UA146735U - PHARMACEUTICAL DRUG FOR TREATMENT OF PAIN AND INFLAMMATION - Google Patents

Abstract

The pharmaceutical preparation for the treatment of pain and inflammation comprises an active pharmaceutical ingredient of formula (I) and at least one excipient. The drug is made in the form of a solution for injection.

Description

The utility model is in the field of medicine, namely non-steroidal anti-inflammatory pharmaceuticals for the prevention and symptomatic treatment of pain and inflammation.

Pain (physical) is an unpleasant feeling that occurs in a person. Pain is one of the most important and most alarming signs of a disorder in the body, which ultimately prompts the patient to seek professional medical help.

To date, several mechanisms of pain formation have been studied: nociceptive, neuropathic, psychogenic, and others. Nociceptive pain syndrome appears as a result of activation of nociceptors during trauma, inflammation, ischemia, tissue swelling. Impulses that arise at the same time enter the ascending nociceptive pathways and reach the higher parts of the nervous system, as a result of which a feeling of pain is formed.

With neuropathic pain syndrome, the mechanisms of generation and conduction of nociceptive signals in nerve fibers and processes of controlling the excitation of nociceptive neurons in the structures of the spinal cord and brain are disturbed. Nerve damage leads to structural and functional changes in nerve fibers, resulting in an inadequate response of the nervous system to irritation. For these reasons, the pain sensation is formed.

In clinical practice, a combination of various pain syndromes is most common.

For example, in rheumatoid arthritis, inflammatory (nociceptive) pain is combined with neuropathic pain.

Depending on the duration, the pain can be acute or chronic. Acute pain is associated with damage, the elimination of which leads to the disappearance of pain. Pain lasting more than 3 months, which lasts longer than the normal tissue healing period, is considered chronic.

Chronic pain, due to its prevalence among the population, is considered a separate disease in modern clinical practice.

According to the localization of acute pain, the following are distinguished: 1) superficial, which occurs in case of damage to the skin; 2) deep, which occurs with damage to the musculoskeletal system (for example, irritation of muscle receptors, tendons, ligaments, joints and bones);

From 3) visceral, which occurs when internal organs are damaged; 4) reflected pain, that is, the projection of pain in dermatomes that are innervated by the same segments as those involved in the pathological process.

Most often, the pain syndrome is not a separate disease, but a symptom of another disease, in particular, diseases accompanied by inflammatory processes, such as arthritis. In general, inflammatory processes accompany a large number of human diseases, as they are the result of the body's protective reaction to the action of various harmful agents.

Arthritis is one of the leading causes of disability worldwide. Arthritis is a general designation of diseases (damages) of the joints of inflammatory etiology. Arthritis occurs in acute and chronic form with damage to one or more joints. At the same time, all types of arthritis are accompanied by pain, the nature of which depends on the type of arthritis. It is also characterized by reddening of the skin, limitation of joint mobility and a change in their shape.

The main class of pharmaceuticals used for the symptomatic treatment of pain and inflammation, particularly arthritis, are non-steroidal anti-inflammatory drugs. Opioid drugs are often recommended as an alternative to non-steroidal anti-inflammatory drugs, but they have obvious disadvantages, namely the possibility of drug addiction in the patient.

In the modern world, acute or chronic pain, which in particular are symptoms of diseases accompanied by inflammatory processes, such as arthritis, is one of the most frequent causes of loss of functional capacity, disability and social maladjustment. Pathological conditions such as depression, sleep disorders, development and progression of the cardiovascular system are closely related to pain. The need for long-term pharmacotherapy of pain becomes a heavy burden for the person suffering from pain, as well as for society. Moreover, chronic pain is considered as a serious factor that affects life prognosis.

The well-known pharmaceutical drug ARKOXIAF for symptomatic therapy in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, as well as in pain and signs of inflammation associated with acute gouty arthritis (see the web page at the address: per:/LikisopigoYi.sot.tsa/instruction /7(120551). The well-known pharmaceutical preparation is produced in the form of film-coated tablets containing 30 mg, 60 mg, 90 mg or 120 mg of etoricoxib, as well as auxiliary substances - calcium hydrogen phosphate anhydrous, microcrystalline cellulose, croscarmellose sodium and magnesium stearate

Disadvantages of the known pharmaceutical drug are largely related to the dosage form of the known pharmaceutical drug, i.e., the unpleasant smell and taste of the tablets, complications of taking pills in case of swallowing disorders, complications of taking pills in diseases of the liver and digestive tract, the influence of digestive enzymes and food components on disintegration of tablets and absorption of active pharmaceutical ingredients, as well as the dependence of absorption of the active pharmaceutical ingredient (API) on the filling of the digestive tract. In particular, the effectiveness of a known pharmaceutical drug depends on the filling of the digestive tract, and the onset of action of the tablets of a known pharmaceutical drug occurs faster when taken on an empty stomach.

