WO2023007514A1 - Compositions pharmaceutiques orales biodisponibles améliorées - Google Patents

Compositions pharmaceutiques orales biodisponibles améliorées Download PDF

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Publication number
WO2023007514A1
WO2023007514A1 PCT/IN2022/050671 IN2022050671W WO2023007514A1 WO 2023007514 A1 WO2023007514 A1 WO 2023007514A1 IN 2022050671 W IN2022050671 W IN 2022050671W WO 2023007514 A1 WO2023007514 A1 WO 2023007514A1
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Prior art keywords
composition
itraconazole
oral pharmaceutical
cellulose
pharmaceutical composition
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PCT/IN2022/050671
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English (en)
Inventor
Radhakrishna Vankayala
Dhananjay Panigrahi
Anup Avijit Choudhury
Hariharan V
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Dr. Reddy's Laboratories Limited
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Publication of WO2023007514A1 publication Critical patent/WO2023007514A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/10—Antimycotics
    • 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
    • A61K31/495—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
    • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
    • A61K9/1605—Excipients; Inactive ingredients
    • A61K9/1629—Organic macromolecular compounds
    • A61K9/1652—Polysaccharides, e.g. alginate, cellulose derivatives; Cyclodextrin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4841—Filling excipients; Inactive ingredients
    • A61K9/4866—Organic macromolecular compounds

Definitions

  • compositions such as solid oral dosage forms, comprising itraconazole.
  • Methods of preparing such compositions and methods of using the same for treating disorders including, but not limited to, fungal infections and other related conditions.
  • Itraconazole (also known as ( ⁇ )-cis-4-[4-[4-[4-[4-[[2-(2,4-dichlorophenyl)-2- (1 H- 1 ,2,4-triazol- 1 -ylmethyl)- 1 ,3 -dioxolan-4-yl]methoxy]phenyl]- 1 -piperazinyl] phenyl]-2,4-dihydro-2-(l-methylpropyl)-3H-l,2,4-triazol-3-one) is a triazole antifungal compound with a piperazine portion. Itraconazole is disclosed in U.S. Pat. No. 4,267,179 to Heeres et al.
  • Itraconazole is ( ⁇ )-l-[(RS)-sec-butyl]-4-[p- [4- [p- [ [[(2R,4S)-2-(2,4-dichlorophenyl)-2-( 1 H- 1 ,2,4-triazol- 1 - ylmethyl) 1 ,3 -dioxolan- 4-yl]methoxy]phenyl]-l-piperazinyl]phenyl]-A 2 -l,2,4-triazolin-5-one.
  • Itraconazole is an equal mixture of four diastereomers (two enantiomeric pairs), each possessing three chiral centers.
  • Itraconazole has a molecular formula of C35H38CI2N8O4 and a molecular weight of 705.64. It is a white to slightly yellowish powder. It is insoluble in water, very slightly soluble in alcohols, and freely soluble in dichloromethane. It has a pKa of 3.70 (based on extrapolation of values obtained from methanolic solutions) and a log (n-octanol/water) partition coefficient of 5.66 at pH 8.1 it is represented by the following structural formula: iiraccfta ⁇ oie
  • Itraconazole is a triazole antifungal compound that can be used for the treatment of fungal infections, including superficial infections, such as onychomycosis, as well as systemic fungal infections, for example, pulmonary or extrapulmonary blastomycosis, histoplasmosis, and aspergillosis.
  • Solid oral dosage forms of itraconazole are commercially available under the trade name SPORANOX.
  • SPORANOX must be taken with food because bioavailability of the itraconazole in the SPORANOX formulation is enhanced when ingested in the fasted state. Further, the bioavailability of itraconazole in SPORANOX varies greatly both between subjects (inter-subject), and from dose to dose in a single subject (intra-subject).
  • Itraconazole which is currently available in USA under the brand name TOLSURA having strength 65mg of Itraconazole. Further other marketed formulation in Australia is LOZANOC which is of strength 50mg of Itraconazole which is equivalent to the lOOmg of Itraconazole formulation of Sporanox. There is no approved formulation of Itraconazole lOOmg Strength which is equal to the 2*50mg of LOZANOC Itraconazole formulation.
  • drugs such as commercially available itraconazole dosage form (SporanoxTM) is only prescribed for use with food because of relatively poor bioavailability results when administered under fasted conditions. It is an aim of the present invention to provide a solid oral pharmaceutical composition with improved bioavailability for itraconazole, therapeutically consistent variability and reduced dose of administration and achieving the therapeutically equal effect as of conventional itraconazole formulation, by which patient dose regimen can be reduced.
  • the present invention provides a differentiated first to world formulation of Itraconazole lOOmg strength which is equivalent to 2 capsules of 50mg Lozanoc Itraconazole formulation by using the proprietary technology by which the bioavailability of the drug and amount of the drug loading is also increased.
  • the in- house proprietary technology is a novel technology for enhancing the bioavailability of poorly soluble drugs.
  • the technology utilizes a solid dispersion of drug in a polymer that improves the dissolution of poorly soluble drugs compared to their normal crystalline form. This results in an improvement of the absorption in the gastrointestinal tract to achieve maximum bioavailability compared to conventional formulations.
  • the present specification relates to the improved oral solid pharmaceutical formulations of Itraconazole with increased bioavailability.
  • the present specification relates to oral pharmaceutical composition
  • oral pharmaceutical composition comprising Itraconazole and one or more pharmaceutically acceptable rate controlling polymers in a matrix system.
  • the present specification relates to oral pharmaceutical composition comprising about lOOmg of Itraconazole, wherein the composition exhibits an AUCo- t which is 80% to 125% of about 1500 ng.hr/mL to about 1800 ng.hr/mL following administration of the composition to a subject under fed conditions.
  • the present specification relates to the oral pharmaceutical composition
  • the oral pharmaceutical composition comprising about 1 OOmg of itraconazole wherein the composition exhibits a Cmax which is 80% to 125% of about 65ng/ml to about 95ng/ml following administration of the composition to a subject under fed conditions.
