WO2022045335A1 - 神経変性疾患の症状の緩和又は治療のための貼付剤 - Google Patents
神経変性疾患の症状の緩和又は治療のための貼付剤 Download PDFInfo
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- WO2022045335A1 WO2022045335A1 PCT/JP2021/031712 JP2021031712W WO2022045335A1 WO 2022045335 A1 WO2022045335 A1 WO 2022045335A1 JP 2021031712 W JP2021031712 W JP 2021031712W WO 2022045335 A1 WO2022045335 A1 WO 2022045335A1
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- scopolamine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/46—8-Azabicyclo [3.2.1] octane; Derivatives thereof, e.g. atropine, cocaine
-
- 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
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
- A61K9/7023—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms
- A61K9/703—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms characterised by shape or structure; Details concerning release liner or backing; Refillable patches; User-activated patches
- A61K9/7038—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer
- A61K9/7046—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds
- A61K9/7053—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds obtained by reactions only involving carbon to carbon unsaturated bonds, e.g. polyvinyl, polyisobutylene, polystyrene
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
- A61K9/7023—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms
- A61K9/703—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms characterised by shape or structure; Details concerning release liner or backing; Refillable patches; User-activated patches
- A61K9/7038—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer
- A61K9/7046—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds
- A61K9/7053—Transdermal patches of the drug-in-adhesive type, i.e. comprising drug in the skin-adhesive layer the adhesive comprising macromolecular compounds obtained by reactions only involving carbon to carbon unsaturated bonds, e.g. polyvinyl, polyisobutylene, polystyrene
- A61K9/7061—Polyacrylates
Definitions
- the present invention relates to a patch for alleviating or treating the symptoms of neurodegenerative diseases, which contains a salt of scopolamine and / or a hydrate thereof as an active ingredient.
- Scopolamine is widely known as an anticholinergic drug, and is a drug that has effects such as suppressing oral and airway endocrine secretion and preventing harmful parasympathetic reflexes. So far, pharmaceutical products containing scopolamine as an active ingredient have been developed. For example, in Japan, scopolamine hydrobromide hydrate, which is a salt of scopolamine, is an injection containing scopolamine as an active ingredient. "Subcutaneous Injection, Kyorin Pharmaceutical Co., Ltd.” manufactures and sells "Transderm Scop (registered trademark), Novartis", which is a patch containing scopolamine free base as an active ingredient, overseas.
- Non-Patent Document 1 suggests that scopolamine ointment tends to reduce saliva secretion.
- Non-Patent Documents 2 to 7 describe that transdermal administration of scopolamine reduces the amount of saliva secretion.
- An object of the present invention is to provide a novel patch for alleviating or treating the symptoms of neurodegenerative diseases.
- a patch containing a salt of scopolamine and / or a hydrate thereof, polyvinylpyrrolidone and a base is transdermally applied at a predetermined dosage and administration.
- ⁇ 5> The patch according to any one of ⁇ 1> to ⁇ 4>, wherein the patch is applied to the back of the auricle, shoulders, upper arms, chest, abdomen, lower back, buttocks, or thigh.
- the salt of scopolamine and / or its hydrate is scopolamine hydrobromide and / or scopolamine hydrobromide hydrate, according to any one of ⁇ 1> to ⁇ 5>.
- Patch. ⁇ 7> The patch according to any one of ⁇ 1> to ⁇ 6>, which further contains polyvinylpyrrolidone and a base.
- ⁇ 8> The patch according to ⁇ 7>, wherein the base is at least one selected from an amine compound.
- the patch is a patch containing a support, a drug-containing pressure-sensitive adhesive layer and a release liner, and the drug-containing pressure-sensitive adhesive layer contains a salt of scopolamine and / or a hydrate thereof, polyvinylpyrrolidone and a base.
- ⁇ 11> The patch according to ⁇ 10>, wherein the content of the salt of scopolamine and / or its hydrate is 0.5 to 10% by mass with respect to the total mass of the pharmaceutical composition.
- ⁇ 12> The patch according to ⁇ 10> or ⁇ 11>, wherein the content of polyvinylpyrrolidone is 0.3 to 12% by mass with respect to the total mass of the pharmaceutical composition.
- ⁇ 13> The patch according to any one of ⁇ 10> to ⁇ 12>, wherein the content of the base is 0.3 to 10% by mass with respect to the total mass of the pharmaceutical composition.
- the base component of the drug-containing pressure-sensitive adhesive layer is at least one selected from an acrylic pressure-sensitive adhesive, a rubber-based pressure-sensitive adhesive, and a silicone-based pressure-sensitive adhesive, to any one of ⁇ 10> to ⁇ 13>.
- the acrylic pressure-sensitive adhesive is at least one selected from a hydroxyl group-containing type and a non-polar type.
- a patch containing a salt of scopolamine and / or a hydrate thereof as an active ingredient according to the present invention can effectively suppress the amount of saliva secretion, and neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS). It is useful for alleviating or treating the symptoms of the disease.
- ALS amyotrophic lateral sclerosis
- FIG. 1 shows changes in plasma scopolamine concentration (upper row: normal scale, lower row: logarithmic scale) when NPC-22 was administered once (pasted for 24 hours) to healthy adult males.
- FIG. 2 shows changes in plasma scopolamine concentration (upper row: normal scale, lower row: logarithmic scale) after a single subcutaneous administration of 0.25 mg of scopolamine hydrobromide hydrate injection to healthy adult males.
- FIG. 3 shows a dose proportional study (C max ) of pharmacokinetic parameters when a single dose of NPC-22 0.75 mg, 1.5 mg, 3 mg, 6 mg or 9 mg was administered (pasted for 24 hours).
- C max dose proportional study
- FIG. 4 shows a study of dose proportionality of pharmacokinetic parameters (AUC 0-24 ) when a single dose of NPC-22 0.75 mg, 1.5 mg, 3 mg, 6 mg or 9 mg was administered (pasted for 24 hours).
- FIG. 5 shows a study of dose proportionality of pharmacokinetic parameters (AUC inf ) when a single dose of NPC-22 0.75 mg, 1.5 mg, 3 mg, 6 mg or 9 mg was administered (pasted for 24 hours).
- FIG. 6 shows the cumulative urinary excretion rate (mean ⁇ standard deviation) of scopolamine after a single dose (24-hour application) of scopolamine 0.75 mg, 1.5 mg, 3 mg, 6 mg or 9 mg with NPC-22. ..
- FIG. 7 shows the cumulative urinary excretion rate (mean ⁇ standard deviation) of scopolamine after a single subcutaneous administration of 0.25 mg of scopolamine hydrobromide hydrate injection.
- FIG. 8 shows the relationship between the amount of change in plasma scopolamine concentration and the amount of saliva secretion and the rate of change.
- FIG. 9 shows the relationship between the plasma scopolamine concentration and the amount / rate of change in heart rate (12-lead ECG).
- FIG. 10 shows changes in plasma scopolamine concentration (mean ⁇ standard deviation) at each administration site when NPC-22 was administered once (applied for 24 hours) to healthy adult males.
- the patch of the present invention is a patch containing a salt of scopolamine and / or a hydrate thereof for alleviation or treatment of symptoms of neurodegenerative diseases, and the patch time per application is within 48 hours. There is a patch.
- Neurodegenerative diseases include muscular atrophic lateral sclerosis (ALS), anxiety-related diseases (social anxiety disorder, anxiety neuropathy, compulsive disorder, post-traumatic stress disorder (PTSD)), polyglutamine disease, and retinal pigment degeneration.
- ALS muscular atrophic lateral sclerosis
- anxiety-related diseases social anxiety disorder, anxiety neuropathy, compulsive disorder, post-traumatic stress disorder (PTSD)
- polyglutamine disease and retinal pigment degeneration.
- Neurosis cramps, panic disorder, sleep disorder, depression, reactive depression, epilepsy, Parkinson's disease, Parkinson's syndrome, Down's disease, schizophrenia, autonomic dysfunction, Huntington's disease, Alzheimer's disease, Levy body dementia , Frontotemporal dementia, emotional disorders (including depressive or bipolar disorders), migraine headaches, tension headaches, swarm headaches, dissecting disorders, optic neuromyelitis, optic neuritis, acute diffuse (disseminated) Cerebromyelitis, allergic encephalomyelitis, Marquifava-
- ALSFRS-R ALS function evaluation scale
- Symptoms of neurodegenerative diseases include increased saliva production. Relief or treatment of symptoms of neurodegenerative diseases includes reducing saliva production.
- the application time of the patch of the present invention per application is 48 hours or less, preferably 36 hours or less, more preferably 30 hours or less, and further preferably 24 hours or less.
- the one-time application time of the patch of the present invention is particularly preferably 24 hours.
- the patch of the present invention is continuously repeated two or more times within 48 hours (preferably within 36 hours, more preferably within 30 hours, still more preferably within 24 hours) at a time. Can be done.
