WO2022156373A1 - 一种滴眼给药治疗黄斑水肿、视神经炎和非感染性眼内炎的眼用制剂 - Google Patents
一种滴眼给药治疗黄斑水肿、视神经炎和非感染性眼内炎的眼用制剂 Download PDFInfo
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- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0048—Eye, e.g. artificial tears
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/13—Amines
- A61K31/155—Amidines (), e.g. guanidine (H2N—C(=NH)—NH2), isourea (N=C(OH)—NH2), isothiourea (—N=C(SH)—NH2)
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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
- A61K31/38—Heterocyclic compounds having sulfur as a ring hetero atom
- A61K31/385—Heterocyclic compounds having sulfur as a ring hetero atom having two or more sulfur atoms in the same ring
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- A—HUMAN NECESSITIES
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- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
- A61K9/51—Nanocapsules; Nanoparticles
- A61K9/5107—Excipients; Inactive ingredients
- A61K9/513—Organic macromolecular compounds; Dendrimers
- A61K9/5161—Polysaccharides, e.g. alginate, chitosan, cellulose derivatives; Cyclodextrin
Definitions
- the above-mentioned surfactant is a non-ionic surfactant; preferably, the non-ionic surfactant is span class, polysorbate, poloxamer, alkyl glucoside, vitamin E polyethylene succinate Alcohol esters, sucrose stearate or azone; preferably spans or polysorbates.
- the tackifier is polyethylene glycol, carbomer, poloxamer, povidone, hydroxypropyl cellulose, methyl cellulose, hydroxyethyl cellulose, polyvinyl alcohol, yellow At least one of original gum, polyoxyethylene fatty alcohols, hyaluronic acid and its salts or hydroxypropyl methylcellulose, and the cosolvent is propylene glycol, glycerol, liquid polyethylene glycol or castor oil;
- the mass ratio of tackifier and surfactant, or tackifier and povidone with low polymerization degree is 1:(0.1 ⁇ 100), and the mass of cosolvent and surfactant, or cosolvent and povidone with low polymerization degree The ratio is (1 ⁇ 10):1;
- the mass ratio of the above-mentioned surfactant or povidone with a low degree of polymerization to the active ingredient for treating eye diseases is (12-31):1.
- the carrier or adjuvant of the above-mentioned ophthalmic preparation contains nanobodies, and the nanobodies are formed by self-assembly of the components of the carrier or adjuvant of the ophthalmic preparation; the nanobodies are encapsulated with active ingredients for treating eye diseases.
- the above preparation also contains nano-spheres, and the nano-spheres are spherical and have a particle size of 10-2000 nm.
- the nano-spheres are formed by self-assembly of nano-body; preferably, the diameter of the nano-spheres is 100-2000 nm.
- the ophthalmic preparation for eye-drop administration prepared by the present invention has stable properties, is easy to store, can effectively deliver the active ingredients for treating eye diseases to the posterior segment of the eye, and reaches an effective (expected) concentration in the fundus of the eye, thereby realizing the treatment of eye diseases.
- the treatment of macular edema overcomes the existing problems of intravitreal injection, intravitreal injection implant, oral administration and systemic injection, solves serious complications such as intraocular hemorrhage and pain, and greatly reduces the risk of patients with fundus diseases. Pain, increase compliance, improve the quality of life of patients and their families, or avoid systemic side effects caused by systemic administration.
- the reagents or instruments used in the present invention can be purchased from the market. If no specific conditions are indicated, the conventional conditions or the conditions suggested by the manufacturer are used.
- the property testing method of the preparation of the present invention is as follows
- HPLC detection Column: ZORBAX Eclipse Plus C18, 4.6x100mm 3.5 ⁇ m; mobile phase A: 0.1% phosphoric acid, mobile phase B: methanol (80:20) isocratic elution, Temp.: 35°C, detection wavelength: 280nm, Flowrate : 0.8ml/min; test result: 98.4%.
- the particle size is 39.7 nm (95.5%), PdI: 0.318; it was placed in the dark at room temperature for 1 month, and the appearance and content did not change.
- HPLC detection method is the same as that of Example 3, and the detection result is: 97.8%; particle size: 46.2 nm (95.5%), PdI: 0.343; the appearance and content are obviously unchanged after being placed in the dark at room temperature for 1 month.
- HPLC detection method is the same as that of Example 1, and the detection result: 96.8%;
- Fig. 2 it can be seen that the retinal full-thickness increased significantly after modeling, while the retinal full-thickness was significantly decreased on both D2 and D4 after the formulation of the present invention was administered by eye drops, and the effect was similar to that of the vitreous
- the effects of injection of commercially available drugs are comparable, indicating that the preparation of the present invention can achieve a very good effect of improving retinal edema through eye drop administration.