  • the present composition is therapeutically similar to the reference composition under fed conditions.
  • the present composition exhibits an absorption profile under fed conditions which is therapeutically similar to the absorption profile of the reference composition under fed conditions.
  • the present composition under fed conditions is bioequivalent to the reference composition under fed conditions.
  • the present composition exhibits an absorption profile under fed conditions which is bioequivalent to the absorption profile of the reference composition under fed conditions.
  • the oral pharmaceutical composition of the present invention exhibits a ratio in the range from about 0.70 to about 1.43 for AUCo-t between the oral pharmaceutical composition of present invention and a reference composition with the 90% confidence interval.
  • the oral pharmaceutical composition of the present specification exhibits an AUC/MIC ratio of about 25 or greater.
  • the present invention provides a method of treating onychomycosis, candidiasis, aspergillosis comprising administering to a subject an oral pharmaceutical composition comprising itraconazole, wherein the amount of itraconazole in the composition is lOOmg double the weight of the amount of itraconazole in a reference composition and the method provides an effective cure with faster onset efficacy as compared to the reference composition.
  • the present specification relates to the improved oral solid pharmaceutical formulations of Itraconazole with increased bioavailability.
  • the present specification relates to oral pharmaceutical composition
  • oral pharmaceutical composition comprising Itraconazole and one or more pharmaceutically acceptable rate controlling polymers in a matrix system.
  • the present specification relates to oral pharmaceutical composition
  • oral pharmaceutical composition comprising about lOOmg of Itraconazole, wherein the composition exhibits an AUCo- t which is 80% to 125% of about 1500 ng.hr/mL to about 1800 ng.hr/mL following administration of the composition to a subject under fed conditions.
  • the present specification relates to the oral pharmaceutical composition
  • the oral pharmaceutical composition comprising about 1 OOmg of itraconazole wherein the composition exhibits a Cmax which is 80% to 125% of about 65ng/ml to about 95ng/ml following administration of the composition to a subject under fed conditions.
  • the present composition under fed conditions is therapeutically similar to the reference composition under fed conditions.
  • the present composition exhibits an absorption profile under fed conditions which is therapeutically similar to the absorption profile of the reference composition under fed conditions.
  • the present composition under fed conditions is bioequivalent to the reference composition under fed conditions.
  • the present composition exhibits an absorption profile under fed conditions which is bioequivalent to the absorption profile of the reference composition under fed conditions.
  • the oral pharmaceutical composition of the present invention exhibits a ratio in the range from about 0.70 to about 1.43 for AUCo-t between the oral pharmaceutical composition of present invention and a reference composition with the 90% confidence interval.
  • the oral pharmaceutical composition of the present specification exhibits an AUC/MIC ratio of about 25 or greater.
  • the present invention provides a method of treating onychomycosis, candidiasis, aspergillosis comprising administering to a subject an oral pharmaceutical composition comprising itraconazole, wherein the amount of itraconazole in the composition is lOOmg double the weight of the amount of itraconazole in a reference composition and the method provides an effective cure with faster onset efficacy as compared to the reference composition.
  • ABSOR includes all values having substantially the same effect, or providing substantially the same result, as the reference value.
  • range encompassed by the term “about” will vary depending on context in which the term is used, for instance the parameter that the reference value is associated with.
  • “about” can mean, for example, .+-.15%, .+-.10%, .+-.5%, .+- .4%, .+-.3%, .+-.2%, .+-.1%, or +-.less than 1%.
  • all recitations of a reference value preceded by the term “about” are intended to also be a recitation of the reference value alone.
  • Absorption profile refers to the rate and extent of exposure of a drug, e.g., itraconazole, by data analysis of the AUC and/or C.sub.max including the curves thereof.
  • administering includes any mode of administration, such as oral, subcutaneous, sublingual, transmucosal, parenteral, intravenous, intra-arterial, buccal, sublingual, topical, vaginal, rectal, ophthalmic, otic, nasal, inhaled, and transdermal.
  • administering can also include prescribing or filling a prescription for a dosage form comprising a particular compound, such as itraconazole, as well as providing directions to carry out a method involving a particular compound or a dosage form comprising the compound.
  • the administration method can be oral administration.
  • Bioequivalence means the absence of a significant difference in the rate and extent to which the active agent or surrogate marker for the active agent in pharmaceutical equivalents or pharmaceutical alternatives becomes available at the site of action when administered in an appropriately designed study.
  • the 90% Cl limits for a ratio of the geometric mean of logarithmic transformed Cmax for the two products or methods can have a wider acceptance range when justified by safety and efficacy considerations.
  • Co-administration refers to administration of two or more different active agents together in a coordinated manner. Co-administration includes administration of two or more different active agents simultaneously, sequentially, or separately. Thus, “co-administration” includes administration in the same or different dosage forms, concurrent administration, as well as administration that is not concurrent, such as administration of a first active agent followed or alternated with administration of a second active agent as part of a coordinated plan for treatment.
  • composition is a collection of materials containing the specified components.
  • One or more dosage forms may constitute a composition, so long as those dosage forms are associated and designed for use together.
  • a composition comprising about lOOmg mg of itraconazole includes two unit dosage forms having about 50 mg of itraconazole.
  • Enteric polymer refers to a polymer that is poorly soluble in aqueous medium at a pH of about 4.5 or less, but becomes soluble in aqueous medium at a pH of greater than about 5.
  • an enteric polymer is poorly soluble in gastric juice, but is soluble in the lower GI tract environment.
  • traconazole is a common name for a triazole antifungal compound, the specific chemical structure and IUPAC name of which are well known in the art. It is available commercially (see Merck Index Reg. No. 5262 (12.sup.th ed. 1996) and U.S. Pat. No. 4,267,179).
  • "itraconazole” includes not only the chemical compound (free base form, also referred to as “free itraconazole”), but also all optical isomers, such as enantiomers, diastereomers, ineso compounds, and the like, as well as pharmaceutically acceptable salts, solvates, and prodrugs (such as esters) thereof.