- the lower limit of the number of times of pasting is not particularly limited, and may be two or more times, three times or more, four times or more, five times or more, six times or more, or seven times or more.
- the upper limit of the number of times of pasting is not particularly limited, and may be 100 times or less, 50 times or less, 40 times or less, 30 times or less, 20 times or less, and 10 times or less.
- the dose of scopolamine salt and / or its hydrate per day for adults is preferably 0.75 mg to 50 mg, more preferably 0.75 mg to 30 mg, and even more preferably 0.75 mg to 30 mg. It is 0.75 mg to 20 mg, and particularly preferably 0.75 mg to 9 mg. Specific examples of the daily dose of scopolamine salt and / or its hydrate are 0.75 mg, 1.5 mg, 3 mg, 6 mg, 9 mg or 18 mg.
- the application site of the patch of the present invention is not particularly limited, and examples thereof include the posterior auricle, shoulder, upper arm, chest, abdomen, lower back, hip, and thigh, and the posterior auricle and upper arm are preferable.
- the active ingredient used in the patch of the present invention is scopolamine ((-)-(S) -3-hydroxy-2-phenylpropionic acid (1R, 2R, 4S, 7S, 9S) -9-methyl-3-oxa.
- the scopolamine salt include acid addition salts with an inorganic acid or an organic acid, such as hydrochloride, hydrobromide, nitrate, phosphate, sulfate, acetate, ascorbate, and benzoate.
- Katsura syrup citrate, formate, fumarate, glutamate, lactate, maleate, malate, malonate, mandelate, methanesulfonate (mesylate), phthalate
- Examples thereof include, but are not limited to, salicylate, stearate, succinate, tartrate, propionate, butyrate, pamoate, and p-toluenesulfonate (tosylate).
- the patch of the present invention may contain a therapeutically effective amount of a scopolamine salt and / or a hydrate thereof, and the state thereof is not particularly limited, but is in a dissolved state or an amorphous state from the viewpoint of absorption into a living body. Is preferable. It is important to contain a certain amount of the active ingredient in order to allow the patient to administer a therapeutically effective amount of the active ingredient.
- the patch of the present invention is a patch containing a support, a drug-containing pressure-sensitive adhesive layer and a release liner, in which the drug-containing pressure-sensitive adhesive layer contains a salt of scopolamine and / or a hydrate thereof, polyvinylpyrrolidone and a base. It is preferable that it contains a pharmaceutical composition to be used.
- the content of the scopolamine salt and / or its hydrate in the above pharmaceutical composition is 0.5 to 10% by mass, preferably 1 to 8% by mass, and more preferably 3 to 6% by mass with respect to the entire composition. %. If it is less than 0.5% by mass, the therapeutic effect may not be sufficient, while if it is more than 10% by mass, it is economically disadvantageous.
- the above pharmaceutical composition contains polyvinylpyrrolidone to improve the chemical stability of scopolamine.
- polyvinylpyrrolidones have a weight average molecular weight of several thousand to several million. One or more of these polyvinylpyrrolidones can be used.
- the content of polyvinylpyrrolidone in the above-mentioned pharmaceutical composition is in the range of 0.3 to 12% by mass, preferably 0.5 to 10% by mass, and more preferably 1 to 8% by mass with respect to the entire composition. If it is less than 0.3% by mass, a sufficient effect of improving chemical stability may not be obtained, while if it exceeds 12% by mass, it may adversely affect the physical characteristics of the composition, which is not preferable. Further, if the weight ratio of polyvinylpyrrolidone to the salt and / or its hydrate of scopolamine is 2 or more, the uniformity of the composition may be adversely affected. Therefore, polyvinyl to the salt and / or its hydrate of scopolamine may be adversely affected.
- the weight ratio of pyrrolidone is preferably less than 2.
- the above-mentioned pharmaceutical composition preferably contains an amine compound in order to make a salt and / or a hydrate thereof of scopolamine a free base and to improve the chemical stability of scopolamine.
- the amine compound may be any of a primary amine, a secondary amine, and a tertiary amine, examples of the primary amine include methylamine, ethylamine, and dodecylamine, and examples of the secondary amine are dimethyl.
- Examples thereof include amines, diethylamines, N-methylethaneamines, and examples of the tertiary amines include N, N-diethylmethylamine, tributylamine, N, N-dimethyl-p-toluidine, N, N-diethyl-p-. Examples thereof include, but are not limited to, toluidine, methyl methacrylate, butyl methacrylate, dimethylaminoethyl methacrylate copolymer and the like. One or more of these amine compounds can be used.
- the content of the amine compound in the above-mentioned pharmaceutical composition is 0.3 to 10% by mass, preferably 0.5 to 8.5% by mass, and more preferably 0.9 to 7.5% by mass with respect to the entire composition. It is in the range of%. If it is less than 0.3% by mass, sufficient absorption into the living body may not be obtained, while if it is more than 10% by mass, the chemical stability may be adversely affected.
- Examples of the patch of the present invention include a matrix type and a reservoir type.
- the patch of the present invention may be either a matrix type or a reservoir type, but the matrix type is preferable because the formulation design is easy and the manufacturing cost can be reduced.
- the matrix type patch consists of a support, a drug-containing adhesive layer, and a release liner.
- the drug-containing pressure-sensitive adhesive layer contains a pharmaceutical composition containing an active ingredient and a base ingredient.
- the base component used for this drug-containing adhesive layer is not particularly limited, but a rubber-based adhesive component, an acrylic-based adhesive component, a silicone-based adhesive component, and other adhesive components generally used for patches are preferable.
- an acrylic adhesive component is preferable, and a non-polar type acrylic adhesive component and a hydroxyl group-containing type acrylic adhesive component are more preferable.
- the acrylic adhesive component is a polymer or copolymer containing at least one kind of (meth) acrylic acid ester.
- the non-polar type acrylic adhesive component has no functional group in the side chain in the monomer constituent unit, and is, for example, a (meth) alkyl acrylate polymer or a copolymer, an alkyl (meth) acrylate.
- a (meth) alkyl acrylate polymer or a copolymer examples thereof include vinyl acetate copolymers, and specific examples thereof include -2-ethylhexyl acrylate, -2-ethylhexyl methacrylate, dodecyl methacrylate copolymer, and -2-ethylhexyl acrylate / vinyl acetate.
- examples thereof include, but are not limited to, polymers, methyl methacrylate, butyl methacrylate, dimethylaminoethyl methacrylate copolymers and the like.
- the hydroxyl group-containing type acrylic adhesive component is a polymer or copolymer having at least one of (meth) acrylic acid esters containing a free hydroxyl group in the side chain in the monomer constituent unit as a constituent monomer, and is, for example, a polymer or copolymer.
- examples thereof include copolymers containing (meth) hydroxyalkyl ester of acrylic acid, and specific examples thereof include -2-ethylhexyl acrylate / hydroxylethyl acrylate / vinyl acetate copolymer and -2-ethylhexyl / vinylpyrrolidone acrylate.
- the content of the base component in the drug-containing pressure-sensitive adhesive layer is 60 to 98.9% by mass with respect to the entire drug-containing pressure-sensitive adhesive layer in consideration of the formation of the drug-containing pressure-sensitive adhesive layer and sufficient drug-releasing property. It is preferably 63 to 98% by mass, more preferably 66 to 96% by mass. If it is less than 60% by mass, the physical properties of the patch such as anchorage are deteriorated, and if it exceeds 98.9%, the active ingredient and other additives cannot be sufficiently blended, which is preferable. do not have.
- the drug-containing pressure-sensitive adhesive layer may contain an absorption-promoting agent, if necessary.
- the absorption-promoting agent may be any compound that has been conventionally recognized to have an absorption-promoting effect by transdermal administration. For example, lauric acid, oleic acid, isostearic acid, isopropyl myristate, octyldodecyl myristate, and glycerin oleic acid.
- Monoesters fatty acids such as hexyldecyl isostearate and their esters, alcohols such as oleyl alcohol, propylene glycol, polyethylene glycol monooleate and their esters or ethers, sorbitan sesquioleate, polyoxyethylene sorbitan monooleate, Solbitan esters or ethers such as sorbitan monolaurate and sorbitan monooleate, phenol ethers such as polyoxyethylene nonylphenyl ether and polyoxyethylene octylphenyl ether, castor oil or hardened castor oil, oleoyl sarcosine, laurin dimethylamino Ionic surfactants such as betaine acetate and sodium lauryl sulfate, nonionic surfactants such as polyoxyethylene oleyl ether and polyoxyethylene lauryl ether, and alkylmethylsulfoki such as dimethylsulfoxide and decylmethylsulfoxide.
- Examples thereof include azacycloalkanes such as side, 1-dodecyl azacycloheptane-2-one and 1-geranyl azacycloheptane-2-one, and pyrrolidones other than polyvinylpyrrolidone.
