WO2020248741A1 - 一种具有降血糖作用的药物组合物 - Google Patents

一种具有降血糖作用的药物组合物 Download PDF

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WO2020248741A1
WO2020248741A1 PCT/CN2020/088645 CN2020088645W WO2020248741A1 WO 2020248741 A1 WO2020248741 A1 WO 2020248741A1 CN 2020088645 W CN2020088645 W CN 2020088645W WO 2020248741 A1 WO2020248741 A1 WO 2020248741A1
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composition
glp
pharmaceutical composition
exenatide
small intestine
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PCT/CN2020/088645
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French (fr)
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张菁
金文波
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张菁
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Priority to EP20822972.4A priority Critical patent/EP3871692B1/en
Priority to US17/282,831 priority patent/US12097245B2/en
Publication of WO2020248741A1 publication Critical patent/WO2020248741A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • 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
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/141—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers
    • A61K9/145—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers with organic compounds
    • 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
    • A61K38/26—Glucagons
    • 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
    • A61K47/20—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing sulfur, e.g. dimethyl sulfoxide [DMSO], docusate, sodium lauryl sulfate or aminosulfonic 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
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
    • 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
    • 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
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/141—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers
    • A61K9/146—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers with organic macromolecular compounds
    • 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
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/19—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles lyophilised, i.e. freeze-dried, solutions or dispersions
    • 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
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4891—Coated capsules; Multilayered drug free capsule shells
    • 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

  • the invention belongs to the technical field of biomedicine, and specifically relates to a pharmaceutical composition with a blood sugar lowering effect.
  • type 2 diabetes is now the third non-communicable disease that threatens human health and life after cardiovascular diseases and tumors.
  • Diabetes as an independent risk factor, greatly increases the morbidity and mortality of cardiovascular diseases.
  • the prevention and treatment of cardiovascular complications in patients with type 2 diabetes can significantly reduce the risk of adverse cardiovascular events and improve the short- and long-term prognosis.
  • the pathogenesis of diabetic cardiovascular disease is more complicated. High blood sugar can cause internal environmental disturbances, leading to a high insulin state, activating the neuroendocrine stress system, and then a series of cardiovascular diseases, such as: hypertension, coronary heart disease, stroke , Heart failure, chronic kidney disease, etc.
  • GLP-1 Glucagon-like peptide-1
  • DDP-4 dipeptidyl peptidase-4
  • GLP-1 receptor agonists have the advantages of reducing weight, restoring pancreatic ⁇ -cell function, and less hypoglycemia, so they are increasingly being clinically used, such as exenatide, liraru Peptides and so on.
  • the latest research at home and abroad has found that in addition to its significant hypoglycemic effect, GLP-1 receptor agonists can also exert anti-atherosclerotic effects by expanding blood vessels, controlling inflammation, inhibiting monocyte adhesion, and inhibiting smooth muscle cell proliferation. Thereby improving the occurrence and development of cardiovascular complications in patients with type 2 diabetes.
  • Type 2 diabetes patients are high-risk patients of cardiovascular disease. The prevention and treatment of cardiovascular complications is an important part of the treatment of diabetes.
  • GLP-1 receptor agonists use their unique, efficient and safe mechanism of action to reduce blood sugar, blood pressure, blood lipids, weight control, improve vascular endothelial function, protect myocardium, and improve cardiac diastolic and contraction functions.
  • Patients with type diabetes play a cardiovascular protective role.
  • many larger clinical trials on the efficacy and safety of GLP-1 receptor agonists in the treatment of cardiovascular complications of diabetes are being carried out. It is believed that in the near future, GLP-1 receptor agonists will become anti-diabetic An important treatment strategy for cardiovascular complications.
  • the GLP-1 agonists that have been marketed are all polypeptide injections, which have the disadvantages of inconvenience and pain for diabetic patients. Therefore, it is of great significance to change the route of administration of GLP-1 agonists.
  • the composition is composed of sodium lauryl sulfate, carbomer, chitosan, and sodium citrate. It is shown that the composition for promoting small intestinal absorption of the present invention can be prepared into a composite adjuvant, which can improve the absorption of the active ingredient in the small intestine and so on after being combined with a GLP-1 agonist.
  • the present invention is achieved through the following technical solutions.
  • a pharmaceutical composition with a hypoglycemic effect the pharmaceutical composition containing: a GLP-1 receptor agonist, a composition for promoting small intestinal absorption; wherein the composition for promoting small intestinal absorption includes: sodium lauryl sulfate, calcareous Perme, chitosan, sodium citrate.
  • the pharmaceutical composition is prepared as an oral preparation.
  • the GLP-1 receptor agonists include: exenatide, liraglutide, risenatide, somaglutide, benaglutide, pramlintide and the like.
