Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
  • A61K38/08—Peptides having 5 to 11 amino acids
  • A61K38/095—Oxytocins; Vasopressins; Related peptides
• • 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
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
  • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
• • 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
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
  • A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
• • 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
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
  • A61K9/006—Oral mucosa, e.g. mucoadhesive forms, sublingual droplets; Buccal patches or films; Buccal sprays
• • 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
  • A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
  • A61K9/7007—Drug-containing films, membranes or sheets
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
  • A61P7/12—Antidiuretics, e.g. drugs for diabetes insipidus

Definitions

• the present invention relates to pharmaceutical compositions comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient, wherein the desmopressin or pharmaceutically acceptable salt thereof is stabilized in the pharmaceutical composition, to methods for stabilizing desmopressin or a pharmaceutically acceptable salt thereof in a composition, to methods for preparing orally disintegrating films comprising desmopressin or a pharmaceutically acceptable salt thereof as well as to orally disintegrating films obtainable thereby.
• Desmopressin is a synthetic analogue of the natural antidiuretic hormone vasopressin.
• desmopressin has no vasopressor activity, but only has antidiuretic activity.
• the selective antidiuretic activity is due to its ability to bind to V-2 receptors only and not to V-1 receptors.
• V-2 receptors are G-protein coupled receptors present in the collecting ducts of the kidney and are responsible for the promotion of water reabsorption via stimulation of cyclic AMP production.
• Desmopressin is effective in treatment of various urinary disorders, such as, but not limited to diabetes insipidus, incontinence, enuresis and nocturia, and dysfunctions of the coagulative system.
• desmopressin is useful in abnormal too frequent urination, particularly nocturnal polyuria, (passing of large volumes of urine at night but normal amounts during the day) which is the main cause of primary nocturnal enuresis (involuntary passage of urine during sleep) and nocturia (the complaint that the individual has to wake at night one or more times for urination).
• nocturnal polyuria passing of large volumes of urine at night but normal amounts during the day
• nocturia the complaint that the individual has to wake at night one or more times for urination.
• Desmopressin 1-desamino-8-D-arginine vasopressin
• Peptides generally tend to denature, i.e. lose their native state structure when for example external stress(es) is applied, when brought into contact with a compound(s) such as a strong acid or base, a concentrated inorganic salt, or an organic solvent (e.g., alcohol or chloroform), or e.g. when exposed to radiation or heat. Therefore, desmopressin is vulnerable to instability during and/or after medicine preparation, because of its tendency to denature, in particular due to thermal denaturation.
• the subject invention provides a pharmaceutical composition comprising an active ingredient and a stabilizing agent, wherein the active ingredient is desmopressin or a pharmaceutically acceptable salt thereof, and wherein the stabilizing agent is at least one gum.
• the subject invention further provides for the use of one or more gums to increase the stability of a pharmaceutical composition comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient against denaturation, as a result of e.g. application of external stress(es) or contact with a compound(s) such as but not limited to a strong acid or base, a concentrated inorganic salt, or an organic solvent, or exposure to radiation or heat.
• a pharmaceutical composition comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient against denaturation, as a result of e.g. application of external stress(es) or contact with a compound(s) such as but not limited to a strong acid or base, a concentrated inorganic salt, or an organic solvent, or exposure to radiation or heat.
• the subject invention also provides for a method for preparing an orally disintegrating film, comprising adding at least one gum to a solution comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient and water as the only solvent, spreading the solution onto a support and drying the spread solution to prepare an orally disintegrating film.
• the subject invention provides for an orally disintegrating film obtainable by the above method.
• the subject invention provides for a pharmaceutical composition
• a pharmaceutical composition comprising an active ingredient and a stabilizing agent, wherein the active ingredient is desmopressin or a pharmaceutically acceptable salt thereof, and wherein the stabilizing agent is at least one gum.
• the pharmaceutically acceptable salt of desmopressin is desmopressin acetate.
