WO2018203061A1 - Formulations stables d'insuline - Google Patents

Formulations stables d'insuline Download PDF

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Publication number
WO2018203061A1
WO2018203061A1 PCT/GB2018/051179 GB2018051179W WO2018203061A1 WO 2018203061 A1 WO2018203061 A1 WO 2018203061A1 GB 2018051179 W GB2018051179 W GB 2018051179W WO 2018203061 A1 WO2018203061 A1 WO 2018203061A1
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Prior art keywords
formulation
insulin
formulation according
zinc
ionic
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PCT/GB2018/051179
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English (en)
Inventor
Jan Jezek
David GERRING
Sarah HOWELL
Leon ZAKRZEWSKI
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Arecor Limited
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Publication of WO2018203061A1 publication Critical patent/WO2018203061A1/fr

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    • 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
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/22—Hormones
    • A61K38/28—Insulins
    • 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
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/12—Carboxylic acids; Salts or anhydrides thereof
    • 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
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
    • A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
    • 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
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
    • 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
    • A61K9/08—Solutions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics

Definitions

  • This invention relates inter alia to rapid acting aqueous liquid formulations of insulin and insulin analogues.
  • Such formulations are suitable for the treatment of subjects suffering from diabetes mellitus, especially Type 1 diabetes mellitus.
  • Diabetes mellitus is a metabolic disorder associated with poor control of blood sugar levels leading to hypo or hyperglycemia. Untreated diabetes can lead to serious microvascular and macrovascular complications including coronary artery disease, peripheral artery disease, stroke, diabetic nephropathy, neuropathy and retinopathy.
  • the two main types of diabetes are (i) Type 1 diabetes resulting from the pancreas not producing insulin for which the usual treatment is insulin replacement therapy and (ii) Type 2 diabetes where patients either produce insufficient insulin or have insulin resistance and for which treatments include insulin sensitising agents (such as metformin or pioglitazone), traditional insulin
  • GLP-1 agonists such as exenatide and dulaglutide
  • DPPIV inhibitors such as sitagliptin or vildagliptin
  • a range of therapeutic options are possible.
  • the use of recombinant human insulin has in recent times been overtaken by use of insulin analogues which have modified properties, for example, are longer acting or faster acting than normal insulin.
  • a common regimen for a patient involves receiving a long acting basal insulin supplemented by a rapid acting insulin around mealtimes.
  • Insulin is a peptide hormone formed of two chains (A chain and B chain, respectively 21 and 30 amino acids in length) linked via disulfide bridges. Insulin normally exists at neutral pH in the form of a hexamer, each hexamer comprising three dimers bound together by zinc ions. Histidine residues on the insulin are known to be involved in the interaction with the zinc ions. Insulin is stored in the body in the hexameric form but the monomer form is the active form. Traditionally, therapeutic compositions of insulin have also been formulated in hexameric form in the presence of zinc ions. Typically, there are approximately three zinc cations per one insulin hexamer. It has been appreciated that the hexameric form is absorbed from the injection site considerably more slowly than the monomeric and dimeric form.
  • a first is insulin lispro (Humalog®) in which residues 28 and 29 of the B chain (Pro and Lys respectively) are reversed
  • a second is insulin aspart (NovoLog®) in which residue 28 of the B chain, normally Pro, is replaced by Asp
  • a third is insulin glulisine (Apidra®) in which residue 3 of the B chain, normally Asn, is replaced by Lys and residue 29 of the B chain, normally Lys, is replaced by Glu.
  • US5,866,538 (Norup) describes insulin preparations of superior chemical stability comprising human insulin or an analogue or derivative thereof, glycerol and/or mannitol and 5 to 100mM of a halogenide (e.g. NaCI).
  • US7,205,276 (Boderke) addresses the stability problems associated with preparing zinc free formulations of insulin and insulin derivatives and analogues and describes an aqueous liquid formulation comprising at least one insulin derivative, at least one surfactant, optionally at least one preservative and optionally at least one of an isotonicizing agent, a buffer and an excipient, wherein the formulation is stable and free from or contains less than 0.4% (e.g. less than 0.2%) by weight of zinc based on the insulin content of the formulation.
  • the preferred surfactant appears to be polysorbate 20 (polyoxyethylene (20) sorbitan monolaurate).
  • polypeptides including insulin which contain an alkylglycoside, which component is said to reduce aggregation and immunogenicity.
  • WO2012/006283 describes formulations containing insulin together with a zinc chelator such as ethylenediaminetetracetate (EDTA). Modulating the type and quantity of EDTA is said to change the insulin absorption profile.
  • EDTA ethylenediaminetetracetate
  • Modulating the type and quantity of EDTA is said to change the insulin absorption profile.
  • Calcium EDTA is the preferred form of EDTA since it is said to be associated with reduced pain at the injection site and is less likely to remove calcium from the body.
  • formulations also contain citrate which is said to further enhance absorption and to improve the chemical stability of the formulation.
  • US2010/0227795 describes a composition comprising insulin, a dissociating agent such as citric acid or sodium citrate, and a zinc chelator such as EDTA wherein the formulation has a physiological pH and is a clear aqueous solution.
  • the formulations are said to have improved stability and rapid onset of action.
  • WO2015/120457 (Wilson) describes stabilized ultra-rapid acting insulin formulations comprising insulin in combination with a zinc chelator such as EDTA, a dissolution/stabilization agent such as citric acid, a magnesium salt, a zinc compound and optionally additional excipients.
  • W091 /09617 reports that nicotinamide or nicotinic acid or a salt thereof increases the speed of absorption of insulin from aqueous preparations administered parenterally.
  • WO2010/149772 (Olsen) describes a formulation comprising insulin, a nicotinic compound and arginine. The presence of arginine is said to improve the chemical stability of the formulation.