In addition, the well-known pharmaceutical drug in the form of a tablet, when ingested, passes the protective barrier of the body, such as the gastrointestinal tract and the liver, which reduces the bioavailability of the well-known pharmaceutical drug. In addition, the known oral pharmaceutical preparation is impractical in the need for rapid relief of acute pain or short-term treatment of perioperative and/or post-traumatic pain in hospital patients.

In addition, in pharmaceutical practice, the method of dividing tablets is widely used to select the necessary dose of the drug, and this can have a number of such disadvantages, such as the inability to ensure the accuracy of the dosage of a known pharmaceutical drug, the difficulty of following the patient's treatment regimen and reducing the desire to adhere to the therapy regimen, errors during the procedure separation of tablets by the patient himself.

In addition, the degree of development of side effects, for example, disorders of the cardiovascular system, from the use of a known pharmaceutical drug increases with an increase in the dose and duration of exposure, therefore it is recommended to conduct the shortest courses of treatment with the use of the smallest effective daily doses.

Another disadvantage of the well-known drug is the impossibility of its use for the treatment of patients with active peptic ulcer or active gastrointestinal bleeding. In addition, even in healthy patients without gastrointestinal abnormalities, it is recommended to use the known drug together with additional pharmaceuticals that protect the gastrointestinal tract from harmful effects from contact with etoricoxib. Thus, the cost of treatment increases

Due to the need to use several pharmaceuticals.

In addition, if there is no response to the treatment of a number of diseases with a known pharmaceutical drug, it is recommended to use other methods of treatment. Thus, the effectiveness of the known pharmaceutical preparation is largely offset by the disadvantages associated with the dosage form of the known pharmaceutical preparation.

Therefore, there is a need for new, highly effective anti-inflammatory drugs that possess analgesic, anti-inflammatory and antipyretic effects for successful and easy-to-follow treatment of pain and inflammation, which are symptoms of a wide range of diseases, including arthritis.

The useful model is based on the task of creating an effective and safe tool for the treatment of pain and inflammation, which is convenient to use, contributes to the improvement of the quality and standard of living of patients, is characterized by optimal physical properties and a simple and cost-effective method of production, acceptable for introduction into production.

The task is solved by a pharmaceutical preparation for the treatment of pain and inflammation, containing an active pharmaceutical ingredient of the formula (I) and at least one auxiliary substance and made in the form of a solution for injections.

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In addition, according to one of the variants of the implementation of the technical solution, the pharmaceutical preparation contains the pharmaceutical ingredient of formula (I) in an amount from 30 mg/ml to 120 mg/ml.

In addition, according to one of the variants of the implementation of the technical solution, the pharmaceutical preparation contains the pharmaceutical ingredient of formula (I) in the amount of 90 mg/ml.

In addition, according to one of the variants of the implementation of the technical solution, solvents, antioxidants, stabilizers, preservatives, solubilizers, co-solvents, isotonic agents, buffers are used as auxiliary substances.

In addition, according to one of the variants of the implementation of the technical solution, the pharmaceutical drug is administered intramuscularly, intravenously or intra-articularly.

In addition, according to one of the variants of the implementation of the technical solution, the pharmaceutical drug is used to treat inflammation, which is a symptom of rheumatoid arthritis, psoriatic arthritis, osteoarthritis, ankylosing spondylitis and gout.

A pharmaceutical preparation is a combination of substances (one or more APIs and excipients) that has properties and purpose for the treatment or prevention of diseases in humans. According to the technical decision, API is an active pharmaceutical ingredient of the formula ().