- the support used for the patch of the present invention is not particularly limited, but for example, a drug-impermeable, stretchable or non-stretchable support can be used.
- the support include synthetic resin films or sheets such as polyethylene, polypropylene, polybutadiene, ethylene vinyl acetate copolymer, polyvinyl chloride, polyester (polyethylene terephthalate, etc.), nylon, polyurethane, etc., or laminates thereof, porous bodies. , Foam, paper, woven fabric, non-woven fabric and the like.
- the release liner used for the patch of the present invention is not particularly limited, but for example, a drug-impermeable release liner can be used.
- the release liner include a film made of a polymer material such as polyethylene, polypropylene, and polyester, a film on which aluminum is vapor-deposited, and a paper coated with silicone oil or the like.
- a polyester film is preferable in terms of processability, low cost, etc. because the active ingredient does not permeate, and a polyethylene terephthalate (PET) film is particularly preferable.
- PET polyethylene terephthalate
- a laminated film or the like in which a plurality of materials are bonded may be used as the release liner.
- the patch of the present invention is stored in the packaging material until it is used.
- the packaging material is not particularly limited, but is limited to plastic film, metal (aluminum, etc.) laminated plastic film, metal vapor-deposited plastic film, ceramics (silicon oxide, etc.) vapor-deposited plastic film, metal foil such as aluminum foil, metal such as stainless steel, glass, etc. Can be mentioned. Above all, it is preferable to use a metal laminated plastic film, a metal-deposited plastic film, or the like in terms of manufacturing cost and the like.
- a release control film is added to the skin sticking side of the drug-containing pressure-sensitive adhesive layer to control the transdermal absorption of the active ingredient, and a pressure-sensitive adhesive layer is added to the patch to be attached to the skin. You may.
- the patch of the present invention preferably comprises a support, a drug-containing pressure-sensitive adhesive layer and a release liner, wherein the support is 1 to 1000 ⁇ m, preferably 10 to 700 ⁇ m, and the drug-containing pressure-sensitive adhesive layer is 10 to 200 ⁇ m.
- the thickness of the release liner is preferably 30 to 150 ⁇ m, and the thickness of the release liner is 1 to 500 ⁇ m, preferably 10 to 200 ⁇ m.
- the patch of the present invention can be manufactured according to a known method for manufacturing a patch.
- Preferred methods for producing the patch of the present invention include, for example, the following methods.
- a patch is prepared by spreading the solution dissolved in the solvent on a release liner or a support, evaporating the organic solvent in the solution to form a drug-containing pressure-sensitive adhesive layer, and then attaching the support or the release liner. To get.
- Example 1 According to the compounding ratios shown in Table 1, scopolamine hydrobromide hydrate, isopropyl myristate, and dodecylamine were dissolved in an ethyl acetate / methanol mixed solution, and an acrylic adhesive component (trade name: DURO-TAK 87-4287, Henkel) was dissolved. Manufactured) was added, and the mixture was mixed and stirred to obtain a uniform solution. Next, this solution was spread on a release film using a doctor knife coating machine so that the thickness after drying was 100 ⁇ m, dried to form a drug-containing pressure-sensitive adhesive layer, and then the support was applied. I pasted them together. Then, it was cut into a desired size to obtain a patch.
- an acrylic adhesive component trade name: DURO-TAK 87-4287, Henkel
- Example 2 A patch was obtained in the same manner as in Example 1 except that diethylamine was added instead of dodecylamine so that the amount of scopolamine free base was equal to that in Example 1 according to the compounding ratios shown in Table 1. ..
- Example 3 Methyl methacrylate, butyl methacrylate, dimethylaminoethyl methacrylate copolymer (trade name) instead of dodecylamine so that the amount of scopolamine free base is equal to that of Example 1 according to the compounding ratios shown in Table 1. : A patch was obtained in the same manner as in Example 1 except that Eudragit EPO (manufactured by Evonik) was blended.
- Example 4 Examples except that sodium hydroxide was added instead of dodecylamine and polyvinylpyrrolidone was added so that the amount of scopolamine free base was equal to that of Example 1 according to the compounding ratios shown in Table 1. A patch was obtained in the same manner as in 1.
- Example 5 Example 1 except that Eudragit EPO was added instead of dodecylamine and polyvinylpyrrolidone was added so that the amount of scopolamine free base was equal to that of Example 1 according to the compounding ratios shown in Table 1. A patch was obtained in the same manner as above.
- Example 6 According to the compounding ratios shown in Table 1, scopolamine hydrobromide hydrate, Eudragit EPO, and polyvinylpyrrolidone are dissolved in an ethyl acetate / methanol mixed solution, DURO-TAK 87-4287 is added, and the mixture is stirred and uniformly dissolved. Got Next, this solution was spread on a release film using a doctor knife coating machine so that the thickness after drying was 100 ⁇ m, dried to form a drug-containing pressure-sensitive adhesive layer, and then the support was applied. I pasted them together. Then, it was cut into a desired size to obtain a patch.
- Example 7 A patch was obtained in the same manner as in Example 6 except that the compounding amount of polyvinylpyrrolidone was increased according to the compounding ratio shown in Table 1.
- Example 8> According to the compounding ratios shown in Table 1, scopolamine hydrobromide hydrate, isopropyl myristate, eudragit EPO, and polyvinylpyrrolidone are dissolved in an ethyl acetate / methanol mixed solution, DURO-TAK 87-4287 is added, and the mixture is stirred and stirred. A uniform lysate was obtained. Next, this solution was spread on a release film using a doctor knife coating machine so that the thickness after drying was 100 ⁇ m, dried to form a drug-containing pressure-sensitive adhesive layer, and then the support was applied. I pasted them together. Then, it was cut into a desired size to obtain a patch.
- Example 9 According to the compounding ratios shown in Table 1, scopolamine hydrobromide hydrate, isopropyl myristate, eudragit EPO, and polyvinylpyrrolidone are dissolved in an ethyl acetate / methanol mixed solution, DURO-TAK 87-4287 is added, and the mixture is stirred and stirred. A uniform lysate was obtained. Next, this solution was spread on a release film using a doctor knife coating machine so that the thickness after drying was 50 ⁇ m, dried to form a drug-containing pressure-sensitive adhesive layer, and then the support was applied. I pasted them together. Then, it was cut into a desired size to obtain a patch.
- Example 10 A patch was obtained in the same manner as in Example 9 except that the blending amount of isopropyl myristate was increased according to the blending ratio shown in Table 1.
- Example 1 Plasma concentration measurement test (administration) in a single transdermal administration in rats A single transdermal administration (24-hour occlusion patch) of scopolamine patch (Example 5) to 5 male rats (Crl: CD (SD) strain: 6 weeks of age at the time of administration) (animal numbers 10101 to 10105) )did. Hair was removed with an electric razor before administration on the day of administration. After confirming the condition of the back, the test substance was attached to the back (on the right side of the median line). The application site was covered with a lint cloth (about 4.0 cm ⁇ 4.0 cm) and wrapped with an elastic adhesive bandage to close the application. The dose was 1 sheet / rat (content: 0.75 mg / sheet). The area per sheet is 2.5 cm 2 / sheet.
- Table 2 shows the measurement results of plasma scopolamine concentration. * Indicates that the sample was reanalyzed because the measured value exceeded the upper limit of quantification. In a, animal number 10101 was excluded from the calculation of mean and SD. As shown in Table 2, scopolamine was detected in plasma from 3 hours to 24 hours after administration. AUC 0-24h was 8569 pg ⁇ h / mL.
- Tables 3 and 4 show the observation results of the general condition (observation time point: before administration on the administration day and each blood sampling time point) and the body weight (g) before administration on the administration day, respectively. No abnormalities were found in the general condition.
- Example 2 (Administration) We investigated the saliva secretion inhibitory effect of the patch of the present invention on saliva secretion induced by intravenous administration of pilocarpine hydrochloride to rats.
- the test group consisted of a control group (no administration), a scopolamine placebo preparation (a patch containing no scopolamine), and a scopolamine patch (Example 5) (0.75 mg / 2.5 cm 2 as scopolamine hydrobromide hydrate).
- the 0.4, 1.2 and 3.6 mg / kg groups were used.
- the composition of the group is shown in Table 5 below.
- the hair on the back of the animal was removed with an electric clipper and an electric razor. Points were added to the administration site with an oil-based felt-tip pen. Scopolamine placebo or scopolamine was applied to the center of the hair removal site.
- a non-woven adhesive bandage (Meshpore (registered trademark), Nichiban Co., Ltd.), which is larger than the attached formulation, was attached so as to overlap the formulation.
- An adhesive cloth elastic bandage (Elastopore scopolamine, Nichiban Co., Ltd.) was wrapped to occlude the application site.