  • composition for promoting small intestine absorption is used to ensure the absorption of the GLP-1 receptor agonist in the small intestine.
  • composition for promoting small intestine absorption is used to promote the absorption of GLP-1 receptor agonists in the small intestine.
  • the weight ratio of the sodium lauryl sulfate, carbomer, chitosan, and sodium citrate is 15-25:5-8:5-8:50-80.
  • the weight ratio of the GLP-1 receptor agonist to the composition for promoting intestinal absorption is 1:5-860.
  • an oral preparation with the effect of lowering blood sugar includes: GLP-1 receptor agonist, sodium lauryl sulfate, carbomer, chitosan, and sodium citrate.
  • the weight ratio of the sodium lauryl sulfate, carbomer, chitosan, and sodium citrate is 15-25:5-8:5-8:50-80.
  • the weight ratio of the GLP-1 receptor agonist to the composition for promoting intestinal absorption is 1:5-860.
  • a pharmaceutical composition with a hypoglycemic effect which is prepared from raw materials containing a GLP-1 receptor agonist and a composition for promoting small intestinal absorption, wherein the composition for promoting small intestine absorption includes: Sodium alkyl sulfate, carbomer, chitosan, sodium citrate.
  • the composition for promoting small intestinal absorption of the present invention is a new type of adjuvant obtained.
  • the adjuvant can be used for: drugs (active ingredients or active ingredients) that cannot be taken orally and can only be injected can be administered orally, thereby changing the drug (active ingredient or Active ingredient).
  • composition for promoting small intestinal absorption of the present invention can promote the absorption in the intestine of drugs (active ingredients or active ingredients) that are easily decomposed in the gastrointestinal tract.
  • composition for promoting small intestinal absorption of the present invention can promote the absorption in the intestine of drugs (active ingredients or active ingredients) that are not easily absorbed in the gastrointestinal tract.
  • composition for promoting small intestinal absorption of the present invention promotes the absorption of drugs (active ingredients or active ingredients) in the small intestine, and requires release in the small intestine to exert its effects
  • rodents use small intestinal catheters when conducting efficacy tests and pharmacokinetic tests
  • mammals use enteric-coated capsules for oral administration.
  • the composition for promoting small intestine absorption and the medicine are matched one by one on rodents for bioavailability detection, and at the same time, some polypeptides are selected for pharmacodynamic and pharmacokinetic testing on different animals.
  • Figure 1 shows the PD test of Exenatide on STZ rats
  • the abscissa is time (h), and the ordinate is the blood sugar reduction efficiency (%);
  • the solid round solid line is the small intestine injection of normal saline 2ml/kg
  • the solid square dashed line is the subcutaneous injection of Exenatide 1 ⁇ g/kg
  • the solid round dashed line is the subcutaneous injection of Exenatide 250 ⁇ g/kg
  • the solid triangle dashed line is the subcutaneous injection of Exenatide 1mg/kg
  • the hollow triangle solid line is the small intestine administration of Test Example 1 composition + Exenatide (administration amount Exenatide 30 ⁇ g/kg)
  • the hollow round solid line is the small intestine administration of Test Example 1 composition + Exenatide (administration amount Exenatide 40 ⁇ g/kg)
  • hollow The solid square line is the small intestine administration of Test Example 1 composition + Exenatide (administration amount Exenatide 50 ⁇ g/kg)
  • the hollow solid line is the small intestine administration of Test Example 1 composition + Exenatide (administration amount Exenatide 60 ⁇ g/kg).
  • Figure 2 shows the iv PK test of Exenatide in rats
  • the abscissa is time (min), and the ordinate is the concentration of Exenatide in rat plasma (ng/ml).
  • Figure 3 shows the ei PK test of the Exenatide/Test Example 1 composition in rats
  • the abscissa is time (min), and the ordinate is the concentration of Exenatide in rat plasma (ng/ml).
  • Figure 4 shows the iv PK test of Exenatide on beagle dogs
  • the abscissa is time (min), and the ordinate is the Exenatide concentration (ng/ml) in beagle plasma.
  • Figure 5 shows the po PK test of Exenatide/Test Example 1 composition on beagle dogs
  • the abscissa is time (min), and the ordinate is the Exenatide concentration (ng/ml) in beagle plasma.
  • Figure 6 shows the PD test of Exenatide on Alloxan Beagle dogs
  • the abscissa is time (h), and the ordinate is beagle blood glucose (mM);
  • the solid round solid line is the postprandial blood glucose status of Alloxan beagle dogs
  • the solid square solid line is the postprandial blood glucose status of Alloxan beagle dogs swallowing Exenatide/Test Example 1 composition
  • the solid diamond-shaped solid line is normal beagle dogs. Serum conditions after meals.
  • the following experiments of the present invention are conclusive experiments by research and development personnel based on the technical solutions to be protected by the present invention on the basis of multiple creative experiments.
