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SK4592001A3 - Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition - Google Patents

Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition Download PDF

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SK4592001A3
SK4592001A3 SK459-2001A SK4592001A SK4592001A3 SK 4592001 A3 SK4592001 A3 SK 4592001A3 SK 4592001 A SK4592001 A SK 4592001A SK 4592001 A3 SK4592001 A3 SK 4592001A3
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atypical antipsychotic
patients suffering
antipsychotic agent
active ingredient
acetylcholinesterase
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SK459-2001A
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Slovak (sk)
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Nijs Paul Leonce Irma De
Wim Louis Julien Parys
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Janssen Pharmaceutica Nv
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/18Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/28Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

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Abstract

The present invention is concerned with pharmaceutical compositions comprising a carrier and as first active ingredient an atypical antipsychotic agent (I) and as second active ingredient an acetylcholinesterase inhibitor (II), each in an amount producing a therapeutically beneficial effect in patients suffering from psychosis, or Alzheimer's disease or related dementias. Said therapeutically beneficial effect can be a synergistic effect on the cognitive functioning of patients suffering from Alzheimer's disease or related dementias or the prevention of the further deterioration of cognition in said patients, or the reduction of adverse effects associated with the one of the active ingredients by the other of the active ingredients.

Description

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Liečba zlepšujúca kognitívne funkcieTreatment improving cognitive function

Oblasť technikyTechnical field

Predkladaný vynález sa týka farmaceutických preparátov obsahujúcich nosič a atypickú antipsychotickú látku (I) ako prvú aktívnu zložku, a inhibítor acetylcholinesterázy (II) ako druhú aktívnu zložku, každú obsiahnutú v množstve vytvárajúcom terapeuticky prospešný efekt pacientov trpiacich psychózou, Alzheimerovou chorobou, alebo príbuznými demenciami. Spomínaný terapeuticky prospešný efekt môže byť synergistickým efektom na kognitívne funkcie pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami, alebo prevenciou ďalšieho zhoršovania kognitívnych funkcií spomínaných pacientov, alebo môže znižovať nežiadúce účinky spojené s jednou z aktívnych zložiek pomocou inej aktívnej zložky.The present invention relates to pharmaceutical compositions comprising a carrier and an atypical antipsychotic agent (I) as the first active ingredient, and an acetylcholinesterase inhibitor (II) as the second active ingredient, each contained in an amount producing a therapeutically beneficial effect for patients suffering from psychosis, Alzheimer's disease or related dementia. Said therapeutically beneficial effect may be a synergistic effect on the cognitive functions of patients suffering from Alzheimer's disease or related dementias, or preventing further deterioration of the cognitive functions of said patients, or it may reduce the adverse effects associated with one of the active ingredients with another active ingredient.

Doterajší stav technikyBACKGROUND OF THE INVENTION

Špecifickým záujmom je použitie atypickej antipsychotickej látky (I) na prípravu lieku znižujúceho nežiadúce účinky spojené s inhibítormi acetylcholinesterázy (II), ako sú napríklad neusea, zvracanie, potenie, neklud a nespavosť, pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami. Obzvlášť zaujímavým je použitie atypickej antipsychotickej látky (I) na prípravu lieku zlepšujúceho spánok pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami, ktorí sú liečení inhibítormi acetylcholinesterázy (II).Of particular interest is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing the adverse effects associated with acetylcholinesterase (II) inhibitors such as neusea, vomiting, sweating, restlessness and insomnia in patients suffering from Alzheimer's disease or related dementias. Of particular interest is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep sleep in patients suffering from Alzheimer's disease or related dementias who are treated with acetylcholinesterase (II) inhibitors.

• ·· ·· ·· ·· ·· · ···· · · • · · · · · ·· • · · · · · ··· · · · ··· ·· ·· ·· ··• ·····················································

Opis vynálezuDescription of the invention

Predkladaný vynález sa týka farmaceutických preparátov obsahujúcich nosič a atypickú antipsychotickú látku (I) ako prvú aktívnu zložku, a inhibítor acetylcholinesterázy (II) ako druhú aktívnu zložku, každú obsiahnutú v množstve vytvárajúcom terapeuticky prospešný efekt pacientom trpiacich psychózou, Alzheimerovou chorobou, alebo príbuznými demenciami.The present invention relates to pharmaceutical preparations comprising a carrier and an atypical antipsychotic agent (I) as the first active ingredient, and an acetylcholinesterase inhibitor (II) as the second active ingredient, each contained in an amount producing a therapeutically beneficial effect for patients suffering from psychosis, Alzheimer's disease or related.

