WO2023237093A1 - 培美曲塞二钠液体组合物、其制备方法及应用 - Google Patents

培美曲塞二钠液体组合物、其制备方法及应用 Download PDF

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WO2023237093A1
WO2023237093A1 PCT/CN2023/099336 CN2023099336W WO2023237093A1 WO 2023237093 A1 WO2023237093 A1 WO 2023237093A1 CN 2023099336 W CN2023099336 W CN 2023099336W WO 2023237093 A1 WO2023237093 A1 WO 2023237093A1
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pemetrexed disodium
liquid composition
content
disodium liquid
regulator
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PCT/CN2023/099336
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English (en)
French (fr)
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付俊
郭桢
金海刚
陈志祥
黄安平
刘爽
王婷婷
应述欢
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上海云晟研新生物科技有限公司
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Priority to CN202380012675.5A priority Critical patent/CN117693334A/zh
Publication of WO2023237093A1 publication Critical patent/WO2023237093A1/zh

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic 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
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/08Solutions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents

Definitions

  • the invention relates to a pemetrexed disodium liquid composition, its preparation method and application.
  • Pemetrexed is a multi-target anti-metabolite anti-tumor drug. It is a folic acid antagonist that can inhibit folate-dependent enzymes such as thymidylate synthase, dihydrofolate reductase, and glycine ribonucleoside formyltransferase. These enzymes participate in the biosynthesis of thymine nucleosides and purine nucleosides, thereby achieving anti-tumor effects.
  • Pemetrexed disodium was first developed by Eli Lilly and Company. It was approved for marketing by the FDA in 2004. In August 2005, it obtained my country's import drug license and began to be used clinically in my country. The drug is combined with cisplatin in the first-line treatment of unresectable malignant pleural mesothelioma, and as a single agent in the second-line treatment of non-squamous non-small cell lung cancer.
  • this drug is a freeze-dried powder for injection. Before use, it needs to be reconstituted with 0.9% sodium chloride solution to a concentrated solution with a concentration of 25 mg/ml according to the drug specifications, and then re-dissolved twice. Dilute administration. The reconstitution process may lead to patient dosing errors, raising safety concerns and the risk of microbial contamination.
  • the invention provides a liquid composition of pemetrexed disodium, which includes: pharmaceutical active ingredients and a stabilizer.
  • the pharmaceutical active ingredients are selected from the group consisting of pemetrexed disodium and pemetrexed disodium.
  • Pharmaceutically acceptable pemetrexed disodium One or more of the accepted complexes, salts, solvates and hydrates; the stabilizer is selected from one or more of organic solvents, pH adjusters and antioxidants.
  • the content of the pharmaceutical active ingredient is 1 mg/mL ⁇ 50 mg/mL, preferably 15 mg/mL ⁇ 30 mg/mL, such as 20 mg/mL, 25.00 mg/mL, 27.57 mg/mL, 30 mg/mL mL, 40 mg/mL, the content refers to the ratio of the mass of the active pharmaceutical ingredient to the total volume of the pemetrexed disodium liquid composition.
  • the organic solvent is selected from one or more of ethanol, propylene glycol and polyethylene glycol.
  • the polyethylene glycol is selected from polyethylene glycol 400 (PEG400) and/or polyethylene glycol 300 (PEG300).
  • the content of the organic solvent is 70 mg/mL ⁇ 300 mg/mL, such as 90 mg/mL ⁇ 260mg/mL, examples are 90mg/mL, 180mg/mL, 260mg/mL or 280mg/mL; the content refers to the mass of the organic solvent and the pemetrexed disodium pharmaceutical composition Ratio of total volume.
  • the pH adjuster may be an acidic pH adjuster and/or an alkaline pH adjuster.
  • the acidic pH adjuster is preferably hydrochloric acid and/or citric acid, and more preferably citric acid.
  • the alkaline pH adjuster may be one or more of sodium hydroxide, lysine, arginine, meglumine and tromethamine, preferably tromethamine.
  • the lysine can be L-lysine and/or D-lysine.
  • the arginine can be L-arginine and/or D-arginine.
  • the antioxidant is selected from one or more of anhydrous sodium sulfite, cysteine hydrochloride, acetylcysteine and methionine, and cysteine hydrochloride is further preferred.
  • the content of the antioxidant is preferably 0 to 15 mg/mL, more preferably 0.1 mg/mL to 10 mg/mL, such as 0.3 mg/mL, 1 mg/mL, 1.63 mg/mL or 3 mg/mL.
  • the content refers to the ratio of the mass of the antioxidant to the total volume of the pemetrexed disodium pharmaceutical composition.
  • the content of the stabilizer (such as alkaline pH adjuster) in the pemetrexed disodium liquid composition is preferably 0.5 mg/mL to 50 mg/mL, and more preferably 1 mg/mL. ⁇ 10 mg/mL, such as 2.4 mg/mL.
  • the content refers to the ratio of the mass of the stabilizer (such as an alkaline pH adjuster) to the total volume of the pemetrexed disodium liquid composition.
  • the stabilizer contains at least one or more of citric acid, tromethamine, cysteine hydrochloride, meglumine and arginine; in other embodiments , the stabilizer may also contain propylene glycol.
  • the pH of the pemetrexed disodium liquid composition is preferably 7.5 to 9.5, and further preferably 8.0 to 9.0.
  • the pemetrexed disodium liquid composition may further comprise an osmotic pressure regulator.
  • the osmotic pressure regulator is preferably selected from one or more of sodium chloride, mannitol, glycerin and propylene glycol.
  • the content of the osmotic pressure regulator is preferably 1 mg/mL to 300 mg/mL, such as 1 mg/mL to 100 mg/mL, and more preferably 2 mg/mL to 30 mg/mL, such as 5.8 mg/mL, 11 mg/mL, 15 mg/mL.
  • the content refers to the ratio of the mass of the osmotic pressure regulator to the total volume of the pemetrexed disodium liquid combination.
  • the pemetrexed disodium liquid composition contains propylene glycol, propylene glycol can not only adjust the osmotic pressure, but also improve the stability of the pemetrexed disodium liquid composition.
  • the pemetrexed disodium liquid composition further includes water, such as water for injection, for volume stabilization. For example, add water to make the volume up to 1 mL.
  • the pemetrexed disodium liquid composition is selected from any of the following compositions:
  • Composition 1 including pharmaceutical active ingredients, stabilizer and water, the pharmaceutical active ingredients are pemetrexed disodium, its Pharmaceutically acceptable complexes, salts or hydrates, the stabilizer is selected from trometamol and citric acid;
  • the content of active pharmaceutical ingredients is 25 mg/mL, and the content of tromethamine is 2.4 mg/mL;
  • Composition two including pharmaceutical active ingredients, stabilizers and water;
  • the pharmaceutical active ingredients are pemetrexed disodium, its pharmaceutically acceptable complexes, salts or hydrates;
  • the stabilizers include ambutanol triols and citric acid, further including anhydrous sodium sulfite, acetylcysteine, sodium thiosulfate and/or cysteine hydrochloride;
  • the content of active pharmaceutical ingredients is 20 mg/mL, 25 mg/mL, 27.57 mg/mL, 30 mg/mL or 40 mg/mL, and the content of tromethamine is 2.4 mg/mL.
  • the content of the anhydrous sodium sulfite is 1mg/mL
  • the content of the acetylcysteine is 1.63mg/mL
  • the content of the cysteine hydrochloride is 0.3mg/mL