  • the quantitative tests in the following test examples are all set to three repeated experiments, and the data is the average value of the three repeated experiments or the average ⁇ standard deviation.
  • Test Example 1 Significantly improves the efficacy of Exenatide (Exendin4, EXE4) administered into the small intestine
  • composition for promoting intestinal absorption is: sodium lauryl sulfate, carbomer, chitosan, and sodium citrate, and the weight ratio is: 20:6.5:6.5:65.
  • Test animals SD male rats, intraperitoneally injected 45mg/kg STZ to construct a hyperglycemia model;
  • Small intestine efficacy test subcutaneous injection (sc) or administration through small intestine catheter (ei), blood samples were collected at 0h, 3h, 6h and 9h to detect blood glucose.
  • Test Example 2 Significantly improves the bioavailability of Exenatide administered in the small intestine
  • Test animals adult male SD rats;
  • Small intestine PK test On adult SD rats in fasting state, the dose of Exenatide is 200 ⁇ g/kg at a volume of 1ml/kg administered via a small intestine catheter, and a separate group is injected into the small intestine catheter (ei) of 200 ⁇ g/kg Exenatide or Exenatide added with the composition of the present invention, 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h after administration, blood was collected from the tail, the blood sample was anticoagulated with 10mM EDTA, centrifuged at 4°C 3000rpm for 5min, and the plasma was collected and snap frozen.
  • the small intestine catheter ei
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • Oral PK test Animals are in fasting state. After oral administration of enteric-coated capsules, blood samples are collected at 0.5, 1, 1.5, 2, 2.5, and 3 hours. The blood sample was anticoagulated with 10mM EDTA, centrifuged at 4°C, 3000rpm for 5min, and the plasma was collected and snap frozen.
  • Intravenous PK test Animals in fasting state, intravenous injection of 0.3 ⁇ g/kg Exenatide, blood samples were collected at 5, 15, 30, 60, 90, and 120 minutes. The blood sample was anticoagulated with 10mM EDTA, centrifuged at 4°C, 3000rpm for 5min, and the plasma was collected and snap frozen. See Figure 4 and Figure 5.
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • the PK data of beagle dogs showed that the AUC of intravenous injection of 0.3 ⁇ g/kg of Exenatide was about 0.82 ng/ml.hour, and the AUC of oral Exenatide/Test Example 1 composition 0.7 mg was about 1.36 ng/ml.hour.
  • the bioavailability of the Oral Exenatide/Test Example 1 composition is about 0.83%.
  • Exenatide cannot successfully enter the blood without the assistance of the composition of the present invention, but after adding the composition of the present invention, the blood entry efficiency is significantly improved. Although the blood efficiency of Exenatide increased slightly with the increase in the weight of the composition of Test Example 1, the increase was limited. Considering the convenience of oral administration and the effectiveness of drugs, the amount of No. 3 capsules is more appropriate.
  • Test Example 4 Exenatide/Test Example 1
  • the composition for promoting small intestinal absorption can significantly inhibit the increase in blood glucose after meals in Alloxan Beagle dogs
  • Animal physical examination and adaptation Collect fasting blood samples of animals to test blood biochemical indicators. After confirming that everything is normal, place the animals in a quieter room to adapt for 1 week. The daily feeding time and feeding amount are required to be consistent;
  • Blood samples are collected at 4 time points every day (before feeding, 2h, 4h, 6h after feeding) for 5 consecutive days;
  • Modeling test fasting state, intravenous injection of 60mg/kg Alloxan solution, one week later, blood samples are collected at 4 time points every day (before feeding, 2h, 4h, 6h after feeding) for 5 consecutive days; judge according to the collected data Whether the model is qualified. Start the efficacy test if qualified;
  • Efficacy test swallow the test capsule before feeding, and collect blood samples at 4 time points (before feeding, 2h, 4h, 6h after feeding).
  • Test Example 5 The composition for promoting small intestinal absorption of the present invention can significantly improve the bioavailability of Liraglutide administered into the small intestine
  • the weight ratio of the composition of the present invention is 20:6.5:6.5:65.
  • Test animals adult male SD rats;
  • Small intestine PK test On adult SD rats in fasting state, the dose of liraglutide is 200 ⁇ g/kg at a volume of 1ml/kg administered via a small intestinal catheter. Another group is injected into the small intestine catheter (ei) 200 ⁇ g /kg of liraglutide or liraglutide added with the composition of the present invention, 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h after administration, blood was collected from the tail, and the blood sample was anticoagulated by 10mM EDTA, 4 Centrifuge at 3000 rpm for 5 min, and collect plasma for quick freezing.
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • composition for promoting small intestinal absorption of the present invention can significantly improve the bioavailability of lixisenatide (Lixisenatide) administered into the small intestine
  • the weight ratio of the composition of the present invention is 20:6.5:6.5:65.
