WO2012123539A1 - Traitement de l'atrophie vaginale en tant qu'une nouvelle indication de myrrhe - Google Patents

Traitement de l'atrophie vaginale en tant qu'une nouvelle indication de myrrhe Download PDF

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Publication number
WO2012123539A1
WO2012123539A1 PCT/EP2012/054548 EP2012054548W WO2012123539A1 WO 2012123539 A1 WO2012123539 A1 WO 2012123539A1 EP 2012054548 W EP2012054548 W EP 2012054548W WO 2012123539 A1 WO2012123539 A1 WO 2012123539A1
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WO
WIPO (PCT)
Prior art keywords
vaginal
myrrh
extract
suppository
use according
Prior art date
Application number
PCT/EP2012/054548
Other languages
English (en)
Inventor
Eva Brandt
Original Assignee
Sonia Pharma Gmbh
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
Priority claimed from EP11158593.1A external-priority patent/EP2500026B1/fr
Priority claimed from US13/050,225 external-priority patent/US8287924B2/en
Application filed by Sonia Pharma Gmbh filed Critical Sonia Pharma Gmbh
Priority to KR1020137021591A priority Critical patent/KR20130130034A/ko
Priority to AU2012228213A priority patent/AU2012228213B2/en
Priority to MX2013010415A priority patent/MX352788B/es
Priority to CA2829792A priority patent/CA2829792C/fr
Priority to BR112013023092A priority patent/BR112013023092A2/pt
Priority to JP2013555906A priority patent/JP5519879B2/ja
Publication of WO2012123539A1 publication Critical patent/WO2012123539A1/fr