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Abstract
一种治疗黄斑水肿、视神经炎和非感染性眼内炎的眼用制剂,它是由治疗眼病的活性成分和眼用制剂载体或辅料组成的制剂;所述治疗眼病的活性成分为糖皮质激素类药物和/或非甾体类药物;所述眼用制剂载体或辅料含有如下成分:表面活性剂、离子型高分子和有溶剂;或,所述眼用制剂载体或辅料含有如下成分:低聚合度聚维酮、中聚合度聚维酮和溶剂。该眼用制剂能够通过滴眼给药的方式,携载(包裹)糖皮质激素类和/或非甾体类药物穿过眼前段,输送到眼后段治疗黄斑水肿、视神经炎和非感染性眼内炎,具有极为优良的临床使用价值和非常积极的社会意义。
Description
本发明属于眼用药物领域,具体涉及一种滴眼给药治疗黄斑水肿、视神经炎和非感染性眼内炎的眼用制剂。
眼底疾病患者众多,仅中国患者数量已逾数千万,随着社会日益老龄化,电子产品的普及,发病率将会逐年上升;常见的眼底疾病有糖尿病性黄斑水肿、糖尿病性视网膜病变、年龄相关性黄斑病变、视网膜静脉阻塞、病理性近视、地图样萎缩、眼部肿瘤、眼内炎等,可能导致视力下降甚至失明,严重影响人们生活质量。例如,约有6.8%的糖尿病人患有糖尿病性黄斑水肿(DME),该疾病是导致糖尿病人失明的主要原因(Urias et al.,Vision Research,V139:221-227,2017;Mandal et al.,Ocular delivery of proteins and peptides:Challenges and novel formulation approaches,Advanced Drug Delivery Reviews,126:67–95,2018)。
药物治疗是眼底疾病的主要治疗方法和研究趋势。但是,由于眼内存在复杂的生理结构和屏障,导致药物很难进入眼球,特别是眼后段,难以达到有效剂量,因而难以实现有效治疗。寻找一种有效且安全的治疗眼底疾病的制剂或方法是本领域研究人员一直孜孜以求的奋斗目标。
临床眼科给药通常有3种途径:⑴结膜囊给药(滴眼):药物通过角膜进入前房水后可以扩散分布到虹膜、睫状体,但晶状体和玻璃体膜的屏障作用,使药物难以进入晶状体和玻璃体;⑵眼部注射给药:包括结膜下注射、眼前房注射、玻璃体注射、眼球后注射和眼眶注射,注射给药可以使药物直接抵达治疗部位,但注射是创伤性的,存在潜在危险,如前房注射产生疼痛,畏光,流泪,前房浑浊,出血,角膜内皮细胞损害,外伤性白内障等;玻璃体注射会出现晶状体浑浊,玻璃体机化,视网膜/视神经损害等;⑶全身给药包括口服给药,静脉给药:药物在体内一般大多聚集在肝脏,肾脏或肺脏,受到血-视网膜屏障(blood retinal barrier,BRB)的阻碍,抵达眼球组织的浓度较低,同时全身尤其是主要脏器承受了不必要的毒副作用。
目前,临床上为了使药物穿过眼屏障,通常采用眼球玻璃体注射、或玻璃体植入(眼内插入)等技术手段,把药物输送到患者玻璃体,治疗眼后段疾病(凌沛学主编《眼科药物与制剂学》,中国轻工业出版社,2010,P3,;Wang et.al.,Mediators of Inflammation,Vol.2013,Article ID 780634;Luaces-Rodríguez et al.,Pharmaceutics,2018,10,66)。药物玻璃体注射或玻璃体植入操作是创伤性给药,需要经过专门培训的眼科医师在手术室等无菌环境下操作;因为操作有创伤性可能会出现并发症,如高眼压、白内障、医源性感染性眼内炎、玻璃体出血、视网膜损伤等;操作条件及操作环境要求 高,必须在有条件的医院进行;生物药眼用注射剂生产成本和使用成本高;同时亦存在治疗时机上因为医疗条件限制而延误治疗的情况发生,调整给药方案灵活性差(M.HATA et al.,RETINA,37:1320–1328,2017)。
事实上,现有的治疗湿性年龄相关性黄斑变性(wet Age-related Macular Degeneration,wAMD)和糖尿病性黄斑水肿(Diabetes-related Macular Edema,DME)等生物药眼用注射液等都是采用玻璃体注射给药,依照药物说明书需要每1~3个月注射1次,并需要长期注射给药。此外,糖皮质激素地塞米松也被开发成玻璃体植入剂(眼内插入剂,商品名:傲迪适
Ozurdex)用于治疗眼后段疾病如视网膜静脉阻塞引起的黄斑水肿,植入后药效可持续维持6个月。但植入后部分患者眼压增高,在2个月时达到峰值(傲迪适
患者管理手册,Allergan,CN/011/2018),存在副作用风险。
结膜囊给药是最方便、最安全的眼部给药方式。但是眼角膜有多层结构,从外至内大致分为:富含脂质体的上皮层、富含水性成分的基质层和富含脂质体的内皮层,滴眼液在滴眼后首先接触眼表泪水层,继而需要跨过上皮层、基质层和内皮层才可能到达眼后段。在此过程中,由于泪液的稀释、角膜、结膜的眼表屏障和晶状体、玻璃体的解剖位置,滴眼液往往在眼前段的组织中浓度高,很难进入眼后段并达到有效的治疗浓度。因此,结膜囊给药的方式虽然安全,但是药物输送性差,难以达到有效治疗眼底疾病的目的。
综上,现有治疗黄斑水肿等眼底疾病主要给药方法均难以兼顾安全和有效。
发明内容
滴眼给药的方式相比于静脉注射、玻璃体注射具有安全、方便的显著优势,发明能将药物输送到眼后段治疗黄斑水肿的眼科制剂是临床实践中亟待解决的技术问题,非常具有临床治疗价值和社会意义。