  • WO2015/171484 (Christe) describes rapid acting formulations of insulin wherein onset of action and/or absorption of insulin is faster due to the presence of treprostinil.
  • US2013/0231281 describes an aqueous solution composition comprising insulin or an insulin analogue and at least one oligosaccharide whose average degree of polymerisation is between 3 and 13 and whose polydispersity index is above 1 .0, said oligosaccharide having partially substituted carboxyl functional groups, the unsubstituted carboxyl functional groups being salifiable.
  • a formulation is said to be rapid acting.
  • an aqueous liquid pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc, (iii) a zinc binding species selected from diethylenetriamine (DETA) and triethylenetetramine (TETA) and (iv) a non-ionic surfactant ("the formulation of the invention").
  • the formulations of the invention provide insulin in a form which is rapid or ultra-rapid acting with good physical and chemical stability.
  • use of EDTA to chelate zinc ions in hexameric insulin does increase the rapidity of action but at the cost of greatly reduced stability.
  • the present inventors have appreciated and demonstrated that the use of species which bind zinc less strongly, specifically DETA and TETA, can achieve good speed of action of insulin and their moderately destabilising effects can be reduced or eliminated by using a non-ionic surfactant.
  • Formulations of the invention may be used in the treatment of subjects suffering from diabetes mellitus, particularly Type 1 diabetes mellitus especially for administration at meal times.
  • SEQ ID NO: V A chain of human insulin
  • SEQ ID NO: 2 B chain of human insulin
  • SEQ ID NO: 3 B chain of insulin lispro
  • SEQ ID NO: 4 B chain of insulin aspart
  • SEQ ID NO: 5 B chain of insulin glulisine
  • Fig. 1 Pharmacodynamic profile of Formulations 1 -3 of Example 2 in a validated diabetic Yucatan miniature pig model. DETAILED DESCRIPTION OF THE INVENTION
  • insulin compound refers to insulin and insulin analogues.
  • insulin refers to native human insulin having an A chain and a B chain as set out in SEQ ID NOs. 1 and 2 and containing and connected by disulfide bridges as in the native molecule (Cys A6-Cys A1 1 , Cys B7 to Cys A7 and Cys-B19-Cys A20). Insulin is suitably recombinant insulin.
  • Insulin analogue refers to an analogue of insulin which is an insulin receptor agonist and has a modified amino acid sequence, such as containing 1 or 2 amino acid changes in the sequence of the A or B chain (especially the B chain). Desirably such amino acid modifications are intended to reduce affinity of the molecule for zinc and thus increase speed of action.
  • an insulin analogue has a speed of action which is the same as or preferably greater than that of insulin. The speed of action of insulin or an insulin analogue may be determined in the Diabetic Pig
  • Exemplary insulin analogues include faster acting analogues such as insulin lispro, insulin aspart and insulin glulisine. These forms of insulin have the human insulin A chain but variant B chains - see SEQ ID NOs. 3-5. Further faster acting analogues are described in EP0214826, EP0375437 and EP0678522 the contents of which are herein incorporated by reference in their entirety.
  • the insulin compound is recombinant human insulin. In another embodiment it is insulin lispro. In another embodiment it is insulin aspart. In another embodiment it is insulin glulisine.
  • aqueous pharmaceutical formulation refers to a formulation suitable for therapeutic use in which the aqueous component is or comprises water, preferably distilled water, deionized water, water for injection, sterile water for injection or bacteriostatic water for injection.
  • the aqueous pharmaceutical formulations of the invention are solution formulations in which all components are dissolved in water.
  • the concentration of insulin compound in the formulation will typically be in the range 10-1000 U/ml, such as 50-500 U/ml e.g. 50-200 U/ml.
  • An exemplary formulation contains insulin compound at a concentration of 100 U/ml (around 3.6 mg/ml).
  • Another range of interest is 500-1000 U/ml e.g. 800-1000 U/ml and another exemplary formulation contains insulin compound at a concentration of 1000 U/ml (around 36 mg/ml).
  • the formulations of the invention contain ionic zinc i.e. Zn 2+ ions.
  • the source of the ionic zinc will typically be a water soluble zinc salt such as ZnCI 2 , ZnO, ZnS0 , Zn(N0 3 )2 or Zn(acetate) 2 and most suitably ZnC or ZnO.
  • the concentration of the ionic zinc in the formulation will typically be more than 0.05% e.g. more than 0.1 % e.g. more than 0.2%, more than 0.3% or more than 0.4% by weight of zinc based on the weight of insulin compound in the formulation.
  • concentration of the ionic zinc in the formulation may be more than 0.5% by weight of zinc based on the weight of insulin compound in the formulation, for example 0.5-1 %, e.g. 0.5-0.75%, e.g. 0.5-0.6% by weight of zinc based on the weight of insulin compound in the formulation.
  • the weight of the counter ion to zinc is excluded.
  • concentration of the ionic zinc will typically be more than 0.015 mM e.g. more than 0.03 mM e.g. more than 0.06 mM, more than 0.09 mM or more than 0.12 mM.
  • concentration of the ionic zinc in the formulation may be more than 0.15 mM, for example 0.15-0.60 mM, e.g. 0.20-0.45 mM, e.g. 0.25-0.35 mM.
  • concentration of the ionic zinc will typically be more than 0.15 mM e.g. more than 0.3 mM e.g. more than 0.6 mM, more than 0.9 mM or more than 1 .2 mM.
  • concentration of the ionic zinc in the formulation may be more than 1 .5 mM, for example 1 .5-6.0 mM, e.g. 2.0-4.5 mM, e.g. 2.5-3.5 mM.
  • the formulations of the invention contain a zinc binding species, specifically selected from DETA or TETA.
  • a zinc binding species specifically selected from DETA or TETA.
  • the zinc binding species is TETA.
