WO2022175428A1 - Composition hydrogel et ses utilisations dans la prévention et/ou le traitement des dommages cutanés causés par les rayonnements - Google Patents
Composition hydrogel et ses utilisations dans la prévention et/ou le traitement des dommages cutanés causés par les rayonnements Download PDFInfo
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- WO2022175428A1 WO2022175428A1 PCT/EP2022/054037 EP2022054037W WO2022175428A1 WO 2022175428 A1 WO2022175428 A1 WO 2022175428A1 EP 2022054037 W EP2022054037 W EP 2022054037W WO 2022175428 A1 WO2022175428 A1 WO 2022175428A1
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- composition
- composition according
- brimonidine
- skin
- concentration
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- JOXIMZWYDAKGHI-UHFFFAOYSA-N toluene-4-sulfonic acid Chemical compound CC1=CC=C(S(O)(=O)=O)C=C1 JOXIMZWYDAKGHI-UHFFFAOYSA-N 0.000 description 1
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Classifications
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- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0014—Skin, i.e. galenical aspects of topical compositions
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- 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
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/498—Pyrazines or piperazines ortho- and peri-condensed with carbocyclic ring systems, e.g. quinoxaline, phenazine
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- 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
- A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
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- 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
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- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/22—Heterocyclic compounds, e.g. ascorbic acid, tocopherol or pyrrolidones
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- A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
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- A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
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- A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
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- A61P17/16—Emollients or protectives, e.g. against radiation
Definitions
- the invention relates to the field of pharmaceutical compositions in a form suitable for topical administration. It relates more particularly to a pharmaceutical composition comprising a vasoconstrictor such as brimonidine or its salts, as well as such a composition for its use as a medicine, more particularly in the prevention and/or treatment of skin damage caused by radiation .
- a vasoconstrictor such as brimonidine or its salts
- UV ultraviolet
- UVA ultraviolet
- UVB ultraviolet
- IR infrared radiation
- ionizing radiation such as X-rays and alpha
- befa ionizing radiation
- gamma radiation even radiation composed of protons.
- One of the first tissue effects of radiation exposure is ⁇ erythema, an inflammatory response causing vasodilation of blood vessels and reddening of the skin. This ⁇ e reaction is ⁇ visible approximately 6 to 8 hours after UV exposure and ⁇ disappears after 36 to 48 hours.
- Dermal application of a highly selective alpha2-adrenergic receptor agonist to the face is known to reduce erythema through direct cutaneous vasoconstriction.
- the main characteristic of cutaneous vasoconstriction is ⁇ pallor; by reducing the diameter of the arterioles and small vessels of the dermis, this causes an immediate reduction in blood flow, producing in particular a reduction in the color of the skin.
- MIRVASO® gel (0.5% w/w brimonidine ⁇ ar ⁇ ra ⁇ e) is ⁇ indicated for the symptomatic treatment of facial erythema associated with rosacea in adults.
- This gel includes, in addition to brimonidine tartrate, carbomer homopolymer type B, glycerin, methylparaben, phenoxyetahnol, propylene glycol, sodium hydroxide, titanium dioxide and purified water.
- Brimonidine is best known as a highly selective alpha2-adrenergic receptor agonist. Brimonidine is ⁇ 1000 times more selective for alpha2-adrenergic receptors than for alpha 1-adrenergic receptors.
- Brimonidine has been shown to be useful in the treatment of erythema caused by acne rosacea, and has been proposed for other skin disorders, see for example patent application US10/853585, patent application US10/626037 and patent application US12/193098.
- a topical product for therapeutic purposes usually consists of an active ingredient and excipients.
- the choice of excipients is essential to guarantee the efficacy of the medicinal product by solubilizing the active ingredients and optimizing their skin penetration, for the stability of the galenic form and its texture, for the local tolerance e ⁇ for patient compliance.
- a complex and complementary challenge is to identify the optimal balance of these key factors to deliver a product that meets the needs of patients, healthcare professionals and regulators.
- Brimonidine ( ⁇ ar ⁇ ra ⁇ e) exhibits appropriate chemical stability for topical administration and a solubility profile that offers different formulation options.
- Brimonidine is ⁇ indeed a hydrophilic molecule e ⁇ therefore has a difficult penetration through the lipid stratum corneum.
- brimonidine is in a hydrophilic medium (epidermis, in particular the granular layer and the basal layer, then dermis), to be then eliminated, thus resulting in a loss of effectiveness in terms of vasoconstriction. .
- the structure of the barrier formed by the skin therefore constitutes a real challenge for obtaining a topical formulation intended to be applied to the skin allowing the vasoconstrictor active ingredient on the one hand ⁇ to pass the outer lipid layer and then not to be rapidly eliminated at the level of the lower hydrophilic layers in order to have a rapid, constant and prolonged vasoconstrictor effect for a period of 16 hours or even 24 hours.
- the concentration of active vasoconstrictor used must not be too high because it would then entail a risk of significant exposure and potentially harmful at the systemic level.
- MIRVASO® gel based on methyl parahydroxybenzoate, propylene glycol, carbomer, phenoxyethanol, glycerol, titanium dioxide, sodium hydroxide and ⁇ purified water is ⁇ for example not suitable for the prevention of radiation-related injuries; such a formulation has non-optimal pharmacokinetics with limited activity from 6 hours to 12 hours after application.
- it contains particles of titanium dioxide which interfere with the radiation if the latter is used for therapeutic purposes such as in the prevention or treatment of radiation dermatitis.
- Radiation dermatitis are ⁇ lesions that can be painful, are ⁇ worrying for the patient and ⁇ can lead to temporary or permanent discontinuation of treatment.
- emollients applied a few hours after the radiation session (for example DEXERYL®, TOPICREME®) moisturize the skin and bring transitory well-being to the patient.
- radiodermatitis lesions such as creams based on hyaluronic acid, TETA® cream or BIAFINE®. It is nevertheless recalled here that these treatments have not been proven to be effective and that, on the contrary, clinical studies have concluded that there is no effect.
- Topical corticosteroids for example DIPROSONE®
- DIPROSONE® Local topical corticosteroids
- topical corficoids do not bring any real benefits on the development of radiodermatitis, they are effective in the event of a local allergic reaction (for example in the event of eczema linked to the adhesives used for markings).
