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
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/498—Pyrazines or piperazines ortho- and peri-condensed with carbocyclic ring systems, e.g. quinoxaline, phenazine
• • 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
  • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
• • 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
  • A61K9/0014—Skin, i.e. galenical aspects of topical compositions
• • 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
  • A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P17/00—Drugs for dermatological disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P17/00—Drugs for dermatological disorders
  • A61P17/10—Anti-acne agents

Definitions

• Brimonidine tartrate in aqueous solution (0.15% and 0.20%) is a known for ophthalmic use. It is sold by Allergan under the name ALPHAGAN ® P.
• brimonidine tartrate is also useful in treating erythema caused by rosacea.
• Creams and gels containing brimonidine tartrate have been disclosed in the following U.S. Patent Applications: U.S. Serial No. 10/853,585 to DeJovin, et al.; U.S. Serial No. 10/626,037 to Scherer; and U.S. Serial No. 10/607,439 to Gil, et al.
• the present invention relates to pharmaceutical compositions for treating erythema associated with rosacea.
• the pharmaceutical compositions comprise brimonidine tartrate in an amount from about 0.17 percent by weight to about 0.19 percent by weight in a pharmaceutically acceptable carrier such as a gel or a cream.
• the amount of brimonidine tartrate in the composition is preferably from about 0.175 percent by weight to about 0.185 percent by weight, more preferably the brimonidine tartrate is present in the amount of 0.18 percent by weight.
• the pharmaceutically acceptable carrier is a gel or cream.
• the gel may include one or more skin-penetrating agents, moisturizers, preservatives, gelling agents, and protective agents.
• the cream may include one or more emulsifiers, skin-penetrating agents, moisturizers, preservatives, and protective and/or cosmetic agents.
• the skin-penetrating agent may be present in an amount from about 2 percent by weight to about 10 percent by weight.
• the preferred skin-penetrating agent is propylene glycol.
• the moisturizer is preferably present in an amount from about 2 percent by weight to about 10 percent by weight.
• the preferred moisturizer is glycerin.
• the preservative may be present in an amount from about 0.1 percent by weight to about 1 percent by weight.
• the preferred preservatives are methylparaben and phenoxyethanol.
• the gelling agent is preferably present in an amount from about 0.5 percent by weight to about 2 percent by weight.
• the preferred gelling agent is Carbomer 934P.
• the protective agent may be present in an amount from about 0.1 percent by weight to about 1.5 percent by weight.
• the preferred protective agent is titanium dioxide.
• the composition may contain a sufficient amount of base to cause the carrier to have a pH of about 5 to about 7.5 when the gel is diluted by a factor often.
• the pH range is about 6.2 to about 6.8 when the gel is diluted by a factor often.
• the preferred base is sodium or potassium hydroxide.
• the composition includes water, a carbomer, propylene glycol, glycerin, methylparaben, phenoxyethanol, glycerin, titanium dioxide and a sufficient amount of base to cause the carrier to have a pH from about 6.2 to about 6.8 when the gel is diluted by a factor often.
• the invention also relates to a method for treating erythema in patient with rosacea by topically administering brimonidine tartrate in an amount from about 0.17 percent by weight to about 0.19 percent by weight in a pharmaceutically acceptable cream or gel to the site of the erythema on the skin of the patient.
• the invention in a second aspect, relates to methods of treating erythema in a patient with rosacea including topically administering brimonidine tartrate in an amount from about 0.17 percent by weight to about 0.19 percent by weight in a pharmaceutically acceptable cream or gel to the site of erythema on the skin of the patient.
• the brimonidine tartrate is present in an amount from about 0.175 percent by weight to about 0.185 percent by weight.
• the brimonidine tartrate is present in an amount of about 0.18 percent by weight.
• the carrier is preferably a gel or a cream. If the carrier is a gel, the gel preferably contains a skin-penetrating agent. The preferred skin-penetrating agent is propylene glycol.
• the gel may also contain a moisturizer.
• the preferred moisturizer is glycerin.
• the gel may also contain a preservative.
• the preferred preservatives include methylparaben and phenoxyethanol.
• the gel contains a sufficient amount of base to cause the carrier to have a minimum pH of about 5 and a maximum pH of about 7.5 when the gel is diluted by a factor often.