The active pharmaceutical ingredient of formula (I) - etoricoxib belongs to the group of coxibs and is a highly selective inhibitor of COX-2, which is formed exclusively in foci of inflammation. ooo

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COX-2 cyclooxygenase is responsible for the formation of prostaglandins, is an isoform of the enzyme induced by a proinflammatory impulse and is considered to be the main factor responsible for the synthesis of prostanoid mediators of pain, inflammation and fever. Etoricoxib, due to the selective inhibition of COX-2, reduces the formation of prostaglandins from arachidonic acid, which effectively eliminates pain and inflammation, which are symptoms of many diseases. Since etoricoxib has less inhibitory activity to COX-1, its use is much less often accompanied by side effects from the gastrointestinal tract.

Etoricoxib binds to blood plasma proteins (at 92 95). Metabolized in the liver with the formation of inactive metabolites, excreted from the body, mainly with urine in the form of metabolites, part of etoricoxib is excreted with feces. The half-life of etoricoxib is 22 hours.

Additionally, the pharmaceutical preparation may contain at least one pharmaceutically acceptable excipient. Use of pharmaceutically acceptable excipients

Zo for the production of pharmaceutical preparations according to the technical solution allows to ensure the receipt of pharmaceutical preparations in a liquid dosage form, in particular in the form of a solution for injections, which is characterized by acceptable physico-chemical indicators and good indicators of storage terms.

Solvents, antioxidants, stabilizers, preservatives, solubilizers, co-solvents, isotonic agents, buffers, etc. can be used as part of a pharmaceutical preparation according to a technical decision.

Purified water or water for injections, isotonic sodium chloride solution, Ringer's solution, glucose solution, etc. can be used as a solvent, according to the essence of the technical solution.

According to the essence of the technical solution, high molecular compounds can be used as co-solvents, for example, dextran, polyvinylpyrrolidone, polyethylene glycols, cyclodextrins, cremophor, dimethyl sulfoxide, etc.

According to the essence of the technical solution, polysorbate, poloxamer, sodium deoxycholate, etc. can be used as solubilizers.

According to the essence of the technical solution, polyethylene glycols, cellulose derivatives, ascorbic, hydrochloric, tartaric, citric, acetic acids, sodium carbonate and bicarbonate, sodium hydrosulfate and metabisulfite, sodium thiosulfate, disodium edetate, sodium citrate, sodium phosphate, etc. can be used as stabilizers.

According to the essence of the technical solution, methylparahydroxybenzoate, propylparahydroxybenzoate, chlorobutanol, cresol, phenol, etc. can be used as antimicrobial preservatives.

According to the essence of the technical solution, parenterally acceptable sugars, such as mannitol, sucrose, dextrose, sorbitol, lactose, sodium chloride, etc., can be used as isotonic agents.

According to the essence of the technical solution, as buffers, phosphate buffer, citrate buffer, acetate buffer, carbonate buffer, trihydroxymethylaminomethane, etc. can be used.

According to the essence of the technical solution, the liquid dosage form is a solution for injections, intended for injection into certain body tissues or organs, or a vascular bed. The solution for injection is in a pharmaceutically acceptable primary package and can contain 30 mg, 60 mg, 90 mg or 120 mg of etoricoxib in 1 ml of solution.

Pharmaceutically acceptable primary packaging can be an ampoule, a bottle with a stopper, a syringe, etc., and be made of materials acceptable in the field of pharmaceuticals, which are physically and chemically inert to the components of the pharmaceutical preparation, preserve its therapeutic activity, quality, purity during the manufacturing process, storage , transportation, implementation and use. Such acceptable materials can be glass and polymers.

The pharmaceutical preparation can be administered intramuscularly, intravenously, or intra-articularly by technical decision.

EXAMPLE 1

Obtaining a pharmaceutical preparation in the form of a solution for injections.

The production of a pharmaceutical preparation according to a technical solution is fully automated.

42.5 kg of water is loaded into a stainless steel reactor equipped with a stirrer. 6 kg of polyethylene glycol 3350 are loaded into the reactor with water. The reactor is heated to a temperature of 40 "C, and the contents of the reactor are stirred until the polyethylene glycol 3350 is completely dissolved. After the polyethylene glycol 3350 is completely dissolved, the reactor is allowed to cool to room temperature. 0.5 kg is loaded into the reactor of polysorbate 80, and the contents of the reactor are stirred until the polysorbate 80 is completely dissolved. 5 kg of mannitol are charged into the reactor, and the contents of the reactor are stirred until the mannitol is completely dissolved. 50 mM sodium phosphate is charged into the reactor, and the contents of the reactor are stirred until the sodium phosphate is completely dissolved.