  • “Pharmaceutical composition” refers to a formulation of a compound of the disclosure, such as itraconazole, and a medium generally accepted in the art for the delivery of the biologically active compound to mammals, e.g., humans. Such a medium includes all pharmaceutically acceptable carriers, diluents or excipients therefor.
  • the pharmaceutical composition may be in various dosage forms or contain one or more unit dose formulations.
  • “Pharmaceutically acceptable” means suitable for use in contact with the tissues of humans and animals without undue toxicity, irritation, allergic response, and the like, commensurate with a reasonable benefit/risk ratio, and effective for their intended use within the scope of sound medical judgment.
  • a “reference composition of itraconazole” is a composition comprising itraconazole that exhibits one or more of (1) has a AUC.sub.t in the fasted state that is about 35% or more lower than the AUC.sub.t in the fed state; (2) has an intra-subject variability of about 30% or greater; and (3) about 100 mg of itraconazole or more.
  • Particular reference compositions include those with about 100 mg of itraconazole or more.
  • Other particular reference compositions include those that do not include a solid solution or solid dispersion of itraconazole in an acid resistant polymeric carrier.
  • One exemplary particular reference composition of Itraconazole is Lozano Itraconazole formulation of 50mg strength.
  • Salts include derivatives of an active agent, wherein the active agent is modified by making acid or base addition salts thereof.
  • pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid addition salts of basic residues such as amines; alkali or organic addition salts of acidic residues; and the like, or a combination comprising one or more of the foregoing salts.
  • the pharmaceutically acceptable salts include salts and the quaternary ammonium salts of the active agent.
  • acid salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; other acceptable inorganic salts include metal salts such as sodium salt, potassium salt, cesium salt, and the like; and alkaline earth metal salts, such as calcium salt, magnesium salt, and the like, or a combination comprising one or more of the foregoing salts.
  • inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like
  • other acceptable inorganic salts include metal salts such as sodium salt, potassium salt, cesium salt, and the like
  • alkaline earth metal salts such as calcium salt, magnesium salt, and the like, or a combination comprising one or more of the foregoing salts.
  • Organic salts includes salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, mesylic, esylic, besylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, HOOC-- (CH.sub.2).sub.n— COOH where n is 0-4, and the like; organic amine salts such as triethylamine salt, pyridine salt, picoline salt, ethanolamine salt, triethanolamine salt, dicyclohexylamine salt, N,N'-dibenzylethylenediamine salt, and the like; and amino acid salts such as
  • Solvate means a complex formed by solvation (the combination of solvent molecules with molecules or ions of the active agent of the present invention), or an aggregate that consists of a solute ion or molecule (the active agent of the present invention) with one or more solvent molecules.
  • a solvate where the solvent molecule or molecules are water is called a hydrate. Hydrates are particularly contemplated as solvates of the materials described herein.
  • Solid dispersion relates to a solid system comprising a nearly homogeneous or homogeneous dispersion of an active ingredient, such as itraconazole, in an inert carrier or matrix.
  • substantially similar to means having a great extent or degree of likeness to the reference item, term, quantity, etc.
  • Prodrug refers to a precursor of the active agent wherein the precursor itself may or may not be pharmaceutically active but, upon administration, will be converted, either metabolically or otherwise, into the active agent or drug of interest.
  • prodrug includes an ester or an ether form of an active agent.
  • “Therapeutically effective amount” or “effective amount” refers the amount of a pharmaceutically active agent, such as itraconazole, that, when administered to a patient for treating a disease according to the dosing regimen as described herein, is sufficient to effect such treatment for the disease.
  • the “therapeutically effective amount” will vary depending on the disease and its severity, and the age, weight, and other conditions of the patient to be treated.
  • a composition or dosage form is “therapeutically equivalent” to a reference composition or dosage form if it has a therapeutic effect that is substantially similar to the therapeutic effect of the reference composition or dosage form, for example, therapeutically equivalent dosage forms can have substantially similar efficacy towards a particular disease or condition when administered over a substantially similar time period.
  • Treating includes ameliorating, mitigating, and reducing the instances of a disease or condition, or the symptoms of a disease or condition, in addition to providing directions or prescribing a drug for such purpose.
  • Patient or “subject” refers to a mammal, e.g., a human, in need of medical treatment.
  • rate controlling polymers as used in the context of the present specification relates to one or more pharmaceutically acceptable polymers which controls the drug release from the formulation.
  • the rate controlling polymers helps to achieve extended release or delayed or sustained release profile.
  • Suitable “rate controlling polymers” may include but not limited to one or more hydrophilic polymers, hydrophobic polymers, natural polymers, bioadhesive polymer, pH-dependent or pH-independent, enteric, degradable, non-degradable, enteric polymers, melt extrusion polymers and the like.
  • Suitable hydrophilic polymers may include one or more of cellulosic polymers/copolymers or its derivatives including, but not limited to methyl cellulose, hydroxypropyl methylcellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxyethyl methylcellulose, carboxymethylcellulose, sodium carboxymethylcellulose; polyacrylates, methyl acrylates, polyethylene oxides, polyethylene glycols, chitosan, gums, starch derivatives, polyurethanes, galactomannans, polysaccharides, polyalcohols, acrylic acid or acrylamide derivatives, and the like.
  • Suitable hydrophobic polymers include one or more of ethyl cellulose, glycerol palmitostearate, beeswax, glycowax, carnaubawax, hydrogenated vegetable oil, glycerol monostearate, stearylalcohol, glyceryl behenate, polyanhydrides, methyl acrylates and the like.
  • Natural polymers include but are not limited to proteins (e.g., hydrophilic proteins), such as pectin, zein, modified zein, casein, gelatin, gluten, serum albumin, or collagen, chitosan, oligosaccharides and polysaccharides such as cellulose, dextrans, tamarind seed polysaccharide, gellan, carrageenan, xanthan gum, gum Arabic; hyaluronic acid, polyhyaluronic acid, alginic acid, sodium alginate and the like.
