Pharmaceutical compositions comprising imidazoquinolin(amines) and derivatives thereof suitable for local administration
Abstract
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Term
3.4 yearsto projected expiry
Projected expiry 5 February 2030, counted from filing; an application has no term until it is granted.
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1 claim: 1 independent, 0 dependent
- 1Patent claims Zastrzeżenia patentowe 1. A pharmaceutical composition comprising imidazoquinoline (amine) and lactic acid for use in a method of treating bladder diseases in which imidazoquinoline (amine) in 1. Kompozycja farmaceutyczna zawierająca imidazochinolino(aminę) i kwas mlekowy do stosowania w sposobie leczenia chorób pęcherza, w której imidazochinolino(amina) w 102 the pharmaceutical composition is selected from a compound defined by one of the following groups (a), (b) and (c):102 kompozycji farmaceutycznej jest wybrana spośród związku zdefiniowanego przez jedną z następujących grup (a), (b) i (c): a) 1H-imidazo [4,5-c] quinoline-4-amine;a) 1H-imidazo[4,5-c]chinolino-4-amina;b) the imidazoquinoline (amine) compound selected from the following formula (I): b) zwią zek imidazochinolino(aminowy) wybrany spoś ród nast ę puj ą cego wzoru (I): w którym wherein 2 3 2 3 R , R , i R wybiera się niezależ nie spoś ród atomu wodoru;cyklicznego alkilu ma10 jącego trzy, cztery lub pięć atomów węgla;alkilu o prostym lub rozgałęzionym łańcuchu zawierającym jeden do dziesięciu atomów węgla i podstawionego alkilu o prostym lub rozgałęzionym łańcuchu zawierającym jeden do dziesięciu atomów węgla, w którym podstawnik wybiera się z grupy obejmującej cykloalkil zawierający trzy do sześciu atomów węgla i cykloalkil zawierający trzy do sześciu atomów węgla podstawiony alkilem o prostym lub rozgałęzionym łańcuchu zawierającym jeden do czterech atomów węgla;fluoro- lub chloroalkilu zawierającego od jednego do dziesięciu atomów węgla i jeden lub większą liczbę atomów fluoru lub chloru;alkenylu o prostym lub rozgałęzionym łańcuchu zawierającego dwa do dziesięciu atomów węgla i podstawionego alkenylu o prostym lub rozgałęzionym łańcu20 chu zawierającego dwa do dziesięciu atomów węgla, w którym podstawnik wybiera się z grupy obejmującej cykloalkil zawierający trzy do sześciu atomów węgla i cykloalkil zawierający trzy do sześciu atomów węgla podstawiony alkilem o prostym lub rozgałęzionym łańcuchu zawierającym jeden do czterech atomów węgla;hydroksyalkilu mającego jeden do sześciu atomów węgla;alkoksyalkilu, gdzie ugrupowanie alkoksylowe zawiera jeden do czterech atomów węgla i ugrupowanie alkilowe zawiera jeden do sześciu atomów węgla;acyloksyalkilu, gdzie ugrupowanie acyloksylowe oznacza alkanoiloksyl mający dwa do czterech atomów węgla lub benzoiloksyl, i ugrupowanie alkilowe zawiera jeden do sześciu atomów węgla, pod R, R, and R are independently selected from hydrogen;cyclic alkyl having three, four or five carbon atoms;straight or branched chain alkyl containing one to ten carbon atoms and substituted straight or branched chain alkyl containing one to ten carbon atoms in which the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted or straight chain branched alkyl containing one to four carbon atoms;fluoro or chloroalkyl containing from one to ten carbon atoms and one or more fluorine or chlorine atoms;straight or branched chain alkenyl containing two to ten carbon atoms and substituted straight or branched chain alkenyl having two to ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six atoms carbon substituted straight or branched chain alkyl containing one to four carbon atoms;hydroxyalkyl having one to six carbon atoms;alkoxyalkyl, wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms;acyloxyalkyl, where the acyloxy moiety is an alkanoyloxy having two to four carbon atoms or benzoyloxy, and the alkyl moiety contains one to six carbon atoms, under 103 provided that no such alkyl, substituted alkyl, alkenyl, substituted alkenyl, hydroxyalkyl, alkoxyalkyl, or acyloxyalkyl group has a fully carbon substituted carbon atom attached directly to a nitrogen atom;benzyl;(Phenyl) ethyl;and phenyl;wherein the benzyl, (phenyl) ethyl or phenyl substituent is optionally substituted on the benzene ring with one or two moieties independently selected from the group consisting of alkyl having one to four carbon atoms, alkoxy having one to four carbon atoms, and halogen, under provided that when the benzene ring is substituted with two such moieties, these moieties together contain no more than six carbon atoms;103 warunkiem, że żaden taki alkil, podstawiony alkil, alkenyl, podstawiony alkenyl, hydroksyalkil, alkoksyalkil, lub grupa acyloksyalkilowa nie ma w pełni podstawionego atomami węgla atomu węgla związanego bezpośrednio z atomem azotu;benzylu;(fenylo)etylu;i fenylu;przy czym podstawnik benzylowy, (fenylo)etylowy lub fenylowy jest ewentualnie podstawiony na pierścieniu benzenowym jednym lub dwoma ugrupowaniami niezależnie wybranymi z grupy obejmuj ącej alkil maj ący jeden do czterech atomów węgla, alkoksyl maj ący jeden do czterech atomów węgla, oraz atom fluorowca, pod warunkiem, że gdy ten pierścień benzenowy jest podstawiony dwoma takimi ugrupowaniami, ugrupowania te razem zawierają nie więcej niż sześć atomów węgla;-CHRxRy, in which Ry is hydrogen or a carbon-carbon bond, provided that when Ry is hydrogen, Rx is alkoxy having one to four carbon atoms, hydroxyalkoxy having one to four carbon atoms, 1-alkynyl having two up to ten carbon atoms, tetrahydropyranyl, alkoxyalkyl, where the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, 2-, 3-, or 4-pyridyl, and with a further condition, that when Ry is a carbon-carbon bond, Ry and Rx together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from the group consisting of hydroxy or hydroxyalkyl having one to four carbon atoms;-CHRxRy, w którym Ry oznacza atom wodoru lub wiązanie węgiel-węgiel, pod warunkiem, że gdy Ry oznacza atom wodoru, Rx oznacza alkoksyl maj ący jeden do czterech atomów węgla, hydroksyalkoksyl mający jeden do czterech atomów węgla, 1-alkinyl maj ący dwa do dziesięciu atomów węgla, tetrahydropiranyl, alkoksyalkil, gdzie ugrupowanie alkoksylowe zawiera jeden do czterech atomów węgla i ugrupowanie alkilowe zawiera jeden do czterech atomów węgla, 2-, 3-, lub 4pirydyl, i z kolejnym warunkiem, że gdy Ry oznacza wiązanie węgiel-węgiel, Ry i Rx razem tworzą grupę tetrahydrofuranylową ewentualnie podstawioną jednym lub większą liczbą podstawników niezależnie wybranych z grupy obejmującej hydroksyl lub hydroksyalkil mający jeden do czterech atomów węgla;alkilu o prostym lub rozgałęzionym łańcuchu zawierającym jeden do ośmiu atomów węgla, hydroksyalkil o prostym lub rozgałęzionym łańcuchu zawierający jeden do sześciu atomów węgla, morfolinometyl, benzyl, (fenylo)etyl i fenyl, przy czym podstawnik benzylowy, (fenylo)etylowy lub fenylowy jest ewentualnie podstawiony na pierścieniu benzenowym ugrupowaniem wybranym z grupy obejmującej metyl, metoksyl, lub atom fluorowca;straight or branched chain alkyl having one to eight carbon atoms, straight or branched chain hydroxyalkyl containing one to six carbon atoms, morpholinomethyl, benzyl, (phenyl) ethyl and phenyl, wherein the benzyl, (phenyl) ethyl or phenyl substituent is optionally a benzene ring substituted moiety selected from the group consisting of methyl, methoxy, or halogen;-C (RS) (RT) (X) wherein RS and RT are independently selected from the group consisting of hydrogen, alkyl having one to four carbon atoms, phenyl, and substituted phenyl, where the substituent is selected from the group consisting of alkyl one to four carbon atoms, alkoxy having one to four carbon atoms, and halogen;-C(RS)(RT)(X) w którym RS i RT są wybrane niezależnie z grupy obejmującej atom wodoru, alkil maj ący jeden do czterech atomów węgla, fenyl, i podstawiony fenyl, gdzie podstawnik wybiera się z grupy obejmuj ącej alkil maj ący jeden do czterech atomów węgla, alkoksyl maj ący jeden do czterech atomów węgla, oraz atom fluorowca;X is alkoxy containing one to four carbon atoms, alkoxyalkyl, where the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, a haloalkyl having one to four carbon atoms, an alkylamide where the alkyl group contains one X oznacza alkoksyl zawierający jeden do czterech atomów węgla, alkoksyalkil, gdzie ugrupowanie alkoksylowe zawiera jeden do czterech atomów węgla i ugrupowanie alkilowe zawiera jeden do czterech atomów węgla, fluorowcoalkil maj ący jeden do czterech atomów węgla, alkiloamid, gdzie grupa alkilowa zawiera jeden 104 up to four carbon atoms, an amino group, a substituted amino group, where the substituent is alkyl or hydroxyalkyl having one to four carbon atoms, an azido group, an alkylthio having one to four carbon atoms, or morpholinoalkyl, where the alkyl moiety contains one to four carbon atoms;104 do czterech atomów węgla, grupę aminową, podstawioną grupę aminową, gdzie podstawnik oznacza alkil lub hydroksyalkil mający jeden do czterech atomów węgla, grupę azydową, alkilotio mający jeden do czterech atomów węgla, lub morfolinoalkil, gdzie ugrupowanie alkilowe zawiera jeden do czterech atomów węgla;R4 is hydrogen, C1-8 alkyl, C1-8 alkoxy, or halogen;n is 1, 2, 3, or 4;R4 oznacza atom wodoru, C1-8 alkil, C1-8 alkoksyl, lub atom fluorowca;n oznacza 1, 2, 3, lub 4;Ra i Rb oznaczają niezależnie atom wodoru, (C1-C6)alkil, hydroksy(C1-C6) alkil, amino(C1-C6)alkil, aminosulfonyl, (C1-C6)alkanoil, aryl, lub benzyl, wszystkie ewentualnie podstawione jedną lub większą liczbą grup aminowych;lub Ra i Rb razem z atomem azotu, z którym są związane tworzą grupę pirolidynową, piperydynową lub morfolinową;linie kreskowane w pierścieniu pięcioczłonowym o wzorze (I) powyż ej oznaczają ewentualne wią zanie łączą ce atom azotu pierś cienia pięcioczłonowego z atomem węgla pomiędzy dwoma atomami azotu pierścienia pięcioczłonowego, i gdy wiązanie występuje, albo R1, albo R2 3 nie występują;pod warunkiem, że Ra i Rb razem pozwalają na utworzenie czwartorzędowego jonu amoniowego albo na atomie azotu centralnego elementu struktury N(Ra)(Rb) albo dzięki dowolnemu czwartorzędowemu jonowi amoniowemu dostarczanemu przez Ra i/lub Rb;Rand and Rb are independently hydrogen, (C1-C6) alkyl, hydroxy (C1-C6) alkyl, amino (C1-C6) alkyl, aminosulfonyl, (C1-C6) alkanoyl, aryl, or benzyl, all optionally substituted with one or more groups amino;or Rand and Rb together with the nitrogen atom to which they are attached form a pyrrolidine, piperidine or morpholine group;the dashed lines in the five-membered ring of formula (I) above indicate a possible bond connecting the nitrogen of the five-membered ring to the carbon atom between two nitrogen atoms of the five-membered ring, and when bonding occurs, or R1or R2 3 do not occur;provided that Rand and Rb together, they allow the formation of a quaternary ammonium ion or on the nitrogen atom of the central element of the N structure (Rand) (Rb) or thanks to any quaternary ammonium ion supplied by Rand and / or Rb;lub jego farmaceutycznie dopuszczalna sól;i or a pharmaceutically acceptable salt thereof;and c) Imichimod, having the specific formula, 1-isobutyl-1H-imidazo [4,5-c] quinoline-4-amine, selected from the following formula (X): c) imichimod, mając konkretny wzór, 1-izobutylo-1H-imidazo[4,5-c]chinolino-4-amina, wybrany spośród następującego wzoru (X): 2. The pharmaceutical composition for use according to claim The pharmaceutical composition of Claim 1, wherein the pharmaceutical composition further comprises at least one thermosensitive agent, wherein said at least one thermosensitive agent is selected from chitosan, or from a copolymer of poly (ethylene oxide) -poly (propylene oxide) -poly (ethylene oxide) (also called PEO) -PPO-PEO or poloxamer). 2. Kompozycja farmaceutyczna do zastosowania według zastrz. 1, która to kompozycja farmaceutyczna zawiera ponadto co najmniej jeden środek termoczuły, gdzie ten co najmniej jeden środek termoczuły jest wybrany spośród chitosanu, lub spośród kopolimeru poli(tlenek etylenu)-poli(tlenek propylenu)-poli(tlenek etylenu) (również nazywanego PEO-PPO-PEO lub poloksamerem). 105 105 3. The pharmaceutical composition for use according to any one of claims from 1 to 3. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 1 do 2, która to kompozycja farmaceutyczna zawiera kwas mlekowy w stężeniu od 0,025 M do 0,200 M, korzystnie w stężeniu od 0,025 M do 0,100 M lub w stężeniu od 0,100 M do 0,200 M lub w stężeniu od 0,075 do 1,125 M. 2. The pharmaceutical composition of claim 2, wherein the pharmaceutical composition comprises lactic acid in a concentration from 0.025 M to 0.200 M, preferably in a concentration from 0.025 M to 0.100 M or in a concentration from 0.100 M to 0.200 M or in a concentration from 0.075 to 1.125 M. 4. The pharmaceutical composition for use according to any one of claims from 1 to 4. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 1 do 3, która to kompozycja farmaceutyczna zawiera imidazochinolino(aminę) w ilości od 0,005% (wag./obj.) do 5% (wag./obj.), w tym ilości od 0,01% (wag./obj.) do 5% (wag./obj.), ilości od 0,1% (wag./obj.) do 4% (wag./obj.), ilości od 0,1% (wag./obj.) do 3% (wag./obj.), ilości od 0,2% (wag./obj.) do 2% (wag./obj.), ilości od 0,2% (wag./obj.) do 1% (wag./obj.), ilości od 0,5% (wag./obj.) do 1% (wag./obj.) lub ilości od 0,1% (wag./obj.) do 1% (wag./obj.). 3. The pharmaceutical composition of claim 3, wherein the pharmaceutical composition comprises imidazoquinoline (amine) in an amount of 0.005% (w / v) to 5% (w / v), including 0.01% (w / v) to 5% (w / v), quantities from 0.1% (w / v) to 4% (w / v), amounts from 0.1% (w / v) to 3% (w / v), amounts from 0.2% (w / v) to 2% (w / v), amounts from 0.2% (w / v) to 1% (w / v) / vol), from 0.5% (w / v) to 1% (w / v) or from 0.1% (w / v) to 1% (w / v) vol.). 5. The pharmaceutical composition for use according to any one of claims 1 to 4: 5. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. 1 do 4: i) która to kompozycja farmaceutyczna zawiera ponadto jedną lub większą liczbę cyklodekstryn, wybranych spośród a-cyklodekstryny, β-cyklodekstryny, γ-cyklodekstryny, δ-cyklodekstryny i ε-cyklodekstryny, korzystnie spośród e-cyklodekstryny, w tym hydroksypropylo-e-cyklodekstryny (HP-e-CD);w szczególności zawiera cyklodekstrynę (cyklodekstryny) w ilości od 0,1% (wag./obj.) do 30% (wag./obj.), typowo w ilości od 1% (wag./obj.) do 20% (wag./obj.), korzystnie w ilości od 2% (wag./obj.) do 20% (wag./obj.), korzystniej w ilości od 5% (wag./obj.) do 20% (wag./obj.), jeszcze korzystniej w ilości od 5% (wag./obj.) do 15% (wag./obj.), i najkorzystniej w ilości od 10% (wag./obj.) do 15% (wag./obj.) lub w ilości od 2% (wag./obj.) do 6% (wag./obj.);i/lub ii) która to kompozycja farmaceutyczna zawiera co najmniej jeden środek termoczuły, gdzie ten co najmniej jeden środek termoczuły jest wybrany spośród chitosanu, lub spośród kopolimeru poli(tlenek etylenu)-poli(tlenek propylenu)poli(tlenek etylenu) (również nazywanego PEO-PPO-PEO lub poloksamerem), i gdzie ten co najmniej jeden środek termoczuły wykazuje konkretną „niższą krytyczną temperaturę roztworu” (LCST) mierzoną pod ciśnieniem otoczenia w zakresie od 15°C do 35°C, korzystniej w zakresie od 15°C do 30°C, jeszcze korzystniej w zakresie od 15 lub 20°C lub 25°C do 30°C, najkorzystniej w zakresie od 15 lub 20°C do 25°C. i) which pharmaceutical composition further comprises one or more cyclodextrins selected from? -cyclodextrin, β-cyclodextrin, γ-cyclodextrin, δ-cyclodextrin and ε-cyclodextrin, preferably from e-cyclodextrin, including hydroxypropyl-e-cyclodextrin ( e-HP-CD);in particular it contains cyclodextrin (cyclodextrin) in an amount of 0.1% (w / v) to 30% (w / v), typically in an amount of 1% (w / v) to 20% (w / v) / vol), preferably in an amount of 2% (w / v) to 20% (w / v), more preferably in an amount of 5% (w / v) to 20% (w / v) v / v), more preferably in an amount from 5% (w / v) to 15% (w / v), and most preferably in an amount from 10% (w / v) to 15% (w / v) vol.) or in an amount of 2% (w / v) to 6% (w / v);and / or ii) which pharmaceutical composition comprises at least one thermosensitive agent, wherein said at least one thermosensitive agent is selected from chitosan, or from a poly (ethylene oxide) -poly (propylene oxide) poly (ethylene oxide) copolymer (also called PEO-PPO-PEO or poloxamer), and where the at least one thermosensitive agent exhibits a specific "lower critical solution temperature" (LCST) measured at ambient pressure in the range of 15 ° C to 35 ° C, more preferably in the range of 15 ° C to 30 ° C, even more preferably in the range of 15 or 20 ° C or 25 ° C to 30 ° C, most preferably in the range of 15 or 20 ° C to 25 ° C. 106 106 6. The pharmaceutical composition for use according to any one of claims from 2 to 6. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 2 do 5, która to kompozycja farmaceutyczna zawiera co najmniej jeden środek termoczuły w ilości od 0,1% (wag./obj.) do 40% (wag./obj.), typowo w ilości od 2% (wag./obj.) do 30% (wag./obj.), korzystnie w ilości od 5% (wag./obj.) do 30% (wag./obj.), korzystniej w ilości od 10% (wag./obj.) do 30% (wag./obj.), i najkorzystniej w ilości od 10% (wag./obj.) do 25% (wag./obj.) lub w ilości od 10% (wag./obj.) do 20% (wag./obj.);w szczególności gdzie dowolne dwa środki termoczułe są zawarte w kompozycji farmaceutycznej jako mieszanina w stosunku od 1:20 do 20:1, w tym stosunku 1:20, 2:20, 3:30, 4:20, 5:20, 6:20, 7:20, 8:20, 9:20, 10:20, 11:20, 12:20, 13:20, 14:20, 15:20, 16:20, 17:20, 18:20, 19:20, 20: 20 (= 1:1), lub w stosunku 20:20, 19:20, 18: 20, 17:20, 16:20, 15:20, 14:20, 13:20, 12:20, 11:20, 10:20, 9:20, 8:20, 7:20, 6:20, 5:20, 4:20, 3:20, 2:20, lub 1:20, lub zakresie tworzonym przez dowolne z dwóch z wartości stosunków zdefiniowanych wyżej. 5. The pharmaceutical composition of claim 5, wherein the pharmaceutical composition comprises at least one thermosensitive agent in an amount from 0.1% (w / v) to 40% (w / v), typically in an amount from 2% (w / v) up to 30% (w / v), preferably in an amount from 5% (w / v) to 30% (w / v), more preferably in an amount from 10% (w / v) to 30 % (w / v), and most preferably in an amount from 10% (w / v) to 25% (w / v) or in an amount from 10% (w / v) to 20% ( wag./obj.);in particular where any two thermosensitive agents are included in the pharmaceutical composition as a mixture in a ratio of 1:20 to 20: 1, including a ratio of 1:20, 2:20, 3:30, 4:20, 5:20, 6: 20, 7:20, 8:20, 9:20, 10:20, 11:20, 12:20, 13:20, 14:20, 15:20, 16:20, 17:20, 18:20, 19:20, 20:20 (= 1: 1), or in a ratio of 20:20, 19:20, 18: 20, 17:20, 16:20, 15:20, 14:20, 13:20, 12:20, 11:20, 10:20, 9:20, 8:20, 7:20, 6:20, 5:20, 4:20, 3:20, 2:20, or 1:20, or the range created by any of the two of the ratio values defined above. 7. The pharmaceutical composition for use according to any one of claims from 2 to 7. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 2 do 6, w której co najmniej jeden środek termoczuły stanowi Poloksamer 407 i/lub Poloksamer 188 lub mieszanina Poloksameru 407 i Poloksameru 188. 6. The process of claim 6, wherein the at least one thermosensitive agent is Poloxamer 407 and / or Poloxamer 188 or a mixture of Poloxamer 407 and Poloxamer 188. 8. The pharmaceutical composition for use according to claim 7: 8. Kompozycja farmaceutyczna do zastosowania według zastrz. 7: i) in which at least one thermosensitive agent is Poloxamer 407 in an amount from 10% (w / v) to 25% (w / v) or in an amount from 12% (w / v) to 25% (w / v), in particular where the at least one thermo-sensitive agent is Poloxamer 407 in (total) amount from 17.5% (w / v) / (w / w) to 22.5% i) w której co najmniej jeden środek termoczuły stanowi Poloksamer 407 w ilości od 10% (wag./obj.) do 25% (wag./obj.) lub w ilości od 12% (wag./obj.) do 25% (wag./obj.), w szczególności gdzie ten co najmniej jeden środek termoczuły stanowi Poloksamer 407 w (ogólnej) ilości od 17,5% (wag./obj.)/(wag./wag.) do 22,5% (wag./obj.)/(wag./wag.), lub dowolnym zakresie utworzonym przez dowolne dwie z tych wartości;lub ii) gdzie ten co najmniej jeden środek termoczuły stanowi mieszaninę Poloksameru 407 i Poloksameru 188 w (ogólnej) ilości od 22,5% (wag./obj.)/(wag./wag.) do 27,5% (wag./obj.)/(wag./wag.), korzystniej w ogólnej ilości 25% (weight / volume) / (weight / weight), or any range formed by any two of these values;or ii) wherein the at least one thermosensitive is a mixture of Poloxamer 407 and Poloxamer 188 in (total) amounts from 22.5% (w / v) / (w / w) to 27.5% (w / w) /obj.)/(w / w), more preferably in the total amount of 25% 107 (w / v) / (w / w), and in a Poloxamer 407: Poloxamer 188 ratio of 15: 5, 16: 4, 17: 3, 18: 2, 19: 1 or 20: 1, or in the range formed by any two of these ratio values, more preferably in a ratio of 9.5: 0.5, 9: 1, 8.5: 1.5 or 8: 2, or the range formed by any two of these ratio values. 107 (wag./obj.)/(wag./wag.), i w stosunku Poloksamer 407 : Poloksamer 188 wynoszącym 15:5, 16:4, 17:3, 18:2, 19:1 lub 20:1, lub zakresie tworzonym przez dowolne dwie z tych wartości stosunków, korzystniej w stosunku 9,5:0,5, 9:1, 8,5:1,5 lub 8:2, lub zakresie tworzonym przez dowolne dwie z tych wartości stosunków. 9. The pharmaceutical composition for use according to any one of claims from 1 to 9. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 1 do 8, która to kompozycja farmaceutyczna zawiera kwas mlekowy w stężeniu od 0,025 do 0,2 M, korzystnie w stężeniu od 0,075 do 1,125 M, imidazochinolino(aminę) w ilości od 0,1% (wag./obj.) do 1% (wag./obj.), cyklodekstrynę (cyklodekstryny) w ilości od 2% (wag./obj.) do 6% (wag./obj.) i Poloksamer 407 w ilości od 10% (wag./obj.) do 25% (wag./obj.), korzystnie w ilości od 12% (wag./obj.) do 25% (wag./obj.). 8. The pharmaceutical composition of claim 8, wherein the pharmaceutical composition comprises lactic acid in a concentration from 0.025 to 0.2 M, preferably in a concentration from 0.075 to 1.125 M, imidazoquinoline (amine) in an amount from 0.1% (w / v) to 1% ( w / v), cyclodextrin (cyclodextrin) in an amount from 2% (w / v) to 6% (w / v) and Poloxamer 407 in an amount from 10% (w / v) to 25 % (w / v), preferably in an amount from 12% (w / v) to 25% (w / v). 10. The pharmaceutical composition for use according to any one of claims from 1 to 10. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 1 do 9, w której choroby pęcherza są wybrane spośród raka pęcherza i zapalenia pęcherza. The method of claim 9, wherein the bladder diseases are selected from cystic cancer and cystitis. 11. The pharmaceutical composition for use according to any one of claims 1 to 10 for intravesical treatment of bladder diseases, in particular wherein the bladder diseases are cystitis and cystic cancer. 11. Kompozycja farmaceutyczna do zastosowania według któregokolwiek z zastrz. od 1 do 10 do dopęcherzowego leczenia chorób pęcherza, w szczególności gdzie chorobami pęcherza są zapalenie pęcherza i rak pęcherza. 12. Use of a pharmaceutical composition as defined in any one of claims 1 to 11 for the manufacture of a medicament for the treatment of bladder diseases, including bladder cancer and cystitis, comprising administering a pharmaceutical composition as defined in any one of claims 1 to 11;from 1 to 11 a patient in need of this. 12. Zastosowanie kompozycji farmaceutycznej zdefiniowanej w dowolnym z zastrz. od 1 do 11 do wytwarzania leku do leczenia chorób pęcherza, w tym raka pęcherza i zapalenia pęcherza, obejmującego podawanie kompozycji farmaceutycznej zdefiniowanej w którymkolwiek z zastrz. od 1 do 11 pacjentowi potrzebującemu tego. 13. Application according to claim 12. The method of claim 12, wherein the pharmaceutical composition is administered intravesically and / or wherein the cystic diseases are cystitis and cystic cancer. 13. Zastosowanie według zastrz. 12, w którym kompozycja farmaceutyczna jest podawana dopęcherzowo i/lub w którym chorobami pęcherza są zapalenie pęcherza i rak pęcherza. Telormedix SA Pełnomocnik: Telormedix SA Proxy: 108 108 Poloksamer 407 (20 obrotów na minutę) Poloksamer 407 (20 rpm) LH LH Ol (cP) ?SO>|d0-| (0o) BJnłBjadiŁiąj_ Ol (cP)? SO> | d0- | (0about) BJnłBjadiŁiąj_ Figura 1 Figure 1 109 109 Temperatura (°C) Temperature (° C) 110 α> 110 α> α α. α α. ΙΑ ΙΑ ΙΛ m ΙΛ m ο m ο m ΙΑ ΙΑ ΓΜ ΓΜ Ο Ο ΓΜ ιΛ ιΛ ΓΜ ιΛ ιΛ Temperatura (°C) Temperature (° C) (jo) oso> ido- | (jo) oso>ido-| Figura 3 Figure 3 111 ♦ 111 ♦ <ί i <ί i AND I Acetic acid (20 revolutions per minute Kwas octowy (20 obrotów na minut Φ * (to) osn ^ dsn Φ* (do) oso^dsn 1O 1O CM o fM tH 10 v * 4 CM o fM tH lO v*4 CM ▼ - s s 00 CM ▼-ł s 00 < < «Ν «Ν ABOUT O Temperatura (°C) Temperature (° C) Figura 4 Figure 4 112 ο 112 ο L * L ł*ł ΙΛ ΙΛ ΓΜ ΓΜ LO LO Ο (cP) ?so>|dag Ο (cP)? So> | dag Ο Ο ΓΜ ΓΜ Temperatura (°C) Temperature (° C) Figura 5 Figure 5 113 ο 113 ο m tn m tn jden Temperatura (°C) Temperature (° C) Figura 6 Figure 6 114 (d0) Οδθ> [όθη 114 (d0) Οδθ>[όθη ΙΛ ΙΛ ΓΜ ΓΜ ΓΜ ιΛ o ΓΜ ιΛ o Temperatura (°C) Temperature (° C) Figura 7 Figure 7 115 115 LA η LA η CM CM LO (d3) oso> | dsn LO (d3) oso>|dsn Temperatura (°C) Temperature (° C) Figura 8 Figure 8 116 is' ν ό 116 to 'ν ό ο ο Q> Q> -t— '= 5 C 'P · 2 £ o * at wo -t—' =5 C 'P ·2 £ o * u w o CM O O o. CM OO o o 'rt £ oo 'rt £ '2 Φ '2 Φ E that's what E to co -and what -ić o & about gac &o g a c What co N N CO WHAT Φ Φ Φ Φ E co w E what in 2Ć 2Ć o m m mm CM CM ABOUT O CM tn m CM tn m Temperatura (°C) (do) oso>łde-| Temperature (° C) (up to) people> Figura 9 Figure 9 117 117 PG-LAO1 % rozpuszczenia % rozpuszczenia PG-LAO1% dissolution% dissolution Czas (min) Time (min) Figura 10 Figure 10 118 ί 118 ί ΧΙΛΙ1 oBeueMopunjApezjd % ΧΙΛΙ1 oBeueMopunjApezjd% P) Au1 AuBMopunjApezjd c P) ΧΙΛΙ1 AuBMopunjApezjd c E_ <n ffi E_ <n ffi N N About “ΤΜΧ PPG-LA01 - TMXPS'IAD1 ~ ΤΜΧ in lactic acid solution O “ ΤΜΧ PPG-LA01 -r.· TMXPS’IAD1 ~ ΤΜΧ w roztworze kwasu mlekowego Figura 11 Figure 11 119 ο 119 ο ο ο LFL Lfl ΓΜ ΓΜ Θ Θ Ο Ο Ο Ο ΓΜ ΓΜ Ο Ο Ο ιη Ο ιη ABOUT Ó Ο ο Ο ο Η Η Ο Ο Q Q LD LD Ο grubość (pm) Ο thickness (pm) ΚΗ'ΧΙΛΙΙ Aubmoz! | Blujouz ΚΗ’ΧΙΛΙΙ Aubmoz!|blujouz Figura 12 Figure 12 120 (βΒΜ / βΒΜ%) ΚΗ "ΧΙΛΙ1 3S0U | BZ0ZSndZ0d 120 (βΒΜ/βΒΜ %) ΚΗ"ΧΙΛΙ1 3S0U|BZ0ZSndZ0d Figura 13 uD fM c* o Figure 13 uD fM c * o fM n fM n O [kwas mlekowy] (M) O [lactic acid] (M) 121 121 Figura 14 Figure 14 122 122 123 123 Figura 16 Figure 16 124 124 Figura 17 Figure 17 125 (| lu / 6u) nzooso m zes-a θιυθζόΐδ 125 (|lu/6u) nzooso m zes-a θιυθζόΐδ Figura 18 Figure 18 126 126 Figura 19 Figure 19 127 127 128 128 129 129 Pod 50 150 500 1500 5000 naiwne Pod 50 150 500 1500 5000 naiwne Under 50 150 500 1500 5000 naive Under 50 150 500 1500 5000 naive Figura 22 Figure 22 130 130 Ο 1M Lactic acid Poloxamerw 0.1 M Lactic acid Poloxamerw ' s lactic acid, lactic acid Ο 1M kwas mlekowy Poloksamerw 0,1 M kwas mlekowy Poloksamerw ' y kwasie mlekowym kwasie mlekowym 131 131 132 132 Figura 25 Figure 25 133 ρ <0.01 133 ρ<0,01 Terapia mających nowotwór myszy Therapy for cancer-bearing mice Figura 26 Figure 26
722 paragraphs, as filed
[0001] The present invention generally relates to the field of innate immune system modulators, particularly pharmaceutical compositions containing imidazoquinoline (amines) and derivatives thereof, preferably suitable for local administration, such as intravesical administration. In addition, the present invention relates to the use of imidazoquinoline (amines) and their derivatives for the treatment of intravesical bladder diseases, such as, for example, cystic cancer and cystitis. The present invention further includes methods of treating these diseases as well as methods of administering the pharmaceutical compositions of the invention.