Spomínaný terapeuticky prospešný efekt môže byť synergistickým efektom na kognitívne funkcie pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami, alebo prevenciou ďalšieho zhoršovania kognitívnych funkcií spomínaných pacientov, alebo môže znižovať nežiadúce účinky spojené s jednou z aktívnych zložiek pomocou inej aktívnej zložky.Said therapeutically beneficial effect may be a synergistic effect on the cognitive functions of patients suffering from Alzheimer's disease or related dementias, or preventing further deterioration of the cognitive functions of said patients, or it may reduce the adverse effects associated with one of the active ingredients with another active ingredient.

Atypická antipsychotická látka (I) je vybraná z risperidónu, 9-hydroxyrisperidónu, alebo jeho esteru C10-20 alkánovej kyseliny, olanzapínu, quetiapínu,iloperidónu alebo ziprasidónu, a inhibítor acetylcholinesterázy (II) je vybraný z galantamínu, rivastigmínu alebo donepezilu, alebo terapeuticky aktívnej kyslej adičnej soli akejkoľvek z predchádzajúcich látok. Spomínané soli zahŕňajú formy solí, ktoré sú aktívne zložky (I) a (II) schopné vytvárať s príslušnými kyselinami, ako sú napríklad anorganické kyseliny, ako napríklad kyseliny hydrohalové, napríklad kyselina chlorovodíková a bromovodíková; sírová, dusičná, fosforečná a podobné kyseliny, alebo organické kyseliny, ako sú napríklad kyselina octová, propánová, hydroxyoctová, mliečna, pyrohroznová, šťavelová, malónová, jantárová, pyrogalólová, fumárová, jablčná, vinná, citrónová, metansulfonová, etansulfonová, benzensulfonová,p-toluénsulfonová, cyklamová, β· *·· ·· ·· ·· s ··· · · · · a a *!The atypical antipsychotic agent (I) is selected from risperidone, 9-hydroxyrisperidone, or a C10-20 alkanoic acid ester, olanzapine, quetiapine, iloperidone or ziprasidone, and the acetylcholinesterase (II) inhibitor is selected from galantamine, rivastigmine or donepeziline an acid addition salt of any of the foregoing. Said salts include the salt forms which the active ingredients (I) and (II) are able to form with the corresponding acids, such as inorganic acids such as hydrohalic acids, for example hydrochloric and hydrobromic acid; sulfuric, nitric, phosphoric and the like acids, or organic acids such as acetic, propanoic, hydroxyacetic, lactic, pyruvic, oxalic, malonic, succinic, pyrogallic, fumaric, malic, tartaric, methanesulfonic, ethanesulfonic, benzenesulfonic, benzenesulfonic toluenesulfonic, cyclamic, β * · · · · · · · · · · · · · to · a *!

J · · · · · ··· a · a a ··· ·· ·· ·· ·· aaa salicylová, p-amínosalicylová, pamoová a podobné kyseliny. Napríklad galantamín môže byť pohodlne použitý ako (1:1) hydrobromidová sol.J and a and a and salicylic, β-aminosalicylic, pamoic and the like acids. For example, galantamine can conveniently be used as the (1: 1) hydrobromide salt.

Cio-20 alkánové kyseliny sú vybrané zo skupiny obsahujúcej kyselinu dekanoovú (kaprxnová), undekanoová, dodekanoová (laurová), tridekanoová, tetradekanoová (myristová), pentadekanoová, hexadekanoová (palmitová), heptadekanoová, oktadekanoová (stearová), nonadekanoová a eikosanoová. V dôsledku ich obmedzenej rozpustnosti vo vode sa všeobecne domnievalo, že estery musia byť rozpustené v olejoch. Ester majúci C15 (pentadecylový) reťazec a aktívnu zložku zodpovedajúcu esteru 9-hydroxysperidón palminátu bol zistený ako najlepší ester z pohladu farmakokinetiky, rovnako tak, ako z pohladu tolerancie.The C 10-20 alkanoic acids are selected from the group consisting of decanoic (caproic), undecanoic, dodecanoic (lauric), tridecanoic, tetradecanoic (myristic), pentadecanoic, hexadecanoic (palmitic), heptadecanoic, octadecanoic (stearic), eosadanoic. Due to their limited solubility in water, it was generally believed that esters had to be dissolved in oils. The ester having the C15 (pentadecyl) chain and the active ingredient corresponding to the 9-hydroxysperidone palminate ester was found to be the best ester in terms of pharmacokinetics as well as in terms of tolerance.