本发明的目的在于提供一种滴眼给药的眼用药物,能够将治疗眼病的活性成分递送到眼后段,治疗黄斑水肿、视神经炎、非感染性眼内炎。
本发明提供了一种滴眼给药的眼用制剂,它是由治疗眼病的活性成分和眼用制剂载体或辅料组成的制剂;
所述治疗眼病的活性成分为糖皮质激素类药物和/或非甾体类药物;
所述眼用制剂载体或辅料含有如下成分:表面活性剂、离子型高分子和溶剂;
或,所述眼用制剂载体或辅料含有如下成分:低聚合度聚维酮、中聚合度聚维酮和溶剂。
进一步地,上述的眼用制剂的载体或辅料中表面活性剂、离子型高分子的质量比为:(1~100):(0.1~50);所述表面活性剂与溶剂的比例为:每100mL溶剂含5~3000mg表面活性剂。
更进一步地,上述的眼用制剂的载体或辅料中表面活性剂、离子型高分子的质量比为:(12~31):(2~7.5);所述表面活性剂与溶剂的比例为:每100mL溶剂含880~1240mg表面活性剂;
进一步地,上述表面活性剂为非离子表面活性剂;优选的,所述非离子表面活性剂为司盘类、聚山梨酯、泊洛沙姆、烷基葡萄糖苷、维生素E聚琥珀酸乙二醇酯、蔗糖硬脂酸酯或氮酮;优选为司盘类或聚山梨酯。
进一步地,上述离子型高分子选自羧甲基纤维素及其盐、羟基乙酸淀粉钠、透明质酸及其盐、黄原胶、海藻酸及其盐、二乙酸聚乙二醇PEG-(COOH)
2中的至少一种;优选地,所述离子型高分子选自羧甲基纤维素及其盐、透明质酸及其盐中的至少一种。
进一步地,上述的眼用制剂的载体或辅料中低聚合度聚维酮、中聚合度聚维酮的质量比为:(0.1~10):1,所述低聚合度聚维酮与溶剂的比例为:每100mL溶剂含5~3000mg低聚合度聚维酮;
优选地,所述低聚合度聚维酮、中聚合度聚维酮的质量比为:(0.24~0.8):1,所述低聚合度聚维酮与溶剂的比例为:每100mL溶剂含240~840mg低聚合度聚维酮。
更进一步地,上述低聚合度聚维酮为重均分子量为2000~5000的聚维酮,优选为重均分子量为3500的聚维酮PVP K12。
更进一步地,上述中聚合度聚维酮为重均分子量为20000~60000的聚维酮,优选为重均分子量为35000~50000的聚维酮PVP K30。
进一步地,上述眼用制剂的载体或辅料中的溶剂为极性溶剂,优选为水。
进一步地,上述眼用制剂的载体或辅料中还含有如下成分:增粘剂和/或助溶剂。
更进一步地,所述增粘剂为聚乙二醇、卡波姆、泊洛沙姆、聚维酮、羟丙基纤维素、甲基纤维素、羟乙基纤维素、聚乙烯醇、黄原胶、聚氧乙烯脂肪醇类、透明质酸及其盐或羟丙基甲基纤维素中的至少一种,所述助溶剂为丙二醇、丙三醇、液态聚乙二醇或蓖麻油;增粘剂和表面活性剂,或增粘剂和低聚合度聚维酮的质量比为1:(0.1~100),助溶剂和表面活性剂,或助溶剂和低聚合度聚维酮的质量比为(1~10):1;
优选地,所述增粘剂和表面活性剂的质量比为1:(1.2~30),助溶剂和表面活性剂的质量比为(2.56~9):1;
进一步地,上述表面活性剂或低聚合度聚维酮与治疗眼病的活性成分的质量比为(12~31):1。
进一步地,上述糖皮质激素类药物为地塞米松、氢化可的松、泼尼松龙、倍他米松中的至少一种;所述非甾体类药物为双氯芬酸、普拉洛芬、吲哚美辛、溴芬酸钠中的至少一种。
进一步地,上述眼用制剂的载体或辅料含有纳米小体,所述纳米小体由眼用制剂的载体或辅料的成分自组装形成;所述纳米小体中包裹有治疗眼病的活性成分。
更进一步地,上述纳米小体为球形,其粒径为1~100nm;优选地,所述纳米小体粒径为5~30nm。
更进一步地,上述制剂还含有纳米小球,所述纳米小球为球形,其粒径为10~2000nm。所述纳米小球是纳米小体自组装形成的;优选地,所述纳米小球粒径为100~2000nm。
本发明还提供了一种制备上述的制剂的方法,包括以下步骤:
(1)将表面活性剂和/或增粘剂加入溶剂中配制成溶液;
(2)将治疗眼病的活性成分和/或助溶剂分散在步骤(1)得到的溶液中,再加入离子型高分子或其溶液,分散混合得到初悬液;
(3)将步骤(2)得到的初悬液搅拌分散或均质分散,即得;
或包括以下步骤:
(a)将低聚合度聚维酮和/或增粘剂加入溶剂中配制成溶液;
(b)将治疗眼病的活性成分和/或助溶剂分散在步骤(a)得到的溶液中,再加入中聚合度聚维酮或其溶液,分散混合得到初悬液;
(c)将步骤(b)得到的混合液研磨或均质分散,即得。
进一步地,步骤(2)或步骤(b)中所述分散选自机械搅拌分散、磁力搅拌分散、涡旋振摇分散、剪切分散、均质分散、研磨分散、超声分散中的至少一种。
本发明还提供了上述的制剂在制备治疗眼底疾病的药物中的用途;优选地,所述治疗眼底疾病的药物为治疗黄斑水肿,和/或视神经炎,和/或非感染性眼内炎的药物。
进一步地,上述治疗黄斑水肿的药物为治疗眼底血管性疾病所致的黄斑水肿、网膜中央静脉阻塞性黄斑水肿、视网膜分支静脉阻塞性黄斑水肿、糖尿病性黄斑水肿、病理性近视黄斑水肿、和/或湿性年龄相关性黄斑变性所致黄斑水肿的药物。
本发明还提供了一种治疗眼底疾病的方法,即对患者使用上述的制剂。
进一步地,上述眼底疾病为黄斑水肿,和/或视神经炎,和/或非感染性眼内炎。
更进一步地,上述黄斑水肿为眼底血管性疾病所致的黄斑水肿、网膜中央静脉阻塞性黄斑水肿、视网膜分支静脉阻塞性黄斑水肿、糖尿病性黄斑水肿、病理性近视黄斑水肿、和/或湿性年龄相关性黄斑变性所致黄斑水肿。
更进一步地,所述使用的方式是滴眼给予。