[0002] Induction and / or enhancement of the immune response of the innate immune system, and depending on the type of trigger, the acquired immune system, plays an important role in modern medicine in the treatment and prevention of numerous diseases. For such a purpose, immunomodulatory compositions that are directed to a small number of receptors, called pattern recognition receptors, are widely used in the art. Such pattern recognition receptors typically recognize conserved molecular patterns that distinguish a foreign organism such as viruses, bacteria, fungi and parasites from their host cells. As is known today, pattern recognition receptors include, but are not limited to, so-called components of the "Toll-like" (TLR) family of receptors, the first family of receptors that recognize patterns studied in detail.
[0003] TLRs are transmembrane proteins that recognize ligands of the extracellular environment or lumen of endosomes. After ligand binding, they conduct a signal through cytoplasmic adapter proteins, which leads to triggering host defense reactions and starting the production of antimicrobial peptides, pro-inflammatory chemokines and cytokines, antiviral cytokines, etc. To date, at least 10 members of the Toll-like receptor family (TLR 1-10) have been identified in humans and 13 (TLR 1-13) in mice. Toll-like receptors (TLRs) in humans include TLR1-TLR2, which recognize triacyl lipopeptides; Toll-like TLR1-TLR6 receptors that recognize diacyl lipopeptide; Toll-like TLR2 receptor that recognizes peptidoglycans; a Toll-like TLR3 receptor that is known to recognize dsRNA, a viral product; Toll-like TLR4 receptor that has LPS (lipopolysaccharide) Gram-negative bacteria as a known ligand; Toll-like TLR5 receptor that recognizes bacterial flagellin (flagellins); Toll-like TLR7 / 8 receptors whose known ligands include imidazoquinolines, guanosine analogs and ssRNA; a Toll-like TLR9 receptor that recognizes unmethylated CpG motifs commonly found in bacteria, viruses and protozoa genes, but not vertebrates; TLR9 also recognizes malaria pigment hemozoin, a hemoglobin digestion product; finally, a Toll-like receptor
TLR10 appeared to be directly associated with MyD88, a common Toll IL-1 receptor domain adapter (see, e.g., Hasan et al., The Journal of Immunology, 2005, 174: 29425 2950). Upon recognition of microbial pathogens, these TLRs typically trigger intracellular signaling pathways that induce inflammatory cytokines (e.g. TNFalpha, IL-6, IL-1-beta and IL-12), type I interferon (IFN-beta and many IFN-alpha) and chemokines (Kawai, T. and S. Akira (2006). "TLR signaling". Cell Death Differ 13 (5): 816-25).
[0004] Among the above, TLR, TLR3, TLR7 and TLR9 are the most important. TLR7 recognizes small synthetic immune modifiers containing imiquimod, R-848, loxoribine and bropyrimine, all of which are already used or promised for clinical use against viral infections and cancers. In addition, plasmacytoid dendritic cells express TLR7 and TLR9, and react to TLR7 and
TLR9 production of large amounts of interferon (IFN-alpha). These results indicate that TLR3, TLR7 and TLR9 may play an important role in detecting and controlling viral infections.
[0005] A specific example of the immune modifiers described above includes imiquimod (hereinafter also referred to as R-837, TMX, TMX-101), which belongs to the class of imidazoquinoline (amine) immune modifiers. The immunomodulatory molecule imichimod (1-isobutyl-1H-imidazo [4,5-c] quinoline-420 amine) has been shown to have clinical efficacy in oncological, viral and inflammatory diseases. The mechanism of immunostimulatory activity of imichimod is believed to be caused in a substantial part by an increase in the immune response by induction of various important cytokines (e.g., interferons, interleukins, tumor necrosis factor, etc.). Even if the exact mechanism of action of imiquimod is not yet known, the binding of imiquimod to the toll-like 7 receptor (TLR7) is considered one of the key steps in activating the immune system. Cells stimulated by imichimod via TLR-7 secrete cytokines (primarily interferon-α (IFN-α), interleukin6 (IL-6) and tumor necrosis factor-α (TNF-α), which contribute to the antiviral, anti-tumor and anti-inflammatory properties of the agent.
[0006] Imichimod has been shown to be a potent immunomodulator currently used as local first-line therapy for genital warts and superficial basal cell carcinomas (Purdon CH, Azzi CG, Zhang J, Smith EW, Maibach HI. Penetration enhancement of transdermal delivery-current permutations and limitations. Crit Rev Ther Drug Carrier Syst. 2004; 21: 97-132; Chang YC, Madkan V, Cook-Norris R, Sra K,
Tyring S. Current and potential uses of imiquimod. South Med J. 2005; 98: 914-20; Wagstaff AJ, Perry CM. Topical imiquimod: a review of its use in the management of anogenital warts, actinic keratoses, basal cell carcinoma and other skin lesions. Drugs. 2007; 67: 2187-210). In addition, imichimod was used to treat malignant skin lesions, including melanoma and basal cell carcinoma (Wagstaff AJ, Perry CM. Topical imiquimod: a review of its use in the management of anogenital warts, actinic keratoses, basal cell carcinoma and other skin lesions. Drugs. 2007; 67: 2187-210). Imichimod induces pro-inflammatory cytokines and chemokines in vitro and in vivo (Chan M, Hayashi T, Kuy CS et al. Synthesis and Immunological Characterization of Toll-Like Receptor 7 Agonistic Conjugates. Bioconjugate chemistry. 2009) which attract immune cells to the local site of administration (Barnetson RS, Satchell A, Zhuang L, Slade HB, Halliday GM. Imiquimod induced regression of clinically diagnosed superficial basal cell carcinoma is associated with early infiltration by CD4 T cells and dendritic cells. Clinical and experimental dermatology, 2004; 29: 639-43).
[0007] In addition, imidazoquinolines have been shown to direct the cytotoxic effect on bladder cancer cells and induce their secretion of proinflammatory cytokines (Smith EB, Schwartz M, Kawamoto H et al. Antitumor effects of imidazochinolines in urothelial cell carcinoma of the bladder. The Journal of urology. 2007; 177: 2347-51). In addition, imidazoquinolines have been reported to have anti-tumor activity in mouse models of orthotopic bladder cancer (Smith EB, Schwartz M, Kawamoto H et al. Antitumor effects of imidazoquinolines in urothelial cell carcinoma of the bladder. The Journal of urology. 2007; 177: 2347-51).
[0008] In addition, TLR-7 has also been shown to be expressed in murine and human bladder cancer cell lines and imidazoquinoline have a strong direct biological effect on urinary tract epithelial cancer cells by reducing cell viability and inducing apoptosis and cytokine production (Smith EB, Schwartz M, Kawamoto H, et al. Antitumour effects of Imidazoquinolines in urothelial cell carcinoma of the bladder. J Urol 2007; 177: 2347). Direct action appears to be the result of down regulation of c-Myc and could interact synergistically with the immunomodulatory effect of imidazoquinolines (Liu H, Schwartz MJ, Hwang DH, Scherr OS. Tumor growth inhibition by an imidazoquinoline is associated with c-Myc down-regulation in urothelial cell carcinoma. BJU Int 2008; 101: 894-901). In addition, initial results in the immunocompetitive, orthotopic mouse model suggested antitumor activity in vivo (Smith EB, Schwartz M, Kawamoto H, et al. Antitumour effects of Imidazoquinolines in urothelial cell carcinoma of the bladder. J Urol 2007; 177: 2347; Liu H , Schwartz MJ, Hwang DH, Scherr OS. Tumor growth inhibition by an imidazoquinoline is associated with c-Myc down-regulation in urothelial cell carcinoma. BJU Int 2008; 101: 894-901). Thus, imidazoquinolines have therapeutic potential as an intravesical agent for bladder cancer.
[0009] Although some beneficial effects of immune modifiers such as imiquimod are known, the ability to provide therapeutic benefit by topical administration of these immune modifiers to treat a particular condition at a particular site can be inhibited by various factors. These factors include the insolubility and / or degradation of these immune modifiers in the formulation before, during or even after administration, but also the physical instability of the formulation, including factors such as separation of ingredients, thickening, deposition / agglomeration of active ingredients, and the like, as well as poor passage of the immune modifier (s) to the surrounding tissue or cells upon administration. In particular, the solubility of the imiquimod immune modifier is critical, and its use in pharmaceutical compositions, in particular, in liquid or semi-liquid compositions is limited due to its hydrophobic properties. Even though imiquimod is soluble at low concentrations in polar organic solvents such as DMSO, dimethylformamide and N-methyl-2-pyrrolidone, such solvents do not allow imiquimod to be administered to or to the human body due to their various toxic effects. However, non-toxic solvents such as water or ethanol solubilize members of the imidazoquinoline (amine) group, such as imiquimod, only slightly, and only allow imiquimod to be administered to or to the human body at low (lower than therapeutic) concentrations.
[0010] Thus, there is a need to provide a pharmaceutical composition, particularly as a liquid or semi-liquid formulation that allows the solubilization of imidazoquinoline (amines), such as imiquimod, to a significant extent, and thus allows higher effective concentrations of immune modifiers such as imiquimod. when administered to a subject in need. Particularly, there is a need in the art to provide such a liquid or semi-liquid formulation in topical administration modes that does not exhibit toxic effects but exhibits improved solubility and preferably reduces the physical instability of the formulation.
[0011] However, the use of immune modifiers, particularly members of the imidazoquinoline (amine) class, such as imiquimod, for the treatment of oncological and viral diseases is also limited by its various side effects. For example, imichimod has been reported to cause, for example, agitation, anemia, angioedema, arrhythmias, capillary leak syndrome, heart failure, cardiomyopathy, cerebrovascular accident, depression, dyspnoea, erythema multiforme, exfoliative dermatitis, Henoch-Schonle's syndrome insomnia, anemia, leukopenia, abnormal liver function, lymphoma, aggravated multiple sclerosis, paralysis, proteinuria, pulmonary edema, seizure, fainting, thrombocytopenia and thyroiditis.
[0012] To reduce the risk of such severe side effects - which can be life-threatening in some cases - it is now generally administered locally rather than systemically. In this context, routes of systemic administration in general include, for example, transdermal, oral, or parenteral routes, including subcutaneous, intravenous, intramuscular, intraarterial, intradermal and intraperitoneal and / or intranasal injection. Such systemic administration typically leads to the general distribution of immune modifiers in the human body, and thus significantly increases the risk of side effects. In contrast, topical routes generally include, for example, topical routes, but also intradermal, transdermal, subcutaneous, or intramuscular or intraocular injection, intracranial, pulmonary, intracardiac and sublingual injections, where such administration typically occurs at the site of disease and allows direct drug action with a significant reduction in systemic side effects that can be expected with systemic administration.
[0013] In the context of the immune modifiers as defined above, in particular imidazoquinoline (amines) such as imiquimod or its derivatives, the specific requirement for topical administration due to the above-mentioned physicochemical properties of these compounds and side effects with systemic administration limits their therapeutic use and the number of diseases which you can treat them. Today, most of the diseases that can be treated with imiquimod or its derivatives are specific skin diseases, including skin cancers such as basal cell carcinoma, disease
Bowen, surface squamous cell carcinoma, as well as genital warts (Condylomata acuminata). Another known disease that can be treated with immune modifiers, in particular imidazoquinoline (amines) such as imichimod, includes bladder diseases, in particular cystic cancer and cystitis.
[0014] In this context, bladder cancer refers to any of several types (malignant or benign) of bladder cancer. It is one of the fastest growing cancers in the world due to the rapid aging of the population in most countries. Every year, more than 60,000 people are diagnosed with bladder cancer for the first time in the US, and 80% of them are non-invasive bladder cancer.
Because the death rate from bladder cancer is relatively low, the total number of patients in the US and Europe is over 400,000. Thus, bladder cancer is the fifth most common malignancy among people in Western society. Most cases of bladder cancer are diagnosed as non-invasive, surface cancers that are potentially cured by surgical therapy and immunotherapy (Schenk-Braat EA, Bangma CH. Immunotherapy for superficial bladder cancer. Cancer Immunol Immunother. , 2005; 54: 414-23).
[0015] Most patients with non-invasive (surface) bladder cancer are treated with so-called "Bacillus Calmette-Guerin (BCG) solutions" which are administered by the intravesical route. However, such BCG solutions are uncharacterised products composed of the attenuated form of Mycobacterium tuberculosis, and therefore have a poor safety profile.
[0016] In addition, surface-growing tumors can be removed by transurethral resection, but the frequency of relapses is high. To extend the tumor-free intervals after chirgic excision, Baccilus20 Calmette-Guerin (BCG) Mycobacterium bovis, a vaccine strain against tuberculosis infection, is currently used as a supportive treatment option (Alexandroff AB, Jackson AM, O'Donnell MA, James K. BCG) immunotherapy of bladder cancer: 20 years on. Lancet. 1999; 353: 1689-94. De Jager R, Guinan P, Lamm D et al. Long-term complete remission in bladder carcinoma in situ with intravesical TICE bacillus Calmette Guerin. Overview analysis of six phase II clinical trials. Urology. 1991; 38: 507-13. Totterman TH, Loskog A, Essand M. The immunotherapy of prostate and bladder cancer. BJU international. , 2005; 96: 72835.) However, BCG M therapy. bovis induces non-specific local cystitis accompanied by various pro-inflammatory cytokines (IL-2, IL-6, IL-8 and TNFa) (De Boer EC,
Rooijakkers SJ, Schamhart DH, Kurth KH. Cytokine gene expression in a mouse model: the first instillations with viable bacillus Calmette-Guerin determine the succeeding Th1 response. The Journal of urology. 2003; 170: 2004-8) and chemokines, which in turn initiate the infiltration of immune cells into the bladder epithelium (Suttmann H, Riemensberger J, Bentien G et al. Neutrophil granulocytes are required for effective Bacillus Calmette8
Guerin immunotherapy of bladder cancer and orchestrate local immune responses. Cancer research. 2006; 66: 8250-7. Simons MP, O'Donnell MA, Griffith TS. Role of neutrophils in BCG immunotherapy for bladder cance. Urologic oncology. 2008; 26: 341-5).
BCG instillation causes non-specific stimulation of the immune system, which induces local infiltration of the bladder wall by activated T cells derived from cell mediated immunity (Bohle A, Brandau S. Immune mechanisms in bacillus Calmette-Guerin immunotherapy for superficial bladder cancer. The Journal of urology. 2003; 170: 964-9).
[0018] The incidence of non-muscle-invasive bladder carcinoma (NMIBC) is high (Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E,
Bohle A, Palou-Redorta J; European Association of Urology (EAU). EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2008; 54: 303-14) and morbidity is even higher due to the high recurrence rate after primary transurethral resection. In patients at high risk of tumor recurrence and / or progression to muscular infiltration, intravesical BCG immunotherapy for at least one year is indicated (Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Bohle A, Palou-Redorta J ; European Association of Urology (EAU). EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2008; 54: 303-14). However, BCG is only partially effective and serious local and systemic side effects may occur (Witjes JA, Palou J, Soloway M,
Lamm 0, Brausi M, Spermon JR, Persad R, Buckley R, Akaza H, Colombel M, Bohle A. Clinical Practice recommendations for the prevention and management of intravesical therapy-associated adverse events. Eur. Urol Suppl 2008; 7: 667-74). Thus, developing new options for intravesical therapy to reduce recurrence and tumor progression
NMIBC remains relevant.
[0019] As a further cystic disease, cystitis is typically cystitis and occurs when the normally sterile lower urinary tract (urethra and bladder) is infected with bacteria and becomes irritated and inflamed. Because of the risk of the infection spreading to the kidneys and due to the high rate of complication in the older population and in diabetics, rapid therapy is almost always recommended. To combat bacterial infection, cystitis is usually treated with antibiotics. Antibiotics usually used for treatment include, for example, nitrofurantoin, trimethoprim sulfamethoxazole, amoxicillin, cephalosporins, ciprofloxacin or levofloxacin and doxycycline. However, such antibiotic therapies often upset the normal balance of intestinal flora, causing diarrhea. In addition, an antibiotic-induced violation of the population of bacteria normally present as components of normal vaginal flora may also occur, which may lead to overgrowth of yeast species of the Candida genus in the vulvovaginal region.
[0020] For such diseases, especially for the treatment of cystic bladder diseases such as non-invasive cancer and / or cystitis, it would be desirable to provide an alternative agent that works by activating the immune system. However, even though immune modifiers as defined above, especially imiquimod or derivatives thereof, may be used to treat these diseases, administration may be inhibited by acute side effects in systemic administration as explained above. In addition, upon local administration, such immune modifiers, particularly imiquimod or its derivatives, are not typically present in a therapeutically effective amount in vivo due to their (pharmaceutically-provocative) physicochemical properties. Such pharmaceutical compositions have also not been described in this field, indicating an important challenge in this field. As one skilled in the art knows, various pharmaceutical aspects should be considered to provide such a specific pharmaceutical composition, such as dose, compatibility with excipient, solubility, stability, sterile manufacturing, scalability, catheter delivery, patient cost and compliance, as well as pharmacological aspects. such as biological activity, membrane permeability, effect durability, low systemic circulation (to avoid systemic side effects) and toxicity profiles. As with many other active agents, providing pharmaceutical compositions containing the desired active agent and releasing the agent so that local drug delivery is assured is one of the major challenges for any pharmacist. In addition, (critical) physico-chemical properties should be taken into account, e.g. imidazoquinoline (amines), in particular the hydrophobicity profile of this class of compound, which (in view of the approaches described in the art) typically leads to insufficient in vivo concentration of the administered immune modifier acting as a TLR-7 ligand.
[0021] Thus, there is an urgent need to provide a pharmaceutical composition suitable for the specific local delivery of immune modifiers as defined above, especially imiquimod or its derivatives, for the treatment of bladder diseases, e.g. by intravesical administration.
[0022] Briefly, as explained above, imiquimod is an active agent effective in the treatment of oncological, viral and inflammatory diseases. However, the use of imidazoquinoline (amines) such as imiquimod and its derivatives in the preparation of a medicament is strictly limited by its solubility characteristics. In addition, imidazoquinoline (amines) such as imiquimod cause various side effects if they are administered systemically. Accordingly, the administration of this agent in a formulation that allows specific delivery of the agent to the target organ by using the appropriate pharmaceutical composition is of the utmost importance. Thus, it would be highly desirable to provide specific pharmaceutical compositions including imidazoquinoline (amines), such as imiquimod, in sufficiently dissolved amounts to provide effective treatment for the diseases mentioned herein. In addition, it would be beneficial if imidazoquinoline (amines), such as imiquimod and its derivatives, were formulated in a suitable formulation for local administration, in particular intravesical administration, for controlling bladder disease, thereby significantly reducing the risk of severe systemic side effects.
[0023] Thus, in accordance with one preferred embodiment of the present invention, the pharmaceutical composition comprises imidazoquinoline (amine) and lactic acid for use in the method of treating bladder diseases according to claim 1.
[0024] For some embodiments, one or more of the following conditions apply:
- topical pharmaceutical compositions are excluded,
- pharmaceutical compositions containing oil are excluded,
- pharmaceutical compositions formulated as w / o (water in oil) or o / w (oil in water) preparations are excluded,
- pharmaceutical compositions formulated as a cream containing 4% by weight of imiquimod (1-isobutyl-1H-imidazo [4,5-c] -quinoline-4-amine) in the oil phase and 1% by weight of lactic acid (85%) are excluded in the water phase,
- pharmaceutical compositions for parenteral administration are excluded,
- pharmaceutical compositions containing glycerin and / or sorbitol are excluded,
- parenteral pharmaceutical compositions containing ce are excluded
1% by weight of 1-isobutyl-1H-imidazo [4,5-c] quinoline-4-amine and / or 1% by weight
1- (2-hydroxy-2-methylpropyl) -1H-imidazo [4,5-c] quinoline-4-amine or N- [4- (4 amino-2-ethyl-1H-imidazo [4,5-c] quinolin-1-yl) butyl] methanesulfonamide and 1% or 2% by weight lactic acid (85%) or 0.6% by weight acetic acid,
- pharmaceutical compositions containing acetic acid and sorbitan myristate monooleate or isopropyl myristate are excluded, and / or
- pharmaceutical compositions containing nanoparticles of chitosan and imiquimod obtained by mixing a solution of chitosan in acetic acid with imiquimod are excluded.
[0025] According to another preferred embodiment of the present invention, the pharmaceutical composition further comprises at least one thermosensitive agent, wherein the at least one thermosensitive agent is preferably selected from chitosan or derivatives thereof, or from a poly (ethylene oxide) -poly (propylene oxide) copolymer ) - poly (ethylene oxide) (also called PEO-PPO-PEO or poloxamer).
[0026] According to another preferred embodiment of the present invention, the at least one thermosensitive agent is selected from chitosan or its derivatives, or from a poly (ethylene oxide) -poly (propylene oxide) -poly (ethylene oxide) copolymer (also called PEO-PPO) -PEO or poloxamer) including Pluronic F 108 Cast Solid Surfacta; Pluronic F 108 Pastille; Pluronic F 108 Prill; Pluronic F 108NF Prill (Poloksamer 338); Pluronic F 127; Pluronic F 127 Prill; Pluronic F 127 NF; Pluronic F 127 NF 500 BHT Prill; Pluronic F 127 NF Prill (Poloksamer 407); Pluronic F 38; Pluronic F 38 Pastille; Pluronic F 68; Pluronic F 68 Pastille; Pluronic F 68 LF Pastille; Pluronic F 68 NF Prill (Poloksamer 188); Pluronic F 68 Prill; Pluronic F 77; Pluronic F 77 Micropastille; Pluronic F 87; Pluronic F 87 NF Prill (Poloksamer 237); Pluronic F 87 Prill; Pluronic F 88 Pastille; Pluronic F 88 Prill; Pluronic F 98; Pluronic F 98 Prill; Pluronic L 10; Pluronic L 101; Pluronic L 121; Pluronic L 31; Pluronic L 35; Pluronic L 43; Pluronic L 44; Pluronic L 44 NF (Poloksamer 124); Pluronic L 61; Pluronic L 62; Pluronic L 62 LF; Pluronic L 62D; Pluronic L 64; Pluronic L 81; Pluronic L 92; the surfactant Pluronic L44 NF INH (Poloksamer 124); Pluronic N 3; Pluronic P 103; Pluronic P 104; Pluronic P 105; the active agent Pluronic P 123; Pluronic P 65; Pluronic P 84; Pluronic P 85; and Poloxamer 403, or is selected from mixtures formed by any two or more of the above defined thermosensitive agents.
[0027] According to another preferred embodiment of the present invention, the at least one thermosensitive agent is selected from a poly (ethylene oxide) -poly (propylene oxide) -poly (ethylene oxide) copolymer (also called PEO-PPO-PEO or poloxamer) including Pluronic F 108 Cast Solid Surfacta; Pluronic F 108 Pastille; Pluronic F 108 Prill; Pluronic F 108NF Prill (Poloksamer 338); Pluronic F 127; Pluronic F 127 Prill; Pluronic F 127 NF; Pluronic F 127 NF 500 BHT Prill; Pluronic F 127 NF Prill (Poloksamer 407); Pluronic F 38; Pluronic F 38 Pastille; Pluronic F 68; Pluronic F 68 Pastille; Pluronic
F 68 LF Pastille; Pluronic F 68 NF Prill (Poloksamer 188); Pluronic F 68 Prill; Pluronic F 77; Pluronic F 77 Micropastille; Pluronic F 87; Pluronic F 87 NF Prill (Poloksamer 237); Pluronic F 87 Prill; Pluronic F 88 Pastille; Pluronic F 88 Prill; Pluronic F 98; Pluronic F 98 Prill; Pluronic L 10; Pluronic L 101; Pluronic L 121; Pluronic L 31; Pluronic L 35; Pluronic L 43; Pluronic L 44; Pluronic L 44 NF (Poloksamer 124); Pluronic L 61; Pluronic L 62; Pluronic L 62 LF; Pluronic L 62D; Pluronic L 64; Pluronic L 81; Pluronic L 92; the surfactant Pluronic L44 NF INH (Poloksamer 124); Pluronic N 3; Pluronic P 103; Pluronic P 104; Pluronic P 105; the active agent Pluronic P 123; Pluronic P 65; Pluronic P 84; Pluronic P 85; and Poloxamer 403, or is selected from mixtures formed by any two or more of the above defined thermosensitive agents.
[0028] In the context of the present invention, the pharmaceutical composition according to the invention comprises as the first component one organic acid selected from lactic acid. Although the "acetic acid" and "lactic acid" organic acids were already known to the person skilled in the art of formulating pharmaceutical compositions in general, the inventors of the present invention have surprisingly found that specifically these short chain carboxylic acids are suitable for the efficient solubilization of imidazoquinoline (amines) or their derivatives, which is a discovery not yet published or discussed in this field. In addition, acetic acid and lactic acid have been found to exhibit significantly better solubilization properties than any other (carboxylic) acid. More specifically and even more surprisingly, acetic acid (CH3COOH) and / or lactic acid (2-hydroxypropionic acid) solubilize imidazoquinoline (amine) 3 to 100 times better than other short-chain (carboxylic) acids, namely phosphoric acid, succinic acid and citric acid.
[0029] These surprising effects are, without being bound by any theory, particularly due to the specific structure of imidazoquinoline (amines) or their derivatives used here, e.g. imiquimod, and the specific interaction of specific acetic acid and lactic acid with the imidazoquinoline (amino) compound, which lead to an unexpected adduct structure. The term "imidazoquinoline (amines)" refers to the general class of imidazoquinolines and more specifically in a preferred embodiment also to the subclass of imidazoquinolines.
[0030] Since imidazoquinoline (amines) or their derivatives used here have a basic functional group, especially an amino moiety, it has been assumed in the literature in the prior art that imidazoquinoline (amines) can be dissolved in any acidic solution at pH values below the pKa of compounds of this class, e.g. in the case of imiquimod, i.e. about 4. However, as demonstrated by the present inventors, the solubility of imidazoquinoline (amines) or their derivatives used herein does not simply depend on the pH of the solution. Without wishing to be bound by theory, these excellent properties seem to be realized by the interaction that occurs between imidazoquinoline (amines) or their derivatives used here and an (organic) acid specifically selected from acetic acid and / or lactic acid, thereby forming specific adducts. between both components. Clearly, this interaction does not appear to occur between imidazoquinoline (amines) or their derivatives used here and any other (organic) acid. Accordingly, it is assumed that the surprising results, particularly the specific excellent characteristics of the solubilization of imidazoquinoline (amines) or their derivatives used here in organic acetic acid and / or lactic acid, seem to depend on specific structural properties that only mean realized by lactic and acetic acid, but not any other (organic) acid. Thus, lactic and / or acetic acid form an anion in the adduct structure and imidazoquinoline (amines) are positively charged cations.
[0031] According to a preferred embodiment of the present invention, the pharmaceutical composition of the invention as defined above comprises an organic acid selected from lactic acid in a concentration of from about 0.025 M to about 0.200 M, preferably in a concentration from about 0.025 M to about 0.100 M or in a concentration of from about 0.100 M to about 0.200 M, or at a concentration from about 0.075 M to about 0.125 M, e.g. at a concentration from about 0.025 M to about 0.200 M, from about 0.030 M to about 0.200 M, from about 0.035 M to about 0.200 M, from about 0.040 M to about 0.200 M, from about 0.045 M to about 0.200 M, from about 0.050 M to about 0.200 M, from about 0.055 M to about 0.200 M, from about 0.060 M to about 0.200 M, from about 0.065 M to about 0.200 M, from about 0.070 M to about 0.200 M, from about 0.075 M to about 0.200 M, from about 0.080 M to about 0.200 M, from about 0.085 to 0 about, 200 M, from about 0.090 M to about 0.200 M, from about 0.095 M to about 0.200 M, from about 0.095 M to about 0.200 M, from about 0.100 M to about 0.200 M, from about 0.125 M to about 0.200 M, from about 0.130 M to about 0.100 M, from about 0.135 M to about 0.1200 M, from about 0.140 M to about 0.1200 M, from about 0.145 M to about 0.1200 M, from about 0.0150 M to about 0.200 M, from about 0.155 M to about 0.200 M, from about 0.160 M to about 0.200 M, from about 0.165 M to about 0.200 M, from about 0.170 M to about 0.200 M, from about 0.175 M to about 0.200 M, from about 0.180 M to about 0.200 M, from about 0.185 M to about 0.200 M, from about 0.190 M to about 0.200 M, or about
0.195 M to about 0.200 M, or preferably at a concentration from about 0.050 M to about 0.100 M, e.g. at a concentration from about 0.055 M to about 0.100 M, from about 0.060 M to about 0.100 M, from about 0.065 M to about 0.100 M , from about 0.070 M to about 0.100 M, from about 0.075 M to about 0.100 M, from about 0.080 M to about 0.100 M, from about 0.085 M to about 0.100 M, from about 0.090 M to about 0.100 M , or from about 0.095 M to about 0.100 M, or at a concentration from about 0.025 M to about 0.100 M, e.g. at a concentration of about 0.025 M to about 0.100 M, from about 0.030 M to about 0.100 M, from about 0.035 M to about 0.100 M, from about 0.040 M to about 0.100 M, from about 0.045 M to about 0.100 M, from about 0.050 M to about 0.100 M, from about 0.055 M to about 0.100 M, from about 0.060 M to about 0.100 M, from about 0.065 M to about 0.100 M, from about 0.070 M to about 0.100 M, from about 0.075 M to about 0.100 M, from about 0.080 M to about 0.100 M, from about 0.085 to 0 about, 200 M, from about 0.090 M to about 0.100 M, from about 0.095 M to about 0.100 M, from about 0.095 M to about 0.100 M, or at a concentration from about 0.100 M to about 0.200 M, e.g. at a concentration of from about 0.100 M to about 0.200 M, from about 0.125 M to about 0.200 M, from about 0.130 M to about 0.200 M, from about 0.135 M to about 0.200 M, from about 0.140 M to about 0.100 M, from about 0.145 M to about 0.100 M, from about 0.0150 M to about 0.200 M, from about 0.155 M to about 0.200 M, from about 0.160 M to about 0.200 M, from about 0.165 M to about 0.200 M, from about 0.170 M to about 0.200 M, from about 0.175 M to about 0.200 M, from about 0.180 M to about 0.200 M, from about 0.185 M to about 0.200 M, from about 0.190 M to about 0.200 M, or about 0.195 M to about 0.200 M, or at a concentration from about 0.075 M to about 0.125 M, e.g. from about 0.08 M to about 0.125 M, from about 0.085 M to about 0.125 M, from about 0.09 M to about 0.125 M, from about 0.095 M to about 0.125 M, from about 0.1 M to about 0.125 M , or from about 0.075 M to about 0.120 M, from about 0.075 M to about 0.115 M, from about 0.075 M to about 0.110 M, from about 0.075 M to about 0.105 M, from about 0.075 M to about 0.105 M or from about 0 , 08 M to about 0.120 M, e.g. from about 0.085 M to about 0.115 M, from about 0.09 M to about 0.110 M, from about 0.095 M to about 0.105 M, or about 0.1 M. In this context, it has been shown that the amount of dissolved imidazoquinoline (amines) or their derivatives used here in solution is directly related to the acid concentration, i.e. lactic acid concentration. Accordingly, higher concentrations of lactic acid may be preferred for dissolution, preferably within the ranges defined above.