- the continuation of the radiotherapy treatment can be interrupted temporarily if the radiotherapist deems it necessary or preferable, depending on the progress of the treatment and the therapeutic priorities.
- a problem which the present invention proposes to solve consists in developing an optimized topical formulation based on a well-established vasoconstrictor, such as brimonidine ⁇ ar ⁇ ra ⁇ e, aimed at improving the duration e ⁇ the power of vasoconstrictor activity to significantly prevent and reduce the main cutaneous side effects caused by radiation, particularly in the treatment of cancer by radiotherapy.
- a well-established vasoconstrictor such as brimonidine ⁇ ar ⁇ ra ⁇ e
- the Applicant has developed a new topical composition which improves the duration and potency of vasoconstriction by allowing bioavailability of the vasoconstrictor in the dermis and epidermis for a period greater than 12-14 hours, to provide protection of the skin against skin damage induced by radiation and ⁇ more particularly against the cutaneous side effects of radiotherapy treatment, tou ⁇ avoiding any interference with the radiotherapy rays which would reduce ⁇ their effectiveness on the tumor treated or the radiation field.
- compositions according to the invention have been established around optimal solvent systems which facilitate cutaneous administration and ⁇ provide adequate physical, chemical and microbiological stability, in addition to appropriate local tolerance and cosmetic elegance. .
- the optimized topical composition thus proposed by the Applicant improves the duration of vasoconstriction (with a duration of at least 14 hours up to 24 hours) as well as the power thereof without disturbing the passage of radiation through the skin , which would compromise ⁇ its effectiveness.
- composition according to the invention will allow the creation of a reservoir of polar vasoconstrictor active ingredient at the level of the stratum corneum, a phenomenon usually obtained only with lipophilic molecules such as corticosteroids, the polar molecules generally being "washed out” quickly by the circulation blood. This allows a duration of persistence in the skin e ⁇ therefore a maximum e ⁇ rapid effect during each reapplication e ⁇ offers flexibility of use to patients e ⁇ to radiotherapists.
- composition adapted in particular to the treatment by radiotherapy makes it possible to promote patient compliance and ⁇ to maximize the effectiveness of the anticancer treatment.
- the new topical formulation thus developed by the Applicant is ⁇ well tolerated because it is non-irritating or very slightly irritating compared to the compositions of the prior art, with improved skin penetration and solubilization of brimonidine tartrate.
- compositions according to the invention developed are also economical, easy and quick to prepare.
- compositions in a form suitable for topical water-based administration comprising a vasoconstrictor, said vasoconstrictor being chosen from brimonidine or its salts, in a solvent phase comprising:
- hydrophilic film-forming agent chosen from a Polyvinylpyrrolidone/Vinyl Acetate copolymer, polyvinylpyrrolidone (PVP) in a non-crosslinked, crosslinked or acetate form, taken alone or in combination, preferably a polyvinylpyrrolidone/vinyl acetate copolymer as hydrophilic film-forming agent; and
- composition being in the form of a hydrogel.
- composition according to the invention for its use as a medicament.
- Figure 1 shows the skin whitening scores obtained with different hydrogel compositions 19-0155.0058/Fl, 19-0155.0059/Fl, 19-0155.0060/Fl and 19-0155.0061/Fl.
- FIG. 2 represents the skin whitening scores obtained with different hydrogel compositions 19-0155.0100/Fl and 19-0155.0101/Fl.
- Figure 3 represents the skin whitening scores obtained with different hydrogel compositions optionally comprising an antioxidant and a surfactant: 19-0155.01 1 1 /Fl (control; without antioxidant, without solubilizing agent), 19-0155.01 17/Fl (l % Tween 80 and 0.1% BHA), 19-0155.0121/Fl (1.5% Tween 80 and 0.1% BHA), 19-0155.0124/Fl (1% Kolliphor RH40 and 0.1% DL Tocopherol) , and 19-0155.0125/Fl (3% Kolliphor RH40 and 1% DL Tocopherol).
- an antioxidant optionally comprising an antioxidant and a surfactant: 19-0155.01 1 1 /Fl (control; without antioxidant, without solubilizing agent), 19-0155.01 17/Fl (l % Tween 80 and 0.1% BHA), 19-0155.0121/Fl (1.5% Tween 80 and 0.1% BHA), 19-0155.0124/Fl (1% Kolliphor RH40 and 0.
- FIG. 4 represents the skin whitening scores obtained with different hydrogel compositions 19-0155.0101/F1, 19-0155.0111/F1 and 19-0155.0112/F1.
- FIG. 5 represents the skin whitening scores obtained with different active hydrogel compositions (including brimonidine tartrate) or without active (comprising only the vehicle).
- FIG. 6 represents the mean erythema scores obtained with different active hydrogel compositions (comprising brimonidine tartrate) or without active (comprising only the vehicle).
- Figure 7 represents the skin whitening scores obtained with the same hydrogel composition by varying the concentration of active ingredient (brimonidine tartrate 1.5%, 0.75%, 0.25% and 0.15% w/w) .
- Figure 8 represents the skin whitening scores obtained with reference vasoconstrictor products.
- FIG. 9 represents the skin whitening scores obtained in a comparative manner between a hydrogel composition according to the invention and a MIRVASO composition modified with 1.5% w/w of brimonidine tartrate (19-0155-0098/F1) as well as with a Norepinephrine solution and the product MIRVASO® (0.5% w/w of brimonidine tartrate).
- FIG. 10 represents the skin whitening scores obtained in a comparative manner between a hydrogel composition according to the invention containing different concentrations of xanthan gum and the MIRVASO® product.
- the invention relates to a composition in a form suitable for topical water-based administration comprising a vasoconstructor.
- the topical composition according to the invention is characterized in that it is in the form of a hydrogel.
- Hydrogels are ⁇ defined as hydrophilic three-dimensional polymeric matrices capable of absorbing and ⁇ swelling with water without dissolving.
- hydrogels typically are ⁇ that they are ⁇ not compatible with lipophilic active ingredients or excipients, known to promote skin delivery and have good sensory qualities, without the addition of pharmaceutically acceptable solvents which are ⁇ hydrophilic in nature.
- pharmaceutically acceptable solvents which are ⁇ hydrophilic in nature.
- tolerability and organoleptic characteristics may be compromised.