• Gum as used herein should be understood to refer to hydrophilic materials that are polymers composed of heteropolysaccharides with high viscosity even at a low concentration, and are bound to water to form a viscous solution or a gel.
• the gum is used as a stabilizing agent for desmopressin or a pharmaceutically acceptable salt thereof.
• Non-limiting examples of 'gums' which can be used in the present invention are galactomannan gum (including acacia gum, locust bean gum, tara gum, and guar gum), carrageenan gum, xanthan gum, tragacanth gum, agar, quince seed gum, karaya gum, arabic gum, and gellan gum.
• the gum is xanthan gum.
• the composition does not substantially comprise additional stabilizing agents other than gum(s).
• the term "not substantially comprise” means that the amount of additional stabilizing agents other than gum(s) is 10% (w/w) or less, 5% (w/w) or less, 4% (w/w) or less, 3% (w/w) or less, 2% (w/w) or less, 1 % (w/w) or less, 0.5% (w/w) or less, and more preferably 0.1 % (w/w) or less based on the total weight of all stabilizing agents used.
• the at least one gum constitutes at least 90%, 95%, 96%, 97%, 98%, 99%, 99.5%, or 99.9% by weight based on the total weight of all stabilizing agents used.
• the pharmaceutical composition may be administered for treating or preventing various urinary disorders such as diabetes insipidus, incontinence, enuresis and nocturia, and dysfunctions of the coagulative system, in particular nocturnal enuresis or nocturnal polyuria.
• the pharmaceutical composition provides for increased stability of desmopressin or a pharmaceutically acceptable salt thereof against denaturation during application of external stress(es), contact with a compound(s) such as but not limited to a strong acid or base, a concentrated inorganic salt or an organic solvent, or when exposed to radiation or heat.
• a compound(s) such as but not limited to a strong acid or base, a concentrated inorganic salt or an organic solvent, or when exposed to radiation or heat.
• the pharmaceutical composition will provide increased stability of desmopressin or a pharmaceutically acceptable salt thereof against thermal denaturation, in particular against thermal denaturation during drying, during distribution, during storage and/or during preservation under normal conditions, meaning, in the context of this application, room temperature (15 - 25 °C) and 60% relative humidity.
• the present invention further provides for the use of one or more gums to increase the stability of a pharmaceutical composition comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient against e.g. denaturation by application of external stress(es), contact with a compound(s) such as, but not limited to, a strong acid or base, a concentrated inorganic salt, an organic solvent, or exposure to radiation or heat, in particular against thermal denaturation, more in particular against thermal denaturation during drying at a temperature of about 80 ' ⁇ for about 30 minutes or during at least 6 weeks distribution, storage and/or preservation under normal conditions.
• a compound(s) such as, but not limited to, a strong acid or base, a concentrated inorganic salt, an organic solvent, or exposure to radiation or heat, in particular against thermal denaturation, more in particular against thermal denaturation during drying at a temperature of about 80 ' ⁇ for about 30 minutes or during at least 6 weeks distribution, storage and/or preservation under normal conditions.
• the subject invention further provides a method for preparing an orally disintegrating film, comprising adding at least one gum to a solution comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient and water as the only solvent, spreading the solution onto a support and drying the spread solution to prepare an orally disintegrating film.
• the solution used for the preparation of an orally disintegrating desmopressin film of the subject invention contains water as the sole solvent, thereby restricting the use of an organic solvent that may remain in a medicine to be administered to patients and may cause safety problems.
• the preparation solution of an orally disintegrating film after having being spread on a support, is preferably dried at a temperature of ⁇ ⁇ ' ⁇ or less, 90°C or less, 80°C or less, preferably at about 80°C.
• time periods of 100 minutes or less, 50 minutes or less, 30 minutes or less, 20 minutes or less, more preferably 15 minutes or less have been proven to be appropriate so as to minimize the stability deterioration of desmopressin or a pharmaceutically acceptable salt thereof.
