Inhalable compositions
Abstract
A pharmaceutical composition including a mixture of active compounds (A) a pharmaceutically active polypeptide, and (B) an enhancer compound which enhances the systemic absorption of the polypeptide in the lower respiratory tract of a patient, the mixture being in the form of a dry powder for inhalation in which at least 50% of the total mass of the active compounds consists of primary particles having a diameter less than or equal to about 10 microns, the primary particles optionally being formed into agglomerates.

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Expired 23 June 2014, 12.3 years ago.
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26 claims: 9 independent, 17 dependent
- 1Patent claims Zastrzeżenia patentowe 1. A pharmaceutical composition comprising a polypeptide hormone active compound and a polypeptide absorption enhancer, characterized in that as active compounds it comprises a pharmaceutically active non-insulin polypeptide hormone with an average molecular weight of less than 40,000 and a substance that increases systemic absorption of the polypeptide in the patient's lower respiratory tract, selected from the group consisting of fatty acid salts, bile salt or bile salt derivative, phospholipid, glycoside, cyclodextrin, acylcarnitine and glycerin salt, in an amount of at least 10% relative to the polypeptide and absorption enhancer, and optionally a pharmaceutically acceptable carrier, and is in the form of a dry powder for inhalation, in which at least 50% of the total weight of the active compounds consists of primary particles less than or equal to 10 microns in diameter, wherein said primary particles are optionally formed into agglomerates. 1. Kompozycja farmaceutyczna zawierająca związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienna tym, że jako związki aktywne zawiera farmaceutycznie aktywny hormon polipeptydowy inny niż insulina, o średniej masie cząsteczkowej mniejszej niż 40 000 i substancję zwiększającą absorpcję ogólnoustrojową polipeptydu w dolnych drogach oddechowych pacjenta, wybraną z grupy składającej się z soli kwasu tłuszczowego, soli kwasu żółciowego lub pochodnej soli kwasu żółciowego, fosfolipidu, glikozydu, cyklodekstryny, acylokarnityny i soli kwasu glicyryzyny, w ilości co najmniej 10% w stosunku do polipeptydu i substancji zwiększającej absorpcję, oraz ewentualnie farmaceutycznie dopuszczalny nośnik, i ma postać suchego proszku do inhalacji, w którym co najmniej 50% całkowitej masy związków aktywnych składa się z cząstek pierwotnych o średnicy mniejszej niż lub równej 10 mikrometrów, przy czym wspomniane cząstki pierwotne są ewentualnie uformowane w aglomeraty.
- 3Composition according to claim 1 or 2, characterized in that as a hormone it contains vasopressin, a vasopressin analogue, desmopressin, glucagon, corticotropin (ACTH), gonadotropin (luteinizing hormone or LHRH), calcitonin, insulin C peptide, parathyroid hormone (PTH), human growth hormone (hGH ), growth hormone (HG), growth hormone releasing hormone (GHRH), oxytocin, corticotropin releasing hormone (CRH), somatostatin analogues, gonadotropin agonist (GnRHa) analogues, urinary sodium excretion (hANP), thyroxine releasing hormone (TRHrh), follicle stimulating hormone (FSH) or prolactin. 3. Kompozycja według zastrz. 1 albo 2, znamienna tym, że jako hormon zawiera wazopresynę, analog wazopresyny, desmopressynę, glukagon, kortykotropinę (ACTH), gonadotropinę (hormon luteinizujący, albo LHRH), kalcytoninę, peptyd C insuliny, hormon przytarczyczny (PTH), ludzki hormon wzrostu (hGH), hormon wzrostu (HG), hormon uwalniający hormon wzrostu (GHRH), oksytocynę, hormon uwalniający kortykotropinę (CRH), analogi somatostatyny, analogi agonisty gonadotropiny (GnRHa), peptyd powodujący wydalanie sodu z moczem (hANP), hormon uwalniający tyroksynę (TRHrh), hormon folikulotropowy (FSH) lub prolaktynę.
- 19A pharmaceutical composition comprising a polypeptide hormone active compound and a polypeptide absorption enhancer, characterized in that as active compounds it comprises a pharmaceutically active non-insulin polypeptide hormone with an average molecular weight of less than 40,000 and a substance that increases the systemic absorption of the polypeptide in the patient's lower respiratory tract fatty acid salt in an amount of at least 10% relative to the polypeptide and the enhancer, and optionally a pharmaceutically acceptable carrier, and is in the form of a dry inhalable powder in which at least 50% of the total weight of the active compounds consists of primary particles less than or equal in diameter 10 microns, wherein said primary particles are optionally formed into agglomerates. 19. Kompozycja farmaceutyczna zawierająca związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienna tym, że jako związki aktywne zawiera farmaceutycznie aktywny hormon polipeptydowy inny niż insulina, o średniej masie cząsteczkowej mniejszej niż 40 000 i substancję zwiększającą absorpcję ogólnoustrojową polipeptydu w dolnych drogach oddechowych pacjenta, stanowiącą sól kwasu tłuszczowego, w ilości co najmniej 10% w stosunku do polipeptydu i substancji zwiększającej absorpcję, oraz ewentualnie farmaceutycznie dopuszczalny nośnik, i ma postać suchego proszku do inhalacji, w którym co najmniej 50% całkowitej masy związków aktywnych składa się z cząstek pierwotnych o średnicy mniejszej niż lub równej 10 mikrometrów, przy czym wspomniane cząstki pierwotne są ewentualnie uformowane w aglomeraty.