- Hydrogels are ⁇ dosage forms advantageously used for topical treatment of skin diseases because they are ⁇ generally very well tolerated and ⁇ facilitate the application of the active ingredient. These attributes are ⁇ combined with high water content and ⁇ the use of effective and ⁇ biocompatible polymeric gelling agents.
- Such a composition is ⁇ advantageously suitable for delivering hydrophilic active agents such as brimonidine, e ⁇ preferentially brimonidine ⁇ ar ⁇ ra ⁇ e e ⁇ promotes penetration into the skin e ⁇ permeation through the skin.
- hydrophilic active agents such as brimonidine, e ⁇ preferentially brimonidine ⁇ ar ⁇ ra ⁇ e e ⁇ promotes penetration into the skin e ⁇ permeation through the skin.
- the hydrogels according to the invention have a low viscosity e ⁇ and can be spread easily on the site of application at the level of the skin. They allow relatively rapid absorption of the finished product while leaving minimal residue on the surface of the skin after drying quickly with no feeling of residue within 10 minutes after application, preferably less than 5 minutes, more preferably less than 2 minutes. minutes and even more advantageously less than one minute after application.
- the topical compositions according to the invention have a viscosity of between 50 cps and 3000 cps, preferably between 300 cps and 2800 cps, for example approximately 500 cps, 1000 cps, 1500 cps, 1600 cps, 1700 cps, 1800 cps. cps, 2000 cps, 2500 cps or 2750 cps.
- the hydrogels according to the invention also offer a hydrating sensation thanks to a high water and glycol content as well as the possibility of using polymers to modulate water retention and prolonged solubilization of the active ingredient on the surface. e ⁇ thus prolonging the effective duration of vasoconstriction following dermal administration.
- the topical composition according to the invention is characterized in that it comprises a vasoconstrictor chosen from brimonidine or its salts, in a solvent phase comprising:
- hydrophilic film-forming agent chosen from a Polyvinylpyrrolidone/Vinyl Ace ⁇ a ⁇ e copolymer (KOLLIDON VA 64®), polyvinylpyrrolidone (PVP) in a non-crosslinked form, crosslinked or acetate, taken alone or in combination, preferably a Polyvinylpyrrolidone/Vinyl Acefafe copolymer as hydrophilic film-forming agent; e ⁇
- salts or pharmaceutically acceptable salts are meant those salts of a compound of interest which are safe and effective for topical use in mammals and which possess a desired biological activity.
- Pharmaceutically acceptable salts include salts of acidic or basic groups present in the specified compounds.
- Pharmaceutically acceptable acid addition salts include, but are not limited to, hydrochloride, hydrobromide, hydroiodide, nitrate, sulfate, bisulfate, phosphate, acid phosphate, isonicotinate, acetate, lactate, salicylate, citrate, tartrate salts.
- pantothenate bitartrate, ascorbate, succinate, maleate, gentisinate, fumarate, gluconate, glucuronate, saccharate, formate, benzoate, glutamate, methanesulfonate, ethanesulfonate, benzenesulfonate, p-toluenesulfonate e ⁇ pamoate (i.e. l ,1'-methylene-bis-(2-hydroxy-3-naph ⁇ oa ⁇ e)).
- Certain compounds used in the present invention can form pharmaceutically acceptable salts with various amino acids.
- Suitable base salts include, but are not limited to, aluminum, calcium, lithium, magnesium, potassium, sodium, zinc, and diethanolamine salts.
- hydrate means a compound of interest, or a pharmaceutically acceptable salt thereof which further comprises a stoichiometric or non-stoichiometric amount of water bound thereto by non-intermolecular forces. covalent.
- the brimonidine used in the compositions according to the invention is brimonidine tartrate, although the salt form presents a stability challenge for a hydrogel formulation.
- the salts can interact with surfactants and ⁇ nonionic polymers and ⁇ reduce their aqueous solubility and thus harm the physical stability of the semi-solid formulation.
- the salt form of the active generates a relatively high aqueous solubility e ⁇ advantageously allows the design and evaluation of aqueous-based formulations, which can offer improved performance in terms of local sensory tolerance e ⁇ .
- Concentrations between 0.15% and ⁇ 3.00% of brimonidine or its salts, preferably brimonidine tartrate, by weight of the total weight of the composition are ⁇ preferably used to obtain efficacy and duration of effect improved up to 24 hours after application tou ⁇ by preventing tou ⁇ risk of systemic exposure.
- the composition according to the invention comprises brimonidine or its salts, preferably brimonidine tartrate at a concentration of between 0.50% and 2.50% by weight of the total weight of the composition, preferably between 0, 75% e ⁇ 1.50% w/w, more preferably between 1.00% e ⁇ 1.50% w/w, even more preferably 1.00% or 1.50% W/W
- concentration of brimonidine, preferably of brimonidine wax, and the dose thus applied are advantageously adapted according to the site of application.
- the barrier constituted by the skin is ⁇ thicker, particularly in terms of the stratum corneum to be crossed at the level of the feet and the hands than of the scalp, the rest of the body, and in particular the chest, presenting an intermediate thickness.
- the concentration preferably used is ⁇ advantageously lower on the scalp, for example of the order of 0.15-0.5% w/w, compared to that used on the rest of the body.
- the topical composition according to the invention is characterized in that it comprises polyethylene glycol (PEG) in combination with propylene glycol and/or dimethyl sulphoxide (DMSO).
- PEG polyethylene glycol
- DMSO dimethyl sulphoxide
- PEGs polyethylene glycols
- the high solubilizing capacity of PEGs can ⁇ result in suboptimal thermodynamics for topical administration, and ⁇ when used at high concentrations, product transformation, often associated with evaporation of volatile components such as water, cannot ⁇ be used to enhance dermal release.
- these features may reduce delivery efficiency, although high concentrations are possible; much of the applied dose of topical agents remains on the surface of the skin or is lost to the environment by contact transfer.
- Increased delivery efficiency, fraction of the applied dose may ⁇ limit the need to increase the dose to achieve targeted levels of dermal delivery and the need to use high concentrations of PEG.
- the PEGs are essential to the topical formulation.
- PEGs with small molecular weights up to PEG-600 are preferably used, more preferably PEG-400 and even more preferably PEG- 400 SR advantageously promoting the stability and tolerance of the hydrogel composition according to the invention by limiting the potential for irritation, eliminating the polar impurities and thus reducing the excipient-active interaction (brimonidine farfrafe) and the subsequent degradation of the active.
