WO2011016749A1 - Комбинированная противотуберкулезная композиция - Google Patents
Комбинированная противотуберкулезная композиция Download PDFInfo
- Publication number
- WO2011016749A1 WO2011016749A1 PCT/RU2010/000110 RU2010000110W WO2011016749A1 WO 2011016749 A1 WO2011016749 A1 WO 2011016749A1 RU 2010000110 W RU2010000110 W RU 2010000110W WO 2011016749 A1 WO2011016749 A1 WO 2011016749A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- tuberculosis
- zinc
- composition according
- pask
- drugs
- Prior art date
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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
- A61K31/60—Salicylic acid; Derivatives thereof
- A61K31/606—Salicylic acid; Derivatives thereof having amino groups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K33/00—Medicinal preparations containing inorganic active ingredients
- A61K33/24—Heavy metals; Compounds thereof
- A61K33/30—Zinc; Compounds thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
- A61P31/06—Antibacterial agents for tuberculosis
Definitions
- the invention relates to medicine, specifically to combination anti-TB drugs, and can be used to treat various forms of tuberculosis.
- tuberculosis Despite significant success in many areas of medicine, including in the treatment of tuberculosis, the incidence of tuberculosis remains extremely high. The main problem of reducing the effectiveness of treatment for tuberculosis patients remains the rapid development of drug-resistant forms of tuberculosis, the limited arsenal of anti-TB drugs, and the decrease in the immune status of tuberculosis patients.
- An individual set of treatment methods for each patient is chosen by the attending physician, and this implies: determining the organizational form of treatment (inpatient, sanatorium, outpatient), choosing a combination of anti-TB drugs and determination of the chemotherapy regimen taking into account the regional and individual drug sensitivity of the office, the choice of pathogenetic methods aimed at normalizing impaired body functions, reducing the degree of inflammatory reaction, eliminating metabolic and immune disorders, as well as stimulating therapy (Manicheva O.A., Skvortsova L.A. , Pavlova MB, Sapozhnikova HB, Archakova L.I., Vishnevsky B.I. Bacteriostatic blood activity in patients with respiratory tuberculosis // Mat. VIII Ross. Congress of TB doctors. - M. - 2007.
- Tuberculosis chemotherapy is an etiotropic (specific) therapy for patients using the optimal combination of anti-TB drugs (hereinafter PTP), which is aimed at destroying the mycobacterial population (bactericidal effect) or suppressing its multiplication (bacteriostatic effect) (Khomenko A.G. Chemotherapy of pulmonary tuberculosis. - M. - 1980.— 279 p.)
- PTP anti-TB drugs
- anti-TB drugs are used to treat newly diagnosed tuberculosis patients, which are divided into main and reserve ones.
- the main drugs isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin.
- Reserve preparations protionamide (ethionamide), kanamycin, amikacin, capreomycin, cycloserine, rifabutin, PASK, fluoroquinalones.
- Anti-TB drugs of the main series are more effective, have high bactericidal activity against tuberculosis mycobacteria (hereinafter referred to as the Office). However, with their prolonged use, which is required for the treatment of tuberculosis, the resistance of the office develops over several months. For the treatment of drug-resistant forms of tuberculosis, backup anti-TB drugs are used.
- PASK p-aminosalicylic acid and its sodium salt
- PASK PASK for the treatment of tuberculosis patients
- the most convenient form of PASK for the treatment of tuberculosis patients should be recognized as tablets.
- US Pat. No. 2,676,902, 1954 discloses a composite product for the treatment of tuberculosis that contains PASK or a non-toxic salt thereof and an adjuvant, p- (di-n-propylcylfamyl) benzene acid.
- the invention solves the problem of only reducing the side effects of taking large amounts of PASK, which are necessary for the treatment of tuberculosis.