- 21A method for preparing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer, characterized in that it is prepared at room temperature, a solution at pH 3.0 to 8.5 of the active compound being a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000 other than insulin and a substance that increases the absorption of the polypeptide in the patient's lower respiratory tract, selected from the group consisting of fatty acid salts, bile salt or bile salt derivative, phospholipid, glycoside, cyclodextrin, acylcarnitine and glycerin acid salt, where the ratio of the enhancer to the polypeptide is greater than 10:90, the solvent is removed from the solution by evaporation or in another known manner at a temperature not greater than 40 ° C, the obtained solid substance is comminuted and, optionally, a pharmaceutically acceptable carrier is added to obtain a powder, in which at least 50% by weight of the total weight of active compounds consists of particles with a diameter of up to 10 pm. 21. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy i środek zwiększający absorpcję polipeptydu, znamienny tym, że sporządza się w temperaturze pokojowej, roztwór o pH 3,0 do 8,5 związku aktywnego stanowiącego farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000 innego niż insulina i substancji zwiększającej absorpcję polipeptydu w dolnych drogach oddechowych pacjenta, wybranej z grupy składającej się z soli kwasu tłuszczowego, soli kwasu żółciowego lub pochodnej soli kwasu żółciowego, fosfolipidu, glikozydu, cyklodekstryny, acylokarnityny i soli kwasu glicyryzyny przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, usuwa się z roztworu rozpuszczalnik przez odparowanie lub w inny znany sposób w temperaturze nie większej niż 40°C, otrzymaną stałą substancję rozdrabnia się i ewentualnie dodaje się do niej farmaceutycznie dopuszczalny nośnik do uzyskania proszku, w którym co najmniej 50% masy całkowitej masy związków aktywnych składa się z cząstek o średnicy do 10 pm.
- 22A method for producing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer, characterized in that dry mixing of active compounds comprising a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000, other than insulin and a substance that increases systemic absorption of the polypeptide in the lower respiratory tract a patient selected from a fatty acid salt, bile salt or bile salt derivative, phospholipid, glycoside, cyclodextrin, acylcarnitine and glycerin acid salt, where the ratio of the enhancer to the polypeptide is over 10:90, and optionally a pharmaceutically acceptable carrier is added and the resulting mixture is crushed to obtain a powder, in which at least 50% of the total weight of active compounds consists of particles with a diameter of up to 10 pm. 22. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienny tym, że miesza się na sucho związki aktywne stanowiące farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000, inny niż insulina i substancję zwiększającą absorpcję ogólnoustrojową polipeptydu w dolnych drogach oddechowych pacjenta, wybraną spośród soli kwasu tłuszczowego, soli kwasu żółciowego lub pochodnej soli kwasu żółciowego, fosfolipidu, glikozydu, cyklodekstryny, acylokarnityny i soli kwasu glicyryzyny przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, i ewentualnie dodaje się farmaceutycznie dopuszczalny nośnik i rozdrabnia się otrzymana mieszaninę do uzyskania proszku, w którym co najnrniej 50% ca&owttej masy związków- aktywnych składa się z cząstek o średnicy do 10 pm. 178 261 178 261
- 23A method for producing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer, characterized in that the active compound is micronized to a micron size, a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000 other than insulin and a second micronized active compound that is a substance that enhances the systemic absorption of the polypeptide in the patient's lower respiratory tract, selected. of the fatty acid salt, bile salt or bile salt derivative, phospholipid, glycoside, cyclodextrin, acylcarnitine and glycerizine acid salt, the ratio of the enhancer to the polypeptide being more than 10:90, to obtain a powder in which at least 50% of the total the mass of active compounds consists of particles with a diameter of up to 10 pm. 23. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienny tym, że miesza się aktywny związek rozdrobniony do mikronowych rozmiarów, stanowiący farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000 inny niż insulina i drugi rozdrobniony do mikronowych rozmiarów aktywny związek stanowiący substancję zwiększającą absorpcję ogólnoustrojową polipeptydu w dolnych drogach oddechowych pacjenta, wybraną. spośród soli kwasu tłuszczowego, soli kwasu żółciowego lub pochodnej soli kwasu żółciowego, fosfolipidu, glikozydu, cyklodekstryny, acylokarnityny i soli kwasu glicyryzyny przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, do uzyskania proszku, w którym co najmniej 50% całkowitej masy związków aktywnych składa się z cząstek o średnicy do 10 pm.
- 24A method for preparing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer, characterized in that it is prepared at room temperature, a solution at pH 3.0 to 8.5 of the active compound being a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000 other than insulin and a substance that increases the absorption of the polypeptide in the patient's lower respiratory tract, which is a fatty acid salt, wherein the ratio of the enhancer to the polypeptide is above 10:90, the solvent is removed from the solution by evaporation or in another known manner at a temperature not exceeding 40 ° C, the solid obtained is comminuted and optionally a pharmaceutically acceptable carrier is added to it. obtaining a powder in which at least 50% by weight of the total weight of the active compounds consists of particles with a diameter of up to 10 pm. 24. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy i środek zwiększający absorpcję polipeptydu, znamienny tym, że sporządza się w temperaturze pokojowej, roztwór o pH 3,0 do 8,5 związku aktywnego stanowiącego farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000 innego niż insulina i substancji zwiększającej absorpcję polipeptydu w dolnych drogach oddechowych pacjenta, będącej solą kwasu tłuszczowego, przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, usuwa się z roztworu rozpuszczalnik przez odparowanie lub w inny znany sposób w temperaturze nie większej niż 40°C, otrzymaną stałą substancję rozdrabnia się i ewentualnie dodaje się do niej farmaceutycznie dopuszczalny nośnik do uzyskania proszku, w którym co najmniej 50% masy całkowitej masy związków aktywnych składa się z cząstek o średnicy do 10 pm.