  • proteins e.g., hydrophilic proteins
  • Suitable bioadhesive polymers selected from but are not limited to polyamides, polycarbonates, polyalkylenes, polyalkylene glycols, polyalkylene oxides, polyalkylene terephthalates, polyvinyl alcohols, polyvinyl ethers, polyvinyl esters, polyvinyl halides, polyvinylpyrrolidone, polyglycolides, polysiloxanes, polyurethanes, polystyrene, polymers of acrylic and methacrylic esters, polylactides, poly(butyric acid), poly( valeric acid), poly(lactide-co-glycolide), polyanhydrides, polyorthoesters, poly(fumaric acid), poly(maleic acid), and blends and copolymers or mixtures thereof and the like.
  • rate controlling polymers suitable for use in the invention include, but are not limited to, cellulose acetate, cellulose propionate, cellulose acetate butyrate, cellulose acetate phthalate, carboxymethyl cellulose, cellulose triacetate, cellulose sulfate sodium salt, poly(methyl methacrylate), poly(ethyl methacrylate), poly(butyl methacrylate), poly(isobiityl methacrylate), poly(hexyl methacrylate), poly(isodecyl methacrylate), poly(lauryl methacrylate), poly(phenyl methacrylate), poly(methyl acrylate), poly(isopropyl acrylate), poly(isobutyl acrylate), poly(octadecyl acrylate) polyethylene, polypropylene, poly(ethylene glycol), poly( ethylene oxide), poly (ethylene terephthalate), polyvinyl acetate), polyvinyl chloride, polystyrene, polyvinyl pyr
  • Methacrylates can be but not limited to Eudragit® L; Eudragit® S; Eudragit® FS 30 D; Eudragit® L30D-55; and Eudragit® L100-55, Eudragit RL PO, Eudragit RL 100, Eudragit RL 30 D, Eudragit ® E, Eudragit ® NE and the like.
  • the present composition comprising itraconazole can also comprise one or more excipients.
  • the excipients can include one or more of waxes, polymers, binders, fillers, disintegrants, glidants, and the like.
  • the polymers can include any pharmaceutically acceptable polymer, such as one or more hydrophilic polymers; one or more non-gelling polymers; one or more acid-resistant polymers and enteric polymers; one or more osmopolymers; one or more film-forming, water insoluble polymers; one or more film-forming, water soluble polymers; or combinations thereof.
  • the waxes can include one or more of beeswax, spermaceti, lanolin, carnauba wax, candelilla wax, ouricury wax, powercane wax, retamo wax, jojoba oil, epicuticula waxes, paraffin, montan wax, waxes produced from cracking polyethylene, microcrystalline wax, petroleum jelly, and the like.
  • Binders can include any one or more of saccharides, such as sucrose, lactose, mannose, trehaolse, fructose, starches, cellulose, microcrystalline cellulose, methyl cellulose, ethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, and the like, gelatin, polyvinylpyrrolidone, polyethylene glycol, and the like.
  • saccharides such as sucrose, lactose, mannose, trehaolse, fructose, starches, cellulose, microcrystalline cellulose, methyl cellulose, ethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, and the like
  • gelatin polyvinylpyrrolidone
  • polyethylene glycol and the like.
  • Disintegrants can include one or more of crospovidone, croscarmellose, such as crosscarmellose sodium, polyvinylpyrrolidone, methyl cellulose, microcrystalline cellulose, lower alkyl-substituted hydroxypropyl cellulose, such as hydroxypropyl methyl cellulose and hydroxypropyl ethyl cellulose, starch, pregelatinised starch, sodium alginate, and sodium starch glycolate, for example, sodium starch glycolate.
  • crospovidone croscarmellose
  • crosscarmellose sodium polyvinylpyrrolidone
  • methyl cellulose methyl cellulose
  • microcrystalline cellulose microcrystalline cellulose
  • lower alkyl-substituted hydroxypropyl cellulose such as hydroxypropyl methyl cellulose and hydroxypropyl ethyl cellulose
  • starch pregelatinised starch
  • sodium alginate sodium starch glycolate
  • sodium starch glycolate for example, sodium starch glycolate.
  • Fillers can include one or more of cellulose, microcrystalline cellulose, dibasic calcium phosphate, monobasic calcium phosphate, lactose, sucrose, glucose, mannitol, sorbitol, calcium carbonate, and the like.
  • Polymers can include any pharmaceutically acceptable polymer.
  • the polymer can be formulated with the active compound (e.g., itraconazole) and one or more additional excipients in various forms.
  • the present composition may be formulated to a matrix system, an osmotic delivery system, or a multiparticulate system.
  • matrix denotes a homogeneous solid mixture composed of evenly dispersed ingredients throughout.
  • the matrix system is a solid solution or solid dispersion as described herein.
  • the composition comprises a release rate controlling membrane disposed over a pull layer and an osmotic push layer, wherein the pull layer comprises itraconazole, and the release rate controlling membrane has an orifice immediately adjacent to the pull layer.
  • the pull layer further optionally comprises a release rate controlling polymer and/or a pharmaceutically acceptable excipient.
  • the release rate controlling membrane is a semipermeable wall that surrounds the pull layer and the osmotic push layer. The wall is permeable to the passage of fluid and has an orifice which allows passage of itraconazole, from inside of the wall to outside.
  • the semipermeable wall Upon being exposed to biological or other fluids, the semipermeable wall allows permeation of the fluids through the wall causing expansion of the osmotic push layer, and consequently the osmotic push layer pushes the pull layer through the orifice.
  • the release rate of itraconazole is determined by the permeability of the wall and the osmotic pressure gradient across the wall.
  • the osmotic push layer comprises an osmopolymer.
  • the pull layer further comprises an osmagent, also known as osmotically effective solutes.
  • the osmagent can be any compound, inorganic or organic, that exhibit an osmotic pressure gradient across an external fluid across the semipermeable wall.
