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WO2006062931A2 - Combinaisons medicales - Google Patents

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Publication number
WO2006062931A2
WO2006062931A2 PCT/US2005/044033 US2005044033W WO2006062931A2 WO 2006062931 A2 WO2006062931 A2 WO 2006062931A2 US 2005044033 W US2005044033 W US 2005044033W WO 2006062931 A2 WO2006062931 A2 WO 2006062931A2
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Prior art keywords
combination according
combination
compound
dose
adrenoreceptor agonist
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WO2006062931A3 (fr
Inventor
Dramane Ibrahim Laine
Michael R. Palovich
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SmithKline Beecham Corp
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SmithKline Beecham Corp
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Publication of WO2006062931A2 publication Critical patent/WO2006062931A2/fr
Publication of WO2006062931A3 publication Critical patent/WO2006062931A3/fr
Anticipated expiration legal-status Critical
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    • 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
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
    • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
    • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
    • A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
    • A61K31/7072—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid having two oxo groups directly attached to the pyrimidine ring, e.g. uridine, uridylic acid, thymidine, zidovudine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system

Definitions

  • This invention relates to the olefinic derivatives of 8-azoniabicyclo[3.2.1] octanes, pharmaceutical compositions, and use thereof in treating muscarinic acetylcholine receptor mediated diseases of the respiratory tract and combinations thereof.
  • Muscarinic acetylcholine receptors (mAChRs) belong to the superfamily of G-protein coupled receptors that have seven transmembrane domains. There are five subtypes of mAChRs, termed M1 -M5, and each is the product of a distinct gene. Each of these five subtypes displays unique pharmacological properties. Muscarinic acetylcholine receptors are widely distributed in vertebrate organs where they mediate many of the vital functions.
  • Muscarinic receptors can mediate both inhibitory and excitatory actions.
  • M3 mAChRs mediate contractile responses.
  • mAChRs have been localized to smooth muscle in the trachea and bronchi, the submucosal glands, and the parasympathetic ganglia. Muscarinic receptor density is greatest in parasympathetic ganglia and then decreases in density from the submucosal glands to tracheal and then bronchial smooth muscle. Muscarinic receptors are nearly absent from the alveoli.
  • mAChR expression and function in the lungs please see Fryer and Jacoby (1998 Am J Respir Crit Care Med 158(5, pt 3) S 154-60).
  • Three subtypes of mAChRs have been identified as important in the lungs,
  • M 1 , M 2 and M 3 mAChRs located on airway smooth muscle, mediate muscle contraction. Stimulation of M 3 mAChRs activates the enzyme phospholipase C via binding of the stimulatory G protein Gq/11 (Gs), leading to liberation of phosphatidyl inositol-4,5-bisphosphate, resulting in phosphorylation of ( contractile proteins.
  • Gq/11 stimulatory G protein
  • M 3 mAChRs are also found on pulmonary submucosal glands. Stimulation of this population of M 3 mAChRs results in mucus secretion.
  • M 2 mAChRs make up approximately 50-80% of the cholinergic receptor population on airway smooth muscles. Although the precise function is still unknown, they inhibit catecholaminergic relaxation of airway smooth muscle via inhibition of cAMP generation.
  • Neuronal M 2 mAChRs are located on postganglionic parasympathetic nerves. Under normal physiologic conditions, neuronal M 2 mAChRs provide tight control of acetylcholine release from parasympathetic nerves. Inhibitory M 2 mAChRs have also been demonstrated on sympathetic nerves in the lungs of some species. These receptors inhibit release of noradrenaline, thus decreasing sympathetic input to the lungs.
  • M 1 mAChRs are found in the pulmonary parasympathetic ganglia where they function to enhance neurotransmission. These receptors have also been localized to the peripheral lung parenchyma, however their function in the parenchyma is unknown.
  • Muscarinic acetylcholine receptor dysfunction in the lungs has been noted in a variety of different pathophysiological states.
  • COPD chronic obstructive pulmonary disease
  • inflammatory conditions lead to loss of inhibitory M2 muscarinic acetylcholine autoreceptor function on parasympathetic nerves supplying the pulmonary smooth muscle, causing increased acetylcholine release following vagal nerve stimulation (Fryer et al. 1999 Life Sc/ 64 (6-7) 449- 55).
  • This mAChR dysfunction results in airway hyperreactivity and hyperresponsiveness mediated by increased stimulation of M3 mAChRs.
  • potent mAChR antagonists would be useful as therapeutics in these mAChR-mediated disease states.
  • COPD chronic bronchitis, chronic bronchiolitis and emphysema
  • Smoking is the major risk factor for the development of COPD; nearly 50 million people in the U.S. alone smoke cigarettes, and an estimated 3,000 people take up the habit daily.
  • COPD is expected to rank among the top five as a world-wide health burden by the year 2020.