- the hair removal site was covered with a non-woven adhesive bandage (Meshpore (registered trademark), Nichiban Co., Ltd.) of the same size as when the hair was removed, and then an adhesive cloth elastic bandage (Elastopore (registered trademark)) was used. ), Nichiban Co., Ltd.) was rolled up and closed.
- Medetomidine hydrochloride 0.4 mg / kg (Domitol (registered trademark), Nippon Zenyaku Kogyo Co., Ltd.) + Midazolam 2 mg / kg (Midazolam Note 10 mg, Fuji Pharma Co., Ltd.) + Butorphanol tartrate 5 mg / kg (Betolfar (registered trademark), Meiji Seika Pharma Co., Ltd.)
- the mixed solution was intraperitoneally administered. To prevent asphyxiation due to saliva, an incision was made in the skin under anesthesia to expose the trachea and a cannula was inserted.
- Pilocarpine hydrochloride 1 mg / kg (2 mL / kg) is intravenously administered 4 hours (allowable range: within +10 minutes) after application to stabilize the plasma concentration of scopolamine, and the weight is measured in advance with an electronic analysis balance.
- Plasma balls using cotton balls in the range of 0.082 to 0.085 g
- saliva-moistened cotton balls were taken out and immediately weighed with an electronic analysis balance. The weight before insertion was subtracted to obtain the amount of saliva produced. Depending on the amount of saliva produced, it was replaced with a new cotton ball on the way.
- Scopolamine patch A patch containing 0.75 mg of scopolamine hydrobromide hydrate in one sheet (2.5 cm 2 ) (Example 10) (hereinafter, also referred to as NPC-22).
- Scopolamine placebo A pharmaceutical product that does not contain scopolamine (active ingredient) and is visually indistinguishable.
- Scopolamine group When scopolamine is administered: 0.75 mg group; scopolamine patch is applied one by one to the back of the auricle for 24 hours. 1.5 mg group; 2 sheets of scopolamine patch are applied to the back of the auricle for 24 hours. 3 mg group; 4 scopolamine patches at a time, applied to the back of the auricle for 24 hours. 6 mg group; 8 sheets of scopolamine patch are applied to the back of the auricle for 24 hours. 9 mg group; 12 scopolamine patches at a time, applied to the back of the auricle for 24 hours.
- Placebo is applied once to the posterior auricle for 24 hours, depending on the number of doses of each scopolamine patch.
- Scopolamine injection group A single subcutaneous injection of 0.25 mg of scopolamine injection is given. The subjects are the same as those in the 3 mg group.
- administering period It should be a single dose.
- the scopolamine patch is applied for 24 hours. Scopolamine injection is administered subcutaneously once.
- Scopolamine patch group Safety: Adverse events, skin findings (according to patch test research group criteria), vital signs, 12-lead ECG (including QT / QTc evaluation), laboratory test values, Pharmacodynamics: saliva volume, saliva secretion score (VAS by subject), heart rate (Holter ECG) Pharmacokinetics: Plasma concentration of scopolamine unchanged form, urinary excretion rate and pharmacokinetic parameters (Cmax, Tmax, AUC and half-life, etc.) Others: Amount of drug remaining in scopolamine patch
- Scopolamine injection group Safety: adverse events, vital signs, 12-lead ECG, laboratory test pharmacokinetics: plasma concentration of unchanged scopolamine, urinary excretion rate and pharmacokinetic parameters (Cmax, Tmax, AUC and half-life, etc.)
- Measurement time Before administration, after administration 2, 4, 8, 12, 24 (after measurement, drug removal), 26, 28, 32, 36, 48, and 72 hours. Also, as a baseline, the measurement is performed at the same time as the measurement time on the first day of administration on the day before administration. In the scopolamine injection group, saliva volume is not measured.
- Scopolamine patch group Immediately before administration, 0.5, 1, 2, 4, 6, 8, 10, 12, 24 (after blood collection, drug removal), 26, 28, 32, 36, 48, 72 hours and Do it on the 7th day.
- Scopolamine injection group Immediately before injection, 0.08 (5 minutes), 0.25 (15 minutes), 0.5 (30 minutes), 1, 2, 4, 6, 12, 24 hours after administration.
- Scopolamine patch group Before administration (as needed urine), 0-4, 4-8, 8-12, 12-24 (after urine collection, drug removal), 24-32, 32-48, 48-72 hours Store urine.
- Scopolamine injection group Collect urine before administration (as needed) and 0-4, 4-8, 8-12, 12-24 hours after administration.
- plasma scopolamine concentration was also observed on the 7th day (6th day after exfoliation).
- the plasma scopolamine concentration on the 7th day was above the lower limit of quantification (1.0 pg / mL) in all subjects, and the plasma concentrations were about 13% and about 11%, respectively, of the maximum concentration.
- the plasma scopolamine concentration in 2 of 6 subjects was below the lower limit of quantification at all measurement time points.
- the coefficient of variation (CV%) of plasma scopolamine concentration at the time of NPC-22 exfoliation (24 hours after administration) was 42.2% to 90.6%, and a large variation was observed among the subjects.
- the plasma scopolamine concentration rapidly increased, reaching a maximum concentration of 1337.5 pg / mL 15 minutes after administration. After that, it decreased monophasically, and the plasma scopolamine concentration was 1/500 or less of the maximum concentration 24 hours after the administration.
- Figure 6 shows changes in the cumulative urinary excretion rate of scopolamine (mean ⁇ standard deviation) when NPC-22 was administered once (pasted for 24 hours). Indicated. The urinary excretion rate of scopolamine after administration of NPC-22 was as low as 0.024% to 0.065% by 24 hours and 0.093% to 0.190% by 72 hours, regardless of the dose. No significant difference was observed in the urinary excretion rate. In addition, the transition of the urinary excretion rate after exfoliation of NPC-22 corresponded well to the transition of the plasma scopolamine concentration.
- FIG. 7 shows changes in the cumulative urinary excretion rate of scopolamine (mean ⁇ standard deviation) when 0.25 mg of scopolamine hydrobromide hydrate injection was administered subcutaneously once. Scopolamine hydrobromide hydrate injection 0.25 mg The urinary excretion rate of scopolamine up to 24 hours after subcutaneous administration was 5.767%, and up to 72 hours after NPC-22 administration (0.093% to 0.190). %) Showed a higher price.
- t max and t 1/2 were shorter.
- the C max of the scopolamine subcutaneous administration group was about 191 times that of the NPC-22 3 mg administration group, and the AUC inf was 2.15 times.
- C max was about 42 times and about 27 times, but AUC inf was 0.81 times and 0.57 times, and 0.25 mg subcutaneously was administered in comparison with the NPC-22 6 mg and 9 mg administration groups. The values were similar to those of the group.
- Adverse events and side effects Table 10 shows the adverse events and side effects that occurred in this study. Adverse events were observed in 4/30 patients (13.3%) in the NPC-22 group, 2/10 patients (20.0%) in the placebo group, and 5/8 patients (62.5%) in the scopolamine injection group. No serious adverse events or adverse events leading to study discontinuation were observed in any of the groups. Adverse events by dose of NPC-22 were 0.75 mg group 1/6 cases, 1.5 mg group 1/6 cases, 3 mg group 0/6 cases, 6 mg group 1/6 cases, and 9 mg group 1/6 cases. Of these, 1/6 of the 0.75 mg group was judged to have side effects. The side effects of the 0.75 mg group were mild leukocyte count, lymphocyte count decrease, and neutrophil count increase on the 7th day after administration (6th day after exfoliation), respectively, on the 11th day after administration. Disappeared.
- Plasma spocoramine concentrations C max , AUC 0-24 and AUC inf after a single dose of NPC-22 increased with increasing dose.
- the t max in the NPC-22 administration group was 23.1 to 36.8 hours after administration, and the t 1/2 was 42.0 to 54.8 hours.
- the AUC inf was about 6 to 16 times that of AUC 0-24 .
- linearity was observed in the drug concentration in the dose range of NPC-22 0.75 to 9 mg.
- the urinary excretion rate of scopolamine up to 72 hours after NPC-22 administration was 0.093% to 0.190%, and the urinary excretion was slight.
- the change in urinary excretion rate after NPC-22 exfoliation corresponded well to the change in plasma scopolamine concentration.
- the C max of the scopolamine subcutaneous administration group was 191 times, 42 times and 27 times, respectively, as compared with the NPC-22 3 mg, 6 mg and 9 mg administration groups.
- the AUC inf of the scopolamine subcutaneous administration group was 2.15 times, 0.81 times and 0.57 times, respectively, as compared with the NPC-22 3 mg, 6 mg and 9 mg administration groups.
- a weak negative correlation correlation coefficient: -0.248, -0.289
- Scopolamine patch A patch containing 0.75 mg of scopolamine hydrobromide hydrate in one sheet (2.5 cm 2 ) (Example 10) (hereinafter, also referred to as NPC-22).