  • Test animals adult male SD rats;
  • Small intestine PK test In fasting adult SD rats, administer 1ml/kg via a small intestinal catheter to make the dose of risnatide 200 ⁇ g/kg, another group, small intestinal catheter injection (ei) 200 ⁇ g /kg of lixisenatide or lixisenatide added with the composition of the present invention, after administration 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h, blood was collected from the tail, and the blood sample was anticoagulated by 10mM EDTA, 4 Centrifuge at 3000 rpm for 5 min, and collect plasma for quick freezing.
  • small intestinal catheter injection ei
  • lixisenatide or lixisenatide added with the composition of the present invention after administration 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h, blood was collected from the tail, and the blood sample was anticoagulated by 10mM EDTA, 4 Centrifuge at 3000 rpm for 5 min, and collect plasma for quick freezing.
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • Test Example 7 The composition for promoting small intestinal absorption of the present invention can significantly improve the bioavailability of benaglutide administered into the small intestine
  • the weight ratio of the composition of the present invention is 20:6.5:6.5:65.
  • Test animals adult male SD rats;
  • Small intestine PK test On adult SD rats in fasting state, the dose of 1ml/kg was administered through a small intestinal catheter to make the dose of benaglutide 200 ⁇ g/kg, and another group was injected into the small intestine catheter (ei) 200 ⁇ g /kg benaglutide or benaglutide added with the composition of the present invention, after administration 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h, blood was collected from the tail, and the blood sample was anticoagulated by 10mM EDTA, 4 Centrifuge at 3000 rpm for 5 min, and collect plasma for quick freezing.
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • Test Example 8 The composition for promoting small intestinal absorption of the present invention can significantly improve the bioavailability of somaglutide into the small intestine
  • the weight ratio of the composition of the present invention is 20:6.5:6.5:65.
  • Test animals adult male SD rats;
  • Small intestine PK test On adult SD rats in fasting state, 1ml/kg was administered through a small intestinal catheter at a dose of 1ml/kg, so that the dose of somaglutide was 200 ⁇ g/kg, and another group was injected into the small intestine catheter (ei) 200 ⁇ g /kg of semaglutide or semaglutide added with the composition of the present invention, 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h after administration, blood was collected from the tail, and the blood sample was anticoagulated by 10mM EDTA, 4 Centrifuge at 3000 rpm for 5 min, and collect plasma for quick freezing.
  • ELISA detection method Coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and incubated with a blood sample or standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.
  • Test Example 9 The composition of the present invention can significantly improve the bioavailability of Pramlintide administered into the small intestine
  • the weight ratio of the composition of the present invention is 20:6.5:6.5:65.
  • Test animals adult male SD rats;
  • Small intestine PK test On adult SD rats in fasting state, the dose of pramlintide is 200 ⁇ g/kg and the dose of pramlintide is 200 ⁇ g/kg in adult SD rats in a fasting state.
  • the pramlintide of the pharmaceutical composition of the invention is 200 ⁇ g/kg, 0h, 0.5h, 1h, 1.5h, 2h, 2.5h and 3h after administration, blood is collected from the tail, the blood sample is anticoagulated by 10mM EDTA, centrifuged at 4°C, 3000rpm for 5min, and collected Plasma is quick frozen.
  • Intravenous PK test In the fasting state of animals, 1 ⁇ g/kg pramlintide was intravenously injected, and blood samples were collected at 5, 15, 30, 60, 90, and 120 minutes. The blood sample was anticoagulated with 10mM EDTA, centrifuged at 4°C, 3000rpm for 5min, and the plasma was collected and snap frozen.
  • the ELISA detection method is coated with a mouse monoclonal antibody against the target polypeptide, blocked with 1% BSA, and then incubated with a blood sample or a standard diluted with 0.1% BSA, captured by Biotin-labeled rabbit polyclonal antibody against the target polypeptide, HRP conjugated Incubate with strepavidin, and finally develop color with TMB, stop with HCl, and read at 450nm. According to the standard curve obtained from the standard, the concentration of the target polypeptide in the plasma is calculated.

