipredane, steroid esters according to WO 2002/12265, WO 2002/12266 and WO 2002/88167 (I) e.g.
• Long-acting ⁇ 2 agonists include: salmeterol, formoterol, bambuterol, TA 2005 (chemically identified as 2(lH)-Quinolone, 8-hydroxy-5-[l-hydroxy-2-[[2-(4-methoxy-phenyl)-l- methylethyl]amino] ethyl] -monohydrochloride, [R-(R*,R*)] also identified by Chemical Abstract Service Registry Number 137888-11-0 and disclosed in U.S. Patent No 4.579.854, formanilide derivatives (III) e.g.
• esters, salts, solvates such as hydrates, or solvates of such esters or salts, if any.
• racemic mixtures as well as one or more optical isomers of the above compounds are within the scope of the invention.
• the preferred pharmacologically active glucocorticosteroid agents for use in accordance with the present invention include mometasone furoate, ciclesonide, zoticasone, flumoxonide, steroids from WO 2002/88167 e.g.
• the preferred pharmacologically active long-acting ⁇ 2 -agonist is salmeterol xinafoate, formanilide derivatives (III), benzenesulfonamide derivatives (IV) and formoterol (e.g. as fumarate dihydrate) and even more preferred is formoterol fumarate dihydrate.
• Combinations of pharmacologicaly active ingredients include fluticasone propionate/salmeterol xinafoate, ciclesonide/formoterol fumarate dihydrate, mometasone furoate/formoterol fumarate dihydrate, fluticasone propionate/formoterol fumarate dihydrate, and budesonide/formoterol fumarate dihydrate.
• steroids from WO 2002/88167 /formanilide derivatives from WO 2002/76933 steroids from WO 2002/88167/benzenesulfonamide derivatives from WO 2002/88167, steroids from DE 4129535/formoterol fumarate dihydrate, zoticasone/benzenesulfonamide derivatives from WO 2002/88167 and zoticasone/formanilide derivative.
• a most preferred combination is budesonide/formoterol fumarate dihydrate.
• Figure 1 shows the general structure of a modified ⁇ cylcodextrin. " R' " are the groups that can be substituted on the cyclodextrin ring with acyl functions.
• Figure 2 shows pMDI suspensions of terbutaline sulphate in HFA 227, with (right can) and without (left can) peracetylated ⁇ cyclodextrin.
• Figure 3 shows an HFA pMDI solution formulation in HFA 227.
• the solubility of peracetylated cyclodextrins (alpha, beta and gamma) in HFA propellants was assessed visually in clear PET vials crimped with a continuous pMDI valve. Known amounts of cyclodextrins were weighed into the PET vials. Continuous valves were crimped on the vial, and HFAs were added under pressure to the required amount. The samples were left to equilibrate over one week and were visually inspected. The solubility of the modified cyclodextrin at room temperature was evaluated by discriminating between samples that were clear by opposition to those samples that still had solid particles in suspension.
• the solubility of peracetylated alpha ( ) cyclodextrin in HFA 227 was shown to be above 0.5 %w/w. Its solubility in HFA 134a was shown to be above 1 %w/w.
• the solubility of peracetylated beta ( ⁇ ) cyclodextrin in HFA 227 was shown to be above 0.1 %w/w. Its solubility in HFA 134a was shown to be above 1 %w/w.
• the solubility of peracetylated gamma ( ⁇ ) cyclodextrin in HFA 227 was shown to be above 1 %w/w.
• HFA 134a Its solubility in HFA 134a was shown to be above 1 %w/w.
• Peracetylated beta ( ⁇ ) cyclodextrin was chosen to exemplify the invention.
• reference samples of pure drugs in HFAs were prepared. Then samples with solubilised peracetylated beta ( ⁇ ) cyclodextrin and micronised drug were prepared. The concentration of drug in these samples was the same as in the reference samples. The cyclodextrin concentration was at saturation level.
• the reference samples (pure drug) were prepared by weighing the drug in a PET vial. A valve was then crimped on the vial and propellant added under pressure. The vial was then sonicated for at least 15 minutes and left to equilibrate for one week.
• the drug - cyclodextrin samples were prepared by weighing a known amount of drug in a PET vial. The vial was then crimped with a continuous valve.
• the solution of peracetylated beta ( ⁇ ) cyclodextrin was prepared thus: a large amount of cyclodextrin was placed in large metallic can, it was crimped and filled with one of the propellants. This can was left to equilibrate for at least a week at room temperature. When equilibration was reached, the saturated cyclodextrin solution was filtered through a 0.2 run PTFE filter into the PET vials containing the known drug amounts. This way the maximum amount of soluble cyclodextrin was used in the suspensions. The concentration of drugs in the vials was then calculated through accurate recording of the weights of propellant/cyclodextrin added. The phase separation phenomenon present in both samples (pure drug and with the cyclodextrin) was then recorded photographically.
• a selection of HFA pMDI suspension examples follows.
• the samples were prepared by weight with HFA 227 added by pressure filling.
• the sample containing the modified cyclodextrin was far more stable than the sample without cyclodextrin. Its phase separation, flocculation and sedimentation, was much slower, the suspension was much finer, and head space adhesion was less than for the pure drug sample. See Figure 2.
• Efficacy of peracetylated ⁇ cyclodextrin as a solubiliser was tested with budesonide and peracetylated ⁇ cyclodextrin.
• a good solvent for these two molecules is chloroform.
• Five solutions of budesonide with cyclodextrin in chloroform were prepared by weight. They were prepared so as to have an increasing molar ratio of cyclodextrin vs. budesonide, i.e. the following budesonide: cyclodextrin ratios were prepared: 1:1, 1:2, 1:3, 1:4 and 1:5.
• the solutions were left to equilibrate for a couple of days.
• the solutions were then spray dried to form solid particles of drug cyclodextrin complex.
• the dry powders were then weighed in glass tubes and known amount of propellant added under pressure. Visual observations were performed.
• 2 types of reference samples were prepared.
• the first reference sample was a suspension of pure drug at the same concentration as the drug in the drug-cyclodextrin spraydried complex.
• the second reference sample was a physical mixture of drug and cyclodextrin at the same concentrations as in the spray dried complex.
• These 2 samples are suspensions.
• Figure 2 shows that the addition of an acylated ⁇ cyclodextrin to an HFA pMDI drug suspension improves the suspension properties dramatically. In particular it helps to form a finely dispersed suspensions, showing little to no device adhesion. These suspensions phase separate at a much lower rate than cyclodextrin fee suspensions, and are easily re-dispersible. Further more no sign of agglomeration is visible on storage.
• Figure 3 shows that it is possible to develop an HFA pMDI solution formulation by appropriate treatment of the drug-cyclodextrin complex.

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