WO2005120491A1 - 炎症性腸疾患の治療薬又は予防薬 - Google Patents
炎症性腸疾患の治療薬又は予防薬 Download PDFInfo
- Publication number
- WO2005120491A1 WO2005120491A1 PCT/JP2005/011204 JP2005011204W WO2005120491A1 WO 2005120491 A1 WO2005120491 A1 WO 2005120491A1 JP 2005011204 W JP2005011204 W JP 2005011204W WO 2005120491 A1 WO2005120491 A1 WO 2005120491A1
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- WIPO (PCT)
- Prior art keywords
- disease
- inflammatory bowel
- bowel disease
- ulcerative colitis
- remedy
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Classifications
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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
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
- A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
- A61K31/235—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group
- A61K31/24—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group having an amino or nitro group
- A61K31/245—Amino benzoic acid types, e.g. procaine, novocaine
-
- 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
- A61K31/60—Salicylic acid; Derivatives thereof
- A61K31/606—Salicylic acid; Derivatives thereof having amino groups
-
- 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
- A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
Definitions
- the present invention relates to a therapeutic or preventive agent for inflammatory bowel disease, particularly ulcerative colitis or Crohn's disease, comprising nafamostat mesilate as an active ingredient.
- Inflammatory bowel disease is an incurable disease of unknown cause with long-term diarrhea and bloody stool, and can be classified symptomatically into ulcerative colitis and Crohn's disease. Although both diseases can lead to a normal life with appropriate treatment, it is said that current technology will not cure them completely. The causes of these inflammatory bowel diseases are not yet fully understood. However, at present it is the dominant theory of impaired intestinal tolerance.
- ulcerative colitis The most common symptom of ulcerative colitis is diarrhea, which is long-lasting with mucus and blood.
- ulcerative colitis is a disease of only the large intestine, whereas Crohn's disease has symptoms in the small intestine.
- the symptoms of colonic Crohn's disease are basically the same as those of ulcerative colitis, but small intestinal Crohn's disease can often be difficult to diagnose. Hemorrhoids (particularly hemorrhoids) may be characteristic of Crohn's disease.
- ulcerative colitis the International Commissioner for Medical Science (CIOMS) stated, "Idiopathic, nonspecific inflammatory diseases of the large intestine, especially the rectum, which mainly affect the mucous membrane and submucosa. It is also present in people over the age of 50. The cause is unknown, and may be related to immunopathological mechanisms and psychological factors, usually showing bloody diarrhea and various degrees of systemic symptoms. Over the entire colon and tends to become malignant.
- the colon consists of a mucosal layer, a submucosal layer, a muscular layer, and a serosa from the inside. Ulcerative colitis is pathologically characterized by wide and shallow inflammation of the mucosal layer, and when severe, mucosal erosion (soreness) may form, and the ulcer may reach the muscle layer. Symptoms usually begin in the rectum, close to the anus, and then spread to the deeper colon. In addition, colitis is an inflammation that occurs in the intestine, causing symptoms such as diarrhea and mucous stool (loose stool mixed with blood, mucus, and pus), fever and weight loss, and the condition subsides (remission), It often worsens or repeats (active period).
- the typical symptoms of colitis are bloody stool, mucous stool, diarrhea, or bloody diarrhea, but the symptoms vary depending on the extent and severity of the lesion.
- bloody stool is often small and is not accompanied by diarrhea.However, in more severe cases, blood was mixed with exudate and mucus without tomato ketchup like watery diarrhea and bleeding, or without fecal mass State.
- Other symptoms often include abdominal pain, fever, loss of appetite, weight loss, and anemia.
- extra-intestinal complications such as arthritis, urolithiasis, ulcerados, and knee inflammation-hyperamylaseemia are not uncommon.
- ulcerative colitis complications of ulcerative colitis include intestinal complications such as major bleeding from the large intestine, perforation, and toxic megacolon, and skin symptoms such as erythema nodosum and gangrenous pyoderma.
- Typical drugs currently used for the treatment of ulcerative colitis include 5-aminosalicylic acid (5-ASA) preparations such as salazosulfapyridine and mesalazine, and steroid drugs such as betamethasone, betamethasone phosphate and prednisolone. It is an immunosuppressant such as azathioprine, 6-mercaptopurine, etc.