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Abstract

一种具有降血糖作用的药物组合物，所述药物组合物含有：GLP-1受体激动剂、促小肠吸收组合物，其中所述促小肠吸收组合物包括：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。所述的促进小肠吸收组合物能够制备成一种复合辅料，该辅料与GLP-1受体激动剂组合后，可以提高该有效成分在小肠内的吸收。

Description

一种具有降血糖作用的药物组合物 技术领域
本发明属于生物医药技术领域，具体涉及一种具有降血糖作用的药物组合物。
背景技术
随着我国经济的高速增长和人们生活质量的提高，糖尿病的发病率也与日俱增。根据世界卫生组织非传染性疾病全球状况报告，2型糖尿病现成为继心血管疾病和肿瘤之后第3位威胁人类健康和生命的非传染性疾病。糖尿病作为独立危险因素大幅度增加心血管疾病的发病率和死亡率。对2型糖尿病患者心血管并发症的防治，可显著降低不良心血管事件的发生风险，改善近远期预后。糖尿病心血管病变的发病机制较为复杂，高血糖可引起内环境的紊乱，导致机体处于高胰岛素状态，激活神经内分泌应激系统，继而出现一系列心血管疾病，如：高血压、冠心病、卒中、心力衰竭、慢性肾脏病等。
胰高血糖素样肽-1(GLP-1)是结肠和小肠远端的L细胞分泌的胃肠激素，可刺激胰腺分泌胰岛素而发挥其降糖的主要作用。GLP-1受体激动剂是GLP-1的同源性(97％)近似物，较GLP-1作用更显著，不会被体内二肽酰肽酶-4(DDP-4)快速降解，通过与GLP-1受体结合，增加额外的GLP-1水平，取代GLP-1产生生理需要的药物浓度。多项研究表明，GLP-1受体激动剂具有减轻体重、恢复胰岛β细胞功能和较少发生低血糖等优势，故越来越多地被临床应用，例如：艾塞那肽、利拉鲁肽等。最新海内外研究发现，GLP-1受体激动剂除了具有显著的降糖作用外，还可通过扩张血管、控制炎症、抑制单核细胞黏附、抑制平滑肌细胞增生等发挥抗动脉粥样硬化作用，从而改善2型糖尿病患者心血管并发症的发生、发展。2型糖尿病患者是心血管疾病的高危患病人群，心血管并发症的防治是糖尿病治疗过程中的重要环节，防治心血管并发症可显著改善2型糖尿病患者的近远期预后。GLP-1受体激动剂以其特有的、高效的、安全的作用机制，通过降血糖、降血压、降血脂、控制体重、改善血管内皮功能、保护心肌及改善心脏舒缩功能等，对2型糖尿病患者发挥心血管保护作用。目前，许多更大规模的关于GLP-1受体激动剂治疗糖尿病心血管并发症疗效及安全性的临床试验正在被开展，相信在不远的将来，GLP-1受体激动剂将成为对抗糖尿病心血管并发症的重要治疗策略。
已上市的GLP-1激动剂均为多肽注射剂，对于糖尿病患者来说注射剂具有使用不便、疼痛等缺陷，因此，改变GLP-1激动剂给药途径具有重要意义。
发明内容
基于上述原因，申请人经过多次创造性研究，得到一种新的促进小肠吸收组合物，该组合物是由十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠组成，研究表明，本发明所述的促进小肠吸收组合物可以制备成一种复合辅料，该辅料与GLP-1激动剂组合后，可以提高该有效成分在小肠内的吸收等作用。
本发明是通过下述技术方案实现的。
一种具有降血糖作用的药物组合物，所述药物组合物含有：GLP-1受体激动剂、促小肠吸收组合物；其中所述促小肠吸收组合物包括：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。
优选地，该药物组合物制备成口服制剂。
其中所述GLP-1受体激动剂包括：埃塞那肽、利拉鲁肽、利司那肽、索玛鲁肽、贝那鲁肽、普兰林肽等。
该促小肠吸收组合物用于保障GLP-1受体激动剂在小肠吸收。
该促小肠吸收组合物用于促进GLP-1受体激动剂在小肠内吸收。
其中所述十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠的重量比为：15-25:5-8:5-8:50-80。
其中GLP-1受体激动剂与促小肠吸收组合物的重量比为：1:5-860。
一种具有降血糖作用的口服制剂，该口服制剂是包括：GLP-1受体激动剂、十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。
其中所述十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠的重量比为：15-25:5-8:5-8:50-80。
其中所述GLP-1受体激动剂与促小肠吸收组合物的重量比为：1:5-860。
一种具有降血糖作用的药物组合物，所述药物组合物由含有：GLP-1受体激动剂、促小肠吸收组合物的原料制备而成，其中所述促小肠吸收组合物包括：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。
本发明的促小肠吸收组合物，是获得的一种新型辅料，该辅料可以用于：不能口服只能注射的药物(有效成分或活性成分)可以通过口服给药，从而改变药物(有效成分或活性成分)的给药方式。
本发明的促小肠吸收组合物能够促进在胃肠道内易于分解的药物(有效成分或活性成分)在肠内的吸收。
本发明的促小肠吸收组合物能够促进在胃肠道不易于吸收的药物(有效成分或活性成分)在肠内的吸收。