- NPC-22 9 mg (NPC-22 12 sheets) is applied once for 24 hours to the posterior auricle, chest, upper arm or abdomen of the same subject by the 4-site 4-stage crossover method (open-label).
- the drug holiday (the period from drug peeling to the next drug application) shall be 14 days.
- administering period It should be a single dose. Paste for 24 hours.
- Plasma pharmacokinetics of scopolamine (1-1-1) Plasma concentration transition Each of the single doses of NPC-22 administered to healthy adult males (pasted for 24 hours). The transition of plasma scopolamine concentration (mean ⁇ standard deviation) at the administration site is shown in FIG. After administration of NPC-22 to the posterior auricle, plasma scopolamine concentration increased during the administration period, increased after NPC-22 exfoliation, continued for several hours, and then gradually decreased after approximately 28 hours (4 hours after exfoliation). did.
- Table 12 shows plasma scopolamine pharmacokinetic parameters (mean and standard deviation) at each administration site when NPC-22 was administered once (applied for 24 hours) to healthy adult males. rice field.
- Plasma scopolamine concentrations of Cmax and AUC 0-312 were 85.093 pg / mL and 4716.497 pg ⁇ hr / mL, respectively, at the time of posterior auricular administration, and 3.5749 pg / mL to 6.8708 pg / mL at other sites. It was 522.618 pg ⁇ hr / mL to 756.356 pg ⁇ hr / mL.
- Cmax and AUC 0-312 when NPC-22 was administered posteriorly to the auricle were much higher than when administered to the chest, upper arm or abdomen.
- t 1/2 was 38.774 hr in the posterior auricle, while 176.587 to 440.550 hr in the other regions, showing a large difference between the posterior auricle and other regions.
- Table 14 shows the skin findings based on the criteria of the Japanese patch test research group.
- Mild erythema was observed in each of them, but none of them was a major clinical problem.
- Plasma scopolamine concentration after a single administration of NPC-22 to each administration site remained high at the posterior auricle administration, but remained extremely low at the chest, upper arm and abdomen.
- Plasma scopolamine concentrations Cmax and AUC when administered to the posterior auricle were significantly higher than those when administered to the chest, upper arm and abdomen, and Cmax was 12.4 times, 16.4 times and 27.1 times, respectively.
- AUC 0-312 were 6.2 times, 7.7 times and 9.1 times, respectively.
- the average residual rate of NPC-22 recovered after administration of NPC-22 to the posterior auricle, chest, upper arm and abdomen (applied for 24 hours) was 66.8% to 68.5%, and the average estimated absorption rate was 31. It was 5.5% to 33.2%, and there was no significant difference between the administration sites. All of the adverse events that occurred with NPC-22 administration were mild, no tolerability problems were observed, and there was no significant difference between the administration sites. In addition, the skin findings were only mild erythema, which was not a major clinical problem, and there was no significant difference between the administration sites. In a single-dose study of NPC-22 in healthy adults conducted prior to this study, a tendency for saliva secretion to decrease as the plasma scopolamine concentration increased was observed.
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Abstract
Description
<2> 1回当たりの貼付時間が24時間以内である、<1>に記載の貼付剤。
<3> 1回当たり48時間以内の貼付を2回以上連続的に反復する、<1>に記載の貼付剤。
<4> 成人一日当たりのスコポラミンの塩及び/又はその水和物の投与量が、0.75mg~50mgである、<1>から<3>の何れか一に記載の貼付剤。
<5> 貼付剤を耳介後部、肩、上腕部、胸部、腹部、腰背部、臀部、又は大腿部に貼付する、<1>から<4>の何れか一に記載の貼付剤。
<6> 前記スコポラミンの塩及び/又はその水和物が、スコポラミン臭化水素酸塩及び/又はスコポラミン臭化水素酸塩水和物である、<1>から<5>の何れか一に記載の貼付剤。
<7> さらにポリビニルピロリドン及び塩基を含有する、<1>から<6>の何れか一に記載の貼付剤。
<8> 前記塩基が、アミン化合物より選ばれる少なくとも1種である、<7>に記載の貼付剤。
<9> 前記アミン化合物が、メタクリル酸メチル・メタクリル酸ブチル・メタクリル酸ジメチルアミノエチル共重合体である、<8>に記載の貼付剤。
<10> 貼付剤が、支持体、薬物含有粘着剤層及び剥離ライナーを含む貼付剤であって、前記薬物含有粘着剤層が、スコポラミンの塩及び/又はその水和物、ポリビニルピロリドン及び塩基を含有する医薬組成物を含む、<1>から<8>の何れか一に記載の貼付剤。
<11> スコポラミンの塩及び/又はその水和物の含有量が、前記医薬組成物全体の質量に対して0.5~10質量%である、<10>に記載の貼付剤。
<12> ポリビニルピロリドンの含有量が、前記医薬組成物全体の質量に対して0.3~12質量%である、<10>又は<11>に記載の貼付剤。