- 25A method for producing a pharmaceutical composition comprising a polypeptide hormone active compound and a polypeptide absorption enhancer, characterized in that the active compounds comprising a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000, other than insulin and a systemic absorption enhancer, are dry mixed. ^^ ą the polypeptide in the patient's lower respiratory tract, which is a fatty acid salt, wherein the ratio of the enhancer to the polypeptide is over 10:90, and optionally a pharmaceutically acceptable carrier is added and the resulting mixture is comminuted to obtain a powder in which at least 50% of the total weight of the active compounds consists of particles with a diameter of up to 10 pm. 25. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienny tym, że miesza się na sucho związki aktywne stanowiące farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000, inny niż insulina i substancję zwiększającą absorpcję ogólnoust^to^^-^^ą polipeptydu w dolnych drogach oddechowych pacjenta, będącą solą kwasu tłuszczowego, przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, i ewentualnie dodaje się farmaceutycznie dopuszczalny nośnik i rozdrabnia się otrzymaną mieszaninę do uzyskania proszku, w którym co najmniej 50% całkowitej masy związków aktywnych składa się z cząstek o średnicy do 10 pm.
- 26A method for producing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer, characterized in that the active compound is micronized to a micron size, a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000 other than insulin and a second micron sized active compound that is a substance that increases the systemic absorption of the polypeptide in the patient's lower respiratory tract, which is a fatty acid salt, with the ratio of the substance increasing the absorption to the polypeptide being more than 10 :90, to obtain a powder, in which at least 50% of the total weight of the active compounds consists of particles with a diameter of up to 10 pm. 26. Sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy oraz środek zwiększający absorpcję polipeptydu, znamienny tym, że miesza się aktywny związek rozdrobniony do mikronowych rozmiarów, stanowiący farmaceutycznie aktywny hormon polipeptydowy o masie cząsteczkowej do 40 000 inny niż insulina i drugi rozdrobniony do mikronowych rozmiarów aktywny związek stanowiący substancję zwiększającą absorpcję ogólnoustrojową polipeptydu w dolnych drogach oddechowych pacjenta, będącą solą kwasu tłuszczowego, przy czym stosunek substancji zwiększającej absorpcję do polipeptydu wynosi ponad 10:90, do uzyskania proszku, w którym co najmniej 50% całkowitej masy związków aktywnych składa się z cząstek o średnicy do 10 pm. The invention relates to a pharmaceutical composition containing an active polypeptide hormone compound and a method for preparing a pharmaceutical composition containing an active polypeptide hormone compound in the form of a dry powder for administration to the respiratory system. Wynalazek dotyczy kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy oraz sposobu wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy w postaci suchego proszku do podawania do układu oddechowego. Although the advent of recombinant DNA technology has resulted in a rapidly expanding list of peptide-based drugs, the main negative feature of peptide-based therapy has inhibited the full potential of this field: in principle, peptide-based drugs cannot be administered at effective doses because they are rapidly degraded by enzymes in the digestive tract before they reach the blood stream. While the polypeptide in question may be altered to be relatively resistant to such enzymes, Chociaż nadejście technologii rekombinacyjnego DNA dało w wyniku szybko rozszerzającą się listę leków opartych na peptydach, główna ujemna cecha terapii opartej na peptydach zahamowała realizację pełnego potencjału tej dziedziny: zasadniczo leki oparte na peptydach nie mogą być podawane w dawkach skutecznych, ponieważ są one szybko degradowane przez enzymy w przewodzie pokarmowym zanim osiągną strumień krwi. O ile rozpatrywany polipeptyd można zmieniać, aby był względnie odporny na takie enzymy, 178 261 the only practical method of delivery is presumably parenteral vibration such as intravenous, intramuscular or subcutaneous injection. Administration by other parenteral routes (e.g. absorption through the nose, oral or rectal membranes or lungs) is limited. 178 261 jedyna praktyczna metoda dostarczania leku to przypuszczalnie drga pozajelitowa, taka jak injekcja dożylna, domięśniowa lub podskórna. Podawanie innymi drogami pozajelitowymi (np. absorpcję przez nos, ustne lub odbytnicze błony lub płuca) napotyka na ograniczone powodzenie. It has been shown that when a peptide or protein (hereinafter collectively referred to as polypeptides) is combined with a suitable absorption enhancer and is introduced into the lungs in the form of a powder with the appropriate particle size, it easily enters the pulmonary circulation by absorption through the layer of epithelial cells in the lower respiratory tract. This is conveniently done by inhaling the powder from an inhalation device that administers the right dose of powdered polypeptide / substance that increases particle size absorption that maximizes deposition in the lower respiratory tract, as opposed to the mouth and throat (for ease, the polypeptide and the enhancer are hereinafter collectively referred to as "active compounds"). To realize this favorable pulmonary delivery, as much as possible of the active compounds should consist of particles less than about 10pm in diameter (i.e. between 0.01 and 10pm, and ideally between 1 and 6pm). In preferred embodiments, at least 50% (more preferably at least 60%, even more preferably at least 70%, even more preferably at least 80%, and most preferably at least 90%) of the total weight of active compounds exiting the inhalation device consists of particles with the desired diameter range. Okazało się, że gdy peptyd lub proteina (dalej zbiorczo nazywane polipeptydami) jest połączona z odpowiednią substancją zwiększającą absorpcję i jest wprowadzana do płuc w formie proszku o odpowiedniej wielkości cząstek, łatwo wchodzi do obiegu płucnego przez absorpcję przez warstwę komórek nabłonkowych w dolnych drogach oddechowych. Dokonuje się tego dogodnie przez inhalację proszku z urządzenia do inhalacji, które podaje właściwą dawkę sproszkowanego polipeptydu/substancji zwiększającej absorpcję w wielkości cząstek, która maksymalizuje odkładanie w dolnych drogach oddechowych, w przeciwieństwie do ust i gardła (dla ułatwienia, polipeptyd i substancja zwiększająca absorpcję są poniżej zbiorczo nazywane „związkami aktywnymi”). Aby zrealizować to korzystne dostarczanie do płuc, jak najwięcej związków aktywnych powinno składać się z cząstek o średnicy mniejszej niż około 10pm (tzn. miedzy 0,01 i 10pm, a w idealnym przypadku miedzy 1 a 6 pm). W korzystnych wykonaniach, co najmniej 50% (korzystniej co najmniej 60%, jeszcze korzystniej co najmniej 70%, jeszcze bardziej korzystnie co najmniej 80%, a najkorzystniej co najmniej 90%) całkowitej masy związków aktywnych wychodzących z urządzenia do inhalacji składa się z cząstek o żądanym zakresie średnicy.