From 0.9 kg of sodium chloride, and the contents of the reactor are stirred until the sodium chloride is completely dissolved.

The resulting solution is filtered through a filter with a cell size of 0.22 μm into a clean dry stainless steel reactor equipped with a stirrer. 3 kg of etoricoxib are loaded into the reactor, and the contents of the reactor are stirred until a homogeneous suspension is obtained. The pH of the suspension is adjusted to 7.020.1 with sodium hydroxide. 42.5 kg of water is loaded into the reactor, and the contents of the reactor are mixed

C5 until a homogeneous solution is obtained.

Ampoules with a nominal volume of 1 ml are filled with the obtained injection solution on a fully automated ampoule filling line. Filled ampoules are sealed on a fully automated ampoule sealing line.

Sealed ampoules are subjected to steam sterilization under pressure at a temperature of 121 "C and a pressure of 1.1 atm for 2 hours.

Sterilized ampoules are labeled and simultaneously packed in 5 pieces on an automatic device. Sterilized ampoules packed in polymer primary packaging are packed in a cardboard box with instructions.

Thus, the cardboard box contains a polymer package with five cells, in each of which there is a glass ampoule, which contains 1 ml of a pharmaceutical preparation according to the technical solution in the form of a solution for injections, and in 1 ml of a solution for injections contains 30 mg of etoricoxib

EXAMPLE 2

Obtaining a pharmaceutical preparation in the form of a solution for injections.

The production of a pharmaceutical preparation according to a technical solution is fully automated.

41 kg of water is loaded into a stainless steel reactor equipped with a stirrer. 6 kg of polyethylene glycol 3350 are loaded into the reactor with water. The reactor is heated to a temperature of 40 "С, and the contents of the reactor are stirred until the polyethylene glycol 3350 is completely dissolved. After the polyethylene glycol 3350 is completely dissolved, the reactor is allowed to cool to room temperature. 0.3 kg is loaded into the reactor of polysorbate 80, and the contents of the reactor are stirred until the polysorbate 80 is completely dissolved. 5 kg of mannitol are charged into the reactor, and the contents of the reactor are stirred until the mannitol is completely dissolved. 50 mM sodium phosphate is charged into the reactor, and the contents of the reactor are stirred until the sodium phosphate is completely dissolved. for 0.9 kg of sodium chloride, and the contents of the reactor are stirred until the sodium chloride is completely dissolved.

The resulting solution is filtered through a filter with a cell size of 0.22 μm into a clean dry stainless steel reactor equipped with a stirrer. 6 kg of etoricoxib are loaded into the reactor, and the contents of the reactor are stirred until a homogeneous suspension is obtained. The pH of the suspension is adjusted to 7.020.1 with sodium hydroxide. 41 kg of water are loaded into the reactor and the contents of the reactor are mixed until a homogeneous solution is obtained.

Ampoules with a nominal volume of 1 ml are filled with the obtained injection solution on a fully automated ampoule filling line. Filled ampoules are sealed on a fully automated ampoule sealing line.

Sealed ampoules are subjected to steam sterilization under pressure at a temperature of 121 "C and a pressure of 1.1 atm for 2 hours.

Sterilized ampoules are labeled and simultaneously packed in 5 pieces on an automatic device. Sterilized ampoules packed in polymer primary packaging are packed in a cardboard box with instructions.

Thus, the cardboard box contains a polymer package with five cells, in each of which there is a glass ampoule, which contains 1 ml of a pharmaceutical preparation according to the technical solution in the form of a solution for injections, and in 1 ml of a solution for injections contains 60 mg of etoricoxib.

EXAMPLE Z

Obtaining a pharmaceutical preparation in the form of a solution for injections.

The production of a pharmaceutical preparation according to a technical solution is fully automated.