  • the content of the sodium thiosulfate is 1mg/mL;
  • Composition three including pharmaceutical active ingredients, stabilizers and water;
  • the pharmaceutical active ingredients are pemetrexed disodium, its pharmaceutically acceptable complexes, salts or hydrates;
  • the stabilizers include citron acid and cysteine hydrochloride, further including meglumine and/or arginine;
  • the content of active pharmaceutical ingredients is 20 mg/mL, 25 mg/mL, 27.57 mg/mL, 30 mg/mL or 40 mg/mL, and the content of cysteine hydrochloride is 0.3 mg/mL.
  • the content of meglumine is 2.4mg/mL
  • the content of arginine is 2.4mg/mL;
  • Composition four including pharmaceutical active ingredients, stabilizers and water; the pharmaceutical active ingredients are pemetrexed disodium, its pharmaceutically acceptable complexes, salts or hydrates; the stabilizers include ambutanol Triols and citric acid, further including propylene glycol and/or polyethylene glycol (such as polyethylene glycol 300 or polyethylene glycol 400);
  • the content of the active pharmaceutical ingredient is 20 mg/mL, 25 mg/mL, 27.57 mg/mL, 30 mg/mL or 40 mg/mL, and the content of tromethamine is 2.4 mg/mL.
  • the content of the propylene glycol is 70 ⁇ 300mg/mL (such as 90, 180, 260mg/mL)
  • the content of the polyethylene glycol is 70 ⁇ 300mg/mL (such as 90, 180, 280mg/mL);
  • Composition five including pharmaceutical active ingredients, stabilizers, osmotic pressure regulators and water;
  • the pharmaceutical active ingredient is pemetrexed disodium, its pharmaceutically acceptable complexes, salts or hydrates;
  • the Stabilizers include tromethamine and citric acid;
  • the osmotic pressure regulator is selected from sodium chloride, mannitol, glycerol and/or propylene glycol;
  • the content of active pharmaceutical ingredients is 20 mg/mL, 25 mg/mL, 27.57 mg/mL, 30 mg/mL or 40 mg/mL, and the content of tromethamine is 2.4 mg/mL.
  • the content of the sodium chloride is 5.8mg/mL
  • the content of the mannitol is 23mg/mL
  • the content of the glycerol is 15mg/mL
  • the content of the propylene glycol is 11mg/mL;
  • the pH of any of the above compositions is 8.0 to 9.0.
  • the present invention also provides a method for preparing the above-mentioned pemetrexed disodium liquid composition, which may include a nitrogen filling step; the filling
  • the nitrogen process can be equipped with liquid nitrogen charging and/or filling nitrogen charging, and liquid nitrogen charging and filling nitrogen charging are preferred.
  • nitrogen is charged until the dissolved oxygen content in the pemetrexed disodium liquid composition is less than 5 mg/L, preferably less than 3 mg/L; the dissolved oxygen content refers to the difference between the mass of oxygen and the The ratio of the volumes of the pemetrexed disodium liquid composition described above.
  • the headspace residual oxygen content is less than 6%, preferably less than 4%.
  • the headspace residual oxygen content refers to the direct contact of the pemetrexed disodium liquid composition with the mixed gas at the top of the packaging sealed container. The volume fraction of oxygen in the medium.
  • the preparation method includes non-terminal sterilization.
  • the invention also provides the use of the pemetrexed disodium liquid composition in the preparation of anti-tumor drugs.
  • the anti-tumor drug can be a liquid pharmaceutical preparation, such as oral liquid or injection.
  • the present invention also provides an anti-tumor drug, which contains the above pemetrexed disodium liquid composition or is prepared from the above pemetrexed disodium liquid composition.
  • the anti-tumor drug can be an oral liquid or an injection.
  • the present invention also provides a method for treating tumors, which involves providing a therapeutically effective amount of the pemetrexed disodium liquid composition or the anti-tumor drug to a patient in need.
  • the reagents and raw materials used in the present invention are all commercially available.
  • the pemetrexed disodium liquid composition of the present invention has the advantages of simple preparation process, good physical and chemical stability, convenient clinical use without the need for reconstitution, low risk of microbial contamination during the preparation process, and is suitable for industrial production.
  • Figure 2 shows the change trend of impurity PMQS-IM-B in the accelerated experiment of prescription 16
  • Figure 3 shows the change trend of impurity PMQS-IM-C in the accelerated experiment of prescription 16
  • Figure 4 shows the change trend of impurity PMQS-IM-F in the accelerated experiment of recipe 16
  • Figure 5 shows the change trend of impurity PMQS-IM-B in the long-term experiment of prescription 16
  • Figure 6 shows the change trend of impurity PMQS-IM-C in the long-term experiment of prescription 16
  • Figure 7 shows the change trend of impurity PMQS-IM-F in the long-term experiment of prescription 16.
  • the amounts of pemetrexed disodium involved in the prescriptions of the examples and comparative examples are based on pemetrexed disodium anhydrous.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial and sealed.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • the solution appearance results show that in prescription 1, the pemetrexed solution is directly filled. Under high temperature and light conditions, the solution appearance changes; in prescription 2, stabilizers—tromethamine and citric acid are added to the prescription, and the appearance of the solution only changes under light.
  • Prescription 2 has significantly increased physical and chemical stability after adding a stabilizer and filling with nitrogen.
  • the medicinal solution in 3-7 quantities according to the prescription.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • the results of related substances show that the total impurities in prescription 2 (without antioxidant) remain basically unchanged under high temperature conditions; among prescriptions 3 to 5, prescription 3 (antioxidant is anhydrous sodium sulfite) and prescription 4 (antioxidant)
  • the impurities of Formula 5 are growing rapidly; while the single impurity of prescription 5 (antioxidant is cysteine hydrochloride) is 0.06% or less, and the total impurities are only 0.32% or less, showing a higher Good stability.
  • cysteine hydrochloride is added as an antioxidant to the pemetrexed solution, and the solution stability is better; while at the same time, the prescription without antioxidants can also be used under high temperature conditions. It ensures good stability and low single impurity detection amount.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • the medicinal solution in 10-12 quantities according to the prescription.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • the medicinal solution is prepared according to the prescription of 13-15 volumes.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into a cleaned and sterilized vial, which is then purged with nitrogen to ensure that the residual oxygen in the headspace is ⁇ 4% and sealed.
  • sample solutions were prepared according to the dilution multiples used in clinical use and their osmotic pressure was tested. The results are shown in the table below:
  • the above results show that when the amount of dissolved oxygen in the solution is reduced, the total impurity increase of pemetrexed disodium solution is smaller, indicating that the amount of dissolved oxygen in the solution has a certain impact on the stability of pemetrexed disodium. Therefore, in order to reduce the influence of dissolved oxygen in water, during the liquid preparation process In the process, the water for injection can be filled with nitrogen first with high-purity nitrogen to replace the dissolved oxygen in the water and reduce the impact of dissolved oxygen on the pemetrexed disodium solution.