Množstvo každej z aktívnych látok je prednostne rovnaké, alebo nižšie ako ktoré je schválené na monoterapiu spomínanou aktívnou zložkou.The amount of each of the active ingredients is preferably equal to or less than that which is approved for monotherapy with said active ingredient.

Najprednostnejšie sú preparáty, kde atypickou antipsychotickou látkou (I) je risperidón a inhibítorom acetylcholinesterázy (II) je galantamín, predovšetkým ako galantamín hydrobromid. V spomínaných preparátoch je množstvo resperidónu 0,5, 1, 2, 4, alebo 6 mg a množstvo galantamínu (vo forme bázi) je 8, 16, 24, alebo 32 na dávkovú formu.Most preferred are preparations wherein the atypical antipsychotic agent (I) is risperidone and the acetylcholinesterase (II) inhibitor is galantamine, especially as galantamine hydrobromide. In said preparations, the amount of resperidone is 0.5, 1, 2, 4, or 6 mg, and the amount of galantamine (as base) is 8, 16, 24, or 32 per dosage form.

Predkladaný vynález sa týka tiež produktov obsahujúcich atypickú antipsychotickú látku (I) ako prvú aktívnu zložku, a inhibitor acetylcholinesterázy (II) ako druhú aktívnu zložku, ako kombinované preparáty na súčasné, oddelené alebo postupné použitie v liečbe pacientov trpiacich psychózou, Alzheimerovou chorobou alebo príbuznými demenciami.The present invention also relates to products comprising an atypical antipsychotic agent (I) as the first active ingredient, and an acetylcholinesterase inhibitor (II) as the second active ingredient, as a combination preparation for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias .

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Predkladný vynález sa tiež týka použitia inhibítora acetylcholinesterázy (II) na prípravu lieku zvyšujúceho účinok atypickej antipsychotickej látky (I) na kognitívne funkcie pacientov trpiacich psychózou.The present invention also relates to the use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for increasing the effect of an atypical antipsychotic agent (I) on the cognitive functions of patients suffering from psychosis.

Na druhú stranu sa vynález tiež týka použitia atypickej antipsychotickej látky (I) na prípravu lieku zvyšujúceho účinok inhibítora acetylcholinesterázy (II) na kognitívne funkcie pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami.On the other hand, the invention also relates to the use of an atypical antipsychotic agent (I) for the preparation of a medicament for increasing the effect of an acetylcholinesterase (II) inhibitor on the cognitive functions of patients suffering from Alzheimer's disease or related dementias.

Naviac sa predkladaný vynález týka použitia atypickej antipsychotickej látky (I) na prípravu lieku znižujúceho nežiadúce účinky spojené s inhibítormi acetylcholinesterázy (II) pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami. Spomínaným nežiadúcim účinkom môže byť nausea,zvracanie, potenie, neklud alebo nespavosť. Obzvlášť zaujímavé je použitie atypickej antipsychotickej látky (I) na prípravu lieku zlepšujúceho spánok pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami, ktorí sú liečení inhibítormi acetylcholinesterázy (II) .In addition, the present invention relates to the use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing the adverse effects associated with acetylcholinesterase (II) inhibitors in patients suffering from Alzheimer's disease or related dementias. Said side effect may be nausea, vomiting, sweating, restlessness or insomnia. Of particular interest is the use of an atypical antipsychotic agent (I) for the preparation of a medicament for improving sleep sleep in patients suffering from Alzheimer's disease or related dementias who are treated with acetylcholinesterase (II) inhibitors.