  • DETA has a logK metal binding stability constant of 8.88 with respect to zinc binding, and
  • TETA has a logK metal binding stability constant of 1 1 .95 with respect to zinc binding, both as determined at 25 °C.
  • Metal binding stability constants are listed in the National Institute of Standards and Technology reference database 46 (Critically
  • Selected Stability Constants of Metal Complexes are typically determined at 25 °C .
  • the concentration of the zinc binding species selected from DETA and TETA is about 0.05 mM or more e.g. in the range 0.05-5 mM.
  • the concentration of the zinc binding species selected from DETA and TETA in the formulation may typically be in the range 0.05-2 mM, more preferably 0.1 -1 .5 mM e.g. 0.2-1 .0 mM e.g. 0.25-0.75 mM, more preferably around 0.5 mM, especially when the zinc binding species is TETA.
  • the concentration of the zinc binding species selected from DETA and TETA is 0.25 mM or more.
  • DETA and TETA may be employed as the free base or a salt form, such as a chloride or acetate salt form.
  • a mixture of DETA and TETA may be employed.
  • the concentration of zinc binding species refers to the combined, total concentration of DETA and TETA.
  • the molar ratio of ionic zinc to the zinc binding species selected from DETA and TETA in the formulation is in the range 10: 1 to 1 : 10 e.g. 5: 1 to 1 : 10 e.g. 2: 1 to 1 :10 or 1 : 1 to 1 :4 e.g.1 : 1 to 1 :3
  • a formulation containing 100 U/ml of insulin compound may contain around 0.3 mM of ionic zinc (i.e. around 19.7 pg/ml of ionic zinc, i.e. around 0.54% by weight of zinc based on the weight of insulin compound in the formulation) and around 0.25-0.75 mM zinc binding species selected from DETA and TETA (especially TETA).
  • ionic zinc i.e. around 19.7 pg/ml of ionic zinc, i.e. around 0.54% by weight of zinc based on the weight of insulin compound in the formulation
  • DETA and TETA especially TETA
  • the formulations of the invention are suitably substantially free of zinc binding species which have a logK metal binding stability constant with respect to zinc binding of more than 12.3 as determined at 25 °C.
  • formulations of the invention will suitably be substantially free of tetradendate ligands or ligands of higher denticity.
  • Substantially free means that the concentration of zinc binding species which have a logK metal binding stability constant with respect to zinc binding of more than 12.3 as determined at 25 °C (such as EDTA) is less than 0.1 mM, such as less than 0.05 mM or less than 0.01 mM.
  • the formulations of the invention contain a non-ionic surfactant.
  • a suitable class of non-ionic surfactants is the alkyl glycosides, especially dodecyl maltoside.
  • Other alkyl glycosides include dodecyl glucoside, octyl glucoside, octyl maltoside, decyl glucoside, decyl maltoside, tridecyl glucoside, tridecyl maltoside, tetradecyl glucoside, tetradecyl maltoside, hexadecyl glucoside, hexadecyl maltoside, sucrose monooctanoate, sucrose mono decanoate, sucrose
  • polysorbates fatty acid esters of ethoxylated sorbitan
  • polysorbate 80 or polysorbate 20 fatty acid esters of ethoxylated sorbitan
  • Polysorbate 80 is polysorbate 80 is a mono ester formed from oleic acid and polyoxyethylene (20) sorbitan in which the number 20 indicates the number of oxyethylene groups in the molecule.
  • Polysorbate 80 is known under a range of brand names including in particular Tween 80, and also Alkest TW 80.
  • the non-ionic surfactant is a polysorbate surfactant other than polysorbate 80.
  • Polysorbate 20 is a mono ester formed from lauric acid and polyoxyethylene (20) sorbitan in which the number 20 indicates the number of oxyethylene groups in the molecule.
  • Polysorbate 20 is known under a range of brand names including in particular Tween 20, and also Alkest TW 20.
  • Other suitable polysorbates include polysorbate 40 and polysorbate 60.
  • non-ionic surfactants is the class of block copolymers of polyethylene glycol and polypropylene glycol, also known as poloxamers, especially poloxamer 188, poloxamer 407, poloxamer 171 and poloxamer 185.
  • Poloxamers are also known under brand names Pluronics or Koliphors.
  • Pluronics for example, poloxamer 188 is marketed as Pluronic F-68.
  • Non-ionic surfactants is the class of alkyl ethers of polyethylene glycol, especially those known under a brand name Brij, such as selected from polyethylene glycol (2) hexadecyl ether (Brij 52), polyethylene glycol (2) oleyl ether (Brij 93) and polyethylene glycol (2) dodecyl ether (Brij L4).
  • Other suitable Brij surfactants include polyethylene glycol (4) laury! ether (Brij 30), polyethylene glycol (10) lauryl ether (Brij 35), polyethylene glycol (20) hexadecyl ether (Brij 58) and polyethylene glycol (10) stearyl ether (Brij 78).
  • non-ionic surfactants is the class of alkylphenyl ethers of polyethylene glycol, especially 4-(1 , 1 ,3,3-tetramethylbutyl)phenyl- polyethylene glycol, also known under a brand name Triton X-100.
  • non-ionic surfactants with molecular weight of less than 1000 g/mole, especially less than 600 g/mole, such as 4-(1 , 1 ,3,3- tetramethylbutyl)phenyl-polyethylene glycol (Triton X-100) (647 g/mole), dodecyl maltoside (51 1 g/mole), octyl glucoside (292 g/mole), polyethylene glycol (2) dodecyl ether (Brij L4) (362 g/mole), polyethylene glycol (2) oleyl ether (Brij 93) (357 g/mole) and polyethylene glycol (2) hexadecyl ether (Brij 52) (330 g/mole).