  • the prepared samples were placed under high temperature conditions to examine the system stability (high temperature: 40°C ⁇ 2°C/75% ⁇ 5%RH), and the appearance of the sample solution and related substances were detected.
  • the results are as follows:
  • the solution appearance results show that when the sample without nitrogen filling is placed under high temperature conditions for 10 days, the appearance of the solution begins to change, changing from a colorless clear liquid to a yellow clear liquid; and after adding the headspace nitrogen filling process, the solution systems with different residual oxygen contents There is no obvious change in its appearance after being placed under high temperature conditions for different times, and it is a colorless and clear solution.
  • the results of related substances show that the impurity content of the sample with headspace filled with nitrogen at 40°C for 10 days is 0.31%, which is 0.26% less than the sample without headspace filled with nitrogen. Therefore, the product needs to be filled with nitrogen in the headspace.
  • the medicinal solution is prepared according to the prescription amount in the table above.
  • the medicinal solution is pre-filtered with a 0.22 ⁇ m filter element.
  • the resulting solution is filled into cleaned and sterilized vials to examine the impact of different nitrogen filling processes on stability.
  • the prepared samples with different residual oxygen contents were placed under high temperature conditions to examine the system stability (high temperature: 40°C ⁇ 2°C/75% ⁇ 5%RH). The appearance of the sample solution and related substances were detected. The results are as follows:
  • the nitrogen filling process has a greater impact on the stability of the system, and when the residual oxygen in the headspace is controlled below 4%, the system stability is better.
  • the pemetrexed disodium liquid composition of the present invention has good stability, the preparation process is stable, and is suitable for commercial production.
  • prescription 16 was selected for subsequent non-clinical experiments.
  • Equilibrium dialysis method was used to examine different concentrations of prescription 16 (based on the pharmacokinetic results of intravenous injection of prescription 16 in Beagle dogs, combined with the preclinical test data of the reference preparation, this trial set the low, medium and high concentrations of the experimental group to 10, 100, 1000 ⁇ g/mL) and human plasma protein binding rate, and compared with the control drug Human plasma protein binding rates were compared.
  • concentrations of 10, 100, and 1000 ⁇ g/mL the binding rates of prescription 16 to human plasma proteins were 86.50%, 90.19%, and 74.72% respectively; the control drug The binding rates to human plasma proteins at corresponding concentrations were 86.14%, 89.94% and 80.96% respectively.
  • Table 2 Detailed data on plasma protein binding rates are shown in Table 2 below.
  • Pemetrexed disodium is a multi-target anti-metabolite anti-tumor drug. It is clinically diluted with 0.9% sodium chloride injection and administered intravenously. Infusion, in vitro hemolysis test was performed on prescription 16.
  • the test consisted of a negative control group (0.9% sodium chloride injection, tube No. 1), a positive control group (sterile water for injection, tube No. 2), and a control drug.
  • Group peermetrexed disodium for injection, dosage concentration 10 mg/mL, 0.1, 0.2, 0.3, 0.4, 0.5mL/tube, tubes 3 to 7 respectively
  • prescription group 16 dosage concentration 10 mg/mL , respectively 0.1, 0.2, 0.3, 0.4, 0.5mL/tube, tubes 8 to 12
  • each group has 3 parallel tubes.
  • Tube 1 is the negative control group
  • tube 2 is the positive control group
  • tubes 3 to 7 are Groups
  • tubes 8 to 12 are prescription groups 16. The same later.
  • the prescription group 16 with a concentration of 10 mg/mL has no hemolysis or aggregation effect on rabbit red blood cells, and the in vitro hemolysis test results are negative.
  • This product needs to be diluted with 0.9% sodium chloride injection for intravenous infusion during clinical use.
  • Prescription 16 was subjected to an active systemic allergy test in guinea pigs to observe whether guinea pigs developed allergic reactions after being given the test product. In order to evaluate the safety of clinical use Sexual reference.
  • This experiment consists of 6 groups, namely negative control group, positive control group, Low and high dose groups and prescription 16 low and high dose groups, each group consisted of 6 guinea pigs, half male and half female.
  • the negative control group was intravenously injected with 0.9% sodium chloride injection in a volume of 4 mL/kg
  • the positive control group was intraperitoneally injected with an 8 mg/mL egg white albumin solution in a volume of 0.5 mL/animal.
  • prescription 16 low-dose and high-dose groups were intravenously injected with 10 mg/mL in volumes of 2 mL/kg and 4 mL/kg respectively.
  • the dosage is 20m/kg, 40mg/kg, which is about 1.5 and 3 times the highest dose proposed for clinical use.
  • the day of first administration as the test Test day 1. Sensitization was performed once every other day and sensitized three times continuously (i.e., sensitization on days 1, 3, and 5 of the test). On the 14th and 21st days after the last sensitization (i.e., the 19th and 26th days of the test), twice the sensitizing dose was intravenously injected for stimulation, and the systemic reactions and death of the guinea pigs after stimulation were observed.
  • British guinea pigs were intravenously injected with a 10 mg/mL prescription 16 at a volume of 2 and 4 mL/kg, respectively, that is, the dosage was 20 and 40 mg/kg, and the active systemic allergy test results were negative.
  • This experiment consists of 2 groups, namely Groups and prescriptions: 16 groups, 8 rabbits in each group, half male and half female. Rabbits in each group were injected with 10 mg/mL via the right ear margin vein at a volume of 4 mL/kg. Or prescription 16, the dosage is 40 mg/kg, which is about three times the highest dose proposed for clinical use. At the same time, autologous control was used, and an equal volume of 0.9% sodium chloride injection was injected through the left marginal ear vein. Single administration, continuous observation for 21 days after administration. The day of administration was defined as the first day of the trial.
  • the general condition of the rabbit and the condition of the injection site were observed every day. 3 days and 21 days after administration (i.e., the 4th and 22nd days of the test), 4 rabbits (half male and half female) from each group were euthanized and dissected, and the irritation reaction at the injection site was observed with the naked eye, and the rabbits were collected. Tissues were subjected to pathological examination.
  • the pemetrexed disodium liquid composition provided by the present invention can achieve an exposure similar to that of the commercially available reference substance, and at the same time has less irritation in the body, lower adverse reactions, is safer, more convenient, and can improve patient health. Medication compliance and convenience of clinical medication have good market prospects.