- a method for the treatment of pulmonary tuberculosis including chemotherapy with combinations of anti-TB drugs based on isoniazid or isoniazid and rifampicin, characterized in that zinc sulfate is also prescribed in a daily dose of 2.30-3.5 mg / kg two or three times an oral course of 21-28 days, which reduced the duration of chemotherapy due to the pronounced anti-apoptotic effect on T-lymphocytes.
- a combined anti-tuberculosis drug containing, as an active principle, a combination of isoniazid, rifampicin, pyrazinamide, ethambutol and pyridoxine, and methocell, methyl cellulose ethers containing 14-30% methoxy groups as an auxiliary substance.
- the present invention is the creation of a new anti-tuberculosis drug with high antibacterial activity against drug-resistant Mycobacterium tuberculosis, in which toxic side effects are minimized, which will expand the range of anti-TB drugs.
- the proposed anti-tuberculosis drug includes a therapeutically effective amount of the active principle, which contains a combination of PASK and a zinc-containing compound; and pharmaceutically acceptable excipients.
- the composition comprises a combination of PASA and a zinc-containing compound.
- the proposed combination of active ingredients is new for combined anti-TB drugs and has been found experimentally.
- PASK means p-aminosalicylic acid or its salt, preferably a sodium salt, which has other names - sodium para-aminosalicylate or sodium aminosalicylate.
- zinc-containing compound zinc salts, more preferably zinc sulfate, are preferably used.
- PASK and a zinc-containing compound in terms of elemental zinc are, parts by weight
- zinc sulfate When zinc sulfate is used as the zinc-containing compound, its preferred amount is:
- zinc sulfate is used in an amount equivalent to 1.5 parts by weight.
- the use of the claimed combination of active ingredients provides a synergistic effect, consisting in a significant increase in antimicrobial activity in relation to drug-resistant mycobacterium tuberculosis, and the inclusion of zinc sulfate in the composition makes it possible to use a new tool for therapy drug-resistant forms of tuberculosis, complicated by the destruction of lung tissue.
- IP vitgo made it possible to study the microbiological methods of the bacteriostatic and bactericidal activity of a new complex anti-tuberculosis drug (hereinafter referred to as PASK ZINC) in relation to the mycobacterium tuberculosis (MVT) laboratory strain
- PASK ZINC complex anti-tuberculosis drug
- MDR-Stamm-1 is resistant to S, H, R and sensitive to E, Kn, Z, OfI, Et, Cs, Cp,
- MDR-amm-2 is resistant to S, H, R, E, Z and sensitive to Kn, OfI, Et, Cs, Cp, and Pas.
- XDR strain-1 is resistant to S, H, R, E, Kn, Z, OfI and sensitive to Et, Cs, Cp,
- XDR-Stamm-2 is resistant to S, H, R, E, Kn, Z, OfI, Et and is sensitive to Cs, Cp,
- V standard optical density (5x10 million microbial bodies in 1 ml).
- the prepared suspension was inoculated with 0.2 ml in test tubes with 2 ml of Shkolnikova's liquid nutrient medium containing the studied compounds in appropriate concentrations - from 500.0 to 0.39 ⁇ g / ml (12 dilutions).
- the required concentration of drugs in test tubes was achieved by serial dilution.
- the tubes were centrifuged for 15 'at 3,000 rpm, the supernatant was drained, and the precipitate was suspended in 0.8 ml of sterile 0.9% NaCl and 0.2 ml were inoculated two tubes with dense nutrient medium F-2.
- the growth of mycobacteria in a dense medium was taken into account after 21, 42, and 70 days of cultivation in an incubator at 37 ° C.
- the control was tubes with inoculated test strains that were not exposed to the studied drugs and their mixtures.
- the minimum inhibitory concentration was characterized by a significant decrease in the number of colonies in a dense nutrient medium compared with the control.
- the minimum bactericidal concentration was defined as the concentration causing a complete suppression of the growth of mycobacteria in a dense nutrient medium.
- the first viewing and recording of data in experimental and control tubes was carried out on 21 days from the time of seeding, as well as on 42 and 70 days, respectively.
