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WO1997026887A1 - Utilisation de galanthamine pour preparer de nouveaux medicaments - Google Patents

Utilisation de galanthamine pour preparer de nouveaux medicaments Download PDF

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Publication number
WO1997026887A1
WO1997026887A1 PCT/AT1997/000011 AT9700011W WO9726887A1 WO 1997026887 A1 WO1997026887 A1 WO 1997026887A1 AT 9700011 W AT9700011 W AT 9700011W WO 9726887 A1 WO9726887 A1 WO 9726887A1
Authority
WO
WIPO (PCT)
Prior art keywords
treatment
galanthamine
glaucoma
trisomy
nerve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/AT1997/000011
Other languages
German (de)
English (en)
Inventor
Martin Alois Hermann Mucke
Werner Frantsits
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Sanochemia Ltd
Original Assignee
Sanochemia Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sanochemia Ltd filed Critical Sanochemia Ltd
Priority to EP97900892A priority Critical patent/EP0876147A1/fr
Priority to AU14328/97A priority patent/AU1432897A/en
Publication of WO1997026887A1 publication Critical patent/WO1997026887A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

  • the invention relates to the new use of galanthamine or an analog or a pharmaceutically acceptable acid addition salt thereof for the manufacture of medicaments for the treatment of Lang-don-Down syndrome (Mongolism, Trisomy 21), for the treatment of glaucoma, for the treatment of myasthenia gravis and the related Eaton-Lambert syndrome and / or for the treatment of nerve compression trauma.
  • Lang-don-Down syndrome Mongolism, Trisomy 21
  • glaucoma for the treatment of myasthenia gravis and the related Eaton-Lambert syndrome and / or for the treatment of nerve compression trauma.
  • Down syndrome is due to a tripling of chromosome 21, i.e. the patients have a set of 47 instead of 46 chromosomes, which is relatively easy to detect cytologically.
  • Trisomie 21 is associated with moderate to severe intellectual disability and a number of physical signs of dysmorphism.
  • Causal therapy is currently not possible.
  • Existing disabilities can be influenced by targeted therapeutic measures, but the need for help usually remains.
  • glaucoma the different types of glaucoma are responsible worldwide for the majority of disease-related cases of blindness. In the USA and Europe, the number of people affected is estimated to be at least 2-3 million each. Since glaucoma usually does not cause pain or other striking symptoms before a clear loss of vision has occurred, it is assumed that about half of the cases are not correctly diagnosed.
  • Glaucoma is an optical neuropathy that is characterized by optic nerve damage and associated visual impairment. It is the common end stage of a number of different diseases affecting the eye. As soon as a critical number of optic nerve neurons are destroyed, "blind spots" initially develop on the periphery of the visual field, which increasingly extend to the central visual field. As soon as the optic nerve can no longer correctly transmit the signals from the retina to the brain, an irreversible there is a loss of vision.
  • the subspecies of glaucoma are classified based on the angle enclosed by the lens and iris and the intraocular pressure:
  • narrow-angle glaucoma angular block glaucoma
  • the iris is pressed by the primarily increased intraocular pressure against the intact trabecular system, whereupon the outflow of the aqueous humor is hindered.
  • Myasthenia gravis is an autoimmune disease in which the immune system forms antibodies against the acetylcholine receptors at the junctures between nerves and muscles (the so-called neuromuscular end plates) of the body.
  • these autoantibodies are not directed against the post-synaptic receptors, but against proteins of the presynaptic, calcium-controlled channels, which allow acetylcholine to escape into the synaptic cleft.
  • the first manifestations often appear in the muscles of the eyes, and subsequently the pharynx and larynx and finally the entire skeletal muscles are affected.
  • the main forms of MG are:
  • Infection-related MG can (possibly caused by a process of molecular mimicry) after herpes or bacterial infections.
  • Medically induced MG is a risk factor for treatment with penicillamine and related antibiotics.
  • Transient neonatal MG occurs in newborns who receive pathogenic immunoglobulins (with or without receptor antibodies) from the maternal circulation in the course of pregnancy. It manifests itself in about 12% of all children of MG patients within the first three days post partum and is self-limiting within 1-4 weeks.
  • Myasthenia gravis can be associated with other autoimmune diseases, whereby an existing thyroid disease can worsen the symptoms. Thymectomy usually improves symptoms within one year and is therefore recommended for all post-pubertal MG patients up to the age of 60.