- PEG-400 or PEG-400 SR exhibits relatively poor penetration into the stratum corneum due to its molecular weight and high polarity (low partition coefficient), it is ⁇ the PEG preferentially used in the hydrogel composition. according to the invention to reduce the rate of precipitation of the active agent at the surface of the skin e ⁇ in the upper layers of the stratum corneum, for surface solubilization. This promotes sustained delivery of brimonidine tartrate into viable layers of skin e ⁇ specifically into the vasculature of the dermal plexus where the target site for brimonidine ⁇ ar ⁇ ra ⁇ e is located.
- PEG-400 or PEG-400 SR has adequate solubility to promote better retention of brimonidine ⁇ ar ⁇ ra ⁇ e in solution on the surface of the skin and in the upper layers of the stratum corneum.
- the composition according to the invention comprises PEG at a concentration of between 1% and 20% by weight of the total weight of the composition, preferably between 5% and 15%, more preferably of 10%.
- Propylene glycol (PG, 1,2-propanediol) is ⁇ a clear, colorless, hygroscopic liquid that is widely used as a solvent and preservative in a variety of parenteral and non-parenteral pharmaceutical formulations.
- PG is ⁇ known to be a better general solvent than glycerin e ⁇ dissolves a wide variety of materials including corticosteroids, phenols, barbiturates, vitamins (A e ⁇ D), most alkaloids e ⁇ de many local anesthetics.
- PG exhibits 50% of the solubilizing capacity of glycerin.
- PG As an antibacterial agent, PG has an effect similar to that of ethanol; however, it is ⁇ slightly less effective against mold with a profile comparable to glycerin.
- PG also exhibits some volatility: although a fraction of the applied dose evaporates upon application to the skin or at least within 37 hours after application, a much larger portion penetrates the stratum corneum. e ⁇ penetrates the deeper layers of the skin.
- the relatively rapid penetration of PG through the stratum corneum and its volatility can deplete the residual vehicle of its solvent, increase the thermodynamic activity of the active in the vehicle and thus modify the driving force of diffusion.
- penetration and permeation of PG can also disrupt the stratum corneum lipid barrier and therefore reduce diffusional resistance.
- PG thus has favorable physico-chemical properties in terms of penetration e ⁇ skin permeation e ⁇ es ⁇ absorbed through the skin. Therefore, solutes that are ⁇ readily dissolved by PG (i.e. high affinity for solvent/vehicle) can advantageously benefit from an improvement in their cutaneous penetration via a mechanism of resistance to the solvent or fraction effects.
- a fortiori, PG is ⁇ known to penetrate the skin faster than most active ingredients and therefore the precipitation of the active ingredient on the surface of the skin will limit its duration of action.
- concentrations of PG are generally limited to about 20% w/w or less, to avoid local irritant reactions and cause systemic toxicity issues.
- the composition according to the invention comprises PG at a concentration of between 5% and 40% by weight of the total weight of the composition, preferably between 10% and 30%, more preferably between 15% and 25 %, even more preferably 20%.
- Dimethyl sulfoxide is ⁇ a colorless, odorless, water-miscible and hygroscopic aprotic solvent. It is known for its abilities to dissolve many small polar and non-polar molecules in addition to several polymeric agents as well as as an agent facilitating the penetration of hydrophilic and lipophilic compounds, including antiviral agents, steroids and antibiotics .
- DMSO easily penetrates and impregnates the skin.
- DMSO can also provide a solvent trail effect in dermal active delivery farms.
- DMSO can be used as an active solubilizer in the stratum corneum, for example at a concentration of 45% in the topical analgesic product PENNSAID®.
- DMSO is preferably used at a limited concentration compared to those of the aforementioned prior art, less than 20% w/w, preferably less than 10% w/w, more preferably 1 5% p/p order.
- the relatively high solubility of brimonidine ⁇ ar ⁇ ra ⁇ e in DMSO coupled with a limited concentration in ton ⁇ a preferred solvent for the compositions according to the invention is provided.
- hydrogel compositions according to the invention it is particularly advantageous in the context of the hydrogel compositions according to the invention to control the PEG:PG and/or PEG:DMSO ratio.
- PEG and PG are used in a ratio of 1:1 to 1:5, preferably 1:2.
- PEG and DMSO are used in a ratio of 1:1 to 5:1, preferably 2:1.
- the PEG is ⁇ taken in combination with the PG only, more preferentially a PEG-400 SR e ⁇ PG combination.
- the composition according to the invention comprises polyethylene glycol (PEG) at a concentration of 10% by weight of the total weight of the composition in combination with propylene glycol (PG) at a concentration of 20% by weight of the total weight of composition.
- PEG polyethylene glycol
- PG propylene glycol
- the topical composition according to the invention is characterized in that it comprises a hydrophilic film-forming agent chosen from a polyvinylpyrrolidone/vinyl acetate copolymer, polyvinylpyrrolidone (PVP) in a non-crosslinked, crosslinked or acetate form, taken alone or in combination.
- a hydrophilic film-forming agent chosen from a polyvinylpyrrolidone/vinyl acetate copolymer, polyvinylpyrrolidone (PVP) in a non-crosslinked, crosslinked or acetate form, taken alone or in combination.
- the composition according to the invention comprises the hydrophilic film-forming agent, taken alone or in combination, at a concentration of between 0.1% and 1.5% by weight of the weight total of the composition, preferably between 0.25% and 1.4%, more preferably between 0.5% and 1.3%, even more preferably between 0.75 and 1.25, even more preferably 1% .
- the topical composition according to the invention comprises a Polyvinylpyrrolidone/Vinyl Acefafe copolymer (KOLLIDON VA 64®) as hydrophilic film-forming agent.
- a Polyvinylpyrrolidone/Vinyl Acefafe copolymer (KOLLIDON VA 64®) as hydrophilic film-forming agent.
- the composition according to the invention comprises the Polyvinylpyrrolidone/Vinyl Acefafe copolymer (KOLLIDON VA 64®) at a concentration of between 0.1% and 1.5% by weight of the total weight of the composition, preferably between 0. 25% and 1.4%, more preferably between 0.5% and 1.3%, even more preferably between 0.75 and 1.25, even more preferably 1%.
- KLLIDON VA 64® Polyvinylpyrrolidone/Vinyl Acefafe copolymer
- the topical composition according to the invention is characterized in that it additionally comprises glycerin.