- the new complex preparation PASK ZINC has a high inhibitory effect at a low concentration of 12.5 ⁇ g / ml against Mycobacterium tuberculosis clinical MDR strains and XDR strains.
- the bactericidal effect, most desirable when creating new drugs, is observed at a concentration of PASK ZINC in the nutrient medium - 18.7 ⁇ g / ml.
- mice Male AKR inbred mice obtained from vivarium of the Central Research Institute of Injection, Russian Academy of Medical Sciences. The weight of the mice is 22-23 grams. The mice were infected by the intravenous administration of M. tubersulosis strain H37Rv from the collection of the Pasteur Institute (France) into the lateral tail vein at a dose of 5x10 6 CFU / mouse.
- MBTs were obtained in the immunogenetics laboratory of the Central Research Institute of Cardiology, Russian Academy of Medical Sciences. Aliquots (lml) were stored at - 70 ° C. To infect mice, the aliquot was thawed, transferred to a phosphate buffered saline containing 0.025% Tween 80 and adjusted to a concentration of 5x10 6 CFU / 0.5ml. To determine the number of CFU of mycobacteria in the resulting suspension, a series of serial dilutions was prepared and 20 ⁇ l of each dilution was placed dropwise into a Petri dish with Dubo agar. The dishes were cultured at 37 ° C. for 14 days to determine the concentration of MB in the infectious material.
- mice All experimental animals were divided into the following groups: infected mice without treatment (control) - 10 pcs.; infected mice receiving intragastric drug PASK-ZINC at a dose of 200 mg / kg - 10 pcs.; infected mice receiving intragastric drug PASK-ZINK at a dose of 1000 mg / kg - 10 pcs.; infected mice receiving intragastric PASK at a dose of 1000 mg / kg - 10 pcs.
- test drugs were administered intragastrically, daily (except weekends), for 2 months, the day after infection, previously dissolved in water.
- the volume of drug administered was 0.5 ml / mouse.
- CFU MBT colony forming units
- M. tuberculosis M. tuberculosis
- N leg 2Ni x P /0.1, where N is the number of colonies in the lungs .
- the main indicators of resistance of an animal to tuberculosis are the survival time after infection, the ability to control the multiplication of mycobacteria in organs (i.e., the number of mycobacteria, measured in CFU) and the degree of pathological changes in lung tissue.
- mice of the control group that did not receive any drugs survival after a lethal dose of infection was 35, 7 D 0.26 days.
- Mice treated with PASK at a dose of UOOmg / kg lived 62.6 D 0.57 days; PASK ZINC at a dose of 200 mg / kg - 85.7 D 1.7; PASK ZINC at a dose of UOOmg / kg - 100.7 D 0.33 days.
- the number of CFU-seeded MBT from lungs of animals treated with PASK at a dose of 10 mg / kg was 10 times higher (8.3 ⁇ 0.78) x 10) than in the group of animals treated with PASK ZINC at a dose of 200 mg / kg (9.2D0.8) x 10 7 .
- the differences between groups of animals treated with PASK ZINC at doses of 200 and 10,000 mg / kg were insignificant [(9.2 D 0.8) x 10 7 and (2.0 D 0.3) x 10 7, respectively).
- intravenous administration of MBT an exudative-necrotic inflammatory process develops in mice, affecting various parenchymal organs. Control animals die from generalized tuberculosis after 36 days.
- PNL polymorphonuclear leukocytes
- Alveoli bordering with foci are partially or completely filled with edematous fluid, contain fibrin and fragments of destroyed cellular elements.
- the interalveolar septa are thickened due to interstitial edema and infiltration by mono- and polynuclear cells. The same cells are defined in the extended loops of the capillary network.
- the formation of perivascular infiltrates the development of dystrophic changes in hepatocytes, especially expressed in the terminal period of inflammation, draws attention.