  • Triton X-100 Triton X-100
  • Triton X-100 Triton X-100
  • dodecyl maltoside 51 1 g/mole
  • the concentration of the non-ionic surfactant in the formulation will typically be in the range 1 -1000 pg/ml, e.g. 5-500 pg/ml, e.g. 10-200 pg/ml, such as 10-100 g/ml especially around 50 pg/ml.
  • the pH of the aqueous formulations of the invention is in the range 5.5-9.0 especially 6.5-8.0 e.g. 7.0-7.8. e.g. 7.0-7.5.
  • the pH is preferably close to physiological pH (around pH 7.4).
  • Another pH range of interest is 7.6-8.0 e.g around 7.8.
  • the formulation of the invention comprises a buffer in order to stabilise the pH of the formulation, which can also be selected to enhance protein stability.
  • a buffer is selected to have a pKa close to the pH of the formulation; for example histidine is suitably employed as a buffer when the pH of the formulation is in the range 5.0-7.0.
  • Histidine is suitably employed as a buffer when the pH of the formulation is in the range 5.0-7.0.
  • Such a buffer may be employed in a concentration of 0.5-20 mM e.g. 2-5 mM.
  • phosphate is suitably employed as a buffer when the pH of the formulation is in the range 6.1 -8.1 .
  • Such a buffer may be employed in a concentration of 0.5-20 mM e.g. 2-5 mM.
  • the formulation of the invention is further stabilised as disclosed in WO2008/084237 (herein incorporated by reference in its entirety), which describes a formulation comprising a protein and one or more additives,
  • the system is substantially free of a conventional buffer, i.e. a compound with an ionisable group having a pKa within 1 unit of the pH of the formulation at the intended temperature range of storage of the formulation, such as 25 °C.
  • the pH of the formulation is set to a value at which the formulation has maximum measurable stability with respect to pH; the one or more additives (displaced buffers) are capable of exchanging protons with the insulin compound and have pKa values at least 1 unit more or less than the pH of the formulation at the intended temperature range of storage of the formulation.
  • the additives may have ionisable groups having pKa between 1 to 5 pH units, preferably between 1 to 3 pH units, most preferably from 1 .5 to 2.5 pH units, of the pH of the aqueous formulation at the intended temperature range of storage of the formulation (e.g. 25 °C). Such additives may typically be employed at a concentration of 0.5-10 mM e.g. 2-5 mM.
  • the aqueous formulations of the present invention cover a wide range of osmolarity, including hypotonic, isotonic and hypertonic formulations.
  • the formulations of the invention are substantially isotonic.
  • the osmolarity of the formulation is selected to minimize pain according to the route of administration e.g. upon injection.
  • Preferred formulations have an osmolarity in the range of about 200 to about 500 mOsm/L.
  • the osmolarity is in the range of about 250 to about 350 mOsm/L. More preferably, the osmolarity is about 300 mOsm/L.
  • Tonicity of the formulation may be adjusted with a tonicity modifying agent.
  • the formulation further comprises a tonicity modifying agent.
  • Tonicity modifying agents may be charged or uncharged.
  • Examples of charged tonicity modifying agents include salts such as a combination of sodium, potassium, magnesium or calcium ions, with chloride, sulfate, carbonate, sulfite, nitrate, lactate, succinate, acetate or maleate ions (especially sodium chloride or sodium sulphate, particularly sodium chloride).
  • Amino acids such as arginine, glycine or histidine may also be used for this purpose.
  • Charged tonicity modifying agent is preferably used at a concentration of 100 - 300 mM, e.g. around 150 mM.
  • uncharged tonicity modifying agents include sugars, sugar alcohols and other polyols, such as trehalose, sucrose, mannitol, glycerol, 1 ,2-propanediol, raffinose, lactose, dextrose, sorbitol or lactitol (especially trehalose, mannitol, glycerol or 1 ,2-propanediol, particularly glycerol).
  • Uncharged tonicity modifying agent is preferably used at a concentration of 200 - 500 mM, e.g. around 300 mM.
  • the tonicity is suitably adjusted using an uncharged tonicity modifying agent, preferably at a concentration of 200 - 500 mM, e.g. around 300 mM.
  • the uncharged tonicity modifying agent is suitably selected from the group consisting of trehalose, mannitol, glycerol and 1 ,2-propanediol (most suitably glycerol).
  • the insulin compound is insulin aspart at a concentration of 500 U/ml or less (e.g.
  • the tonicity is suitably adjusted using a charged tonicity modifying agent, especially sodium chloride, preferably at a concentration of 100 - 300 mM, e.g. around 150 mM.
  • a charged tonicity modifying agent especially sodium chloride
  • the tonicity is suitably adjusted using an uncharged tonicity modifying agent, preferably at a concentration of 200 - 500 mM, e.g. around 300 mM.
  • the uncharged tonicity modifying agent is suitably selected from the group consisting of trehalose, mannitol, glycerol and 1 ,2-propanediol (most suitably glycerol).
  • the ionic strength of a formulation may be calculated according to the formula:
  • I 0.5 x ⁇ c x z in which c x is molar concentration of ion x (mol L "1 ), z x is the absolute value of the charge of ion x and the sum covers all ions (n) present in the formulation. The contribution of the insulin compound itself should be ignored for the purposes of the calculation.
  • the absolute value of the charge is the total charge excluding polarity, e.g. for glycine the possible ions have absolute charge of 0, 1 or 2 and for aspartate the possible ions have absolute charge of 0, 1 , 2 or 3.
  • the ionic strength of the formulation is suitably in the range of around 5 mM up to around 500 mM.
  • the ionic strength of the formulation is suitably kept to a minimum level since higher ionic strength formulations are less stable than lower ionic strength formulations.
  • the ionic strength taking account of ions in the formulation except for the zinc binding species and the insulin compound is less than 40 mM, e.g. less than 20 mM, e.g. less than 10 mM such as 5-10 mM.