  • Inhaled anti-cholinergic therapy is currently considered the "gold standard" as first line therapy for COPD (Pauwels et al. 2001 Am. J. Respir. Crit. Care Med. 163:1256-1276).
  • Ipratropium Bromide (Atrovent ⁇ : and Combivent ⁇ , in combination with albuterol) is currently the only inhaled anticholinergic marketed for the treatment of airway hyperreactive diseases. While this compound is a potent anti-muscarinic agent, it is short acting, and thus must be administered as many as four times daily in order to provide relief for the COPD patient. In Europe and Asia, the long-acting anti-cholinergic Tiotropium Bromide (Spiriva®) was recently approved, however this product is currently not available in the United States.
  • mAChRs are widely distributed throughout the body, the ability to apply anti-cholinergics locally and/or topically to the respiratory tract is particularly advantageous, as it would allow for lower doses of the drug to be utilized. Furthermore, the ability to design topically active drugs that have long duration of action, and in particular, are retained either at the receptor or by the lung, would allow the avoidance of unwanted side effects that may be seen with systemic anticholinergic use.
  • This invention provides for a method of treating a muscarinic acetylcholine receptor (mAChR) mediated disease, wherein acetylcholine binds to an mAChR and which method comprises administering an effective amount of a compound of Formula (I) or a pharmaceutically acceptable salt thereof.
  • mAChR muscarinic acetylcholine receptor
  • This invention also relates to a method of inhibiting the binding of acetylcholine to its receptors in a mammal in need thereof which comprises administering to aforementioned mammal an effective amount of a compound of Formula (I).
  • the present invention also provides for the novel compounds of Formula (I), and pharmaceutical compositions comprising a compound of Formula (I), and a pharmaceutical carrier or diluent.
  • the compounds according to this invention have the structure shown by Formula (I):
  • R2 and R3 are, independently, selected from the group consisting of straight or branched chain lower alkyl groups having preferably from 1 to 6 carbon atoms, cycloalkyl groups having from 5 to 6 carbon atoms, cycloalkyl-alkyl having 6 to 10 carbon atoms, 2-thienyl, 2-pyridyl, phenyl, phenyl substituted with an alkyl group having not in excess of 4 carbon atoms and phenyl substituted with an alkoxy group having not in excess of 4 carbon atoms.
  • X ' represents an anion associated with the positive charge of the N atom.
  • X ' may be but is not limited to chloride, bromide, iodide, sulfate, benzene sulfonate, and toluene sulfonate.
  • the compounds, salts and/or pharmaceutical compositions according to the present invention may also be used in combination with another therapeutically active agtent, for example, a ⁇ 2 adrenoreceptor agonist, or an anti-inflammatory agent.
  • another therapeutically active agtent for example, a ⁇ 2 adrenoreceptor agonist, or an anti-inflammatory agent.
  • the present invention thus provides, in a further aspect, a combination comprising a compound of formula (I) or a pharmaceutically acceptable salt thereof together with another therapeutically active agent, for example, a ⁇ 2-adrenoreceptor agonist, or an anti-inflammatory agent.
  • ⁇ 2 -adrenoreceptor agonists examples include salmeterol (eg as racemate or a single enantiomer such as the R-enantiomer), salbutamol, formoterol, salmefamol, fenoterol or terbutaline, or a salt thereof (e.g. pharmaceutically acceptable salt thereof), for example the xinafoate salt of salmeterol, the sulphate salt or free base of salbutamol or the fumarate salt of formoterol.
  • ⁇ 2 - adrenoreceptor agonists include, but are not limited to:
  • Salmeterol or a pharmaceutically acceptable salt thereof e.g. salmeterol xinofoate
  • a further combination according to the present invention comprises a compound of formula (I) or a pharmaceutically acceptable salt thereof together with an antiinflammatory corticosteroid.
  • Said anti-inflammatory corticosteroid is itself preferably for treatment and/or prophylaxis of asthma, COPD or allergic rhinitis.
  • Said anti- inflammatory corticosteroid may for example be selected from fluticasone, fluticasone propionate (e.g.
  • beclomethasone beclomethasone 17-propionate ester, beclomethasone 17,21-dipropionate ester, dexamethasone or an ester thereof, mometasone or an ester thereof, ciclesonide, budesonide, flunisolide, preferably 6 ⁇ ,9 ⁇ -difluoro-17 ⁇ -[(2-furanylcarbonyl)oxy]-11 ⁇ - hydroxy-16 ⁇ -methyl-3-oxo-androsta-1 ,4-diene-17 ⁇ -carbothioic acid S-fluoromethyl ester ⁇ or 6 ⁇ ,9 ⁇ -dif luoro-1 1 ⁇ -hydroxy-16 ⁇ -methyl-17 ⁇ -[(4-methyl-1 ,3-thiazole-5- carbonyl)oxy]-3-oxo-androsta-1 ,4-diene-17 ⁇ -carbothioic acid S-fluoromethyl ester ⁇ , or a pharmaceutically acceptable salt thereof.