由于本发明促小肠吸收组合物是促进药物(有效成分或活性成分)在小肠吸收，要求在小肠内释放才能发挥其功效，因此在进行药效试验和药代试验时，啮齿类动物采用小肠导管给药，哺乳动物采用肠溶胶囊口服给药。
本发明将促小肠吸收组合物和药物(有效成分或活性成分)逐一搭配在啮齿类动物上进行生物利用度检测，同时会选择部分多肽在不同动物上进行药效和药代动力学的检测。
附图说明
图1为Exenatide在STZ大鼠上的PD试验；
其中：横坐标为时间(h)，纵坐标为降低血糖效率(％)；
其中：实心圆形实线为小肠注射生理盐水2ml/kg，实心方形虚线为皮下注射Exenatide 1μg/kg，实心圆形虚线为皮下注射Exenatide 250μg/kg，实心三角形虚线为皮下注射Exenatide 1mg/kg，空心三角形实线为小肠给予试验例1组合物+Exenatide(给药量Exenatide 30μg/kg)，空心圆形实线为小肠给予试验例1组合物+Exenatide(给药量Exenatide 40μg/kg)，空心方形实线为小肠给予试验例1组合物+Exenatide(给药量Exenatide 50μg/kg)，空心菱形实线为小肠给予试验例1组合物+Exenatide(给药量Exenatide 60μg/kg)。
图2为Exenatide在大鼠上的iv PK试验；
其中：横坐标为时间(min)，纵坐标为大鼠血浆中Exenatide浓度(ng/ml)。
图3为Exenatide/试验例1组合物在大鼠上的ei PK试验；
其中：横坐标为时间(min)，纵坐标为大鼠血浆中Exenatide浓度(ng/ml)。
图4为Exenatide在比格犬上的iv PK试验；
其中：横坐标为时间(min)，纵坐标为比格犬血浆中Exenatide浓度(ng/ml)。
图5为Exenatide/试验例1组合物在比格犬上的po PK试验；
其中：横坐标为时间(min)，纵坐标为比格犬血浆中Exenatide浓度(ng/ml)。
图6为Exenatide在Alloxan比格犬上的PD试验；
其中：横坐标为时间(h)，纵坐标为比格犬血糖(mM)；
其中：实心圆形实线为Alloxan比格犬餐后血糖情况，实心方形实线为Alloxan比格犬吞服Exenatide/试验例1组合物后餐后血糖情况，实心菱形实线为正常比格犬餐后血清情况。
具体实施方式
以下以具体试验例来说明本发明的技术方案，但本发明的保护范围不限于此。
本说明书试验例所述的内容仅仅是对发明构思的实现形式的列举，本发明的保护范围不应当被视为仅限于试验例所陈述的具体形式，本发明的保护范围也及于本领域技术人员根据本发明构思所能够想到的等同技术手段。尽管以下 本发明的实施方案进行了描述，但本发明并不局限于上述的具体实施方案和应用领域，下述的具体实施方案仅仅是示意性的、指导性的，而不是限制性的。
本发明下述试验，是在多次创造性试验的基础上，以本发明所要保护的技术方案为基础，总结的研发人员的结论性试验。以下试验例中的定量试验，均设置三次重复实验，数据为三次重复实验的平均值或平均值±标准差。
试验例1显著提高小肠给入Exenatide(Exendin4，EXE4)的药效
促小肠吸收组合物为：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠，重量比为：20:6.5:6.5:65。
将Exenatide与上述组合物按照重量比1:5充分混匀，待用；
试验动物：SD雄性大鼠，腹腔注射45mg/kg STZ构建高血糖模型；
小肠药效试验：皮下注射(sc)或经小肠导管(ei)给药，于0h，3h，6h和9h采集血样检测血糖情况。
结果显示，小肠给入的Exenatide在没有添加上述组合物的情况下，其降糖效果很微弱，剂量达到1mg/kg时，其9h后的降糖效率也只有70％左右，远低于其皮下1μg/kg的剂量所能达到的50％左右。而添加本发明组合物后，给药剂量50μg/kg即可达到皮下1μg/kg的降糖效果。见附图1。
试验例2显著提高小肠给入Exenatide的生物利用度
将Exenatide与试验例1促小肠吸收组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使Exenatide剂量为200μg/kg，另分一组，小肠导管注射(ei)200μg/kg的Exenatide或添加本发明组合物的Exenatide，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃3000rpm离心5min，收集血浆速冻。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，Exenatide经iv注射1μg/kg后的PK曲线的AUC为0.93ng/ml.h，经小肠注射200μg/kg，血内浓度已低于ELISA检测下限。而添加试验例1组 合物后，PK曲线的AUC可以达到1.47ng/ml.h，小肠给入的生物利用度约为0.79％。试验结果见图2和图3。
试验例3显著提高口服Exenatide的生物利用度
将Exenatide 0.7mg与试验例1促小肠吸收组合物200mg充分混匀，并冻干，装入3号肠溶胶囊，备用；
将Exenatide 0.7mg与试验例1促小肠吸收组合物400mg充分混匀，并冻干，装入0号肠溶胶囊，备用；
将Exenatide 0.7mg与试验例1促小肠吸收组合物600mg充分混匀，并冻干，装入00号肠溶胶囊，备用；
将Exenatide 0.7mg与试验例1促小肠吸收组合物200mg充分混匀，并冻干，装入3号普通胶囊，备用；