- Glycerin (glycerol) is ⁇ a well-known humectant that can ⁇ increase water retention in the stratum corneum and improve hydration.
- Glycerin is also known and used to support the normal functioning of the skin barrier, promote skin elasticity and plasticity, improve skin smoothness and provide an ⁇ i-irri ⁇ an ⁇ effects. s. Glycerin is indeed capable of attracting water into the stratum corneum from the epidermis and from the atmosphere.
- glycerin Due to its relatively high polarity, glycerin does not penetrate the skin to the same degree and depth as propylene glycol but can accumulate and form a reservoir in the hydrophilic regions of the stratum corneum and increase the content of water.
- Glycerin's interaction with the stratum corneum, its dermal distribution e ⁇ its relatively high solubility for brimonidine tartrate (twice that of propylene glycol) offer advantages in terms of improved dermal delivery e ⁇ of extension of skin penetration without causing a sticky effect on the surface of the skin.
- the composition according to the invention comprises glycerin at a concentration of between 1% and 20% by weight of the total weight of the composition, preferably between 2% and 15%, more preferably between 3% and 10 %, even more preferably 4%.
- the combination of PG e ⁇ with glycerin improves the distribution of the active ingredient, preferentially brimonidine ⁇ ar ⁇ ra ⁇ e in the stratum corneum.
- DMSO provides ⁇ a similar function to PG but with higher solubility for brimonidine ⁇ ar ⁇ ra ⁇ e.
- This solubility differential is ⁇ an advantage for dermal administration.
- the topical composition according to the invention further comprises a gelling agent chosen from xanthan gum and hydroxyethylcellulose (HEC), taken alone or in combination, more preferably the topical composition according to the invention comprises at least the gum xanthan as a gelling agent.
- a gelling agent chosen from xanthan gum and hydroxyethylcellulose (HEC), taken alone or in combination, more preferably the topical composition according to the invention comprises at least the gum xanthan as a gelling agent. 14
- the composition according to the invention comprises xanthan gum and/or HEC at a concentration of between 0.1% and 1.5% by weight of the total weight of the composition, preferably between 0.2% and 1% , more preferentially between 0.2% and 0.75%, even more preferentially respectively from 0.2-0.5% for xanthan gum and 0.3-0.5% for HEC preferentially taken in combination.
- hydrogel compositions according to the invention comprising xanthan gum (XANTHANE FNCSP-PC®) and/or HEC (NATROSOL 250HHX®) are indicated in Table 1 below.
- a flexible mixed film is thus advantageously formed on the surface of the skin with xanthan gum and/or HEC and the Polyvinylpyrrolidone/Vinyl Acetate copolymer (KOLLIDON VA 64®) in addition to the other non-volatile solvents, PG and PEG, making it possible to create a reservoir of brimonidine, preferably brimonidine tartrate, and thus slow down the precipitation of brimonidine and prolong its duration of action.
- the topical composition according to the invention also comprises a natural or synthetic antioxidant, or a free radical scavenger.
- the antioxidant is preferably chosen from bufylated hydroxyanisole (BHA), DL-focopherol, bufylhydroxyfoluene (BHT), propaldehyde, palmifate ascorbate or glutathione, taken alone or as a mixture, preferably BHA and/or DL-focopherol.
- BHA bufylated hydroxyanisole
- BHT bufylhydroxyfoluene
- propaldehyde palmifate ascorbate or glutathione
- the antioxidant is ⁇ preferably used in the hydrogel compositions according to the invention at a concentration of between 0.01% e ⁇ 4.0% by weight of the total weight of the composition, more preferably between 0.1% e ⁇ 1 , 0% w/w, even more preferably 0.1%, for example BHA at 0.1% w/w and/or DL-tocopherol at 0.1% w/w.
- the composition preferably used according to the invention comprises the free radical scavenger, preferably amifostine, at a concentration of between 0.1% and 3% by weight of the total weight of the composition, for example 2, 5% w/w.
- the free radical scavenger preferably amifostine
- the topical composition according to the invention comprises an antioxidant, it also comprises a polysorbate, preferably polysorbate 80 (TWEEN 80 SR®) and/or polyoxyethylenated hydrogenated castor oil 40 (KOLLIPHOR RH 40®) .
- a polysorbate preferably polysorbate 80 (TWEEN 80 SR®) and/or polyoxyethylenated hydrogenated castor oil 40 (KOLLIPHOR RH 40®) .
- the topical composition according to the invention comprises less than 5% polysorbate, preferably polysorbate 80 (TWEEN 80 SR®), by weight of the total weight of the composition, more preferably 1-1.5%, even more preferably 1% , and/or less than 3% of polyoxyethylenated 40 hydrogenated castor oil by weight of the total weight of the composition, preferably 1% of polyoxyethylenated 40 hydrogenated castor oil.
- polysorbate 80 TWEEN 80 SR®
- the topical composition according to the invention also comprises oleic alcohol (KOLLICREAM OA®) and vitamin E, taken alone or in combination.
- KOLLICREAM OA® oleic alcohol
- vitamin E taken alone or in combination.
- antioxidants improves the stability of the active ingredient.
- hydrogel compositions according to the invention thus make it possible to improve e ⁇ prolong the cutaneous administration of brimonidine ⁇ ar ⁇ ra ⁇ e ⁇ to meet the needs of patients with adequate local vasoconstriction e ⁇ prolonged e ⁇ protection of the epidermis and upper dermis in relation to reactive oxygen species and inflammatory mediators.
- compositions according to the invention are easy to apply and can be applied to potentially irritated skin.
- the topical compositions according to the invention have a pH of between 4.0 and 6.0, preferably between 4.2 and 5.5, more preferably between 4.3 and 5.0, even more preferably 4 ,5.
- the hydrogel composition according to the invention for its use as a medicament.
- the hydrogel composition according to the invention is used for the prevention and/or treatment of damage caused by radiation, whether this radiation is photons or protons and whether it is natural, therapeutic or accidental, including ultraviolet (UV) including UVA and UVB which can cause sunburn, rays in the visible range, infrared radiation (IR), or even ionizing radiation such as X-rays and alpha, beta, gamma or again the proton beams.
- UV ultraviolet
- UVA and UVB which can cause sunburn
- rays in the visible range infrared radiation (IR)
- IR infrared radiation
- ionizing radiation such as X-rays and alpha, beta, gamma or again the proton beams.