[0032] The pharmaceutical composition may include only lactic acid as the organic acid components, however at least one additional inorganic acid may be included in the pharmaceutical composition according to the invention, e.g. phosphoric acid,
HCl etc.
[0033] According to another specific embodiment of the present invention, the pharmaceutical composition of the invention as defined herein includes only lactic acid as the acid component, preferably having a lactic acid concentration as defined above for the pharmaceutical composition of the invention in general from about 0.025 M to about 0.200 M or from about 0.075 M to about 0.125 M or any further concentration as defined above. In this particular embodiment, it is even more preferred that the pharmaceutical composition of the invention as described above does not contain any acid other than lactic, organic or inorganic acid.
In this context, the present inventors have surprisingly found that lactic acid is even more effective in solubilizing imidazoquinoline (amines) or their derivatives used here than acetic acid. Surprisingly, lactic acid is twice as effective in solubilizing imidazoquinoline (amines) or their derivatives used here than acetic acid. It has also been found that the solubility of imidazochinoline (amines) or their derivatives used herein in lactic acid is not increased by the addition of surfactants, such as Tween or Pluronic, which usually act as solubilization enhancers in pharmaceutical compositions. This finding suggests that imidazoquinoline (amines) or their derivatives used here are not captured in micelles formed by surfactants, and thus supports the assumption that these imidazoquinoline (amines) interact with lactic acid by forming specifically structured adducts.
[0034] According to another specific embodiment of the present invention, the pharmaceutical composition of the invention as defined herein comprises lactic acid at a concentration of from about 0.075 M to about 0.125 M, e.g. from about 0.08 M to about 0.125 M, from about
0.085 M to about 0.125 M, from about 0.09 M to about 0.125 M, from about 0.095 M to about 0.125 M, from about 0.1 M to about 0.125 M, or from about 0.075 M to about 0.120 M, from about 0.075 M to about 0.115 M, from about 0.075 M to about 0.110 M, from about 0.075 M to about 0.105 M, from about 0.075 M to about 0.105 M or from about 0.08 M to about 0.120 M, e.g. from about 0.085 M to about 0.115 M, from about 0.09 M to about 0.110 M, from about 0.095 M to about 0.105 M, or about 0.1 M.
[0035] According to another specific embodiment of the present invention, the pharmaceutical composition of the invention as defined herein typically has a pH of from about 3 to about 8, preferably from about 3 to about 7, more preferably from about 3 to about 6, even more preferably from about 3 to about 5, and most preferably a pH from about 3.5 to about 4, including a pH in the range of from about 3.5 to about 4.9, from about 3.5 to about 4.8, from about 3.6 to about 4.7, from about 3.6 to about 4.6, from about 3.7 to about 4.5, from about 3.7 to about 4.4, from about 3.8 to about 4.3, from about 3.8 to about 4.2, or from about 3.9 to about 4.1. The pharmaceutical composition of the invention may be prepared and administered at the pH value as defined above. If necessary, the pH may also be adjusted for the particular therapy and administration requirements, e.g. to a more neutral pH value of about 5, 6, or 7 (pH 5 to 7), e.g. using the buffers and additives disclosed herein.
[0036] According to one particular embodiment, the pharmaceutical composition of the invention comprises imidazoquinoline (amines) selected from having the following formula (I):
<img file="PL2393474T3_D0001.tif" />
wherein
R<sup>1</sup>, R<sup>2</sup>, and R<sup>3</sup> is independently selected from hydrogen; cyclic alkyl having three, four or five carbon atoms; straight or branched chain alkyl containing one to about ten carbon atoms and substituted straight or branched chain alkyl containing one to about ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to about six carbon atoms and a cycloalkyl containing three to about six carbon atoms substituted with straight or branched chain alkyl containing one to about four carbon atoms; fluoro or chloroalkyl containing from one to about ten carbon atoms and one or more fluorine or chlorine atoms; straight or branched chain alkenyl containing two to about ten carbon atoms and substituted straight or branched chain alkenyl having two to about ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to about six carbon atoms and a cycloalkyl containing three to about six carbon atoms substituted with straight or branched chain alkyl containing one to about four carbon atoms; hydroxyalkyl having one to about six carbon atoms; alkoxyalkyl, wherein the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about six carbon atoms; acyloxyalkyl, wherein the acyloxy moiety is an alkanoyloxy having two to about four carbon atoms or benzoyloxy, and the alkyl moiety contains one to about six carbon atoms, provided that no such alkyl, substituted alkyl, alkenyl, substituted alkenyl, hydroxyalkyl, alkoxyalkyl, or group acyloxyalkyl does not have a carbon atom fully substituted carbon directly linked to the nitrogen atom; benzyl; (Phenyl) ethyl; and phenyl; wherein the benzyl, (phenyl) ethyl or phenyl substituent is optionally substituted on the benzene ring with one or two moieties independently selected from the group consisting of alkyl having one to about four carbon atoms, alkoxy having one to about four carbon atoms, and halogen , provided that when this benzene ring is substituted with two such moieties, those moieties together contain no more than six carbon atoms;
-CHRxRy, in which Ry is hydrogen or a carbon-carbon bond, provided that when Ry is hydrogen, Rx is alkoxy having one to about four carbon atoms, hydroxyalkoxy having one to about four carbon atoms, 1-alkynyl may two to about ten carbon atoms, tetrahydropyranyl, alkoxyalkyl, wherein the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about four carbon atoms, 2-, 3-, or 4-pyridyl, and with a further condition that when Ry is a carbon-carbon bond, Ry and Rx together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from the group consisting of hydroxyl or hydroxyalkyl having one to about four carbon atoms;
straight or branched chain alkyl containing one to about eight carbon atoms, straight or branched chain hydroxyalkyl containing one to about six carbon, morpholinomethyl, benzyl, (phenyl) ethyl and phenyl atoms with the benzyl, (phenyl) ethyl substituent or phenyl is optionally substituted on the benzene ring with a moiety selected from the group consisting of methyl, methoxy, or halogen;
-C (RS) (RT) (X) wherein RS and RT are independently selected from the group consisting of hydrogen, alkyl having one to about four carbon atoms, phenyl, and substituted phenyl, where the substituent is selected from the group consisting of alkyl up to about four carbon atoms, alkoxy having one to about four carbon atoms, and halogen;
X is alkoxy containing one to about four carbon atoms, alkoxyalkyl, where the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about four carbon atoms, a haloalkyl having one to about four carbon atoms, an alkylamide group alkyl contains one to about four carbon atoms, amino group, substituted amino group, wherein the substituent is alkyl or hydroxyalkyl having one to about four carbon atoms, an azido group, an alkylthio group having one to about four carbon atoms, or morpholinoalkyl, wherein the alkyl moiety contains one to about four carbon atoms;
is hydrogen, C1-8 alkyl, C1-8 alkoxy, or halogen;
is 1, 2, 3, or 4;
are independently hydrogen, (C1-C6) alkyl, hydroxy (C1-C6) alkyl, amino (C1-C6) alkyl, aminosulfonyl, (C1-C6) alkanoyl, aryl, or benzyl, all optionally substituted with one or more groups amino; or R<sup>and</sup> and R<sup>b</sup> together with the nitrogen atom to which they are attached form a pyrrolidine, piperidine or morpholine group; the dashed lines in the five-membered ring of formula (I) above denote an optional bond connecting the nitrogen atom of the five-membered ring to the carbon atom between the two nitrogen atoms of the five-membered ring, and when the bond occurs, or R<sup>1</sup>or R<sup>3</sup> do not occur;
provided that R<sup>and</sup> and R<sup>b</sup> together, they allow the formation of a quaternary ammonium ion or on the nitrogen atom of the central element of the N structure (R<sup>and</sup>) (R<sup>b</sup>) or thanks to any quaternary ammonium ion supplied by R<sup>and</sup> and / or R<sup>b</sup>;
or a pharmaceutically acceptable salt thereof. A pharmaceutically acceptable salt within the meaning of the present invention typically refers to a lactic acid salt.
[0037] According to one embodiment, the pharmaceutical composition of the invention comprises as imidazoquinoline (amine) a specific compound, imiquimod, preferably having the specific formula 1-isobutyl-1H-imidazo [4,5-c] quinoline-4-amine, even more preferably having the following specific structure:
<img file="PL2393474T3_D0002.tif" />
[0038] According to one embodiment, the pharmaceutical composition of the invention comprises as imidazoquinoline (amine) a specific compound 1H-imidazo [4,5-c] quinoline-410 amine.
[0039] In the context of imidazoquinoline (amines) or their derivatives as defined above, the following further definitions may preferably apply:
• In formulas containing an integer n where n can be zero, one, 15 or two, n is preferably zero or one.
• R11-R17 substituents above are generally referred to herein as "substituents-1". In one embodiment, the -1 substituents are preferably alkyl having one to six carbon atoms and hydroxyalkyl containing one to six carbon atoms, e.g., substituent-1 is 2-methylpropyl or 2-hydroxy-2-methylpropyl.
• R21-R27 substituents above are generally referred to herein as "2-substituents". In one embodiment, the -2 substituents are preferably hydrogen, alkyl having one to six carbon atoms, alkoxyalkyl, wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, and hydroxyalkyl having one to four carbon atoms, e.g., substituent-2 is hydrogen, methyl, butyl, hydroxymethyl, ethoxymethyl or methoxyethyl.
• The term "alkyl" preferably includes straight or branched C 1-10 alkyl groups, e.g., methyl, ethyl, propyl, butyl, pentyl, isopropyl, isobutyl, 1-methylpropyl, 3-methylbutyl, hexyl, and the like.
• The term "lower alkyl" preferably includes straight or branched C 1-6 alkyl groups, e.g., methyl, ethyl, propyl, 1-methylethyl, butyl, 1-methylpropyl, 2-methylpropyl, 1,1-dimethylethyl, pentyl, 1 -methylbutyl, 2-methylbutyl, 3-methylbutyl, 1,1-dimethylpropyl, 1,2-dimethylpropyl, 2,2-dimethylpropyl, and the like.
• The term "alkylene" preferably refers to a divalent straight or branched hydrocarbon chain (eg, ethylene -CH2-CH2-).
• The term "C3-7 cycloalkyl" preferably includes groups such as cyclopropyl, cyclopentyl, cyclohexyl, cycloheptyl and the like, and an alkyl substituted C3-7 cycloalkyl group, preferably a straight or branched C1-6 alkyl group such as methyl, ethyl, propyl, butyl or pentyl, and a C5-7 cycloalkyl group such as cyclopentyl or cyclohexyl, and the like.
• The term "lower alkoxy" preferably includes C1-6 alkoxy groups such as methoxy, ethoxy or propoxy, and the like.
• The term "lower alkanoyl" preferably includes C 1-6 alkanoyl groups such as formyl, acetyl, propanoyl, butanoyl, pentanoyl or hexanoyl, and the like.
• The term "C7-11 aroyl" includes groups such as benzoyl or naphthyl;
• The term "lower alkoxycarbonyl" preferably includes C 2-7 alkoxycarbonyl groups such as methoxycarbonyl, ethoxycarbonyl or propoxycarbonyl, and the like.
• The term "lower alkylamino" preferably means an amino group substituted with a C 1-6 alkyl group, such as methylamino, ethylamino, propylamino, butylamino, and the like.
• The term "di (lower alkyl) amino group" preferably means an amino group substituted with the same or different C 1-6 alkyl group (eg dimethylamino, diethylamino, ethylmethylamino).
• The term "lower alkylcarbamoyl" preferably means a carbamoyl group substituted with a C 1-6 alkyl group (eg, methylcarbamoyl, ethylcarbamoyl, propylcarbamoyl, butylcarbamoyl).
• The term "di (lower alkyl) carbamoyl group" preferably means a carbamoyl group substituted with the same or different C 1-6 alkyl group (eg, dimethylcarbamoyl, diethylcarbamoyl, ethylmethylcarbamoyl).
• The term "halogen" as defined herein preferably means a halogen atom such as a fluorine atom, chlorine atom, bromine atom or iodine atom.
• The term "aryl" as defined herein preferably refers to a C6-10 monocyclic or fused cyclic aryl group such as phenyl, indenyl or naphthyl, and the like.
• The term "heterocyclic" as defined herein preferably refers to monocyclic saturated heterocyclic groups, or unsaturated monocyclic or fused heterocyclic group containing at least one heteroatom, e.g., 0-3 nitrogen atoms, 0-1 oxygen atom (-O-), and 0-1 sulfur atom (-S-). In this context, non-limiting examples of a saturated monocyclic heterocyclic group include a 5 or 6-membered saturated heterocyclic group such as tetrahydrofuranyl, pyrrolidinyl, morpholinyl, piperidyl, piperazinyl or pyrazolidinyl. Non-limiting examples of the unsaturated monocyclic heterocyclic group include a 5 or 6-membered unsaturated heterocyclic group such as furyl, pyrrolyl, pyrazolyl, imidazolyl, thiazolyl, thienyl, pyridyl or pyrimidinyl. Non-limiting examples of unsaturated condensed heterocyclic groups include unsaturated bicyclic heterocyclic groups such as indolyl, isoindolyl, quinolyl, benzothiazolyl, chromanyl, benzofuranyl, and the like.
In addition, alkyl, aryl, and heterocyclic groups as defined herein may be optionally substituted with one or more substituents, wherein the substituents are the same or different and include lower alkyl; C1-6 alkoxy such as methoxy, ethoxy or propoxy; carboxyl; C2-7 alkoxycarbonyl, such as methoxycarbonyl, ethoxycarbonyl or propoxycarbonyl) and halogen; cycloalkyl and include C3-6 cycloalkyl; hydroxy; C1-6 alkoxy; amino group; cyano group; aryl; substituted aryl, such as 4-hydroxyphenyl, 4-methoxyphenyl, 4-chlorophenyl or 3,4-dichlorophenyl; nitro group and halogen, hydroxyl; hydroxy C1-6 alkylene, such as hydroxymethyl, 2-hydroxyethyl or 3-hydroxypropyl; lower alkoxy; C1-6 alkoxy C1-6 alkyl, such as 2-methoxyethyl, 2-ethoxyethyl or 3-methoxypropyl; amino group; alkylamino; dialkylamino; cyano group; nitro group; acyl; carboxyl;
lower alkoxycarbonyl; halogen; mercapto group; a C1-6 alkylthio group such as a methylthio, ethylthio, propylthio or butylthio group; substituted C1-6 alkylthio, such as methoxyethylthio, methylthioethylthio, hydroxyethylthio or chloroethylthio; aryl; substituted C6-10 monocyclic or fused-cyclic aryl such as 4-hydroxyphenyl, 4-methoxyphenyl, 4-fluorophenyl, 4-chlorophenyl or 3,4-dichlorophenyl; A 5-6 membered unsaturated heterocycle such as furyl, pyrrolyl, pyrazolyl, imidazolyl, thiazolyl, thienyl, pyridyl or pyrimidinyl; and bicyclic unsaturated heterocycle such as indolyl, isoindolyl, quinolyl, benzothiazolyl, chromanyl, benzofuranyl or a phthalimino group. In addition, the heterocyclic ring as defined herein may be optionally substituted with one or more substituents, wherein the substituents are the same or different and include C1-6 alkyl; hydroxy C1-6 alkylene; C1-6 alkoxy
C1-6 alkylene; hydroxy; C1-6 alkoxy; and a cyano group.
[0040] Finally, those skilled in the art will understand that imidazoquinoline (amines) as defined above in the context of the present invention may also have a chiral center and may be secreted in optically active and racemic forms. Certain compounds may exhibit polymorphism. It is to be understood that the present invention includes any racemic, optically active, polymorphic or stereoisomeric form, or mixtures thereof, imidazoquinoline (amines) or derivatives thereof as defined above which exhibits useful properties described herein, and it is well known in the art how to prepare optically active forms (for example, by resolution of the racemic form by recrystallization techniques, by synthesis from optically active substrates, by chiral synthesis, or by chromatographic separation using a chiral stationary phase), and how to determine nicotine agonist activity using standard assays described herein, or using other similar assays that are well known in the art. [0041] In one embodiment, the pharmaceutical composition of the present invention typically includes imidazoquinoline (amine) or a derivative thereof as defined herein, preferably imiquimod or a derivative thereof, in an amount of from about 0.005% (w / v) to about 5% (w / w) / vol), preferably in an amount of from about 0.01% (w / v) to about 5% (w / v), more preferably in an amount of about 0.1% (w / v) up to about 4% (w / v), even more preferably in an amount from about 0.1% (w / v) to about 3% (w / v), further more preferably in an amount from about 0.2% (w / v) to about 2 % (w / v), and most preferably in an amount from about 0.2% (w / v) to about 1% (w / v) or even in an amount from about 0.5% (w / v) / vol) up to about 1% (w / v), where the amounts defined in% (w / v) can be determined on the basis of the weight of imidazoquinoline (amine) or its derivative, as defined here, preferably imiquimod or a derivative thereof, relative to the total volume of the pharmaceutical composition according to the invention, when e.g. it is provided as a liquid or semi-liquid preparation. Alternatively, the above amounts may be defined in% (w / w), where the amount as defined in% (w / w) may be determined based on the weight of imidazoquinoline (amine) or a derivative thereof as defined above, preferably imiquimod or a derivative thereof relative weight of the pharmaceutical composition of the invention.
[0042] According to one particular preferred embodiment, the pharmaceutical composition of the present invention typically includes imidazoquinoline (amine) or a derivative thereof as defined herein, preferably imiquimod or a derivative thereof, in an amount of from about 0.005% (w / v) to about 1 , 2, 3, 4, or 5% (w / v), in an amount from about 0.01% (w / v) to about 1, 2, 3, 4, or 5% (w / v) vol.), in an amount from about 0.1% (w / v) to about 1, 2, 3, 4, or 5% (w / v), in an amount of from about 0.2% (w / v) to about 1, 2, 3, 4, or 5% (w / v), in an amount from about 0.3% (w / v) ) to about 1, 2, 3, 4, or 5% (w / v), in an amount from about 0.4% (w / v) to about 1, 2, 3, 4, or 5% (w / v) in an amount from about 0.5% (w / v) to about 1, 2, 3, 4, or 5% (w / v) in an amount from about 0, 6% (w / v) to about 1, 2, 3, 4, or 5% (w / v), in an amount from about 0.7% (w / v) to about 1, 2 , 3, 4, or 5% (w / v), in an amount from about 0.8% (w / v) to about 1, 2, 3, 4, or 5% (w / v), in an amount from about 0.9% (w / v) ) to about 1, 2, 3, 4, or 5% (w / v), in an amount from about 1.0% (w / v) to about 2, 3, 4, or 5% (w / v) / vol), in an amount from about 1.1% (w / v) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.2% (w / v) / vol) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.3% (w / v) to about 2, 3, 4, or 5% (w.) in an amount from about 1.4% (w / v) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.5% (w / v) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.6% (w / v) to about 2, 3, 4, or 5% (w / v) ), in an amount from about 1.7% (w / v) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.8% (w / v) ) to about 2, 3, 4, or 5% (w / v), in an amount from about 1.9% (w / v) to about 2, 3, 4, or 5% (w / v) by volume), in an amount from about 2.0% (w / v) to about 3, 4, or 5% (w / v), in an amount from about 2.1% (w / v) to about 3, 4, or 5% (w / v), in an amount of about 2 , 2% (w / v) to about 3, 4, or 5% (w / v), in an amount from about 2.3% (w / v) to about 3, 4, or 5% (w / v), in an amount of approximately 2.4% (w / v) to about 3, 4, or 5% (w / v), in an amount of about 2 , 5% (w / v) to about 3, 4, or 5% (w / v), in an amount from about 2.6% (w / v) to about 3, 4, or 5 % (w / v), in an amount from about 2.7% (w / v) to about 3, 4, or 5% (w / v), in an amount from about 2.8% (w / v) to about 3 , 4, or 5% (w / v), from about 2.9% (w / v) to about 3, 4, or 5% (w / v), from about 3.0% (w / v) to about 4, or 5% (w / v), in an amount from about 3.1% (w / v) to about 4, or 5% (w / v) / vol), in an amount from about 3.2% (w / v) to about 4, or 5% (w / v), in an amount from about 3.3% (w / v). ) up to about 4 or 5% (w / v), in an amount from about 3.4% (w / v) to about 4, or 5% (w / v), in an amount from about 3.5% (w / v) to about 4, or 5% (w / v), in an amount from about 3.6% (w / v) to about 4, or 5% (w / v), in an amount from about 3.7 % (w / v) to about 4, or 5% (w / v), in an amount from about 3.8% (w / v) to about 4, or 5% (w / v) ), in an amount from about 3.9% (w / v) to about 4, or 5% (w / v), in an amount from about 4.0% (w / v) to about 5% (w / v), in an amount from about 4.1% (w / v) to about 5% (w / v), in an amount from about 4.2% (w / v) to about 5% (w / v) by volume from about 4.3% (w / v) to about 5% (w / v), from about 4.4% (w / v) to about 5% (w / v) in an amount from about 4.5% (w / v) to about 5% (w / v), in an amount from about 4.6% (w / v) up to about 5% (w / v), in an amount from about 4.7% (w / v) to about 5% (w / v), in an amount from about 4.8% (w / v) / volume) up to about 5% (w / v), or in an amount from about 4.9% (w / v) to about 5% (w / v). The above values can also be determined in% (w / w). Both the terms "% (w / v)" and "% (w / w)" are preferably as defined above.
[0043] According to another specific preferred embodiment, the pharmaceutical composition of the present invention typically includes imidazoquinoline (amine) or a derivative thereof as defined herein, preferably imiquimod or a derivative thereof, in an amount of from about 0.1% (w / v) to about 1% (w / v).
[0044] According to one further particular preferred embodiment, the pharmaceutical composition of the present invention typically comprises imidazoquinoline (amine) or a derivative thereof as defined herein, preferably imiquimod or a derivative thereof, in an amount from about 0.005% (w / v) to about 0 , 5% (w / v), in an amount from about 0.01% (w / v) to about 0.5% (w / v), in an amount from about 0.1% (w / v) . / volume) to about 0.6% (w / v), in an amount from about 0.2% (w / v) to about 0.7% (w / v), in an amount from about 0.3% (w / v) to about 0.8% (w / v), in an amount from about 0.4% (w / v) to about 0.9% (w / v), in an amount from about 0.5% (w / v) to about 1.0% (w / v), in an amount from about 0.6% (w / v) ) up to about 1.1% (w / v), in an amount from about 0.7% (w / v) to about 1.2% (w / v), in an amount from about 0 , 8% (w / v) to about 1.3% (w / v), in an amount from about 0.9% (w / v) to about 1.4% (w / v) .) in an amount from about 1.1% (w / v) to about 1.5% (w / v), in an amount from about 1.2% (w / v) to about 1.6% (w / v), in an amount from about 1.3% (w / v) to about 1.7% (w / v), in an amount from about 1.4% (w / v) ) up to about 1.8% (w / v), in an amount from about 1.5% (w / v) to about 1.9% (w / v), in an amount from about 1 , 6% (w / v) to about 2.0% (w / v), in an amount from about 1.7% (w / v) to about 2.1% (w / v) .) in an amount from about 1.8% (w / v) to about 2.2% (w / v), in an amount from about 1.9% (w / v) to about 2.3% (w / v), in an amount from about 2.0% (w / v) to about 2.5% (w / v), in an amount from about 2.1% (w / v) ) up to about 2.6% (w / v) in an amount from about 2.2% (w / v) to about 2.7% (w / v) in an amount of about 2 , 3% (w / v) to about 2.8% (w / v), in an amount from about 2.4% (w / v) to about 2.9% (w / v) .) in an amount from about 2.5% (w / v) to about 3.0% (w / v), in an amount from about 2.6% (w / v) to about 3.1% (w / v), in an amount from about 2.7% (w / v) to about 3.2% (w / v), in an amount from about 2.8% (w / v) ) up to about 3.3% (w / v), in an amount from about 2.9% (w / v) to about 3.4% (w / v), in an amount from about 3 , 0% (w / v) to about 3.5% (w / v), in an amount from about 3.1% (w / v) to about 3.6% (w / v) .) in an amount from about 3.2% (w / v) to about 3.7% (w / v), in an amount from about 3.3% (w / v) to about 3.8% (w / v), in an amount from about 3.4% (w / v) to about 3.9% (w / v), in an amount from about 3.5% (w / v) ) up to about 4.0% (w / v) in an amount from about 3.6% (w / v) to about 4.1% (w / v) in an amount of about 3 , 7% (w / v) to about 4.2% (w / v), in an amount from about 3.8% (w / v) to about 4.3% (w / v) .) in an amount from about 3.9% (w / v) to about 4.4% (w / v), in an amount from about 4.0% (w / v) to about 4.5% (w / v), in an amount from about 4.1% (w / v) to about 4.6% (w / v), in an amount from about 4.2% (w / v) ) to about 4.7% (w / v), in an amount from about 4.3% (w / v) to about 4.8% (w / v), in an amount from about 4 , 4% (w / v) to about 4.9% (w / v), or in an amount from about 4.5% (w / v) to about 5.0% (w / v) vol.). The above values can also be determined in% (w / w). Both the terms "% (w / v)" and "% (w / w)" are preferably as defined above.
[0045] For the preparation of a pharmaceutical composition according to the invention, e.g. when preparing a (stock) solution during the production of a pharmaceutical composition according to the invention, however, imidazoquinoline (amine) or a derivative thereof as defined herein can be dissolved in such (stock) aqueous solution comprising acid lactic acid as defined above typically at a higher concentration as indicated above to give the final pharmaceutical composition of the invention. For this purpose, the (stock) solution may contain an amount from about 0.005% (w / v) or 0.01% (w / v) to about 30% (w / v), preferably an amount from about 0.005% (w / v) 1% (w / v) to about 25% (w / v), more preferably from about 5% (w / v) to about 25% (w / v), even more preferably from about 10% (w / v) to about 25% (w / v), and most preferably an amount from about 15% (w / v) to about 20 or 25% (w / v) imidazoquinoline (amine) or its derivative as defined here. The above values can alternatively be understood as% (w / w). These percentages "% (w / v)" and "% (w / w)" are preferably as defined above.
[0046] According to another embodiment, the pharmaceutical composition of the invention may also comprise additives or further ingredients. Preferably, such additives or further ingredients increase the solubility and / or penetration of the imidazoquinoline (amine) membrane or derivative thereof as defined herein in the pharmaceutical composition of the invention. Alternatively or additionally, such additives or further ingredients allow providing a more suitable formulation for the particular disease being treated, confer better tolerance to the pharmaceutical composition of the invention, etc.
[0047] According to a specific embodiment, the pharmaceutical composition of the invention may include cyclodextrins, which are also referred to as cycloamylose. As the inventors of the present invention have surprisingly found, cyclodextrins can be used to increase the solubility, preferably the penetration of the imidazoquinoline (amine) membrane or its derivative, as defined herein, in the pharmaceutical composition of the invention, even if the imidazoquinoline (amine) or its derivative may not be sufficiently dissolved by cyclodextrins alone. In this context, the solubility of imidazoquinoline (amine) or a derivative thereof as defined herein is not only increased in the final pharmaceutical composition of the invention using cyclodextrins, but also the intermediate (basic) solution formed by imidazoquinoline (amine) or a derivative thereof as defined herein and organic acid as defined above, lactic acid. Particularly, it was an unexpected finding in the light of the state of the art that cyclodextrin in combination with lactic acid leads to a small but significant increase in the solubility of imidazoquinoline (amine) or its derivative, especially imiquimod, by at least 10%, more preferably by at least 15% or at least about 18% compared to the solubility of the therapeutically active agent in combination with lactic acid alone. Accordingly, cyclodextrins can be used at any stage in the manufacture of the pharmaceutical composition to increase the solubility of imidoquinoline (amine) or a derivative thereof as defined herein. In the context of the present invention, cyclodextrins are preferably understood as being members of a cyclic oligosaccharide family of 5 or more α-D-glucopyranoside units linked between positions 1 and 4, as is known for amylose, a starch fragment. In the context of the present invention, cyclodextrins particularly include α-cyclodextrins, which form six-membered sugar ring molecules, which form ring molecules of seven sugars, which form ring molecules of eight sugars, δcyclodextrin and ε-cyclodextrin. Particularly preferably, the pharmaceutical composition of the invention includes α-cyclodextrin, β-cyclodextrin, and / or γ-cyclodextrin, α-cyclodextrin, β-cyclodextrin, γ-cyclodextrin, even more preferably, β-cyclodextrin, such as hydroxypropyl-e-cyclodextrin ( HP-βCD).
[0048] Surprisingly, the incorporation of HPeCD into the pharmaceutical formulation of the invention improved physical stability, leading to a transparent homogeneous solution.
[0049] According to a particularly preferred embodiment, the pharmaceutical composition of the invention as defined above may comprise cyclodextrins as defined above in an amount from about 0.1% (w / v) to about 30% (w / v), typically in an amount from about 1% (w / v) to about 20% (w / v), preferably in an amount from about 2% (w / v) to about 20% (w / v) , more preferably in an amount from about 5% (w / v) to about 20% (w / v), even more preferably in an amount from about 5% (w / v) to about% (w / v), and most preferably in an amount from about 10% (w / v) to about 15% (w / v) ), or in an amount from about 0.1% (w / v) to about 4% (w / v), 0.1 to 2%, more preferably in an amount of 0.5 to 2% or, alternatively , in an amount from about 2% (w / v) to about 6% (w / v), in an amount from about 4% (w / v) to about 8% (w / v) , in an amount from about 6% (w / v) to about 10% (w / v), in an amount from about 8% (w / v) to about 12% (w / v), in an amount from about 10% (w / v) to about 14% (w / v), in an amount from about 12% (w / v) to about 16% (w / v), in an amount from about 14% (w / v) to about 18% (w / v), in an amount from about 16% (w / v) to about 20% (w / v), in an amount from about 18% (w / v) to about 22% (w / v), in an amount from about 20% (w / v) to about 24% (w / v), in an amount from about 22% (w / v) to about 26% (w / v) . in an amount from about 24% (w / v) to about 28% (w / v), or in an amount from about 26% (w / v) to about 30% (w / v) , wherein the amounts defined in% (w / v) can be understood as based on the weight of the cyclodextrin relative to the total volume of the pharmaceutical composition according to the invention or the intermediate stock solution, e.g. when provided as a liquid or semi-liquid formulation. Alternatively, the above amounts can be defined in% (w / w), where the amount as defined in% (w / w) can be determined based on the weight of the cyclodextrin relative to the total weight of the pharmaceutical composition according to the invention or on the basis of the intermediate stock solution.