• the gel contains a sufficient amount of base to cause the carrier to have a minimum pH of about 6.2 and a maximum pH of about 6.8.
• the preferred bases are sodium and potassium hydroxide.
• the gel may contain a gelling agent.
• the preferred gelling agent is a carbomer.
• the gel may also contain a protective agent, a cosmetic agent, or a combination thereof.
• a preferred protective and /or cosmetic agent is titanium dioxide.
• the gel contains water, a gelling agent, a skin- penetrating agent, a moisturizer, a preservative, and a cosmetic agent.
• the gel comprises water, a carbomer, propylene glycol, glycerin, methylparaben, phenoxyethanol, glycerin, titanium dioxide and a sufficient amount of base to cause the carrier to have a minimum pH of about 6.2 and a maximum pH of about 6.8 when the gel is diluted by a factor often.
• the preferred base is sodium or potassium hydroxide.
• the cream preferably contains water, an emulsifier, a skin-penetrating agent, a moisturizer, a preservative, and a cosmetic agent.
• the cream contains water, oleyl alcohol, propylene glycol, glycerin, methylparaben, and titanium dioxide.
• Another aspect of the invention relates to the use of a composition according to any of the preceding embodiments in the manufacture of a medicament for the treatment of erythema in a patient with rosacea.
• the invention also relates to the use of a composition according to any of the preceding claims for topically administering brimonidine tartrate in the treatment of erythema in a patient with rosacea.
• Figure 1 shows the three-day average change in baseline CEA for all three visits over an eight hour period.
• Figure 2 shows the CEA does response, i.e., the change from the pre-dosage score, for each of the three dosage levels and the vehicle.
• Figure 3 shows the success rate. Patients were evaluated on day 28. Success was defined when a patient achieved a CEA score of 0 or 1, or a patient's erythema decreased by at least two points.
• the Y-axis, i.e., "% responder" is the percent of patients who achieved success over an eight hour period.
• the present invention relates to an improved pharmaceutical composition
• a pharmaceutically acceptable carrier such as a cream or gel.
• Brimonidine tartrate is effective in treating the symptoms of rosacea.
• Rosacea is an inflammatory skin disorder that generally affects the cheeks, nose, chin, and forehead of a patient.
• the major symptom of rosacea is erythema, i.e., the abnormal redness of the skin.
• the pharmaceutically acceptable composition of the present invention can be applied topically to the site of erythema on the skin of a patient.
• composition having a narrow range of concentration of brimonidine tartrate has superior clinical properties, e.g., balance of efficacy and acceptable side effects.
• Brimonidine tartrate i.e., 5-bromo-6- (2-imidazolidinylideneamino) quinoxaline L-tartrate, is a selective alpha-2 adrenergic agonist. Its structure is shown below.
• compositions of the invention contain brimonidine tartrate in an amount from about 0.17% by weight to about 0.19% by weight based upon the total weight of the composition.
• the brimonidine tartrate is administered in an amount from about 0.175% by weight to about 0.185% by weight.
• the brimonidine tartrate is administered in an amount of about 0.18 percent by weight.
• the pharmaceutically acceptable carrier is a gel.
• Gels are semisolid systems that contain suspensions of inorganic particles, usually small inorganic particles, or organic molecules, usually large organic molecules, interpenetrated by a liquid. When the gel mass comprises a network of small discrete inorganic particles, it is classified as a two-phase gel. Single-phase gels consist of organic macromolecules distributed uniformly throughout a liquid such that no apparent boundaries exist between the dispersed macromolecules and the liquid. Suitable gels for use in the invention are known in the art, and may be two-phase or single-phase systems. Some examples of suitable gels are disclosed in REMINGTON: THE SCIENCE AND PRACTICE OF PHARMACY 1517-1518 (Alfonso R.
• Gelling agents that may be used include those known to one skilled in the art, such as hydrophilic and hydroalcoholic gelling agents frequently used in the cosmetic and pharmaceutical industries.
• the hydrophilic or hydroalcoholic gelling agent comprises "CARBOPOL®” (B.F. Goodrich, Cleveland, Ohio), “HYP AN®” (Kingston Technologies, Dayton, N.J.), “NATROSOL®” (Aqualon, Wilmington, Del.), “KLUCEL®” (Aqualon, Wilmington, Del.), or “STABILEZE®” (ISP Technologies, Wayne, N.J.).