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Classifications

    • 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
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/32—Burseraceae (Frankincense family)
    • A61K36/328—Commiphora, e.g. mecca myrrh or balm of Gilead
    • 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
    • A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
    • 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
    • A61K9/0034—Urogenital system, e.g. vagina, uterus, cervix, penis, scrotum, urethra, bladder; Personal lubricants
    • 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
    • A61K9/02—Suppositories; Bougies; Bases therefor; Ovules
    • 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
    • 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 instant invention relates to a novel indication for myrrh according to claim 1 , a pharmaceutical preparation in vaginal dosage form according to claim 10, and a method for preparing a pharmaceutical preparation against menopausal symptoms according to the preamble of claim 13.
  • Myrrh Resin Myrrh is the oleo-gum resin obtained from stems and branches of Commiphora molmol Engler and other related species of Commiphora other than Commiphora mukul. Commiphora mukul - although sharing the genus name - cannot be used for obtaining myrrh.
  • Commiphora molmol Engler is sometimes also referred to as Commiphora myrrha or Commiphora myrrha (Nees) Engler. Suited related species of Commiphora molmol for obtaining myrrh are Commiphora abyssinica Engler and Commiphora schimperi Engler.
  • Pharmacopoeia myrrh is generally obtained from Commiphora molmol Engler, but the other related species, in particular those referred to above, are also well suited.
  • myrrh is used as powdered resin, capsules, myrrh tincture and other galenical preparations for topical use.
  • Myrrh can be separated into three components: volatile oil (ca. 2 to 10%), alcohol-soluble resin (ca. 25 to 40 %) and water-soluble gum.
  • the main constituents of myrrh essential oil are furanosesquiterpenes of various structural types together with sesquiterpenes. Furanosesquiterpenes are the source of its characteristic balsamic odour; a mixture of furanoeudesma-1 ,3-diene and lindestrene has the typical aroma of myrrh.
  • Myrrh essential oil is generally obtained by hydrodistillation, steam distillation, and solvent extraction. Extraction by carbon dioxide in the supercritical state is the state-of-the-art process that offers many advantages in obtaining volatile extracts.
  • Myrrh is known for its wound healing effect.
  • US 4,719,1 1 1 A discloses the external use of myrrh gum for treating decubitus ulcers.
  • US 4,592,912 A discloses the topical use for the relief of or for the prevention of muscular aches, pains, cramps and muscular spasms such as are found, for example, in overexerted muscles, misused muscles, headaches and back aches.
  • US 5,350,774 A describes the topical treatment of skin disorders with myrrh.
  • US 5,248,503 A discloses the utilization of myrrh as food or dietary supplement.
  • US 6,077,513 A discloses a pharmaceutical composition containing myrrh oil and myrrh resin as the active ingredients therein for treating schistosomiasis.
  • CN 1 679 687 A describes the use of a composition comprising seven substances of the traditional Chinese medicine against several diseases, namely vaginitis, cervical erosion, endometritis, hysteromyoma and adnexitis.
  • this document does not teach or suggest the use of myrrh against other diseases or impaired states of a patient, like, e.g. vaginal atrophy.
  • menopausal Vaginal Symptoms The menopause is defined as the permanent cessation of cyclical menstruation due to loss of ovarian follicular activity. The decline in estrogen concentration is associated with both acute and long-term effects. Established acute symptoms are vasomotor instability, manifesting as hot flushes and night sweats, and vaginal atrophy, manifesting as vaginal dryness, itching, burning, and discomfort.
  • Menopausal symptoms may be managed by using hormone replacement therapy (HRT) with estrogens, with or without progestogens.
  • HRT hormone replacement therapy
  • Adverse effects of HRT include an increased risk of breast cancer, ovarian and endometrial cancer, an increased risk of venous thromboembolism, stroke, dementia, gallstone formation and cholecystectomy. It is now generally recommended that menopausal HRT used to relieve vasomotor and vaginal symptoms should be given at the lowest effective dose for no longer than necessary. But to withdraw HRT means recurrence of menopausal symptoms.
  • compositions in gel or suppository form for the treatment of vaginal dryness.
  • the compositions comprise herbal compounds with or without vitamin.
  • this patent application does not suggest using extracts of myrrh for the treatment of vaginal dryness.