- the hydrogel composition according to the invention is used for the prevention and/or the treatment of dermatitis resulting from a treatment by radiotherapy, for example by X-rays or by protons.
- Saturated solutions were prepared by adding excess drug to various solvents and storing samples in sealed containers for 24 hours at room temperature with continuous agitation.
- DMSO appears to be an excellent solvent for brimonidine fartrafe and saturation was not reached even after the addition of 8.5% w/w of brimonidine fartrafe.
- GLY glycerin
- PG propylene glycol
- PEG-400 glycerin
- non-aqueous mixtures of solvents appear to have less solubilizing power than the mixtures containing water.
- non-volatile mixture containing PG/PEG-400/GLY/PVP (20:10:5:1) was able to solubilize approximately 22% of the active ingredient compared to the aqueous mixture PG/PEG-400/GLY/PVP/water (20:10:5:1:40).
- non-volatile polar components of an aqueous gel may have some ability to dissolve brimonidine tartrate on the skin surface and in the stratum corneum into the residual formula even after the water has evaporated.
- the average values are between 99.36% and 101.45% with a relative standard deviation of less than 1%.
- Solvent blends without Glucam E20 show the most favorable stability profile and glycerin appears to improve stability.
- Glucam E10 was included in the compositions at a concentration of 5%, the stability of brimonidine farfrafe improved. Bimonidine tartrate assay values tend to decrease with increasing Glucam concentration.
- the most stable mixture of solvents was obtained for M8 (30% Transcutol in water) then for Ml (10% DMSO, 5% Glucam E10 and 5% Glycerin in water).
- Example 4 Evaluation of the effect of different solvents in formulations according to the invention on the whitening of the skin
- propylene glycol (PG), dimethyl sulphoxide (DMSO) and polyethylene glycol 400 (PEG-400) have been identified as solvents of interest for brimonidine tartrate.
- PG propylene glycol
- DMSO dimethyl sulphoxide
- PEG-400 polyethylene glycol 400
- concentration of these solvents was varied in different low viscosity hydrogel formulations (Table 6) and skin whitening was assessed using the skin whitening model.
- concentrations for each solvent tested was based on solubility data and local tolerance considerations. For example, DMSO being a better solvent than PG for brimonidine tartrate, a lower concentration was chosen to create more favorable thermodynamic activity in the residual formula.
- hydroxyethyl cellulose HEC, Natrasol HHX
- HEC hydroxyethyl cellulose
- Skin whitening scores are plotted in Figure 1 (average of 3 replicates) and trends were used to interpret the data.
- Example 5 Evaluation of the effect of different polymers in formulations according to the invention on skin whitening
- Table 7 Low viscosity hydrogel compositions 19-0155.0100/Fl, 19-0155.0101/Fl, 19-0155.0111/Fl and 19-0155.0112/Fl
- the two low viscosity hydrogels tested generated acceptable skin whitening profiles.
- the same solvent system (20% PG + 10% PEG-400) was used in each of the two compositions but the polymer combinations are ⁇ different in that formula 19-0155.0100/Fl contains KOLLIDON VA-64 ®, NATROSOL HEC® e ⁇ xanthan gum while the 19-0155.0101/Fl formula contains only xanthan gum. Therefore, the 19-0155.0100/Fl formula has a higher viscosity and greater adhesion to the skin after application than the 19-0155.0101/Fl formula.
- Example 6 Test of the effect of different antioxidants in formulations according to
- pH is ⁇ an important element in supporting chemical stability. Based on preliminary work and the natural pH of the skin, values between pH 4.0-5.5 have been targeted. Another important element is ⁇ oxidation e ⁇ as a preliminary step to prevent or control oxidation, this involves screening for antioxidants.
- the first step in the antioxidant selection process is to assess the physical compatibility of antioxidants with formulations of interest.
- Many effective antioxidants are ⁇ lipophilic in nature, eg Butylhydroxyto-luene (BHT), Butylhydroxyanisole (BHA) Propyl gallate and ⁇ tocopherol.
- BHT Butylhydroxyto-luene
- BHA Butylhydroxyanisole
- Tocopherol Propyl gallate and ⁇ tocopherol
- BHA is ⁇ a highly fat-soluble antioxidant that is widely used in bulk oils as well as oil-in-water emulsions. BHA has been reported to possess antimicrobial activity and has demonstrated co-an ⁇ ioxidan ⁇ activity via the regeneration of other antioxidants such as BHT and alpha-tocopherol. BHA is ⁇ often used in combination with BHT and ⁇ propoyl gallate and ⁇ with sequestrants or synergists such as citric acid.
- Naturally occurring vitamin E is ⁇ called RRR-alpha-tocopherol (commonly known as d-alpha-tocopherol); the synthetically produced form is ⁇ all-rac-alpha-tocopherol (commonly known as dl-a-tocopherol).
- ⁇ -Tocopherol is ⁇ a lipophilic antioxidant e ⁇ plays an important role in a broad spectrum of biochemical and physiological processes e ⁇ has been selected as a proton donor. It has synergistic effects with vitamin C and ⁇ other natural antioxidants. ⁇ -Tocopherol effects have also been reported to regenerate in neutral and acidic environments.
- solubilizer Despite the presence of PG e ⁇ of PEG-400, potential solvents for lipophilic antioxidants, the use of additional solubilizer(s) could be advantageous.
- Two surfactants commonly used as solubilizers were screened: TWEEN 80® (polysorbate 80) and KOLLIPHOR RH40® (polyoxyethylene hydrogenated castor oil 40).
- compositions tested in this ⁇ example are ⁇ described in Table 8.
- the pH of the compositions is within the acceptable range of 4.5 to 5 even after 3 months storage at 40°C.
- formula 19-0155.0125/Fl has a cloudy appearance and this could be linked to the increase in antioxidant (1% tocopherol) compared to the other compositions tested. It is necessary to increase the concentration of KOLLIPHOR RH40® to solubilize the high tocopherol load. Even when the tocopherol content is ⁇ decreased from 1% to 0.5%, compositors exhibit blurring (data not shown).