Independent claims9
67 paragraphs, as filed
The subject of the invention is therefore a pharmaceutical composition comprising a polypeptide hormone active compound and a polypeptide absorption enhancer, characterized in that as active compounds it comprises a pharmaceutically active polypeptide hormone other than insulin, with an average molecular weight of less than 40,000, and a substance increasing the systemic absorption of the polypeptide in the lower the patient's respiratory tract, selected from the group consisting of fatty acid salts, bile salt or bile salt derivative, phospholipid, glycoside, cyclodextrin, acylcarnitine and glycerin salt, in an amount of at least 10% relative to the polypeptide and absorption enhancer, and optionally a pharmaceutically acceptable carrier, and is in the form of a dry powder for inhalation a powder inhaler and in which at least 50% of the total weight of the active compounds consists of primary particles less than or equal to 10 microns in diameter, wherein said primary particles are optionally formed into agglomerates. The particles can be packaged as such or can be formed into agglomerates, which are then substantially deagglomerated prior to entry into the patient's airways. Of course, the composition may, if desired, contain other ingredients, including pharmaceutically active agents, other absorption enhancers, and pharmacologically acceptable excipients, such as diluents or carriers. Therefore, the medicinal preparation according to the invention may contain only the mentioned active compounds or may also contain other substances such as a pharmaceutically acceptable carrier. This carrier may largely consist of particles with a diameter less than about 10 microns, such that at least 50% of the resulting powder as a whole consists of optionally agglomerated particles with a diameter less than about 10 microns; alternatively, the support may to a large extent consist of much larger particles ("coarse particles"), so that an "ordered mixture" can be formed between the active compounds and said support. In an ordered mixture, alternatively known as an interactive or adhesive mixture, fine drug particles (in the present invention, active compounds) are distributed fairly evenly over the surface of coarse excipient particles (in the present invention, a pharmaceutically acceptable carrier). Preferably, in this case, the active compounds are not in the form of agglomerates before forming the ordered mixture. Coarse particles may have a diameter of over 20 micrometers, such as 60 micrometers. Above these lower limits, the diameter of coarse particles is not critical, so that different sizes of coarse particles can be used as long as desired according to the practical requirements of the particular recipe. There are no requirements for coarse particles in an ordered mixture to be the same size, but
178 The coarse particles may preferably be of a similar size within the ordered mixture. Preferably, coarse particles have a diameter of 60-800 microns.
The polypeptide may be any medically or diagnostically useful peptide or protein of small to medium size, i.e. up to about 40 kD molecular weight (MW), for which systemic delivery is desired. The mechanisms of increased polypeptide absorption of the present invention are generally applicable and should apply to all such polypeptides, although the extent to which its absorption is improved may vary due to MW and the physico-chemical properties of the polypeptide and the particular absorption absorbing substance. It can be expected that a full molecular weight of 30kD will be useful at the present time, such as polypeptides with molecular weight up to 25 kD or up to 20 kD, especially up to 15 kD or up to 10 kD . Any desired polypeptide can be readily tested for use in the present invention with a particular absorption enhancer by in vivo or in vitro assays as described below.
By the term "enhancing absorption" is meant that the amount of polypeptide absorbed into the systemic circulation in the presence of an enhancer is higher than in the absence of this substance. Preferably, the amount of absorbed polypeptide is significantly higher (p <0.05) in the presence of an enhancer. The liability of any potential absorption enhancer for use in the present invention can easily be assessed by in vivo or in vitro assays as described below.
The amount of polypeptide hormone absorbed according to the present invention is preferably at least 150% of the amount absorbed in the absence of an enhancer. In preferred embodiments, the absorption of the polypeptide hormone is at least doubled, more preferably tripled, and in particular is four times higher in the presence of an enhancer compared to its absence.
The absorption enhancer may be, e.g., a fatty acid salt, bile salt, bile salt derivative, alkyl glycoside, cyclodextrin or phospholipid. The absorption enhancer may be, e.g., the sodium, potassium or organic salt of a fatty acid, and the fatty acid is preferably capric acid or other fatty acid with 10 to 14 carbon atoms. A preferred absorption enhancer is sodium caprate. The ratio of polypeptide to absorption enhancer will preferably vary from about 9: 1 to about 1: 1. Although amounts of enhancer greater than 1: 1 would presumably increase uptake, as is the case or better than smaller quantities, it is believed that the amount of enhancer used should not be higher than is necessary to achieve the desired level of increase because an excess absorption enhancer can trigger unwanted side effects such as local irritation.