Predkladaný vynález sa nakoniec týka použitia inhibítora acetylcholinestrázy (II) na prípravu lieku znižujúceho nežiadúce účinky spojené s atypickými antipsychotickými látkami (I) pacientov trpiacich psychózami. Spomínaný nežiadúci účinok môže byť extrapyramídovým syndrómom alebo pozvoľne sa vyvíjajúcou dyskinéziou.Finally, the present invention relates to the use of an acetylcholine estrase inhibitor (II) for the preparation of a medicament for reducing adverse effects associated with atypical antipsychotic agents (I) in patients suffering from psychoses. Said side effect may be extrapyramidal syndrome or slowly developing dyskinesia.

Vo všetkých predchádzajúcich použitiach je atypickou antipsychotickou látkou (I) prednostne risperidón a inhibítorom acetylcholinesterázy (II) je prednostne galantamín, obzvlášť hydrobromid (1:1).In all previous uses, the atypical antipsychotic agent (I) is preferably risperidone and the acetylcholinesterase (II) inhibitor is preferably galantamine, especially hydrobromide (1: 1).

Claims (14)

PATENTOVÉ NÁROKYPATENT CLAIMS 1. Farmaceutický preparát obsahujúci nosič a atypickú antipsychotickú látku (I) ako prvú aktívnu zložku, a inhibítor acetylcholinesterázy (II) ako druhú aktívnu zložku, každú obsiahnutú v množstve vytvárajúcom terapeuticky prospešný efekt pacientov trpiacich psychózou, Alzheimerovou chorobou, alebo príbuznými demenciami.A pharmaceutical composition comprising a carrier and an atypical antipsychotic agent (I) as the first active ingredient, and an acetylcholinesterase inhibitor (II) as the second active ingredient, each contained in an amount producing a therapeutically beneficial effect for patients suffering from psychosis, Alzheimer's disease or related dementias. 2. Zloženie podľa patentového nároku 1, kde spomínaný terapeutický prospešný efekt môže byť synergistickým efektom na kognitívne funkcie pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami, alebo prevenciou ďalšieho zhoršovania kognitívnych funkcií spomínaných pacientov, alebo znížením nežiadúcich účinkov spojených s jednou z aktívnych zložiek pomocou inej aktívnej zložky.The composition of claim 1, wherein said therapeutic benefit may be a synergistic effect on the cognitive functions of patients suffering from Alzheimer's disease or related dementias, or preventing further deterioration of the cognitive functions of said patients, or reducing the adverse effects associated with one of the active ingredients with another active ingredient. components. 3. Zloženie podľa patentového nároku 1, kde atypická antipsychotická látka (I) je vybraná z risperidónu, 9hydroxyrisperidónu, alebo jeho esteru C10-20 alkanovej kyseliny, olanzapínu, quetiapínu, iloperidónu alebo ziprasidónu, a inhibítor acetylcholinesterázy (II) je vybraný z galantamínu, rivastigmínu alebo donepezilu.The composition of claim 1, wherein the atypical antipsychotic agent (I) is selected from risperidone, 9-hydroxyrisperidone, or a C 10-20 alkanoic acid ester, olanzapine, quetiapine, iloperidone or ziprasidone, and an acetylcholinesterase (II) inhibitor selected from galantamine, rivastigmine or donepezil. 4. Zloženie podľa patentového nároku 3, kde množstvo každej z aktívnych látok je prednostne rovnaké, alebo nižšie ako ktoré je schválené na monoterapiu spomínanou aktívnou zložkou.The composition of claim 3, wherein the amount of each of the active ingredients is preferably equal to or less than that approved for monotherapy by said active ingredient. 5. Zloženie podľa patentového nároku 3, kde atypickou antipsychotickou látkou (I) je risperidón a ihibítorom acetylcholinesterázy (II) je galantamín.The composition of claim 3, wherein the atypical antipsychotic agent (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine. • ·· ·· ·· ·· ···· ···· ··· • · · · · · ··· · · · · • · · ·· · · · · ··· ·· ·· ·· ·· ···• ············································································· · ·· ··· 6. Zloženie podlá patentového nároku 5, kde množstvo risperidónu 0,5, 1, 2, 4, alebo 6 mg a množstvo galantamínu (vo forme bázi) je 8, 16, 24, alebo 32 na dávkovú formu.The composition of claim 5, wherein the amount of risperidone is 0.5, 1, 2, 4, or 6 mg and the amount of galantamine (as base) is 8, 16, 24, or 32 per dosage form. 7. Produkt obsahujúci atypickú antipsychotickú látku (I) ako prvú aktívnu zložku, a inhibítor acetylcholinesterázy (II) ako druhú aktívnu zložku, ako kombinované preparáty na súčasné, oddelené alebo postupné použitie v liečbe pacientov trpiacich psychózou, Alzheimerovou chorobou alebo príbuznými demenciami.A product comprising an atypical antipsychotic agent (I) as the first active ingredient, and an acetylcholinesterase inhibitor (II) as the second active ingredient, as a combination preparation for simultaneous, separate or sequential use in the treatment of patients suffering from psychosis, Alzheimer's disease or related dementias. 