- the cells of the liver beams have an enlightened vacuolated cytoplasm, often with signs of destruction. In areas of necrosis, PNLs are determined.
- the spleen of control mice is depleted in lymphocytes, proliferation of stromal elements, and the formation of diffuse mononuclear infiltrates are observed, the composition of which is determined by PN.
- the morphological picture of the parenchymal organs is close and does not significantly differ from control animals.
- mice treated with PASC ZINC at a dose of 10,000 mg / kg the air pulmonary parenchyma is at least 50-55%, and cell infiltrates are not more than 35-40% of the area of the histological section.
- the number of monocytes and lymphoid elements of varying degrees of maturity noticeably increases, while the frequency of detection of PK and PNL is significantly lower than in other therapeutic groups. Marked cellular elements retain structural integrity, necrosis zones are not expressed. Destructive changes in hepatocytes in the mice of the group treated with PASC ZINC at a dose of UOOmg / kg are less pronounced than in other groups, although the effects of protein dystrophy persist. In the periportal zone, small cellular infiltrates containing single PMNs are determined.
- the new drug is highly therapeutic and that it can be used as an anti-tuberculosis drug.
- the proposed drug is performed in the form of various solid dosage forms - tablets, capsules, granules, powders.
- Obtaining the inventive combined composition can be carried out in accordance with known manufacturing techniques.
- solid dosage forms for example, by wet granulation followed by the addition of a lubricant to the dry granules, molding the final mixture of ingredients to form a dosage form of a given configuration and size, and, if necessary, coating.
- zinc-containing compounds are zinc salts — sulfate, aspartate, hyaluronate, glycerate, picolinate, citrate, acetate, most preferably zinc sulfate.
- substances commonly used in the pharmaceutical industry for the production of solid dosage forms can be used, for example, starch, saccharide, cellulose and its derivatives, gelatin, polyvinylpyrrolidone, polyethylene oxide, calcium phosphate, a lubricant, a wetting agent such as sodium lauryl sulfate, esters polyoxyethylene sorbitan and fatty acids (twins), esters of sorbitan and fatty acids (spans), preferably starch, including modified starch, lactose, microcrystalline c llyuloza, natriykroskarboksimetil-cellulose, polyvinylpyrrolidone, lubricant.
- stearic acid and / or its salts examples include calcium stearate, magnesium stearate, zinc stearate, talc, colloidal silicon dioxide, aerosil, polyethylene glycol, hydrogenated vegetable oil, liquid paraffin.
- the new composition may also contain flavors, colorants and / or flavors.
- zinc sulfate can be introduced into the composition in the form of a hydrate, for example heptahydrate or monohydrate, preferably in the form of a monohydrate.
- Para-aminosalicylate can be introduced into the composition as a dihydrate.
- the preparation is made in the form of a tablet, which may be coated.
- the presence of the latter improves the appearance and organoleptic properties of the dosage form, protects it from mechanical damage.
- the shell is made on the basis of a copolymer of methacrylic acid with ethyl acrylate or a finished mixture of Acrul-Eze brand.
- zinc sulfate means both ZnS ⁇ 4 sulfate and its hydrates, for example heptahydrate or monohydrate.
- the preferred quantity of active ingredient ingredients - sodium para-aminosalicylate and zinc sulfate in a single dose is - for sodium para-aminosalicylate from 500 mg to 2,000 mg, more preferably 1000 mg, for zinc sulfate (in terms of elemental zinc) from 0.75 mg up to 3.0 mg, more preferably 1.5 mg, corresponding to 4.12 mg of monohydrate or 6.6 mg of heptahydrate.
- Zinc sulfate in the form of a monohydrate, colloidal silicon dioxide and a salt of stearic acid (calcium stearate) are added to the crushed granulate and the finished mass is tabletted. Get tablets with an average weight of 1,200 g.
- the content of sodium aminosalicylate in one tablet is 1000.0 mg
- the zinc content is 1.50 mg or, in terms of zinc sulfate, 4.12 mg
- the strength is 250 H.