The invention also includes methods for preparing a pharmaceutical composition suitable for administration by inhalation. The first variant of the process for producing a pharmaceutical composition comprising an active polypeptide hormone compound and a polypeptide absorption enhancer is that it is prepared at room temperature, a solution at pH 3.0 to 8.5 of the active compound which is a pharmaceutically active polypeptide hormone with a molecular weight up to 40 000 other than insulin and a substance that increases the absorption of the polypeptide in the patient's lower respiratory tract, selected from the group consisting of fatty acid salt, bile salt or bile salt derivative, phospholipid, glycoside, cyclodexrrin, acylcarnitine and glycerizine acid salt, where the ratio of the enhancer to the polypeptide is over 10:90, the solvent is removed from the solution by evaporation or other known method at a temperature not exceeding 40 ° C, the resulting solid is comminuted and optionally added with a pharmaceutically acceptable carrier to obtain a powder in which at least 50% by weight of the total weight of the active compounds consists of particles with a diameter of up to 10 pm.
The second variant of the method of producing a pharmaceutical composition containing an active polypeptide hormone compound and a polypeptide absorption enhancer consists in
178 261 in the dry mixing of active compounds that are pharmaceutically active polypeptide hormones up to 40,000 molecular weight, other than insulin, and a substance that increases the systemic absorption of the polypeptide in the patient's lower respiratory tract, selected from a fatty acid salt, bile salt, or acid salt derivative bile, phospholipid, glycoside, cyclodextrin, acylcarnitine and the salt of glycyrrhizin, where the ratio of the substance increasing the absorption to the polypeptide is over 10:90, and optionally a pharmaceutically acceptable carrier is added and the resulting mixture is comminuted to obtain a powder in which at least 50% of the total weight of active compounds consists of particles having diameter up to 10 pm.
The third variant of the method of producing a pharmaceutical composition containing the active compound polypeptide hormone and the agent increasing the absorption of the polypeptide, is that the active compound comminuted to micron sizes is mixed, a pharmaceutically active polypeptide hormone with a molecular weight of up to 40,000 other than insulin and a second micron sized active compound that is a substance that increases the systemic absorption of the polypeptide in the patient's lower respiratory tract, selected from a fatty acid salt, bile salt or bile salt derivative, phospholipid , glycoside, cyclodextrin, acylcarnitine and the salt of glycyrrhizin, where the ratio of the enhancer to the polypeptide is over 10:90, to obtain a powder in which at least 50% of the total weight of the active compounds consists of particles with a diameter of up to 10 pm.
If a carrier is to be added other than when an ordered mixture is desired, it may be added to the solution or to the dry mixture of the pharmaceutically active polypeptide prior to micronization, or the micronized carrier may be dry mixed with other micronized ingredients. In producing the ordered mixture, the micronized polypeptide and the enhancer are mixed with a suitable carrier.
The pharmaceutically active polypeptide is administered systemically by causing the patient to inhale the pharmaceutical composition of the invention in which at least 50% of the total weight of active compounds at the entry point of the patient's respiratory system consists of particles less than or equal to about 10 micrometers in diameter. This is preferably done by using an inhaler device from which the patient inhales the powder. When the powdered composition is in the form of agglomerates of primary particles, the device is preferably configured to cause substantially deagglomeration of the agglomerates after inhalation of the powder from the device by the patient, such that most of the agglomerates disintegrate into particles less than or equal to about 10 microns in diameter before entering the powder to the patient's respiratory system. This deagglomeration could occur inside the device and is typically caused by air turbulence generated in the device by inhalation force. Agglomerates are not generally formed in an ordered mixture. In the case of an ordered mixture, the active compounds should be released from large particles preferably after inhalation, either by mechanical means in an inhalation device or simply by inhalation or other means, then the active compounds are deposited in the lower respiratory tract and the carrier particles in the mouth.
The inhalation device is preferably a single dose dry powder inhaler, but may be a multi dose dry powder inhaler.
Figure 1 is a graph showing the effect of various concentrations of an enhancer - sodium capriculture on the transport of the marker-compound (mannitol) through the monolayer of cultured epithelial cells.
Some of the preferred embodiments of the invention are generally described below.
The polypeptide is preferably a non-insulin peptide hormone such as vasopressin, vasopressin analogue, desmopressin, glucagon, corticotropin (ACTH), gonadotropin (luteinizing hormone, LHRH), calcitonin, insulin C peptide, parathyroid hormone (PTH), human growth hormone ), growth hormone (HG), growth hormone releasing hormone (GHRH), oxytocin, corticotropin releasing hormone (CRH), somatostatin analogues, analogs
178 261 gonadotropin agonist (GnRHa), urinary sodium excretion peptide (hANP), thyroxine releasing hormone (TRHrh), follicle stimulating hormone (FSH), or prolactin.
The use of an enhancer is critical because the polypeptide itself is poorly absorbed by the lungs. The absorption enhancer used may be any of a number of compounds that act to increase absorption through the layer of epithelial cells lining the lower respiratory tract and into the adjacent pulmonary vascular system. An absorption enhancer can do this through one of several mechanisms.
(1) Increasing the para-cellular permeability of a polypeptide by causing structural changes in the closing rims between epithelial cells.
(2) Increasing transcellular permeability of the polypeptide by interacting with the membrane or extracting protein or membrane lipid components and thereby impairing membrane integrity.