• the preparation solution of an orally disintegrating film is preferably dried at a temperature of 100 °C or less for about 30 minutes, at a temperature of 90 °C or less for about 30 minutes, at a temperature of 100 °C or less for about 15 minutes, at a temperature of 90 °C or less for about 15 minutes, at a temperature of about 80 °C for about 30 minutes or at a temperature of about ⁇ ' ⁇ for about 15 minutes so as to minimize the stability deterioration of desmopressin or a pharmaceutically acceptable salt thereof.
• the present invention provides an orally disintegrating film prepared by the above-mentioned method.
• the present invention provides an orally disintegrating film, comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient, in which a gum is used as a stabilizing agent for desmopressin.
• the thickness of the orally disintegrating film may be controlled by a person having ordinary skill, but is preferably controlled to be 80 ⁇ or less so as to minimize the drying time and obtain the physical stability of the film.
• the present invention demonstrates that the use of one or more gums is specifically beneficial to increase the stability of a pharmaceutical composition comprising desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient.
• the one or more gums are used as a stabilizing agent for stabilizing desmopressin or a pharmaceutically acceptable salt thereof against e.g. denaturation by application of external stress(es), contact with a compound(s) such as, but not limited to, a strong acid or base, a concentrated inorganic salt, or an organic solvent, or exposure to e.g. radiation or heat.
• the one or more gums are used as a stabilizing agent for stabilizing desmopressin or a pharmaceutically acceptable salt thereof against thermal denaturation.
• Thermal denaturation should be understood to refer to desmopressin or a pharmaceutically acceptable salt thereof being denatured by heat during either the manufacturing process (e.g. during drying) of the pharmaceutical composition as well as under distribution, storage and preservation conditions.
• the pharmaceutical composition is thus stabilized against thermal denaturation e.g. during drying at a temperatures of 100°C or less, 90 ' ⁇ or less, 80 °C or less for 100 minutes or less, 50 minutes or less, 30 minutes or less, 20 minutes or less, or 15 minutes or less.
• the pharmaceutical composition is also stabilized against thermal denaturation during at least 6 weeks, at least 4 weeks, at least 3 weeks or at least 2 weeks of distribution, storage and/or preservation under normal conditions.
• the gum can effectively stabilize desmopressin or pharmaceutically acceptable salts thereof by the use of a small amount, compared to the amounts of gum(s) when used as e.g. thickening agents in pharmaceutical compositions.
• the weight ratio of desmopressin or a pharmaceutically acceptable salt thereof and the gum may range from 10:1 to 1 :50, preferably from 5:1 to 1 :30, more preferably from 3:1 to 1 :10, most preferably from 1 :1 to 1 :2.
• desmopressin or a pharmaceutically acceptable salt thereof cannot be sufficiently stabilized.
• the viscosity becomes too high and it is difficult to obtain fluidity for several purposes, particularly during the manufacturing process.
• the pharmaceutical composition comprises about 0.1 to 0.5 percent by weight of desmopressin or a pharmaceutical acceptable salt thereof, and about 0.05 to 5 percent by weight of gum(s).
• the term 'pharmaceutically acceptable salt' as used herein refers to any organic or inorganic addition salts which are non-toxic and have an effective function harmless to the patients, so side effects attributed to the salts do not deteriorate the beneficial efficacy of desmopressin.
• organic acids and inorganic acids as a free acid, or non-toxic salts may be used.
• the inorganic acids may include hydrochloric acid, phosphoric acid, sulfuric acid, nitric acid, and tartaric acid.
• organic acids may include methanesulfonic acid, p-toluenesulfonic acid, acetic acid, trifluoroacetic acid, maleic acid, succinic acid, oxalic acid, benzoic acid, tartaric acid, fumaric acid, mandelic acid, propionic acid, citric acid, lactic acid, glycollic acid, gluconic acid, galacturonic acid, glutamic acid, glutaric acid, glucuronic acid, aspartic acid, ascorbic acid, carbonic acid, vanillic acid, and hydroiodic acid.
• acetic acid is preferably used.