  • the composition comprises one or more particles and each of the particles comprises an active core comprising itraconazole; and a release rate controlling polymer disposed over the core.
  • the composition comprises one or more particles and each of the particles comprises an inert core, an active layer comprising itraconazole disposed over the inert core, and a release rate controlling polymer disposed over the active layer.
  • the composition comprises an inert core, and a coating disposed over the inert core, wherein the coating comprises itraconazole.
  • the release rate controlling polymer comprises a film-forming, water insoluble polymer in combination with a film-forming, water soluble polymer. The ratio between the water insoluble polymer and the water soluble polymer can be adjusted depending on the intended drug release profile.
  • Hydrophilic polymer refers to a polymer having a strong affinity for water and tending to dissolve in, mix with, or be wetted by water.
  • hydrophilic polymer include, but are not limited to polyethylene oxide, hydroxypropyl cellulose, hydroxypropyl methyl cellulose, hydroxyethyl cellulose, sodium carboxymethylcellulose, calcium carboxymethyl cellulose, methyl cellulose, polyacrylic acid, maltodextrin, pre-gelatinized starch, guar gum, sodium alginate, polyvinyl alcohol, chitosan, locust bean gum, amylase, any other water-swelling polymer, and a combination thereof.
  • non-gelling polymer a polymer that only swells slightly or does not swell to form a gel when exposed to an aqueous medium.
  • exemplary non gelling polymers include cellulose acetate phthalate (e.g., powder: pH 6.2, available from Eastman Chemical Co. as C-A-P; Dispersion: pH: 6.0, available from FMC BioPolymer as AquaCoat.RTM.
  • CPD cellulose acetate succinate
  • LF pH 5.5; MF: pH 6.0; HF: pH 6.8; LG; pH 5.5; MG: pH 6.0; HG: 6.8,
  • F grades are an aqueous dispersion and G grades are from solvent available from Shin-Etsu under the trade name AQOAT.RTM.
  • HPMCP hypromellose phthalate
  • HP-50 pH 5.0
  • Grade HP-55 pH 5.5 available from Shin-Etsu
  • HPPMCAS hypromellose acetate succinate
  • polyvinylacetate phthalate e.g., aqueous dispersion: pH 5.0; Powder: pH 5.0 available from Colorcon, the aqueous dispersion under the trade name Sureteric.RTM.
  • methacrylic acid-methyl acrylate-methyl methacrylate co-polymers available under the trade name EUDRAGIT.RTM. FS-30D for delivery above pH 7.0, and the like or combinations comprising at least one of the foregoing.
  • Methacrylic acid-methyl methacylate co polymers, methacrylic acid-ethylacrylate co-polymers, and/or methacrylic acid-methyl acrylate-methyl methacrylate co-polymers are also known as polymethacrylates as described in the Handbook of Pharmaceutical Excipients, 2006, the Fifth Edition, edited by Raymond C Rowe, Paul J.
  • EUDRAGIT.RTM is a trademark of Evonik Industries.
  • the specifications for various EUDRAGIT.RTM. products including the above-mentioned ones can be found in the manufacture's product manual or on the website for the corresponding Eudragit.RTM product, the content of which is incorporated by references in its entirety.
  • the osmopolymers are typically hydrophilic polymers and interact with water and aqueous biological fluids and swell or expand to push a drug composition through the orifice.
  • the osmopolymers exhibit the ability to swell in water and retain a significant portion of the imbibed water within the polymer structure.
  • the osmopolymers may swell or expand to a very high degree.
  • the osmopolymers can be noncross-linked or cross-linked.
  • the swellable, hydrophilic polymers may be lightly cross-linked, such as cross-links being formed by covalent or ionic bonds.
  • the osmopolymers can be of plant, animal or synthetic origin.
  • Hydrophilic polymers suitable for the present purpose include, but are not limited to poly(hydroxyalkylmethacrylate) having a molecular weight of from 30,000 to 5,000,000; poly(vinylpyrrolidone) having molecular weight of from 10,000 to 360,000; anionic and cationic hydrogels; polyelectrolyte complexes, poly(vinyl alcohol) having a low acetate residual, cross-linked with glyoxal, formaldehyde, or glutaraldehyde and having a degree of polymerization from 200 to 30,000; a mixture of methyl cellulose, cross-linked agar and carboxymethyl cellulose; a water insoluble, water swellable copolymer reduced by forming a dispersion of finely divided copolymer of maleic anhydride with styrene, ethylene, propylene, butylene or isobutylene cross-linked with from 0.00001 to about 0.5 moles of polyunsaturated cross-linking agent per mo
  • osmopolymers include hydrogel polymers, such as Carbopol (acrylic acid-based polymers crosslinked with polyalkylene polyethers) and the sodium salt thereof; acidic carboxy polymers generally having a molecular weight of 450,000 to 4,000,000 and their metal salts; Polyox; polyethylene oxide polymers having a molecular weight of 100,000 to 7,500,000.
  • hydrogel polymers such as Carbopol (acrylic acid-based polymers crosslinked with polyalkylene polyethers) and the sodium salt thereof; acidic carboxy polymers generally having a molecular weight of 450,000 to 4,000,000 and their metal salts; Polyox; polyethylene oxide polymers having a molecular weight of 100,000 to 7,500,000.
  • Examples of the film-forming, water insoluble polymer include, but are not limited to ethylcellulose, cellulose acetate, cellulose propionate (lower, medium or higher molecular weight), cellulose acetate propionate, cellulose acetate butyrate, cellulose acetate phthalate, cellulose triacetate, poly(methyl methacrylate), poly(ethyl methacrylate), poly(butyl methacrylate), poly(isobutyl methacrylate), poly(hexyl methacrylate), poly(isodecyl methacrylate), poly(lauryl methacrylate), poly(phenyl methacrylate), poly(methyl acrylate), poly(isopropyl acrylate), poly(isobutyl acrylate), poly(octadecyl acrylate), poly(ethylene), poly(ethylene) low density, poly(ethylene) high density, poly(propylene), poly(ethylene oxide), poly(ethylene terephthalate), poly(vinyl is
  • film-forming, water soluble polymer examples include, but are not limited to polyvinyl alcohol, polyvinylpyrrolidone, methyl cellulose, hydroxypropyl cellulose, hydroxypropylmethyl cellulose and polyethylene glycol, Pluronic FI 08, Pluronic FI 27, Pluronic F68 or mixtures thereof.