  • Acute transient compression trauma can be a consequence of the shock wave propagating through the tissue after a stroke, while chronic compression is triggered by congenital malformations, displacements, bleeding or space-consuming processes when the nerve is pressed against a bone.
  • the irritation caused by the compression trauma leads to uncontrolled firing of the affected neurons, a process which triggers sensation of pain, interferes with normal nerve function, and can lead to permanent damage if left untreated.
  • Frequent causes of transient or chronic nerve compression are shock or pressure on the skull or spine, tooth extraction, tumors, innate or proximity of nerves to larger blood vessels or aneurisms caused by displacement, and in the case of glaucoma increased intraocular pressure.
  • Drug treatment for glaucoma focuses on reducing the intraocular pressure by topical application to the anterior part of the eye:
  • Miotics such as pilocarpine (an alkaloid) and carbachol (carbamylcholine, a choline ester) are parasympathomimetics which have been used for decades in narrow-angle glaucoma because they promote the outflow of the aqueous humor by contraction of the pupil.
  • Echothiophate phospholine iodide, a phosphate ester
  • physostigmine eserine
  • Epinephrine adrenaline
  • its precursors such as dipivefrin, which are metabolized to adrenaline in the eye
  • alpha2-agonists eg brominide
  • Beta blockers (e.g. Timolol, Levobunolol and Betaxolol) work by reducing the formation of aqueous humor.
  • Various oral beta blockers (propanolol, atenolol, nadolol) for lowering blood pressure also do this.
  • Carbonic anhydrase inhibitors also reduce the formation of aqueous humor.
  • Ophthalmic formulated steroids e.g. the selective FP receptor agent Latanoprost.
  • Acetylcholinesterase inhibitors accelerate the cholinergic neuromuscular conduction and can achieve rapid symptomatic improvement.
  • Pyridostigmine a short-acting AChEI
  • Distigmine and tetrastigmine essentially dimers or tetramers of pyridostigmine
  • organic phosphate esters have long been effective, but have been discredited because of their often unpredictable profile of effects, cumulative systemic effects and muscarinic side effects.
  • Immunosuppressants eg prednisone, azathioprine and cyclosporin
  • Ablative immunotherapy aims at a short-term reduction of the autoantibodies directed against the acetylcholine receptor or calcium channel through complexation and neutralization. This is achieved by intravenous administration of immunoglobulin or a soluble peptide which mimics the epitopes recognized by the autoantibodies. These processes are usually supported by frequent plasma exchange.
  • the causal therapy of chronic compression trauma is surgical decompression, which, however, is not always necessary or feasible and does not always result in the immediate elimination of the symptoms.
  • analgesics are used topically or instilled.
  • Antiepileptics are sometimes also used, the anticonvulsive effects of which are based on the prevention of repeated discharge of the action potentials of depolarized nerves.
  • Galanthamine has been known for many years as active pharmaceutical ingredients with an inhibitory effect on the synaptic enzyme acetylcholinesterase.
  • Galanthamine is therefore used pharmacologically for paralysis symptoms following poliomyelitis and for various diseases of the nervous system.
  • Galanthamine and some of its derivatives are also used in the symptomatic treatment of Alzheimer's disease and related dementia.
  • galanthamine is an alkaloid of the morphine group, which can be obtained from snowdrops (Galanthus woronowii, G. nivalis, etc.) and other amaryllidaceae.
  • galanthamine for producing a medicament for the treatment of Alzheimer's disease and related dementias is known from EP 236 684 A.
  • the invention is based on the object of providing a medicament with which the functional status of patients suffering from trisomy 21 and related syndromes, in particular adolescents, can be improved and with which the effective treatment of glaucoma, myasthemia gravis and Eaton-Lambert syndrome and / or nerve compression trauma is possible.
  • this is achieved by a medicament containing galanthamine or an acid addition salt.
  • the invention therefore relates to the use of galanthamine or a pharmaceutically acceptable acid addition salt thereof for the manufacture of a medicament for the treatment of trisomy 21 and related syndromes, glaucoma, myasthemia gravis as well as related autoimmune diseases and / or nerve compression trauma.
  • Mongoloids are substantially activated by administration of galanthamine or an acid addition salt of the medicament containing the same.