  • the ionic strength of the formulation is suitably kept to a minimum level since higher ionic strength formulations are less stable than lower ionic strength formulations.
  • the ionic strength taking account of ions in the formulation except for the zinc binding species and the insulin compound is less than 40 mM, e.g. less than 20 mM, e.g. less than 10 mM.
  • the ionic strength of the formulation may be high.
  • the ionic strength taking account of ions in the formulation except for the zinc binding species and the insulin compound is more than 50 mM, e.g. more than 100 mM, e.g. 50-500 mM or 100-500 mM or 100-300 mM such as around 150 mM.
  • the formulations of the invention can optionally include preservative, preferably phenol, m-cresol, chlorocresol, benzyl alcohol, propylparaben,
  • methylparaben benzalkonium chloride or benzethonium chloride.
  • the formulations of the invention may optionally comprise nicotinamide.
  • the presence of nicotinamide may further increase the speed of onset of action of insulin formulated in formulations of the invention.
  • nicotinamide is in the range 10-150 mM, preferably in the range 20-100 mM, such as around 80 mM.
  • the formulations of the invention may optionally comprise nicotinic acid or a salt thereof.
  • the presence of nicotinic acid or a salt thereof may also further increase the speed of onset of action of insulin formulated in formulations of the invention.
  • the concentration of nicotinic acid or a salt thereof is in the range 10-150 mM, preferably in the range 20-100 mM, such as around 80 mM.
  • Example salts include metal salts such as sodium, potassium and magnesium salts.
  • one of nicotinamide and nicotinic acid is included in the formulation but not both.
  • a mixture of nicotinamide and nicotinic acid (or as salt thereof) is included in the formulation.
  • Formulations of the invention may optionally include other beneficial components including stabilising agents.
  • stabilising agents amino acids such as arginine or proline may be included which may have stabilising properties.
  • the formulations of the invention comprise arginine.
  • the formulations are free of acids selected from glutamic acid, ascorbic acid, succinic acid, aspartic acid, maleic acid, fumaric acid, adipic acid and acetic acid and are also free from the corresponding ionic forms of these acids.
  • the formulations are free of arginine. In an embodiment of the invention the formulations are free of protamine and protamine salts.
  • the formulations are free of magnesium ions.
  • the formulations are free of calcium ions.
  • high molecular weight species refers to any irreversibly formed component of the protein content which has an apparent molecular weight at least about double the molecular weight of the parent insulin compound, as detected by a suitable analytical method, such as size-exclusion chromatography. That is, high molecular weight species are multimeric aggregates of the parent insulin compound. The multimeric aggregates may comprise the parent protein molecules with considerably altered conformation or they may be an assembly of the parent protein units in the native or near-native conformation.
  • the determination of high molecular weight species can be done using methods known in the art, including size exclusion chromatography, electrophoresis, analytical ultracentrifugation, light scattering, dynamic light scattering, static light scattering and field flow fractionation.
  • the formulations of the invention are sufficiently stable that they remain substantially free of visible particles after storage at 30°C for at least one, two or three months. Visible particles are suitably detected using the 2.9.20. European Pharmacepoeia Monograph method (Particulate Contamination: Visible Particles).
  • a formulation is substantially free of visible particles if it has a Visual score of 1 , 2 or 3, especially 1 or 2 according to the definition given in the Examples section.
  • the formulations of the invention are sufficiently stable that the concentration of related species remains low upon extended storage.
  • related species refers to any component of the protein content formed by a chemical modification of the parent insulin compound, particularly desamido or cyclic imide forms of insulin. Related species are suitably detected by RP-HPLC.
  • the formulation of the invention retains at least 95%, e.g. at least 96%, e.g. at least 97%, e.g. at least 98%, e.g. at least 99% parent insulin compound (by weight of total protein) after storage at 30°C for one, two or three months.
  • the percentage of insulin compound (by weight of total protein) may be determined by size-exclusion chromatography or RP-HPLC.
  • the formulation of the invention comprises no more than 4% (by weight of total protein), preferably no more than 2% high molecular weight species after storage at 30° C for one, two or three months.
  • the formulation of the invention comprises no more than 4% (by weight of total protein), preferably no more than 2%, preferably no more than 1 % A-21 desamido form of the insulin compound after storage at 30°C for one, two or three months.
  • a formulation of the present invention should exhibit an increase in high molecular weight species during storage which is at least 10% lower, preferably at least 25% lower, more preferably at least 50% lower, than a formulation lacking the non-ionic surfactant but otherwise identical, following storage under the same conditions (e.g. 30°C) and length of time (e.g. one, two or three months).
  • a formulation of the present invention should exhibit an increase in related species during storage which is at least 10% lower, preferably at least 25% lower, more preferably at least 50% lower, than a formulation lacking the non-ionic surfactant but otherwise identical, following storage under the same conditions (e.g. 30°C) and length of time (e.g. one, two or three months).
  • a formulation of the invention may be determined in the Diabetic Pig Pharmacokinetic/Pharmacodynamic Model (see Examples, General Methods).
  • a formulation of the present invention should exhibit a T ma x (i.e. time to peak insulin concentration) that is at least 10% shorter, preferably at least 20% shorter, more preferably at least 30% shorter than a formulation lacking the zinc binding species selected from DETA and TETA but otherwise identical, using the model.
  • a formulation of the present invention should exhibit an area under the curve on the pharmacodynamics profile within the first 45 minutes after injection that is at least 10% greater, preferably at least 20% greater, more preferably at least 30% greater than a formulation lacking the zinc binding species selected from DETA and TETA but otherwise identical, using the model.
  • a formulation of the invention for use in the treatment of a subject suffering from diabetes mellitus.
  • a method of treatment of diabetes mellitus which comprises administering to a subject in need thereof an effective amount of a formulation of the invention.