[0050] According to another particularly preferred embodiment, the pharmaceutical composition of the invention as defined above may comprise cyclodextrins as defined above in an amount of from about 2% (w / v) to about 6% (w / v), e.g. from about 2.5% (w / v) to about 6% (w / v), from about 3% (w / v) to about 6% (w / v), from about 3.5% (w / v) to about 6% (w / v), from about 4% (w / v) to about 6% (w / v), from about 4, 5% (w / v) to about 6% (w / v), or from about 2.5% (w / v) to about 5.5% (w / v), about 3% (w / v) to about 5.5% (w / v), from about 3.5% (w / v) to about 5.5% (w / v), from about 4% (w / v) to about 5.5% (w / v), from about 4.5% (w / v) to about 5.5% (w / v), or about 5% (w / v).
[0051] According to another particularly preferred embodiment, particularly for certain forms of administration and application, the pharmaceutical composition of the present invention further comprises at least one thermosensitive agent. In the context of the present invention, the term "thermosensitive" typically refers to a compound, preferably a polymer, which can change the aggregation state or viscosity at a defined transition (joint transition) point from a liquid or semi-liquid state to a solid or semi-solid state, preferably to a solid state. More preferably the term "thermosensitive" typically refers to a compound, preferably (organic) polymer, which can change its aggregation state from a liquid or semi-liquid state to a solid or semi-solid state (e.g. from liquid to gel-like or solid) at a specific transition point (also called "lower critical solution temperature" (LCST) or "gel transition temperature"), wherein the specific transition point is preferably defined by a specific transition temperature in the range from about 15 ° C to about 35 ° C, more preferably in the range of about 15 ° C to about 30 ° C, even more preferably in the range of about 15 or 20 ° C to about 30 ° C, most preferably in the range of from about 15 or 20 ° C to about 25 ° C. The "lower critical solution temperature" of the present invention is measured at ambient pressure and depends on the molecular weight distribution of the thermosensitive agent. Preferably, such a thermosensitive agent as defined above allows the gel to form in situ the thermosensitive agent and any mixture or composition formulated therefrom, e.g. the pharmaceutical composition of the invention at body temperature, while the pharmaceutical composition typically has (semi) liquid properties. In this context, gel formation in situ of the thermosensitive agent and any mixture or composition formulated therewith typically occurs immediately upon or immediately after administration of the pharmaceutical composition of the invention to the diseased site of the patient being treated, i.e. not before administration of the pharmaceutical composition of the invention. This in situ gel formation is particularly beneficial for specific applications where the release of imidazoquinoline (amine) or a derivative thereof is to take place from a pharmaceutical composition as defined herein for a long time. Such applications are usually directed to placing the formulation in a body cavity, e.g., tissue or organ such as bladder, and may therefore be particularly suitable, e.g., for intra-bladder administration in the treatment of bladder disease.
[0052] One particular benefit of the pharmaceutical composition of the present invention comprising thermosensitive agents is its ease of administration by choosing a transition point within the temperature range as defined above. More specifically, choosing a transition point within the temperature range as defined above allows not only the production or storage of the pharmaceutical composition of the invention in a liquid or semi-liquid aggregate state. It also allows the (preferably liquid) pharmaceutical composition of the invention to be administered by, e.g., injection, because the pharmaceutical composition of the invention directly solidifies or undergoes gelation upon administration due to an increased temperature of the surrounding tissue or organ, which is preferably higher than the transition point temperature. Accordingly, gel formation is induced within a tissue or organ. Administration can thus be carried out using non-invasive methods (without surgery), such as using an injection needle having a tube of suitable diameter, injection tubes, endoscopic methods, etc. Furthermore, such gel formation induces increased biological adhesion properties of the pharmaceutical composition of the present invention, which leads to the prolonged action of imidazoquinoline (amine) or a derivative thereof from the pharmaceutical composition of the invention on TLR7 expressing cells and less systemic drug penetration. As mentioned above, the effects of imidazoquinoline (amine) or a derivative thereof on TLR7 expressing cells induce an immune response exerting the desired therapeutic effect.
[0053] In addition, the pharmaceutical compositions of the present invention containing thermosensitive agents preferably provide for avoiding or at least significantly reducing the systemic side effects of imidazoquinoline (amine) or a derivative thereof due to topical administration at the site of the disease, increased in vivo viscosity of the pharmaceutical composition of the invention, reduced diffusion biologically active agent for surrounding tissues, and in some cases also due to the improved biological adhesion properties.
[0054] Finally, the pharmaceutical compositions of the present invention comprising thermosensitive agents preferably allow the so-called "sustained release" (or sometimes referred to as "long-term release") of imidazoquinoline (amine) or a derivative thereof. Particularly, the gel formation of the pharmaceutical composition of the invention results in sustained release of the drug, imidazoquinoline (amine) or a derivative thereof, with zero order kinetics that increases the stability of the therapeutic effect. Such a prolonged therapeutic effect of imidazoquinoline (amine) or a derivative thereof contained in the pharmaceutical composition of the invention also avoids repeated administration of the pharmaceutical composition of the invention, especially at short intervals of time which typically cannot be avoided when pharmaceutical compositions not showing prolonged drug release. The depot effect of the pharmaceutical composition of the invention typically lasts at least 24 hours, more preferably 48 hours, more preferably at least 7 days, with typical active agent release in approximately constant amounts over time (e.g., comparable amounts released over 24 hours, e.g. on Day 2 and day 8 after administration).
[0055] According to a particular preferred embodiment, the pharmaceutical composition of the invention as defined above comprises a thermosensitive agent as defined herein in an amount from about 0.1% (w / v) to about 40% (w / v), preferably between 0.1 and 5% (more preferably 0.1. and 2%) or, alternatively, typically in an amount from about 2% (w / v) to about 30% (w / v), preferably in an amount from about 5% (w / v) to about 30% (w / v), more preferably in an amount from about 10% (w / v) to about 30% (w / v), and most preferably in an amount from about 10% (w / v). ) up to about 25% (w / v), e.g. in an amount from about 0.1% (w / v) to about 10% (w / v), in an amount from about 5% (w / v) to about 15% (w / v) ), in an amount from about 10% (w / v) to about 20% (w / v), in an amount from about 11% (w / v) to about 20% (w / v) ), in an amount from about 12% (w / v) to about 20% (w / v), in an amount from about 13% (w / v) to about 20% (w / v) ), in an amount from about 14% (w / v) to about 20% (w / v), in an amount from about 15% (w / v) to about 20% (w / v) ) in an amount from about 16% (w / v) to about 20% (w / v), in an amount from about 10% (w / v) to about 19% (w / v), in an amount from about 10% (w / v) to about 18% (w / v), in an amount from about 10% (w / v) to about 17% (w / v), in an amount from about 10% (w / v) to about 16% (w / v), in an amount from about 11% (w / v) to about 19% (w / v), in an amount from about 11% (w / v) to about 18% (w / v), in an amount from about 11% (w / v) to about 17% (w / v), in an amount from about 11% (w / v) to about 16% (w / v), in an amount from about 12% (w / v) to about 19% (w / v), in an amount from about 12% (w / v) to about 18% (w / v), in an amount from about 12% (w / v) to about 17% (w / v) , in an amount from about 12% (w / v) to about 16% (w / v), in an amount from about 13% (w / v) to about 19% (w / v) , in an amount from about 13% (w / v) to about 18% (w / v), in an amount from about 13% (w / v) to about 17% (w / v) . in an amount from about 13% (w / v) to about 16% (w / v), in an amount from about 14% (w / v) to about 19% (w / v), in an amount from about 14% (w / v) to about 18% (w / v), in an amount from about 14% (w / v) to about 17% (w / v), in an amount from about 14% (w / v) to about 16% (w / v), in an amount from about 15% (w / v) to about 19% (w / v), in an amount from about 15% (w / v) to about 18% (w / v), in an amount from about 15% (w / v) to about 17% (w / v), in an amount from about 15% (w / v) to about 16% (w / v), in an amount from about 15% (w / v) to about 25% (w / v) in an amount from about 20% (w / v) to about 30% (w / v), in an amount from about 25% (w / v) to about 35% ( w / v), or in an amount from about 30% (w / v) to about 40% (w / v), where the amounts defined in% (w / v) can be understood to be based on the weight of the thermosensitive defined herein relative to the total volume of the pharmaceutical composition according to the invention or the intermediate stock solution, e.g. when supplied as a liquid or semi-liquid formulation. Alternatively, the above amounts can be defined in% (w / w), wherein the amount defined in% (w / w) can be understood as based on the weight of the thermosensitive agent as defined herein, the relative total weight of the pharmaceutical composition of the invention.
[0056] According to another preferred embodiment of the present invention, the pharmaceutical composition comprises imidazoquinoline (amine), at least one organic acid selected from lactic acid, and at least one thermosensitive agent, wherein the at least one thermosensitive agent is preferably selected from chitosan or its or from poly (ethylene oxide) -poly (propylene oxide) -poly (ethylene oxide) copolymer (also called PEO-PPO-PEO or poloxamer).
[0057] According to one preferred embodiment, the pharmaceutical composition of the invention as defined above comprises as a thermosensitive agent chitosan or a derivative thereof. In the context of the present invention, such chitosan is preferably understood as a linear polysaccharide composed of statistically distributed bound β- (1-4) D-glucosamine (deacetylated unit) and N-acetyl-D-glucosamine (acetylated unit). Chitosan is typically manufactured industrially by deacetylation of chitin, which is a structural element in the exoskeleton of crustaceans such as crabs, shrimps, etc. The degree of deacetylation (% DA) is typically determined by spectroscopy
NMR in which% DA in commercial chitosans is typically in the range of 60-100%. Chitosans in the context of the present invention further include their derivatives such as trimethylchitosan, wherein the amino group of chitosan is trimethylated or oligomeric (3-6 kDa) chitosans.
[0058] According to one further more preferred embodiment, the pharmaceutical composition of the invention as defined above comprises a poloxamer as a thermosensitive agent. Poloxamers, dissolved at relatively high concentrations (> 17.5%) in water, can produce systems that are liquid at low temperature (below room temperature) and that form gelatinous, semi-solid or solid structures or gels at elevated temperatures. Poloxamers are commercially available under the trade names Pluronic and Lutrol (BASF AG, Ludwigshafen, Germany). Poloxamers are found in many sold pharmaceutical products as solubilizers, surfactants, viscosifiers and gelling agents. In this context, the pharmaceutical composition of the invention preferably does not contain any further ingredients exhibiting surfactant properties other than such thermosensitive ingredients, e.g. poloxamers, which additionally exhibit surfactant properties.
[0059] Pharmaceutical compositions of the present invention containing a thermosensitive are particularly preferred. For example, the intravesical use of pharmaceutical compositions of the present invention containing a thermosensitive agent, such as, for example, poloxamer, avoids systemic absorption and furthermore provides increased local contact of imidazoquinoline (amine) with bladder epithelium. Thus, the addition of a thermosensitive agent decreases the systemic absorption of imidazoquinoline (amine) from the bladder epithelium while maintaining local infiltration of immune cells.
[0060] Poloxamers in the context of the present invention are typically understood as a poly (ethylene oxide) -poly (propylene oxide) -poly (ethylene oxide) copolymer, also abbreviated to "PEO-PPO-PEO". Such poloxamers are therefore non-ionic triblock copolymers composed of a central hydrophobic polyoxypropylene chain (poly (propylene oxide)) surrounded by two hydrophilic polyoxyethylene (polyethylene oxide) chains. The molecular weight of such poloxamers is generally not specifically defined and may vary conveniently for each particular purpose. Because the polymer block lengths can be adjusted, many poloxamers having slightly different properties can be provided. From the general term "poloxamer", these copolymers are usually called the letter "P" (from poloxamer) followed by three numbers, where the first two numbers x 100 give the approximate molecular weight of the polyoxypropylene core, and the last number x 10 gives the percentage of polyoxyethylene (e.g. ., P407 = Poloxamer with polyoxypropylene with a molecular weight of 4000 g / mol and 70% polyoxyethylene). For the trade name Pluronic / Lutrol, the coding of these copolymers begins with a letter to define its physical form at room temperature (L = liquid, P = paste, F = flake (solid)) followed by two or three digits. The first digit (two digits in the three-digit number) of the numerical designation, multiplied by 300, indicates the approximate molecular weight of the hydrophobe; and the last digit x 10 gives the percentage of polyoxyethylene (e.g., L61 = Pluronic with polyoxypropylene with a molecular weight of 1800 g / mol and 10% polyoxyethylene). In the example given, poloxamer 181 (P181) = Pluronic L61.
[0061] Poloxamers suitable for the pharmaceutical composition of the invention as a thermosensitive agent preferably include any poly (ethylene oxide) poly (propylene oxide) poly (ethylene oxide) copolymer or a mixture of such copolymers suitable for the purposes of the invention, i.e. any PEO-PPO- PEO or a mixture of such copolymers having thermosensitive properties as defined above. Such PEO-PPO-PEO polymers also include commercially available PEO-PPO-PEO polymers and mixtures thereof, e.g. Pluronic F 108 Cast Solid Surfacta; Pluronic F 108 Pastille; Pluronic F 108 Prill; Pluronic F 108NF Prill (Poloksamer 338); Pluronic F 127; Pluronic F 127 Prill; Pluronic F 127 NF; Pluronic F 127 NF 500 BHT Prill; Pluronic F 127 NF Prill (Poloksamer 407); Pluronic F 38; Pluronic F 38 Pastille; Pluronic F 68; Pluronic F 68 Pastille; Pluronic F 68 LF Pastille; Pluronic F 68 NF Prill (Poloksamer 188); Pluronic F 68 Prill; Pluronic F 77; Pluronic F 77 Micropastille; Pluronic F 87; Pluronic F 87 NF Prill (Poloksamer 237); Pluronic F 87 Prill; Pluronic F 88 Pastille; Pluronic F 88 Prill; Pluronic F 98; Pluronic F 98 Prill; Pluronic L 10; Pluronic L 101; Pluronic L 121; Pluronic L 31; Pluronic L 35; Pluronic L 43; Pluronic L 44; Pluronic L 44 NF (Poloksamer 124); Pluronic L 61; Pluronic L 62; Pluronic L 62 LF; Pluronic L 62D; Pluronic L 64; Pluronic L 81; Pluronic L 92; Pluronic L44 NF INH surfactant (Poloxamer 124); Pluronic N 3; Pluronic P 103; Pluronic P 104; Pluronic P 105; Pluronic P 123 surfactant; Pluronic P 65; Pluronic P 84; Pluronic P 85; and Poloxamer 403. Such PEO-PPO-PEO polymers further include mixtures formed by any two or more (3, 4, 5, 6, etc.) of these PEO-PPO-PEO polymers.
[0062] More preferably, poloxamers suitable for the pharmaceutical composition of the invention as a thermosensitive agent include poloxamers or mixtures thereof, poloxamers selected from Poloxamer 124, Poloxamer 188, Poloxamer 237, Poloxamer 338, Poloxamer 403, and Poloxamer 407. Thus, using poloxamer coding labels from BASF, the appropriate poloxamers are selected from Pluronic / Lutrol F 44 (poloxamer 124), Pluronic / Lutrol F 68 (poloxamer 188), Pluronic / Lutrol F 87 (poloxamer
237), Pluronic / Lutrol F 108 (poloxamer 338), Pluronic / Lutrol F 123 (poloxamer 403), Pluronic / Lutrol F 127 (poloxamer 407).
[0063] Even more preferably, poloxamers suitable for the pharmaceutical composition of the invention as a thermosensitive agent include poloxamers or mixtures thereof, poloxamers selected from Poloxamer 188, Poloxamer 403 and Poloxamer 407.
[0064] Among the various PEO-PPO-PEO polymers suitable for the pharmaceutical composition of the invention as the thermosensitive agent, Poloxamer 407 is most preferably selected and represents the first choice polymer for producing heat-responsive gels in the context of the present invention. Poloxamer 407 as a thermosensitive can be used alone or in a mixture with other poloxamers described above, preferably with Poloxamer 188, to produce a mixture of thermosensitive agents that "gel" at a selected temperature, preferably just above room temperature (> 20 ° C), but below body temperature (<37 ° C).
[0065] According to one particularly preferred embodiment, the pharmaceutical composition of the invention comprises as a thermosensitive agent Poloxamer 407 in an amount as defined above in general for thermosensitive agents, more preferably in an amount of from about 0.1, 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10% (w / v) to about 30% (w / v), even more preferably in an amount from about 5% (w / v) to about 25% (w / v) / vol.), and most preferably in an amount from about 10% (w / v) to about 25% (w / v), e.g. in an amount of from about 0.1, 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10% (w / v) to about 25% (w / v), in an amount of about 10.5% (w / v) to about 25% (w / v), in an amount from about 11% (w / v) to about 25% (w / v), in from about 11.5% (w / v) to about 25% (w / v), from about 12% (w / v) to about 25% (w / v) , in an amount from about 12.5% (w / v) to about 25% (w / v), in an amount from about 13% (w / v) to about 25% (w / v) .) in an amount from about 13.5% (w / v) to about 25% (w / v), in an amount from about 14% (w / v) to about 25% (w / v) ), in an amount from about 14.5% (w / v) to about 25% (w / v), in an amount from about 15% (w / v) to about 25% (w / v) vol.), in an amount from about 15.5% (w / v) to about 25% (w / v), in an amount from about 16% (w / v) to about 25% (w / v) . / volume), in an amount from about 16.5% (w / v) to about 25% (w / v), in an amount from about 17% (w / v) to about 25% (w / v), in an amount from about 17.5% (w / v) to about 25% (w / v) ), in an amount from about 18% (w / v) to about 25% (w / v), in an amount from about 18.5% (w / v) to about 25% (w / v) by volume from about 19% (w / v) to about 25% (w / v), from about 19.5% (w / v) to about 25% (w / v) . / volume), in an amount from about 20% (w / v) to about 25% (w / v), in an amount from about 20.5% (w / v) to about 25% (w / v), in an amount from about 21% (w / v) to about 25% (w / v) ), in an amount from about 21.5% (w / v) to about 25% (w / v), in an amount from about 22% (w / v) to about 25% (w / v) by volume), in an amount from about 22.5% (w / v) to about 25% (w / v), in an amount from about 23% (w / v) to about 25% ( w / v), in an amount from about 23.5% (w / v) to about 25% (w / v), in an amount from about 24% (w / v) to about 25% (w / v), or in an amount from about 24.5% (w / v) to about 25% (w / v) ), or more specifically from about 12% (w / v) to about 25% (w / v), from about 13% (w / v) to about 25% (w / v). in an amount from about 14% (w / v) to about 25% (w / v), in an amount from about 15% (w / v) to about 25% (w / v) / volume), in an amount from about 16% (w / v) to about 25% (w / v), in an amount from about 17% (w / v) to about 25% (w / v), in an amount from about 18% (w / v) to about 25% (w / v), in an amount from about 19% (w / v) to about 25% (w / v), in an amount from about 20% (w / v) to about 25% (w / v), in an amount from about 21% (w / v) to about 25% (w / v), in an amount from about 22% (w / v) to about 25% (w / v), in an amount from about 23% (w / v) to about 25% (w / v), in an amount from about 24% (w / v) to about 25% (w / v) . or more specifically, from about 12% (w / v) to about 24% (w / v), in an amount from about 12% (w / v) to about 23% (w / v) ) in an amount from about 12% (w / v) to about 22% (w / v), in an amount from about 12% (w / v) to about 21% (w / v) ), in an amount from about 12% (w / v) to about 20% (w / v), in an amount from about 12% (w / v) to about 19% (w / v) ), in an amount from about 12% (w / v) to about 18% (w / v), in an amount from about 12% (w / v) to about 17% (w / v), in an amount from about 12% (w / v) to about 16% (w / v), or more specifically in an amount from about 13% (w / v) to about 24% (w / v), in an amount from about 13% (w / v) to about 23% (w / v) ), in an amount from about 13% (w / v) to about 22% (w / v), in an amount from about 13% (w / v) to about 21% (w / v) ), in an amount of about 13% (w / v) to about 20% (w / v), in an amount from about 13% (w / v) to about 19% (w / v), in an amount from about 13% (w / v) to about 18% (w / v), in an amount from about 13% (w / v) to about 17% (w / v), in an amount from about 13% (w / v) to about 16% (w / v) , or more specifically from about 14% (w / v) to about 24% (w / v), from about 14% (w / v) to about 23% (w / v) vol.), in an amount from about 14% (w / v) to about 22% (w / v), in an amount from about 14% (w / v) to about 21% (w / v), in an amount from about 14% (w / v) to about 20% (w / v), in an amount from about 14% (w / v) to about 19% (w / v), in an amount from about 14% (w / v) to about 18% (w / v), in an amount from about 14% (w / v) to about 17% (w / v), in an amount from about 14% (w / v) to about 16% (w / v) , or more specifically in an amount from about 15% (w / v) to about 24% (w / v), in an amount from about 15% (w / v) to about 23% (w / v), in an amount from about 15% (w / v) to about 22% (w / v), in an amount from about 15% (w / v) to about 21% (w / v), in an amount from about 15% (w / v) to about 20% (w / v) , in an amount from about 15% (w / v) to about 19% (w / v), in an amount from about 15% (w / v) to about 18% (w / v) , in an amount from about 15% (w / v) to about 17% (w / v), in an amount from about 15% (w / v) to about 16% (w / v) . or more specifically in an amount from about 24% (w / v) to about 25% (w / v), where the amounts defined in% (w / v) can be understood as based on the weight of the thermosensitive as defined herein relative to the total volume of the pharmaceutical composition according to the invention or the intermediate stock solution, e.g. when provided as a liquid or semi-liquid formulation. Alternatively, the above amounts can be defined in% (w / w), wherein the amount defined in% (w / w) can be understood as based on the weight of the thermosetting agent as defined herein, the relative total weight of the pharmaceutical composition of the invention.
[0066] According to another preferred embodiment, the pharmaceutical composition according to the invention may contain as a thermosensitive agent any of the poloxamers as defined above, preferably any of the poloxamers selected from Poloxamer
124, Poloxamer 188, Poloxamer 237, Poloxamer 338 and Poloxamer 403. Such poloxamers are preferably present in the pharmaceutical composition of the invention as a thermosensitive agent in amounts as described above for thermosensitive agents in general or more specifically as described above for Poloxamer 407.
[0067] According to a particularly preferred embodiment, the pharmaceutical composition according to the invention may also comprise as a thermosensitive a mixture of any thermosensitive agents as defined above. Such a mixture of thermosensitive agents preferably represents the total amount of thermosensitive of such a mixture similarly as described above in general for thermosensitive agents or more specifically as described above for Poloxamer 407. Furthermore, such a mixture of thermosensitive agents preferably includes a ratio of different poloxamers that leads to a mixture of thermosensitive agents that "gelates" at the desired temperature, preferably within the temperature range as defined above. In this context, the ratio and / or amount of different poloxamers in the mixture may affect the "lower critical solution temperature" (LCST), and thus the gel transition temperature. For example, it was found that reducing the percentage of Poloxamer 407 in a blend with Poloxamer 188 causes an increase in LCST. In addition, the amount and / or ratio of the different poloxamers in the mixture is preferably selected taking into account the solubility of the drug. Preferably, any two of the thermosensitive agents as defined above, especially when used in an amount as defined above, may be included in the pharmaceutical composition of the invention as a mixture in a ratio of from about 1: 20 to about 20: 1, preferably in a ratio of from about 1:20, 2:20, 3:30, 4:20, 5:20, 6:20, 7:20, 8:20, 9:20, 10:20, 11:20, 12:20, 13: 20, 14:20, 15:20, 16:20, 17:20, 18:20, 19:20, 20:20 (= 1: 1), or in a ratio of about 20: 20, 19: 20, 18 : 20, 17: 20, 16: 20, 15: 20, 14: 20, 13: 20, 12: 20, 11: 20, 10: 20, 9: 20, 8: 20, 7: 20, 6: 20, 5: 20, 4: 20, 3: 20, 2: 20, or about 1: 20, or a ratio of about 1:20, 1:19, 2:18 :, 3:17, 4:16, 5:15, 6:14, 7: 13, 8:12, 9:11, 10:10 (1: 1), 11: 9, 12: 8, 13: 7, 14: 6, 15: 5, 16: 4, 17: 3, 18: 2 , 19: 1 or 20: 1, or within the range formed by any two of the ratio values as defined above. Even more preferably, any of the two thermosensitive agents as defined above, especially when provided in an amount as defined above, can be included in the pharmaceutical composition of the invention as a mixture in the range of from about 1:10 to about 10: 1, e.g., from about 1:10, 2:10, 3:10, 4:10, 5:10, 6:10, 7:10, 8:10, 9:10, or 10:10 (i.e. 1: 1), or in a ratio of about 10: 9, 10: 8, 10: 7, 10: 6, 10: 5, 10: 4, 10: 3, 10: 2, or 10: 1, or in the range formed by any of the two ratio values as defined above.
[0068] Even more preferably, the pharmaceutical composition according to the invention may comprise as a thermosensitive agent a mixture of Poloxamer 407 and any of the above-described poloxamer, more preferably selected from Poloxamer 124, Poloxamer 188, Poloxamer 237, Poloxamer 338 and Poloxamer 403. Similarly, such a mixture of thermosensitive agents preferably contains an overall amount of thermosensitive mixtures similar to those described above in general for thermosensitive agents or more specifically as described above for Poloxamer 407.
[0069] According to a particularly preferred embodiment, the pharmaceutical composition of the invention may comprise as a thermosensitive agent a mixture of Poloxamer 407 and Poloxamer 188. Preferably, such a mixture of Poloxamer 407 and Poloxamer 188 is included in the pharmaceutical composition of the invention in a general amount as described above in general for agents thermosensitive or more specifically as described above for Poloxamer 407. Preferably, such a mixture of Poloxamer 407 and Poloxamer 188 is also present in the pharmaceutical composition of the invention in a ratio as described above in general for the mixture of poloxamer used as a thermosensitive in the pharmaceutical composition of the invention. Even more preferably, such a ratio is selected from the Poloxamer 407: Poloxamer 188 ratio from about 1:20, 1:19, 2:18 :,
3:17, 4:16, 5:15, 6:14, 7:13, 8:12, 9:11, 10:10 (1: 1), 11: 9, 12: 8, 13: 7, 14 : 6, 15: 5, 16: 4, 17: 3, 18: 2, 19: 1 or 20: 1, or the ratio formed by any two of the values defined above. Most preferably, such a ratio is selected from a Poloxamer 407: Poloxamer 188 ratio from about 7: 3, 7.5: 2.5, 8: 2, 8.5: 1.5, 9: 1, or 9.5: 0, 5, or the ratio created by any two of these values. Accordingly, the absolute content of Poloxamer 188 and Poloxamer 407 in a pharmaceutical composition of the invention can be determined based on the total amount and specific ratio of both poloxamer in the pharmaceutical composition of the invention.
[0070] According to a particular embodiment, the pharmaceutical composition of the invention may contain as a thermosensitive agent Poloxamer 407 in (total) amount from about 17.5% (w / v )/( w / w) to about 22.5 % (w / v) / (w / w), more preferably in general amount from about 17.5% (w / v) / (w / w), from about 18.0% ( w / v) / (w / w), from about 18.5% (w / v) / (w / w), from about 19.0% (w / v) /( w / w), from about 19.5% (w / v) / (w / w), from about 20.0% (w / v) / (w / w), from about 20.5% (w / v) / (w / w), from about 21.0% (w / v) / (w / w), from about 21.5% (w / v) / (w / w), from about 22.0% (w / v) ) / (w / w), or from about 22.5% (w / v) / (w / w), or in (total) from about 10% (w / v) / (w / w) up to about 22.5% (w / v) / (w / w), more preferably in an overall amount of about 11% (w / v) / (w / w) wt.) to about 22.5%
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 16,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 22,5</td><td> %</td>
<td>(weight / volume) / (weight / weight), or</td><td colspan="7">from about 11% (w / v )/( w / w) to about 20.0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 16,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 20,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td> 5</td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 16,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 19,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), or</td><td colspan="6">from about 11% (w / v )/( w / w) to about</td><td> 18,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td> 10</td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 16,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 18,0</td><td> %</td>
<td> 15</td><td>(weight / volume) / (weight / weight), or</td><td colspan="6">from about 11% (w / v )/( w / w) to about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td> 20</td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 16,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 17,0</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), or</td><td colspan="6">from about 11% (w / v )/( w / w) to about</td><td> 16,5</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 12,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 16,5</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 13</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 16,5</td><td> %</td>
<td> 25</td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 14,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 16,5</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,0</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 16,5</td><td> %</td>
<td></td><td>(weight / volume) / (weight / weight), from</td><td>about</td><td> 15,5</td><td> %</td><td>(Wag./obj.)/(wag./wag).</td><td>down</td><td>about</td><td> 16,5</td><td> %</td>
<td></td><td colspan="9">(Wag./obj.)/(wag./wag.). (The term (w / v) / (w / w) means either (w / v) or</td>
(w / w)) or any range formed by any two of these values as defined above.
[0071] According to another specific embodiment, the pharmaceutical composition of the invention may contain as a thermosensitive agent a mixture of Poloxamer 407 and Poloxamer 188 in a total amount from about 22.5% (w / v) / (w / w) to about 27.5% (w / v) / (w / w), more preferably in a total amount of about 25% (w / v) / (w / w), and preferably in a ratio of Poloksamer 407: Poloxamer 188 of about 15: 5, 16: 4,
17: 3, 18: 2, 19: 1 or 20: 1, or the ratio formed by any two of these values, more preferably in a ratio of about 9.5: 0.5, about 9: 1, about 8.5: 1, 5, or about 8: 2, or the ratio formed by any two of these values. Accordingly, when the pharmaceutical composition of the invention comprises a mixture of Poloxamer 407 and Poloxamer 188, Poloxamer 407 may be present in the pharmaceutical composition of the invention in an amount of from about 15.5% (w / v) / (w / w) to about 26.5% (w / v) / (w / w), preferably in an amount from about 17.5% (w / v) / (w / w) to about 22.5 % (w / v) / (w / w), while Poloksamer 188 may be present in the pharmaceutical composition in an amount from about 1.0% (w / v) / (w / w) to about 6.0% (w / v) //w / w / w), preferably in an amount from about 2.5% (w / v) / (w / w) to about 4.5% (w / v) / w / w). (The term (w / v) / (w / w) means either (w / v) or (w / w)).
[0072] The pharmaceutical composition of the invention may further comprise additives or further ingredients such as, for example, cyclodextrin as defined above. In this context, the content of additives, particularly cyclodextrin, may affect the above-defined so-called "lower critical solution temperature" (LCST) or "gel transition temperature". As a specific example, increasing the percentage of cyclodextrin results in an increase in the LCST of Poloxamer 407 or a mixture of Poloxamer 407 and
Poloxamer 188 as defined above. This may accordingly apply to other poloxamers as defined above and to other thermosensitive agents as defined herein.
[0073] Similarly, acetic acid and lactic acid are not affected by LCST of pharmaceutical compositions of roses. Both acids generally increase the LCST of the composition. However, although e.g.
imichimod does not affect the gel transition temperature of pharmaceutical compositions containing only acetic acid at all, LCST of lactic acid containing compositions increases.
