ZA200103081B - Therapy for improving cognition. - Google Patents

Therapy for improving cognition. Download PDF

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Publication number
ZA200103081B
ZA200103081B ZA200103081A ZA200103081A ZA200103081B ZA 200103081 B ZA200103081 B ZA 200103081B ZA 200103081 A ZA200103081 A ZA 200103081A ZA 200103081 A ZA200103081 A ZA 200103081A ZA 200103081 B ZA200103081 B ZA 200103081B
Authority
ZA
South Africa
Prior art keywords
composition
substance
atypical antipsychotic
acetylcholinesterase inhibitor
active ingredient
Prior art date
Application number
ZA200103081A
Inventor
Paul Leonce Irma De Nijs
Wim Louis Julien Parys
Original Assignee
Janssen Pharmaceutica Nv
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Janssen Pharmaceutica Nv filed Critical Janssen Pharmaceutica Nv
Publication of ZA200103081B publication Critical patent/ZA200103081B/en

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Classifications

    • 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
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/18Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/28Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Description

THERAPY FOR IMPROVING COGNITION
The present invention is concerned with pharmaceutical compositions comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second ) active ingredient an acetylcholinesterase inhibitor (I), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer‘s disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active, ingredients by the other of the active ingredients.
Of particular interest is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (II) in patients suffering from Alzheimer's disease or related dementias, such as nausea, vomiting, sweating, restlessness and insomnia. Especially interesting|is the use of an atypical antipsychotic agent (D) for the preparation of a medicament for improving sleep in patients suffering from Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
The present invention is concerned with a pharmaceutical composition comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer‘s disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
The atypical antipsychotic (I) is selected from risperidone, 9-hydroxyrisperidone ora
Cio-20 alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase inhibitor (0) is selected from galantamine, rivastigmine or donepezil, or therapeutically active acid addition salt form of any of the foregoing. Said salts comprise salt forms which the active ingredients (I) and (II) are able to form with appropriate acids, such as, for example, inorganic acids such as hydrohalic acids, e.g. hydrochloric or hydrobromic acid; sulfuric; nitric; phosphoric and the like acids; or organic acids such as, for example, acetic, propanoic, hydroxyacetic, lactic, pyruvic, oxalic, malonic, succinic, maleic, fumaric, malic, tartaric, citric, methanesulfonic, : ethanesulfonic, benzenesulfonic, p-toluenesulfonic, cyclamic, salicylic, gamibo- salicylic, pamoic and the like acids. For example, galantamine may conveniently be used as the (1:1) hydrobromide salt.
C10-20alkanoic acids are selected from the group consisting of decanoic (capric), undecanoic, dodecanoic (lauric), tridecanoic, tetradecanoic (myristic), pentadecanoic, hexadecanoic (palmitic), heptadecanoic, octadecanoic (stearic), nonadecanoic and eicosanoic acid. Due to their limited aqueous solubility, it was generally believed that the esters had to be suspended into oils. The ester having a C15 (pentadecyl) chain and the active ingredient corresponding thereto being the 9-hydroxyrisperidone palmitate ester was found to be the superior ester from a pharmacokinetic, as well as from a tolerance point of view. : 15
Preferably, the amount of each of the active ingredients is equal to or less than'that which is approved in monotherapy with said active ingredient.
Most preferred are compositions wherein the atypical antipsychotic (I) is risperidone : and the acetylcholinesterase inhibitor (II) is galantamine, in particular as galantamine hydrobromide. In said compositions, the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
The present invention also relates to products containing as first active ingrediént an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), as combined preparations for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer‘s disease or related dementias.
The present invention also concerns the use of an acetylcholinesterase inhibitor (II) for - the preparation of a medicament for enhancing the effect of an atypical antipsychotic agent (I) on cognition in patients suffering from psychosis. :
Conversely, the present invention also concerns the use of an atypical antipsychotic agent (I) for the preparation of a medicament for enhancing the effect of an acetylcholinesterase inhibitor (I) on cognition in patients suffering from Alzheimer's disease or related dementias.
-3- eo
Additionally, the present invention concerns the use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (I) in patients suffering from Alzheimer‘s disease or related dementias. Said adverse effect can be nausea, vomiting, sweating, restlessness or insomnia. Especially interesting is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep in patients suffering from
Alzheimer's disease or related dementias while being treated with acetylcholinesterase inhibitors (II).
Finally, the present invention also concerns the use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for reducing adverse effects associated with atypical antipsychotic agents (I) in patients suffering from psychoses. Said the adverse effect can be extrapyramidal syndrome or tardive dyskinesia.
In all the preceding uses the atypical antipsychotic (I) is preferably risperidone and the acetylcholinesterase inhibitor (II) is preferably galantamine, in particular the (1:1) hydrobromide.