  • a typical dose of the formulation of the invention is 2-30 U, e.g. 5-15 U.
  • Administration should suitably occur in the window between 15 minutes before eating
  • An aspect of the invention is a container e.g. made of plastics or glass containing one dose or a plurality of doses of the formulation of the invention.
  • the container can, for example, be a cartridge designed to be a replaceable item for use with an injection device.
  • the formulations of the invention may suitably be packaged for injection, especially sub-cutaneous or intramuscular injection.
  • Sub-cutaneous injection is preferred.
  • Injection may be by conventional syringe or more preferably via a pen device adapted for use by diabetic subjects.
  • Exemplary pen devices include the
  • an aspect of the invention is an injection device, particularly a device adapted for subcutaneous or intramuscular injection, for single or multiple use comprising a container containing one dose or a plurality of doses of the formulation of the invention together with an injection needle.
  • the container is a replaceable cartridge which contains a plurality of doses.
  • the needle is replaceable e.g. after each occasion of use.
  • Another aspect of the invention is a medical device comprising a reservoir comprising plurality of doses of the formulation of the invention and a pump adapted for automatic or remote operation such that upon automatic or remote operation one or more doses of the formulation of the invention is administered to the body e.g. subcutaneously or intramuscularly.
  • a medical device comprising a reservoir comprising plurality of doses of the formulation of the invention and a pump adapted for automatic or remote operation such that upon automatic or remote operation one or more doses of the formulation of the invention is administered to the body e.g. subcutaneously or intramuscularly.
  • Such devices may be worn on the outside of the body or implanted in the body.
  • Formulations of the invention may be prepared by mixing the ingredients.
  • the insulin compound may be dissolved in an aqueous formulation comprising the other components.
  • the insulin compound may be dissolved in a strong acid (typically HCI), after dissolution diluted with an aqueous formulation comprising the other components, and then pH adjusted to the desired pH with addition of alkali (e.g. NaOH).
  • a step of neutralising the acid solution may be performed before the dilution step and it may then not be necessary to adjust the pH after the dilution step (or a small adjustment only may be necessary).
  • a dry solid pharmaceutical composition suitable for reconstitution with an aqueous medium which comprises (i) an insulin compound other than insulin glargine, (ii) ionic zinc e.g. at a concentration of 0.05% or more e.g. 0.5% or more by weight of zinc based on the weight of insulin compound in the formulation, (iii) a zinc binding species selected from DETA and TETA e.g. at a concentration of 0.05 mM or more, and (iv) a non-ionic surfactant.
  • a formulation of the invention may be prepared by dissolving such a dry solid pharmaceutical composition in an aqueous medium e.g. water or saline.
  • Such a dry solid pharmaceutical composition may be prepared by dehydrating (e.g. freeze drying) a formulation of the invention.
  • the invention also provides a container containing one dose or a plurality of doses of such a dry solid pharmaceutical composition.
  • a pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc e.g. at a concentration of 0.05% or more e.g. 0.5% or more by weight of zinc based on the weight of insulin compound in the formulation and (iii) a zinc binding species selected from DETA and TETA e.g. at a concentration of 0.05 mM or more; which comprises adding a non-ionic surfactant to the formulation; and • Use of a non-ionic surfactant to improve the storage stability of an aqueous liquid pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc e.g. at a concentration of 0.05% or more e.g. 0.5% or more by weight of zinc based on the weight of insulin compound in the formulation and (iii) a zinc binding species selected from DETA and
  • TETA e.g. at a concentration of 0.05 mM or more.
  • An aqueous liquid pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc, (iii) a zinc binding species selected from diethylenetriamine (DETA) and triethylenetetramine (TETA), and (iv) a non-ionic surfactant.
  • Clause 6 The formulation according to any one of clauses 1 to 5 wherein the formulation is substantially free of ethylenediaminetetraacetate (EDTA) and any other zinc binding species having a logK with respect to zinc ion binding of more than 12.3 at 25 °C.
  • EDTA ethylenediaminetetraacetate
  • Clause 7 The formulation according to any one of clauses 1 to 6, wherein the insulin compound is present at a concentration of 10-1000 U/ml.
  • Clause 8 The formulation according to any one of clauses 1 to 7, wherein the ionic zinc is present at a concentration of more than 0.05% by weight of zinc based on the weight of insulin compound in the formulation.
  • Clause 10 The formulation according to clause 9, wherein the ionic zinc is present at a concentration of 0.5-1 % by weight of zinc based on the weight of insulin compound in the formulation.
  • Clause 1 1 The formulation according to any one of clauses 1 to 10, wherein the zinc binding species is TETA.
  • Clause 12 The formulation according to any one of clauses 1 to 1 1 , wherein the zinc binding species is present at a concentration of about 0.05 mM or more e.g. 0.05-5 mM e.g. 0.05-2 mM.
  • Clause 13 The formulation according to clause 1 1 , wherein the molar ratio of ionic zinc to the zinc binding species is 2: 1 to 1 : 10.
  • Clause 14 The formulation according to any one of clauses 1 to 13 wherein the non-ionic surfactant is an alkyl glycoside.
  • Clause 16 The formulation according to any one of clauses 1 to 13 wherein the non-ionic surfactant is a polysorbate surfactant other than polysorbate 80.
  • Clause 18 The formulation according to any one of clauses 1 to 13 wherein the non-ionic surfactant is an alkyl ether of polyethylene glycol.
  • Clause 19 The formulation according to clause 18 wherein the alkyl ether of polyethylene glycol is selected from polyethylene glycol (2) dodecyl ether,
  • polyethylene glycol (2) oleyl ether and polyethylene glycol (2) hexadecyl ether are polyethylene glycol (2) oleyl ether and polyethylene glycol (2) hexadecyl ether.