- the 19-0155.0125/Fl formula behaves significantly less well than the other compositions with a much slower onset, a weaker peak and a shorter bleaching time. In fact, the bleaching returned to baseline after 4:00 p.m. It was hypothesized that the higher concentration of KOLLIPHOR RH40®, 3.0%, may be responsible for altering the thermodynamic activity and release of brimonidine farfrafe from the primary and/or residual composition. . A similar effect on skin whitening was observed when 5% Tween 80 was used in combination with 0.1% BHA in the formula 19-0155.0112/Fl (Table 7) as shown in Figure 4 .
- concentrations of anfioxydanfs less than or equal to 0.1% of BHA and tocopherol can be advantageously incorporated into hydrogel compositions according to the invention comprising up to 1.5% of TWEEN 80® e ⁇ up to 1% KOLLIPHOR RH40® without physical instability or compromising the onset, intensity or duration of skin whitening.
- Example 7 Evaluation of the Effect on Skin Whitening of Different Compositions of Low-Viscosity Hvdroaels Using an In Vivo Vasoconstriction Model
- compositions and physical stability data of the low viscosity hydrogels tested are ⁇ described in Table 9. These formulations are ⁇ based on compositions 19.0155-0101 and 19.0155-0121 after positive stability and performance evaluations.
- compositions were tested in triplicate using the in vivo vasoconstriction protocol as described below.
- each composition 60 microliters of each composition were applied once in a blind random manner at 8 a.m. to the upper chest, using a positive displacement pipette, on a 10 cm2 area defined using plastic O-rings.
- compositions comprising brimonidine tartrate and the vehicles listed in Table 10 were evaluated using the UV-induced erythema model. The compositions were applied using the protocol as specified below. This involves application in the evening before UV irradiation and ⁇ 2 hours before UV irradiation in three healthy volunteers.
- MED erythemal doses
- Table 10 Summary information on compositions tested using UV-induced erythema
- Active compositions containing 1.5% brimonidine ⁇ ar ⁇ ra ⁇ e demonstrated substantial reductions in erythema scores compared to vehicles. Additional benefits in terms of anti-erythematous effects were observed when 1.5% w/w brimonidine ⁇ ar ⁇ ra ⁇ e ⁇ was combined with antioxidants. BHA and Ga-tocopherol have been used as model antioxidants at concentrations of 0.1% and 1% w/w.
- hydrogel compositions according to the invention have demonstrated effective anfieryfhemafous properties in the UV-induced erythema model.
- brimonidine tartrate When 1.5% w/w brimonidine tartrate was combined with antioxidants, BHA or ⁇ -tocopherol, additional benefits were observed in terms of treatment and/or prevention of erythema.
- BHA antioxidants
- ⁇ -tocopherol antioxidants
- additional benefits were observed in terms of treatment and/or prevention of erythema.
- the most potent anti-erythematous effects were observed when brimonidine ⁇ ar ⁇ ra ⁇ e ⁇ was combined with 1.0% of each antioxidant.
- Example 9 Performance test - in vivo human skin whitening model
- vasoconstriction An in vivo vasoconstriction model was adapted to study and evaluate the performance of topical formulations according to the invention in terms of onset, magnitude and duration of the effect.
- products are ⁇ applied to the ventral forearms and ⁇ based on skin bleaching, an arbitrary score of 0, 1, 2, or 3 is assigned.
- Table 11 Low viscosity hydrogel compositions (19-0155.0111/Fl, 19-0155.0128/Fl , 19-0155.0129/Fl and 19-0155.0130/Fl) containing different concentrations of brimonidine
- Formula 19-0155.0111/Fl, containing 1.5% brimonidine ⁇ ar ⁇ ra ⁇ e ⁇ is ⁇ the only formula to achieve a maximum skin whitening score of 3.0 e ⁇ stays above 1.0 at 12 hour intervals.
- Example 10 Performance of reference products in the skin whitening model
- the skin whitening (vasoconstriction) model was tested using reference pharmaceuticals known to induce skin whitening/vasoconstriction. Initial studies were ⁇ performed with:
- Norepinephrine hydrochloride solution (82 mg/ml in 70:30 ethanol:water) as used by Fahl (Effect of topical vasoconstrictor exposure upon tumoricidal radiotherapy. In ⁇ J Cancer: 135(4):981-988, 2014 ) e ⁇ similar to the wording used by Cleary et al. (Significan ⁇ suppression of radiation dermatitis in breas ⁇ cancer patients using a topically applied adrenergic vasoconstrictor. Radiation Oncology, 2017).
- the skin whitening model allows to differentiate the skin whitening capacity caused by several actives applied in different formulations in terms of onset, intensity and duration of skin whitening.
- the model exhibits adequate reproducibility and discriminatory performance for the formulation screening phase.
- Clobetasol Propionate Cream has been selected as a well-defined product/ac ⁇ ive that is involved in skin whitening. In fact ⁇ , the efficacy and in vivo bioequivalence of topical corticosteroids (1997 FDA guidance, https://www.fda.gov/media/70931/download) is ⁇ assessed using this ⁇ vasoconstriction effect.
- MIRVASO® gel did not generate significant whitening. This was expected as it was designed for application to relatively thin and sensitive facial skin in the treatment of rosacea. These products generally do not contain high concentrations of potential skin-penetrating agents due to the skin sensitivity of rosacea patients. In addition, the skin of the face is ⁇ thinner than the skin of the chest, e ⁇ thus has a lower barrier to skin penetration and ⁇ to permeation. Intensity and duration of action are insufficient to meet the desired radiation dermatitis requirements.
- Norepinephrine (noradrenaline) solution produced rapid and intermediate skin whitening 1 hour after application: however, the effect began to fade after the 4 hour observation interval. Whitening was 0.5 or less after 10 hours and returned to baseline only after 16 hours. While the initial effects were promising, the duration and intensity of the effect were not sufficient. Unlike the polar molecule norepinephrine and its aqueous ethanol vehicle, clobetasol propionate cream exhibited a slow onset of action with a gradual increase over 2 hours to a peak whitening score of 2.0 between 14 and 16 hours. There is a rapid reduction in bleaching starting at 4 p.m. and returning to baseline at 12 a.m.
- the slower onset of action of clobetasol bleaching may be related to the physico-chemical characteristics of the active, whereby its lipophilic character results in reservoir formation and more limited distribution in viable epidermis compared to the more hydrophilic norepinephrine. It is also important to note that the pharmacodynamic mechanisms of vasoconstriction are also different for clobetasol propionate and norepinephrine.