• CARBOPOL® is one of numerous cross-linked acrylic acid polymers that are given the general adopted name carbomer.
• Carbomer is the USP designation for various polymeric acids that are dispersible but insoluble in water. When the acid dispersion is neutralized with a base a clear, stable gel is formed.
• the preferred carbomer is Carbomer 934P because it is physiologically inert and is not a primary irritant or sensitizer.
• Other carbomers include 910, 940, 941, and 1342.
• Carbomers dissolve in water and form a clear or slightly hazy gel upon neutralization with a caustic material such as sodium hydroxide, potassium hydroxide, triethanolamine, or other amine bases.
• KLUCEL® is a cellulose polymer that is dispersed in water and forms a uniform gel upon complete hydration.
• Other preferred gelling agents include hydroxyethylcellulose, cellulose gum, MVE/MA decadiene crosspolymer, PVM/MA copolymer, or a combination thereof.
• the minimum amount of gelling agent in the composition is about 0.5%, more preferably, about 0.75%, and most preferably about 1%.
• the maximum amount of gelling agent in the composition is about 2%, more preferably about 1.75%, and most preferably about 1.5%.
• the pharmaceutical carrier may also be a cream.
• a cream is an emulsion, i.e., a dispersed system comprising at least two immiscible phases, one phase dispersed in the other as droplets ranging in diameter from 0.1 ⁇ m to 100 ⁇ m.
• An emulsifying agent is typically included to improve stability. Suitable emulsifiers include, but are not limited to, glyceryl stearate, oleyl alcohol, Peg-20 stearate, cetaryl alcohol, cetyl alcohol, lecithin, beeswax, and polysorbate 80.
• the emulsion When water is the dispersed phase and an oil is the dispersion medium, the emulsion is termed a water-in-oil emulsion. When an oil is dispersed as droplets throughout the aqueous phase as droplets, the emulsion is termed an oil-in-water emulsion.
• Emulsions that can be used as topical carriers and their preparation are disclosed in REMINGTON: THE SCIENCE AND PRACTICE OF PHARMACY 282-291 (Alfonso R. Gennaro ed. 19 th ed. 1995).
• the pH of the pharmaceutical carrier is adjusted with, for example, a base such as sodium hydroxide or potassium hydroxide.
• the minimum pH of the carrier is about 5, preferably 5.5, and most preferably 6.2 when the carrier is diluted by a factor often.
• the maximum pH of the carrier is about 7.5, preferably 7, and most preferably 6.8 when the carrier is diluted by a factor often.
• Each minimum pH value can be combined with each maximum pH value to create various pH ranges.
• the pH may be a minimum of 6.2 and a maximum of 7.5.
• the pH values given above are those that occur if the composition is diluted with water by a factor often. It is not necessary to dilute the composition by a factor often in order to obtain a pH value.
• the composition may be diluted by any value that permits pH to be measured. For example, the composition may be diluted by a factor of about five to about twenty.
• compositions of the invention may include pharmaceutically acceptable excipients including, but not limited to, protective agents, adsorbents, preservatives, moisturizers, and skin-penetration agents.
• pharmaceutically acceptable excipients are listed in REMINGTON: THE SCIENCE AND PRACTICE OF PHARMACY 866- 885(Alfonso R. Gennaro ed. 19 th ed. 1995; Ghosh, T. K.; et al. TRANSDERMAL AND TOPICAL DRUG DELIVERY SYSTEMS (1997).
• Suitable protective agents and/or cosmetic agents, and adsorbents include, but are not limited to, dusting powders, zinc sterate, collodion, dimethicone, silicones, zinc carbonate, aloe vera gel and other aloe products, vitamin E oil, allatoin, petrolatum, titanium dioxide, and zinc oxide.
• the preferred protective agent is titanium dioxide. Titanium dioxide may also function as a cosmetic agent.
• the minimum amount of cosmetic agent in the composition is about 0.01%, more preferably, about 0.025%, and most preferably about 0.05%.
• the maximum amount of cosmetic agent in the composition is about 0.15%, more preferably about 0.1%, and most preferably about 0.075%.