Claims (26)

Claims
1. A pharmaceutical composition comprising a carrier and as first active ingredient an ~ atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (IT), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, Alzheimer's disease or related dementias.
2. A composition according to claim 1 wherein said therapeutically beneficial effect is a synergistic effect on the cognitive functioning of patients suffering from : Alzheimer*s disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
3. A composition according to claim 1 wherein the atypical antipsychotic M is selected from risperidone, 9-hydroxyrisperidone or a Cig.29 alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the i ~~ acetylcholinesterase inhibitor (II) is selected from galantamine, rivasti griine or donepezil.
4. A composition according to claim 3 wherein the amount of each of the active ingredients is equal to or less than that which is approved in monotherapy with said active ingredient. :
5. A composition according to claim 3 wherein the atypical antipsychotic @ is risperidone and the acetylcholinesterase inhibitor (IT) is galantamine.
!
6. A composition according to claim 5 wherein the amount of risperidone is 05,1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
7. A product containing as first active ingredient an atypical antipsychotic agent oO and as second active ingredient an acetylcholinesterase inhibitor (II), as a combined preparation for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer‘s disease or related dementias.
g. The use of an acetylcholinesterase inhibitor (ID) for the preparation ofa medicament for enhancing the effect of an atypical antipsychotic agent (I) on cognition in patients suffering from psychosis.
5 9. Theuse of an atypical antipsychotic agent (I) for the preparation of a medicament for enhancing the effect of an acetylcholinesterase inhibitor (II) on cognition in patients suffering from Alzheimer's disease Of related dementias.
10. The use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing adverse effects associated with acetylcholinesterase inhibitors (ID) in patients suffering from Alzheimers disease Of related dementias.
11. Use according to claim 10 wherein the adverse effect is nausea, vomiting, sweating, restlessness of insomnia.
12. The use of an acetylcholinesterase inhibitor (II) for the preparation ofa medicament for reducing adverse effects associated with atypical antipsychotic agents (I) in patients suffering from psychoses.
13. Use according to claim 12 wherein the adverse effect is extrapyramidal syndrome or tardive dyskinesia.
14. Use according to any one of claims 8 t0 13 wherein the atypical antipsychotic @ is risperidone and the acetylcholinesterase inhibitor (If) is galantamine.
PCT/EP99/07804
15. A substance or composition for use in a method of treating psychosis, Alzheimer's disease or related dementias, said substance or composition comprising as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), and said method comprising administering a therapeutically effective amount of said substance or composition to a patient to produce a therapeutically beneficial effect.
16. A substance or composition for use in a method of treatment according to claim wherein said therapeutically beneficial effect is a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias, or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.
17. A substance or composition for use in a method of treatment according to claim 15 wherein the atypical antipsychotic (I) is selected from risperidone, 9- hydroxyrisperidone or a C,,,, alkanoic acid ester thereof, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase inhibitor (II) is selected from galantamine, rivastigmine or donepezil.
18. A substance or composition for use in a method of treatment according to claim 17 wherein the amount of each of the active ingredients is equal to or less than that which is approved in monotherapy with said active ingredient.
19. A substance or composition for use in a method of treatment according to claim 17 wherein the atypical antipsychotic (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine. AMENDED SHEET
PCT/EP99/07804
20. A substance or composition for use in a method of treatment according to claim 19 wherein the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and that of galantamine (as base) is 8, 16, 24 or 32 mg per dosage form.
21. A substance or composition for use in a method for the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias, said substance or composition comprising as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor; (II), as a combined preparation for simultaneous, separate or sequential use, and said method comprising administering said substance or composition.
22. A composition as claimed in claim 1, substantially as herein described and illustrated.
23. A product as claimed in ¢laim 7, substantially as herein described and illustrated.
24. Use as claimed in any one of claims 8 to 14, substantially as herein described and illustrated.
25. A substance or composition for use in a method of treatment as claimed in claim or claim 21, substantially as herein described and illustrated.
26. A new composition, a new product, a new use of an inhibitor (II) as defined in claim 8 or claim 12, a new use of an agent (I) as defined in claim 9 or claim 10, or a substance or composition for a new use in a method of treatment, substantially as herein described. AMENDED SHEET
ZA200103081A 1998-10-16 2001-04-12 Therapy for improving cognition. ZA200103081B (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
EP98203454 1998-10-16

Publications (1)

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ZA200103081B true ZA200103081B (en) 2002-07-12