8. Použitie ihnibítora acetylcholinesterázy (II) na prípravu lieku zvyšujúceho účinok atypickej antipsychotickej látky (I) na kognitívne funkcie pacientov trpiacich psychózou.Use of an acetylcholinesterase (II) inhibitor for the preparation of a medicament for increasing the effect of an atypical antipsychotic agent (I) on the cognitive functions of patients suffering from psychosis. 9. Použitie atypickej antipsychotickej látky (I) na prípravu lieku zvyšujúceho účinok inhibítora acetylcholinesterázy (II) na kognitívne funkcie pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami.Use of an atypical antipsychotic agent (I) for the preparation of a medicament for increasing the effect of an acetylcholinesterase inhibitor (II) on the cognitive functions of patients suffering from Alzheimer's disease or related dementias. 10. Použitie atypickej antipsychotickej látky (I) na prípravu lieku znižujúceho nežiadúce účinky spojené s inhibítormi acetylcholinesterázy (II) pacientov trpiacich Alzheimerovou chorobou alebo príbuznými demenciami.Use of an atypical antipsychotic agent (I) for the preparation of a medicament for reducing the adverse effects associated with acetylcholinesterase inhibitors (II) of patients suffering from Alzheimer's disease or related dementias. 11. Použitie podlá patentového nároku 10, kde nežiadúcim účinkom je nausea, zvracanie, potenie, nekľud alebo nespavosť.Use according to claim 10, wherein the adverse effect is nausea, vomiting, sweating, restlessness or insomnia. 12. Použitie inhibítora acetylcholinesterázy (II) na prípravu lieku znižujúceho nežiadúce účinky spojené s atypickými antipsychotickými látkami (I) pacientov trpiacich psychózami.Use of an acetylcholinesterase inhibitor (II) for the preparation of a medicament for reducing adverse reactions associated with atypical antipsychotic agents (I) in patients suffering from psychoses. a a a a · ·· • · ·· ·· ·· a · · · · • · ··· a · a a · a· aa aaa a a a a · a · a · a · a · a · a · aa aa 13. Použitie podía patentového nároku 12, kde nežiadúcim účinkom je extrapyramídový syndróm alebo pozvoľne sa vyvíjajúca dyskinézia.The use according to claim 12, wherein the side effect is extrapyramidal syndrome or slowly developing dyskinesia. 14. Použitie podľa ktoréhokoľvek z patentovách nárokov 813, kde atypickou antipsychotickou látkou (I) je risperidón a inhibítorom acetylcholinesterázy (II) je galantamín.Use according to any one of claims 813, wherein the atypical antipsychotic agent (I) is risperidone and the acetylcholinesterase inhibitor (II) is galantamine.
SK459-2001A 1998-10-16 1999-10-12 Atypical antipsychotic in combination with acetylcholinesterase inhibitor for improving cognition SK4592001A3 (en)

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EP98203454 1998-10-16
PCT/EP1999/007804 WO2000023057A2 (en) 1998-10-16 1999-10-12 Atypical antiphsychotic in combination with acetylcholinesterase inhibitor for improving cognition

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US9656991B2 (en) 2007-04-18 2017-05-23 Probiodrug Ag Inhibitors of glutaminyl cyclase
MX2007008642A (en) * 2007-07-16 2009-02-25 World Trade Imp Export Wtie Ag Pharmaceutical composition comprising the combination of a benzisoxazolic derived agent and a reversible inhibiting agent of the cholinesterase enzyme prescribed for the control and treatment of psychotic disorders and dementias.
CA2789014C (en) 2010-02-09 2019-01-15 Michela Gallagher Methods and compositions for improving cognitive function
JP6026284B2 (en) 2010-03-03 2016-11-16 プロビオドルグ エージー Inhibitors of glutaminyl cyclase
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