WO2009053932A1 - Méthodes pour améliorer la fonction sexuelle féminine - Google Patents

Méthodes pour améliorer la fonction sexuelle féminine Download PDF

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Publication number
WO2009053932A1
WO2009053932A1 PCT/IB2008/054386 IB2008054386W WO2009053932A1 WO 2009053932 A1 WO2009053932 A1 WO 2009053932A1 IB 2008054386 W IB2008054386 W IB 2008054386W WO 2009053932 A1 WO2009053932 A1 WO 2009053932A1
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WO
WIPO (PCT)
Prior art keywords
vaginal
female
sexual
blood flow
proanthocyanidins
Prior art date
Application number
PCT/IB2008/054386
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English (en)
Inventor
Victor Ferrari
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Horphag Research (Luxembourg) Holding Sa
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Horphag Research (Luxembourg) Holding Sa filed Critical Horphag Research (Luxembourg) Holding Sa
Publication of WO2009053932A1 publication Critical patent/WO2009053932A1/fr

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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
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/13—Coniferophyta (gymnosperms)
    • A61K36/15—Pinaceae (Pine family), e.g. pine or cedar
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A61P15/02—Drugs for genital or sexual disorders; Contraceptives for disorders of the vagina
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A61P15/12—Drugs for genital or sexual disorders; Contraceptives for climacteric disorders