  • a non-hormonal effective treatment of vaginal atrophy as menopausal symptom is needed, as an alternative to HRT. It is an objective of the instant invention to provide an active ingredient for a pharmaceutical preparation or a medicinal product for such a treatment, a pharmaceutical preparation in a suitable dosage form as well as a method for preparing a pharmaceutical preparation against menopausal symptoms.
  • the myrrh is intended to be used for the treatment of vaginal atrophy and symptoms related therewith occurring (not exclusively but also) during menopause.
  • the myrrh is the sole active ingredient within the claimed novel indication of myrrh. This means that pharmaceutical preparations or medicinal products comprise only myrrh as active pharmaceutical ingredient, but no other pharmaceutically active substances.
  • myrrh is to be understood as the oleo-gum resin originating from Commiphora species with the exception of Commiphora mukul.
  • the myrrh used in connection to this invention is preferably pharmacopeia myrrh.
  • menopausal symptoms relates to all symptoms occurring in the menopause. Established acute symptoms are vasomotor instability, manifesting as hot flushes, and vaginal atrophy, manifesting as vaginal dryness, itching, burning, and discomfort.
  • the myrrh is present in the form of a powdered resin, a myrrh tincture or an extract of myrrh.
  • the resin, tincture or extract are provided in vaginal dosage form, i.e. in a form suited for the topical application to the vagina of a patient to be treated.
  • the resin tincture or extract can, e.g., be used to impregnate a tampon or another carrier suited for vaginal application.
  • the extract of myrrh is a dry extract (preferably obtained by extraction of myrrh with an organic solvent) or an aqueous extract.
  • the myrrh is used in pastry form.
  • myrrh resin is subjected to extraction with an organic solvent, for example ethanol, petroleum ether or ethyl acetate.
  • the extract thus obtained is filtered and vacuum-concentrated to a pastry form.
  • myrrh pastry is a filtered and concentrated form of a myrrh extract.
  • the residue is again dissolved in alcohol (e.g., ethanol) or a mixture of alcohol and water, filtered and vacuum-concentrated.
  • the myrrh is used as lipophilic extract of myrrh, in particular obtained by extraction with liquid carbon dioxide in the supercritical state. Other standard extraction methods as explained above are also applicable.
  • the extract contains furanoeudesma-1 ,3-diene, lindestrene and curzerene as main ingredients. The according chemical structures of these compounds are displayed below:
  • furanoeudesma-1 ,3-diene lindestrene curzerene is present in the extract in an amount of more than 20 %, in particular more than 25 %, in particular more than 30 % and very particular more than 35 %. All percentages given in the present application are to be understood as percent by weight if not explicitly indicated otherwise.
  • the extract contains more than 10 %, in particular more than 15 %, in particular more than 20 % and in particular more than 25 % of curzerene.
  • the extract contains more than 5 %, in particular more than 10 %, in particular more than 15 % of lindestrene.
  • the extract has a refractive index at 20 °C (measured with an Abbe refractometer) of 1 .5 to 1 .6, in particular of 1 .51 to 1 .55, in particular of 1 .515 to 1 .54, in particular of 1 .517 to 1 .537.
  • the extract has a density at 20 °C (measured with a pycnometer) of 1 .0 to 2.0 g/cm 3 , in particular of 1 .02 to 1 .08 g/cm 3 , in particular of 1 .025 to 1 .075 g/cm 3 .
  • the myrrh is present in a semisolid dosage form for vaginal application, in particular as vaginal ointment, vaginal cream, or vaginal gel.
  • a semisolid dosage form for vaginal application in particular as vaginal ointment, vaginal cream, or vaginal gel.
  • oleaginous bases or water-soluble bases can be used.
  • the semisolid preparations might be water-in-oil emulsions or oil-in-water emulsions.
  • the myrrh is present in a liquid dosage form for vaginal application, in particular as vaginal liquid, vaginal emulsion, or vaginal suspension.
  • the myrrh is present as vaginal foam or vaginal tampon. In still another embodiment, the myrrh is present in a solid dosage form for vaginal application, in particular as vaginal tablet, vaginal capsule, or vaginal suppository.
  • vaginal dosage forms enables a user to apply the myrrh at the location at which it can develop its activity against menopausal symptoms in a very well suited manner.
  • the solid dosage form in particular the vaginal tablet, vaginal capsule, or vaginal suppository essentially consists of a fatty, oleaginous, or oil-type base and the myrrh.
  • Cocoa butter and hard fat are members of this group of substances. Cocoa butter is an oleaginous base that softens at 30 °C and melts at about 34 °C, just below body temperature, thus representing an ideal suppository base.