实验结果表明,本发明制备的滴眼给药的眼用制剂,性状稳定,易于储 存,能够有效将治疗眼病的活性成分递送到眼后段,在眼底达到有效(预期)浓度,实现对眼底疾病如黄斑水肿的治疗,克服了现有玻璃体注射、玻璃体注射植入剂,口服给药和全身注射给药存在的问题,解决眼内出血、疼痛等严重的并发症问题,极大降低眼底疾病患者的痛苦,增加医从性、改善患者及其家庭的生活质量,或避免全身给药带来的全身毒副作用。
本发明可以避免眼局部注射或植入带来的并发症。
本发明开发的制剂给药量小,毒副作用小,不仅可以作为治疗药物,还可以作为眼科疾病防控。
本发明的制剂可以满足临床上长期给药的需求。
本发明的滴眼给药治疗系统,有效成分(活性成分)可以采用已在临床使用且作用机理明确的小分子药物,质量可控,产品使用方便,病人顺应性好,医师可根据患者病情灵活调整给药方案。
本发明所指的纳米小体是:眼用制剂载体或辅料的成分在溶剂中自组装形成的纳米级的球形聚集体。
本发明所指的纳米小球是:纳米小体在溶剂中自组装形成的球形自组装结构。
本发明所指的溶剂是:能溶解眼用制剂载体或辅料的成分的液体。
本发明所指表面活性剂是:能够显著降低液体表面张力的物质;本发明所指非离子型表面活性剂是指在水中不解离的表面活性剂。
本发明所指离子型高分子是:带有阳离子或阴离子的高分子聚合物。
本发明所指低聚合度聚维酮是:分子量在10000Dalton以下的聚维酮,中聚合度聚维酮是指分子量在10000Dalton以上,100000Dalton以下的聚维酮。
本发明所指的“治疗眼病的活性成分”是:可以用于治疗眼病的活性物质,即目前已经作为眼科用药使用的活性物质,以及作用机理、作用靶点表明其能够治疗眼病,但目前暂没有作为眼科用药使用的活性物质(Active Pharmaceutical Ingredient,API)。
本发明所述滴眼给药是:将药液滴入眼内的一种给药方法,属于角膜给药途径。
显然,根据本发明的上述内容,按照本领域的普通技术知识和惯用手段,在不脱离本发明上述基本技术思想前提下,还可以做出其它多种形式的修改、替换或变更。
以下通过实施例形式的具体实施方式,对本发明的上述内容再作进一步的详细说明。但不应将此理解为本发明上述主题的范围仅限于以下的实例。凡基于本发明上述内容所实现的技术均属于本发明的范围。
图1为实施例1制得的样品的(A)透射电镜图(标尺为200nm);(B)加染 色剂染色后的透射电镜图(标尺为1μm)。
图2为各组动物不同检查时间点阻塞静脉左、右两侧各约750μm、1500μm处视网膜全层厚度,横坐标表示OCT图片中测量点与视盘中央的垂直距离(μm);纵坐标表示视网膜全层厚度(μm),数据以平均值±标准差表示(其中2A为造模前各组视网膜全层厚度,N=8;2B为D2时各组视网膜全层厚度,溶媒对照组和低剂量组N=6,中、高剂量组和阿柏西普组N=8,地塞米松组N=7;2C为D4时各组视网膜全层厚度,溶媒对照组N=6,供试品剂量组N=7,供试品中、高剂量组、阿柏西普组及地塞米松组N=8;与同期溶媒对照组相比,*p≤0.05)。
图3为眼底彩照及血管荧光造影检查图例。
图4为光学相干断层扫描图例(视网膜全层厚度测量)。
本发明所用试剂或仪器可以通过市售购买获得,未注明具体条件的,按照常规条件或制造商建议的条件使用。
部分仪器设备如下:
ES225SM-DR(E)电子分析天平,Precisa公司(瑞士);
DF-101S集热式恒温加热磁力搅拌器,巩义市英峪高科仪器厂(河南,中国);
WH-2微型涡旋混合仪,上海沪西分析仪器厂有限公司(上海,中国);
分散机:T25 easy clean digital,IKA公司(德国);
KQ-500型超声清洗仪,昆山市超声波仪器有限公司(昆山,中国);
JP-010T型超声清洗仪,深圳市洁盟清洗设备有限公司;
AH-NANO Plus高压均质机,安拓思纳米技术(苏州)有限公司(中国);
PM-DK2行星式球磨机,卓的仪器设备(上海)有限公司(上海,中国);
Mettler Toledo FE20pH meter,梅特勒-托利多公司(瑞士);
NS-90纳米粒度分析仪,珠海欧美克仪器有限公司(珠海,中国);
安捷伦1100HPLC高效液相色谱仪,安捷伦科技有限公司(美国);
API4000三重四极杆质谱仪(美国Applied Biosystems公司);
STY-1A渗透压测定仪,天津市天大天发科技有限公司(天津,中国)。
本发明制剂的性质检测方法如下
粒径检测方法:
将1mL实施例或对比例制备得到的样品转移至样品池中,检测温度设置为40℃,将样品池放入NS-90纳米粒度分析仪,开始检测。每个样品重复检测3次,取3次检测结果的平均值为该样品检测结果为粒度(以光强分布,及占比%)和多分散指数(PdI,Polydispersity Index)表示。
渗透压检测方法:
测量溶液的冰点下降来测定其渗透压摩尔浓度。操作:清洗STY-1A渗透压测定仪探头:取三份100μL蒸馏水至3只样品管中,待仪器预热后,将装有100μL蒸馏水的样品管旋上仪器探头,选择清洗3次,点击“清洗”,重复三次。检测:在仪器信息表中填入样品信息后,点击“测试”;用移液枪移取100μL样品至样品管中,轻轻旋上仪器,点击“启动”检测。重复检测三次,取3次检测结果的平均值为检测结果。
pH值检测方法:
FE20型酸度计分别用pH缓冲溶液(pH分别为4.00、6.86和9.18)校准,电极用纯净水冲洗后,用无纤维纸吸去多余水份,浸入待检测液体样品中按读数键开始测量,在读数稳定后所得数据,即为样品pH值。