Definitions

  • the present invention relates to methods and pharmaceutical formulations for improving female sexual function.
  • Sexual excitement is initiated by any of a number of psychogenic or somatogenic stimuli and must be reinforced to result in orgasm. With continued stimulation, excitement progresses in intensity into a plateau stage, from which the individual can shift into orgasm.
  • the orgasmic stage is characterized by a rapid release from vasocongestion and muscular tension. During the various stages of sexual response, characteristic genital and extragenital responses occur.
  • Female sexual dysfunction can be divided into four often overlapping categories:
  • Orgasmic disorder - characterized by an inability to achieve orgasm after sufficient sexual arousal and stimulation
  • Sexual pain disorder - characterized by pain associated with sexual stimulation or vaginal contact.
  • Sexual dysfunction may be due to organic or functional disturbances.
  • vaginal atrophy and dyspareunia are common causes of sexual dysfunction.
  • vaginal epithelium decreases in thickness, hydration, rugae (folds), and blood flow.
  • Kaplan The Evaluation of Sexual Disorders: Psychological and Medical Aspects (Brunner-Mazel, New York, N. Y. 1983), and Kolodny et al, Textbook of Sexual Medicine (Little, Brown & Co., Boston, Mass. 1979).
  • excitement stage dysfunction generally involves touch sensation impairment, loss of clitoral sensation, vaginal dryness, and urinary incontinence.
  • Such excitement phase dysfunction generally results in dyspareunia.
  • Dyspareunia is thought to affect approximately 40% of women, due in large part to inadequate lubrication.
  • Contemporary symptomatic treatments generally involve the use of physiologically safe personal lubricants, such as K- Y ® Jelly, Replens ® and Astroglide ® . However, these products provide only temporary symptomatic relief and provide virtually no long-term benefits Io the vaginal tissue. When symptomatic treatment fails, pharmacological treatment may be indicated.
  • Estrogen therapy is commonly used in the pharmacological treatment of female sexual dysfunction.
  • Estrogen-based therapies are generally used to increase mucous production, provide vasodilatory effects, or to increase the general health of the vagina.
  • estrogen is administered orally, parenterally (e.g., by injection), or topically.
  • estrogen-based therapies are known to increase the risk of endometrial hyperplasia, endometrial cancer and breast cancer in treated individuals.
  • estrogen/progcstogen combinations have been employed.
  • progestogens are known to have some androgenic activity.
  • common side effects from such therapies include uterine bleeding and the continuation of menstrual periods. Accordingly, as female sexual dysfunction creates a variety of quality of life issues for women and their partners, there remains a need in the art to provide safe compositions and methods for treating female sexual dysfunction.
  • Methods of monitoring female sexual function and dysfunction are known.
  • Devices and methods for measuring physiological changes, including changes during sexual arousal, which occur in the female are known.
  • the changes that can be measured include changes in clitoral, vaginal-artery, and/or vaginal-capillary blood flow, clitoral engorgement, and bioimpedance.
  • Overnight arousal-event monitoring, or other continuous monitoring methods over extended periods of time are also known.
  • Doppler velocimetry may be used to measure vaginal blood flow in human subjects.
  • One of the physiological changes that occurs during female sexual arousal is an increase in vaginal-wall blood flow.
  • Vaginal wall capillary blood flow changes have been measured by photoplethysmography.
  • Other methods of monitoring female sexual function including changes in clitoral, vaginal-artery, and/or vaginal- capillary blood flow, clitoral engorgement, and bioimpedance, and contrast enhanced imaging of sexual response are known and discussed in one or more of the following U.S. Patents: US5,782,778, US6,169,914, US6,969,507.
  • a method of improving a female sexual response includes administering to a patient with a reduced female sexual response an effective amount of a composition comprising a NO precursor and a vaginal blood flow enhancing agent, thereby enhancing at least one sexual response characteristic selected from the group consisting of: (1) vaginal blood flow; (2) vaginal blood volume; (3) vaginal mucosal flux; (4) vaginal mucosal thickness; (5) clitorial sensitivity; and (6) combinations of the foregoing.
  • a method of treating female sexual arousal inadequacy includes administering to a patient with at least one symptom of female sexual arousal inadequacy an effective amount of a composition comprising a NO precursor and a vaginal blood flow enhancing agent, thereby improving at least one vaginal sexual response characteristic.
  • the at least one symptom of female sexual arousal inadequacy can be selected from the group consisting of (a) inadequate vaginal blood flow; (b) inadequate vaginal blood volume; (c) inadequate vaginal mucosal flux; (d) inadequate vaginal mucosal thickness; (e) inadequate clitoral sensitivity; (f) decreased autonomic sexual function; (g) age-related atrophy of neurons innervating the clitoris; and (h) combinations of the foregoing. While any period of administration is contemplated for the foregoing methods,
  • Applicants find that continued administration for a period of at least 4 weeks or at least 8 weeks to be particularly effective.
  • the one or more vaginal sexual response characteristics which is to be improved, for methods of this invention, is selected from the group consisting of: (1) vaginal blood flow; (2) vaginal blood volume; (3) vaginal mucosal flux; (4) vaginal mucosal thickness;
  • vaginal sexual response characteristics can be improved during sexual arousal.
  • the NO precursor can comprise L- arginine.
  • the NO precursor is L-arginine or salts of L-arginine.
  • the NO precursor is arginine aspartate.
  • the vaginal blood flow enhancing agent for any of the methods of this invention, can be a proanthocyanidins containing extract.
  • the proanthocyanidins containing extract is a pine bark extract.
  • the pine bark extract can contain at least 50% proanthocyanidins.
  • the agent can function by enhancing nitric oxide synthesis in the brain or in the genitals of a female recipient/patient and thereby (1) ameliorate a female sexual arousal disorder, (2) ameliorate a female orgasmic disorder, (3) ameliorate a female sexual pain disorder, or (4) increase sexual desire in the female.