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Abstract

本发明公开了培美曲塞二钠液体组合物、其制备方法及应用。本发明提供的培美曲塞二钠液体组合物包括:药物活性成分和稳定剂;药物活性成分为培美曲塞二钠、培美曲塞二钠药学上可接受的配合物、盐、溶剂化物和水合物中的一种或多种;所述的稳定剂为有机溶剂、pH调节剂和抗氧剂中的一种或多种。本发明的培美曲塞二钠液体组合物,具有制备工艺简单,物理、化学稳定性好,临床使用方便不需复溶,配制过程微生物污染风险低,适合于工业化生产等优点。

Description

培美曲塞二钠液体组合物、其制备方法及应用
本申请要求享有2022年6月9日向中国国家知识产权局提交的,专利申请号为202210645147.0,发明名称为“培美曲塞二钠液体组合物、其制备方法及应用”的在先申请的优先权权益。所述在先申请的全文通过引用的方式结合于本申请中。
技术领域
本发明涉及一种培美曲塞二钠液体组合物、其制备方法及应用。
背景技术
培美曲塞是一种多靶点抗代谢的抗肿瘤药物,为叶酸拮抗剂,可以抑制胸苷酸合成酶、二氢叶酸还原酶、甘氨酸核糖核苷甲酰基转移酶等叶酸依赖性酶,这些酶参与胸腺嘧啶核苷和嘌呤核苷的生物合成,从而达到抗肿瘤的效果。培美曲塞二钠最早由礼来公司开发,2004年FDA批准上市,2005年8月获得我国进口药品许可,开始在我国用于临床。该药联合顺铂一线治疗不可切除的恶性胸膜间皮瘤,单药二线治疗非鳞状非小细胞肺癌。
目前已在全球多个国家与地区上市销售,该药为冻干粉针剂,使用前需要根据药品规格,用0.9%氯化钠溶液复溶成浓度25mg/ml的浓缩液,然后再经二次稀释给药。复溶过程可能导致患者给药剂量误差,引起安全性担忧和微生物污染的风险。
因此,寻找使用方便、物理及化学稳定性好、制备工艺简单、适合于工业化生产的培美曲塞剂型,是目前急需解决的技术问题。
发明内容
本发明提供了一种培美曲塞二钠液体组合物,包括:药物活性成分和稳定剂,所述的药物活性成分选自培美曲塞二钠、以及培美曲塞二钠药学上可接受的配合物、盐、溶剂化物和水合物中的一种或多种;所述的稳定剂选自有机溶剂、pH调节剂和抗氧剂中的一种或多种。
根据本发明的实施方案,所述的药物活性成分的含量为1mg/mL~50mg/mL,优选15mg/mL~30mg/mL,例如20mg/mL、25.00mg/mL、27.57mg/mL、30mg/mL、40mg/mL,所述的含量是指药物活性成分的质量与所述的培美曲塞二钠液体组合物总体积的比值。
根据本发明的实施方案,所述的有机溶剂选自乙醇、丙二醇和聚乙二醇中的一种或多种。例如,所述的聚乙二醇选自聚乙二醇400(PEG400)和/或聚乙二醇300(PEG300)。
根据本发明的一些实施方案,所述有机溶剂的含量为70mg/mL~300mg/mL,例如90 mg/mL~260mg/mL,示例性为90mg/mL、180mg/mL、260mg/mL或280mg/mL;所述的含量是指有机溶剂的质量与所述的培美曲塞二钠药物组合物总体积的比值。
根据本发明的实施方案,所述的pH调节剂可以为酸性pH调节剂和/或碱性pH调节剂。例如,所述的酸性pH调节剂优选盐酸和/或枸橼酸,进一步优选枸橼酸。例如,所述的碱性pH调节剂可以为氢氧化钠、赖氨酸、精氨酸、葡甲胺和氨丁三醇中的一种或多种,优选为氨丁三醇。例如,所述的赖氨酸可以为L-赖氨酸和/或D-赖氨酸。例如,所述的精氨酸可以为L-精氨酸和/或D-精氨酸。
根据本发明的实施方案,所述的抗氧剂选自无水亚硫酸钠、盐酸半胱氨酸、乙酰半胱氨酸和甲硫氨酸中的一种或多种,进一步优选盐酸半胱氨酸。所述的抗氧剂的含量优选为0~15mg/mL,进一步优选为0.1mg/mL~10mg/mL,例如为0.3mg/mL、1mg/mL、1.63mg/mL或3mg/mL,所述的含量是指抗氧剂的质量与所述的培美曲塞二钠药物组合物总体积的比值。
在一些实施方案中,所述的培美曲塞二钠液体组合物中,所述的稳定剂(例如碱性pH调节剂)的含量优选0.5mg/mL~50mg/mL,进一步优选1mg/mL~10mg/mL,例如2.4mg/mL,所述的含量是指所述的稳定剂(例如碱性pH调节剂)的质量与所述的培美曲塞二钠液体组合物总体积的比值。
根据本发明一些的实施方案,所述稳定剂至少含有枸橼酸、氨丁三醇、盐酸半胱氨酸、葡甲胺和精氨酸中的一种或多种;在另一些实施方案中,所述稳定剂还可以含有丙二醇。
根据本发明的实施方案,所述的培美曲塞二钠液体组合物的pH优选为7.5~9.5,进一步优选为8.0~9.0。
根据本发明的实施方案,所述的培美曲塞二钠液体组合物可以进一步包含渗透压调节剂。所述的渗透压调节剂优选选自氯化钠、甘露醇、甘油和丙二醇中的一种或多种。所述的渗透压调节剂的含量优选为1mg/mL~300mg/mL,例如1mg/mL~100mg/mL,进一步优选2mg/mL~30mg/mL,例如5.8mg/mL、11mg/mL、15mg/mL或23mg/mL,所述的含量是指渗透压调节剂的质量与所述的培美曲塞二钠液体组合总体积的比值。当所述培美曲塞二钠液体组合物中含有丙二醇时,丙二醇既可以调节渗透压,又可以提升培美曲塞二钠液体组合物的稳定性。
根据本发明的实施方案,所述的培美曲塞二钠液体组合物还包括水,例如注射用水,用于定容。示例性地,加水定容至1mL。
根据本发明的实施方案,所述的培美曲塞二钠液体组合物选自下述任一组合物:
组合物一:包括药物活性成分、稳定剂和水,所述的药物活性成分为培美曲塞二钠、其 药学上可接受的配合物、盐或水合物,所述的稳定剂选自氨丁三醇和枸橼酸;
优选地,所述组合物一中,药物活性成分的含量为25mg/mL,所述氨丁三醇的含量为2.4mg/mL;
组合物二:包括药物活性成分、稳定剂和水;所述的药物活性成分为培美曲塞二钠、其药学上可接受的配合物、盐或水合物;所述的稳定剂包括氨丁三醇和枸橼酸,进一步包括无水亚硫酸钠、乙酰半胱氨酸、硫代硫酸钠和/或盐酸半胱氨酸;