检测得到的溶液若pH<5,或>9,则需要用酸或碱调节至pH6~8,常用的pH调节剂为NaOH和HCl,磷酸和磷酸盐(如磷酸二氢钠、磷酸氢二钠),柠檬酸和柠檬酸盐(如柠檬酸钠),硼酸和硼砂;检测所得液体的渗透压如未达到等渗,则添加适量氯化钠,使其达到或接近等渗。
递送药物到达眼后段的效果验证方法:
试验仪器设备:高效液相色谱仪,型号:LC-20AD(日本岛津);质谱仪:型号:API4000三重四极杆质谱仪(美国Applied Biosystems公司);色谱柱:Fortis Pace C18 5μM,2.1X30mm(英国Fortis公司)。
选用健康成年Sprague Dawley(SD)大鼠,分为受试剂组和对照组,每组6只眼,受试剂组滴加本发明实施例制备的眼用制剂,对照组滴加2mg药物/5mL生理盐水的混悬液(使用前涡旋振摇均匀),每只眼睛20μL。给药后于0.5小时或1小时后安乐死处理动物,迅速采集玻璃体,玻璃体样品匀浆处理后,于-80℃保存。取10μL玻璃体匀浆,加入90μL 95%乙醇,超声2分钟,涡旋混合1分钟,得玻璃体匀浆液;取50μL匀浆液,加入175μL甲醇,涡旋混合3min,4℃ 12000rpm离心10min,取上清液用0.45μm的针头式过滤器过滤,滤液用于LC/MS/MS(正离子模式,MRM SCAN)分析。
实施例1、本发明眼用制剂的制备
按照表1称取0.24g CMC-Na(羧甲基纤维素钠,离子型高分子)加到含有40mL纯净水的玻璃三角瓶中,开启磁力搅拌2小时,得溶液1;分别称取1.0g聚山梨酯80(表面活性剂)和0.24g HPMC(羟丙基甲基纤维素,增黏剂)加到含有60mL纯净水的玻璃三角瓶中,开启磁力搅拌、水浴加热40℃左右1.5小时,得溶液2;称取40mg地塞米松和4mLPEG400(即表面活性剂用量的4.3倍(w/w))投入到溶液2,继续加热搅拌30分钟,加入溶液1,搅拌30分钟,得混合液;将混合液用分散机在转速9500转分散5分钟,停机待泡沫消失后,用布氏漏斗减压过滤,得分散液;将分散液转移至高压均质机,控制温度15±5℃,在压力400Bar左右均质3分钟,然后提高压力 至>800Bar均质25分钟,减压至300Bar均质2分钟后排出,得到无色澄明溶液,进一步减压过滤除菌并除去机械杂质得到除杂后的无色澄明溶液。
pH和渗透压调节:加700mg NaH
2PO
4和400mg Na
2HPO
4调节pH至pH=6.3;加氯化钠调节渗透压至282mOsmol/kg。
HPLC检测:检测仪器:安捷伦1100高效液相色谱仪,操纵软件:OpenLab CDS c.01.10(201)Chemstation Edition;
色谱条件:色谱柱为Waters XBridge C18 5μm,4.6x250mm;柱温35℃,流速1.0mL/min,检测波长240nm,流动相:0.1%磷酸水溶液(72.0%)-乙腈(28.0%)等度洗脱。样品用流动相5倍稀释后取10μL注入液相色谱仪。检测结果:96.2%。
粒度为20.6nm(85.6%),PdI:0.266。室温避光保存1月,该样品外观和含量无变化。
实施例2、本发明眼用制剂的制备
制备方法参照实施例1,原料及用量如表1所示。得到除杂后的无色澄明溶液。
pH调节:用0.2N NaOH或/和0.1N HCl调节至pH6.5。
HPLC检测方法同实施例1,HPLC含量检测结果:95.1%,粒径12.9nm(92.1%),PdI:0.509;稳定性较好,室温避光放置1个月外观和含量无明显变化;2个月后出现少量沉淀。
滴眼后1小时大鼠玻璃体API浓度为:13.9ng/g,RSD:17.2%。
实施例3、本发明眼用制剂的制备
制备方法和pH、渗透压调节方法参照实施例1,原料及用量如表1所示,得到除杂后的微黄色澄明溶液。
HPLC检测:Column:ZORBAX Eclipse Plus C18,4.6x100mm 3.5μm;流动相A:0.1%磷酸,流动相B:甲醇(80:20)等度洗脱,Temp.:35℃,检测波长:280nm,Flowrate:0.8ml/min;检测结果:98.4%。粒径39.7nm(95.5%),PdI:0.318;室温避光放置1个月,外观和含量无变化。
滴眼后0.5小时大鼠玻璃体API浓度为:78.3ng/g。
实施例4、本发明眼用制剂的制备
制备方法和pH、渗透压调节参照实施例3,原料及用量如表1所示。得到除杂后的微黄色澄明溶液。
HPLC检测方法同实施例3,检测结果:97.8%;粒径:46.2nm(95.5%),PdI:0.343;在室温避光放置1个月外观和含量明显无变化。
实施例5、本发明眼用制剂的制备
制备方法参照实施例1,原料及用量如表1所示,其中助溶剂PEG400 的用量为表面活性剂的5倍(w/w),得到除杂后的无色澄明溶液。
pH和渗透压调节:用1M Na
2HPO
4溶液调节至pH6.2,加氯化钠调节渗透压至:295mOsmol/kg;
HPLC检测方法同实施例1,检测结果:97.3%;粒径22.4nm(91.4%),PdI:0.293;室温避光放置1个月,外观和含量无明显变化。
滴眼后0.5小时大鼠玻璃体API浓度为:42.7ng/g。
实施例6、本发明眼用制剂的制备
制备方法参照实施例1,原料及用量如表1所示,其中助溶剂PEG400的用量为表面活性剂的5倍(w/w),得到除杂后的无色澄明溶液。
pH6.5,无需调节;渗透压调节参照实施例1.