将Exenatide 0.7mg与甘露醇200mg充分混匀，并冻干，装入3号肠溶胶囊，备用；
试验动物：成年雄性比格犬；
口服PK试验：动物空腹状态，口服肠溶胶囊后，于0.5,1,1.5,2,2.5,3h采集血样。血样经10mM EDTA抗凝，4℃、3000rpm离心5min，收集血浆速冻。
静脉PK试验：动物空腹状态，静脉注射0.3μg/kg Exenatide，于5，15，30，60，90，120min采集血样。血样经10mM EDTA抗凝，4℃、3000rpm离心5min，收集血浆速冻。见图4和图5。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
比格犬的PK数据显示，静脉注射0.3μg/kg的Exenatide的AUC约为0.82ng/ml.hour，口服Exenatide/试验例1组合物0.7mg的AUC约为1.36ng/ml.hour。口服Exenatide/试验例1组合物的生物利用度约为0.83％。
Exenatide在没有本发明组合物的协助下，无法成功进入血液内，而加入本发明组合物后，入血效率得到显著改善。虽然Exenatide的入血效率随着试验例1组合物重量的增加而略有增加，但增加的幅度有限。综合口服的便利性和药物有效性两方面的考虑，3号胶囊量比较合适。
表1 Exenatide/试验例1促小肠吸收药物组合物在比格犬上的po PD试验
Figure PCTCN2020088645-appb-000001
试验例4 Exenatide/试验例1促小肠吸收组合物可以明显抑制Alloxan比格犬餐后血糖的升高
将Exenatide 0.7mg与试验例1促小肠吸收组合物200mg充分混匀，并冻干，装入3号肠溶胶囊，备用；
试验动物：成年雄性比格犬；
动物体检与适应：采集动物空腹血样检测血生化指标，确定一切正常后，将动物放在较安静的房间适应1周，要求每天喂食时间和喂食量保持一致；
造模前数据采集：每天采集4个时间点血样(喂食前、喂食后2h、4h、6h)，连续采集5天；
造模试验：空腹状态，静脉推注60mg/kg Alloxan溶液，一周后，每天采集4个时间点血样(喂食前、喂食后2h、4h、6h)，连续采集5天；根据采集的数据，判断模型是否合格。若合格开始药效试验；
药效试验：喂食前吞服测试胶囊，采集4个时间点血样(喂食前、喂食后2h、4h、6h)。
结果显示，Exenatide/试验例1促小肠吸收组合物在Alloxan造模的比格犬上可以明显抑制餐后血糖的上升。见图6。
试验结论：通过上述试验表明，本发明促小肠吸收组合物具有很好的促进不能口服的有效成分在肠内的吸收，可以作为新型药用辅料使用。
试验例5本发明促小肠吸收组合物可以显著提高小肠给入利拉鲁肽(Liraglutide)的生物利用度
本发明组合物：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠重量比为：20:6.5:6.5:65。
将利拉鲁肽与本发明促小肠吸收组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使利拉鲁肽剂量为200μg/kg，另分一组，小肠导管注射(ei)200μg/kg的利拉鲁肽或添加本发明组合物的利拉鲁肽，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃3000rpm离心5min，收集血浆速冻。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，利拉鲁肽经小肠注射200μg/kg，血内浓度已低于ELISA检测下限。而添加本发明组合物后，小肠给入的生物利用度约为0.57％。
试验例6本发明促小肠吸收组合物可以显著提高小肠给入利司那肽(Lixisenatide)的生物利用度
本发明组合物：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠重量比为：20:6.5:6.5:65。
将利司那肽与本发明促小肠吸收组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使利司那肽剂量为200μg/kg，另分一组，小肠导管注射(ei)200μg/kg的利司那肽或添加本发明组合物的利司那肽，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃3000rpm离心5min，收集血浆速冻。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，利司那肽经小肠注射200μg/kg，血内浓度已低于ELISA检测下限。而添加本发明组合物后，小肠给入的生物利用度约为0.44％。
试验例7本发明促小肠吸收组合物可以显著提高小肠给入贝那鲁肽的生物利用度
本发明组合物：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠重量比为：20:6.5:6.5:65。
将贝那鲁肽与本发明促小肠吸收组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使贝那鲁肽剂量为200μg/kg，另分一组，小肠导管注射(ei)200μg/kg的贝那鲁肽或添加本发明组合物的贝那鲁肽，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃3000rpm离心5min，收集血浆速冻。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，贝那鲁肽经小肠注射200μg/kg，血内浓度已低于ELISA检测下限。而添加本发明组合物后，小肠给入的生物利用度约为0.70％。