  • the proanthocyanidins containing vaginal blood flow enhancing agent further comprises a nitric oxide synthase enhancing activity. Since one agent contains both vaginal blood flow enhancing activity and nitric oxide synthase enhancing activity, these two activities are linked.
  • compositions administered in the foregoing methods can involve a dosage of between 40 mg/day to 160 mg/day of proanthocyanidins extract and between 1.5 g/day to 6 g/day of L-arginine. In preferred embodiments, the dosage is about 80 mg/day of proanthocyanidins and about 3 g per day of L-arginine.
  • the females are diabetic females.
  • pine bark extract in this disclosure refers to a French maritime pine bark extract which is, for example, commercially available as
  • Pycnogenol ® (Horphag). It is also understood that a pine bark extract is one form of a proanthocyanidins containing extract.
  • Pinus pinaster P. pinaster
  • Pinus maritima P. maritime
  • Proanthocyanidins designate a group of flavonoids that includes the subgroups procyanidins, prodelphinidins and propelargonidins.
  • Proanthocyanidins are homogeneous or heterogeneous polymers consisting of the monomer units catechin or epicatechin, which are connected either by 4-8 or 4-6 linkages, to the effect that a great number of isomer proanthocyanidins exist.
  • the proanthocyanidins oligomers have a chain length of 2-12 monomer units.
  • Proanthocyanidins may be synthesized or extracted from a plant material. Proanthocyanidins are extracted from plant material by conventional methods using solvents like water, ethanol or acetone or fluid carbon dioxide.
  • the extracts are purified by solvent/solvent extraction, ultra filtration or chromatographic procedures.
  • the purified extracts are concentrated by solvent evaporation, freeze drying or spray drying.
  • plant material sources of proanthocyanidins include grape seeds, grape skin, pine barks, ginkgo leaves, peanuts, cocoa beans, tamarind, tomato, almond, apple, cranberry, blueberry, and tea leaves.
  • a well-known product containing proanthocyanidins, which is available in trade as a preparation of a food supplement under the name Pycnogenol ® is an extract of the maritime pine bark (Pinus pinaster).
  • Pycnogenol ® the extract from French maritime pine bark (Pinus pinaster) is a registered trademark belonging to Horphag Research, Ltd. Pycnogenol ® is a standardized bark extract of the French maritime pine Pinus pinaster, Aiton, subspecies Atlantica des Villar (Pycnogenol ® , Horphag Research Ltd., UK). The quality of this extract is specified in the United States Pharmacopeia (USP 28)(Maritime Pine Extract. In: United States Pharmacopeia. Rockville: United States Pharmacopeial Convention, Inc.; 2005. pp. 2115-2116.).
  • Pycnogenol ® procyanidins comprising catechin and epicatechin subunits with varying chain lengths
  • Rhdewald P A review of the French maritime pine bark extract (Pycnogenol), an herbal medication with a diverse clinical pharmacology (Int J Clin Pharmacol Ther 2002;40: 158-168.).
  • Other constituents are polyphenolic monomers, phenolic or cinnamic acids and their glycosides (Id).
  • extract includes any preparation obtained from plants, fruits or vegetables using an extraction method.
  • an “effective” amount or a “therapeutically effective amount” of a drug or pharmacologically active agent is meant a nontoxic but sufficient amount of the drug or agent to provide the desired effect, e.g., treatment of female sexual dysfunction.
  • An appropriate "effective" amount in any individual case may be determined by one of ordinary skill in the art using routine experimentation.
  • treating and “treatment” as used herein refer to reduction in severity and/or frequency of symptoms, elimination of symptoms and/or underlying cause, prevention of the occurrence of symptoms and/or their underlying cause, and improvement or remediation of damage.
  • “treating” sexual dysfunction encompasses both prevention of sexual dysfunction in a clinically asymptomatic individual and treatment of dysfunction in a clinically symptomatic individual.
  • enhancing a female sexual response or “treating female sexual arousal inadequacy” is meant enhancing female sexual desire and responsiveness; and optionally, to increase nitric oxide activity in the brain and in the genitals.
  • This term also includes substance-induced sexual dysfunction, including but not limited to, decreases in desire and responsiveness secondary to anti-depressants, neuroleptics, anti-hypertensives, tobacco, opiates, alcohol and any other drug found to decrease or eliminate any part of the sexual response cycle.
  • MUCOSAL FLUX (measured with laser Doppler flowmetry) is altered in most pre- or menopausal women as well as in women in the post-menopausal period.
  • an alteration in flux is characterized by: (a) a decrease in basic mucosal flux; (b) a decrease in vasomotor variations (i.e. those due to changes in position, from supine to standing or to respiratory variations in flux); (c) a decrease in oxygen levels, (d) a general increase in dryness of the mucosa is associated with these microcirculatory changes. These microcirculatory changes are associated with a number of signs/symptoms
  • vaginal blood flow, vaginal blood volume and vaginal mucosal flux can be measured by noninvasive laser Doppler mucosal flow/flux measurements.
  • Vaginal mucosal thickness may be measured by rheometer or viscometer apparatus for measuring such viscoelastic properties (L. E. Kopita and HJ. Kosasky, "The tackiness rheometer determination of the viscoelasticity of cervical mucus", Human Ovulation, edited by E.S.E. Hafez, Elsevier, North-Holland Biomedical Press, 1979. See, also, U.S. Pat. Nos. 4,002,056; and 4,779,627). Clitoral sensitivity was measured by patient survey.
  • the optimum dosage for this treatment is between 40 to 160 mg/day of Pycnogenol ® and 1.5 to 6 grams/day of L-arginine per patient.
  • a preferred dosage would be about 80 mg Pycnogenol ® and 3 grams of L-arginine per female per day.
  • the symptoms of vaginal blood flow; vaginal blood volume; vaginal mucosal flux; vaginal mucosal thickness; and clitoral sensitivity are at a combined maximum.
  • the improvements were more substantial than the non-diabetic group indicating improved responsiveness to the treatment regimen that is two fold, four fold or up to eight fold more effective than that of a non-diabetic patient.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Natural Medicines & Medicinal Plants (AREA)
  • Epidemiology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Reproductive Health (AREA)
  • Endocrinology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Alternative & Traditional Medicine (AREA)
  • Biotechnology (AREA)
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  • Gynecology & Obstetrics (AREA)