  • bases in this category include commercial products such as Fattibase (triglycerides from palm, palm kernel, and coconut oils with self-emulsifying glyceryl monostearate and polyoxyl stearate), Wecobee bases (triglycerides derived from coconut oil), Witepsol bases (triglycerides of saturated C 12 - Ci 8 fatty acids with varying portions of the corresponding partial glycerides), Suppocire and Ovucire bases)
  • Fattibase triglycerides from palm, palm kernel, and coconut oils with self-emulsifying glyceryl monostearate and polyoxyl stearate
  • Wecobee bases triglycerides derived from coconut oil
  • Witepsol bases triglycerides of saturated C 12 - Ci 8 fatty acids with varying portions of the corresponding partial glycerides
  • the inventor could already establish a synergistic effect of the combination of cocoa butter and myrrh.
  • experiments indicate that constituents of cocoa butter and ingredients of myrrh essential oil show synergistic effects on mitotic activity, collagen metabolism, blood flow or lubrication when applied vaginally for treatment of vaginal atrophy.
  • cocoa butter as basic material even enhances the effectiveness of the myrrh.
  • a very well suited dosage for using the myrrh is daily, in particular once a day, in particular once a day at bed time.
  • Such a dosage regime is sufficient to alleviate the menopausal symptoms, in particular vaginal atrophy.
  • the invention also relates to a pharmaceutical preparation or medicinal product in vaginal dosage form which is suited for the treatment of vaginal atrophy (in particular of vaginal atrophy as menopausal symptom), in particular a vaginal ointment, a vaginal cream, a vaginal gel, a vaginal liquid, a vaginal emulsion, a vaginal suspension, a vaginal foam, a vaginal tampon, a vaginal tablet, a vaginal capsule, or a vaginal suppository containing myrrh as the only pharmaceutical active ingredient.
  • vaginal atrophy in particular of vaginal atrophy as menopausal symptom
  • the pharmaceutical preparation is present in form of a vaginal tablet, vaginal capsule or vaginal suppository essentially consisting of a fatty, an oleaginous or an oil-type base material and myrrh according to the preceding explanations.
  • a vaginal tablet, capsule or suppository is suitable for the treatment of menopausal symptoms, in particular for the treatment of vaginal atrophy and vaginal symptoms of dryness, itching, burning, and discomfort.
  • the tablet, capsule or suppository has a weight of 0.5 to 5 g, in particular of 1 to 4 g, in particular of 2 to 3 g, in particular of 1 .5 to 2.5 g, in particular of 1 .7 to 1 .9 g. 1 .8 g is a particular well suited weight.
  • the myrrh is preferably present in the tablet, capsule or suppository in an amount of 0.1 to 10 %, in particular of 0.25 to 9 %, in particular of 0.5 to 8 %, in particular of 0.75 to 7 %, in particular of 1 to 6 %, in particular of 1 .5 to 5 %, in particular of 2 to 4 %, in particular of 2.5 to 3 % based on the total weight of the tablet, capsule or suppository.
  • An amount around 1 % of myrrh is particularly well suited.
  • the objective is also solved by a method for preparing a pharmaceutical preparation or medicinal product, respectively, against vaginal atrophy as menopausal symptom, having the following steps:
  • the mould has a shape to form the mixture such that at least one vaginal tablet, capsule or suppository is obtained.
  • the mould forms the mixture in such a way that a plurality of tablets, capsules or suppositories is obtained.
  • These tablets, capsules or suppositories can have the same size and/or shape or different shapes and/or sizes.
  • differently sized and/or shaped tablets, capsules or suppositories can be provided to address the individual needs of the users of this medical product.
  • Vaginal suppositories were prepared using either hard fat or cocoa butter as suppository base.
  • Cocoa butter was melted at 50 ° C. Under stirring, myrrh extract was added to a final concentration of 1 % by weight of the total weight of the formula (mixture). Stirring was continued for several hours to obtain a stable crystalline form. The mixture was then poured into molds and cooled.
  • vaginal suppositories were applied over a period of 14 consecutive days once a day, namely at bedtime each night. Both preparations provided subjective and objective relief of menopausal symptoms, in particular vaginal symptoms due to vaginal atrophy. Colposcopy revealed an improved status of the vaginal mucosa. Improvement of genital symptoms was more pronounced with the cocoa butter suppositories.
  • Theobroma cocoa seeds contain polyphenols and flavonoids - substances with high antioxidation potential - and procyanidins which exhibit vascular effects. It appeared that in connection to the myrrh extract synergistic effects on mitotic activity, collagen metabolism, blood flow or lubrication occur when both substances are applied concomitantly for the treatment of vaginal atrophy.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Veterinary Medicine (AREA)
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  • Natural Medicines & Medicinal Plants (AREA)
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Abstract