HPLC检测波长245nm,方法同实施例1,检测结果:98.1%;
粒径18.6nm(96.9%),PdI:0.257;室温避光放置1个月,外观和含量无明显变化。
滴眼后0.5小时大鼠玻璃体API浓度为:43.8ng/g。
实施例7、本发明眼用制剂的制备
制备方法和pH、渗透压调节参照实施例1,原料及用量如表1所示。得到除杂后的无色澄明溶液。
HPLC检测方法同实施例6,检测结果:98.3%;
粒径18.5nm(97.6%),PdI:0.208;室温避光放置1个月后,外观和含量无明显变化。
实施例8、本发明眼用制剂的制备
制备方法和pH、渗透压调节参照实施例1,原料及用量如表1所示。得到除杂后的无色澄明溶液。
HPLC检测方法同实施例1,检测结果:96.8%;
粒径18.7nm(89.2%),PdI:0.255;室温避光放置1个月后,外观和含量无明显变化。
实施例9、本发明眼用制剂的制备
制备方法和pH、渗透压调节参照实施例1,原料及用量如表1所示,其中助溶剂PEG400的用量为1mL,即表面活性剂的8倍(w/w)。得到除杂后的无色澄明溶液。
HPLC检测方法同实施例1,检测结果:97.2%;
粒径19.6nm(97.0%),PdI:0.289;室温避光放置1个月后,外观和含量无明显变化。
对比例1
原料及用量如表1所示,用低聚合度聚维酮PVP12替代表面活性剂,羟丙基纤维素(HPC)替代离子型高分子,制备方法参照实施例1,1mL PEG400作助溶剂,得到乳白色液。
检测结果:粒径899nm(92.9%),PdI:0.188,放置过夜有白色沉淀产生。
对比例2
原料及用量如表1所示,用中聚合度聚维酮PVP30替代表面活性剂,制备方法参照实施例1,得到无色澄明液。
检测结果:粒径241nm(53.1%)和89.4nm(32.6%),PdI:1.000,放置1周后有沉淀产生。
对比例3
原料及用量如表1所示,用中聚合度聚维酮PVP30替代表面活性剂,制备方法参照实施例1,得到无色澄明液。
检测结果:粒径483nm(47.6%)和117nm(33.9%),PdI:1.000,放置1周后,有沉淀产生。
对比例4
原料及用量如表1所示,改变HPMC、CMC-Na的用量,制备方法参照实施例1,得到白色乳液。
检测结果:粒径26.9nm(40.5%)和2043nm(31.8%),PdI:1.000,放置过夜,有白色沉淀产生。
对比例5
原料及用量如表1所示,改变HPMC、CMC-Na的用量,制备方法参照实施例1,加3mlPEG400和1ml乙醇为助溶剂,加水至100mL,得到无色溶液。加氯化钠调节渗透压至:262mOsmol/kg。
检测结果:粒径416nm(80%)和18.1nm(20%),PdI:0.462,室温放置2周,变为白色乳液。
实施例10、本发明眼用制剂的制备
原料及用量如表2所示,称取0.52g聚维酮(PVP)K30加到含有25mL纯净水的100mL玻璃三角瓶中,磁力搅拌2小时,得溶液1;分别称取260mg HPMC和420mg聚维酮(PVP)K12加入到含有25mL纯净水的100mL玻璃三角瓶中,开启磁力搅拌、水浴40℃加热2小时,得溶液2;称取1mL PEG400(助溶剂,用量相当于PVP K12的2.56倍)和20mg地塞米松投到溶液2,继续加热搅拌30分钟,加入溶液1,搅拌30分钟,得混合液;用实施例1相似的高速分散、高压均质和膜过滤操作、得到除杂后的无色澄明溶 液。
调节pH和渗透压:pH6.5无需调节,用氯化钠调节渗透压至:293mmol/kg。
HPLC检测方法同实施例1,检测结果:99.2%;粒径575nm(92.6%),PdI:0.211,室温避光放置1个月后,外观和含量无明显变化;2个月后,有沉淀产生。
滴眼后0.5小时大鼠玻璃体API浓度为:5.1ng/g。
实施例11、本发明眼用制剂的制备
原料及用量如表2所示,助溶剂PEG400用量为表面活性剂的8.9倍(w/w),制备方法和pH、渗透压调节方法参考实施例15。得到除杂后的无色澄明溶液。
HPLC检测方法同实施例10,检测结果:98.5%;
粒径125.6nm(63.5%)和13.6nm(33.1%),PdI:0.255;室温避光放置1个月后,外观和含量无明显变化。
对比例6
原料及用量如表2所示,制备方法参照实施例15,加离子型高分子,得到淡白色乳液。
检测结果:粒径1299nm(92.4%),PdI:0.175,放置过夜,有白色沉淀产生。
对比例7
原料及用量如表2所示,制备方法参照实施例15,加1mLPEG400为助溶剂(用量为表面活性剂的20倍(w/w)),得到无色溶液。
检测结果:粒径637nm(85.9%),PdI:0.258,放置过夜,有白色沉淀产生。
对比例8
原料及用量如表2所示,制备方法参照实施例15,无聚维酮,加离子型高分子,得到无色溶液。
检测结果:pH5.2,粒径46.2nm(96.9%),PdI:0.343,HPLC含量检测结果:98.9%,冰箱冷藏保存2周有细微结晶析出。
通过滴眼给药后大鼠玻璃体内API浓度的测定结果,说明本发明眼用制剂可以携载治疗眼病的活性成分穿过眼球结构的屏障,通过结膜囊给药(滴眼给药)的方式即可把有效剂量的药物递送到玻璃体,避免玻璃体注射等侵入性给药方式,还大幅度减少总的药物量,减少药物在全身的吸收,避免产生毒副作用。