Abstract

L'invention concerne des méthodes et des formulations pharmaceutiques pour traiter un dysfonctionnement sexuel féminin. L'invention concerne en particulier des compositions de L-arginine ou d'un précurseur de celle-ci et d'un extrait contenant des proanthocyanidines pour une administration par voie orale. Les compositions de l'invention sont utiles pour améliorer la fonction sexuelle féminine.
PCT/IB2008/054386 2007-10-23 2008-10-23 Méthodes pour améliorer la fonction sexuelle féminine WO2009053932A1 (fr)

Applications Claiming Priority (2)

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US24207P 2007-10-23 2007-10-23
US61/000,242 2007-10-23

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WO2009053932A1 true WO2009053932A1 (fr) 2009-04-30

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011161655A1 (fr) * 2010-06-25 2011-12-29 Horphag Research (Ip) Pre Ltd Composition destinée à améliorer le bien-être sexuel
WO2016149675A1 (fr) 2015-03-19 2016-09-22 Epstein Wendy Anne Composés et formes de traitement des troubles sexuels chez la femme
US12029723B2 (en) 2022-07-18 2024-07-09 Gto Pharma, Llc. Compounds and forms of treatment for female sexual disorders

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999045797A1 (fr) * 1998-03-12 1999-09-16 Mars, Incorporated Produits contenant du ou des polyphenols et de l'arginine-l favorisant la production d'oxyde nitrique
US6548087B1 (en) * 1999-07-12 2003-04-15 Frances B. Kent Nutritional supplement
WO2004062680A1 (fr) * 2003-01-13 2004-07-29 Horphag Research Management Sa Proanthocyanidines permettant un bien-etre sexuel et la sante du systeme vasculaire sexuel
US20060110477A1 (en) * 2004-11-22 2006-05-25 Mccleary Edward L Composition and method for supporting and promoting healthy sexual function and prevention and treatment of sexual dysfunction
US20070060653A1 (en) * 2000-12-14 2007-03-15 Thompson Ronald J Physiologic vaginal lubrication to optimize sperm survival and function
WO2008007227A2 (fr) * 2006-05-19 2008-01-17 Horphag Research (Luxembourg) Holding Sa Procédé et compositions de soulagement de symptômes ménopausiques et périménopausiques