优选地,所述组合物二中,药物活性成分的含量为20mg/mL、25mg/mL、27.57mg/mL、30mg/mL或40mg/mL,所述氨丁三醇的含量为2.4mg/mL,所述无水亚硫酸钠的含量为1mg/mL,所述乙酰半胱氨酸含量为1.63mg/mL,所述盐酸半胱氨酸的含量为0.3mg/mL,所述硫代硫酸钠的含量为1mg/mL;
组合物三:包括药物活性成分、稳定剂和水;所述的药物活性成分为培美曲塞二钠、其药学上可接受的配合物、盐或水合物;所述的稳定剂包括枸橼酸和盐酸半胱氨酸,进一步包括葡甲胺和/或精氨酸;
优选地,所述组合物三中,药物活性成分的含量为20mg/mL、25mg/mL、27.57mg/mL、30mg/mL或40mg/mL,所述盐酸半胱氨酸的含量为0.3mg/mL,所述葡甲胺的含量为2.4mg/mL,所述精氨酸的含量为2.4mg/mL;
组合物四:包括药物活性成分、稳定剂和水;所述的药物活性成分为培美曲塞二钠、其药学上可接受的配合物、盐或水合物;所述的稳定剂包括氨丁三醇和枸橼酸,进一步包括丙二醇和/或聚乙二醇(例如聚乙二醇300或聚乙二醇400);
优选地,所述组合物四中,药物活性成分的含量为20mg/mL、25mg/mL、27.57mg/mL、30mg/mL或40mg/mL,所述氨丁三醇的含量为2.4mg/mL,所述丙二醇的含量为70~300mg/mL(例如90、180、260mg/mL),所述聚乙二醇的含量为70~300mg/mL(例如90、180、280mg/mL);
组合物五:包括药物活性成分、稳定剂、渗透压调节剂和水;所述的药物活性成分为培美曲塞二钠、其药学上可接受的配合物、盐或水合物;所述的稳定剂包括氨丁三醇和枸橼酸;所述的渗透压调节剂选自氯化钠、甘露醇、甘油和/或丙二醇;
优选地,所述组合物五中,药物活性成分的含量为20mg/mL、25mg/mL、27.57mg/mL、30mg/mL或40mg/mL,所述氨丁三醇的含量为2.4mg/mL,所述氯化钠的含量为5.8mg/mL,所述甘露醇的含量为23mg/mL,所述甘油的含量为15mg/mL,所述丙二醇的含量为11mg/mL;
上述任一组合物的pH为8.0~9.0。
本发明还提供上述培美曲塞二钠液体组合物的制备方法,可以包含充氮工序;所述的充 氮工序可选配液充氮和/或灌装充氮,优选配液充氮和灌装充氮。在一些实施方案中,充氮至所述的培美曲塞二钠液体组合物中的溶解氧含量小于5mg/L,优选小于3mg/L;所述的溶解氧含量是指氧气的质量与所述的培美曲塞二钠液体组合物体积的比值。在一些实施方案中,顶空残氧量小于6%,优选小于4%,所述的顶空残氧量是指所述的培美曲塞二钠液体组合物直接接触包装密封容器顶部混合气体中氧气的体积分数。
根据本发明的实施方案,所述制备方法包含非终端灭菌。
本发明还提供了所述的培美曲塞二钠液体组合物在制备抗肿瘤药物中的应用。优选地,所述抗肿瘤药物可以为液体药物制剂,例如口服液或注射液。
本发明还提供一种抗肿瘤药物,含有上述培美曲塞二钠液体组合物或由上述培美曲塞二钠液体组合物制备得到。例如,所述抗肿瘤药物可以为口服液或注射液。
本发明还提供了一种治疗肿瘤的方法,其为给需要的患者提供治疗有效量的所述的培美曲塞二钠液体组合物或所述抗肿瘤药物。
在不违背本领域常识的基础上,上述各优选条件,可任意组合,即得本发明各较佳实例。
本发明所用试剂和原料均市售可得。
本发明的有益效果:
本发明的培美曲塞二钠液体组合物,具有制备工艺简单,物理、化学稳定性好,临床使用方便不需复溶,配制过程微生物污染风险低,适合于工业化生产等优点。
有效克服了现有技术中培美曲塞冻干粉针剂、使用前需要复溶、然后再经二次稀释给药、操作繁琐、复溶过程可能导致患者给药剂量差异和微生物污染的风险等缺陷。
附图说明
图1为Beagle犬静脉注射处方16和对照药后的平均药时曲线图(N=6);其中,
表示处方16的平均药时曲线;表示对照药后的平均药时曲线。
图2为处方16加速实验中杂质PMQS-IM-B的变化趋势;
图3为处方16加速实验中杂质PMQS-IM-C的变化趋势;
图4为处方16加速实验中杂质PMQS-IM-F的变化趋势;
图5为处方16长期实验中杂质PMQS-IM-B的变化趋势;
图6为处方16长期实验中杂质PMQS-IM-C的变化趋势;
图7为处方16长期实验中杂质PMQS-IM-F的变化趋势。
具体实施方式
下面通过实施例的方式进一步说明本发明,但并不因此将本发明限制在所述的实施例范围之中。下列实施例中未注明具体条件的实验方法,按照常规方法和条件,或按照商品说明书选择。
实施例和对比例处方中涉及的培美曲塞二钠的量,均以培美曲塞二钠无水物计。
对比例1
按照处方1量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,密封。
实施例1
按照处方2量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
实施例2
处方1~2得到的样品置于高温/光照条件考察(高温:40℃±2℃/75%±5%RH,光照:总照度1.2×105lux·hr,近紫外能量24w·hr/m2)体系稳定性,检测样品溶液外观、pH、有关物质,数据汇总如下:
溶液外观结果表明,处方1中,培美曲塞溶液直接灌装,在高温、光照条件下,溶液外观 发生改变;处方2中,处方中加入稳定剂—氨丁三醇和枸橼酸,溶液外观仅在光照下发生改变。
pH结果表明,处方1在高温、光照条件下pH均有所下降,最大下降幅度为1.7;处方2在高温、光照条件下pH稳定。
有关物质结果表明,处方1在高温、光照条件下总杂明显增加;处方2总杂虽然有所增长,但增长趋势低于处方1。
综上,处方2与处方1相比,加入了稳定剂且充氮后,溶液的物理稳定性和化学稳定性明显增加。
实施例3
按照处方3-7量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
实施例4
处方3~5得到的样品置于高温/光照条件考察(高温:40℃±2℃/75%±5%RH,光照:总照度1.2×105lux·hr,近紫外能量24w·hr/m2)体系稳定性,检测样品溶液外观、pH、有关物质,与处方2进行对比,数据汇总如下:

溶液外观结果表明,处方2中未加入抗氧剂,放置于光照条件下一段时间后体系颜色有一定的变化;处方3~5中加入不同种类的抗氧剂,其在高温、光照下放置5天、10天,外观均未发生改变。
pH结果表明,加入不同种类抗氧剂后,体系的pH值均较为稳定。
有关物质结果表明,处方2(不加抗氧剂)在高温条件下,总杂基本维持不变;处方3~5中,处方3(抗氧剂为无水亚硫酸钠)和处方4(抗氧剂为乙酰半胱氨酸)的杂质增长较快;而处方5(抗氧剂为盐酸半胱氨酸)单个杂质为0.06%或更小,同时总杂仅为0.32%或更小,显示了更好的稳定性。
综上,在抗氧剂的处方中,盐酸半胱氨酸作为抗氧剂加入到培美曲塞溶液中,溶液稳定性较好;而同时不加抗氧剂的处方,高温条件下也能保证很好的稳定性,且单杂检出量也较低。
实施例5
按照处方8-9量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
实施例6
处方8~9得到的样品置于高温/光照条件考察(高温:40℃±2℃/75%±5%RH,光照:总照度1.2×105lux·hr,近紫外能量24w·hr/m2)体系稳定性,检测样品溶液外观、pH、有关物质, 与处方5(pH调节剂为氨丁三醇)进行对比,数据汇总如下:
由以上结果可知,处方中加入pH调节剂葡甲胺、精氨酸、氨丁三醇,样品在40℃高温/光照条件下放置5天、10天,体系外观未发生改变,单个杂质为0.08%或更小,同时总杂仅为0.33%或更小,表明葡甲胺、精氨酸、氨丁三醇对培美曲塞溶液有很好的稳定作用,起到稳定剂的作用。
实施例7
按照处方10-12量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
处方10~12得到的样品置于高温条件考察(高温:40℃±2℃/75%±5%RH)体系稳定性,检测样品溶液有关物质,与处方5(pH调节剂为氨丁三醇)进行对比,数据汇总如下:

由以上结果可知,当处方中加入有机溶剂丙二醇至180mg/ml及以上时,稳定性与加入抗氧剂的处方5有关增长相当。说明处方中加入丙二醇对产品也有稳定作用。
实施例8
按照处方13-15量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
实施例9
按照处方16-19量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,随后用氮气吹扫,顶空残氧<4%,密封。
实施例10
处方16~19得到的样品置于高温条件考察(高温:40℃±2℃/75%±5%RH)体系稳定性,有关物质数据汇总如下表:

由上表可知,不同种类渗透压调节剂对产品的稳定性影响不明显。
另外,分别按照临床使用时的稀释倍数配制样品溶液并检测其渗透压,结果见下表:
结果表明,在临床拟用法下,本实施例所制备的样品均能够满足等渗的要求。
实施例11
按照处方16的处方量配制药液,将药液灌装于无色中硼硅玻璃注射剂瓶中,溶液中充入氮气降低溶氧量。检测溶液中氧气含量,结果如下表:
安瓿熔封后得到的样品置于高温条件考察(高温:40℃±2℃/75%±5%RH)体系稳定性,外观、有关物质数据汇总如下表:
以上结果可知,降低溶液中的溶氧量,培美曲塞二钠溶液总杂增幅更小,说明溶液中的溶氧量对培美曲塞二钠的稳定性有一定影响。因此为了降低水中溶氧量的影响,在配液过程 中,可先用高纯氮气对注射用水进行充氮处理,置换水中的溶解氧,降低溶解氧对培美曲塞二钠溶液的影响。
实施例12
按照上表处方量配制药液,将药液灌装于无色中硼硅玻璃注射剂瓶中,考察顶空下是否充氮下对稳定性的影响。
将所制备的样品置于高温条件考察(高温:40℃±2℃/75%±5%RH)体系稳定性,检测样品溶液外观、有关物质,结果如下表:
溶液外观结果表明,不充氮的样品在高温条件下放置10天时溶液外观开始发生变化,由无色澄明液体转变为黄色澄明液体;而加入顶空充氮工序后,不同残氧量的溶液体系在高温条件下放置不同时间,其外观均无明显变化,为无色澄明溶液。
有关物质结果表明,顶空充氮的样品,40℃10天时的杂质为0.31%,较未顶空充氮的样品杂质增长少0.26%。故需要对产品进行顶空充氮。
对处方5进行顶空充氮考察,确定顶空残氧的限度。