  • the present composition may be formulated as a matrix system.
  • the composition comprising itraconazole can comprise a solid solution or solid dispersion, for example, a solid dispersion, of itraconazole in a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier can be a polymer.
  • Exemplary polymers include acid-resistant polymers and enteric polymers, although other polymers can also be used. Acid-resistant polymers can include polymers that are insoluble in water at any pH and polymers that are insoluble in water at an acidic pH, such as enteric polymers.
  • Exemplary acid-resistant polymers include hydroxypropyl methylcellulose phthalate, polyvinyl acetate phthalate, hydroxypropyl methylcellulose acetate, such as hydroxypropyl methylcellulose acetate succinate, alginate, poly(meth)acrylic acid homopolymers and copolymers, carbomers, carboxymethyl cellulose, carboxymethyl cellulose, methacrylic acid copolymers, shellac, cellulose acetate phthalate, hydroxypropyl cellulose acetate phthalate, cellulose acetate terephthalate, methyl cellulose acetate phthalate, cellulose acetate isophthalate, cellulose acetate trimellitate, Eudragit.RTM.
  • Polymers (copolymers of one or more of poly (meth) acrylates, poly (meth) acrylic esters, and poly (meth) acrylamides), and the like.
  • a particular exemplary acid-resistant polymer is hydroxypropyl methylcellulose phthalate.
  • Exemplary enteric polymers include one or more of hydroxypropyl methylcellulose phthalate; polyvinyl acetate phthalate; hydroxypropylmethylcellulose acetate succinate; alginate; carbomer; carboxymethyl cellulose; methacrylic acid copolymer; shellac; cellulose acetate phthalate; starch glycolate; polacrylin; cellulose acetate phthalate; methyl cellulose acetate phthalate; hydroxypropylcellulose acetate phthalate; cellulose acetate terephthalate; cellulose acetate isophthalate; and cellulose acetate trimellitate.
  • a particular enteric polymer is hydroxypropyl methylcellulose phthalate, which is commercially available from Shin-Etsu Chemical Industry Co Ltd under the trade names HP-50, HP-55, and HP-55S.
  • a composition comprising itraconazole can comprise a solid solution or solid dispersion, for example, a solid dispersion, of itraconazole in a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier can be a polymer, such as an acid-resistant polymer or an enteric polymer, particularly the acid-resistant polymers discussed herein, or the enteric polymers discussed herein, and, for example, more particularly hydroxypropyl methylcellulose phthalate, which is commercially available from Shin-Etsu Chemical Industry Co Ltd under the trade names HP-50, HP-55, and HP-55S.
  • the solid solution or solid dispersion can be made by methods known in the art, for example, by methods disclosed in U.S. Pat. No. 6,881,745, which is hereby incorporated by reference in its entirety and for all purposes.
  • a solid solution or solid dispersion can be made by dissolving or dispersing the pharmaceutically acceptable carrier and the itraconazole in a suitable solvent and then removing the solvent.
  • the suitable solvent can be, for example, one or more of methylene chloride, chloroform, ethanol, methanol, propan-2-ol, ethyl acetate, acetone, water, and mixtures thereof.
  • a particular solvent is methylene chloride.
  • Removing the solvent can be accomplished by evaporation, spray drying, lyophilizing, and the like. Removing the solvent can also be accomplished by allowing the itraconazole and pharmaceutically acceptable carrier to co-precipitate or co- crystallize out of solution, followed by one or more of filtration, decanting, centrifuging, and the like.
  • solid solutions or solid dispersions include co grinding, melt extrusion, freeze drying, rotary evaporation, and other solvent removal processes.
  • the composition comprising itraconazole can comprise a therapeutically effective amount of free itraconazole.
  • the itraconazole is in the form of a solid dispersion, the solid dispersion can be present in sufficient amounts to provide a therapeutically effective amount of itraconazole.
  • the therapeutically effective amount of itraconazole which in the case of a salt, solvate, ester, or the like is measured by the amount of free itraconazole, is about 100 mg, for a single dosage form.
  • the weight ratio of the free itraconazole in the solid solution or solid dispersion to the pharmaceutically acceptable carrier, such as hydroxypropyl methylcellulose phthalate can be from about 3:1 to about 1:20, such as about 3:1 to about 1:5, about 1:1 to about 1:3, or about 1:1.5, or about 1:2, or about 1:2.5 based on the weight of free itraconazole.
  • the pharmaceutically acceptable carrier such as hydroxypropyl methylcellulose phthalate
  • composition comprising a solid dispersion of itraconazole can further comprise one or more additional pharmaceutically acceptable excipients.
  • the one or more additional pharmaceutically acceptable excipients can be in the solid solution or dispersion, or outside of the solid solution or dispersion, such as admixed or blended with the solid solution or dispersion.
  • the one or more additional pharmaceutically acceptable excipients can include one or more disintegrants, one or more diluents, one or more fillers, one or more colorants, one or more flavorants, one or more binders, one or more glidants, one or more lubricants, one or more surface active agents, and mixtures thereof.
  • Exemplary disintegrants include one or more of crospovidone, croscarmellose, such as crosscarmellose sodium, polyvinylpyrrolidone, methyl cellulose, microcrystalline cellulose, lower alkyl-substituted hydroxypropyl cellulose, such as hydroxypropyl methyl cellulose and hydroxypropyl ethyl cellulose, starch, pregelatinised starch, sodium alginate, and sodium starch glycolate, for example, sodium starch glycolate.