<13> 前記塩基の含有量が、前記医薬組成物全体の質量に対して0.3~10質量%である、<10>から<12>の何れか一に記載の貼付剤。
<14> 前記薬物含有粘着剤層の基剤成分が、アクリル系粘着剤、ゴム系粘着剤及びシリコーン系粘着剤より選ばれる少なくとも1種である、<10>から<13>の何れか一に記載の貼付剤。
<15> 前記薬物含有粘着剤層の基剤成分が、アクリル系粘着剤である、<10>から<14>の何れか一に記載の貼付剤。
<16> 前記アクリル系粘着剤が、ヒドロキシル基含有型及び無極性型より選ばれる少なくとも1種である、<15>に記載の貼付剤。
有効成分であるスコポラミンの塩及び/又はその水和物、アミン化合物、ポリビニルピロリドン、基剤成分、さらに必要に応じて吸収促進剤等を、例えば、酢酸エチル、メタノール等の有機溶媒又はそれらの混合溶媒に溶解させた溶解物を剥離ライナー又は支持体上に展延し、溶解物中の有機溶媒を蒸発させ薬物含有粘着剤層を形成した後、支持体又は剥離ライナーを貼り合わせることによって貼付剤を得る。
有効成分であるスコポラミンの塩及び/又はその水和物、アミン化合物、ポリビニルピロリドン、基剤成分、さらに必要に応じて吸収促進剤等を加熱溶解させ、この溶融物を剥離ライナー又は支持体上に展延し、薬物含有粘着剤層を形成した後、支持体又は剥離ライナーを貼り合わせることによって貼付剤を得る。
表1に記載の配合比に従って、スコポラミン臭化水素酸塩水和物、ミリスチン酸イソプロピル、ドデシルアミンを酢酸エチル/メタノール混液に溶解させ、アクリル系粘着成分(商品名:DURO-TAK 87-4287、ヘンケル製)を加えて混合撹拌し、均一な溶解物を得た。次にこの溶解物を、ドクターナイフ塗工機を用いて、乾燥後の厚さが100μmになるように剥離フィルムに展延し、乾燥して薬物含有粘着剤層を形成した後、支持体を貼り合わせた。それから、所望の大きさに裁断して貼付剤を得た。
表1に記載の配合比に従って、スコポラミン遊離塩基の量が実施例1と等量となるように、ドデシルアミンの代わりにジエチルアミンを配合したことを除き、実施例1と同様として貼付剤を得た。
表1に記載の配合比に従って、スコポラミン遊離塩基の量が実施例1と等量となるように、ドデシルアミンの代わりにメタクリル酸メチル・メタクリル酸ブチル・メタクリル酸ジメチルアミノエチル共重合体(商品名:オイドラギットEPO、エボニック製)を配合したことを除き、実施例1と同様として貼付剤を得た。
表1に記載の配合比に従って、スコポラミン遊離塩基の量が実施例1と等量となるように、ドデシルアミンの代わりに水酸化ナトリウムを配合し、さらにポリビニルピロリドンを配合したことを除き、実施例1と同様として貼付剤を得た。
表1に記載の配合比に従って、スコポラミン遊離塩基の量が実施例1と等量となるように、ドデシルアミンの代わりにオイドラギットEPOを配合し、さらにポリビニルピロリドンを配合したことを除き、実施例1と同様として貼付剤を得た。
表1に記載の配合比に従って、スコポラミン臭化水素酸塩水和物、オイドラギットEPO、ポリビニルピロリドンを酢酸エチル/メタノール混液に溶解させ、DURO-TAK 87-4287を加えて混合撹拌し、均一な溶解物を得た。次にこの溶解物を、ドクターナイフ塗工機を用いて、乾燥後の厚さが100μmになるように剥離フィルムに展延し、乾燥して薬物含有粘着剤層を形成した後、支持体を貼り合わせた。それから、所望の大きさに裁断して貼付剤を得た。
表1に記載の配合比に従って、ポリビニルピロリドンの配合量を増量したことを除き、実施例6と同様として貼付剤を得た。
表1に記載の配合比に従って、スコポラミン臭化水素酸塩水和物、ミリスチン酸イソプロピル、オイドラギットEPO、ポリビニルピロリドンを酢酸エチル/メタノール混液に溶解させ、DURO-TAK 87-4287を加えて混合撹拌し、均一な溶解物を得た。次にこの溶解物を、ドクターナイフ塗工機を用いて、乾燥後の厚さが100μmになるように剥離フィルムに展延し、乾燥して薬物含有粘着剤層を形成した後、支持体を貼り合わせた。それから、所望の大きさに裁断して貼付剤を得た。
表1に記載の配合比に従って、スコポラミン臭化水素酸塩水和物、ミリスチン酸イソプロピル、オイドラギットEPO、ポリビニルピロリドンを酢酸エチル/メタノール混液に溶解させ、DURO-TAK 87-4287を加えて混合撹拌し、均一な溶解物を得た。次にこの溶解物を、ドクターナイフ塗工機を用いて、乾燥後の厚さが50μmになるように剥離フィルムに展延し、乾燥して薬物含有粘着剤層を形成した後、支持体を貼り合わせた。それから、所望の大きさに裁断して貼付剤を得た。
表1に記載の配合比に従って、ミリスチン酸イソプロピルの配合量を増量したことを除き、実施例9と同様として貼付剤を得た。
(投与)
スコポラミン貼付剤(実施例5)を5匹の雄性ラット(Crl:CD(SD)系統:投与時週齢は6週齢)(動物番号10101~10105)に単回経皮投与(24時間閉塞貼付)した。投与日の投与前に電気カミソリで除毛した。背部の状態を確認した後、被験物質を背部(正中線より右側)に貼付した。貼付部位をリント布(約4.0cm ×4.0cm)で覆い、伸縮性粘着包帯を巻いて閉塞した。投与量は1枚/rat(含量:0.75mg/枚)とした。1枚当たりの面積は、2.5cm2/枚である。
投与日の投与前及び各採血時点に一般状態を観察した。投与日の投与前に体重を測定した。投与後3、6、12及び24時間の4時点で採血を行い、投与後3、6、12及び24時間の血漿中スコポラミン濃度を測定した。
血漿中スコポラミン濃度の測定結果を表2に示す。*は、測定値が定量の上限を超えたのでサンプルは再分析したことを示す。aにおいては、動物番号10101は平均値及びSDの計算から除外した。表2に示す通り、投与後3時間から24時間まで血漿中にスコポラミンが検出された。AUC0-24hは、8659 pg・h/mLであった。
(投与)
ラットにピロカルピン塩酸塩を静脈内投与して惹起される唾液分泌に対して、本発明の貼付剤による唾液分泌抑制作用を検討した。1群10匹の雄性Crl:CD(SD)ラットを使用した(投与時:6週齢).試験群は対照群(無投与)、スコポラミンプラセボ製剤(スコポラミンを含まない貼付剤)、スコポラミン貼付剤(実施例5)(スコポラミン臭化水素酸塩水和物として0.75mg/2.5cm2)の0.4、1.2及び3.6mg/kg群とした。群の構成を以下の表5に示す。
結果を以下の表6に示す。1)は ピロカルピン塩酸塩の投与後30分後の唾液分泌量。*:P<0.05、**:P<0.01 コントロール群からの有意差(Dunnett’s multiple comparison test)
対照群とスコポラミンプラセボ群の唾液分泌量に統計学的に有意な差は認められなかった。スコポラミンの0.4及び3.6mg/kg群の唾液分泌量は対照群と比較して有意な減少が認められた。スコポラミンの1.2mg/kg群の唾液分泌量は対照群と比較して有意な減少は認められなかったが、唾液分泌量の減少傾向があることから被験物質の血漿中濃度のばらつきによって統計学的に有意な唾液分泌量の減少に至らなかったと判断された。以上の結果から、スコポラミンは0.4mg/kg以上の投与によりピロカルピン誘発唾液分泌の抑制作用を示すことが実証された。
(試験薬)
スコポラミン貼付剤:1枚(2.5cm2)中にスコポラミン臭化水素酸塩水和物を0.75mg含有する貼付剤(実施例10)(以下において、NPC-22とも称する)
スコポラミンプラセボ:スコポラミン(有効成分)を含有しない実薬と外観上識別不能な製剤
スコポラミン注射剤:1管1mL中スコポラミン臭化水素酸塩水和物を0.5mg含有する注射剤(ハイスコ皮下注)
スコポラミン群
スコポラミン投与の場合:
0.75mg群;スコポラミン貼付剤を1回1枚、耳介後部に24時間貼付する。
1.5mg群 ;スコポラミン貼付剤を1回2枚、耳介後部に24時間貼付する。
3mg群 ;スコポラミン貼付剤を1回4枚、耳介後部に24時間貼付する。
6mg群 ;スコポラミン貼付剤を1回8枚、耳介後部に24時間貼付する。
9mg群 ;スコポラミン貼付剤を1回12枚、耳介後部に24時間貼付する。
プラセボをそれぞれのスコポラミン貼付剤投与用量の投与枚数に応じて1回、耳介後部に24時間貼付する。
スコポラミン注射剤を1回0.25mgを1回皮下注射する。なお、被験者は3mg群と同じ被験者とする。
単回投与とする。スコポラミン貼付剤は24時間貼付する。スコポラミン注射剤は1回皮下投与する。
スコポラミン貼付剤群:
安全性:有害事象、皮膚所見(パッチテスト研究班判定基準による)、バイタルサイン、12誘導心電図(QT/QTc評価を含む)、臨床検査値、
薬力学:唾液量、唾液分泌スコア(被験者によるVAS)、心拍数(ホルター心電図)
薬物動態:スコポラミン未変化体の血漿中濃度、尿中排泄率及び薬物動態パラメータ(Cmax、Tmax、AUC及び半減期など)
その他:スコポラミン貼付剤に残存する薬物量
安全性:有害事象、バイタルサイン、12誘導心電図、臨床検査値
薬物動態:スコポラミン未変化体の血漿中濃度、尿中排泄率及び薬物動態パラメータ(Cmax、Tmax、AUC及び半減期など)
測定1時間前より被験者の姿勢を臥位とし、安静、飲食物の摂取は禁止にする。測定10分前に座位にし、その後、唾液を採取するために、脱脂綿を左右の臼歯と頬の間および舌下の計3ヶ所に定着させ、唾液を吸収させる。唾液分泌量は唾液を吸収させた脱脂綿の重量を測定することで算出する。
スコポラミン未変化体を測定する。
採血時期:
スコポラミン貼付剤群:投与直前、投与後0.5、1、2、4、6、8、10、12、24(採血後、薬剤除去)、26、28、32、36、48、72時間及び7日目に行う。
スコポラミン注射群:注射直前、投与後0.08(5分)、0.25(15分)、0.5(30分)、1、2、4、6、12、24時間に行う。
スコポラミン未変化体を測定する
採尿時期:
スコポラミン貼付剤群:投与前(随時尿)、投与後0~4、4~8、8~12、12~24(採尿後、薬剤除去)、24~32、32~48、48~72時間に蓄尿を行う。
スコポラミン注射群:投与前(随時尿)、投与後0~4、4~8、8~12、12~24時間に蓄尿を行う。
(1)薬物動態学的解析
(1-1)スコポラミンの血漿中薬物動態
(1-1-1)血漿中濃度推移
健康成人男性にNPC-22を単回投与(24時間貼付)したときの血漿中スコポラミン濃度推移(平均値±標準偏差)を図1に示す。
健康成人男性にスコポラミン臭化水素酸塩水和物注0.25mgを単回皮下投与したときの血漿中スコポラミン濃度推移(平均値±標準偏差)を図2に示した。
NPC-22を投与後、血漿中スコポラミン濃度は投与期間中上昇し、NPC-22剥離後も上昇し数時間継続した後、おおむね28時間(剥離後4時間)以降に緩やかに低下した。血漿中スコポラミン濃度は投与量の増加に伴い高濃度で推移した。1.5 mg以上の投与群では、7日目(剥離後6日目)においても血漿中スコポラミン濃度が認められた。6及び9mg投与群ではすべての被験者で7日目の血漿中スコポラミン濃度は定量下限(1.0pg/mL)以上で、血漿中濃度はそれぞれ最高濃度の約13%及び約11%を示した。0.75mg投与群では、6名中2名の血漿中スコポラミン濃度は、すべての測定時点において定量下限未満であった。
NPC-22剥離時(投与後24時間)の血漿中スコポラミン濃度の変動係数(CV%)は42.2%~90.6%であり、被験者間に大きなバラツキが認められた。
スコポラミン臭化水素酸塩水和物注0.25mgを単回皮下投与後、血漿中スコポラミン濃度は速やかに上昇し、投与15分後には最高濃度1337.5pg/mLに達した。その後一相性に減少し、投与後24時間では血漿中スコポラミン濃度は最高濃度の1/500以下であった。
健康成人男性にNPC-22を単回投与(24時間貼付)したときの血漿中スコポラミン薬物動態パラメータ(平均及び標準偏差)を表7に示した。なお、すべての測定時点で定量下限未満であった0.75mg投与群の2例は解析から除外した。
NPC-22を単回投与(24時間貼付)後の血漿中スポコラミン濃度のCmax、AUC0-24及びAUCinfは投与量の増加に伴い上昇した。NPC-22剥離時の血漿中濃度(C24)はCmaxの約69.6%~88.6%であり、またAUCinfはAUC0-24の約6~16倍であった。tmaxは、投与後23.1~36.8時間であり、t1/2は42.0~54.8時間であった。
NPC-22 0.75mg、1.5mg、3mg、6mg又は9mgを単回投与(24時間貼付)したときの血漿中スコポラミン濃度の用量比例性を、回帰分析[パワーモデル:ln(Cmax or AUC)=ln(α)+β・ln(Dose) ]により検討した。なお、すべての測定時点で定量下限未満であった0.75mg投与群の2例は解析から除外した。結果を図3~図5に示した。
Cmax、AUC0-24及びAUCinfのβの点推定値(90%信頼区間)は、それぞれ1.247(0.962~1.532)、1.299(0.917~1.681)及び1.137(0.931~1.343)であった。NPC-22 0.75~9 mgの用量範囲で、薬物濃度に線形性が認められた。
NPC-22を単回投与(24時間貼付)したときのスコポラミンの累積尿中排泄率の推移(平均値±標準偏差)を図6に示した。
NPC-22投与後スコポラミンの尿中排泄率は、24時間までに0.024%~0.065%、72時間まででは0.093%~0.190%とわずかであり、いずれの投与量でも尿中排泄率に大きな差は認められなかった。また、NPC-22剥離後の尿中排泄率の推移は、血漿中スコポラミン濃度の推移によく対応していた。
スコポラミン臭化水素酸塩水和物注0.25mg皮下投与後24時間までのスコポラミンの尿中排泄率は5.767%であり、NPC-22投与後72時間まで(0.093%~0.190%)より高値を示した。
スコポラミン皮下投与群(全8名)とNPC-22の3 mg~9mg投与群の曝露量の比較を、薬物動態パラメータ(Cmax、tmax、AUC0-24、AUCinf及びt1/2)を用いて検討し、その結果を表8に示した。
スコポラミン皮下投与群では、血漿中スコポラミンのCmax、tmax、AUCinf及びt1/2はそれぞれ1388.7 pg/mL、0.396時間、1796.253 pg*hr/mL及び4.584時間であった。NPC-22の3mg~9mg投与群と比較するとtmax及びt1/2は短かった。
スコポラミン皮下投与群のCmaxは、NPC-22 3mg投与群と比較すると約191倍、AUCinfは2.15倍であった。また、NPC-22 6mg及び9mg投与群との比較では、Cmaxは約42倍及び約27倍であったが、AUCinfは0.81倍及び0.57倍であり、0.25mg皮下投与群と同様な値を示した。
(2-1)血漿中スコポラミン濃度と唾液分泌量の関係
NPC-22テープを投与したNPC-22群のすべて被験者における血漿中スコポラミン濃度の測定値と同一時点における唾液分泌量のベースラインからの変化量及び変化率について散布図で示し、回帰パラメータ、相関係数及び90%信頼区間の値を算出した結果を図8に示した。
血漿中スコポラミン濃度と唾液分泌量の変化量及び変化率に弱い負の相関(相関係数:-0.248、-0.289)があり、血漿中スコポラミン濃度が高くなるに従って唾液分泌量の減少傾向が認められた。
NPC-22テープを投与したNPC-22群のすべて被験者における血漿中スコポラミン濃度の測定値と心拍数(12誘導心電図)のベースラインからの変化量及び変化率について散布図で示し、回帰パラメータ、相関係数及び90%信頼区間の値を算出した(図9)。
血漿中スコポラミン濃度と心拍数の変化量及び変化率に弱い負の相関(相関係数:-0.229、-0.230)があり、血漿中スコポラミン濃度が高くなるに従って心拍数の減少傾向が認められた。
NPC-22投与後に回収した製剤に残存する薬物量の解析
NPC-22 0.75mg、1.5mg、3mg、6mg又は9mgを単回投与(24時間貼付)したときの投与後に回収した製剤のスコポラミン臭化水素酸塩水和物残存量及び残存率の要約統計量を表9に示した。
NPC-22(0.75mg/1枚)の平均残存率(最小値、最大値)は、71.3%(58.3%、79.8%)、変動係数(CV%)は6.88%であり、残存する薬物量に大きなバラツキは認められなかった。また、投与後の製剤に残存する薬物量から推定したスコポラミンの平均吸収率(SD)は28.7%(4.90)であった。
(1)有害事象及び副作用
本試験で発現した有害事象及び副作用を表10に示す。有害事象はNPC-22群4/30例(13.3%)、プラセボ群2/10例(20.0%)、スコポラミン注群5/8例(62.5%)にみられたが、いずれの群も重篤な有害事象や試験中止などに至る有害事象は認められなかった。NPC-22の投与量別の有害事象は、0.75mg群1/6例、1.5mg群1/6例、3mg群0/6例、6mg群1/6例、9mg群1/6例で、このうち副作用と判断されたのは、0.75mg群の1/6例であった。0.75mg群の副作用は、投与後7日目(剥離後6日目)にみられた軽度の白血球数増加、リンパ球数減少、好中球数増加であり、それぞれ投与後11日目には消失した。
本邦パッチテスト研究班判定基準による皮膚所見を表11に示す。
いずれの判定時期も「軽度な紅斑」が認められたのみであった。剥離後1時間で、0.75mg群6/6名、1.5 mg群1/6名、3mg群2/6名、6mg群5/6名、9mg群2/6名、剥離後24時間では、順に3/6名、0/6名、0/6名、0/6名、2/6名に軽度な紅斑がそれぞれ認められたが、用量の増加に伴って皮膚所見の悪化はなく、臨床上大きな問題となるものではなかった。一方、プラセボ群の皮膚所見でも剥離後1時間7/10名、剥離後24時間2/10名に軽度の紅斑が認められ、NPC-22群と同程度の皮膚所見であった。
NPC-22投与後、血漿中スコポラミン濃度は投与期間中上昇し、NPC-22剥離後も上昇し数時間継続した後、おおむね28時間(剥離後4時間)以降に緩やかに低下した。血漿中スコポラミン濃度は投与量の増加に伴い高濃度で推移し、1.5mg以上の投与群では、7日目(剥離後6日目)においても血漿中スコポラミン濃度が認められる例があった。
NPC-22剥離時(投与後24時間)の血漿中スコポラミン濃度の変動係数(CV%)は42.2%~90.6%であり、被験者間に大きなバラツキが認められた。
NPC-22単回投与後の血漿中スポコラミン濃度のCmax、AUC0-24及びAUCinfは、投与量の増加に伴い上昇した。NPC-22投与群におけるtmaxは、投与後23.1~36.8時間であり、t1/2は42.0~54.8時間であった。またAUCinfはAUC0-24の約6~16倍であった。NPC-22を単回投与したときの用量比例性をパワーモデルにより検討した結果、NPC-22 0.75~9 mgの用量範囲で、薬物濃度に線形性が認められた。
NPC-22投与後72時間までのスコポラミンの尿中排泄率は0.093%~0.190%であり、尿中への排泄はわずかであった。