按照上表处方量配制药液,药液采用0.22μm滤芯预过滤,所得溶液填装进清洗且灭菌的西林瓶中,考察不同充氮工艺下对稳定性的影响。
将所制备的不同残氧量的样品置于高温条件考察(高温:40℃±2℃/75%±5%RH)体系稳定性,检测样品溶液外观、有关物质,结果如下表:
顶空残氧为3.9%和1.8%的样品总杂涨幅较小,均与0天时结果相近,且两组差距不大。
综上,充氮工序对体系的稳定性影响较大,且当顶空残氧控制在4%以下时,体系稳定性较好。
实施例13
以处方16及相应工艺:配液前注射用水充氮置换氧气;冻干机抽真空充氮顶空残氧控制在4%以内。商业化生产三批产品,代号分别为1、2、3。所得三批样品分别放置于加速条件(25℃/60%RH)、长期条件(5±3℃)下。得到的有关物质检测结果如下表A-B和图2-7。
表A
由表A和图2-4可知,加速条件下,6个月的稳定性数据远在限度范围内,符合标准。
表B

由表B和图5-7可知,长期条件(5±3℃)下,6个月数据显示,有关物质远在限度以内,稳定性良好。
由以上数据可知,本发明培美曲塞二钠液体组合物具有良好的稳定性,制备工艺稳定,适合商业化生产。
考虑到注射液处方尽量简单的一般原则,选择处方16进行后续非临床实验的考察。
实施例14
本实验采用雌雄各半共12只的Beagle犬,按两周期交叉实验设计分别静脉给予处方16和对照药给药剂量均为25mg/kg,采样时间点:给药前及给药结束即刻(0~1分钟)、5min、20min、1h、2h、3h、4h、6h、8h、10h、12h、16h、24h、36h;各组Beagle犬血浆中培美曲塞的平均药动学参数见表1,平均药物浓度-时间曲线图见图1。
表1:Beagle犬静脉注射处方16和对照药后的平均药动学参数(Mean±SD,N=12)
上述结果表明,处方16可达到与对照药相近的暴露量,且关键药代动力学参数基本一致。
实施例15
采用平衡透析法考察不同浓度的处方16(根据Beagle犬静脉注射处方16的药代动力学结果,结合参比制剂临床前试验资料,本试验设置实验组低、中、高浓度分别设为10、100、1000 μg/mL)与人血浆蛋白的结合率,并与对照药的人血浆蛋白结合率进行比较。在10、100、1000μg/mL浓度下,处方16与人血浆蛋白结合率分别为86.50%、90.19%和74.72%;对照药在相应浓度下与人血浆蛋白结合率分别为86.14%、89.94%和80.96%。血浆蛋白结合率的详细数据见下表2。
表2:处方16和对照药不同浓度下与人的血浆蛋白结合率
结果表明,在本试验条件下,10μg/mL、100μg/mL、1000μg/mL的处方16和对照药 中培美曲塞二钠与人血浆蛋白结合率均在中等结合水平(50%~90%)。
实施例16
培美曲塞二钠为多靶点抗代谢的抗肿瘤药物,临床用0.9%氯化钠注射液稀释后进行静脉 输注,对处方16进行体外溶血试验。
试验设阴性对照组(0.9%氯化钠注射液,1号管),阳性对照组(灭菌注射用水,2号管),对照药组(注射用培美曲塞二钠,给药浓度10mg/mL,分别为0.1、0.2、0.3、0.4、0.5mL/管,3~7号管),处方16组(给药浓度10mg/mL,分别为0.1、0.2、0.3、0.4、0.5mL/管,8~12号管),每组3个平行管。将2%红细胞悬液、0.9%氯化钠注射液、灭菌注射用水、对照药处方16组按设定比例混匀后置于恒温箱中在37±0.5℃温度范围内静置,并分别于0、15、30、45、60、120、180分钟(±10%)各观察一次,具体结果详见表3。
表3:不同制剂体外溶血试验结果

备注:
1)“-”代表“无溶血或凝聚”,“+”代表“部分溶血”,“++”代表“全溶血”,“*”代表“凝聚”。
2)1号管为阴性对照组,2号管为阳性对照组,3~7号管为组,8~12号管为处方16组。后同。
结果显示:37±0.5℃静置180分钟后,阴性对照组管红细胞全部下沉,上层液无色澄明,适当振摇后下沉的红细胞重新分散,未见溶血和凝聚;阳性对照组管溶液澄明红色,管底无红细胞残留,全溶血。以上结果提示本试验体系正常可靠。
组管红细胞全部下沉,上层液无色澄明,未见溶血,但下沉的红细胞中还可见凝聚红细胞,振摇后不分散,镜检凝聚红细胞亦不被冲散判定为不溶血但凝聚。
处方16组管红细胞全部下沉,上层液无色澄明,适当振摇后下沉的红细胞重新分散,镜检红细胞亦未见异常,未见溶血和凝聚。
综上,浓度为10mg/mL的处方16组对兔红细胞无溶血和凝聚作用,体外溶血试验结果为阴性。
实施例17
本品临床使用时需采用0.9%氯化钠注射液稀释后进行静脉输注,对处方16进行豚鼠主动全身过敏试验,观察豚鼠给予该供试品后是否产生过敏反应,为评价临床使用的安全性提供参考。
本试验设6个组,分别为阴性对照组、阳性对照组、低、高剂量组及处方16低、高剂量组,每组6只豚鼠,雌雄各半。致敏阶段,阴性对照组按4mL/kg的体积静脉注射0.9%氯化钠注射液,阳性对照组按0.5mL/只的体积腹腔注射8mg/mL鸡蛋清白蛋白溶液,和处方16低、高剂量组分别按2mL/kg、4mL/kg的体积静脉注射10mg/mL或处方16,给药剂量为20m/kg、40mg/kg,约为临床拟用最高剂量的1.5、3倍。以首次给药当天定义为试 验第1天。隔日致敏1次,连续致敏3次(即试验第1、3、5天致敏)。末次致敏后第14天和第21天(即试验第19天和第26天),按致敏剂量的2倍量静脉注射进行激发,观察激发后豚鼠出现的全身反应及死亡情况。
表4首次激发后全身过敏试验观察结果
备注:*过敏反应动物数按该动物出现的过敏反应最高级数计。附表5同。
表5末次激发后全身过敏试验观察结果
结果显示,致敏期间,各组豚鼠一般状况良好、自主活动正常、皮肤被毛洁净、无异常分泌物、体重正常增长,未见其它异常症状出现。
首次激发后30分钟内,阴性对照组、低、高剂量组及处方16低、高剂量组所有豚鼠均未见过敏反应;阳性对照组豚鼠出现过敏症状,并于给药后7分钟内全部死亡,过敏反应极强阳性。
末次激发后30分钟内,阴性对照组、低、高剂量组及处方16低、高剂量组所有豚鼠均未见过敏反应。
综上所述,在本试验条件下,英国种豚鼠分别按2、4mL/kg的体积静脉注射10mg/mL处方16,即给药剂量为20、40mg/kg,主动全身过敏试验结果为阴性。
实施例18
对处方16进行兔单次静脉注射刺激试验,观察该供试品对兔耳缘静脉血管及周围组织产 生的刺激性反应及可逆程度,为评价临床使用的安全性提供参考。
本试验设2个组,分别为组和处方16组,每组8只兔,雌雄各半。各组兔按4mL/kg的体积经右侧耳缘静脉注射10mg/mL或处方16,给药剂量40mg/kg,约为临床拟用最高剂量的3倍。同时采用自身同体对照,经左侧耳缘静脉注射等体积的0.9%氯化钠注射液。单次给药,给药后连续观察21天。给药当天定义为试验第1天。
试验期间,每天观察兔一般状况及注射部位情况。给药后3天和21天(即试验第4天和第22天),每组各取4只兔(雌雄各半)实施安乐死后解剖,肉眼观察注射局部的刺激反应情况,并对所取组织进行病理学检查。
给药后观察期内,各组兔双侧注射部位均未见红肿、充血、坏死等反应,兔一般状况良好、自主活动正常,未见其它异常症状出现。
给药后3天和21天,各组兔双侧注射部位均未发现肉眼可见的异常改变。
给药后3天,对照侧1个注射部位(1/8比例)出现与注射穿刺机械刺激相关的轻微血管炎症。除此之外,给药后3天和21天,各组其余注射部位均未见异常。
上述结果表明,在本试验条件下,日本大耳白兔按4mL/kg的体积经右侧耳缘静脉注射10mg/mL处方16,即给药剂量40mg/kg,对注射部位血管及周围组织未见刺激性。
综上所述,本发明提供的培美曲塞二钠液体组合物能够达到与市售对照品相近的暴露量,同时体内刺激性小,不良反应更低,更安全,更方便,能够增进患者用药顺应性及临床用药的便利性,市场化前景好。
尽管已详细地描述了本发明的一些实施案例,本领域普通技术人员可以对所示的具体实施方案做出各种改进和变化,而不实质上脱离本发明的心的教导和优点。这样的改进和变化被包括在所附权利要求书所属的本发明的精神和范围内。