  • crospovidone croscarmellose
  • crosscarmellose sodium such as crosscarmellose sodium
  • polyvinylpyrrolidone polyvinylpyrrolidone
  • methyl cellulose methyl cellulose
  • microcrystalline cellulose microcrystalline cellulose
  • lower alkyl-substituted hydroxypropyl cellulose such as hydroxypropyl methyl cellulose and hydroxypropyl ethyl cellulose
  • starch pregelatinised starch
  • sodium alginate sodium starch
  • the disintegrant is often present outside of solid solution or solid dispersion, and the weight ratio of the solid solution to solid dispersion can be from about 1:1 to about 1:10, such as about 2:1 to about 6:1, about 4:1 to about 5:1, for example, from about 4.2:1, although this is not required unless otherwise specified.
  • the dosage form when the dosage form is a tablet, the dosage form can comprise from about 0.3% to about 25% of disintegrant by weight.
  • Exemplary colorants include one or more of titanium dioxide and food dyes.
  • Exemplary flavors include one or more of cinnamon oil, wintergreen oil, peppermint oil, bay oil, anise oil, eucalyptus oil, thyme oil, vanilla, such as tincture of vanilla, citrus oil, such as one or more of lemon, orange, lime, and grapefruit oil, and essences of fruits, such as essence of one or more of apple, banana, pear, peach, strawberry, raspberry, cherry, plum, pineapple, and apricot.
  • Exemplary lubricants include one or more of hydrogenated vegetable oil, magnesium stearate, sodium lauryl sulfate, magnesium lauryl sulfate, colloidal silica, and talc.
  • the lubricant is magnesium stearate.
  • the lubricant is colloidal silica.
  • the lubricant is a mixture of magnesium stearate and colloidal silica.
  • Exemplary glidants include one or more of silicon dioxide and talc.
  • Exemplary binders include one or more of microcrystalline cellulose, gelatin, sugars, such as one or more of mannitol, lactose, and cellulose, polyethylene glycol, gums, such as one or more of xanthan gum and guar gum, polyvinylpyrrolidone, pregelatinised starch, hydroxypropyl cellulose, and hydroxypropylmethylcellulose.
  • Exemplary diluents include one or more of lactose, such as one or more of lactose monohydrate, spray-dried lactose monohydrate, and anhydrous lactose, mannitol, xylitol, dextrose, sucrose, sorbitol, microcrystalline cellulose, starch, and calcium phosphate, such as dibasic calcium phosphate dihydrate.
  • Exemplary surface active agents include one or more of sodium lauryl sulfate, polyethylene glycol, and polysorbate 80.
  • the composition can be, for example, in the form of one or more dosage forms, such as one or more of a powder, sachet, tablet, capsule, pill, suppository, implant, wafer, cream, ointment, syrup, gel, suspension, and the like.
  • the capsule shell can be a hard capsule shell, such as a gelatin shell, comprising the solid solution or solid dispersion of itraconazole and the pharmaceutically acceptable carrier.
  • the capsule shell can also comprise one or more of the additional pharmaceutically acceptable excipients discussed above, although that is not required unless otherwise specified.
  • the capsule shell can be a sufficient size to accommodate the contents of the capsule.
  • the tablet can comprise the solid solution or solid dispersion of itraconazole and pharmaceutically acceptable carrier such that the itraconazole is from about 1% to about 80%, such as about 5% to about 60%, by weight, of the tablet.
  • the tablet can also comprise one or more lubricant, such as the one or more lubricants discussed above.
  • the one or more lubricant can be present from about 0.25% to about 10% by weight of the tablet.
  • the tablet can further comprise one or more disintegrants, such as one of more of the disintegrants discussed above.
  • the one or more disintegrant can be present from about 1% to about 25% by weight of the tablet.
  • the tablet can further comprise one or more glidants, such as one or more of the glidants discussed above.
  • the one or more glidants can be present from about 0.2% to about 1% by weight of the tablet.
  • the tablet can further comprise one or more surface active agents, such as one or more of the surface active agents discussed above.
  • the one or more surface active agents can be present from about 0.2% to about 5% by weight of the tablet.
  • the capsule can comprise a therapeutically effective amount of itraconazole, such as the amounts discussed above.
  • the remainder of the capsule can be filled with additional pharmaceutical excipients, such as those discussed above.
  • the use of a solid dispersion of itraconazole in an acid resistant pharmaceutically acceptable carrier can prevent the itraconazole from dissolving too fast in the gastric juice and subsequently precipitating out in the higher pH environment of the lower GI tract thereby increasing the consistency of the bioavailability of itraconazole.
  • the composition can be specially adapted to have an AUC with a reduced dose-to-dose intra-subject variability in the same subject.
  • the reduced intra-subject variability can be with respect to the SPORANOX dosage form.
  • the dosage form can have a reduced variability in the AUC.sub.O-t, C.sub.max, and/or T.
  • an intra-subject coefficient of variability under fed conditions for the AUC.sub.O-t can be about 35% or less.
  • an intra-subject coefficient of variability under fed conditions for the AUC.sub.O-.infia can be about 35% or less.
  • the composition can also comprise one or more additional antifungal agents.
  • the one or more additional antifungal agents can comprise, for example, amphotericin B, candicidin, filipin, hamycin, natamycin, mystatin, rimocidin, bifunazole, butoconazole, clotrimazole, fenticonazole, isoconazole, ketoconazole, miconazole, omoconazole, oxiconazole, sertaconazole, sulconazole, tioconazole, albaconazole, fluconazole, isavuconazole, itraconazole, posaconazole, ravuconazole, terconazole, voriconazole, abafungin, amorolfin, butenafine, naftifine, terbinafine, anidulafingin, casporofungin, micafungin, benzoic acid in combination with a
  • composition can be therapeutically equivalent to the reference composition.
  • administration of the composition over about the same time period as the reference composition can produce a substantially similar therapeutic outcome.
  • the composition can be bioequivalent to the reference composition Lozonac.