表1、
表2
以下通过实验例证明本发明滴眼给药的药物制剂的有益效果。
实验例1、本发明载体的透射电镜观察结果
透射电子显微镜(JEM-2100Plus,日本JEOL公司)
吸取1滴实施例1制备的液体样品于铜质样品网,静置5分钟后吸去多余的液体样品后,自然放干,放置于电镜样品室作检测;样品染色:吸取1滴液体样品于铜质样品网,在除去样品网上多余的样品后,加1滴2%磷钼酸,静置5分钟后吸去多余的液体,自然放干,样品网放置于电镜作检测。结果见图1。可以看出,本发明制备的载药载体在溶剂中形成了粒径为1~100nm的球形结构(纳米小体,图1A),纳米小体又能进一步自组装成粒径为10~2000nm的球体(纳米小球,图1B)。
实验例2、粒径、含量及稳定性检测
1、实验方法
将1mL实施例和对比例制备得到的样品转移至样品池中,检测温度设置为40℃,将样品池放入NS-90钠米粒度分析仪,开始检测。每个样品重复检测3次,取3次检测结果的平均值为该样品检测结果为粒度(以光强分布,及占比%)和多分散指数(PdI,Polydispersity Index)表示。检测后避光保存,观察外观变化并再次检测粒径。
采用安捷伦1100高效液相色谱仪检测本发明制得的眼用制剂样品的HPLC含量。
2、实验结果
见表3:
表3
上述结果可以看出,本发明制备的药物制剂粒径小,HPLC检测活性成分含量高,长时间放置形态和含量均稳定;说明本发明制剂包封率高,稳定性好。而使用与本发明的辅料原料不同的对比例制得的制剂,稳定性很差,短时间就会出现沉淀或变质现象。
实验例3、本发明眼用制剂通过滴眼给药的方式治疗黄斑水肿的效果验证
1、实验方法
将48只双眼无明显异常的SD大鼠随机分成6组(每组8只,雌雄各半),于D1尾静脉注射光敏剂孟加拉红(40mg/mL,40mg/kg)后即刻进行右眼单支视网膜静脉激光光凝,光凝完成后约15min确认目标视网膜静脉是否阻塞。确认阻塞成功后,按表4进行给药处理,供试品用实施例1制备的制剂为高剂量组、实施例1制备的制剂用医用生理盐水3倍稀释得中剂量组、实施例1制备的制剂用医用生理盐水9倍稀释得低剂量组;以市售药品阿柏西普眼内注射溶液(拜尔公司,德国)和地塞米松磷酸钠注射液(国药集团容生制药有限公司,中国)为对照药。于D-1(造模前)、D1(造模后即刻)、D2(造模后第2天)和D4(造模后第4天)对所有动物的右眼行眼底照相(FP)、眼底血管荧光造影(FFA)及光相干断层扫描(OCT,D1造模后即刻不检查)。对FP及FFA图像进行阅图分析,在OCT扫描图上测量阻塞静脉左、右两侧约750、1500μm处的视网膜全层厚度。所有动物的左眼不进行造模、给药及相应的眼科检查。
表4动物分组给药处理表
2、实验结果
如图2所示,可以看出,造模后视网膜全层厚度出现显著增加,而滴眼给予本发明制剂后在D2、D4均可观察到视网膜全层厚度的显著降低,而且其效果与玻璃体注射市售药品的效果相当,说明本发明制剂能够通过滴眼给药的方式实现非常好的改善视网膜水肿的功效。
如图3所示,造模后(D1)相比于造模前出现了明显的激光光凝处静脉内血栓形成,血流瘀滞;而滴眼给予本发明制剂后,虽然仍有一定的视网膜静脉阻塞,但已明显改善了静脉血栓。
如图4所示,滴眼给予本发明制剂后在D2出现了视网膜急性水肿增厚,但在D4水肿就开始逐渐恢复,与造模前的正常状态接近。
上述结果表明,重复滴眼给予中剂量组(0.133mg/mL)和高剂量组(0.4mg/mL)的供试品(20μL/眼,连续4天,前3天4次/天,第4天单次)对激光光凝联合光敏剂诱导的视网膜静脉阻塞大鼠的急性视网膜水肿具有较明显的抑制/治疗作用,且有剂量相关性,高剂量组药效接近市售对照品阿柏西普眼内注射液。本试验中,市售对照品地塞米松磷酸钠注射液一次性玻璃体注射未显示明确的急性视网膜水肿抑制/治疗作用。
综上,本发明提供了一种滴眼给药制剂,能够通过滴眼给药的方式,携载(包裹)糖皮质激素类和/或非甾体类药物穿过眼前段,输送到眼后段发挥治疗作用。实现了通过滴眼给药治疗黄斑水肿等眼底疾病的目标,解决了本领域一直期限亟待解决但未解决的技术问题,具有极为优良的临床使用价值和非常积极的社会意义。
Claims (23)
- 一种滴眼给药的眼用制剂,其特征在于,它是由治疗眼病的活性成分和眼用制剂载体或辅料组成的制剂;所述治疗眼病的活性成分为糖皮质激素类药物和/或非甾体类药物;所述眼用制剂载体或辅料含有如下成分:表面活性剂、离子型高分子和溶剂;或,所述眼用制剂载体或辅料含有如下成分:低聚合度聚维酮、中聚合度聚维酮和溶剂。
- 根据权利要求1所述的制剂,其特征在于,所述的眼用制剂的载体或辅料中表面活性剂、离子型高分子的质量比为:(1~100):(0.1~50);所述表面活性剂与溶剂的比例为:每100mL溶剂含5~3000mg表面活性剂。
- 根据权利要求2所述的制剂,其特征在于,所述的眼用制剂的载体或辅料中表面活性剂、离子型高分子的质量比为:(12~31):(2~7.5);所述表面活性剂与溶剂的比例为:每100mL溶剂含880~1240mg表面活性剂。
- 根据权利要求1~3任一项所述的制剂,其特征在于,所述表面活性剂为非离子表面活性剂;优选的,所述非离子表面活性剂为司盘类、聚山梨酯、泊洛沙姆、烷基葡萄糖苷、维生素E聚琥珀酸乙二醇酯、蔗糖硬脂酸酯或氮酮;优选为司盘类或聚山梨酯。