  • Clause 20 The formulation according to any one of clauses 1 to 13 wherein the non-ionic surfactant is a block copolymer of polyethylene glycol and polypropylene glycol.
  • Clause 21 The formulation according to clause 20 wherein the block copolymer of polyethylene glycol and polypropylene glycol is poloxamer 188, poloxamer 407, poloxamer 171 or poloxamer 185.
  • Clause 22 The formulation according to any one of clauses 1 to 13 wherein the non-ionic surfactant is an alkylphenyl ether of polyethylene glycol.
  • Clause 24 The formulation according to any one of clauses 1 to 23 wherein the non-ionic surfactant is present at a concentration of 1 -1000 pg/ml.
  • Clause 25 The formulation according to any one of clauses 1 to 24, further comprising a tonicity modifying agent.
  • Clause 28 The formulation according to clause 27, wherein the uncharged tonicity modifying agent is glycerol.
  • Clause 29 The formulation according to any one of clauses 1 , 2 and 6-28 wherein the insulin compound is insulin lispro and the ionic strength of the formulation taking account of ions in the formulation excluding the zinc binding species and the insulin compound is less than 40 mM or wherein the insulin compound is insulin aspart at a concentration of > 500 U/ml and the ionic strength of the formulation taking account of ions in the formulation excluding the zinc binding species and the insulin compound is less than 40 mM.
  • Clause 31 The formulation according to clause 30, wherein the charged tonicity modifier is sodium chloride.
  • Clause 32 The formulation according to any one of clauses 1 , 3 and 6-28 wherein the insulin compound is insulin aspart at a concentration of 500 U/ml or less and the ionic strength of the formulation taking account of ions in the formulation excluding the zinc binding species and the insulin compound is more than 50 mM.
  • Clause 33 The formulation according to any one of clauses 1 to 32, wherein the formulation is substantially isotonic.
  • Clause 34 The formulation according to any one of clauses 1 to 33, wherein the pH is in the range 5.5 to 9.0.
  • Clause 35 The formulation according to any of clauses 1 to 34, further comprising a preservative.
  • Clause 36 The formulation according to clause 35, wherein the preservative is selected from the group consisting of phenol, m-cresol, chlorocresol, benzyl alcohol, propylparaben, methylparaben, benzalkonium chloride and benzethonium chloride.
  • Clause 37 The formulation according to any one of clauses 1 to 36, further comprising nicotinamide.
  • Clause 38 The formulation according to any one of clauses 1 to 36, further comprising nicotinic acid or a salt thereof.
  • Clause 39 The formulation according to any one of clauses 1 to 37 for use in the treatment of a subject suffering from diabetes mellitus.
  • a method of treatment of diabetes mellitus which comprises
  • An injection device for single or multiple use comprising a container containing one dose or a plurality of doses of the formulation according to any one of clauses 1 to 38 together with an injection needle.
  • a medical device comprising a reservoir comprising plurality of doses of the formulation according to any one of clauses 1 to 38 and a pump adapted for automatic or remote operation such that upon automatic or remote operation one or more doses of the formulation is administered to the body.
  • a dry solid pharmaceutical composition suitable for reconstitution with an aqueous medium which comprises (i) an insulin compound other than insulin glargine, (ii) ionic zinc, (iii) a zinc binding species selected from DETA and TETA, and (iv) a non-ionic surfactant.
  • Clause 45 A method of preparing a formulation according to any one of clauses 1 to 38 which comprises dissolving a dry solid pharmaceutical composition according to clause 44 in an aqueous medium.
  • a method of improving the storage stability of an aqueous liquid pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc and (iii) a zinc binding species selected from DETA and TETA; which comprises adding a non-ionic surfactant to the formulation.
  • a non-ionic surfactant to improve the storage stability of an aqueous liquid pharmaceutical formulation comprising (i) an insulin compound other than insulin glargine, (ii) ionic zinc and (iii) a zinc binding species selected from DETA and TETA.
  • Pigs are injected subcutaneously with a sample of the test formulation and blood is taken (1 or 2 ml) at various time- points (min) with respect to the injection e.g. at the time points (min): -30 (or -15), 0, 5, 10, 15, 20, 30, 40, 50, 60, 75, 90, 105, 120, 150, 180, 210 and 240.
  • min time- points
  • serum is analysed for glucose (using a commercially available glucometer).
  • insulin concentration is pharmacokinetic profile.
  • Visible particles are suitably detected using the 2.9.20. European Pharmacepoeia Monograph (Particulate Contamination: Visible Particles).
  • the apparatus required consists of a viewing station comprising:
  • an adjustable lampholder fitted with a suitable, shaded, white-light source and with a suitable light diffuser (a viewing illuminator containing two 13 W fluorescent tubes, each 525 mm in length, is suitable).
  • the intensity of illumination at the viewing point is maintained between 2000 lux and 3750 lux.
  • any adherent labels are removed from the container and the outside washed and dried.
  • the container is gently swirled or inverted, ensuring that air bubbles are not introduced, and observed for about 5 s in front of the white panel.
  • the procedure is repeated in front of the black panel. The presence of any particles is recorded.
  • Visual score 1 Clear solution, virtually free of particles
  • samples with visual score 1 -3 Whilst the particles in samples with visual scores 4 and 5 are clearly detectable on casual visual assessment under normal light, samples with visual score 1 -3 generally appear as clear solutions on the same assessment. Samples with visual scores 1 -3 are considered to be “Pass”; samples with visual score 4-5 are considered to be “Fail”.