  • the composition can have 90% Confidence Interval (Cl) limits for a ratio of the geometric mean for of logarithmic transformed AUC.sub.O-.infin., AUC. sub.0- t, and C.sub.max for the composition is about 0.80 to about 1.25 of the reference composition.
  • the composition can have 90% Cl limits for a ratio of the geometric mean of logarithmic transformed AUC.sub.O-.infin., and AUC.sub.O- t of about 0.80 to about 1.25 of the reference composition.
  • the amount of itraconazole in the composition can be from about 2.5 times, to about 2 times, to about 1.5 times of that of the amount of itraconazole in the reference composition (Lozanoc).
  • a method of treating a fungal infection can comprise administering one or more dosage forms comprising itraconazole, such as one or more of the dosage forms described herein, to a subject.
  • the subject is typically a human.
  • the fungal infection can be any infection treatable by a triazole antifungal agent, such as itraconazole.
  • the fungal infection can be a systemic infection or a local infection, particularly a systemic infection.
  • Exemplary fungal infections that can be treated include one or more of onychomycosis, pulmonary or extrapulmonary blastomycosis, histoplasmosis, and aspergillosis.
  • the dosage form is used to treat onychomycosis.
  • the dosage form can be any acceptable dosage form, such as a powder, sachet, tablet, capsule, pill, suppository, implant, wafer, cream, ointment, syrup, gel, suspension, and the like.
  • the dosage form is particularly an orally deliverable dosage form, such as a tablet or capsule, and typically a capsule.
  • a dosage form as described herein, such as a capsule, can be administered at appropriate intervals. For example, once per day, twice per day, three times per day, and the like. In particular, the dosage form is administered once or twice per day. Even more particularly, the dosage form is administered once per day.
  • the dosage form can be administered for a duration of time sufficient to treat the fungal infection.
  • the dosage form is typically administered for about four weeks to about forty weeks, particularly about eight weeks to about thirty six weeks.
  • the dosage form can be administered for about twelve weeks to about twenty four weeks.
  • the dosage form is administered for about twelve weeks, at which point the therapeutic effect on the fungal infection is determined, for example, by determining the amount or degree of improvement in the patient conditions or the amount of degree of severity of the fungal infection after about twelve weeks of administration of the dosage form with respect to the amount or degree of severity before administration of the dosage form.
  • administration of the dosage form can then be continued for about six to about thirty additional weeks, for example, about eight to about twenty eight additional weeks, such as about twelve additional weeks.
  • the dosage form can be administered for about twenty four weeks, which in studies was sufficient to treat most onychomycosis infections.
  • a dosage form as described herein can also be used in a method of administering itraconazole to a fasted subject, for example, a subject who has not eaten a meal about 30 minutes or more, about 1 hour or more, about 2 hours or more, about 3 hours or more, about 4 hours or more, about 5 hours or more, about 6 hours or more, about 7 hours or more, about 8 hours or more, about 9 hours or more, or about 10 hours or more before ingesting the dosage form.
  • the dosage form used for a method of administering itraconazole to a fasted subject is typically an oral dosage form, such as a tablet, capsule, powder, sachet, lozenge, and the like, and particularly a capsule.
  • a dosage form as described herein can also be used in a method comprising coadministering an itraconazole dosage form with one or more second pharmaceutically active agents that alters the gastric pH, and particularly drugs that increase gastric pH.
  • the second pharmaceutically active agent can be a gastric acid suppressor or neutralizer.
  • second pharmaceutically active agents that alter the gastric pH include antacids, proton pump inhibitors, and H2-receptor antagonists.
  • Exemplary antacids include alkali or alkali earth salts of carbonate or bicarbonate, such as sodium bicarbonate, potassium bicarbonate, calcium carbonate, magnesium carbonate, sodium carbonate, and potassium carbonate, hydroxides such as aluminum hydroxide and magnesium hydroxide, and, bismuth subsalicylate.
  • Exemplary proton pump inhibitors include omeprazole, lansoprazole, dexlansoprazole, esomeprazole, pantoprazole, rabeprazole, and ilaprazole.
  • Exemplary H2-receptor antagonists include cimetidine, ranitidine, famotidine, and nizatidine.
  • step 2 The blended solution of step 1 was extruded by Holt melt extrusion at 160- 180 °C
  • step 4 The milled granules of step 4 were then lubricated with Aerosil 200 and filled into capsule.
  • the bioequivalence of the Itraconazole formulation of the present invention was established with respect to the reference formulation Lozonac which is an itraconazole 50mg capsule formulation.
  • Lozonac an itraconazole 50mg capsule formulation.
  • An open label, balanced, randomized, three-treatment, three-period, three-sequence, single dose, crossover design was used to establish the bioequivalence with respect to the approved formulations of Itaconazole 50mg (Lozanoc).
  • Table 2 shows the bioequivalence tests of the Itraconoazole formulation of the current specification.
  • Table 2 BE test parameters of the reference and test formulations of Itraconazole.

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Abstract

La présente invention concerne des compositions pharmaceutiques orales solides d'itraconazole ou un de ses sels pharmaceutiquement acceptables, lesdites compositions comprenant de l'itraconazole dans une dispersion de polymère matriciel. L'invention concerne également des procédés de préparation de telles formulations. L'invention concerne également l'utilisation de ces formulations pour traiter des troubles comprenant, entre autres, des infections fongiques.
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WO2013192566A1 (fr) * 2012-06-21 2013-12-27 Mayne Pharma International Pty. Ltd. Compositions et formes galéniques d'itraconazole et leurs procédés d'utilisation

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Title
WOO, J. S. ET AL.: "Reduced food-effect and enhanced bioavailability of a selfmicroemulsifying formulation of itraconazole in healthy volunteers", EUROPEAN JOURNAL OF PHARMACEUTICAL SCIENCES, vol. 33, 21 November 2007 (2007-11-21), pages 159 - 165, XP022442205, DOI: http://dx.doi.org/10.1016/j.ejps. 2007.11.00 1 *

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