  • the cognitive performance and learning ability of these patients increases sharply, so that improved accessibility for learning therapy etc. is given.
  • the chances of increased integration into society thus increase considerably, since not only are the necessary social activities much better mastered, but also much better information processing and memory are provided.
  • acetylcholinesterase physostigmine and neostigmine
  • pilocarpine for the topical treatment of glaucoma. Because of their unfavorable pharmacological properties, however, in order to achieve a reasonably constant intraocular active ingredient level, they must be applied into the tear sac several times a day, which is always accompanied by acute eye irritation and impaired vision.
  • the long-acting miotics are, from a pharmacological point of view, consistently irreversible and also non-selective inhibitors of cholinesterases, which makes it difficult to control their effects.
  • they have a denaturing effect on the protein of the eye lens and can therefore cause clouding (cataracts) as the most important side effect.
  • clouding cataracts
  • the permanent narrowing of the pupil complicates the removal of the lens that may become necessary, since the pupil muscle tears frequently.
  • the use of echothiophate, isofluorophate and other alkylated miotics is therefore only recommended after cataract surgery.
  • Galanthamine combines the complete reversibility of the inhibitory effect with a half-life that is an order of magnitude higher than that of physostigmine and neostigmine. If necessary, its effect can be completely and at any time neutralized by parasympatholytics, such as atropine.
  • the selectivity of galanthamine for acetylcholinesterase is also almost a power of ten higher than for physostigmine, which results in a reduced potential for side effects.
  • Ophthalmic formulations can be created in the form of drops for twice a day use, or as an emulsion for application once a day, just as a membrane bag to be carried in a tear bag can release the active ingredient over several days.
  • galanthamine In contrast to the AChEI described above, galanthamine has excellent pharmacological properties. After oral ingestion as a tablet or solution, it is quickly and completely absorbed through the gastrointestinal tract and, because of its high distribution volume, reaches the entire skeletal muscles in sufficient concentration. It combines the good uptake and the reversibility of the AChEI action of pyridostigmine and neostigmine with the prolonged activity of the alkylated pyridostigmine oligomers, but avoids their cumulative effects.
  • Galanthamine alone and in combination with immunotherapy, is suitable for the symptomatic treatment of myasthenia gravis and Eaton-Lambert syndrome.
  • galanthamine Although the analgesic effect of galanthamine is too low to be of therapeutic significance, it can contribute to the restoration of normal stimulus conduction in mild or moderate compression trauma when used locally or systemically, especially with trigeminal neuralgia and facial paresis as well as with conditions after removal of medullary tumors . This may be due to the inhibitory effect of galanthamine on synaptic acetylcholinesterase, or to another mechanism that has not yet been characterized.
  • Galanthamine is suitable for the treatment of nerve compression trauma and supports the restoration of normal nerve function after surgical decompression.
  • Galanthamine or an acid addition salt thereof can be administered in any suitable chemical or physical form.
  • hydrobromide hydrochloride
  • methyl sulfate methiodide
  • Galanthamine or its pharmaceutically acceptable acid addition salts can be administered to patients orally or by subcutaneous or intravenous injection or intracerebroventricularly using an implanted container.
  • Typical dosing rates when administering galanthamine or its acid addition salts depend on the nature of the compound used and on the condition of the patient.
  • Typical treatment rates for treatment with galantamine or with galanthamine hydrobromide are in the range from 0.2 to 1.0 mg per day and kilogram of body mass, depending on the age, physical condition and other medication of the patient.
  • Tablets or capsules containing 5 or 10 mg galanthamine Parenteral solution containing 1 mg / ml galanthamine.
  • Liquid formulation for oral administration in one concentration of 1 or 5 mg / ml galanthamine / ml.
  • Ophthalmic aqueous solution 0.5% or 1.0%
  • Film-coated tablet 5 mg and 10 mg drinking solution, 1 mg / ml parenteral solution, 1 mg / ml ophthalmic solution, 0.5% and 1.0%
  • Film-coated tablet 5 mg and 10 mg drinking solution, 1 mg / ml parenteral solution, 1 mg / ml