[0074] According to a further embodiment, the pharmaceutical composition of the invention may further comprise a pharmaceutically acceptable carrier and / or vehicle. In the context of the present invention, a pharmaceutically acceptable carrier typically comprises a liquid base of the pharmaceutical composition of the invention, e.g. pyrogen-free water; the solution in free water can be combined in any suitable ratio with the water miscible, pharmaceutically acceptable organic solvent, e.g. alcohol (e.g., ethanol or isopropanol); the following can also be used: isotonic saline or buffered (aqueous) solutions, e.g. phosphate, citrate, etc. buffered solutions, aqueous buffered solution, containing e.g. sodium salt, preferably at least 50 mM sodium salt, calcium salt, preferably at least 0.01 mM calcium salt, and / or potassium salt, preferably at least 3 mM potassium salt. According to a preferred embodiment, the sodium, calcium and / or potassium salts may be in the form of their halides, e.g. chlorides, iodides or bromides, in the form of their hydroxides, carbonates, bicarbonates or sulfates, etc. Non-limiting examples of sodium salts include e.g. NaCl, NaI, NaBr, Na2CO3, NaHCO3, Na2SO4, examples of optional potassium salts include e.g. KCl, KI, KBr, K2CO3, KHCO3, K2SO4, and examples of calcium salts include e.g. CaCl2, CaI2, CaBr2, CaCO3, CaSO4 , Ca (OH) 2. In addition, organic anions of said cations may be included in the composition of the invention. According to a more preferred embodiment, the composition of the invention suitable for injection purposes as defined above may contain salts selected from sodium chloride (NaCl), calcium chloride (CaCl2) and optionally potassium chloride (KCl), where further anions may be present in addition to the chlorides. CaCl2 can also be replaced by another salt such as KCl. The composition according to the invention may be hypertonic, isotonic or hypotonic relative to a particular reference environment, i.e. the composition according to the invention may have a higher, identical or lower salt content relative to a specific reference environment in which concentrations of said salts may preferably be used which do not lead to cell damage due to osmosis or other concentration effects. Reference environments are e.g. liquids found in "in vivo" methods, such as blood, lymph, cytosolic fluid, or other body fluids, or, for example, liquids that can be used as reference environments in "in vitro" methods, such as common buffers or liquids. Such common buffers or liquids are known to the skilled person.
[0075] However, one or more compatible solid or liquid fillers or diluents or encapsulating compounds that are suitable for administration to the patient being treated may also be used in the pharmaceutical composition of the invention. The term "compatible" as used herein means that these components of the pharmaceutical composition of the invention can be mixed with imidazoquinoline (amines) or their derivatives as defined in the present invention in such a way that there is no interaction that would substantially reduce the pharmaceutical effectiveness of the pharmaceutical composition of the invention in typical conditions of use. Pharmaceutically acceptable carriers, fillers and diluents must, of course, be of sufficiently high purity and sufficiently low toxicity to be suitable for administration to the treated person. Some examples of compounds that can be used as pharmaceutically acceptable carriers, fillers or their ingredients are sugar, such as, for example, lactose, glucose and sucrose; starches, such as, for example, corn starch or potato starch; cellulose and its derivatives, such as, for example, sodium carboxymethyl cellulose, ethyl cellulose, cellulose acetate; powdered tragacanth; malt; gelatine; tallow; solid lubricants such as, for example, stearic acid, magnesium stearate; calcium sulfate; vegetable oils such as, for example, peanut oil, cottonseed oil, sesame oil, olive oil, corn oil and cocoa butter; polyols such as, for example, polypropylene glycol, glycerol, sorbitol, mannitol and polyethylene glycol;
alginic acid.
[0076] Further additives that may be included in the pharmaceutical composition of the invention are emulsifiers, such as, for example, Tween®; wetting agents such as, for example, sodium lauryl sulfate; coloring agents; flavoring agents, pharmaceutical carriers; tablet forming agents; stabilizing agents; antioxidants; preservatives.
[0077] According to another embodiment, the pharmaceutical composition of the invention may comprise an adjuvant. In this context, an adjuvant can be understood as any compound that is suitable for initiating or enhancing the immune response of the innate immune system, i.e., the non-specific immune response. In other words, when administered, the pharmaceutical composition of the invention typically elicits an innate immune response due to an adjuvant, optionally contained therein. Such an adjuvant may be selected from any adjuvants known to the skilled person and suitable in the present case, i.e. those supporting the induction of an innate immune response in a mammal. Preferably, the adjuvant may be selected from the group consisting of, but not limited to, any of the following, including chitosan, TDM, MDP, muramyl dipeptide, pluronic agents, alum solution, aluminum hydroxide, ADJUMER ™ (polyphosphazene); aluminum phosphate gel; algae glucases; algammulin; aluminum hydroxide gel (alum); highly protein adsorbing aluminum hydroxide gel; low viscosity aluminum hydroxide gel; AF or SPT (squalane emulsion (5%), Tween 80 (0.2%), Pluronic L121 (1.25%), phosphate buffered saline, pH 7.4); AVRIDINE ™ (propanediamine); BAY R1005 ™ (hydroacetate (N- (2-deoxy-2-L-leucylamino-bD-glucopyranosyl) -N-octadecyldodecanoyl amide); CALCITRIOL ™ (1-alpha, 25-dihydroxy-vitamin D3); calcium phosphate; CAPTM (calcium phosphate nanoparticles); cholera holotoxin, cholera toxin-protein-A1-fragment-AD fusion protein, cholera toxin B subunit; CRL 1005 (close copolymer P1205); cytosine-containing liposomes; DDA (dimethyldioctadecylammonium bromide); DHEA (dehydroepiandrosterone); DMPC (dimirystoyl phosphatidylcholine); DMPG (dimirystoyl phosphatidylglycerol); DOC / alum complex (deoxycholic acid sodium salt); Freund's complete adjuvant; Freund's incomplete adjuvant;
gamma inulin; Gerbu adjuvant (mixture: i) N-acetylglucosaminyl- (P1-4) -Nacetylmuramyl-L-alanyl-D-glutamine (GMDP), ii) dimethyldioctadecylammonium chloride (DDA), iii) zinc-L-proline salt complex (ZnPro- 8); GM-CSF); GMDP (N-acetylglucosaminyl- (b1-4) -N-acetylmuramyl-L-alanyl-D-isoglutamine); ImmTher ™ (N-acetylglucosaminyl-N-acetylmuramyl-L-Ala-D-isoGlu-L-Ala10 glycerol dipalmitate); DRV (immunoliposomes made from dehydration-hydration of vesicles);
interferon-gamma; interleukin-1 beta; interleukin-2; interleukin-7; interleukin-12; ISCOMS ™; ISCOPREP 7.0.3. ™; liposomes; LOXORIBINE ™ (7-allyl-8oxoguanosine); oral LT adjuvant (labile enterotoxin-E. coli protoxin); microspheres and microparticles of any composition; MF59 ™; (squalene-water emulsion);
MONTANIDE ISA 51 ™ (Freund's incomplete adjuvant purified); MONTANIDE ISA 720 ™ (adjuvant, metabolizable oil); MPL ™ (3-Q-desacyl-4'-monophosphoryl lipid A); MTP-PE and MTP-PE liposomes ((N-acetyl-L-alanyl-D-isoglutaminyl-L-alanine2- (1,2-dipalmitoyl-sn-glycero-3- (hydroxyphosphoryloxy)) ethylamide, sodium monosodium); MURAMETIDE ™ (Nac-Mur-L-Ala-D-Gln-OCH3); MURAPALMITINE ™ and
D-MURAPALMITINE ™ (Nac-Mur-L-Thr-D-isoGln-sn-glycerodipalmitoyl); NAGO (neuraminidase-galactose oxidase); nanospheres or nanoparticles of any composition;
NISV (vesicles of nonionic surfactant); PLEURAN ™ (β-glucan); PLGA, PGA and PLA (homo- and copolymers of lactic acid and glycolic acid; microspheres / nanospheres); PLURONIC L121 ™; PMMA (polymethylmethacrylate);
PODDS ™ (proteinoid microspheres); polyethylene carbamate derivatives; poly-rA: polyir (polyadenylic acid-polyuridyl acid complex); Polysorbate 80 (Tween 80); kochleaty cochleates) (Avanti Polar Lipids, Inc., Alabaster, AL); STIMULON ™ (QS-21); Quilo-A (Quilo-A saponin); S-28463 (4-amino-otec-dimethyl-2-ethoxymethyl-1H-imidazo [4,5-c] quinoline-1-ethanol); SAF-1 ™ ("Syn30 tex adjuvant formulation"); Sendai proteoliposomes and Sendai lipid matrices; Span-85 (sorbitan trioleate); Specol (Marcol 52, Span 85 and Tween 85 emulsion); squalene or Robane® (2,6,10,15,19,23-hexamethyltetracosan and 2,6,10,15,19,23-hexamethyl-2,6,10,14,18,22tetracozahexane); stearyl tyrosine (octadecyl tyrosine hydrochloride); Theramid® (N-acetylglucosaminyl-N-acetylmuramyl-L-Ala-D-isoGlu-L-Ala44 dipalmitoxypropylamide); Theronyl-MDP (Termurtide ™ or [thr 1] -MDP; N-acetylmuramyl-L-threonyl-D-isoglutamine); Ty particles (Ty-VLP or virus-like particles); Walter-Reed liposomes (liposomes containing lipid A adsorbed on aluminum hydroxide), and lipopeptides, including Pam3Cys, in particular aluminum salts such as Adjuphos, Alhydrogel, Rehydragel; emulsions, including CFA, SAF, IFA, MF59, Provax, TiterMax, Montanide, Vaxfectin; copolymers including Optivax (CRL1005), L121, etc .; liposomes, including Stealth, kochleaty cochleates), including BIORAL; plant-derived adjuvants, including QS21, Quil A, Iscomatrix, ISCOM; adjuvants suitable for co-stimulation, including Tomatine, biopolymers, including PLG, PMM, Inulin; microbial adjuvants, including Romurtide, DETOX, MPL, CWS, mannose, CpG, CpG7909 nucleic acid sequences, human TLR 1-10 ligands, mouse TLR 1-13 ligands, ISS-1018, IC31, Ampligen, Ribi529, IMOxine, IRIV, VLP, cholera toxin, thermally labile toxin, Pam3Cys, flagellin, GPI anchor, LNFPIII / Lewis X, antimicrobial peptides, UC-1V150, RSV fusion protein, cdiGMP; and adjuvants suitable as antagonists, including the CGRP neuropeptide.
[0078] The pharmaceutical composition of the invention may further comprise one or more excipients to further enhance its immunomodulatory effect. Advantageously, thereby, synergistic effects of imidazoquinoline (amine) or a derivative thereof as defined according to the present invention and an excipient substance which can optionally be included in the pharmaceutical composition according to the invention as described above are achieved. Depending on the different types of excipients, different mechanisms may come into play in this regard. For example, compounds that allow dendritic cells (DCs) to mature, for example lipopolysaccharides, TNF-alpha or CD40 ligand, form a first class of suitable excipients. In general, it is possible to use any agent as an auxiliary substance that affects the immune system in the manner of a "danger signal" (LPS, GP96, etc.) or cytokines, such as GM-CSF, which allow it to strengthen and / or affect the immune response produced by the cumulative resistance adjuvant of the invention in a targeted manner. Cytokines such as monokines, lymphokines, interleukins or chemokines, which further promote the innate immune response, such as IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, are particularly preferred excipients. IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-14, IL-15, IL-16, IL-17, IL-18, IL-19, IL20, IL-21, IL-22, IL-23, IL-24, IL-25, IL-26, IL-27, IL-28, IL-29, IL-30, IL-31, IL-32, IL33, INF-alpha, IFN-beta, INF-gamma, GM-CSF, G-CSF, M-CSF, LT-beta or TNF-alpha, growth factors, such as hGH.
[0079] The pharmaceutical composition of the invention may also additionally or alternatively contain any further compound that is known to be immunostimulated due to its binding affinity (as ligands) to human Toll-like TLR1 receptors.
TLR2, TLR3, TLR4, TLR5, TLR6, TLR7, TLR8, TLR9, TLR10, or due to binding affinity (as ligands) to mouse Toll-like receptors TLR1, TLR2, TLR3, TLR4, TLR5, TLR6, TLR7, TLR8, TLR9 , TLR10, TLR11, TLR12 or TLR13.
[0080] Another class of compounds that can be added to the pharmaceutical composition of the invention in this context may be CpG nucleic acids, in particular
CpG-RNA or CpG-DNA. And CpG-RNA or CpG-DNA can be single-stranded CpGDNA (ss CpG-DNA), double-stranded CpG-DNA (dsDNA), single-stranded CpG-RNA (ss CpG-RNA) or double-stranded CpG-RNA (ds CpG-RNA). The CpG nucleic acid is preferably in the form of CpG-RNA, more preferably in the form of single-stranded CpG-RNA (ss CpGRNA). The CpG nucleic acid preferably contains at least one or more (mitogenic) dinucleotide cytosine / guanine sequences (CpG motif (s)). According to a first preferred alternative, at least one CpG motif contained in these sequences, i.e. C (cytosine) and G (guanine) of the CpG motif, is unmethylated. All subsequent cytosines or guanines optionally contained in these sequences may be methylated or unmethylated. According to another preferred alternative, however, C (cytosine) and G (guanine) of the CpG motif may also be present in methylated form.
[0081] The pharmaceutical composition of the invention typically includes a "safe and effective amount" of the above ingredients of the pharmaceutical composition of the invention, especially imidazoquinoline (amines) and their derivatives as defined according to the present invention. "Safe and effective amount" as used herein means the amount of these components, especially imidazoquinoline (amines) and their derivatives, which is sufficient to significantly induce positive modification of the disease or disorder as defined herein. At the same time, however, the "safe and effective amount" is small enough to avoid serious side effects, that is, allow a reasonable relationship between benefit and risk. Determining these limits is typically within a reasonable medical judgment.
The "safe and effective amount" of the ingredients of the pharmaceutical composition of the invention, especially imidazoquinoline (amines) and their derivatives, will also fluctuate in relation to the particular condition being treated, as well as the age and physical condition of the patient being treated, body weight, overall health, sex, diet , the time of administration, the rate of excretion, the combination of drugs, their activity, the severity of the condition, the duration of treatment, the nature of the accompanying therapy, the specific pharmaceutically acceptable carrier employed, and similar factors within the knowledge and experience of the attending physician.
The pharmaceutical composition of the invention can be used for medical purposes in humans and also in veterinary medicine, preferably for medical purposes in humans.
[0082] Without being limited in this way, in some embodiments, the pharmaceutical composition of the invention will contain or release sufficiently active imidazoquinoline (amine) or a derivative thereof to provide a dose of about 10, 20, 50, or 100 nanograms per kilogram (ng / kg) to about 50 milligrams per kilogram (mg / kg), preferably about 10 micrograms per kilogram (Lig / kg) to about 5 mg / kg, of the compound or its salt to the subject. In other embodiments, the pharmaceutical composition of the invention will contain or release sufficiently active imidazoquinoline (amine) or a derivative thereof to provide a dose, for example, from about 0.0001, 0.001, 0.01 or 0.01 mg / m<sup>2</sup> up to about 5.0 mg / m<sup>2</sup>, calculated according to the Dubois method, in which the surface area of 2 2 0.425 of the subject's body is calculated (m<sup>2</sup>) using body weight of the individual: m<sup>2</sup> = (mass kg<sup>0,425</sup> x height cm<sup>0,725</sup>) x 0.007184, although in some embodiments the methods can be carried out by administering the compound or salt or composition at a dose outside this range. In some of these embodiments, the method comprises administering a sufficient amount of imidazoquinoline (amine) or a derivative thereof to provide a dose of from about 0.0001, 0.001, 0.01, or 0.1 mg / m<sup>2</sup> up to about 2.0 mg / m<sup>2</sup> subject, for example, doses from about 0.004, 0.04, or 0.4 mg / m<sup>2</sup> up to about 1.2 mg / m<sup>2</sup>.
[0083] The pharmaceutical composition of the invention may be administered locally. Routes of topical administration generally include, for example, routes of topical administration, but also intravesical, intradermal, transdermal, subcutaneous, or intramuscular injections, or intracranial, pulmonary, intracardial and sublingual injections.
More preferably, the pharmaceutical composition of the invention may be administered by the intravesical route. The appropriate amount of the pharmaceutical composition of the invention for administration can be determined by routine experimentation with animal models. Such models include, without limitation, rabbit, sheep, mouse, rat, dog and non-human primate models. Preferred unit dosage forms for injection include sterile solutions of water, saline, or mixtures thereof.
[0084] The following embodiments are specific preferred compositions of the invention limited to specific ingredients.
[0085] The pharmaceutical composition as defined above includes at least one imidazoquinoline (amine) or derivative thereof as defined herein and at least one organic acid as defined above selected from lactic acid - preferably in such a concentration that the final pH is from 3 to 5, preferably 3 , 5 to 4.5. Thus, the components of the composition according to the invention form adduct structures according to the invention. The pharmaceutical composition as defined above preferably includes at least one imidazoquinoline (amine) or derivative thereof as defined herein and at least one organic acid as defined above selected from lactic acid, however containing no more than 4, 3, 2, 1 or most preferably no further organic and / or inorganic acid as defined herein or, alternatively, less than 2 inorganic acids and any further organic acids or, alternatively, only one additional organic acid and no inorganic acids.
[0086] Preferably, the pharmaceutical composition as defined above comprises at least one imidazoquinoline (amine) or derivative thereof as defined herein, and at least one organic acid as defined above selected from lactic acid, and less than 4 or 3 thermosensitive agents or more preferably only one thermosensitive agent. Alternatively, the composition may also not include a thermosensitive agent. A combination of a limited number of thermosensitive agents in a pharmaceutical composition and a limited number of acids as defined above is also provided. Accordingly, the pharmaceutical composition as defined above may include, e.g. at least one imidaquinoline (amine) or derivative thereof, as defined herein, and at least one organic acid as defined above selected from lactic acid, and less than 4, 3, 2, or 1 further organic and / or inorganic acids as defined herein, and less than a further 4, 3 or 2 thermosensitive agents, preferably all of them belong to the class of Pluronic agents, more preferably those Pluronic agents which are defined herein as being preferred.
[0087] Preferably, the pharmaceutical composition may not include surfactants other than thermosensitive agents (if used) that may additionally have surfactant properties. Accordingly, the composition may also not include a surfactant and a thermosensitive.
[0088] Preferably, the pharmaceutical composition may contain less than 4, 3 or 2 cyclodextrins or, alternatively, no cyclodextrins at all. These embodiments can be combined with the preferred embodiments above. Accordingly, the composition of the invention may e.g. contain no thermosensitive agent, cyclodextrin and surfactant. Furthermore, the composition of the invention may not contain a further solubilizing agent, whether it is a surfactant, cyclodextrin or other solubilizing agent, except lactic acid.
[0089] Preferably, the composition comprises at least one imidazoquinoline (amino) compound as defined herein, lactic acid and 1, 2 thermosensitive agents or no thermosensitive agent and no further solubilizing compound and no further therapeutically active ingredient and no cellulose or cellulose derivative. In such an embodiment, the composition may only additionally contain one or more of the following standard components belonging to the class of stabilizing agents and preservatives.
[0090] In one particular embodiment, the pharmaceutical composition comprises lactic acid in a concentration from about 0.025 to about 0.2 M, imidazoquinoline (amine) in an amount from about 0.1% (w / v) to about 1% ( w / v), cyclodextrin (cyclodextrin) in an amount from about 2% (w / v) to about 6% (w / v) and Poloxamer 407 in an amount from about 10% (w / v) ) up to about 25% (w / v), preferably the pharmaceutical composition of the invention contains lactic acid in a concentration of from about 0.075 to about 0.125 M, e.g. from about 0.08 M to about 0.125 M, from about 0.085 M to about 0.125 M, from about 0.09 M to about 0.125 M, from about 0.095 M to about 0.125 M, from about 0.1 M to about 0.125 M , or from about 0.075 M to about 0.120 M, from about 0.075 M to about 0.115 M, from about 0.075 M to about 0.110 M, from about 0.075 M to about 0.105 M, from about 0.075 M to about 0.105 M or from about 0 , 08 M to about 0.120 M, e.g. from about 0.085 M to about 0.115 M, from about 0.09 M to about 0.110 M, from about 0.095 M to about 0.105 M, or from about 0.1 M, imidazoquinoline (amine) in an amount of about 0.1% ( w / v) to about 1% (w / v), e.g. in an amount of from about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0, 7, 0.8, 0.9 or 1.0 (w / v), cyclodextrin (s) in an amount from about 2% (w / v) to about 6% (w / v), for example. from about 2.5% (w / v) to about 6% (w / v), from about 3% (w / v) to about 6% (w / v), from about 3.5% (w / v) to about 6% (w / v), from about 4% (w / v) to about 6% (w / v), from about 4, 5% (w / v) to about 6% (w / v), or from about 2.5% (w / v) to about 5.5% (w / v), about 3% (w / v) to about 5.5% (w / v), from about 3.5% (w / v) to about 5.5% (w / v), from about 4% (w / v) to about 5.5% (w / v), from about 4.5% (w / v) to about 5.5% (w / v), or from about 5% (w / v), and Poloxamer 407 in an amount from about 12% ( w / v) up to about 25% (w / v), e.g. in an amount from about 12% (w / v) to about 24% (w / v), in an amount from about 12% (w / v) to about 23% (w / v), in an amount from about 12% (w / v) to about 22% (w / v), in an amount from about 12% (w / v) to about 21% (w / v), in an amount from about 12% (w / v) to about 20% (w / v), in an amount from about 12% (w / v) to about 19% (w / v), in an amount from about 12% (w / v) to about 18% (w / v), in an amount from about 12% (w / v) to about 17% (w / v), in an amount from about 12% (w / v) to about 16% (w / v), or more specifically in an amount from about 13% (w / v) to about 24% (w / v) ), in an amount from about 13% (w / v) to about 23% (w / v), in an amount from about 13% (w / v) to about 22% (w / v) ), in an amount from about 13% (w / v) to about 21% (w / v), in an amount from about 13% (w / v) to about 20% (w / v) ), in an amount from about 13% (w / v) to about 10% (w / v), in an amount from about 13% (w / v) to about 18% (w / v), in an amount from about 13% (w / v) to about 17% (w / v), in an amount from about 13% (w / v) to about 16% (w / v), or more specifically in an amount from about 14% (w / v) to about 24% (w / v) ), in an amount from about 14% (w / v) to about 23% (w / v), in an amount from about 14% (w / v) to about 22% (w / v) ), in an amount from about 14% (w / v) to about 21% (w / v), in an amount from about 14% (w / v) to about 20% (w / v), in an amount from about 14% (w / v) to about 19% (w / v), in an amount from about 14% (w / v) to about 18% (w / v), in an amount from about 14% (w / v) to about 17% (w / v), in an amount from about 14% (w / v) to about 16% (w / v), or more specifically in an amount from about 15% (w / v) to about 24% (w / v) ), in an amount from about 15% (w / v) to about 23% (w / v), in an amount from about 15% (w / v) to about 22% (w / v), in an amount from about 15% (w / v) to about 21% (w / v), in an amount from about 15% (w / v) to about 20% (w / v), in an amount from about 15% (w / v) to about 19% (w / v), in an amount from about 15% (w / v) to about 18% (w / v), in an amount from about 15% (w / v) to about 17% (w / v), in an amount from about 15% (w / v) to about 16% (w / v), or in an amount from about 16% (w / v).
[0091] According to the present invention, the object of the present invention is achieved by the use of imidazoquinoline (amines) and their derivatives as defined herein (for the preparation of a pharmaceutical composition, e.g. as defined herein) for use in a method of treatment of bladder diseases such as, for example, cystic cancer and cystitis .
[0092] Transurethral resection of bladder cancer and BCG adjunctive intravesical immunotherapy is standard therapy for high grade NMIBC. However, many patients have relapses and the effect of disease progression is only limited (Sylvester FJ, Van der Meijden AP, Lamm DL. Intravesical bacillus Calmetie-Guerin reduces the risk of progression in patients with superficial bladder cancer: a metaanalysis of the published results of randomized clinical trials .. J Urol 2002; 168: 196470) or not even present (Malmstrom PU, Sylvester RJ, Crawford ED, Friedrich M, Krege S, Rintala E,
Solson E, Di Stasi SM, Witjes JA. An individual patient data meta-analysis of the longterm outcome of randomized studies comparing Mitomycin C versus Ba5 cillus Caimettte-Guerin for non-muscle-invasive bladder cancer. Eur Urol 2009; 56 (2): 247256). In addition, BCG therapy can lead to serious local and systemic side effects (Witjes JA, Palou J, Soloway M, Lamm O, Brausi M, Spermon JR, Persad R, Buckley R, Akaza H, Colombel M, Bohle A. Clinic) Practice recommendations for the prevention and management of intravesical therapy-associated adverse events. Eur. Urol Suppl 2008; 7: 667-74). Thus, new therapeutic therapy options are urgently needed to improve the overall frequency of treatment success, possibly with a lower toxicity profile, for non-muscular bladder cancer.
[0093] Surprisingly, it could be demonstrated that intravesical administration of imidazoquinoline (amines) in pigs is well tolerated, does not cause bladder wall toxicity, and preparations with poloxamer and HPeCD remain longer in the bladder with less systemic absorption. The safety profile of intravesical imidazoquinoline (amines) is more favorable than current therapies such as BCG.
[0094] Accordingly, the object of the present invention is achieved by the use of imidazoquinoline (amines) and their derivatives as defined herein (for the preparation of a pharmaceutical composition, e.g. as defined herein) for (intravesical) treatment of bladder diseases such as, for example, bladder cancer such as for example, non-invasive muscular bladder cancers, and cystitis, etc. For this particular purpose, imidazoquinoline (amines) and their derivatives as defined herein are preferably provided in the formulation as described above for the pharmaceutical composition of the invention.
[0095] Accordingly, the present invention further encompasses use in a method of treating bladder diseases, such as, for example, bladder cancer, such as, for example, non-muscular bladder cancer, and cystitis. In this context, such use in the method of treatment as defined above preferably includes administering the pharmaceutical composition using any of the modes of administration defined above, preferably including topical routes of administration, but also intravesical, intradermal, transdermal, subcutaneous or intramuscular injections, or intracranial, intrapleural injections , cardiac and sublingual.
[0096] The present invention includes methods for (intravesical) treatment of bladder diseases, such as, for example, bladder cancer such as, for example, non-invasive cystic bladder cancers, and cystitis, etc., using the pharmaceutical composition of the invention, preferably as defined above. In this context, such (intravesical) methods for treating bladder diseases typically include intravesical administration of a pharmaceutical composition of the invention. In addition, the pharmaceutical composition of the invention may be administered using non-invasive methods, such as injection needles having a tube of suitable diameter, injection tubes, endoscopic methods, etc.
[0097] It should be understood that the invention is not limited to the specific methodology, protocols and reagents described in the invention, as they may vary. It is also to be understood that the terminology used in the present invention is intended only to describe specific embodiments, and is not intended to limit the scope of the present invention, which will be limited only by the appended claims. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art.
FIGURES [0098] The following Figures are to further illustrate the invention. They are not intended to limit the object of the present invention to each other.
Figure 1 shows the viscosity of systems containing different percentages of Poloxamer 407 (20% and 25%) as a function of temperature.
Figure 2 shows the viscosity of systems containing different percentages of HPβ-CD (0% to 20%) as a function of temperature.
Figure 3 shows the viscosity of systems containing different ratios of Poloxamer 407 and Poloxamer 188 (0% to 30%) as a function of temperature.
Figure 4 (not according to the invention) shows the viscosity of systems made from 20% Poloxamer 407 or 25% poloxamer mixture in acetic acid (AA) solution in the presence or absence of imiquimod (TMX, 0.4%) as a function of temperature.
Figure 5 (not according to the invention) shows the viscosity of the systems made with
20% Poloxamer 407 in water or acetic acid (AA), or in the presence of imiquimod (TMX) in acetic acid as a function of temperature.
Figure 6 (not according to the invention) shows the viscosity of systems made from a 25% mixture of poloxamers (Poloksamer 407 and Poloksamer 188) in water or acetic acid in the presence of imiquimod (TMX) in acetic acid as a function of temperature.
Figure 7 shows the viscosity of systems made from 20% Poloxamer 407 (PG) or 25% mixture of poloxamer (Poloksamer 407 and Poloksamer 188, PPG) in lactic acid solution (LA) in the presence and absence of imiquimod (TMX, 0.9%) in temperature function.
Figure 8 shows the viscosity of the systems prepared with 20% Poloxamer 407 in water or in lactic acid solution, or in the presence of imiquimod (TMX, 0.9) in lactic acid solution as a function of temperature.
Figure 9 shows the viscosity of the systems prepared from a 25% mixture of poloxamers (Poloksamer 407 and Poloksamer 188) in water or in an aqueous lactic acid solution or in the presence of imiquimod (TMX, 0.9) in a lactic acid solution as a function of temperature.
Figure 10 shows the erosion (dissolution) profile of PG-LA1 (Poloxamer 407 in lactic acid solution) without imiquimod (top) and with imiquimod (TMX PG-LA1) (bottom) over time.
Figure 11 shows the diffusion profiles (g) of imiquimod (TMX) passing through a cellulose membrane for gel formulations made with 0.1 M lactic acid and Poloxamer 407 (PG) or a mixture of Poloksamer 407 / Poloksamer 188 (PPG): the same figure shows the diffusion imiquimod (TMX) in a 0.1 M lactic acid solution without gel formation for comparison purposes.
Figure 12 shows the amount of imiquimod (TMX-101) recovered in BE (bladder epithelium) after 4 hours of contact with the preparation (see Example 5), namely for 0.9%
Imichimod - 15% ΗΡ-β-CD dissolved in 0.1 M lactic acid solution, or in 19% Poloxamer 407 gel containing 15% HP-e-CD (0.1 M lactic acid) or in liposomal dispersion (1% lecithin soybean in a 0.1 M lactic acid solution). The inventive formulations have been shown to exhibit significantly better long-term release performance than the liposome formulations that are presented herein for comparative purposes.
Figure 13 shows the solubility of imiquimod (TMX-101) in the presence of different concentrations of lactic acid. Solubility increases as a function of lactic acid concentration.
Figure 14 In the upper part, pig bladders are excised, washed and transferred to a NaCl solution at 37 ° C. The formulations of the invention were applied to the bladder and the bladder was cut after 10 minutes. The gel state of the applied preparation was observed. The lower part shows the bladder after adding the preparation of the invention containing imiquimod in 20% Poloxamer 4077 in lactic acid solution (0.1 M), which had previously been stained with Coomassie Blue, where the gel is still observed. No gel adhesion was observed.
Figure 15 shows the amount of imiquimod (TMX) recovered in the bladder epithelium (BE) after 4 hours of contact with various imiquimod preparations (data were normalized to the absorption surface and are means of 3 experiments).
Figure 16 shows the immunohistochemical staining of TLR-7 (sub) mucosa of human bladder cancer according to example 10.3.1 (original 40x magnification).
Figure 17 shows the immunohistochemical staining of TLR-7 (sub) of the porcine bladder mucosa according to example 10.3.1 (original 40x magnification).
Figure 18 shows the pharmacokinetic parameters of imiquimod plasma (R-837) administered to groups of pigs treated with different imiquimod preparations. The animals received a 0.5% solution of imiquimod dissolved in 0.1 M lactic acid (group 1); 0.5% solution of imiquimod dissolved in 0.1 M lactic acid, 16% poloxamer 407 as an emulsifying agent and 15% HPeCD (hydroxypropyl-e-cyclodextrin) as a stabilizing agent (group 2); 0.5% solution of imiquimod dissolved in 0.1 M lactic acid, 16% poloxamer 407 and 5% HPeCD (group 3).