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EP (1) EP1121131A2 (en)
JP (1) JP2002527469A (en)
KR (1) KR20010072878A (en)
CN (1) CN1367697A (en)
AU (1) AU6472799A (en)
BG (1) BG105302A (en)
BR (1) BR9914419A (en)
CA (1) CA2345767A1 (en)
EE (1) EE200100136A (en)
HK (1) HK1039745A1 (en)
HR (1) HRP20010262A2 (en)
HU (1) HUP0103781A3 (en)
ID (1) ID28441A (en)
IL (1) IL142588A0 (en)
NO (1) NO20011403D0 (en)
PL (1) PL348107A1 (en)
SK (1) SK4592001A3 (en)
TR (1) TR200101082T2 (en)
WO (1) WO2000023057A2 (en)
ZA (1) ZA200103081B (en)

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DE60238780D1 (en) 2001-10-30 2011-02-10 Novartis Ag DEPOT FORMULATIONS OF ILOPERIDONE AND A STAR-TERM POLYMER
GB0216416D0 (en) 2002-07-15 2002-08-21 Novartis Ag Organic compounds
WO2004084905A2 (en) * 2003-03-24 2004-10-07 University Of Florida Use of 5-ht2c receptor activity affecting compounds for treating idiopathic hyperhidrosis and associated conditions
TW200501962A (en) * 2003-04-01 2005-01-16 Novartis Ag Use of carbamazepine derivatives for the treatment of agitation in dementia patients
WO2006065233A1 (en) * 2004-12-10 2006-06-22 Abbott Laboratories Fused bicycloheterocycle substituted quinuclidine derivatives
WO2005065645A2 (en) * 2003-12-31 2005-07-21 Actavis Group Hf Donepezil formulations
EP2089383B1 (en) 2006-11-09 2015-09-16 Probiodrug AG 3-hydr0xy-1,5-dihydr0-pyrr0l-2-one derivatives as inhibitors of glutaminyl cyclase for the treatment of ulcer, cancer and other diseases
US9126987B2 (en) 2006-11-30 2015-09-08 Probiodrug Ag Inhibitors of glutaminyl cyclase
JP5930573B2 (en) 2007-03-01 2016-06-15 プロビオドルグ エージー New use of glutaminyl cyclase inhibitors
DK2142514T3 (en) 2007-04-18 2015-03-23 Probiodrug Ag Thiourea derivatives as glutaminyl cyclase inhibitors
MX2007008642A (en) * 2007-07-16 2009-02-25 World Trade Imp Export Wtie Ag Pharmaceutical composition comprising the combination of a benzisoxazolic derived agent and a reversible inhibiting agent of the cholinesterase enzyme prescribed for the control and treatment of psychotic disorders and dementias.
CA2789014C (en) 2010-02-09 2019-01-15 Michela Gallagher Methods and compositions for improving cognitive function
JP6026284B2 (en) 2010-03-03 2016-11-16 プロビオドルグ エージー Inhibitors of glutaminyl cyclase
US8269019B2 (en) 2010-03-10 2012-09-18 Probiodrug Ag Inhibitors
EP2560953B1 (en) 2010-04-21 2016-01-06 Probiodrug AG Inhibitors of glutaminyl cyclase
US8530670B2 (en) 2011-03-16 2013-09-10 Probiodrug Ag Inhibitors
US10154988B2 (en) 2012-11-14 2018-12-18 The Johns Hopkins University Methods and compositions for treating schizophrenia
ES2881081T3 (en) 2013-03-15 2021-11-26 Agenebio Inc Procedures and compositions to improve cognitive function
EP3827820A1 (en) 2013-03-15 2021-06-02 The Johns Hopkins University Brivaracetam for improving cognitive function
CN107810002B (en) 2015-05-22 2021-01-05 艾吉因生物股份有限公司 Extended release pharmaceutical compositions of levetiracetam
ES2812698T3 (en) 2017-09-29 2021-03-18 Probiodrug Ag Glutaminyl cyclase inhibitors

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DK1073432T3 (en) * 1998-04-14 2007-12-17 Gen Hospital Corp Use of D serine or D alanine for the treatment of schizophrenia

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Publication number Publication date
CA2345767A1 (en) 2000-04-27
BG105302A (en) 2001-11-30
CN1367697A (en) 2002-09-04
IL142588A0 (en) 2002-03-10
AU6472799A (en) 2000-05-08
SK4592001A3 (en) 2001-12-03
JP2002527469A (en) 2002-08-27
HK1039745A1 (en) 2002-05-10
PL348107A1 (en) 2002-05-06
WO2000023057A2 (en) 2000-04-27
KR20010072878A (en) 2001-07-31
HUP0103781A2 (en) 2002-03-28
ID28441A (en) 2001-05-24
EP1121131A2 (en) 2001-08-08
HRP20010262A2 (en) 2002-06-30
NO20011403L (en) 2001-03-20
TR200101082T2 (en) 2001-09-21
BR9914419A (en) 2001-06-26
WO2000023057A3 (en) 2000-07-27
HUP0103781A3 (en) 2003-09-29
EE200100136A (en) 2002-06-17
NO20011403D0 (en) 2001-03-20

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