• Suitable preservatives include, but are not limited to, quaternary ammonium compounds, such as benzalkonium chloride, benzethonium chloride, cetrimide, dequalinium chloride, and cetylpyridinium chloride; mercurial agents, such as phenylmercuric nitrate, phenylmercuric acetate, and thimerosal; alcoholic agents, for example, chlorobutanol, phenylethyl alcohol, and benzyl alcohol; parabens such as methylparaben, ethylparaben, propylparaben, and butylparaben; antibacterial esters, for example, esters of parahydroxybenzoic acid; and other anti-microbial agents such as chlorhexidine, chlorocresol, benzoic acid, polymyxin, and phenoxyethanol.
• the preferred preservatives are methylparaben and phenoxyethanol.
• the minimum amount of preservative in the composition is about 0.1%, more preferably, about 0.2%, and most preferably about 0.3%.
• the maximum amount of preservative in the composition is about 1%, more preferably about 0.75%, and most preferably about 0.5%.
• Suitable moisturizers include, but are not limited to, glycerin, sorbitol, polyethylene glycols, urea, and propylene glycol.
• the preferred moisturizer is glycerin.
• the minimum amount of moisturizer in the composition is about 2%, more preferably, about 3.5%, and most preferably about 4.5%.
• the maximum amount of moisturizer in the composition is about 10%, more preferably about 8%, and most preferably about 6%.
• Suitable skin-penetration agents include, but are not limited to, ethyl alcohol, isopropyl alcohol, octylphenylpolyethylene glycol, oleic acid, polyethylene glycol 400, propylene glycol, N-decylmethylsulfoxide, fatty acid esters (e.g., isopropyl myristate, methyl laurate, glycerol monooleate, and propylene glycol monooleate); and N-methylpyrrolidone.
• the preferred skin-penetrating agent is propylene glycol.
• the minimum amount of skin-penetrating agent in the composition is about 2%, more preferably, about 3.5%, and most preferably about 4.5%.
• the maximum amount of skin-penetrating agent in the composition is about 10%, more preferably about 8%, and most preferably about 6%.
• the pharmaceutical composition is delivered topically to the affected area of the skin.
• the pharmaceutical compositions of the invention are topically applied directly to the affected area in any conventional manner well known in the art.
• the compositions are applied by cotton swab or applicator stick, or by simply spreading a formulation of the invention onto the affected area with fingers.
• the amount of a topical formulation of the invention applied to the affected skin area ranges from about 0.0001 g/cm of skin surface area to about 0.01 g/ cm , preferably, 0.001 g/ cm 2 to about 0.003 g/ cm 2 of skin surface area.
• one to four applications per day are recommended during the term of treatment.
• the 5-bromo-6-isothiocyanato-quinoxaline (3.5 g) is directly dissolved in benzene (400 ml) and added dropwise to a well-stirred solution of ethylene diamine (15 g.) in benzene (50 ml). During a period of about two hours, an oil separates as a lower layer. The upper benzene layer is poured off and the oil is washed with diethyl ether and then dissolved in methanol (500 ml). The methanolic solution is refluxed until hydrogen sulfide evolution ceases. The methanolic solution is concentrated in vacuo to a volume of approximately 100 ml upon which a yellow solid precipitates.
• the tartrate salt of brimonidine can be synthesized by adding (L)-(+)-tartaric acid to a solution of brimonidine in aqueous methanol.
• the brimonidine tartrate will separate out of solution.
• a double-blind, placebo-controlled study was conducted at six centers of 1 10 patients with moderate to severe erythema. Patients were administered a gel similar to the formulation in Example 3, which contained either a "low” dosage of brimonidine tartrate (0.02% by weight), a “mid” dosage of brimonidine tartrate (0.07% by weight), a “high” dosage of brimonidine tartrate (0.20% by weight), or no brimonidine tartrate ("vehicle” or placebo group). (These concentrations are greater or less than the claimed ones.) The treatment lasted for 28 days during which time patients applied the gel each day. On days 1, 14, and 28, patients applied the gel under the supervision of clinical staff in the study centers, and were evaluated at set intervals for up to eight hours.
• CCA Clinician's Erythema Assessment Score

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  • 2008-08-18 US US12/193,098 patent/US20090061020A1/en not_active Abandoned
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