试验例8本发明促小肠吸收组合物可以显著提高小肠给入索玛鲁肽的生物利用度
本发明组合物：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠重量比为：20:6.5:6.5:65。
将索玛鲁肽与本发明促小肠吸收组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使索玛鲁肽剂量为200μg/kg，另分一组，小肠导管注射(ei)200μg/kg的索玛鲁肽或添加本发明组合物的索玛鲁肽，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃3000rpm离心5min，收集血浆速冻。
为避免动物出现低血糖，在给药前，先给入1g/kg的葡萄糖。
ELISA检测方法：用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，索玛鲁肽经小肠注射200μg/kg，血内浓度已低于ELISA检测下限。而添加本发明组合物后，小肠给入的生物利用度约为0.32％。
试验例9本发明组合物可以显著提高小肠给入普兰林肽(Pramlintide)的生物利用度
本发明组合物：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠重量比为：20:6.5:6.5:65。
将普兰林肽与本发明组合物按照重量比1:5充分混匀，待用；
试验动物：成年雄性SD大鼠；
小肠PK试验：在空腹状态的成年SD大鼠上，按1ml/kg给药体积经小肠导管给药，使普兰林肽剂量为200μg/kg，另分一组，小肠导管注射(ei)添加本发明药物组合物的普兰林肽200μg/kg，给药后0h，0.5h，1h，1.5h，2h，2.5h和3h，尾部采血，血样经10mM EDTA抗凝，4℃、3000rpm离心5min，收集血浆速冻。
静脉PK试验：动物空腹状态，静脉注射1μg/kg普兰林肽，于5，15，30，60，90，120min采集血样。血样经10mM EDTA抗凝，4℃、3000rpm离心5min，收集血浆速冻。
ELISA检测方法为用抗目标多肽的小鼠单抗包被，1％BSA封闭，再加入血样或0.1％BSA稀释的标准品孵育，Biotin标记的抗目标多肽的兔多抗捕获，HRP偶联的strepavidin孵育，最后TMB显色，HCl终止，450nm读数。根据标准品得到的标准曲线，计算血浆内目标多肽的浓度。
根据PK曲线计算AUC，以静脉注射(iv)的生物利用度为100％，计算小肠给药的生物利用度。
结果显示，普兰林肽经小肠给药200μg/kg，血内浓度低于ELISA检测下限。而添加本发明组合物后，小肠给入的生物利用度可以达到1.77％。
本领域的普通技术人员在本说明书的启示下和在不脱离本发明权利要求所保护的范围的情况下，还可以做出很多种的形式，这些均属于本发明保护之列。

Claims (10)

  1. 一种具有降血糖作用的药物组合物，所述药物组合物含有：GLP-1受体激动剂、促小肠吸收组合物；其中所述促小肠吸收组合物包括：十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。
  2. 根据权利要求1所述的具有降血糖作用的药物组合物，其特征在于，所述药物组合物制备成口服制剂。
  3. 根据权利要求1所述的具有降血糖作用的药物组合物，其中所述GLP-1受体激动剂包括：埃塞那肽、利拉鲁肽、利司那肽、杜拉鲁肽、贝那鲁肽、阿必鲁肽。
  4. 根据权利要求1-3任一项所述的具有降血糖作用的药物组合物，该促小肠吸收组合物用于保障GLP-1受体激动剂在小肠吸收。
  5. 根据权利要求1-3任一项所述的具有降血糖作用的药物组合物，该促小肠吸收组合物用于促进GLP-1受体激动剂在小肠内吸收。
  6. 根据权利要求1-3任一项所述的具有降血糖作用的药物组合物，其中所述十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠的重量比为：15-25:5-8:5-8:50-80。
  7. 根据权利要求1-3任一项所述的具有降血糖作用的药物组合物，其中所述GLP-1受体激动剂与促小肠吸收组合物的重量比为：1:5-860。
  8. 一种具有降血糖作用的口服制剂，其特征在于：该口服制剂包括：GLP-1受体激动剂、十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠。
  9. 根据权利要求8所述的具有降血糖作用的口服制剂，其中十二烷基硫酸钠、卡波姆、壳聚糖、枸橼酸钠的重量比为：15-25:5-8:5-8:50-80。
  10. 根据权利要求8所述的具有降血糖作用的口服制剂，其中GLP-1受体激动剂与促小肠吸收组合物的重量比为：1:5-860。
PCT/CN2020/088645 2019-06-10 2020-05-06 一种具有降血糖作用的药物组合物 WO2020248741A1 (zh)

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