Figure 19 shows the normal appearance (under) the pig's mucosa (original 20x magnification)
Figure 20 shows moderate mainly lymphocytic submucosal inflammation one day after instillation of study drug (group 3) from Example 10.3.2 (original 20x magnification).
Figure 21 shows leukocytoclastic vasculitis with fibrinoid vascular necrosis in the porcine bladder submucosa (group 1) of Example 10.3.2 (original 20x magnification).
Figure 22 shows induction of cytokines and chemokines by intravesical administration of imiquimod in 0.1% lactic acid according to example 11.3.1. Mice (n = 8) received intravesical administration of various doses of imiquimod in a lactic acid preparation. Two hours after administration, sera and bladder lavage were collected. Serum TNFa (A) and KC (B) levels and TNFa (C) and KC (D) in bladder lavage fluid were measured. The data shown are representative of two independent experiments (mean ± SEM). * means p <0.05 compared to vehicle treated (Pod) mice in one-way variance analysis with Dunnett's post hoc test.
Figure 23 shows the pharmacokinetics of imiquimod (R-837) in mice after intravesical administration according to example 11.3.2. (AD) Mice (n = 8) were administered 5000 nmol of imiquimod in a preparation with lactic acid or poloxamer. Serum levels of TNFa (A), TNFa in bladder lavage fluid (B), serum KC (C) and KC in bladder lavage fluid (D) were measured. * means p <0.01 as assessed by the unpaired Student's t test. (E) Mice (n = 6 to 8) were administered 1500 nmol of imiquimod in a lactic acid or poloxamer preparation. Sera were collected 2, 4, 6, 24 hours after administration. (F) Mice (n = 6) were given different doses of imiquimod in 100 μL in lactic acid or poloxamer preparations. Sera were collected 2 to 4 hours after administration. Himod levels were determined by the Chiman SRL method. Data shown are collected values from two independent experiments (mean ± SEM). * means p <0.05 according to one-way analysis of variance tests with Dunnett's post hoc test compared to mice treated at time 0 or mice treated with vehicle alone (Pod). ** means statistical significance (p <0.01) assessed according to one-way analysis of variance tests with the Bonferroni post hoc test.
Figure 24 shows the incorporation of HPeCD which partially restores systemic levels of TNFα and KC according to example 11.3.3. Mice (n = 8) were administered 1500 nmol imiquimod in a preparation with lactic acid, poloxamer or poloxamer-HPeCD. TNFα (A) and KC (B) levels are shown. The data presented are collected values from two independent experiments (mean ± SEM). * means p <0.05 according to one-way analysis of variance tests with Dunnett's post hoc test. (C) C57BU6 mice were injected with 5000 nmol imiquimod in formulations with lactic acid, poloxamer or poloxamer-HPeCD. KC levels in the wash liquid were evaluated in a Luminex bead test. The data presented are collected values from three independent experiments (mean ± SEM).
Figure 25 shows a representative histology of mouse bladder treated with 0.1% imiquimod (R-837) in a preparation with poloxamer-HPeCD according to example 11.3.4. A: Single treatment with Pod (wild type C57BL / 6) B: Triple treatment with Pod (wild type C57BL / 6) C: Single treatment with imiquimod (wild type C57BL / 6) D: Three treatments with imiquimod (wild type C57BU6) E: Triple treatment saline (wild type C57BU6) F: Three treatments with imiquimod (TLR7 co) mice deficient in C57BU6 (AE) or TLR7 (co) (F) were intravesically treated with 0.1% imiquimod in the preparation with poloxamer-HPeCD on day 0 (single treatment), 50 μL on days 0, 4 and 8 (three times). Blisters were collected on day 1 for single treatment (A and C) or on day 9 for three treatments (B, D, E and F) and stained with H&E. Mice treated with vehicle alone (Pod, n = 4) and untreated mice served as controls (B and E). Scale bar: 100 μm. The original magnification was 200x.
Figure 26 shows the reduced bladder weight of mice having MB49 treated with 0.1% imiquimod in a poloxamer-HPeCD preparation according to example 11.3.5. Mice (n = 11) having MB49 bladder tumor received intravesical 50 μL of 0.1% imiquimod in poloxamer-HPeCD on day 3, 6 and 9. Mice were killed on day 11 and bladder weight was measured. Mice without an implanted tumor ("naïve"), mice implanted with MB49 without therapy (None) or treated with vehicle mice (Pod) served as controls. Data shown are collected values from three independent experiments (mean ± SEM). Statistical significance was assessed by one-way analysis of variance tests with the Kruskal-Wallis test.
EXAMPLES [0099] The following Examples are intended to further illustrate the invention. They are not intended to limit the object of the invention to each other.
1. Example: Solubility of imiquimod
1.1. Preliminary tests
1.1.1. Solubility of imiquimod in hydrochloric acid [0100] 48 mg of imiquimod were weighed and added to solutions of hydrochloric acid in various concentrations: in particular, 48.2 mg of imiquimod was treated with 8 ml of 0.1 N hydrochloric acid, 48.6 mg of imiquimod 9 ml 0.2 N hydrochloric acid and 48.4 mg of imiquimod 8 ml of 2 N hydrochloric acid. After rotation for 5 minutes, the samples were visually checked.
[0101] The drug is slightly soluble in 0.1 N, 0.2 N and 2 N hydrochloric acid. The system made from 2 N HCl is a transparent solution at 74 ° C. The theoretical concentration of drug dissolved therein was 0.042 M, corresponding to 1.0%.
1.1.2. Solubility of imiquimod in glacial acetic acid [0102] A weighed amount of drug (48.2 mg) was dissolved with mechanical stirring in 2 ml glacial acetic acid. After complete solubilization, a weighed portion of imiquimod (150 mg) was added to this solution for visual assessment of the maximum dissolved drug concentration. This preliminary experiment shows that it is possible to solubilize 10 g of imiquimod in 100 ml of 100% acetic acid at room temperature (10% (w / v).
1.1.3. Solubility of imiquimod in buffers [0103] The solubility of imiquimod at various pH values was determined. Two different procedures were used. The drug was dispersed in buffer (without acetic acid as a co-solvent). 72 mg of imichimod were dispersed in 10 ml of citrate buffer, 155 mg of imichimod in 10 ml of phosphate buffer and 192 mg in 10 ml of acetate buffer. After inversion for 5 minutes, each sample was visually checked.
[0104] Imichimod completely dissolved in glacial acetic acid and 1 ml of this solution (2.41% imichimod) was diluted with 9 ml water, 0.9% w / w. NaCl solution, phosphate buffer pH 7.0 (0.1 M), citrate buffer pH 6.0 (0.1 M) or acetate buffer pH 5.0 (0.1 M). A visual system check has been carried out.
[0105] The results of these preliminary tests indicate that imiquimod is slightly soluble in buffers. When the drug was dissolved in glacial acetic acid and then diluted with buffers, clear, transparent solutions were obtained: the pH of these systems was always lower than 3.6.
1.2. Imichimod analysis
1.2.1. Calibration curve of imiquimod in acetic acid using a spectrophotometer [0106] A weighed amount of drug (0.0124 g) was dissolved in 100 ml of solvent (acetic acid / water 1: 9). The solution concentration was 0.0005 M. Different amounts of this solution were conveniently diluted with the same solvent to prepare five standard solutions with concentrations ranging from 2x10<sup>-6</sup> - 5x10<sup>-5</sup> M (in particular 2x10<sup>-6</sup> M, 5x10<sup>-6</sup> M, 10x10<sup>-6</sup> M, 20x10<sup>-6</sup> M, 50x10<sup>-6</sup> M). These solutions were spectrophotometrically analyzed. Absorbance was determined at three wavelengths (250, 305, 319 nm).
[0107] The concentrations of the standard solutions used for calibrating the method and the corresponding absorbance values at 319, 305 and 250 nm are shown in Table 1 below.
Table 1: Concentration and absorbance values of imiquimod standard solutions.
<td>Concentration (10 "<sup>6</sup>minor)</td><td>λ = 319 nm</td><td>abs λ = 305 nm</td><td>λ = 250 nm</td>
<td> 2,0</td><td> 0,0308</td><td> 0,0254</td><td> 0,0652</td>
<td> 5,0</td><td> 0,0669</td><td> 0,0625</td><td> 0,2853</td>
<td>Concentration (10 "<sup>6</sup>minor)</td><td>λ = 319 nm</td><td>abs λ = 305 nm</td><td>λ = 250 nm</td>
<td> 10,0</td><td> 0,13,29</td><td> 0,1146</td><td> 0,4213</td>
<td> 20,0</td><td> 0,2548</td><td> 0,2082</td><td> 0,6687</td>
<td> 50,0</td><td> 0,6164</td><td> 0,4858</td><td> 1,3974</td>
1.2.2. Imichimod in acetic acid calibration curve by HPLC [0108] A weighed amount of imiquimod (0.0316 g) was dissolved in 250 mL solvent (acetonitrile (ACN) / water pH 3.5). The concentration of the solution was 0.0005 M. Different amounts of this solution were appropriately diluted with the same solvent to prepare standard solutions with concentrations in the range of 2x10<sup>-6</sup> - 3x10<sup>-5</sup> M (in particular 2x10<sup>-6</sup> M, 3x10<sup>-6</sup> M, 10x10<sup>-6</sup> M, 20x10<sup>-6</sup> M, 30x10<sup>-6</sup> M). These solutions were analyzed by HPLC on imiquimod.
[0109] Samples were analyzed under the following conditions:
• Column: Symmetry Shield RP18 (150 x 4.6 mm, 3.5 μm) • Pre-column: Symmetry C18 (3.9 x 20 mm, 5 μm) • Mobile phase: Solution A: Acetonitrile [0110] Solution B: solution containing 50 mM ammonium acetate (3.85 g in 11 water) • Flow (ml / min): 1.0 • Gradient: see Table 2 • Furnace temperature (° C): 40 • Wavelength (nm): 250 · Volume injected Yl): 20
Table 2: HPLC calibration gradient
<td>Time (minutes)</td><td>Solution A (%)</td><td>Solution B (%)</td><td>elution</td>
<td> 0</td><td> 20</td><td> 80</td><td>balancing</td>
<td> 0-16</td><td> 20-30</td><td> 80-70</td><td>linear gradient</td>
<td> 16-18</td><td> 30</td><td> 70</td><td>isocratically</td>
<td> 18-26</td><td> 30-50</td><td> 70-50</td><td>linear gradient</td>
<td> 26-31</td><td> 50-80</td><td> 50-20</td><td>linear gradient</td>
<td>Time (minutes)</td><td>Solution A (%)</td><td>Solution B (%)</td><td>elution</td>
<td> 31-40</td><td> 80</td><td> 20</td><td>isocratically</td>
<td> 40-42</td><td> 80-20</td><td> 20-80</td><td>linear gradient</td>
<td> 42-50</td><td> 20</td><td> 80</td><td>rebalancing</td>
[0111] Under these analysis conditions, the retention time of imiquimod was 18 minutes.
[0112] The concentrations of the standard solutions used in the calibration method and the respective areas under the peaks are shown in Table 3 below.
Table 3: Concentrations and areas under the peaks of imiquimod standard solutions.
<td>Concentration (10<sup>-6</sup>minor)</td><td>Field (contractual units)</td>
<td> 2,0</td><td> 55868,98</td>
<td> 3,0</td><td> 74818,33</td>
<td> 10,0</td><td> 262028,00</td>
<td> 20,0</td><td> 526459,49</td>
<td> 30,0</td><td> 824246,64</td>
1.3. Solubility test
1.3.1. Solubility of imiquimod in glacial acetic acid and buffers [0113] As stated, the solubility of imiquimod in glacial acetic acid at room temperature was 100 mg / ml (10% w / v).
[0114] Solubility was experimentally determined by weighing out 1200 mg of the drug, adding 10 ml glacial acetic acid and gently shaking the dispersion for 24 hours. This sample, after filtration (0.22 μm Millipore membrane filter) was analyzed by HPLC for imiquimod content and its pH was measured.
[0115] Imichimod (738 mg) was initially dissolved in glacial acetic acid (10 mL). A certain volume of this solution was appropriately diluted with phosphate buffer pH 7.0 (0.1 M), citrate buffer pH 6.0 (0.1 M) or acetate buffer pH 5.0 (0.1 M) to produce systems containing 2, 0% medicine. Samples, after filtration through a 0.22 μm Millipore membrane filter, were analyzed spectrophotometrically and chromatographically for imiquimod content. PH was determined.
[0116] The drug solubility values in glacial acetic acid or in acetic acid diluted with phosphate, citrate or acetate buffer (0.1 M) were determined by HPLC and / or spectrophotometry and the respective pH values are shown in Table 4.
Table 4: Compositions, solution pH and solubility of imiquimod in systems
<td colspan="4">Percent</td><td colspan="2">Imichimod (Wt.% / Vol.)</td><td></td>
<td>glacial acetic acid</td><td>pH phosphate buffer 7.0</td><td>citrate buffer pH 6.0</td><td>acetate buffer pH 5.0</td><td>UV</td><td>HPLC</td><td>pH</td>
<td> 100</td><td></td><td></td><td></td><td></td><td> 7,50</td><td></td>
<td> 27</td><td> 73</td><td></td><td></td><td> 1,55</td><td> 1,69</td><td> 2,92</td>
<td> 27</td><td></td><td> 73</td><td></td><td> 0,72</td><td> 0,86</td><td> 3,20</td>
<td> 27</td><td></td><td></td><td> 73</td><td> 1,92</td><td> 1,89</td><td> 2,92</td>
1.3.2. Solubility of imiquimod in short chain acids [0117] Certain inorganic and organic acids have been considered as potential drug solubilizers. 100 mg of imiquimod were dissolved in 10 ml of 0.1 M phosphoric acid, 0.1 M succinic acid, 0.1 M citric acid, 0.01 M acetic acid, 0.05 M, 0.1 M and 0.01 lactic acid M, 0.05 M, 0.088 M, and 0.1 M. These systems, after filtration, were analyzed spectrophotometrically for imiquimod and their pH measured.
1.3.3. Solubility of imiquimod in the presence of cyclodextrin [0118] Exactly weighed amounts of imiquimod (200 mg) and hydroxypropyl-β-cyclodextrin (ΗΡ-β-CD) (4000 mg) were dissolved in 10 ml:
• water • water at pH 5.0 (HCl corrected) • water at pH 3.0 (HCl corrected) • lactic acid solution (0.1 M) [0119] After shaking for 24 hours and filtration (membrane filter 0.22 μm Millipore) dissolved imiquimod was determined spectrophotometrically. The pH of the solution was also measured.
1.3.4. Solubility of imichimod in the presence of surfactants [0120] Imichimod (200 mg) was weighed and mixed with various amounts of surfactants (Tween 20, Tween 80, Cremophor EL or Pluronic F-68) for the preparation of preparations containing 0.5, 2.5 and 5% surfactant.
Each mixture was added to 10 ml of lactic acid (0.1 M), gently shaken for hours, filtered and analyzed by spectrophotometry, and pH was measured.
[0121] Imichimod present in solution in compositions prepared with various acids and surfactants was determined spectrophotometrically and the values are shown in Table 5 together with the pH values.
Table 5: Composition, pH value and amount of imiquimod in preparations Acid (M) Excipient (%) Imiquimod pH
<td></td><td> 1,80</td><td> 2,94</td><td> 2,10</td><td> 4,37</td><td>OO ABOUT<sub>r</sub></td><td> 3,97</td><td> 4,20</td><td> 3,90</td><td> 3,71</td><td> 3,61</td><td> 3,88</td><td> 3,86</td><td> 3,89</td><td> 3,83</td><td> 3,82</td><td> 3,82</td>
<td>(Wt.% / Vol.)</td><td> 0,159</td><td> 0,079</td><td> 0,010</td><td> 0,070</td><td> 0,220</td><td>about CC ^ ICT</td><td> 0,130</td><td> 0,530</td><td>about 00 about"</td><td> 0,980</td><td> 0,945</td><td>^ r about about</td><td> 1,001</td><td> 0,997</td><td> 1,009</td><td> 0,872</td>
<td>HP-ECD</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>Pluronic F68</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>Cremophor EL</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>Tween 80</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>Ά about"</td><td>Ά these</td><td><a iri</td>
<td>Tween twenty</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>Ά about"</td><td>ιζγ these</td><td>ABOUT<sub>r</sub>ir?</td><td></td><td></td><td></td>
<td>lactic acid</td><td></td><td></td><td></td><td></td><td></td><td></td><td> 0,010</td><td> 0,050</td><td>00 00 about about"</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td>
<td>acid acetic</td><td></td><td></td><td></td><td> 0,010</td><td> 0,050</td><td> 0,100</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>citric acid</td><td></td><td></td><td> 0,100</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>succinic acid</td><td></td><td> 0,100</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>phosphoric acid</td><td> 0,100</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
Acid (M) Excipient (%) Imichimod pH
<td></td><td> 3,90</td><td> 3,87</td><td> 3,88</td><td> 3,85</td><td> 3,87</td><td> 3,89</td><td> 7,09</td><td>Γmd "</td><td> 3,05</td><td> 4,46</td>
<td>(Wt.% / Vol.)</td><td>00 00 about"</td><td> 0,989</td><td> 0,969</td><td>00 ^ r ABOUT<sub>r</sub></td><td>00 00 ABOUT<sub>r</sub></td><td> 0,972</td><td> 0,004</td><td> 0,143</td><td> 0,655</td><td> 1,141</td>
<td>HP-βCD</td><td></td><td></td><td></td><td></td><td></td><td></td><td> 40,0</td><td> 40,0</td><td> 40,0</td><td> 40,0</td>
<td>Pluronic F68</td><td></td><td></td><td></td><td>MD about"</td><td>MD ^ these</td><td>ABOUT<sub>r</sub>md "</td><td></td><td></td><td></td><td></td>
<td>Cremophor EL</td><td>MD about"</td><td>md ^ these</td><td>ABOUT<sub>r</sub>md "</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>Tween 80</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>Tween twenty</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>lactic acid</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td> 0,100</td><td></td><td></td><td></td><td> 0,100</td>
<td>acid acetic</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>citric acid</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>succinic acid</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
<td>phosphoric acid</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td>
1.3.5. Solubility of imichimod in glycerol or propylene glycol [0122] Imichimod was weighed (100 mg) and glycerol or propylene glycol was added to a volume of 10 ml. After shaking (at 120 ° C for 24 hours) and cooling, 10 ml of water were added: the dispersions were filtered and the amount of imiquimod in liquid phases was determined. The system prepared with glycerol as solvent showed a pH of 5.42 and an imimimod concentration of 0.02%. When propylene glycol was used, the pH was 3.03 and the concentration of imiquimod in the solution was 0.02%.
1.4. Discussion of the results [0123] Imichimod is much better soluble in pure acetic and lactic acid (> 7.5% w / v). These two acids can be used as cosolvents for the preparation of preparations containing relatively high amounts of the active substance. [0124] Among the acids considered as a solubilizer for imiquimod, acetic and lactic acids confirm the ability to interact with the drug and its solubilization. The amount of drug in solution is directly related to the acid concentration (this is also confirmed in Example 6.1.). As a solubilizer, lactic acid is more effective than acetic acid. [0125] Surfactants combined with lactic acid do not improve the solubility of imiquimod. The results obtained show that for these systems, the solubility of the drug depends primarily on lactic acid and indicate that the drug is not trapped in micelles formed by surfactants.
[0126] Regarding the inclusion agent, although a single, high concentration of HP-e-CD was used, it can be confirmed that this complexing agent does not substantially modify drug solubility: the increasing concentrations observed in various experiments are due to decreasing pH.
[0127] When HP-e-CD was used in combination with lactic acid, a small but significant increase (about 18%) in solubility could be observed.
2. Example: Thermoreversible gel imiquimod preparations
2.1. Preparations of semi-solid systems
2.1.1. Preparations with Poloxamer 407 [0128] Poloxamer 407 was used to prepare semi-solid systems that contained as the liquid phase:
• water • 10% acetic acid solution • 0.1 M acetic acid solution • 0.1 M lactic acid solution [0129] All systems consisted of 25% polymer (total amount / concentration of teruvial agent)
2.1.2. Preparations with Poloxamer 407 and hydroxypropyl methylcellulose (not according to the invention) [0130] The effect of cellulose derivative, hydroxypropyl methylcellulose (HPMC Methocel KL5M, Colorcon, MW 15000) on the thermal gelling properties of poloxamer was evaluated: pure HPMC has a gel phase transition between 40 and 50 ° C and its lower critical solution temperature (LCST) can be lowered by chemical modification (by reducing the degree of substitution, the gel transition temperature can be lowered to about 40 ° C). Different amounts of this polymer were used: the compositions of the HPMC containing formulations were as follows:
Table 6: Compositions containing HPMC
<td colspan="3">Composition (%)</td>
<td>Poloxamer 407</td><td>HPMC</td><td>water</td>
<td> 25</td><td> 0</td><td> 75,0</td>
<td> 25</td><td> 0,5</td><td> 74,5</td>
<td> 25</td><td> 1,0</td><td> 74</td>
<td> 25</td><td> 2,0</td><td> 73</td>
As a result, the addition of cellulose derivatives does not significantly modify the rheological behavior of the preparations.
2.1.3. Preparations with Poloxamer 407 and cyclodextrin (not according to the invention) [0132] The use of cyclodextrin as a component of thermosensitive semi-solid systems has been described in the literature (CDG. Palmieri et al., 15th Int. Sym. On Microencapsulation, Parma, Italy September 18-21, 2005). ). HydroxypropylT-cyclodextrin (ΗΡ-β-CD) in high percentage amounts, in the range from 0 to 20%, was used in systems consisting of
Poloxamer 407 and water and the LCST of these preparations was determined.
2.1.4. Preparations with poloxamer and Poloxamer 188 (not according to the invention) [0133] Mixtures of poloxamer as gelling systems were also evaluated. Poloxamer 188, a PEO-PPO-PEO copolymer with a molecular weight lower than that of Poloxamer 407, can be used to modulate LCST gel. Poloksamer 407 was partially replaced
Poloxamer 188 to form hydrogels that contain amounts of polymers corresponding to 25%.
Table 7: Various mixtures of poloxamers
<td colspan="3">Composition (%)</td><td>Polymer ratio</td>
<td>Poloxamer 407</td><td>Poloxamer 188</td><td>water</td><td></td>
<td> 23,75</td><td> 1,25</td><td> 75</td><td> 9,5/0,5</td>
<td> 22,50</td><td> 2,5</td><td> 75</td><td> 9/1</td>
<td> 21,25</td><td> 3,75</td><td> 75</td><td> 8,5/1,5</td>
<td> 21</td><td> 4</td><td> 75</td><td> 8/2</td>
2.1.5. Preparations with poloxamers and lactic or acetic acid (not according to the invention) [0134] The liquid phase (water) was replaced with lactic acid or acetic acid: their and drug's effects were evaluated on the rheological behavior of thermosensitive systems. Among the various gel formulations made with organic acids (lactic or acetic acid), those with gel transition temperatures around 20 ° C were considered. So, the gel systems we selected included:
• 20% w / w Poloxamer 407 • 25% w / w Poloxamer 407 / Poloxamer 188 (9: 1 weight ratio)
2.1.6. Preparations with imiquimod [0135] The composition of the gels tested was as follows:
Imichimod PPG-LA 01 [0136]
<td></td><td>Imichimod</td><td>0.90 g</td>
<td></td><td>Poloxamer 407</td><td>22.50 g</td>
<td></td><td>Poloxamer 188</td><td>2.50 g</td>
<td></td><td>Lactic acid solution (0.135 M)</td><td>74.02 g</td>
<td colspan="2">Imichimod PG-LA 01</td><td></td>
<td> [0137]</td><td>Imichimod</td><td>0.90 g</td>
<td></td><td>Poloxamer 407</td><td>20.00 g</td>
<td></td><td>Lactic acid solution (0.125 M)</td><td>79.02 g</td>
<td colspan="2">Imichimod PPG-AA 01 (not according to the invention)</td><td></td>
<td> [0138]</td><td>Imichimod</td><td>0.40 g</td>
<td></td><td>Poloxamer 407</td><td>22.50 g</td>
<td></td><td>Poloxamer 188</td><td>2.50 g</td>
<td></td><td>Acetic acid solution (0.135 M)</td><td>74.02 g</td>
Imichimod PG-AA01 (not according to the invention) [0139]
Imichimod 0.40 g
Poloksamer 407 20.00 g
Acetic acid solution (0.125 M) 79.02 g
2.2. Influence of ingredients on lower critical solution temperature (LCST) [0140] LCST values cannot be determined by DSC: although systems consisting of pure Poloxamer 407 showed an endothermic peak that can be associated with gel transition using a mixture of poloxamers, ΗΡ-β- CD / Poloksamer 407 or HPMC / Poloksamer 407 as gelling agents, DSC transition signal was lost. Thus, the gel transition temperature was determined by a viscosity measurement method. The viscosities of the systems were determined in a temperature range of 1-40 ° C using a BROOKFIELD DV-II + rheometer, equipped with a small sample adapter and an S-25 spindle.
2.2.1. Viscosity of systems containing different amounts of Poloxamer 407 [0141] With a decrease in the percentage of polymer, LCST increases (see Figure 1): at a lower concentration of poloxamer, micelles require excess energy to establish interactions giving a semi-solid consistency to the formulation. The LCST of the gels containing 20 or 25% Poloxamer 407 and water as solvent is 19.93 and 13.9 ° C, respectively. These results are consistent with those described in the literature [A. Cabana et al., Study of the Gelation Process of Polyethylene Oxide-Polypropylene Oxide-Polyethylene Oxide Copolymer (Poloxamer 407) Aqueous Solutions, J. COLLOID INTERFACE SCI. 190, 307-312 (1997)].
2.2.2. Viscosity of systems containing poloxamer and HPMC [0142] It was found that HPMC, in the concentration range considered (<2%), does not modify the gel transition temperature of the formulation containing pure Poloxamer 407.
2.2.3. Viscosity of systems containing poloxamer and cyclodextrin [0143] Increasing the percentage of cyclodextrin (HP-e-CD) led to a weak but significant increase in LCST: the results obtained indicate a non-linear relationship between CD concentration and viscosity. Because CD increases drug solubility (an increase of about 17%), the use of this component in final gel formation may be considered (measurements on drug-containing systems were not performed) (see Figure 2).
2.2.4. Viscosity of systems containing a mixture of Poloxamer 407 and 188 [0144] Appropriate effect of poloxamer 188 on LCST was observed: increasing the content of this component increases the gel transition temperature (please note the linear relationship between P188 concentration and system viscosity) (see Figure 3).
2.2.5. Viscosity of systems containing acetic acid, lactic acid and imiquimod [0145] It should be noted that, regardless of the gelling system, acetic acid raises the LCST of the system: this acid component increases the LCST of imiquimod PG-AA 01 and imiquimod PPG-AA 01 to 22.85 ° C. Imichimod does not significantly modify the gel transition temperature (22.95 and 23.00 ° C for imiquimod PG-AA 01 and imiquimod PPG-AA 01, respectively) (Figures 4, 5, 6).
[0146] Lactic acid also increases the LCST of the gel preparations: as previously observed for acetic acid, the gel transition temperature of poloxamer 407 containing systems is 23.8 ° C. For the Poloksamer 407 / Poloksamer 188 mixture, in the presence of lactic acid, this value is even higher (= 25.9 ° C) (Figures 7, 8, 9).
[0147] Unlike acetic acid, imiquimod significantly affects LCST systems made with lactic acid: for imiquimod PG-LA 01 (pure Poloxamer 407), the drug obtains a further, slight increase in gel transition temperature (Figure 8); when a mixture of gelling components is used, the temperature drops to 24.1 ° C (LCST gel in the absence of drug = 25.9 ° C) (Figure 9).
3. Example: Dissolution / erosion test and formulation release experiments containing imiquimod
3.1. The compositions and conditions of the experiment
3.1.1. Compositions [0148] The dissolution / erosion test assay was performed for the following formulations:
Imichimod PG-LA 01 [0149]
Imichimod 0.90 g
Poloksamer 407 20.00 g
Lactic acid solution (0.125 M) 79.02 g
PG-LA01 [0150]
Poloksamer 407 20.00 g
Lactic acid solution (0.125 M) 79.02 g
3.1.2. Experiment conditions [0151] The test is illustrated in the "Development and in-vitro evaluation of sustained release Poloxamer 407 (P407) gel formulations of ceftiofur" by L. Zhang -J. Control. Release, 85 (2002) 73-81. The test was carried out in 10 ml vials sealed with elastomer. A weighed amount from about 3 g of the formulation as a sol (temperature = 4 ° C) was transferred to the vial and the vial was stored at 37 ° C for gelation. The vial was then weighed, 2 ml of acetate buffer (pH 6.0; 0.1 M) was placed on the gel layer. At fixed intervals (after 1, 2, 3, 4 hours) the liquid phase was completely removed and the vial was weighed. Fresh acetate buffer was placed on the remaining gel. The difference in mass of the vial after each time interval corresponded to the amount of gel dissolved by the buffer. The percentage of dissolved gel was given as a function of time.
[0152] For comparison, the gel tested by Zhang (J. Control. Release, 85 (2002) 73-81) was considered: it was a 25% Poloxamer 407 gel system containing ceftiofur.
3.2. Results and discussion [0153] The results obtained are illustrated in Figure 10 (values are means of three replicates). It can be seen that the erosion profiles of the systems considered are quite similar (p> 0.973), indicating that the drug does not affect polymer erosion. Dissolution / erosion of both systems was a zero order kinetics process, almost up to 4 hours (about 40% erosion): Zhang observed identical kinetics, but the process speed was higher (about 0.26% min<sup>-1</sup>) than the one we received (about 0.19% min<sup>-1</sup>) Zhang observed that the pH of the dissolution medium had a negligible effect on the dissolution of the gel and phosphate buffer solutions with different pH were used as the solvent for the polymer. Current discoveries may be associated with low pH formulations or lactic acid interactions with poloxamer.
[0154] Furthermore, during the dissolution / erosion experiment with imiquimod formulation from
PG-LA 01, no drug separation / precipitation was observed.
4. Example: Imichimod diffusion / release experiments
<td>4.1. The compositions and conditions of the experiment 5 4.1.1. compositions Imichimod PPG-LA 01</td><td></td>
<td colspan="2"> 10 [0155]</td>
<td>Imichimod</td><td>0.90 g</td>
<td>Poloxamer 407</td><td>22.50 g</td>
<td>Poloxamer 188</td><td>2.50 g</td>
<td>Lactic acid solution (0.135 M)</td><td>74.02 g</td>
Imichimod PG-LA 01
<td> [0156]</td><td>Imichimod Poloxamer 407 Lactic acid solution (0.125 M)</td><td>0.90 g 20.00 g 79.02 g</td>
<td>PG-LA01</td><td></td><td></td>
<td> 15</td><td></td><td></td>
<td> [0157]</td><td>Poloxamer 407</td><td>20.00 g</td>
<td></td><td>Lactic acid solution (0.125 M)</td><td>79.02 g</td>
4.1.2. Experiment conditions [0158] Imichimod diffusion / release experiments were performed with Franz cells with an effective diffusion surface of 1.76 cm<sup>2</sup> and the volume of the receiving compartment 14 ml: the delivery compartment contained about 2 g of gel formulation, while the receiving compartment was filled with 0.1 M lactic acid solution (pH = 3.5). A cellulose acetate membrane (MWCO = 23,000) was placed between the two compartments. Experiments were carried out at 37 ° C using a recirculation bath and the fluid in the receiving chamber was stirred at 300 rpm at all times.