- 5-ASA 5-aminosalicylic acid
- steroid drugs such as betamethasone, betamethasone phosphate and prednisolone.
- antibiotics, antiallergic drugs, herbal medicines, etc. are also used depending on symptoms and therapeutic effects.
- Leukocyte ablation therapy is an extracorporeal circulatory treatment that removes blood once from the body, removes various pathogens, especially white blood cells, present in the blood using a blood purifier, and returns the purified blood back to the body. It is one of the laws. This treatment differs from conventional treatments if the drug does not provide sufficient or reduced efficacy, or if patients experience adverse drug treatments due to side effects of the drug. It is a new treatment.
- Crohn's disease is a disease in which ulcerative colitis is a disease of only the large intestine, but has symptoms in the small intestine.
- the symptoms of colonic Crohn's disease are basically the same as those of ulcerative colitis, but small intestinal Crohn's disease is often difficult to diagnose.
- Crohn's disease may be accompanied by unique hemorrhoids (especially hemorrhoids).
- Crohn's disease at present, there is no drug that can cure the disease. Therefore, as in the case of ulcerative colitis, so-called symptomatic treatment for suppressing inflammation and alleviating the condition is being performed.
- the main treatments for Crohn's disease include steroids, 5-ASA preparations, salazopyrine, immunosuppressants, antibiotics, and intestinal medicines.
- Mesalazine which is commonly used for ulcerative colitis and Crohn's disease, is a preparation that acts on the affected part of the intestine to suppress inflammation. It is a preparation that improves on the conventional salazosulfaviridin (salazopyrine). , Side effects have also been reduced. There are still side effects such as abdominal pain, nausea, diarrhea, rash and itching.
- Steroid preparations are mainly used for the treatment of moderate to severe ulcerative colitis.
- steroid preparations reduce inflammation not only in the intestinal tract but also throughout the body.
- side effects of mental illnesses such as conditions, eye diseases such as cataract and cataract, and bone abnormalities such as osteoporosis. Therefore, great care is required when using steroids, and it is usually used in active or acute periods when the symptoms are severe, and the dosage is gradually reduced as the symptoms are alleviated. It has been used to discontinue administration.
- tryptase inhibitors represented by the following formulas (I) to (V) are used in a large number of diseases such as asthma, pulmonary fibrosis, interstitial pneumonia, nephritis, hepatic fibrosis, hepatitis, cirrhosis, and scleroderma.
- nafamostat mesylate is an amidinonaphthyl ester of guanidinobenzoic acid, which was found by studying the structure-activity relationship of various guanidino and amidino derivatives to proteases, particularly to serine proteases. It potently inhibits active coagulation factors ( ⁇ a, Xa, VIIa), kallikrein, plasmin, complement (active C1r, active C1s), trypsin, etc. and suppresses platelet aggregation. Having Due to these properties, acute symptoms of vaginitis and generalized intravascular coagulation
- 5-azominosalicylic acid preparations such as salazosulfapyridine and mesalazine, betamethasone / betamethasone phosphate / prednisolone, etc.
- 5-azominosalicylic acid preparations such as salazosulfapyridine and mesalazine, betamethasone / betamethasone phosphate / prednisolone, etc.
- steroids are widely used, the cause of colitis is not clearly understood in the first place, so these drugs suppress inflammation of the colon rather than cure the disease fundamentally.
- the goal is to relieve symptoms such as diarrhea and mucous stool and maintain a long period of remission, which is a state without inflammation.
- these drugs could not always be expected to have a therapeutic effect depending on the patient's individual symptoms or the progress of the disease state, and could not completely eliminate the risk of side effects.
- an object of the present invention is to provide a new therapeutic agent for inflammatory bowel disease, which has a different mechanism from that of a conventional therapeutic agent and can therefore be expected to have a new effect. Disclosure of the invention
- the present inventors have conducted intensive research to find such a new therapeutic agent for inflammatory bowel disease, in particular, a therapeutic agent for ulcerative colitis and a therapeutic agent for Crohn's disease.
- Nafamostat mesilate whose efficacy and safety has already been confirmed as a therapeutic agent for coagulation (DIG) and an anticoagulant for perfused blood during extracorporeal blood circulation, is extremely effective as a therapeutic agent for inflammatory bowel disease This has been specifically found, and the present invention has been completed.