  • the anti-inflammatory cortic preferably 6 ⁇ ,9 ⁇
  • Fluticasone propionate is preferred and is preferably for inhaled administration to a human either (a) at a dose of 250 micrograms once per day or (b) at a dose of 50 to 250 micrograms twice per day.
  • a combination comprising a compound of formula (I) or a pharmaceutically acceptable salt thereof together with ⁇ 2 -adrenoreceptor agonist and an anti-inflammatory corticosteroid.
  • this combination is for treatment and/or prophylaxis of asthma, COPD or allergic rhinitis.
  • the ⁇ 2 -adrenoreceptor agonist and/or the anti-inflammatory corticosteroid can be as described above.
  • the ⁇ 2 -adrenoreceptor agonist is salmeterol or a pharmaceutically acceptable salt thereof (e.g. salmeterol xinafoate) and the anti-inflammatory corticosteroid is fluticasone propionate.
  • compositions comprising a combination as defined above together with one or more pharmaceutically acceptable carriers and/or excipients represent a further aspect of the invention.
  • the individual compounds of such combinations may be administered either sequentially or simultaneously in separate or combined pharmaceutical composition(s). Appropriate doses of known therapeutic agents will readily be appreciated by those skilled in the art.
  • the combination as defined herein can be for simultaneous inhaled administration and is disposed in a combination inhalation device.
  • a combination inhalation device is another aspect of the invention.
  • Such a combination inhalation device can comprise a combined pharmaceutical composition for simultaneous inhaled administration (e.g.
  • the composition comprising all the individual compounds of the combination, and the composition being incorporated into a plurality of sealed dose containers mounted longitudinally in a strip or ribbon inside the inhalation device, the containers being rupturable or peel-openable on demand;
  • inhalation device can be substantially as described in GB 2,242,134 A (DISKUS TM) and/or as described above.
  • the combination inhalation device can be such that the individual compounds of the combination are administrable simultaneously but are stored separately (or wholly or partly stored separately for triple combinations), e.g. in separate pharmaceutical compositions, for example as described in PCT/EP03/00598 filed on 22 January 2003, published as WO 03/061743 (e.g. as described in the claims thereof e.g. claim 1), incorporated herein in its entirely by reference..
  • the invention also provides a method of preparing a combination as defined herein, the method comprising either
  • the invention also provides a combination as defined herein, prepared by a method as defined herein.
  • the compounds of Formula (I) may be obtained by applying synthetic procedures well known in the art as described in the patent US2800482, incorporated herein in its entirety by reference.
  • inhibitory effects of compounds at the M3 mAChR of the present invention are determined by the following in vitro and in vivo functional assays:
  • mAChRs expressed on CHO cells were analyzed by monitoring receptor-activated calcium mobilization as previously described (H. M.Sarau et al, 1999. MoI. Pharmacol. 56, 657-663).
  • CHO cells stably expressing M3 mAChRs were plated in 96 well black wall/clear bottom plates. After 18 to 24 hours, media was aspirated and replaced with 100 ⁇ l of load media (EMEM with Earl's salts, 0.1% RIA-grade BSA (Sigma, St. Louis MO), and 4 ⁇ M Fluo-3- acetoxymethyl ester fluorescent indicator dye (Fluo-3 AM, Molecular Probes, Eugene, OR) and incubated 1 hr at 37° C.
  • load media EMEM with Earl's salts, 0.1% RIA-grade BSA (Sigma, St. Louis MO
  • Fluo-3- acetoxymethyl ester fluorescent indicator dye Fluo-3 AM, Molecular Probes, Eugene, OR
  • the dye-containing media was then aspirated, replaced with fresh media (without Fluo-3 AM), and cells were incubated for 10 minutes at 37° C. Cells were then washed 3 times and incubated for 10 minutes at 37° C in 100 ⁇ l of assay buffer (0.1% gelatin (Sigma), 120 mM NaCI, 4.6 mM KCI, 1 mM KH 2 PO 4 , 25 mM NaH CO 3 , 1.0 mM CaCI 2 , 1.1 mM MgCI 2 , 11 mM glucose, 2OmM HEPES (pH 7.4)). 50 ⁇ l of compound (1x10 "1 1 - 1x10" 5 M final in the assay) was added and the plates were incubated for 10 min.
  • assay buffer (0.1% gelatin (Sigma), 120 mM NaCI, 4.6 mM KCI, 1 mM KH 2 PO 4 , 25 mM NaH CO 3 , 1.0 mM CaCI 2 , 1.1 mM
  • Radioligand binding studies using 0.5 nM [ 3 H]-N-methyl scopolamine (NMS) in a SPA format is used to assess binding of muscarinic antagonists to M 1 , M 2 , M 3 , M 4 and M 5 muscarinic acetylcholine receptors.