[0159] At set intervals, the receiving phase was completely withdrawn and replaced with fresh acid solution. The receiving solution was subjected to UV analysis for imiquimod.
4.2. Results and discussion [0160] The flow of imiquimod through the artificial barrier is high (1.95x10<sup>-6</sup> gi'nPs<sup>-</sup>and constant (almost for the first hour), suggesting that drug transfer across the membrane does not affect the imiquimod kinetics through poloxamer gels.
[0161] Imiquimod gel preparation profiles are very different from the solution profiles but very similar to each other. Imichimod diffuses through the gel matrix at a relatively high rate: after 6 hours, about 44.4% for imiquimod from PG-LA 01 and about 48.3% for imiquimod from PPG-LA01 was in the receiving phase of Franz's cell. Drug diffusion profiles for both gel preparations are linear, suggesting pseudo zero order kinetics: imiquimod flows through the gel matrix are 2.00x10<sup>-7</sup> gOiiY 'for imiquimod from PG-LA 01 and 2.19x10<sup>-7</sup> bosom<sup>-</sup>'for imiquimod with the PPG-LA01 system (Figure 11).
[0162] These findings lead to the conclusion that the diffusion rate of the drug across the two systems studied is not significantly different and show that the composition of the gelling material does not significantly affect the diffusion of imiquimod in the gel: the small particle size (low molecular weight) of the active agent promotes its movement through the micellar structure of the gel.
[0163] As the experiment progresses, the polymer gradually dissolves in the liquid that passes through the membrane. The outflow of liquid, in countercurrent to the drug, could change the diffusion of the active molecule from the delivery to the receiving compartment. However, this effect is negligible: the outflow of imiquimod through the membrane is 10 times higher than its outflow through poloxamer systems.
5. Example: Imichimod penetration test
5.1. The compositions and conditions of the experiment
5.1.1. Compositions [0164] The compositions tested were:
• 0.9% imiquimod - 15% HP-e-CD in 0.1 M lactic acid solution • 0.9% imiquimod in 19% gel Poloxamer 407 containing 15% HP-e-CD (0.1
M lactic acid) • 0.9% imiquimod in liposomal dispersion (1% soy lecithin in 0.1 M lactic acid solution)
5.1.2. Experimental conditions [0165] A bladder of 6-9 month old female pigs was used: immediately after excision, the urethra was cut off and the bladder epithelium (BE) was cut to form pieces with an area of about 3 cm<sup>2</sup>. Each portion of epithelium attached between the compartments of Franz's cell with the inner surface facing up. As the receiving phase (lower compartment), a 0.1 M phosphate buffer solution (pH 7.4) was used: it was kept under mechanical stirring (about 300 rpm) at 37 ° C during the experiment. One of the formulations described represents the feed phase (upper compartment): the formulation (2 g) was introduced into the receiving compartment when the apparatus temperature reached 37 ° C. At the end of the experiment (4 hours after the start), BE removed from the diffusion cell was thoroughly washed with distilled water to remove excess formulation and carefully wiped with paper. Then BE was frozen and cut with a cryostatic microtome. Five consecutive BE slices (each 100 m thick) were introduced into the tube, 5 ml lactic acid (92%) added and kept shaking overnight. The liquid phase was filtered (0.22 μm) and tested by HPLC on imiquimod.
5.2. Results [0166] Figure 12 shows the results obtained showing the amount of imiquimod recovered in BE after 4 hours of contact with the formulation (data are normalized to the absorption area). Data are the average of 3 experiments (solution and liposomes) or 6 experiments (gel formulation).
[0167] The gel formulation affects the absorption of imiquimod into the bladder epithelium: the amount of active agent released from the gel and recovered in BE is lower than the amount released from the solution. It is interesting to note that the amount of imiquimod formulated in liposomes and present in BE is greater than the amount from solution: this result suggests the supporting effect of lipid vesicles on drug absorption.
6. Example: Solubility, density and viscosity of various compositions containing imiquimod
6.1. Solubility
6.1.1. Compositions [0168] The solubility of imiquimod has been determined in various solvent systems:
• lactic acid solutions - 0.025, 0.05, 0.1 and 0.2 M • 0.1 M lactic acid solution containing 5 or 15% HP-e-CD • 0.1 M lactic acid solution containing 5, 16 and 20% Poloxamer 407 • 0.1 M lactic acid solution containing 5 or 15% HP-β -CD and 16% Poloxamer 407 • 0.1 M solutions of glycolic acid, tartaric acid and glutamic acid • DMSO • N-methyl pyrrolidone • PEG 400
6.1.2. Experimental conditions [0169] An amount exceeding the solubility of the drug (2 g) was added to various solvent systems (50 ml) and stirred for 24 hours (400 rpm) at 25 ° C. The dispersions were centrifuged at 10,000 rpm for 10 minutes and the liquid phases were collected and stored at room temperature until analysis. The concentration of imiquimod in these solutions was determined spectrophotometrically (λ = 319 nm) after appropriate dilution.
6.1.3. Results and discussion [0170] Table 8 gives the results obtained. The values are means of 3 determinations. The solubility of imiquimod in the maleic acid solution will be determined within a few days.
Table 8: Solubility studies of imiquimod in various solvent systems
<td>Preparation</td><td>% w / w imichimodu</td><td>pH</td>
<td>LA 0.025 M</td><td> 0,33</td><td> 3,93</td>
<td>LA 0.05 M</td><td> 0,58</td><td> 3,81</td>
<td>LA 0.1 M</td><td> 1,18</td><td> 3,73</td>
<td>LA 0.2 M</td><td> 2,20</td><td> 3,52</td>
<td>5% CD LA 01</td><td> 1,23</td><td> 3,90</td>
<td>15% CD LA 01</td><td> 1,37</td><td> 4,03</td>
<td>5% PF127 LA 01</td><td> 1,19</td><td> 3,92</td>
<td>16% PF127 LA 01</td><td> 1,10</td><td> 3,99</td>
<td>20% PF127 LA 01</td><td> 1,04</td><td> 4,16</td>
<td>5% CD- 16% PF127 LA 01</td><td> 1,15</td><td> 4,05</td>
<td>15% CD-16% PF127 LA 01</td><td> 1,22</td><td> 4,25</td>
<td>Glycolic acid 0.1 M</td><td> 0,68</td><td> 3,82</td>
<td>Tartaric acid 0.1 M</td><td> 0,01</td><td> 2,48</td>
<td>0.072 M glutamic acid</td><td> 0,54</td><td> 3,95</td>
<td>DMSO</td><td> 0,09</td><td>nd</td>
<td>N-methyl-pyrrolidone</td><td> 0,16</td><td>nd</td>
<td>PEG 400</td><td> 0,03</td><td>nd</td>
[0171] The results obtained indicate that:
• there is a linear relationship between lactic acid and imiquimod (Figure 13, top): drug solubility increases with increasing carboxylic acid concentration • cyclodextrin increases the solubility of imiquimod: also in this case, the increase in dissolved drug is linearly related to the amount of cyclodextrin used (Figure 13, down).
• Poloxamer 407 has a negative effect on the solubility of the drug: as the percentage of polymer increases, the concentration of imiquimod in the solution decreases.
• When Poloxamer 407 and cyclodextrin are present in the formulation, the opposite effects of these components are balanced and the solubility of imiquimod was not substantially modified relative to the 0.1 M lactic acid solution.
• In the presence of carboxylic acids such as glycolic, tartaric and glutamic acids, the solubility of the drug is lower than for lactic acid (glutamic acid was used at a concentration appropriate to its solubility, ie 10.6 g / l). The solubility of imiquimod observed in the presence of tartaric acid can be explained given the structural differences between this (dicarboxylic) acid and other acidic compounds (hydroxycarboxylic acids): the lower solubility value suggests the involvement of the alcohol function in the formation of the drug / hydroxycarboxylic acid adduct. For glutamic acid, the primary amino group plays the role of the hydroxyl group.
• The solubility of imiquimod in a hydrophilic, non-aqueous solvent is very low.
6.2. Density
6.2.1. Compositions [0172] The density assessment was carried out on 5 ml of the following compositions:
• 0.1 M lactic acid solution containing 16% Poloxamer 407 • 0.1 M lactic acid solution containing 5 or 15% HP-e-CD and 16% Poloxamer 407 • 0.1 M lactic acid solution containing 5 or 15% HP -e-CD, 16% Poloxamer 407 and 0.5% imiquimod • 0.1 M lactic acid solution containing 5 HP-e-CD and 0.5% imiquimod
6.2.2. Experiment conditions [0173] Five measurements were made and mean values and standard deviations were calculated
6.2.3. Results [0174]
Table 9: Density determination
<td>preparation</td><td>density ± SD (g / ml)</td>
<td>16% PF127 LA 01</td><td> 1,0155 ± 0,0032</td>
<td>5% CD-16% PF127 LA 01</td><td> 1,0299 ± 0,0039</td>
<td>15% CD-16% PF127 LA 01</td><td> 1,0639 ± 0,0040</td>
<td>5% CD-16% PF127 LA 01 - 0.5% imiquimod</td><td> 1,0359 ± 0,0033</td>
<td>15% CD-16% PF127 LA 01 - 0.5% imiquimod</td><td> 1,0670 ± 0,0023</td>
<td>5% CD LA 01 - 0.5% imiquimod</td><td> 1,0158 ± 0,0036</td>
6.3. Viscosity
6.3.1. Compositions [0175] Viscosity was determined on the following compositions:
• gel containing 16% poloxamer 407 • gel containing 16% poloxamer 407 and 15% HP-e-CD • gel containing 16% poloxamer 407 and 5% HP-CD • 0.5% solution of imiquimod in lactic acid (0.1M ) containing 15%
HP-e -CD • 0.5% solution of imiquimod in lactic acid (0.1 M) containing 5% HP-e CD • 0.5% imiquimod gel preparation containing 16% poloxamer 407 and 15%
HP-e-CD • 0.5% imiquimod gel formulation containing 16% poloxamer 407 and 5% HP-e-CD
6.3.2. Results [0176] Table 10 shows the viscosity of other systems. The values are means of 3 measurements ± SD
Table 10: gel viscosity (20 rpm) at 10, 25 and 37 ° C
<td>preparation</td><td colspan="3">Viscosity at 20 rpm (cP) ± standard deviation</td>
<td></td><td>10 ° C<sup>1</sup></td><td>25 ° C<sup>1</sup></td><td>37 ° C<sup>2</sup></td>
<td>16% PF127LA01</td><td> 22,47±0,45</td><td> 63,03±1,93</td><td> 1103,00±82,31</td>
<td>5% CD-16% PF127 LA 01</td><td> 31,90±0,35</td><td> 65,80±1,08</td><td> 571,77±94,73</td>
<td>15% CD-16% PF127 LA 01</td><td> 64,27±1,33</td><td> 76,43±0,47</td><td> 573,33±50,14</td>
<td>5% CD-16% PF127 LA 01 0.5% imiquimod</td><td> 32,27±0,40</td><td> 68,20±1,82</td><td> 963,05±3,32</td>
<td>15% CD-16% PF127 LA 01 0.5% imiquimod</td><td> 70,33±0,51</td><td> 93,47±2,64</td><td> 795,13±110,56</td>
<td colspan="4">• SC18 spindle • SC29 spindle</td>
[0177] For the tested formulations, significantly different behavior was observed at different temperatures: at 10 and 25 ° C, the addition of cyclodextrin and / or imiquimod to the polymeric solution leads to a viscosity increase, while at 37 ° C, the viscosity is lowered by cyclodextrin and increased by medicine.
7. Example: Solubility of imiquimod in saline solutions and artificial urine solution
7.1. Compositions [0178] The solubility of imiquimod contained in gel formulations was evaluated in several salt solutions. The study was conducted on imichimod preparations consisting of:
Imiquimod 0.9% gel
<td>Poloxamer 407</td><td>mg</td><td> 160,162</td>
<td>HPeCD</td><td>mg</td><td> 50,025</td>
<td>Imichimod</td><td>mg</td><td> 9,005</td>
<td>Lactic acid (90.3%)</td><td>mg</td><td> 10,017</td>
<td>Water for injections</td><td>qb mg</td><td> 1000,000</td>
<td>Imichimod 0.5% gel</td><td></td><td></td>
<td>Poloxamer 407</td><td>mg</td><td> 160,157</td>
<td colspan="3">Imiquimod 0.9% gel</td>
<td>HPeCD</td><td>mg</td><td> 50,031</td>
<td>Imichimod</td><td>mg</td><td> 5,002</td>
<td>Lactic acid (90.3%)</td><td>mg</td><td> 10,024</td>
<td>Water for injections</td><td>qb mg</td><td> 1000,000</td>
<td colspan="3">Imichimod gel 0.1%</td>
<td>Poloxamer 407</td><td>mg</td><td> 160,098</td>
<td>HPeCD</td><td>mg</td><td> 50,013</td>
<td>Imichimod</td><td>mg</td><td> 1,007</td>
<td>Lactic acid (90.3%)</td><td>mg</td><td> 10,028</td>
<td>Water for injections</td><td>qb mg</td><td> 1000,000</td>
[0179] The following solutions were used as solvents for the drug:
• water • Na 10 mM sulfate • K 14 mM phosphate • Na 25 mM bicarbonate • AUS [0180] The pH was corrected to 6.50 ± 0.05 1 HCl [0181] The artificial urine solution (AUS) had the following composition:
<td>Bicarbonate Na</td><td>25 mM</td>
<td>Urea</td><td>170 mM</td>
<td>Uric acid</td><td>0.4 mM</td>
<td>creatinine</td><td>7 mM</td>
<td>Chloride Na</td><td>90 mM</td>
<td>Sulfate Na</td><td>10 mM</td>
<td>K2 hydrogen phosphate</td><td>7 mM</td>
<td>Dihydrogen phosphate K</td><td>7 mM</td>
<td>NH4 chloride</td><td>25 mM</td>
[0182] The pH was corrected to 6.50 ± 0.05 1 M HCl]
7.2. Experimental conditions [0183] Pre-determined preparation and solvent volumes were transferred to a 10ml flask to form a mixture where the solvent / preparation volume ratio was 0.5, 1, 5 and 10. These systems were maintained under mechanical agitation for various times (25, 50 , 240 and 240 minutes for systems with 0.5, 1, 5 and 10 solvent / formulation volumes respectively). The times selected correspond to the presumed urine formation times (urine production rate = 1 ml / min) (for a system with a 10 solvent / preparation volume ratio, the applied time of 240 minutes is shorter than expected because the calculated time (500 minutes) exceeds the effective contact time of the preparation with the bladder ). After this time, the pH of each system was measured. The systems were centrifuged at 5000 rpm for 15 minutes and the recovered liquid fractions were subjected to spectrophotometric analysis (A = 319 nm) for imiquimod content.
7.3. Results and discussion [0184] Results (mean of 3 replicates) are presented as pH units and as percentages of precipitated imiquimod in Tables 11 and 12 below.
Table 11: pH measurements
<td colspan="2">Solution / preparation ratio</td><td rowspan="2">h<sub>2</sub>about</td><td rowspan="2">SO4<sup>2</sup>'</td><td rowspan="2">H2KO4P / HK2O4P</td><td rowspan="2">HCO<sup>3-</sup></td><td rowspan="2">AUS</td><td rowspan="2">Gel 0.9%</td>
<td>Imiquimod 0.9% gel</td><td>solution</td>
<td> 0</td><td></td><td></td><td> 6,53</td><td> 6,50</td><td> 6,52</td><td> 6,51</td><td> 3,40</td>
<td> 1</td><td> 0,5</td><td> 3,34</td><td> 3,30</td><td> 3,38</td><td> 3,48</td><td> 3,56</td><td></td>
<td> 1</td><td> 1</td><td> 3,25</td><td> 3,31</td><td> 3,36</td><td> 3,50</td><td> 3,80</td><td></td>
<td> 1</td><td> 5</td><td> 4,50</td><td> 3,28</td><td> 3,57</td><td> 4,49</td><td> 5,73</td><td></td>
<td> 1</td><td> 10</td><td> 3,30</td><td> 3,30</td><td> 3,89</td><td> 6,10</td><td> 6,33</td><td></td>
<td colspan="2">Solution / preparation ratio</td><td>H2O</td><td>SO4<sup>2</sup>'</td><td>H2KO4P /</td><td>HCO<sup>3-</sup></td><td>AUS</td><td>Gel</td>
<td>Imichimod 0.5% gel</td><td>solution</td><td></td><td></td><td>HK2O4P</td><td></td><td></td><td> 0,5%</td>
<td> 0</td><td></td><td></td><td> 6,53</td><td> 6,50</td><td> 6,52</td><td> 6,51</td><td> 3,21</td>
<td> 1</td><td> 0,5</td><td> 3,28</td><td> 3,30</td><td> 3,33</td><td> 3,49</td><td> 3,72</td><td></td>
<td colspan="2">Solution / preparation ratio</td><td rowspan="2">H2O</td><td rowspan="2">SO4<sup>2</sup>'</td><td rowspan="2">H2KO4P / HK<sub>2</sub>ABOUT<sub>4</sub>P</td><td rowspan="2">HCO<sup>3-</sup></td><td rowspan="2">AUS</td><td rowspan="5">Gel 0.9%</td>
<td>Imiquimod 0.9% gel</td><td>solution</td>
<td> 1</td><td> 1</td><td> 3,36</td><td> 3,35</td><td> 3,42</td><td> 3,66</td><td> 4,06</td>
<td> 1</td><td> 5</td><td> 3,26</td><td> 3,30</td><td> 3,68</td><td> 5,10</td><td> 6,41</td>
<td> 1</td><td> 10</td><td> 3,33</td><td> 3,35</td><td> 4,08</td><td> 6,55</td><td> 6,60</td>
<td colspan="2">Solution / preparation ratio</td><td rowspan="2">H2O</td><td rowspan="2">SO4<sup>2</sup>'</td><td rowspan="2">H2KO4P / HK<sub>2</sub>ABOUT<sub>4</sub>P</td><td rowspan="2">HCO<sup>3-</sup></td><td rowspan="2">AUS</td><td rowspan="2">Gel 0.5%</td>
<td>Imichimod gel 0.1%</td><td>solution</td>
<td> 0</td><td></td><td></td><td> 6,53</td><td> 6,50</td><td> 6,52</td><td> 6,51</td><td> 3,21</td>
<td> 1</td><td> 0,5</td><td> 2,88</td><td> 2,85</td><td> 2,91</td><td> 3,06</td><td> 3,31</td><td rowspan="4"></td>
<td> 1</td><td> 1</td><td> 2,80</td><td> 2,81</td><td> 2,95</td><td> 3,25</td><td> 3,62</td>
<td> 1</td><td> 5</td><td> 2,90</td><td> 2,94</td><td> 3,34</td><td> 4,88</td><td> 6,14</td>
<td> 1</td><td> 10</td><td> 3,02</td><td> 3,09</td><td> 3,78</td><td> 8,29</td><td> 6,53</td>
Table 12: Imiquimod precipitation
<td colspan="6">Precipitated imiquimod (% p / p)</td>
<td colspan="6">Sulfate solution</td>
<td colspan="2">Solution / preparation ratio (v / v)</td><td> 0,5</td><td> 1</td><td> 5</td><td> 10</td>
<td colspan="6"></td>
<td rowspan="3">Initial% imiquimod</td><td> 0,9</td><td> 22,46</td><td> 47,56</td><td> 83,54</td><td> 75,84</td>
<td> 0,5</td><td> 43,17</td><td> 69,28</td><td> 71,54</td><td> 68,56</td>
<td> 0,1</td><td> 0,00</td><td> 0,00</td><td> 0,00</td><td> 0,00</td>
<td colspan="6">Bicarbonate solution</td>
<td colspan="2">Solution / preparation ratio (v / v)</td><td> 0,5</td><td> 1</td><td> 5</td><td> 10</td>
<td colspan="6"></td>
<td rowspan="3">Initial% imiquimod</td><td> 0,9</td><td> 0,00</td><td> 0,00</td><td> 43,22</td><td> 99,76</td>
<td> 0,5</td><td> 0,00</td><td> 0,00</td><td> 74,82</td><td> 99,77</td>
<td> 0,1</td><td> 0,00</td><td> 1,86</td><td> 0,00</td><td> 98,84</td>
<td colspan="6">Phosphate buffer solution</td>
<td colspan="2">Solution / preparation ratio (v / v)</td><td> 0,5</td><td> 1</td><td> 5</td><td> 10</td>
<td colspan="6"></td>
<td rowspan="2">Initial% imiquimod</td><td> 0,9</td><td> 0,00</td><td> 0,00</td><td> 0,33</td><td> 4,29</td>
<td> 0,5</td><td> 2,21</td><td> 0,00</td><td> 1,30</td><td> 2,19</td>
<td colspan="6">Precipitated imiquimod (% p / p)</td>
<td colspan="6">Sulfate solution</td>
<td></td><td> 0,1</td><td> 0,00</td><td> 0,26</td><td> 0,00</td><td> 1,29</td>
<td colspan="6">Water</td>
<td colspan="2">Solution / preparation ratio (v / v)</td><td> 0,5</td><td> 1</td><td> 5</td><td> 10</td>
<td colspan="6"></td>
<td rowspan="3">Initial% imiquimod</td><td> 0,9</td><td> 30,36</td><td> 0,00</td><td> 2,60</td><td> 3,06</td>
<td> 0,5</td><td> 0,39</td><td> 0,00</td><td> 0,74</td><td> 2,74</td>
<td> 0,1</td><td> 0,00</td><td> 0,00</td><td> 0,00</td><td> 0,00</td>
<td colspan="6">Artificial urine solution</td>
<td colspan="2">Solution / preparation ratio (v / v)</td><td> 0,5</td><td> 1</td><td> 5</td><td> 10</td>
<td colspan="6"></td>
<td rowspan="3">Initial% imiquimod</td><td> 0,9</td><td> 23,23</td><td> 44,02</td><td> 96,60</td><td> 98,92</td>
<td> 0,5</td><td> 38,89</td><td> 57,75</td><td> 97,93</td><td> 98,63</td>
<td> 0,1</td><td> 0,00</td><td> 0,00</td><td> 84,29</td><td> 86,35</td>
[0185] The pH of various solutions (except AUS) was corrected to about 6.5. It should be noted that • a small volume of solution (regardless of the type of salt) cannot control the pH of the mixture.
• AUS and bicarbonate solution at high volume to formulation ratio showed a pH that did not differ significantly from the initial value.
• the amount of drug present in the formulation did not significantly change the buffering capacity of AU.S and bicarbonate solution: a slight decrease in pH was observed when the percentage of imiquimod in the formulation decreased (increase in free lactic acid).
[0186] Dilution with water did not cause significant precipitation of the drug, regardless of the gel / solution ratio: the exception was the 0.9% imiquimod water / gel system (0.5: 1 volume ratio), for which a consistent decrease in dissolved drug concentration was observed (more than 30%).
[0187] The precipitation of the drug with a phosphate buffer solution was not macroscopically obvious: at most a 4.29% decrease in the amount of drug in solution for the formulation containing the highest amount of imiquimod (0.9%) and at the maximum dilution ratio.
[0188] Among the anions, only bicarbonate provided the greatest drug precipitation: at a 10: 1 volume ratio, almost complete imiquimod precipitation was observed for all formulations.
[0189] The sulfate solution separated the drug from the 0.9% and 0.5% gels, but not from the 0.1% drug system: for the gel containing the most drug, there was a parabolic relationship between the percentage of imiquimod precipitated and the dilution ratio.
[0190] The results obtained with the artificial urine solution can be attributed primarily to the presence of bicarbonate and sulfate ions, although an additive / synergistic effect of some other AUS component cannot be excluded.
8. Example: Comparison of imiquimod preparations with different percentages of poloxamer
8.1. Compositions [0191] The experimental work was aimed at comparing certain physicochemical characteristics of imiquimod preparations which contain different amounts of poloxamer 407 and drug.
[0192] The tested systems had the following compositions:
<td colspan="2">Preparation 0.5% - 16 Poloxamer 407</td><td rowspan="2">160.06 mg 5.02 mg 50.06 mg 10.00 mg 1000.00 mg</td>
<td>Imichimod HPeCD Lactic acid (90.3%) Water for injections</td><td>qb</td>
<td>Preparation 0.1% - 16</td><td></td><td></td>
<td>Poloxamer 407</td><td></td><td>160.05 mg</td>
<td>Imichimod</td><td></td><td>1.01 mg</td>
<td>HPeCD</td><td></td><td>50.02 mg</td>
<td>Lactic acid (90.3%)</td><td></td><td>10.00 mg</td>
<td>Water for injections</td><td>qb</td><td>1000.00 mg</td>
<td>Preparation 0.5% - 16 Preparation 0.5% - 10 Poloxamer 407 Imichimod HPeCD Lactic acid (90.3%) Water for injections</td><td>qb</td><td>160.03 mg 5.01 mg 50.06 mg 10.00 mg 1000.00 mg</td>
<td>Preparation 0.1% - 10</td><td></td><td></td>
<td>Poloxamer 407</td><td></td><td>100.06 mg</td>
<td>Imichimod</td><td></td><td>1.04 mg</td>
<td>HPeCD</td><td></td><td>50.01 mg</td>
<td>Lactic acid (90.3%)</td><td></td><td>10.00 mg</td>
<td>Water for injections</td><td>qb</td><td>1000.00 mg</td>
8.2. Results [0193] The viscosities and pH of these preparations were determined at 25 and 37 ° C and the results are given in Table 13 below:
<td>Preparation</td><td colspan="3">Viscosity at 25 ° C (*) -</td><td colspan="3">Viscosity at 37 ° C (**) -</td><td>pH</td>
<td></td><td>Speed rotary (Rpm)</td><td>Torsional force (%)</td><td>Viscosity (CP)</td><td>Speed rotary (Rpm)</td><td>Torsional force (%)</td><td>Viscosity (CP)</td><td></td>
<td>P. 0.5% - 16</td><td> 20</td><td> 47,8</td><td> 2221</td><td> 8</td><td> 72,1</td><td> 270,7</td><td> 3,26</td>
<td>P. 0.1% - 16</td><td> 20</td><td> 50,3</td><td> 2350</td><td> 15</td><td> 83,1</td><td> 166,2</td><td> 2,99</td>
<td>P. 0.5% - 10</td><td> 35</td><td> 12,5</td><td> 334,8</td><td> 35</td><td> 11,9</td><td> 10,2</td><td> 3,23</td>
<td>P. 0.1% - 10</td><td> 35</td><td> 12,7</td><td> 340,0</td><td> 35</td><td> 11,5</td><td> 9,86</td><td> 2,60</td>
<td colspan="8">(*) Spindle No. 25 (**) Spindle No. 18</td>
9. Example: In vitro evaluation of imichimod toxicity to pig bladder epithelium
9.1. Material and methods
9.1.1. Study design [0194] The study was carried out on the bladder epithelium from two pigs using the following therapies:
• 0.1% imiquimod preparation (a mixture of 16% poloxamer, 5% hydroxypropylbetacyclodextrin, in 0.1 M lactic acid) • Medium (a mixture of 16% poloxamer, 5% hydroxypropyl betacyclodextrin, in 0.1 M lactic acid) • 0.9% NaCl solution [0195] Parts of the pig's bladder were placed between the delivery chamber (therapy) and the receiving Franz cell. The receiving PBS environment (pH 7.4) was used in all experiments. One hour after the start of the experiments, the receiving environment was removed and analyzed for imiquimod content. The bladder was recovered; the treated part was separated and divided into two parts: one was fixed in formalin, embedded, cut and stained (H&E) for histological examination; and the other part was subjected to drug extraction and analysis.
9.1.2. Review [0196] Histopathological examination was carried out on five sections of the bladder, i.e. 2 slides from pig 1 (designated imiquimod 1 and medium 1), 2 slides from pig 2 (designated imiquimod 2 and medium 2) and one slide with NaCl solution (designated control ). [0197] The slides were examined primarily for the entirety of the urinary tract epithelium and all submucosal lesions, including inflammation.
9.2. Results and conclusion [0198] Bladder epithelium and submucosa appear to be normal on all slides tested. There were no significant differences between treatments (data not shown).
9.3. Imichimod penetration experiments for toxicity assessment
9.3.1. Objective [0199] To evaluate the penetration of the active molecule into the pig bladder epithelium, a series of in-vitro penetration experiments were performed.
[0200] The studied imiquimod preparations were:
• 0.5% imiquimod in 0.1 M lactic acid solution • 0.5% imiquimod - 5% HP-e-CD in 0.1 M lactic acid solution • 0.5% imiquimod in 16% poloxamer 407 gel • 0 , 5% imiquimod - 5% HP-e-CD on a 16% poloxamer 407 gel [0201] The composition of the systems was as follows:
0.5% imiquimod in a 0.1 M lactic acid solution
<td>Imichimod</td><td></td><td>5,020 mg</td>
<td>Lactic acid (90.3%)</td><td></td><td>10,020 mg</td>
<td>Water for injections</td><td>qb</td><td>1000.00 mg</td>
<td>0.5% imiquimod - 5% HP-e-CD</td><td colspan="2">in 0.1 M lactic acid solution</td>
<td>him</td><td></td><td></td>
<td>E-HP-CD</td><td></td><td>50,080 mg</td>
<td>Imichimod</td><td></td><td>5,020 mg</td>
<td>Lactic acid (90.3%)</td><td></td><td>10,080 mg</td>
<td>Water for injections</td><td>qb</td><td>1000,000 mg</td>
0.5% imiquimod in 16% poloxamer 407 gel
<td>Poloxamer 407</td><td></td><td>160,020 mg</td>
<td>Imichimod</td><td></td><td>5,000 mg</td>
<td>Lactic acid (90.3%)</td><td></td><td>10,100 mg</td>
<td>Water for injections</td><td>qb</td><td>1000,000 mg</td>
0.5% imiquimod - 5% HP-e-CD on a 16% poloxamer 407 gel
<td>Poloxamer 407</td><td>160,162 mg</td>
<td>E-HP-CD</td><td>50.025 mg</td>
<td>Imichimod</td><td>5.005 mg</td>
0.5% imiquimod in a 0.1 M lactic acid solution
Lactic acid (90.3%) 10.017 mg
Water for injection qb 1000,000 mg
9.3.2. Method [0202] The bladder, from a 6-9-month-old female pig, was cut and secured between the compartments of Franz's cell with the inner surface up. In all experiments, a 0.1 M phosphate buffer solution (pH 7.4) was used as the receiving phase: it was mixed mechanically (about 300 rpm) at 37 ° C during the experiment. The formulation containing imiquimod (2 g) represented the feed phase.
[0203] At the end of the experiment (4 hours after the start), the bladder epithelium (BE) removed from the diffusion cell was thoroughly washed with distilled water to remove excess formulation and carefully wiped with paper. Then BE was frozen and cut with a cryostatic microtome. Five consecutive BE slices (each 100 μm thick) were introduced into the tube, 5 ml lactic acid (92%) added and kept shaking overnight. The liquid phase was filtered (0.22 μm) and tested by HPLC on imiquimod.
9.3.3. Results [0204] Figure 15 shows the results obtained giving the amount of imiquimod recovered in BE after 4 hours of contact with the preparation (data normalized for the absorption area). Data are means of 3 experiments.
10. Example: Pharmacokinetics and toxicity of intravesical imiquimod: preclinical study in pigs
10.1. Introduction [0205] To investigate whether bladder cancer could be a suitable target for imidazoquinoline (amine) therapy, TLR-7 expression in human bladder cancer and normal bladder tissue was examined. Pig tissue samples were tested for model validation. Then, to investigate the potential and risks of imidazoquinoline (amines) when used in intravesical administration, an animal study was conducted in which three different intravesical imiquimod preparations and control media were tested. Animal welfare, co-kinetic properties, cytokine production and bladder wall histology were examined.