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999045797A1 (fr) * 1998-03-12 1999-09-16 Mars, Incorporated Produits contenant du ou des polyphenols et de l'arginine-l favorisant la production d'oxyde nitrique
US6548087B1 (en) * 1999-07-12 2003-04-15 Frances B. Kent Nutritional supplement
US20070060653A1 (en) * 2000-12-14 2007-03-15 Thompson Ronald J Physiologic vaginal lubrication to optimize sperm survival and function
WO2004062680A1 (fr) * 2003-01-13 2004-07-29 Horphag Research Management Sa Proanthocyanidines permettant un bien-etre sexuel et la sante du systeme vasculaire sexuel
US20060110477A1 (en) * 2004-11-22 2006-05-25 Mccleary Edward L Composition and method for supporting and promoting healthy sexual function and prevention and treatment of sexual dysfunction
WO2008007227A2 (fr) * 2006-05-19 2008-01-17 Horphag Research (Luxembourg) Holding Sa Procédé et compositions de soulagement de symptômes ménopausiques et périménopausiques

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
KIM NOEL N ET AL: "Role of arginase in the male and female sexual arousal response", JOURNAL OF NUTRITION, vol. 134, no. 10, Suppl. S, October 2004 (2004-10-01), pages 2873S - 2879S, XP002513208, ISSN: 0022-3166 *
MARTHOL H ET AL: "WEIBLICHE SEXUELLE FUNKTIONSSTOERUNGEN: KLASSIFIKATION, DIAGNOSTIK UND THERAPIE//FEMALE SEXUAL DYSFUNCTION: A SYSTEMATIC OVERVIEW OF CLASSIFICATION, PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENT", FORTSCHRITTE DER NEUROLOGIE PSYCHIATRIE, STUTTGART, DE, vol. 72, no. 3, 1 March 2004 (2004-03-01), pages 121 - 135, XP008060111, ISSN: 0720-4299 *

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011161655A1 (fr) * 2010-06-25 2011-12-29 Horphag Research (Ip) Pre Ltd Composition destinée à améliorer le bien-être sexuel
CN103037883A (zh) * 2010-06-25 2013-04-10 合飞研究(Ip)Pre股份有限公司 用以改善性良好度的组合物
JP2013530985A (ja) * 2010-06-25 2013-08-01 ホーファグ リサーチ （アイピー） ピーアールイー リミテッド セクシャルウェルネスを改善するための組成物
US9028890B2 (en) 2010-06-25 2015-05-12 Horphag Research (Ip) Pre Ltd. Composition for improving sexual wellness
TWI494103B (zh) * 2010-06-25 2015-08-01 Horphag Res Ip Pre Ltd 用以在性之良好度的增進之混合物
WO2016149675A1 (fr) 2015-03-19 2016-09-22 Epstein Wendy Anne Composés et formes de traitement des troubles sexuels chez la femme
US9750716B2 (en) * 2015-03-19 2017-09-05 Wendy Anne Epstein Compounds and forms of treatment for female sexual disorders
CN107530321A (zh) * 2015-03-19 2018-01-02 温迪·安妮·爱泼斯坦 针对女性性障碍的治疗化合物和治疗形式
EP3270914A4 (fr) * 2015-03-19 2018-08-08 Epstein, Wendy Anne Composés et formes de traitement des troubles sexuels chez la femme
US10624873B2 (en) 2015-03-19 2020-04-21 Wendy Anne Epstein Compounds and forms of treatment for Female Sexual Disorders
US11395814B2 (en) 2015-03-19 2022-07-26 Wendy Anne Epstein Compounds and forms of treatment for female sexual disorders
US12029723B2 (en) 2022-07-18 2024-07-09 Gto Pharma, Llc. Compounds and forms of treatment for female sexual disorders

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