Claims (10)

  1. 一种培美曲塞二钠液体组合物,其特征在于其包括:药物活性成分和稳定剂,所述的药物活性成分为培美曲塞二钠、以及培美曲塞二钠药学上可接受的配合物、盐、溶剂化物和水合物中的一种或多种;所述的稳定剂为有机溶剂、pH调节剂和抗氧剂中的一种或多种。
  2. 如权利要求1所述的培美曲塞二钠液体组合物,其特征在于:所述的药物活性成分的含量为1mg/mL~50mg/mL,所述的含量是指药物活性成分的质量与所述的培美曲塞二钠液体组合物总体积的比值。
  3. 如权利要求1或2所述的培美曲塞二钠液体组合物,其特征在于:
    所述的药物活性成分的含量为15mg/mL~30mg/mL,所述的浓度是指药物活性成分的质量与所述的培美曲塞二钠液体组合物总体积的比值;
    和/或,
    所述的有机溶剂为乙醇、丙二醇和聚乙二醇中的一种或多种;
    和/或,
    所述的pH调节剂为酸性pH调节剂和/或碱性pH调节剂;
    和/或,
    所述的抗氧剂为无水亚硫酸钠、盐酸半胱氨酸、乙酰半胱氨酸和甲硫氨酸中的一种或多种。
  4. 如权利要求3所述的培美曲塞二钠液体组合物,其特征在于:
    所述的酸性pH调节剂为盐酸和/或枸橼酸;
    和/或,
    所述的碱性pH调节剂为氢氧化钠、赖氨酸、精氨酸、葡甲胺和氨丁三醇中的一种或多种;
    和/或,
    所述的聚乙二醇为聚乙二醇300和/或聚乙二醇400。
  5. 如权利要求4所述的培美曲塞二钠液体组合物,其特征在于:
    所述的赖氨酸为L-赖氨酸和/或D-赖氨酸;
    和/或,
    所述的精氨酸为L-精氨酸和/或D-精氨酸。
  6. 如权利要求3所述的培美曲塞二钠液体组合物,其特征在于:
    所述的培美曲塞二钠液体组合物中,所述的碱性pH调节剂的含量为0.5mg/mL~ 50mg/mL,所述的含量是指所述的碱性pH调节剂的质量与所述的培美曲塞二钠液体组合物总体积的比值;
    和/或,
    所述的培美曲塞二钠液体组合物的pH为7.5~9.5;
    和/或,
    所述的抗氧剂的含量为0~15mg/mL,所述的含量是指抗氧剂的质量与培美曲塞二钠液体组合物总体积比值。
  7. 如权利要求6所述的培美曲塞二钠液体组合物,其特征在于:
    所述的培美曲塞二钠液体组合物中,所述的碱性pH调节的含量为1mg/mL~10mg/mL,所述的含量是指所述的碱性pH调节剂的质量与所述的培美曲塞二钠液体组合物总体积的比值;
    和/或,
    所述的培美曲塞二钠液体组合物的pH为8.0~9.0;
    和/或,
    所述的抗氧剂的含量为0.1mg/mL~10mg/mL,所述的含量是指抗氧剂的质量与培美曲塞二钠液体组合物总体积比值。
  8. 如权利要求1-7任一项所述的培美曲塞二钠液体组合物,其特征在于:所述的培美曲塞二钠液体组合物进一步包含渗透压调节剂;
    优选地,所述的渗透压调节剂为氯化钠、甘露醇、甘油和丙二醇中的一种或多种;
    和/或,
    所述的渗透压调节剂的含量为1mg/mL~300mg/mL,所述的含量是指渗透压调节剂的质量与所述的培美曲塞二钠液体组合物总体积的比值。
  9. 如权利要求1~8任一项所述的培美曲塞二钠液体组合物的制备方法,其特征在于:包含充氮工艺;
    优选地,所述的充氮工艺为配液充氮和/或灌装充氮;
    优选地,所述的充氮工艺为充氮至所述的培美曲塞二钠液体组合物中的溶解氧含量小于5mg/L和/或顶空残氧量小于6%;还优选地,所述的充氮工艺为充氮至所述的培美曲塞二钠液体组合物中的溶解氧含量小于3mg/L和/或顶空残氧量小于4%。
  10. 权利要求1~8任一项所述的培美曲塞二钠液体组合物在制备抗肿瘤药物中的应用;优选地,所述抗肿瘤药物为口服液或注射液。
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