L'invention porte sur une nouvelle indication médicale de myrrhe, à savoir le traitement de l'atrophie vaginale en tant que symptôme ménopausique. L'invention porte en outre sur une préparation pharmaceutique sous forme de dosage vaginal pour le traitement de l'atrophie vaginale et sur un procédé de préparation d'une préparation pharmaceutique contre l'atrophie vaginale en tant que symptôme ménopausique.
PCT/EP2012/054548 2011-03-17 2012-03-15 Traitement de l'atrophie vaginale en tant qu'une nouvelle indication de myrrhe WO2012123539A1 (fr)

Priority Applications (6)

Application Number Priority Date Filing Date Title
KR1020137021591A KR20130130034A (ko) 2011-03-17 2012-03-15 몰약의 신규 용도로서 폐경기 증상의 치료
AU2012228213A AU2012228213B2 (en) 2011-03-17 2012-03-15 Treatment of vaginal atrophy as novel indication for myrrh
MX2013010415A MX352788B (es) 2011-03-17 2012-03-15 La mirra en forma de dosificación vaginal para su uso en el tratamiento de la atrofia vaginal como síntoma menopáusico.
CA2829792A CA2829792C (fr) 2011-03-17 2012-03-15 Traitement de l'atrophie vaginale en tant qu'une nouvelle indication de myrrhe
BR112013023092A BR112013023092A2 (pt) 2011-03-17 2012-03-15 mirra em uma forma de dosagem vaginal
JP2013555906A JP5519879B2 (ja) 2011-03-17 2012-03-15 ミルラの新規な適用としての更年期症状としての膣の委縮の処置

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US13/050,225 2011-03-17
EP11158593.1A EP2500026B1 (fr) 2011-03-17 2011-03-17 Traitement des symptômes de la ménopause en tant que nouvelle indication pour myrrhe
US13/050,225 US8287924B2 (en) 2011-03-17 2011-03-17 Treatment of menopausal symptoms as novel indication for myrrh
EP11158593.1 2011-03-17

Publications (1)

Publication Number Publication Date
WO2012123539A1 true WO2012123539A1 (fr) 2012-09-20

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PCT/EP2012/054548 WO2012123539A1 (fr) 2011-03-17 2012-03-15 Traitement de l'atrophie vaginale en tant qu'une nouvelle indication de myrrhe

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JP (1) JP5519879B2 (fr)
KR (1) KR20130130034A (fr)
AU (1) AU2012228213B2 (fr)
BR (1) BR112013023092A2 (fr)
CA (1) CA2829792C (fr)
CO (1) CO6771460A2 (fr)
MX (1) MX352788B (fr)
WO (1) WO2012123539A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017126995A1 (fr) 2016-01-18 2017-07-27 Alessa Nadiah Abdulkarim A Composition pour le traitement et la prévention d'une infection, d'ulcérations et de boutons causés par le papillomavirus humain hpv
CN112236198A (zh) * 2018-06-29 2021-01-15 宝洁公司 阴道护理组合物
WO2021123925A1 (fr) * 2019-12-15 2021-06-24 Banooye Armaghan Teb Compositions à base d'herbes et procédés d'administration servant au traitement d'infections et d'inflammation vulvovaginale et des organes pelviens

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017126995A1 (fr) 2016-01-18 2017-07-27 Alessa Nadiah Abdulkarim A Composition pour le traitement et la prévention d'une infection, d'ulcérations et de boutons causés par le papillomavirus humain hpv
CN112236198A (zh) * 2018-06-29 2021-01-15 宝洁公司 阴道护理组合物
WO2021123925A1 (fr) * 2019-12-15 2021-06-24 Banooye Armaghan Teb Compositions à base d'herbes et procédés d'administration servant au traitement d'infections et d'inflammation vulvovaginale et des organes pelviens

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MX2013010415A (es) 2013-12-02
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MX352788B (es) 2017-12-05
CA2829792A1 (fr) 2012-09-20
CA2829792C (fr) 2017-04-04
AU2012228213B2 (en) 2015-08-06
JP5519879B2 (ja) 2014-06-11
AU2012228213A1 (en) 2013-09-12
CO6771460A2 (es) 2013-10-15
BR112013023092A2 (pt) 2016-12-06

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