(3) Interaction between the enhancer and the polypeptide that increases the solubility of the polypeptide in aqueous solution. This can be done by preventing the formation of insulin aggregates (dimers, trimers, hexamers) or by dissolving the polypeptide particles in the micelles of the enhancer.
(4) Decrease in viscosity or dissolution of the mucus barrier lining the vesicles and lung passages, thereby exposing the epithelial surface to direct absorption of the polypeptide.
Absorption enhancers can only function through one mechanism listed above, or through two or three. An absorption enhancer that works through several mechanisms is more likely to promote effective absorption of a polypeptide than one that uses only one or two mechanisms. For example, it is believed that absorption enhancers, which are surfactants, work through all four mechanisms listed above. Surfactants are amphiphilic particles with both lipophilic and hydrophilic moieties, with a change in the proportion of these two characteristics. If the molecule is very lipophilic, the low solubility of the substance in water may limit its usefulness. If the hydrophilic part dominates, active properties on the surface may be minimal. To be effective, the surfactant must therefore have an appropriate balance between sufficient solubility and sufficient surface activity.
Another property of the surfactant that may be important is the net charge of the surfactant at a lung pH value (about 7.4). At pH 7.4, some polypeptides have a negative net charge. This results in electrostatic repulsion between the molecules, which in turn prevents aggregation and thus increases solubility. If the surfactant is also negatively charged, it may interact with the polypeptide by e.g. hydrophobic interactions and additional repulsion occurs between the polypeptide molecules. In this case, the anionic surfactant will have the added benefit (compared to those with net or neutral charge at physiological pH) to increase absorption by helping stabilize the polypeptide in the monomer state.
A number of different compounds potentially useful as enhancers in the compositions of the invention have been tested in rats. Other substances with known absorption enhancement properties or physical characteristics that are candidates for use in the method of the invention can easily be tested by one of the usual methods, including by in vivo assay or alternatively in vitro assay described in Example I.
It is possible that the combination of two or more substances that increase absorption also gives satisfactory results. The use of such a combination in the method of the invention is considered to fall within the scope of the invention.
An absorption enhancer useful in the methods of the invention will combine effective enhancement of polypeptide absorption with (1) no toxicity at the concentrations used and (2) good powder properties, i.e. no sticky or waxy solid consistency. The toxicity of a given substance can be tested by standard methods, such as the MTT assay, e.g. described in Int. J. Pharm., 65 (1990), 249-259. The powder properties of a given substance can be evaluated from published substance data or empirically.
One very promising type of absorption enhancer is the fatty acid salt. It has been found that sodium salts of saturated fatty acids with a carbon chain length of 10 (i.e. sodium caprate), 12 (sodium laurate) and 14 (sodium myristate) give good results in the process of the invention. Potassium and lysine salts of capric acid have also been found to be effective in the method of the invention. If the carbon chain length is shorter than about 10, the surface activity of the surfactant may be too small, and if the chain length is longer than about 14, the reduced solubility of the fatty acid salt in water limits its usefulness.
The most preferred substance in the present invention that increases the absorption of the polypeptide hormone in the lower respiratory tract is sodium caprate.
Different counterions may change the solubility of the saturated fatty acid salt in water, so that an absorption enhancer with a carbon chain other than 10-14 would be even more beneficial than the substances specifically mentioned above. Salts of unsaturated fatty acids may also be useful in the present invention because they are more water-soluble than salts of saturated fatty acids, and may therefore have a greater chain length than the latter still maintaining the solubility necessary for the corresponding substance to increase absorption of the polypeptide.
All tested bile salts and bile salt derivatives (sodium salts of ursodeoxycholate, taurocholate, glycocholate and taurodihydrofusidate) effectively increase the absorption of the polypeptide in the lungs.
Phospholipids have also been studied as absorption enhancers. It was established that single-chain phospholipid (lysophosphatidylcholine) was an effective absorption enhancer, while double-chain phospholipids (dioctanoylphosphatidylcholine and didecanoylphosphatidylcholine) did not give such desirable characteristics. This can be explained by the fact that double chain phospholipids are much less water soluble than their single chain counterparts; however, it is reasonable to expect that short chain double-chain phospholipids with greater water solubility than longer chain counterparts will be useful as absorption enhancers in the present invention, so that both single and double chain phospholipids can be used.
One glycoside, octylglucopyranoside, was tested as an enhancer in the present invention and was found to have some absorption enhancing properties. It is expected that other alkyl glycosides, such as thioglucopyranosides and maltopiranosides, will exhibit absorption enhancing properties in the methods of the present invention.
Cyclodextrins and their derivatives effectively increase nasal absorption and can act similarly in the lungs. Dimethyl-P-cyclodextrin was tested and found to have an effect of increasing absorption.
Other potentially useful absorption enhancers are naturally occurring surfactants such as salts of glycirizine acid, saponin glycosides and acylcarnitine.
For ionic substances that increase absorption (e.g. the anionic surfactants described above), the nature of the reverse agent may be important. The specific counterion selected may affect the powder properties, solubility, stability, hygroscopicity, and local / systemic toxicity of the absorption enhancer or any recipe containing the substance zwit ^ l ^^^ ^ ^ j ^ <^^. absorption. It can also affect the stability and / or solubility of the polypeptide to which it is attached. In the general case, eedvalent cations can be expected
178 261 metals such as sodium, potassium, lithium, rubidium and cesium will be useful as counterions for anionic absorption enhancers.