• the acid addition salts may be prepared according to any conventional method, for example, by dissolving a compound in excessive amounts of an aqueous solution of acid, and precipitating the resulting salt in a water-miscible organic solvent such as methanol, ethanol, acetone, and acetonitrile.
• a water-miscible organic solvent such as methanol, ethanol, acetone, and acetonitrile.
• non-toxic salts may include sulfate, pyrosulfate, bisulfate, sulfite, bisulfite, nitrate, phosphate, monohydrogen phosphate, dihydrogen phosphate, metaphosphate, pyrophosphate, chloride, bromide, iodide, fluoride, acetate, propionate, decanoate, caprylate, acrylate, formate, isobutylate, caprate, heptanoate, propiolate, oxalate, malonate, succinate, suberate, sebacate, fumarate, maleate, butyne-1 ,4-dioate, hexane-1 ,6-dioate, benzoate, chlorobenzoate, methyl benzoate, dinitro benzoate, hydroxybenzoate, methoxy benzoate phthalate, terephthalate, benzene sulfonate, toluene sulf
• the pharmaceutical composition according to the present invention comprises desmopressin or a pharmaceutically acceptable salt thereof as an active ingredient, and therefore, can be used in the treatment or prevention of diseases, symptoms, and disorders that need the pharmacological effect of desmopressin or a pharmaceutically acceptable salt thereof, for example, nocturnal enuresis or nocturnal polyuria.
• treatment refers to any actions that improve or favorably modify diseases, disorders and symptoms thereof by the administration of the pharmaceutical composition. Also, the term 'treatment' includes the meaning of 'prevention' broadly, so the term 'prevention' refers to any actions that inhibit diseases, disorders and symptoms thereof or suppress occurrence thereof.
• the pharmaceutical composition according to the present invention may further comprise pharmaceutically acceptable carriers which are conventionally added to a pharmaceutical composition.
• the pharmaceutically acceptable carriers may include but are not limited to additives such as fillers, pH adjusting agents, protecting agents, wicking agents, diluents, disintegrating agents, binders, lubricants, emulsifiers, non-effervescent disintegrants, effervescent disintegrants, surfactants, anti-oxidants, wetting agents, taste- masking agents, preservatives and/or suspending agents. If necessary, sweetening agents, flavors, coloring agents and/or printing pigment colours may be further added.
• the pharmaceutical composition of the present invention is used in the treatment of urinary disorders such as nocturnal enuresis, besides desmopressin or a pharmaceutically acceptable salt thereof, other drugs may concomitantly be used unless deteriorating the object of the present invention.
• other drugs may concomitantly be used unless deteriorating the object of the present invention.
• at least one drug selected from the non-limiting examples consisting of antidiuretic hormone, tolterodine, tamsulosine, amitriphthaline, and a combination thereof may optionally be further used.
• the pharmaceutical composition according to the present invention is formulated for oral administration.
• the formulation for oral administration may take various forms such as tablet, film, suspension, granule, gel, pill, tincture, decoction, infusion, spirit, fluid extract, elixir, extract, syrup, powder, aromatic water, and lemonade.
• the tablet may take various forms such as an orally disintegrating tablet, a mucoadhesive tablet, a dispersible tablet, a sublingual tablet, a buccal tablet, a chewable tablet, a dispensing tablet, a mulitilayered tablet, a press-coated tablet, an effervescent tablet, and a solution tablet. If necessary, the various tablets may also be variously modified by a person having ordinary skill.
• a liquid form or an orally disintegrating formulation for example, orally dispersing (dissolving) formulations, such as an orally dissolving film, an orally disintegrating tablet, a suspension, a suspending tablet, an immediate release dissolving tablet, an orally disintegrating granule, an orally disintegrating troche, a sublingual tablet, a powder, and/or a chewable tablet may be used.
• orally dispersing (dissolving) formulations such as an orally dissolving film, an orally disintegrating tablet, a suspension, a suspending tablet, an immediate release dissolving tablet, an orally disintegrating granule, an orally disintegrating troche, a sublingual tablet, a powder, and/or a chewable tablet may be used.