- the present invention relates to a therapeutic or prophylactic agent for inflammatory bowel disease comprising nafamostat mesilate as an active ingredient, and is specifically as follows.
- a therapeutic or prophylactic agent for inflammatory bowel disease comprising nafamostat mesilate as an active ingredient.
- the inflammatory bowel disease therapeutic agent comprising nafamostat mesylate according to the present invention as an active ingredient is, as is clear from the test examples described later, mesalazine (5) which is a currently used representative therapeutic agent for inflammatory bowel disease. — ASA) and is expected to be a new therapeutic agent for inflammatory bowel disease because its safety has been confirmed and its mechanism of action is different.
- the present invention relates to a therapeutic or prophylactic agent for inflammatory bowel disease containing nafamostat mesilate as an active ingredient, and its use form is not particularly limited. It is usually administered systemically or locally, in oral or parenteral form. It is preferably administered in the form of a liquid preparation such as an enema fluid, an injection solution, or an infusion solution, but is not limited to this. In some cases, it is a solid preparation such as a tablet or a suppository. You may.
- the dosage varies depending on the age, body weight, symptoms, therapeutic effect, administration method, treatment time, etc., but is generally within the range of 10 pg to 300 mg per day per adult, each time. Administer orally or parenterally once to several times.
- Solid compositions for oral administration include tablets, pills, capsules, powders, granules and the like.
- Capsules include hard capsules and soft capsules.
- the one or more active substances comprise at least one inert diluent, such as lactose, mannitol, mannitol, glucose, hydroxypropylcellulose, microcrystalline cellulose, starch. Mixed with polyvinylpyrrolidone, magnesium aluminate metasilicate.
- the composition may be formulated according to conventional methods, with additives other than inert diluents, e.g., lubricants such as magnesium stearate, disintegrants such as calcium cellulose glycolate, dissolution aids such as glutamic acid or aspartic acid. May be contained.
- Tablets or pills may be coated with a film of gastric or enteric substance such as sucrose, gelatin, hydroxypropylcellulose, hydroxypropylmethylcellulose phthalate, etc., if necessary, or with two or more layers. You may. Also included are capsules of absorbable substances such as gelatin.
- Liquid compositions for oral administration include pharmaceutically acceptable emulsions, solutions, syrups, elixirs and the like.
- one or more active substances are contained in a commonly used inert diluent (eg, purified water, ethanol).
- the composition may contain, in addition to the inert diluent, adjuvants such as wetting agents and suspending agents, sweetening agents, flavoring agents, and preservatives.
- compositions for oral administration include sprays which contain one or more active substances and are formulated in a manner known per se.
- This composition Contains, in addition to the inert diluent, a stabilizer such as sodium bisulfite to provide isotonicity and an isotonic agent such as sodium chloride, sodium citrate or citrate. Is also good.
- Solutions for parenteral administration include sterile aqueous or non-aqueous solutions, suspensions, and emulsions.
- Aqueous solutions and suspensions include, for example, distilled water for injection and physiological saline.
- water-insoluble solutions and suspensions include propylene glycol, polyethylene glycol, vegetable oils such as olive oil, alcohols such as ethanol, polysorbate 80 (registered trademark), and the like.
- Such compositions may also contain adjuvants such as preserving, wetting, emulsifying, dispersing, stabilizing, and solubilizing agents (eg, glutamic acid, aspartic acid).
- compositions for parenteral administration include nafamostat mesilate as an active ingredient, enema, external solution, ointment, liniment, and suppository for rectal administration, which are prescribed by ordinary methods And a pessary for vaginal administration.
- test drug consisted of normal saline infusion water as normal control, ⁇ ⁇ ⁇ BS infusion water + physiological saline infusion water as a disease control, and TNBS infusion water + FU ⁇ ( Nafamostat mesylate) solution enema.
- the test solution has a FUT concentration of 1 0 one 'and was prepared as of 1 0 one 9 M 1 M of things.
- TBA-RS means a thiobarbituric acid reactant which is considered to be a lipid peroxide product.
- MPO myelinated peroxide
- the damaged large intestine generally thickens. As shown in Table 3, the wet weight of the large intestine was 475 mg in the normal control, but increased to 98 Omg in the TNBS rat as a disease control. The dose was reduced to about 600-70 Omg by administering FUT.
- TBA-RS is a thiobarbituric acid-reactive substance that is considered to be a lipid peroxide product, and is an indicator of oxidative stress.