The relative proportions of the polypeptide and the enhancer may vary as needed. A sufficient amount of enhancer must be present to enable effective absorption of the inhaled polypeptide; however, the amount of enhancer should be kept as low as possible to minimize the risk of adverse effects caused by the enhancer. Although each specific polypeptide / enhancer combination needs to be tested to determine the optimal proportions, it can be expected that to achieve acceptable polypeptide absorption, the enhancer must comprise more than 10% of the polypeptide / enhancer; for most types of enhancer, the proportion of the substance should be above 15% or above 20% and preferably between 25% and 50%. The favorable ratio for each combination polypeptide / enhancer (or polypeptide / enhancer / diluent) can easily be determined by one of the usual methods in the pharmacological state of the art by standard methods based on criteria such as effective, consistent delivery of the optimal dose, minimizing side effects and acceptable absorption rate.
No further ingredients are needed for the formulation to work, but they may be included if desired. For example, the amount of powder that forms a single dose of a given polypeptide / absorption enhancer can be increased (e.g., for use in an inhalation device which, according to the design, requires a large volume of powder per dose) by diluting the powder with pharmaceutically acceptable diluents. Other additives may be included to facilitate processing or improve powder properties or formulation stability. Flavor may be added so that the amount of powder that is inevitably deposited in the mouth and throat can serve to give the patient a positive feeling that the dose has been delivered from the inhalation device. Any such additive should have the following properties: (a) that it is stable and does not adversely affect the stability of the polypeptide and substance by increasing absorption; (b) that it does not adversely interfere with absorption of the polypeptide; (c) that it has good powder properties as understood in pharmacy; (d) that it is not hygroscopic; and that at the concentrations used there are no adverse effects on the respiratory tract. Useful types of such additives include mono-, di and polysaccharides, sugar alcohols and other polyols: e.g. lactose, glucose, raffinose, meleitose, lactitol, maltitol, trehalose, sucrose, mannitol and starch. Because reducing sugars such as lactose and glucose tend to form complexes with proteins, non-reducing sugars such as raffinose, melezitose, lactitol, maltitol, trehalose, sucrose, mannitol and starch may be preferred additives for use in the present invention. Such additives can constitute anywhere from 0% (i.e. without addition) to almost 100% of the total preparation.
In a preferred embodiment, the present invention provides a therapeutic preparation of a pharmaceutically active polypeptide hormone and a substance that increases the absorption of said polypeptide in the lower respiratory tract, which preparation is in the form of a dry powder formulation suitable for 'inhalation, wherein at least 50% by weight consists of (a) particles with a diameter less than about 10 microns, or (b) agglomerates of said particles; in another preferred embodiment, the invention provides a therapeutic preparation comprising a pharmaceutically active polypeptide hormone, a substance that increases the absorption of the polypeptide hormone in the lower respiratory tract and a pharmaceutically acceptable carrier, which preparation is in the form of a dry powder suitable for inhalation, in which at least 50% by weight consists of (a) particles with a diameter less than about 10 microns, or (b) agglomerates of said particles; and in a further preferred embodiment, the present invention provides a therapeutic preparation containing the active compounds: (A) a pharmaceutically active hormone, polypeptide and (B) a substance that increases the absorption of said polypeptide hormone in the lower respiratory tract, and at least 50% of the total weight of active compounds (A) and (B) consists of particles less than about 10 microns in diameter, and a pharmaceutically acceptable carrier, and the formulation is
178 261 in the form of a dry powder formulation suitable for inhalation in which an ordered mixture can be formed between the active compounds and a pharmaceutically acceptable carrier.
The described powder formulation can be produced in a number of ways using conventional techniques. In many cases, a purified polypeptide can be obtained commercially. Alternatively, the polypeptide in question may be purified from a naturally occurring source using standard biochemical techniques, or it may be obtained by expressing prokaryotic and eukaryotic cells obtained by genetic engineering methods to contain the nucleotide sequence encoding the polypeptide and have appropriate expression control sequences attached to it (including is a transgenic animal that has been engineered to produce the desired peptide or protein, e.g. in his milk). Such methods are standard prior art (e.g., see Sambrook et al., Molecular Cloning: A Laboratory Manual; Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY, 1989). Peptides (i.e., polypeptides with 30 or less amino acid residues) can be easily synthesized by methods known in chemistry.
The absorption enhancers described above are also commercially available in general or can be prepared using published methods. In the case of ionic absorption enhancers, the counterion associated with the enhancer may be exchanged for another, if desired, using standard ion exchange techniques.
In the production of the described powder preparation, in general it will be necessary to micronize the powder in a suitable mill, e.g. in a micronizer, at the same time in the process to produce primary particles in a size range suitable for maximum deposition in the lower respiratory tract (i.e. below 10 pm). For example, you can dry mix powders of a polypeptide and an enhancer, and then micronize the substances together; alternatively, the substances can be micronized separately and then mixed. In the case where mixed compounds have different physical properties, such as hardness and brittleness, the resistance to ιηΓλΓοηί zmieniaη ^ varies and they can swap out different particles to break down into suitable particle sizes. Thus, when combined with micronization, the obtained size of one of the components may be unsatisfactory. In this case, it would be beneficial to micronize the various ingredients separately and then mix them.
It is possible to first dissolve the ingredients in a suitable solvent, e.g. water, to obtain mixing at the molecular level. This procedure also allows the pH to be adjusted to the desired level, e.g., to improve absorption of the polypeptide. Pharmaceutically accepted pH limits of 3 to 8.5 for products for inhalation should be considered because products with a pH outside this area may cause irritation and narrowing of the respiratory tract. To obtain a powder, the solvent must be removed by a process that stops the biological activity of the polypeptides. Suitable drying methods include vacuum concentration, open space drying, spray drying, and freeze drying. Temperatures above 40 ° C for more than a few minutes should generally be avoided as some degradation of certain polypeptides may occur. After the drying step, the solid material can, if necessary, be ground to obtain a coarse powder, then, if necessary, micronized.