- 根据权利要求1~3任一项所述的制剂,其特征在于,所述离子型高分子选自羧甲基纤维素及其盐、羟基乙酸淀粉钠、透明质酸及其盐、黄原胶、海藻酸及其盐、二乙酸聚乙二醇PEG-(COOH) 2中的至少一种;优选地,所述离子型高分子选自羧甲基纤维素及其盐、透明质酸及其盐中的至少一种。
- 根据权利要求1所述的制剂,其特征在于,所述的眼用制剂的载体或辅料中低聚合度聚维酮、中聚合度聚维酮的质量比为:(0.1~10):1,所述低聚合度聚维酮与溶剂的比例为:每100mL溶剂含5~3000mg低聚合度聚维酮;优选地,所述低聚合度聚维酮、中聚合度聚维酮的质量比为:(0.24~0.8):1,所述低聚合度聚维酮与溶剂的比例为:每100mL溶剂含240~840mg低聚合度聚维酮。
- 如权利要求6所述的制剂,其特征在于,所述低聚合度聚维酮为重均分子量为2000~5000的聚维酮,所述中聚合度聚维酮为重均分子量为20000~60000的聚维酮。
- 如权利要求6所述的制剂,其特征在于,所述低聚合度聚维酮为重均分子量为3500的聚维酮PVP K12。所述中聚合度聚维酮为重均分子量为35000~50000的聚维酮PVP K30。
- 根据权利要求1~8任一项所述的制剂,其特征在于:所述眼用制剂的载体或辅料中的溶剂为极性溶剂,优选为水。
- 根据权利要求1~8任意一项所述的制剂,其特征在于:所述眼用制剂的载体或辅料中还含有如下成分:增粘剂和/或助溶剂;优选的,所述增粘剂为聚乙二醇、卡波姆、泊洛沙姆、聚维酮、羟乙基纤维素、羟丙基纤维素、甲基纤维素、聚乙烯醇、黄原胶、聚氧乙烯脂肪醇类、透明质酸及其盐或羟丙基甲基纤维素中的至少一种,所述助溶剂为丙二醇、丙三醇、液态聚乙二醇或蓖麻油;所述增粘剂和表面活性剂的质量比为1:(0.1~100),助溶剂和表面活性剂的质量比为(1~10):1;所述增粘剂和低聚合度聚维酮的质量比为1:(0.1~100),助溶剂和低聚合度聚维酮的质量比为(1~10):1;更优选地,所述增粘剂和表面活性剂的质量比为1:(1.2~30),助溶剂和表面活性剂的质量比为(2.56~9):1;所述增粘剂和低聚合度聚维酮的质量比为1:(1.2~30),助溶剂和低聚合度聚维酮的质量比为(2.56~9):1。
- 根据权利要求1所述的制剂,其特征在于,所述表面活性剂或低聚合度聚维酮与治疗眼病的活性成分的质量比为(12~31):1。
- 根据权利要求1所述的制剂,其特征在于,所述糖皮质激素类药物为地塞米松、氢化可的松、泼尼松龙、倍他米松中的至少一种;所述非甾体类药物为双氯芬酸、普拉洛芬、吲哚美辛、溴芬酸钠中的至少一种。
- 根据权利要求1~12任一项所述的制剂,其特征在于,所述眼用制剂的载体或辅料含有纳米小体,所述纳米小体由眼用制剂的载体或辅料的成分自组装形成;所述纳米小体中包裹有治疗眼病的活性成分。
- 根据权利要求13所述的制剂,其特征在于,所述纳米小体为球形,其粒径为1~100nm;优选地,所述纳米小体粒径为5~30nm。
- 根据权利要求14所述的制剂,其特征在于:它含有纳米小球,所述纳米小球为球形,其粒径为10~2000nm;所述纳米小球是纳米小体自组装形成的;优选地,所述纳米小球粒径为100~2000nm。
- 一种制备权利要求1~15任一项所述的制剂的方法,其特征在于,包括以下步骤:(1)将表面活性剂和/或增粘剂加入溶剂中配制成溶液;(2)将治疗眼病的活性成分和/或助溶剂分散在步骤(1)得到的溶液中,再加入离子型高分子或其溶液,分散混合得到初悬液;(3)将步骤(2)得到的初悬液搅拌分散或均质分散,即得;或包括以下步骤:(a)将低聚合度聚维酮和/或增粘剂加入溶剂中配制成溶液;(b)将治疗眼病的活性成分和/或助溶剂分散在步骤(a)得到的溶液中,再加入中聚合度聚维酮或其溶液,分散混合得到初悬液;(c)将步骤(b)得到的混合液研磨或均质分散,即得。
- 根据权利要求16所述的方法,其特征在于,步骤(2)或步骤(b)中所述分散选自机械搅拌分散、磁力搅拌分散、涡旋振摇分散、剪切分散、均质分散、研磨分散、超声分散中的至少一种。
- 权利要求1~15任意一项所述的制剂在制备治疗眼底疾病的药物中的用途;优选地,所述治疗眼底疾病的药物为治疗黄斑水肿,和/或视神经炎,和/或非感染性眼内炎的药物。
- 根据权利要求18所述的用途,其特征在于,所述治疗黄斑水肿的药物为治疗眼底血管性疾病所致的黄斑水肿、网膜中央静脉阻塞性黄斑水肿、视网膜分支静脉阻塞性黄斑水肿、糖尿病性黄斑水肿、病理性近视黄斑水肿、和/或湿性年龄相关性黄斑变性所致黄斑水肿的药物。
- 一种治疗眼底疾病的方法,其特征在于,对患者使用有效治疗量的权利要求1~15任一项所述的制剂。
- 根据权利要求20所述的方法,其特征在于,所述眼底疾病为黄斑水肿,和/或视神经炎,和/或非感染性眼内炎。
- 根据权利要求21所述的方法,其特征在于,所述黄斑水肿为眼底血管性疾病所致的黄斑水肿、网膜中央静脉阻塞性黄斑水肿、视网膜分支静脉阻塞性黄斑水肿、糖尿病性黄斑水肿、病理性近视黄斑水肿、和/或湿性年龄相关性黄斑变性所致黄斑水肿。
- 根据权利要求20所述的方法,其特征在于,所述使用的方式是滴眼给予。
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