10.2. Animals, material and methods
10.2.1. Detection of TLR-7 expression [0206] Fifteen formalin-fixed paraffin-embedded human bladder cancer samples and six normal bladder samples were stained on TLR-7 in Mosaic Laboratories, LLC (Lake Forest, CA). In addition, 28 different samples of normal (non-bladder) human tissue were stained for TLR-7 expression. In addition, tissue samples of pig bladder, tonsils, heart, liver, spleen and kidneys were tested.
[0207] The intensity of the color of each sample was evaluated relative to the intensity of a control slide containing an adjacent section stained with unbound species and isotype antibody. The color of the section marked as the control negative reagent was considered the "background." The sections were scored as follows: 0 no color against background, 1+ weak color, 2+ moderate color, and 3+ strong color. The total positive color (the sum of all 1+, 2+, and 3+ colors was recorded for each sample. The H rating was calculated based on the sum of the product of the percentage of cells stained at each intensity using the following equation: (3 x% cells 3+) + ( 2 x% of cells stained with 2+) + (1 x% of cells stained with 1+) The H-values ranged from 0-300.
10.2.2. Pig model [0208] Procedures with animals were carried out according to the protocol recommended by the Institutional Animal Care and Use Committee (IACUC, Radboud University Nijmegen Medical Center, The Netherlands) and in accordance with national and European regulations. Female pigs (Dutch Landrace) were used for this study. The urogenital tract of a pig closely resembles the human urogenital system, and the shape of the penis and foreskin diverticulum prevent catheterization through the urethra in a male pig. The sows were housed in special stainless steel pig cages and fed with universal pig food. Pigs were divided into four groups of six animals. Experimental procedures were carried out under general anesthesia. Premedication consisted of a mixture of 10 mg / kg ketamine and 0.5 to 1.0 mg / kg midazolam intramuscularly in one injection. Maintenance of relief was done with the same mixture at half dose every 45 minutes.
The bladder was emptied without injury at suction before treatment (through a Foley catheter 12) and 50 ml of study drug was instilled intravesically. The animals received a solution of 0.5% imiquimod dissolved in 0.1 M lactic acid (group 1); a solution of 0.5% imiquimod dissolved in 0.1 M lactic acid, 16% poloxamer 407 as an emulsifying agent and 15% HPeCD (hydroxypropyl-e-cyclodextrin) as a stabilizing agent (group 2); a solution of 0.5% imiquimod dissolved in 0.1 M lactic acid, 16% poloxamer 407 and 5% HPeCD (group 3) or control medium (0.1 M lactic acid) (group 4). The catheter was clamped and the instilled fluid was retained in the bladder for 60 minutes, after which the bladder was emptied. The bladder was not rinsed after emptying.
[0209] Blood samples were taken for pharmacokinetic (PK) analyzes, cytokine measurements (IL6), creatinine measurements and complete blood counts. The head or internal vein, external or common zygomatic vein was punctured, depending on the puncture angle and depth of insertion of the needle.
[0210] Samples for counting blood and measuring creatinine were collected in 3 ml potassium EDTA tubes and 3 ml lithium heparin tubes with a gel separator, respectively, before instillation and 60 minutes, 24 hours and 1 week (just before bladder excision) after starting instillation . Samples were stored on ice and transferred to the laboratory for analysis.
[0211] Blood samples for pharmacokinetic analysis and cytokine measurement were collected in 4 ml lithium heparin tubes with a gel separator before test drug instillation and 15, 30, 60, 120, 240 and 480 minutes after the start of drug instillation and also just before bladder resection. Samples were transferred on ice to a laboratory for plasma processing within 30 minutes. Blood was centrifuged for 15 minutes at 3200 rpm at 4 ° C, plasma was collected for PK and cytokine analysis, stored at 80 ° C and sent on dry ice for analysis.
[0212] The bladder content removed after therapy and urine removed just before the section were collected for imiquimod concentration analysis. Urine was immediately frozen and stored in plastic tubes at -80 ° C, and sent on dry ice to determine imiquimod content. Urine strip tests were carried out on urine removed before and after therapy and on urine collected just before the section. Imichimod plasma and urine concentrations were determined in CHIMAN srl (Rottofreno, Italy) by liquid chromatography-mass spectroscopy / mass spectroscopy (LC-MSMS). Plasma samples for IL-6 measurement were analyzed at Areta International srl (Gerenzano, Italy) using the "Quantikine Porcine IL-6" kit (P6000; R&D System).
[0213] Body temperature was measured rectally before and 1, 8 and 24 hours and one week after the start of therapy. Animal welfare was monitored by experienced staff according to a selected formal list of possible signs and symptoms of toxicity before the experiment, immediately after instillation and just before bladder excision.
[0214] 24 hours after treatment, three animals per group were killed and their bladder excised, and 7 days after treatment the remaining animals were treated the same. Bladder material was collected and processed histologically as follows: Bladder biopsies 1 cm<sup>2</sup> taken from the top, triangle, right side wall and left side wall and transferred to 10% formalin in PBS. The material was embedded in paraffin, cut and stained with H&E. The slides were evaluated for signs of inflammation and an allergic reaction in the submucosa and mucosa. Microscopic abnormalities were classified as no reaction, mild, moderate or severe reaction.
10.3. Results
10.3.1. Expression of TLR-7 [0215] Expression of TLR-7 in 15 human bladder cancer samples showed positive staining in all samples in the range of 70% to 100% with an average of 90% (SD = 9%). The most intense staining was nuclear / perinuclear staining and weaker cytoplasmic (Figure 16). The H rating ranged from 90 to 155 with an average of 127 (SD = 23). Positive staining was also observed in 6 samples of normal bladder epithelium ranging from 80% to 100% with an average of 95% (SD = 8%). The H rating ranged from 100 to 230 with an average of 179 (80 = 55). TLR-7 expression was observed in almost all non-bladder tissues examined (data not shown), particularly prominently in lymphoid tissue. No coloration was observed in the heart and smooth muscle. Expression of TLR-7 in pig tissues (Figure 17) was similar to that of the corresponding human tissues.
10.3.2. Experiment in pigs [0216] 24 pigs with an average weight of 57.1 kg (range 40.0-85.0 kg) were divided into four groups of six pigs and treated with different preparations of imiquimod as a single 50-minute intravesical instillation. For one week of the control period after instillation (3 pigs per group) no deterioration of animal welfare was observed. Slight signs of toxicity probably due to study drug were observed in four pigs (i.e. low food intake in three pigs, groups 1, 2 and 4 and loose one hundred pigs in one pig, group 1). There were no other signs of impaired animal welfare.
[0217] Postoperative body temperature was not affected by instillation of study medication and was comparable to body temperature before therapy for all treatment groups. Although a slight increase in creatinine levels was observed one week after instillation in group and 2, which could indicate poor renal failure, no obvious correlation was seen with the therapy.
[0218] Hematologic values were within the normal range except for one pig in group 1 that exhibited abnormal hematology values (hemoglobin concentration 2.5 mmol / l, hematocrit 12%, thrombocyte count 18 x10<sup>9</sup>/ l, leukocyte count 8.8 x10<sup>9</sup>/ l at the end of the 50-minute instillation period). However, at T = 24 h, almost all hematological values of this animal were in the normal range, except for thrombocyte count (53 x 10<sup>9</sup>/ l), which was in the normal range one week after instillation.
[0219] Urine analysis after therapy (50 minutes after the start of instillation) showed high amounts of imiquimod (Table 14) for all treatment groups except vehicle control. The amount of imiquimod collected in the urine of animals in Group 1 was almost 2-fold higher than in animals in Groups 2 and 3, without much difference between Groups 2 and 3. After 24 hours, imiquimod levels were very low (<5 μg / ml).
Table 14 Amount of imiquimod administered and measured at the end of therapy per treatment group
<td>Group</td><td>The total amount of imichimo served<sup>du</sup> (Hh)</td><td>Total amount of imiquimod at the end of Yg therapy, range,%)</td>
<td> 1</td><td> 268950</td><td> 218860 (23440-320400) (81,4)</td>
<td> 2</td><td> 257500</td><td> 132735 (64350-176040) (51,5)</td>
<td> 3</td><td> 247850</td><td> 121636 (46260-219075) (49,1)</td>
[0220] Pharmacokinetic analyzes revealed only slight systemic absorption (Table 15 and Figure 18). The maximum plasma levels of the animals in Group 1 were three times higher than the maximum plasma levels of the Groups 2 and 3 in animals giving twice the AUC. After eight hours, almost no imiquimod (<2.10 ng / ml) could be detected in any pig plasma.
Table 15 Pharmacokinetic parameters of imichimod in plasma, per treatment group (mean ± standard deviation)
<td>Group</td><td>Cmax (ng / ml)</td><td>AUC (ng * h / ml)</td><td>T1 / 2 (h)</td>
<td> 1</td><td> 45,17 ± 29,96</td><td> 96,75 ± 50,42</td><td> 1,18 ± 0,12</td>
<td> 2</td><td> 16,23 ± 10,22</td><td> 45,67 ± 26,53</td><td> 1,58 ± 1,05</td>
<td> 3</td><td> 17,00 ± 6,57</td><td> 56,65 ± 24,94</td><td> 1,90 ± 1,06</td>
<td>Cmax = <sup>It has</sup></td><td colspan="3">maximum concentration; AUC = area under the curve; T<sub>1/2</sub> = half-life</td>
[0221] IL-6 cytokine levels were similar in all groups, including vehicle control group, with maximum IL-6 levels reached eight hours after instillation of test drugs (data not shown).
[0222] Macroscopic examination of excised blisters showed no abnormalities, except in certain areas with hemorrhagic appearance, in pigs killed 24 hours after instillation of imiquimod (groups 1-3), which were less visible or absent in pigs killed after seven days.
[0223] Microscopic examination of the excised blisters did not reveal the difference between the four sampled regions (left side wall, right side wall, peak, triangle). Most animals in the three treatment groups had a moderate, mainly lymphocytic submucosal inflammatory response 24 hours after intravesical instillation (figure 20), which decreased to mild inflammation in pigs killed after seven days. 24 hours after instillation, vasculitis was observed in three pigs, equally divided into three therapy legs (figure 21). Moderate myositis was observed in one pig in group 1. Mild reactive atypical bladder epithelium was observed in almost all animals killed after 24 hours, which disappeared in time and was not visible in animals killed after one week. Erosion, submucosal edema and bleeding were mild, no allergic reaction was observed.
10.4. Discussion [0224] As already stated herein, imichimod, a major member of the imidazoquinoline (amine) family, has shown efficacy against many types of cancer (Schon MP, Schon M. Imichimod: mode of action. Br J Dermatol 2007; 157: 8-13) . The compound binds to TLR-7, which indicates the production and secretion of pro-inflammatory cytokines that subsequently induce a deep tumor-specific cell-mediated immune response that is quite similar to the proposed mechanism of BCG action. In addition, imiquimod may exert direct apoptotic effects on tumor cells, may stimulate TLR independent gene expression, and may affect ade93 receptor signaling pathways (Schon MP, Schon M. Imichimod: mode of action. Br J Dermatol
2007;157:8-13).
[0225] Imichimod is effective and well tolerated as a topical agent for the treatment of various benign and malignant dermatological lesions. Local skin reactions are the most common side effects (Geisse J, Caro I, Lindholm J, Golitz L, Stampone P, Owens M. Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: Results from two phase III, randomized, vehicle-controlled studies. J Am Acad Dermatol 2004; 50: 722-33). Imichimod has also been studied as a method of systemic therapy: weekly administration of a high dose of oral imichimod was studied in a Phase I trial in cancer patients (Witt PL, Ritch PS, Reding D, McAuliffe TL, Westrick L, Grossberg SE, Borden EC. Phase I trial of an oral immunomodulator and interferon inducer in cancer patients. Cancer Res 1993; 53: 5176-5180). Dose-limiting side effects were flu-like symptoms and mild lymphopenia.
[0226] Bladder cancer may be an interesting target for imiquimod therapy: Intravesical administration of imiquimod resembles local therapy of skin lesions with direct contact with malignant cells and direct cytotoxicity or imiquimod induced apoptosis regardless of the immune response. In addition, intravesical instillation avoids the losses associated with first pass metabolism and allows the therapeutic effect of the drug to be localized in the desired location with minimal systemic side effects.
[0227] Experimental evidence that imidazoquinoline (amines) may indeed be appropriate therapies for bladder cancer, provided by Smith et al. These researchers showed that TLR-7 is expressed in murine human bladder cancer cell lines and that imidazoquinoline has a direct biological effect on these cell lines: cell viability has decreased and apoptosis and cytokine production have been induced. In addition, initial results in the immunocompetitive orthotopic mouse model suggested anti-tumor activity in vivo (Smith EB, Schwartz M, Kawamoto H, et al. Antitumour effects of Imidazoquinolines in urothelial cell carcinoma of the bladder. J Urol 2007; 177: 2347; Liu H , Schwartz MJ, Hwang DH, Scherr OS. Tumor growth inhibition by an imidazoquinoline is associated with c-Myc down-regulation in urothelial cell carcinoma. BJU Int 2008; 101: 894-901) [0228] To examine whether the imiquimod target, TLR-7, is expressed in human bladder cancer, TLR-7 expression was evaluated in 15 samples. Positive staining appeared in all samples with an average of 90%, however, there was some heterogeneity in the intensity leading to H scores in the range of 90 to 165. These results show that bladder cancer may be an attractive target for imiquimod therapy.
[0229] To assess the pharmacokinetics and possible toxicity of instillation of imiquimod, pig experiments were performed. TLR-7 expression in porcine and human bladder tissue samples was similar, confirming the validity of the pig model. Three different intravesical imiquimod solutions and control medium (lactic acid solution) were tested. None of the test preparations affected the overall well-being of the pig, as assessed by e.g. mucosal appearance, behavior, food / water intake, etc. Plasma analysis showed only slight systemic absorption of imiquimod after instillation into the bladder, regardless of the preparation used. Accordingly, large amounts of imiquimod were recovered from urine after instillation. However, imiquimod levels after urinary therapy in animals treated with imiquimod in simple lactic acid solution (group 1) were almost 2-fold higher than in animals treated with imiquimod poloxamer and HPeCD preparations (groups 2 and 3). In addition, the mean maximum plasma level of imiquimod in Group 1 was 3 times higher than in Group 2 and Group 3 animals. This difference is probably the result of increased and prolonged biological adhesion of drug preparations with poloxamer and HPeCD with the bladder wall. However, this effect was short-lived because after eight hours imiquimod could hardly be detected in pig plasma and after 24 hours imiquimod could hardly be detected in the urine of any animal, regardless of the imiquimod preparation. It is possible that drug formulations 2 and 3 lead to longer, prolonged membrane levels of imiquimod.
[0230] Plasma IL-6 levels were similar in all groups, including the vehicle control group, with maximum values reached eight hours after bladder instillation, most likely due to a stress response following general anesthesia and bladder catheterization, rather than imiquimod immunostimulation. In addition, plasma imiquimod levels were too low to achieve a systemic cytokine response.
[0231] Histopathological examination of the bladder wall revealed an intended inflammatory response in imiquimod treated groups. Apart from this intended inflammatory reaction, no significant abnormalities were observed. Only vasculitis can represent some toxic reaction, albeit transient: no vasculitis was observed in animals killed on day 7. It is not possible to make meaningful intergroup comparisons with such a small number of groups, however, there was no significant difference between the imiquimod solutions tested.
[0232] In summary, intravesical administration of imiquimod in pigs is well tolerated, does not cause bladder wall toxicity, and preparations with poloxamer and HPeCD remain longer in the bladder with less systemic absorption. The intravesical safety profile of imichimod is preferably better than that of current therapies such as
BCG. Given the very similar pharmacokinetic characteristics, phase I studies of marker markers for dose escalation will be initiated with 0.5% imiquimod in
0.1 M lactic acid, 16% poloxamer 407 and 5% HPeCD in patients with NMIBC.
11. Example: Optimization of an intravesical preparation of a toll-like 7 receptor agonist in the treatment of bladder cancer
11.1. Introduction [0233] The aim of this study was to optimize the imiquimod formulation for improving therapeutic use. Systemic and local inflammation induced by different imiquimod preparations was compared. The anti-cancer efficacy of imiquimod in a thermosensitive poloxamer polymer was evaluated in mouse models of orthotopic bladder cancer.
11.2. Material and methods
11.2.1. Mice [0234] 6- to 8-week-old female C57BL / 6 mice were purchased from Charles River Laboratory (Wilmington, MA). TLR7 deficient mice were donated by S. Akira (Osaka University, Osaka, Japan) and backcrossed for 10 generations into the background of C57BL / 6 mice. All mice were housed under standard conditions at the University of California, San Diego Animal Facility. All procedures and protocols have been approved in advance by the UCSD institutional review commission.
11.2.2. Reagents [0235] Imichimod (TMX, TMX-101, R-837) and Lutrol® F127 were from Telormedix SA (Bioggio, Switzerland). Lactic acid was purchased from Fisher Scientific (Pittsburgh, PA). 2 (hydroxypropyl) -e-cyclodextrin (HPeCD) was purchased from Sigma Aldrich (St. Louis, MO). Imichimod was dissolved at a final concentration of 1% (w / v, 41.7 mM) in 0.1% lactic acid (lactic acid preparation). Lutrol® F127 (poloxamer 407) was added to 0.1M lactic acid to 20% (poloxamer preparation). 5% HPeCD was incorporated into 16% Lutrol® F127, in 0.1M lactic acid (poloxamer-HPeCD preparation). All solutions were filtered through a 0.22 micron filter before administration.
11.2.3. In vivo pharmacological study [0236] Mice were anesthetized and catheterized using a 20G Teflon intravenous catheter (Terumo Co. Somerset, NJ). Intravesical administration of 150, 500 or 1500 nmol of imiquimod, respectively, in 50 or 100 μl media. 120 μl volumes were used for the addition of 5000 nmol. The imiquimod solution was held in the bladder for 20 min. Cytokine levels were measured in a Luminex microbeads assay (Invitrogen, Carlsbad, CA) according to the manufacturer's instructions. The minimum detection levels of TNFa and KC were 5 pg / ml and 25pg / ml, respectively. Serum imiquimod levels were analyzed in Chiman SRL (Rottofreno, Italy).
11.2.4. Histological examination [0237] Mice were administered 100 μl of 0.1% imiquimod in poloxamer-HPeCD preparation once, or 50 μl three times every four days. 24 hours after the last administration, blisters were collected. Fixed blisters were embedded in paraffin and stained with hematoxylin and eosin (H&E) at UCSD Cancer Center Histology Core.
11.2.5. Implantation, therapy and tumor evaluation [0238] After 20 min of poly-L-lysine (0.1 mg / ml) therapy, 1x10<sup>6</sup> MB49 cells were implanted as previously described (Hegele A, Dalpke A, Barth P et al. Antineoplastic effect of immunostimulatory DNA (CpG-ODN) in a murine C57-BL6 / MB-49 transitional cell carcinoma model. Anticancer research. 2004; 24: 2225-30). Therapy was performed on days 3, 6 and 9. Mice implanted with MB49 without therapy or with vehicle therapy served as controls. Mice were killed on day 11 and bladder weight was measured.
11.2.6. Statistical analysis
11.3. Results [0239] The software package (Prism 4.0, GraphPad, San Diego CA) was used for statistical analyzes as indicated in the figure legends. A p value <0.05 was considered statistically significant.
11.3.1. Intravesical administration of imichimod induced systemic inflammation [0240] Imichimod is known to be insoluble in water and poorly soluble in conventional pharmaceutical solvents. As shown above, the acetic and / or lactic acid solution increases the solubility of imiquimod. Thus, 0.1M lactic acid was used to produce 1% imiquimod solution (~ 41.7 mM). Mice received intravesical 150, 500, 1500 and 5000 nmol. Serum TNFa and KC were induced in a dose dependent manner (0.1 M lactic acid in Figures 22A and B). The levels of these factors in the bladder were 10 to 100 times lower than their serum levels (p <0.001 at 1500 and 5000 nmol, Figure 22C and D).
11.3.2. Addition of poloxamer polymer prevented imiquimod absorption and systemic cytokine induction [0241] Systemic induction of proinflammatory cytokines causes anorexia and fatigue, so-called "disease syndrome" in hosts (Hayashi T, Cottam HB, Chan M et al. Mast celldependent anorexia and hypothermia induced by mucosal activation of Toll-like receptor 7. Am J Physiol RegulIntegr Comp Physiol. 2008; 295: R123-32). To avoid systemic absorption as well as an increase in local contact of imiquimod with the bladder epithelium, a thermosensitive poloxamer polymer, Lutrol® F127, was added to the formulation. Serum and bladder TNFα (Figure 23A and B) and KC (Figure 23C and D) levels were significantly reduced in mice receiving 5000 nmol of imiquimod in this preparation compared to the lactic acid preparation.
[0242] To evaluate the effect of poloxamer polymer on the systemic absorption of imiquimod by the bladder epithelium, sera from mice that received 1500 nmol imiquimod were collected after 2, 4, 6, 24 and 48 hours. In mice receiving imichimod in lactic acid alone or in the poloxamer preparation, the maximum serum concentration of imichimod was observed 2 hours after administration (Figure 23E) (p <0.01). Serum imiquimod levels increased in a dose-dependent manner (Figure 23F). Addition of poloxamer polymer in the formulation reduced serum levels of imiquimod at 2 hours (p <0.01, Figure 23E) and at 5000 nmol (p <0.01, Figure 23F). These data indicate that the inclusion of poloxamer in the formulation significantly reduces the systemic absorption of imiquimod.
11.3.3. Incorporation of HPeCD restores systemic and local inflammation [0243] To improve physical stability and achieve a transparent homogeneous solution and achieve full release from the poloxamer polymer, imiquimod was added with HPeCD to poloxamer in lactic acid (poloxamer-HPeCD preparation). Systemic levels of TNFα and KC were evaluated and compared with other formulations (Figure 24). The addition of poloxamer polymer reduces serum KC levels to almost basal levels, compared to the lactic acid preparation (p <0.001, Figure 24A and 24B). Addition of HPeCD to the poloxamer formulation significantly restored serum KC levels (Figure 24B), but not TNFa (Figure 24A). A similar trend was observed at local KC levels (Figure 24C).
11.3.4. Assessment of local cystitis by intravesical administration of imichimod in a poloxamer-HPeCD preparation [0244] To assess local cystitis, mice received intravesical 0.1% of imichimod in poloxamer-HPeCD preparation as vehicle. The inflow of inflammatory cells in the bladder was assessed by histological examination (Figure 25). Because patients were receiving repeated intravesical therapies under clinical conditions, we tested the effect of repeated administration of imiquimod in poloxamer-HPeCD on days 0, 4, and 8. After the first instillation of imiquimod, cell infiltration (Figure 25C) started compared to the vehicle alone (Figure 25A ). After the third therapy, significant infiltration of mononuclear cells in the lamina propria was observed in imiquimod-treated bladder (Figure 25D), while several cells were infiltrated in the vehicle or saline-treated bladder (Figure 25B and E). Limited cell infiltration was observed in the bladder of imiquimod-treated TLR7 deficient mice in poloxamer-HPeCD preparation similar to saline-treated mice, indicating that imiquimod induced inflammation in the bladder depended on TLR7 (Figure 25F).
11.3.5. Evaluation of therapeutic efficacy in orthotopic bladder cancer models in mice [0245] Orthotopic bladder cancer models were generated using MB49, a cell line derived from transient epithelial carcinoma of the mouse urinary tract. Mice suffering from MB49 bladder cancer were treated three times (days 3 and 9) with 50 Pl of 0.1% imiquimod preparation in HP CD poloxamer as medium. The treatment group showed a significantly lower average tumor burden compared to the untreated or vehicle-treated group (p <0.01, Figure 26). Thus, imichimod therapy in HP CD poloxamer allowed to maintain bladder mass almost as much as in non-tumor ("naïve") mice.
11.4. Discussion [0246] In this study, a thermosensitive poloxamer polymer was used to provide prolonged local contact and minimize systemic absorption of imiquimod. The polymer preparation reduced the systemic absorption of imiquimod from the bladder epithelium with prolonged local infiltration of immune cells. Incorporation of HP CD into the formulation improved physical stability, leading to a transparent homogeneous solution. Such a preparation improved the induction of a local chemokine and showed anti-tumor activity in an orthotopic model of murine bladder cancer.
[0247] Intravesical administration of BCG is a well established immunotherapy of superficial bladder cancer (Alexandroff AB, Jackson AM, O'Donnell MA, James K. BCG immunotherapy of bladder cancer: 20 years on. Lancet. 1999; 353: 1689-94). Although live BCG bacilli provide a significant benefit in eliciting an immune response, the use of live BCG requires extreme caution due to the biohazard to health care personnel and patients (Games J. Nursing implications in the management of superficial bladder cancer. Seminars in urologic oncology. 1996; 14: 36-40). BCG is only partially effective and serious side effects may occur, including severe fever, pneumonia, hepatitis and sepsis. Attempts are being made to develop a safer and more effective therapy for bladder cancer. Among them, there have been reports of attempts to use an individual TLR agonist to treat bladder cancer (Smith EB, Schwartz M, Kawamoto H et al. Antitumor effects of imidazoquinolines in urothelial cell carcinoma of the bladder. The Journal of urology. 2007; 177: 347-51; Mangsbo SM, Ninalga C, Essand M, Loskog A, Totterman TH. CpG therapy is superior to BCG in an orthotopic bladder cancer model and generates CD4 + T-ell immunity. J Immunother. 2008; 31: 3442.) Repeated use of the TLR9 agonist improved survival and reduced tumor burden (Mangsbo SM, Ninalga C, Essand M, Loskog A, Totterman TH. CpG therapy is better than BCG in the orthotopic bladder cancer model and generates CD4 + T cell immunity. J Immunother. 2008; 31: 34-42). The TLR7 agonist imichimod directly affects human and murine bladder cancer cells by inducing chemo100 secretion, and inducing apoptosis and limiting tumor growth (Smith EB, Schwartz M,
Kawamoto H et al. Antitumor effects of imidazoquinolines in urothelial cell carcinoma of the bladder. The Journal of urology. 2007; 177: 2347-51).
[0248] In this study, imichimod in a poloxamer-HP CD preparation was shown to initiate a significant local innate immune response. Because the acid preparation increased the solubility of imiquimod, imiquimod was initially tested after dissolving in 0.1 M lactic acid, which is commonly used in the pharmaceutical industry. Imichimod in the lactic acid preparation was absorbed systemically and caused a significant induction of systemic inflammation. Live BCG bacilli adhere to the surface of the bladder walls (Atkins H, Davies BR, Kirby JA, Kelly JD. Polarisation of a T-helper cell immune response by activation of dendritic cells with CpG-containing oligonucleotides: a potential therapeutic regime for bladder cancer immunotherapy. British journal of cancer. 2003; 89: 2312-9; Akazawa T, Masuda H, Saeki Y et al. Adjuvant-mediated tumor regression and tumor-specific cytotoxic response are impaired in MyD88-deficient mice. Cancer research. 2004; 64: 757-64) and provide prolonged immune stimulation of bladder epithelium and local immune cells for extended periods of time. The thermosensitive poloxamer polymer limits drug release and maintains drug concentration on the cell surface and prevents systemic absorption of the drug (Anderson BC, Pandit NK, Mallapragada SK. Understanding drug release from poly (ethylene oxide) -b-poly (propylene oxide) -b-poly ( ethylene oxide) gels. J Control Release. 2001; 70: 157-67). To reproduce the beneficial pro-inflammatory properties of live BCG infection and to reduce systemic absorption as well as increase drug surface contact, a thermosensitive poloxamer polymer was added to the lactic acid formulation. The poloxamer formulation significantly reduced the systemic absorption of imiquimod by the bladder surface and reduced systemic cytokine induction to basal levels.
[0249] A component of this study that was of particular interest was that the formulation comprising HPeCD restored the induction of KC by imiquimod compared to the formulation with poloxamer alone. Complexing with HPeCD is a common approach to increase drug solubility and stability in an aqueous environment (Brewster ME, Loftsson T. Cyclodextrins as pharmaceutical solubilizers. Advanced drug delivery reviews. 2007; 59: 645-66. [25] Bilensoy E, Rouf MA, Vural I, Sen M, Hincal AA. Mucoadhesive, thermosensitive, prolonged-release vaginal gel for clotrimazole: beta-cyclodextrin complex. AAPS PharmSciTech. 2006; 7: E38). In addition, incorporation of HPbCD in polymers is used in vaginal delivery systems (Chang JY, Oh YK, Kong HS et al. Prolonged anti101 fungal effects of clotrimazolecontaining mucoadhesive thermosensitive gels on vaginitis. J Control Release. , 2002; 82: 39-50.) Since it was observed that 20% thermosensitive poloxamer solidified in the bladder in a short time, causing urethral blockage, the concentration of poloxamer was reduced to 16%. Specifically, the incorporation of HPeCD into the polymer formulation improved water solubility and imiquimod was effective anti-tumor in an orthotopic model of a murine bladder cancer. This discovery strongly supports the use of poloxamer-HPeCD for further clinical research.
[0250] Effective anti-cancer immunotherapy requires appropriate recruitment of Simons MP immune cells, O'Donnell MA, Griffith TS. Role of neutrophils in BCG immunotherapy for bladder cancer. Urologic oncology. 2008; 26: 341-5; Saban MR, Simpson C, Davis C et al. Discriminators of mouse bladder response to intravesical Bacillus Calmette-Guerin (BCG). BMC immunology. 2007; 8: 6). Histological examination shows significant infiltration of immune cells into the proper lamina due to imichimod. Imichimod-induced cell infiltration of bladder decreased in TLR7-deficient mice, indicating that inflammation was dependent on TLR7, not caused by substrate or mechanical damage. The integrity of the bladder epithelium was well preserved after repeated administration of the vehicle alone (poloxamerHPeCD preparation). 1 V2 70, a phospholipid conjugate of TLR7 agonist, has been reported to have excellent and rapid Th1 12 adaptive immune responses. Because immunotherapy by instillation of live BCG leads to Th1-type adaptive immune activation that is tumor specific (Luo Y, Chen X, O ' Donell MA. Roles of Th1 and Th2 cytokines in BCG-induced IFN-gamma production: cytokine promotion and simulation of BCG effect. Cytokine. 2003; 21: 17-26), the phospholipid conjugate has the potential to enhance the therapeutic potency of the unconjugated TLR7 agonist against bladder cancer.
[0251] In summary, these results suggest that a formulation of poloxamer and HPeCD with low solubility drugs may exhibit beneficial properties, such as slow release profiles and prolonged surface contact, while avoiding possible systemic side effects. Optimized poloxamer-HP CD preparations can increase the maximum tolerated dose of imiquimod and improve patient compliance.
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| 2009000834 | European Patent Office (EPO) | W | |
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Titles2
- English
- PHARMACEUTICAL COMPOSITIONS COMPRISING IMIDAZOQUINOLIN(AMINES) AND DERIVATIVES THEREOF SUITABLE FOR LOCAL ADMINISTRATION
- Polish
- Kompozycje farmaceutyczne zawierające imidazochinolino(aminy) i ich pochodne odpowiednie do podawania miejscowego
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- CPC, 14
- A61K31/4745
- A61K47/40
- A61K9/0034
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- A61P17/12
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- A61K31 4745
- A61K47 12
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