- Table 4 shows the results. It is already clear in the art that oxidative stress is involved in the pathology of inflammatory bowel disease. As is evident from the experimental results, FUT administration clearly relieved the stress in the TNBS rats as a disease control, despite the extreme stress load.
- the test method is the same as in Example 1 above.
- the test drug was “saline inoculated saline” as a normal control, “TNBS infused water + saline infused water” as a disease state control, and “FUT (10-1” M) as a test solution. ) solution enema solution ", using" TNBS Chuchosui + FUT (1 0 one '1 M) dissolved liquid enema solution ", GanmaTNBS Chuchosui + 5-ASA solution enema solution (5 mg)”.
- the evaluation was made from the viewpoints of weight gain, damage score, colon weight increase, TBA-RS, MPO activity, cytokines in colon mucosa (CINC-1), and the like.
- the results for weight gain, colon weight gain, TBA-RS, MPO activity, and CINC-1 are shown in Table 6 below.
- Example 1 The scoring criteria of Example 1 were used for the damage score.
- Table 7 shows the damage score test results. According to this, while a FUT 1 0- 11 M 0. 0 equivalent and damage scores of normal rats by single administration, was increased to about 7.1 in the TNBS rat is condition control. However, the score when administering TNBS enema water + FUT (10- "M) solution enema" was almost the same as that in the case of "TNBS enema fluid-ASA solution enema". Obtained.
- the therapeutic agent for inflammatory bowel disease containing nafamostat mesilate according to the present invention as an active ingredient is, as is clear from the test examples described later, the typical treatment for inflammatory bowel disease currently used. It is as good as or less than the drug mesalazine (5-ASA), and its safety has been confirmed and its mechanism of action is different, so it is highly expected as a new therapeutic agent for inflammatory bowel disease. Things.
Abstract
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JP2004-175839 | 2004-06-14 | ||
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN103012214A (zh) * | 2011-09-28 | 2013-04-03 | 南京长澳医药科技有限公司 | 一种萘莫司他盐酸盐及萘莫司他甲磺酸盐的制备方法 |
WO2021251792A1 (en) * | 2020-06-12 | 2021-12-16 | Chong Kun Dang Pharmaceutical Corp. | Pharmaceutical composition for the treatment of covid-19 respiratory syndrome |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS611063B2 (ja) * | 1980-09-16 | 1986-01-13 | Torii Yakuhin Kk | |
JP2003246730A (ja) * | 2002-02-22 | 2003-09-02 | Torii Yakuhin Kk | トリプターゼ阻害剤 |
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Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS611063B2 (ja) * | 1980-09-16 | 1986-01-13 | Torii Yakuhin Kk | |
JP2003246730A (ja) * | 2002-02-22 | 2003-09-02 | Torii Yakuhin Kk | トリプターゼ阻害剤 |
Non-Patent Citations (3)
Title |
---|
CENAC N, COELHO A AND NGUYEN C. ET AL.: "Induction of intestinal inflammation in mouse by activation of proteinase-activated receptor-2.", AMERICAN JOURNAL PF PATHOLOGY., vol. 161, no. 5, 2002, pages 1903 - 1915, XP002990950 * |
NISHIDA Y, MURASE K AND FURUSU H ET AL.: "Response to urinary Trypsin inhibitor in ulcerative colitis is associated with a decrease in mast cell count in the colonic mucosa.", ACTA MEDICA NAGASAKIENSIA., vol. 44, no. 3-4, 1999, pages 39 - 43, XP002990949 * |
TREMAINE W BRZEZINSKI A AND KATZ J. ET AL: "Treatment of mildly to moderately active ulcerative colitis with a tryptase inhibitor (APC 2059): an open-label pilot study.", ALIMENTARY PHARMACOLOGY AND THERAPEUTICS., vol. 16, no. 3, 2002, pages 407 - 413, XP002990948 * |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN103012214A (zh) * | 2011-09-28 | 2013-04-03 | 南京长澳医药科技有限公司 | 一种萘莫司他盐酸盐及萘莫司他甲磺酸盐的制备方法 |
WO2021251792A1 (en) * | 2020-06-12 | 2021-12-16 | Chong Kun Dang Pharmaceutical Corp. | Pharmaceutical composition for the treatment of covid-19 respiratory syndrome |
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