42.5 kg of water is loaded into a stainless steel reactor equipped with a stirrer. 5 kg of polyethylene glycol 3350 are loaded into the reactor with water. The reactor is heated to a temperature of 40 "C, and the contents of the reactor are stirred until the polyethylene glycol 3350 is completely dissolved. After the polyethylene glycol 3350 is completely dissolved, the reactor is allowed to cool to room temperature. 0.2 kg is loaded into the reactor of polysorbate 80, and the contents of the reactor are stirred until the polysorbate 80 is completely dissolved. 50 mM sodium phosphate is charged into the reactor, and the contents of the reactor are stirred until the sodium phosphate is completely dissolved. 0.9 kg of sodium chloride is charged into the reactor, and the contents of the reactor are stirred until the sodium chloride is completely dissolved .

The resulting solution is filtered through a filter with a cell size of 0.22 μm into a clean dry stainless steel reactor equipped with a stirrer. 9 kg of etoricoxib are loaded into the reactor, and the contents of the reactor are stirred until a homogeneous suspension is obtained. The pH of the suspension is adjusted to 7.020.1 with sodium hydroxide. 42.5 kg of water is loaded into the reactor and the contents of the reactor are mixed until a homogeneous solution is obtained.

Ampoules with a nominal volume of 1 ml are filled with the obtained injection solution on a fully automated ampoule filling line. Filled ampoules are sealed on a fully automated ampoule sealing line.

Sealed ampoules are subjected to steam sterilization under pressure at a temperature of 121 "C and a pressure of 1.1 atm for 2 hours.

Sterilized ampoules are labeled and simultaneously packed in 5 pieces on an automatic device. Sterilized ampoules packed in polymer primary packaging are packed in a cardboard box with instructions.

Thus, the cardboard box contains a polymer package with five cells, in each of which there is a glass ampoule, which contains 1 ml of a pharmaceutical preparation according to the technical solution in the form of a solution for injections, and in 1 ml of a solution for injections contains 90 mg of etoricoxib.

EXAMPLE 4

Obtaining a pharmaceutical preparation in the form of a solution for injections.

The production of a pharmaceutical preparation according to a technical solution is fully automated.

42 kg of water is loaded into a stainless steel reactor equipped with a stirrer. Three kg of polyethylene glycol 3350 are loaded into the reactor with water. The reactor is heated to a temperature of 40 "C, and the contents of the reactor are stirred until the polyethylene glycol 3350 is completely dissolved. After the polyethylene glycol 3350 is completely dissolved, the reactor is allowed to cool to room temperature. 0.1 kg is loaded into the reactor of polysorbate 80, and the contents of the reactor are stirred until the polysorbate 80 is completely dissolved. 50 mM sodium phosphate is charged into the reactor, and the contents of the reactor are stirred until the sodium phosphate is completely dissolved. 0.9 kg of sodium chloride is charged into the reactor, and the contents of the reactor are stirred until the sodium chloride is completely dissolved .

The resulting solution is filtered through a filter with a cell size of 0.22 μm into a clean, dry, stainless steel reactor equipped with a stirrer. 12 kg of etoricoxib are loaded into the reactor, and the contents of the reactor are stirred until a homogeneous suspension is obtained. The pH of the suspension is adjusted to 7.050.1 with sodium hydroxide. 42 kg of water are loaded into the reactor, and the contents of the reactor are stirred until a homogeneous solution is obtained.

Ampoules with a nominal volume of 1 ml are filled with the obtained injection solution on a fully automated ampoule filling line. Filled ampoules are sealed on a fully automated ampoule sealing line.

Sealed ampoules are subjected to steam sterilization under pressure at a temperature of 121 "C and a pressure of 1.1 atm for 2 hours.

Sterilized ampoules are labeled and simultaneously packed in 5 pieces on an automatic device. Sterilized ampoules packed in polymer primary packaging are packed in a cardboard box with instructions.

Thus, the cardboard box contains a polymer package with five cells, in each of which there is a glass ampoule, which contains 1 ml of a pharmaceutical preparation according to the technical solution in the form of a solution for injections, and in 1 ml of a solution for injections contains 120 mg of etoricoxib.

EXAMPLE 5

A 12-week double-blind, randomized, placebo-controlled, active-drug-controlled study was conducted. 816 patients were involved in the study, in whom there was a worsening of the clinical picture of rheumatoid arthritis when non-steroidal anti-inflammatory drugs were stopped. Patients were randomized into three groups: placebo group - 323 people, etoricoxib group - 323 people and naproxen group - 170 people. The placebo group received placebo intramuscularly once daily, the etoricoxib group received etoricoxib 90 mg intramuscularly once daily, and the naproxen group received 500 mg naproxen twice daily.