Landscapes

  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

L'invention concerne l'utilisation de galanthamine ou d'un de ses sels d'addition d'acide pour préparer un médicament s'utilisant dans le traitement de la trisomie 21 et des syndromes apparentés, pour traiter le glaucome, la myasthénie grave, ainsi que les maladies neuromusculaires auto-immunes apparentées et/ou le traumatisme de compression nerveuse.
PCT/AT1997/000011 1996-01-26 1997-01-27 Utilisation de galanthamine pour preparer de nouveaux medicaments Ceased WO1997026887A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP97900892A EP0876147A1 (fr) 1996-01-26 1997-01-27 Utilisation de galanthamine pour preparer de nouveaux medicaments
AU14328/97A AU1432897A (en) 1996-01-26 1997-01-27 Use of galanthamine in the preparation of novel drugs

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AT0014996A AT402691B (de) 1996-01-26 1996-01-26 Verwendung von galanthamin zum herstellen von arzneimitteln zur behandlung von trisomie 21 oder verwandter trisomie-syndrome
ATA149/96 1996-01-26

Publications (1)

Publication Number Publication Date
WO1997026887A1 true WO1997026887A1 (fr) 1997-07-31

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Application Number Title Priority Date Filing Date
PCT/AT1997/000011 Ceased WO1997026887A1 (fr) 1996-01-26 1997-01-27 Utilisation de galanthamine pour preparer de nouveaux medicaments

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Country Link
EP (1) EP0876147A1 (fr)
AT (1) AT402691B (fr)
AU (1) AU1432897A (fr)
WO (1) WO1997026887A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000032199A1 (fr) * 1998-12-01 2000-06-08 Sanochemia Pharmazeutika Aktiengesellschaft Utilisation de galanthamine et de derives de galanthamine en cas de lesions cerebrales fonctionnelles aigues
EP1503765A4 (fr) * 2002-02-22 2007-02-07 Bonnie M Davis Utilisation de modulateurs des recepteurs nicotiniques dans le traitement d'un dysfonctionnement cognitif
WO2007016793A1 (fr) * 2005-08-11 2007-02-15 Universite De Montreal La galantamine en tant que médicament neuroprotecteur pour les cellules ganglionnaires de la rétine

Citations (2)

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Publication number Priority date Publication date Assignee Title
EP0236684A2 (fr) * 1986-01-15 1987-09-16 Synaptech, Inc. Galanthamine ou ses analogues pour le traitement de la maladie d'Alzheimer
DE19509663A1 (de) * 1995-03-17 1996-09-19 Lohmann Therapie Syst Lts Verfahren zur Isolierung von Galanthamin

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DE4010079A1 (de) * 1990-03-29 1991-10-02 Lohmann Therapie Syst Lts Pharmazeutische formulierung zur behandlung des alkoholismus
US5336675A (en) * 1991-05-14 1994-08-09 Ernir Snorrason Method of treating mania in humans
US5177070A (en) * 1991-11-15 1993-01-05 Ciba-Geigy Corporation Method of treating physiologic male erectile impotence
DE4301783C1 (de) * 1993-01-23 1994-02-03 Lohmann Therapie Syst Lts Transdermales therapeutisches System mit Galanthamin als wirksamem Bestandteil
DE4301782C1 (de) * 1993-01-23 1994-08-25 Lohmann Therapie Syst Lts Verwendung von Galanthamin zur Behandlung der Nicotinabhängigkeit
US5428159A (en) * 1994-04-08 1995-06-27 Ciba-Geigy Corporation Method of manufacture of (-)-galanthamine in high yield and purity substantially free of epigalanthamine

Patent Citations (3)

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EP0236684A2 (fr) * 1986-01-15 1987-09-16 Synaptech, Inc. Galanthamine ou ses analogues pour le traitement de la maladie d'Alzheimer
DE19509663A1 (de) * 1995-03-17 1996-09-19 Lohmann Therapie Syst Lts Verfahren zur Isolierung von Galanthamin
WO1996029332A1 (fr) * 1995-03-17 1996-09-26 Lts Lohmann Therapie-Systeme Gmbh Procede d'isolation de galanthamine

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000032199A1 (fr) * 1998-12-01 2000-06-08 Sanochemia Pharmazeutika Aktiengesellschaft Utilisation de galanthamine et de derives de galanthamine en cas de lesions cerebrales fonctionnelles aigues
EP1503765A4 (fr) * 2002-02-22 2007-02-07 Bonnie M Davis Utilisation de modulateurs des recepteurs nicotiniques dans le traitement d'un dysfonctionnement cognitif
EP2289519A3 (fr) * 2002-02-22 2011-06-08 Bonnie M. Davis Utilisation de modulateurs de récepteurs nicotiniques pour le traitement des dysfonctionnements cognitifs
WO2007016793A1 (fr) * 2005-08-11 2007-02-15 Universite De Montreal La galantamine en tant que médicament neuroprotecteur pour les cellules ganglionnaires de la rétine

Also Published As

Publication number Publication date
AT402691B (de) 1997-07-25
EP0876147A1 (fr) 1998-11-11
AU1432897A (en) 1997-08-20
ATA14996A (de) 1996-12-15

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