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example A3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example B1 surfactant dodecyl maltoside (0.05 mg/ml)
  • Example B2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example B3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example C1 surfactant dodecyl maltoside (0.05 mg/ml)
  • Example C2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example C3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCb) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example D1 surfactant dodecyl maltoside (0.05 mg/ml)
  • Example D2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example D3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example E1 surfactant dodecyl maltoside (0.05 mg/ml)
  • Example E2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example E3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example F2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example F3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example G2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example G3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Example J1 surfactant dodecyl maltoside (0.05 mg/ml)
  • Example J2 surfactant polysorbate 20 (Tween 20) (0.05 mg/ml)
  • Example J3 surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Example K surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Example K surfactant polyethylene glycol (2) dodecyl ether (Brij L4) (0.05 mg/ml)
  • Ionic zinc (as ZnCb) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Ionic zinc (as ZnCI 2 ) 19.7 pg/ml (0.3 mM), equals 0.55% (w/w) based on the weight of insulin compound in the formulation
  • Insulin powder is added to water and HCI is added until the powder is fully dissolved (pH has to be ⁇ 3 in order to achieve full dissolution).
  • ZnCI 2 is added to the required level. Once dissolved, pH is adjusted to approximately 7 and volume is adjusted with water so that the insulin concentration is 2* the required concentration.
  • the formulation is then mixed 1 : 1 (v/v) with a mixture of additional excipients (all at 2* the required concentration).
  • Example 2 Comparison of pharmacodynamic profiles of insulin aspart formulations in the presence of (a) TETA, (b) EDTA and (c) nicotinamide
  • Formulation 1 insulin aspart (100 U/ml), NaCI (10 mM), TRIS (7 mM), glycerol (83.6 mM), arginine (30 mM), nicotinamide (80 mM), phenol (16 mM), m-cresol (16 mM), zinc (from ZnCI 2 , 19.6 pg/ml with respect to zinc), pH 7.4
  • Formulation 2 insulin aspart (100 U/ml), NaCI (150 mM), sodium phosphate (2 mM), EDTA (0.5 mM), dodecyl maltoside (0.05 mg/ml), phenol (16 mM), m-cresol (16 mM), zinc (from ZnCI 2 , 19.6 pg/ml with respect to zinc), pH 7.4
  • Formulation 3 insulin aspart (100 U/ml), NaCI (150 mM), sodium phosphate (2 mM), TETA (0.5 mM), dodecyl maltoside (0.05 mg/ml), phenol (16 mM), m-cresol (16 mM), zinc (from ZnCI 2 , 19.6 pg/ml with respect to zinc), pH 7.4
  • Formulation 1 is identical to Formulation K in Example 1 of WO2010/149772, which was shown to have a significantly more rapid onset of action compared with that of commercially available NovoRapid® product (Formulation A in Example 1 of WO2010/149772) - see Figures 4 and 5 of WO2010/149772.
  • Results are shown in Figure 1 . It was shown that the formulation comprising TETA (Formulation 3) resulted in a comparable PD profile to that of the formulation comprising nicotinamide (Formulation 1 ). The decline in glucose concentration appeared to be slightly more rapid in the TETA-based formulation in the first 50 minutes after injection, but it appeared to slow down beyond that point.
  • Formulation comprising EDTA resultsed in a more rapid glucose decrease compared with both the TETA-based and the nicotinamide-based formulation. However, as shown below, this formulation is very unstable and therefore not suitable for a viable pharmaceutical product.
  • Example 3 Stability of insulin aspart formulations in the presence of (a) TETA and (b) EDTA
  • TETA and EDTA on stability of insulin aspart was investigated.
  • the stability was compared to that of the ultra-rapid acting formulation disclosed in WO2010/149772 (Formulation K in Example 1 of WO2010/149772). All formulations tested comprised insulin aspart (100 U/ml), phenol (16 mM), m-cresol (16 mM) and zinc (from ZnCI 2 , 19.6 pg/ml with respect to zinc).
  • the additional components of each formulation are listed in Table 1 .
  • Table 1 Additional components in formulations of insulin aspart tested.
  • Visual scores of insulin aspart formulations following storage at 30 °C Visual score 1 : clear solution, virtually free of particles; visual score 2: ⁇ 5 very small particles; visual score 3: -10-20 very small particles; visual score 4: 20-50 particles, including larger particles; visual score 5: >50 particles, including larger particles.
  • SEQ ID NO: 2 FVNQHLCGSHLVEALYLVCGERGFFYTPKT
  • SEQ ID NO: 3 FVNQHLCGSHLVEALYLVCGERGFFYTKPT
  • SEQ ID NO: 4 FVNQHLCGSHLVEALYLVCGERGFFYTDKT

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Abstract

La présente invention concerne, entre autres, une formulation pharmaceutique liquide aqueuse comprenant (i) un composé d'insuline autre que l'insuline glargine, (ii) du zinc ionique, (iii) une espèce se liant au zinc choisie entre la diéthylènetriamine (DETA) et la triéthylènetétraamine (TETA), et (iv) un tensio-actif non ionique. L'invention concerne également des procédés, des utilisations et des compositions pharmaceutiques s'y rapportant.
PCT/GB2018/051179 2017-05-05 2018-05-03 Formulations stables d'insuline WO2018203061A1 (fr)

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WO2019193351A1 (fr) * 2018-04-04 2019-10-10 Arecor Limited Système de pompe à perfusion médicale pour l'administration d'un composé d'insuline
WO2019193353A1 (fr) * 2018-04-04 2019-10-10 Arecor Limited Système de pompe à perfusion médicale pour l'administration d'un composé d'insuline
WO2019193349A1 (fr) * 2018-04-04 2019-10-10 Arecor Limited Système de pompe à perfusion médicale pour l'administration d'un composé d'insuline
US11207384B2 (en) 2017-06-01 2021-12-28 Eli Lilly And Company Rapid-acting insulin compositions
US11278624B2 (en) 2016-05-06 2022-03-22 Arecor Limited Formulations

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EP0375437A2 (fr) 1988-12-23 1990-06-27 Novo Nordisk A/S Analogues de l'insuline humaine
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