The primary measure of treatment effectiveness was determined by patients and researchers using a global assessment of rheumatoid arthritis progression and a direct assessment of the number of painful and swollen joints. The secondary key effectiveness measure was determined using the patient's overall pain assessment, a questionnaire, and the percentage of patients who completed the 12-week course of treatment.

Out of 816 patients, 448 people completed the full 12-week course of treatment: 122 people in the placebo group, 230 people in the etoricoxib group, and 96 people in the naproxen group. Compared with patients who received placebo, patients who received etoricoxib and naproxen showed significant improvements in all measures of effectiveness (p<0.01). Compared with naproxen-treated patients, etoricoxib-treated patients showed significant improvements in all primary efficacy endpoints (p<0.05) and most secondary efficacy endpoints.

The percentage of patients who completed the 12-week treatment course was 21,95, 53,90, and 39,905 in the placebo, etoricoxib, and naproxen groups, respectively.

Thus, the results of the study show that intramuscular injections of a pharmaceutical drug are technically more effective than placebo or naproxen in the treatment of rheumatoid arthritis.

The technical result that is achieved when using a pharmaceutical preparation according to a technical solution: - Efficiency. The speed of action, because the pharmaceutical drug is administered intramuscularly, intravenously or intra-articularly, and not orally. In this regard - practicality, speed and efficiency for the rapid termination of acute pain or for the short-term treatment of perioperative and/or post-traumatic pain of patients in the hospital. Greater efficiency due to more complete bioavailability, since etoricoxib in the composition of the solution for injections bypasses such protective barriers of the body as the gastrointestinal tract and liver. - Safety. Reduction of the manifestation of side effects from the use of etoricoxib, for example, from the gastrointestinal tract, since the pharmaceutical drug is not used orally by technical decision. The drug can also be used for the treatment of patients with gastrointestinal tract diseases according to a technical solution. The accuracy of the dosage of the pharmaceutical preparation in the form of a solution for injections, which reduces the risks of overdose. - Convenience of using the pharmaceutical drug according to the technical solution, since there is no need to take additional actions to obtain an effective therapeutic amount of etoricoxib, for example, drink the tablet with water, eat or not eat before taking the drug, divide the tablet in half, etc. Also, when using the drug according to a technical solution, there is no need to take additional drugs to protect the organs of the gastrointestinal tract. The ability to administer a pharmaceutical drug to patients with limited functional capacity,

in particular, with a violation of the act of swallowing.

Absence of unpleasant sensations associated with the unpleasant smell and/or taste of the pharmaceutical preparation.

- Improving the quality and standard of living of patients.

Faster onset of action and high efficiency of the pharmaceutical drug according to the technical solution allow to achieve effective therapy of pain and symptoms of inflammation, and improve the patient's condition and quality of life.

- The selection of the qualitative and quantitative composition of the declared pharmaceutical preparation was carried out in such a way as to ensure its optimal physical properties and an acceptable shelf life, as well as a simple and cost-effective way of obtaining it, acceptable for introduction into production.

Claims (5)

USEFUL MODEL FORMULA 1. A pharmaceutical preparation for the treatment of pain and inflammation, containing an active pharmaceutical ingredient of the formula (I) and at least one auxiliary substance, which differs in that it is made in the form of a solution for injections. M not and: Y (). 2. Pharmaceutical preparation according to claim 1, which is characterized in that the pharmaceutical preparation contains the pharmaceutical ingredient of formula (I) in an amount from 30 mg/ml to 120 mg/ml. 3. Pharmaceutical preparation according to any one of claims 1, 2, which is characterized in that the pharmaceutical preparation contains the pharmaceutical ingredient of formula (I) in an amount of 90 mg/ml. 4. Pharmaceutical preparation according to any of claims 1-3, which differs in that solvents, antioxidants, stabilizers, preservatives, solubilizers, co-solvents, isotonic agents, buffers are used as auxiliary substances. 5. Pharmaceutical preparation according to any one of claims 1-4, which differs in that it is administered intramuscularly, intravenously or intra-articularly. b. A pharmaceutical preparation according to any one of claims 1-5, characterized in that it is used to treat inflammation which is a symptom of rheumatoid arthritis, psoriatic arthritis, osteoarthritis, ankylosing spondylitis and gout.