• the pharmaceutical composition according to the present invention is preferably formulated in the form of an orally dissolving film.
• orally dissolving film used interchangeably herein and should be understood to be administered by placing it on the tongue, under the tongue, in the oral cavity, or any other mucosal sublingual parts.
• the orally disintegrating film of the present invention dissolves in less than 30 seconds i.e. fulfills the respective criteria for such type of medication both in the U.S. and Europe.
• the addition of gum(s) can thus effectively stabilize desmopressin or a pharmaceutically acceptable salt thereof to allow formulation in the form of a film, in particular an orally disintegrating film, thereby solving the need for water intake, and also allow for drying of the film preparation solution in which water is used as the sole solvent.
• a film formulation which has an increased stability against denaturation desmopressin was prepared as follows: [41 ] A gum as well as further excipients (as specified in nature and amounts below in the Examples) were added to water and stirred for dissolution and dispersion, followed by homogenization using a homogenizer (Ultra Turrax T-25, IKA, 5000 rpm). Thereto, desmopressin acetate was added and dissolved, followed by homogenization again using the same homogenizer. The resulting film-preparation solution was degassed under vacuum conditions, and coated onto a polyethylene terephthalate (PET) film. The film was dried (under conditions as specified below in the Examples) to obtain a desmopressin- containing film formulation having a thickness of 80 ⁇ .
• a homogenizer Ultra Turrax T-25, IKA, 5000 rpm
• desmopressin acetate was added and dissolved, followed by homogenization again using the same homogenizer.
• the resulting film-preparation solution
• a film prepared according to the Preparation Example equivalent to 1 mg of desmopressin acetate, was put in a 10 ml volume flask. It was mixed with the mobile phase as listed for the HPLC conditions hereinunder until the solution reached the marking for 10 ml. The solution was put into a centrifuge tube, and then centrifuged for 20 minutes. The solution was filtered with 0.2 ⁇ filter (hydrophilic polytetrafluoroethylen (PTFE)). The completion of these steps resulted in the test solution (0.1 mg/ml).
• PTFE hydrophilic polytetrafluoroethylen
• Buffer solution 3.4 g of monobasic potassium phosphate and 2.0 g of sodium 1 - heptanesulfonic acid was dissolved in 1000 ml of water. The pH was adjusted to 4.50 ⁇ 0.05 with phosphoric acid or sodium hydroxide, as needed and passed through a filter having a porosity of 0.45 ⁇ .
• a glass bottle was dried in 105°C chamber for 1 hour and then cooled down for 30 minutes in the desiccator (room temperature).
• the cooled glass bottle from the desiccator was weighed.
• the film sample was then rolled or folded and then, without undue delay, put in a glass bottle in standing position.
• the glass bottle with the sample was weighed accurately.
• the glass bottle was cooled down for 30 minutes in the desiccator (room temperature).
• Example 1 To calculate the LOD value, the reduced weight of the film sample was divided by the weight of the first film sample.
• the film-preparation solutions were prepared by the same method as described in the Preparation Example, with the components and amounts as given in Table 1 .
• the resulting film-preparation solutions were degassed under vacuum conditions, and coated on a PET film.
• the films were dried under different drying conditions (Temperature, Moving speed, Air flow rate) (See Table 2).
• Table 1
• Test Nos. 1 to 4 and 7 satisfied all of three conditions.
• the film was prepared according to the method as described in the Preparation Example with the components and amounts as given in Table 4. The film was dried at 80°C for 30 minutes.
• the film was prepared according to the method as described in the Preparation Example, with the components and amounts as given in Table 5. The film was dried at 80°C for 30 minutes.
• Total Impurities (%) determines the total amount of impurities of desmopressin measured after film drying ('Initial' in Table 6) and after 2 - 4 weeks under accelerated conditions (40 ⁇ 2 ° C?C, Relative Humidity 75 ⁇ 5%).

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