NPC-22剥離後の尿中排泄率推移は、血漿中スコポラミン濃度推移によく対応していた。
スコポラミン皮下投与群のCmaxは、NPC-22 3mg、6mg及び9mg投与群と比較すると、それぞれ191倍、42倍及び27倍であった。
スコポラミン皮下投与群のAUCinfは、NPC-22 3mg、6mg及び9mg投与群と比較するとそれぞれ2.15倍、0.81倍及び0.57倍であった。
血漿中スコポラミン濃度と唾液分泌量の変化量及び変化率に弱い負の相関(相関係数:-0.248、-0.289)が認められ、血漿中スコポラミン濃度が高くなるに従って唾液分泌量の減少傾向が認められた。
血漿中スコポラミン濃度と心拍数の変化量及び変化率に弱い負の相関(相関係数:-0.229、-0.230)が認められ、血漿中スコポラミン濃度が高くなるに従って心拍数の減少傾向が認められた。
NPC-22(0.75mg/1枚)の平均残存率(最小値、最大値)は71.3%(58.3%、79.8%)、変動係数(CV%)は6.88%であり、残存する薬物量に大きなバラツキは認められなかった。また、投与後の製剤に残存する薬物量から推定したスコポラミンの平均吸収率(SD)は28.7%(4.90)であった。
NPC-22の有害事象は、用量依存的な増加もなく、発現した有害事象の程度は軽度であり、忍容性に問題は認められなかった。
(試験薬)
スコポラミン貼付剤:1枚(2.5cm2)中にスコポラミン臭化水素酸塩水和物を0.75mg含有する貼付剤(実施例10)(以下において、NPC-22とも称する)
NPC-22 9mg(NPC-2212枚)を4部位4期クロスオーバー法(非盲検)により同一被験者の耳介後部、胸部、上腕部又は腹部にそれぞれ24時間単回貼付する。休薬期間(薬剤剥離から次回薬剤貼付までの期間)は、14日間とする。
単回投与とする。24時間貼付する。
安全性:有害事象、皮膚所見(本邦パッチテスト研究班判定基準による)、バイタルサイン、12誘導心電図、臨床検査
薬物動態:スコポラミン未変化体の血漿中濃度及び薬物動態パラメータ(Cmax、Tmax、AUC及び半減期など)
その他:スコポラミン貼付剤に残存する薬物量
スコポラミン未変化体を測定する。
採血時期:
投与前、投与後8、12、24(治験薬剥離前に採血)、26、28、32、36、48、72時間、7日目及び14日目に行う。
本試験の被験者1名は、クロスオーバー法I期の耳介後部投与時に発現した有害事象によって、中止例となったため、2期以降に予定していた胸部、上腕部及び腹部への投与はなされていない。そのため、本試験の投与部位別の例数は、耳介後部16名、胸部、上腕部又は腹部はそれぞれ15名である。
(1-1)スコポラミンの血漿中薬物動態
(1-1-1)血漿中濃度推移
健康成人男性にNPC-22を単回投与(24時間貼付)したときの各投与部位における血漿中スコポラミン濃度推移(平均値±標準偏差)を図10に示した。
NPC-22を耳介後部に投与後、血漿中スコポラミン濃度は投与期間中上昇し、NPC-22剥離後も上昇し数時間継続した後、おおむね28時間(剥離後4時間)以降に緩やかに低下した。
耳介後部(Postauricular)以外の胸部(Chest)、上腕部(Upper Arm)及び腹部(Abdomen)への投与では、血漿中スコポラミンの最高濃度は、耳介後部に比べいずれの部位も極めて低い値を示し、血漿中からの消失も遅かった。
健康成人男性にNPC-22を単回投与(24時間貼付)したときの各投与部位における血漿中スコポラミン薬物動態パラメータ(平均及び標準偏差)を表12に示した。
血漿中スコポラミン濃度のCmax及びAUC0-312は、耳介後部投与時でそれぞれ85.093pg/mL、4716.497pg・hr/mL、その他の部位では3.5749pg/mL~6.8708pg/mL及び522.618pg・hr/mL~756.356pg・hr/mLであった。NPC-22を耳介後部に投与した際のCmax及びAUC0-312は、胸部、上腕部又は腹部へ投与したときよりも非常に高かった。また、t1/2は、耳介後部38.774hrに対し、その他の部位は176.587~440.550hrと、耳介後部とその他の部位で大きな違いがみられた。
NPC-22に投与後に回収した製剤に残存する薬物量
NPC-22投与後に回収した製剤を基に薬物残存率及び推定吸収率を検討した。
NPC-22(0.75 mg/1枚)の投与部位ごとの平均残存率は、66.8~68.5%、変動係数(CV%)は6~9.29%であり、残存率に大きなバラツキは認められなかった。また、投与後の製剤に残存する薬物量から推定したスコポラミンの平均推定吸収率は、31.5~33.2%であり、投与部位によらず平均残存率及び平均推定吸収率に違いは認められなかった。
(1)有害事象及び副作用
本試験で発現した有害事象を表13に示す。
有害事象は、耳介後部投与時2/16名(12.5%)、腹部投与時1/15名(6.7%)にみられたが、いずれも軽度で重篤な有害事象や試験中止などに至る有害事象の発現はなかった。また、いずれの有害事象も薬剤との因果関係は「関連なし」と判定され、副作用とされたものはなかった。
本邦パッチテスト研究班判定基準による皮膚所見を表14に示す。
各部位ともに、いずれの判定時期も「軽度な紅斑(±)」が認められたのみであった。剥離後1時間で、耳介後部で1/16名、胸部で4/15名、上腕部で8/15名、腹部で1/15名、剥離後24時間では、上腕部で1/15名に軽度な紅斑がそれぞれ認められたが、いずれも臨床上大きな問題となるものではなかった。
NPC-22を各投与部位に単回投与した時の血漿中スコポラミン濃度は、耳介後部投与時には高濃度で推移したが、胸部、上腕部及び腹部では極めて低い濃度で推移した。耳介後部に投与したときの血漿中スコポラミン濃度のCmax及びAUCは、胸部、上腕部及び腹部投与時と比較し非常に高く、Cmaxはそれぞれ12.4倍、16.4倍及び27.1倍、AUC0-312は、それぞれ6.2倍、7.7倍及び9.1倍であった。
NPC-22を耳介後部、胸部、上腕部及び腹部に投与(24時間貼付)後に回収したNPC-22の平均残存率は、66.8%~68.5%、平均推定吸収率は、31.5%~33.2%であり、投与部位間で大きな違いはなかった。
NPC-22投与で発現した有害事象は、いずれも軽度であり、忍容性に問題は認められず、投与部位間でも大きな違いはなかった。また、皮膚所見も軽度な紅斑がみられたのみで、臨床上大きな問題となるものではなく、投与部位間で大きな違いはなかった。
本試験に先立って実施したNPC-22の健康成人を対象とした単回投与試験で、血漿中スコポラミン濃度が高くなるに従って唾液分泌量の減少傾向が認められている。
本試験でみられた有害事象及び皮膚所見は、投与部位間で大きな違いは見られなかったが、胸部、上腕部又は腹部投与時の血漿中スコポラミン濃度は、いずれの部位も耳介後部と比較して非常に低くなるため、NPC-22の投与部位は、耳介後部とすることが適切である。
Claims (16)
- スコポラミンの塩及び/又はその水和物を含有する、神経変性疾患の症状の緩和又は治療のための貼付剤であって、1回当たりの貼付時間が48時間以内である、貼付剤。
- 1回当たりの貼付時間が24時間以内である、請求項1に記載の貼付剤。
- 1回当たり48時間以内の貼付を2回以上連続的に反復する、請求項1に記載の貼付剤。
- 成人一日当たりのスコポラミンの塩及び/又はその水和物の投与量が、0.75mg~50mgである、請求項1から3の何れか一項に記載の貼付剤。
- 貼付剤を耳介後部、肩、上腕部、胸部、腹部、腰背部、臀部、又は大腿部に貼付する、請求項1から4の何れか一項に記載の貼付剤。
- 前記スコポラミンの塩及び/又はその水和物が、スコポラミン臭化水素酸塩及び/又はスコポラミン臭化水素酸塩水和物である、請求項1から5の何れか一項に記載の貼付剤。
- さらにポリビニルピロリドン及び塩基を含有する、請求項1から6の何れか一項に記載の貼付剤。
- 前記塩基が、アミン化合物より選ばれる少なくとも1種である、請求項7に記載の貼付剤。
- 前記アミン化合物が、メタクリル酸メチル・メタクリル酸ブチル・メタクリル酸ジメチルアミノエチル共重合体である請求項8に記載の貼付剤。
- 貼付剤が、支持体、薬物含有粘着剤層及び剥離ライナーを含む貼付剤であって、前記薬物含有粘着剤層が、スコポラミンの塩及び/又はその水和物、ポリビニルピロリドン及び塩基を含有する医薬組成物を含む、請求項1から8の何れか一項に記載の貼付剤。
- スコポラミンの塩及び/又はその水和物の含有量が、前記医薬組成物全体の質量に対して0.5~10質量%である、請求項10に記載の貼付剤。
- ポリビニルピロリドンの含有量が、前記医薬組成物全体の質量に対して0.3~12質量%である、請求項10又は11に記載の貼付剤。
- 前記塩基の含有量が、前記医薬組成物全体の質量に対して0.3~10質量%である、請求項10から12の何れか一項に記載の貼付剤。
- 前記薬物含有粘着剤層の基剤成分が、アクリル系粘着剤、ゴム系粘着剤及びシリコーン系粘着剤より選ばれる少なくとも1種である請求項10から13の何れか一項に記載の貼付剤。
- 前記薬物含有粘着剤層の基剤成分が、アクリル系粘着剤である請求項10から14の何れか一項に記載の貼付剤。
- 前記アクリル系粘着剤が、ヒドロキシル基含有型及び無極性型より選ばれる少なくとも1種である請求項15に記載の貼付剤。
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