If desired, the micronized powder can be processed to improve flow properties, e.g., by dry granulation, to form spherical agglomerates with favorable handling characteristics before being incorporated into the inhalation device. In this case, the device would be configured to ensure that the agglomerates are substantially deagglomerated prior to leaving the device, so that particles entering the patient's airways are largely within the desired size range. When an ordered mixture is desired, the active compound can be processed, e.g., by micronization, to obtain, if desired, particles within a specific range of values. The carrier can also be processed, e.g. to achieve the desired size and surface properties, such as a specific surface / weight pennant, or some resistance, and to provide optimal adhesion forces in the ordered mixture. Such a requirement12
178 The physical requirements of the ordered mixture are well known, and various methods of obtaining an ordered mixture that meet the said requirements are well known, and this can be easily determined by a specialist according to the particular circumstances.
A preferred inhalation apparatus would have the following design characteristics: protection of the powder against moisture and no risk at occasional high doses; in addition, it is desirable to as many of the following features as possible: protect the powder from light; high respiratory rate and high lung deposition in a wide range of flow rates; low deviation in dose size and respiratory rate; low powder retention in the mouthpiece - this is especially important for a multi-dose inhaler, in which case the polypeptide in the mouthpiece could degrade and then be inhaled with subsequent doses; low absorption to the surface of the inhaler; flexibility in dose size and low inhalation resistance. The inhaler is preferably a single-dose inhaler, although a multi-dose inhaler , such as a multi-dose, breath-activated, reusable dry powder inhaler may also be used. Preferably the inhaler used is a breath activated dry powder unit dose unit for single use.
A number of dry powder formulations containing the polypeptide and various substances that increase absorption were prepared and tested in the in vivo assay described below. An in vitro assay useful for polypeptide / absorption enhancer combinations has also been described.
Example 1. In vitro method for determining the usefulness of specific polypeptides for the present invention.
A standard in vitro assay using epithelial cell lines, CaCo-2 (available from the American Type Culture Collection (ATCC), Rockville, MD. USA) was developed to assess the ability of various absorption enhancers to promote the transport of markers through the epithelial cell monolayer as a layer model an epithelial cell that works in the lungs by separating the vesicles from the blood supply to the lungs.
In this assay, the absorption enhancer and the polypeptide or other marker are dissolved in the aqueous solution at various amounts and / or concentrations and applied to the apical side of the cell monolayer. After 60 min incubation at 37 ° C and 95% RH (relative humidity), the amount of marker on the basolateral side of the cells is determined, e.g. by using a radio-labeled marker.
For the test absorption enhancer, sodium caprate, the amount of marker (mannitol, high frequency 360) that appears on the basolateral side depends on the concentration of the enhancer used, at least up to 16 nM sodium capriculation (Fig. 1). It has been found that sodium capriciousness concentration (16 nM) increases the cell monolayer absorption of the low molecular weight peptide hormone vasopressin (MW 1208). The amount of vasopressin that was absorbed by the monolayer increased 10-15 times compared to the amount in the absence of any enhancer.
In contrast, no increase in transport speed was observed for larger proteins such as cytochrome C (MW 12300), carbon anhydrase (MW 30,000) and albumin when tested with up to 16 nM sodium caprate. It can be expected that at higher concentrations of sodium caprate, cell permeability will further increase, allowing the transport of larger polypeptides; however, the potential cytotoxicity of sodium caprate may prevent the use of substantially higher concentrations of this particular absorption enhancer.
Other absorption enhancers may allow the transport of larger polypeptides; they can also be tested in an in vitro epithelial cell permeability model that can be used as a screening tool for rapid testing of any polypeptide / absorption enhancer for suitability in the methods of the invention.
Example II. The therapeutic preparation of the present invention.
Human growth hormone (hGH, MW 22kD, source: Humatrope from Lilly, 3 parts) was mixed with capricious sodium (1 part). The mixture was ground in a Retsch mechanical mill to a particle size with a median mass diameter (MMD) of 6.7 pm.
178 261
The resulting endotracheal powder and hGH uptake were compared to that of a 9.6 pm MMD powder using hGH and mannitol in the same proportions and prepared in the same manner as above.
The results showed an increase in hGH uptake in a formulation containing sodium caprate, compared to uptake in a formulation without an enhancer.
178 261 fraction absorbed
<img file="PL178261B1_D0001.tif" />
-Control sample
- JOmM
- 13mM
- J6tnM
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Numbers
- Publication, DOCDB
- 178261
- Publication, EPODOC
- PL178261B
- Application
- 94312210
- Application, DOCDB
- 31221094
- Application, EPODOC
- PL19940312210
Titles2
- English
- INHALABLE COMPOSITIONS
- Polish
- Kompozycja farmaceutyczna zawierająca związek aktywny hormon polipeptydowy oraz sposób wytwarzania kompozycji farmaceutycznej zawierającej związek aktywny hormon polipeptydowy
Classification
- CPC, 8
- A61K9/0075
- A61K9/145
- A61K9/1623
- A61K38/27
- A61K38/28
- A61K47/12
- A61P43/00
- A61P5/00
- IPC, 16
- A61K9 00
- A61K9 14
- A61K9 16
- A61K9 72
- A61K38 00
- A61K38 04
- A61K38 095
- A61K38 22
- A61K38 23
- A61K38 24
- A61K38 26
- A61K38 27
- A61K38 28
- A61K38 35
- A61K38 46
- A61K47 12