- a modified formula of the MIRVASO type was prepared with a high dose of 1.5% w/w of brimonidine ⁇ ar ⁇ ra ⁇ e (19-0155-0098/Fl). This ⁇ e evaluation was conducted to assess the impact of an increased dose on skin whitening in a vehicle similar to MIRVASO.
- a low viscosity hydrogel composition according to the invention (19-0155-101/F1) was also tested at the same concentration. The corresponding skin whitening results for the two formulations are ⁇ shown in Figure 9. Norepinephrine solution and commercially available MIRVASO® gel (brimonidine ⁇ ar ⁇ ra ⁇ e 0.5%) are ⁇ also included for comparison purposes.
- compositions thus tested are ⁇ detailed in the table above ⁇ .
- the modified MIRVASO gel (1.5% Brimonidine tartrate 19-0155-0098/Fl) caused a substantial increase in the intensity e ⁇ of the duration of skin whitening compared to the marketed MIRVASO® gel (0.5 % Brimonidine tartrate).
- the intensity of the whitening of the skin did not persist for a prolonged period of time as desired to solve the technical problem according to the invention.
- a low viscosity hydrogel formulation according to the invention (19-0155-101/Fl) offered improved performance compared to the modified MIRVASO gel (1.5% Brimonidine tartrate 19-0155-0098/Fl) in terms of onset of action, peak effect and duration of action.
- the low-viscosity hydrogel formulation according to the invention (19-0155-101/F1) demonstrated substantial performance superiority from 8 hours after application (FIG. 9).
- Example 1 1 This example is carried out to demonstrate the advan ⁇ ages provided by increasing the concen ⁇ ra ⁇ ion of xan ⁇ hane gum in the hydrogel compositions according to the inven ⁇ ion.
- the ⁇ ormula ⁇ ion hydrogel 19-0155.0163 contains 0.5% w/w xanthan gum while the other ⁇ ormula ⁇ ions tested 19-0155.0135/Fl e ⁇ 19-0155.01 1 1 /Fl contain 0.2% w/w xanthan gum.
- composition according to the invention comprising a higher concentration of xanthan gum (0.5% relative to, for example, 0.2% w/w) is advantageous because the hydrogel is better retained at the site of application.
- the composition according to the invention 190155.0163 comprising a xanthan gum concentration of 0.5% provides the best result ⁇ , comparable to that obtained with the same composition with 0.2% xanthan gum.
Abstract
Description
Claims
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CN202280015187.5A CN116887813A (zh) | 2021-02-19 | 2022-02-18 | 水凝胶组合物及其在预防和/或治疗由辐射引起的皮肤损伤中的用途 |
US18/264,286 US20240100044A1 (en) | 2021-02-19 | 2022-02-18 | Hydrogel composition and uses thereof in the prevention and/or treatment of skin damage caused by radiation |
EP22706811.1A EP4294370A1 (fr) | 2021-02-19 | 2022-02-18 | Composition hydrogel et ses utilisations dans la prévention et/ou le traitement des dommages cutanés causés par les rayonnements |
AU2022224394A AU2022224394A1 (en) | 2021-02-19 | 2022-02-18 | Hydrogel composition and uses thereof in the prevention and/or treatment of skin damage caused by radiation |
KR1020237031798A KR20230147668A (ko) | 2021-02-19 | 2022-02-18 | 방사선으로 인한 피부 손상의 예방 및/또는 치료에 있어서의 하이드로겔 조성물 및 이의 용도 |
JP2023550646A JP2024507266A (ja) | 2021-02-19 | 2022-02-18 | ヒドロゲル組成物、ならびに放射線によって引き起こされる皮膚損傷の予防および/または処置におけるその使用 |
CA3204652A CA3204652A1 (fr) | 2021-02-19 | 2022-02-18 | Composition hydrogel et ses utilisations dans la prevention et/ou le traitement des dommages cutanes causes par les rayonnements |
ZA2023/06750A ZA202306750B (en) | 2021-02-19 | 2023-06-30 | Hydrogel composition and uses thereof in the prevention and/or treatment of skin damage caused by radiation |
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US20150119401A1 (en) * | 2008-08-01 | 2015-04-30 | Eye Therapies, Llc | Compositions and Methods for the Treatment of Nasal Conditions |
US20200121675A1 (en) | 2017-05-26 | 2020-04-23 | Scott Whitcup | A topical composition for treating rosacea and a method for treating rosacea with the same |
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US20150119401A1 (en) * | 2008-08-01 | 2015-04-30 | Eye Therapies, Llc | Compositions and Methods for the Treatment of Nasal Conditions |
US20200121675A1 (en) | 2017-05-26 | 2020-04-23 | Scott Whitcup | A topical composition for treating rosacea and a method for treating rosacea with the same |
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BERGE ET AL., J. PHARM. SCI., vol. 66, 1977, pages 1 - 19 |
FAHL: "Effect of topical vasoconstrictor exposure upon tumoricidal radiotherapy", INT J CANCER, vol. 135, no. 4, 2014, pages 981 - 988 |
JAMES F. CLEARY ET AL.: "Significant suppression of radiation dermatitis in breast cancer patients using a topically applied adrenergic vasoconstrictor", RADIATION ONCOLOGY, 2017 |
UNKNOWN: "MIRVASO (brimonidine) topical gel, for topical use", 1 August 2013 (2013-08-01), XP055857729, Retrieved from the Internet <URL:https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/204708lbl.pdf> [retrieved on 20211103] * |
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EP4306112A1 (fr) * | 2022-07-15 | 2024-01-17 | Tarian Pharma | Nouveau regime posologique d'une composition comprenant de la brimonidine pour son utilisation dans la prevention et le traitement des dommages cutanes resultant d'un rayonnement |
WO2024013283A1 (fr) * | 2022-07-15 | 2024-01-18 | Tarian Pharma | Nouveau regime posologique d'une composition comprenant de la brimonidine pour son utilisation dans la prevention et le traitement des dommages cutanes resultant d'un rayonnement |
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FR3119987A1 (fr) | 2022-08-26 |
FR3119987B1 (fr) | 2023-01-13 |
KR20230147668A (ko) | 2023-10-23 |
JP2024507266A (ja) | 2024-02-16 |
AU2022224394A1 (en) | 2023-09-21 |
EP4294370A1 (fr) | 2023-12-27 |
ZA202306750B (en) | 2024-02-28 |
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