- a film-forming composition based on the finished Acrul-Eze composition is applied to the obtained tablets. Layering is performed until a film of satisfactory thickness is obtained.
- the resulting tablets with an average weight of 1.320 g satisfy the regulatory requirements for a pharmaceutical agent.
- the resulting tablets have a shelf life of more than 2 years.
- the inventive pharmaceutical composition can be widely used in healthcare as a medicine for the treatment of tuberculosis.
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- Veterinary Medicine (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Inorganic Chemistry (AREA)
- Pulmonology (AREA)
- Communicable Diseases (AREA)
- Oncology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- General Chemical & Material Sciences (AREA)
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Abstract
Description
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Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
UAA201202544A UA104204C2 (ru) | 2009-08-07 | 2010-03-15 | Комбинированная противотуберкулезная композиция |
EA201200238A EA020933B1 (ru) | 2009-08-07 | 2010-03-15 | Комбинированная противотуберкулезная композиция |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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RU2009130212/15A RU2413517C1 (ru) | 2009-08-07 | 2009-08-07 | Комбинированная противотуберкулезная композиция |
RU2009130212 | 2009-08-07 |
Publications (1)
Publication Number | Publication Date |
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WO2011016749A1 true WO2011016749A1 (ru) | 2011-02-10 |
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Family Applications (1)
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PCT/RU2010/000110 WO2011016749A1 (ru) | 2009-08-07 | 2010-03-15 | Комбинированная противотуберкулезная композиция |
Country Status (4)
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EA (1) | EA020933B1 (ru) |
RU (1) | RU2413517C1 (ru) |
UA (1) | UA104204C2 (ru) |
WO (1) | WO2011016749A1 (ru) |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
RU2248797C1 (ru) * | 2004-02-09 | 2005-03-27 | Открытое акционерное общество "Химико-фармацевтический комбинат "АКРИХИН" (ОАО "АКРИХИН") | Противотуберкулёзная фармацевтическая композиция |
RU2253460C1 (ru) * | 2004-08-02 | 2005-06-10 | Федеральное государственное образовательное учреждение высшего профессионального образования Чувашский государственный университет им. И.Н. Ульянова | Способ лечения туберкулеза легких |
RU2295330C2 (ru) * | 2004-12-03 | 2007-03-20 | Александр Владимирович Балышев | Фармацевтическая композиция для профилактики и дополнительной химиотерапии туберкулеза |
-
2009
- 2009-08-07 RU RU2009130212/15A patent/RU2413517C1/ru not_active IP Right Cessation
-
2010
- 2010-03-15 WO PCT/RU2010/000110 patent/WO2011016749A1/ru active Application Filing
- 2010-03-15 UA UAA201202544A patent/UA104204C2/ru unknown
- 2010-03-15 EA EA201200238A patent/EA020933B1/ru not_active IP Right Cessation
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
RU2248797C1 (ru) * | 2004-02-09 | 2005-03-27 | Открытое акционерное общество "Химико-фармацевтический комбинат "АКРИХИН" (ОАО "АКРИХИН") | Противотуберкулёзная фармацевтическая композиция |
RU2253460C1 (ru) * | 2004-08-02 | 2005-06-10 | Федеральное государственное образовательное учреждение высшего профессионального образования Чувашский государственный университет им. И.Н. Ульянова | Способ лечения туберкулеза легких |
RU2295330C2 (ru) * | 2004-12-03 | 2007-03-20 | Александр Владимирович Балышев | Фармацевтическая композиция для профилактики и дополнительной химиотерапии туберкулеза |
Also Published As
Publication number | Publication date |
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EA020933B1 (ru) | 2015-02-27 |
EA201200238A1 (ru) | 2012-08-30 |
UA104204C2 (ru) | 2014-01-10 |
RU2413517C1 (ru) | 2011-03-10 |
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