  • NMS N-methyl scopolamine
  • Tissues were then rinsed every 15 minutes over 1 hour until reaching baseline tone. The preparations were then left for at least 30 minutes before the start of the experiment. Concentration-response curves were obtained by a cumulative addition of carbachol in half-log increments (Van Rossum, 1963, Arch. Int. Pharmacodyn., 143:299), initiated at 1 nM. Each concentration was left in contact with the preparation until the response plateaued before the addition of the subsequent carbachol concentration. Paired tissues were exposed to mAChR antagonist compounds or vehicle for 30 min before carbachol cumulative concentration- response curves were generated. All data is given as mean ⁇ standard error of the mean (s.e.m.) with ⁇ being the number of different animals.
  • Antagonist concentration-response curves were obtained by plotting the maximal relaxation data at 0, 60 and 180-min following antagonist withdrawal. Recovery, termed shift, was calculated from the ratio of the 0-min inhibition curve IC50 and the concentration of compound yielding a similar tension recovery at 60 and 180 minutes.
  • Halftimes for onset and offset of response were plotted vs. corresponding concentration and the data were fit with non-linear regression. These values were extrapolated at the IC50 (determined from the inhibition concentration-response curve) and designated Otso (time required, at the IC50 concentration, to reach half of the onset response) and Rt50 (time required, at the IC50 concentration, to reach half of the recovery response).
  • Mice were pre-treated with 50 ⁇ l of compound (0.003-10 ⁇ g/mouse) in 50 ⁇ l of vehicle (10% DMSO) intranasally (i.n.) and were then placed in the plethysmography chamber a given amount of time following drug administration (15 min - 96 h). For potency determination, a dose response to a given drug was performed, and all measurements were taken 15 min following i.n. drug administration. For duration of action determination, measurements were taken anywhere from 15 min to 96 hours following i.n. drug administration.
  • mice were allowed to equilibrate for 10 min before taking a baseline Penh measurement for 5 minutes.
  • Mice were then challenged with an aerosol of methacholine (10 mg/ml) for 2 minutes. Penh was recorded continuously for 7 min starting at the inception of the methacholine aerosol, and continuing for 5 minutes afterward. Data for each mouse were analyzed and plotted by using GraphPad PRISM software. This experiment allows the determination of duration of activity of the administered compound.
  • the present compounds are useful for treating a variety of indications, including but not limited to respiratory-tract disorders such as chronic obstructive lung disease, chronic bronchitis, asthma, chronic respiratory obstruction, pulmonary fibrosis, pulmonary emphysema, and allergic rhinitis.
  • respiratory-tract disorders such as chronic obstructive lung disease, chronic bronchitis, asthma, chronic respiratory obstruction, pulmonary fibrosis, pulmonary emphysema, and allergic rhinitis.
  • the present invention further provides a pharmaceutical formulation comprising a compound of formula (I), or a pharmaceutically acceptable salt, solvate, or physiologically functional derivative (e.g., salts and esters) thereof, and a pharmaceutically acceptable carrier or excipient, and optionally one or more other therapeutic ingredients.
  • a pharmaceutical formulation comprising a compound of formula (I), or a pharmaceutically acceptable salt, solvate, or physiologically functional derivative (e.g., salts and esters) thereof, and a pharmaceutically acceptable carrier or excipient, and optionally one or more other therapeutic ingredients.
  • active ingredient means a compound of formula (I), or a pharmaceutically acceptable salt, solvate, or physiologically functional derivative thereof.
  • Compounds of formula (I) will be administered via inhalation via the mouth or nose.
  • Dry powder compositions for topical delivery to the lung by inhalation may, for example, be presented in capsules and cartridges of for example gelatine, or blisters of for example laminated aluminium foil, for use in an inhaler or insufflator.
  • Powder blend formulations generally contain a powder mix for inhalation of the compound of the invention and a suitable powder base (carrier/diluent/excipient substance) such as mono-, di- or poly-saccharides (e.g., lactose or starch), organic or inorganic salts (e.g., calcium chloride, calcium phosphate or sodium chloride), polyalcohols (e.g., mannitol), or mixtures thereof, alternatively with one or more additional materials, such additives included in the blend formulation to improve chemical and/or physical stability or performance of the formulation, as discussed below, or mixtures thereof.
  • a suitable powder base such as mono-, di- or poly-saccharides (e.g., lactose or starch),
  • the compound of the invention may be presented without excipients, or may be formed into particles comprising the compound, optionally other therapeutically active materials, and excipient materials, such as by co-precipitation or coating.
  • the medicament dispenser is of a type selected from the group consisting of a reservoir dry powder inhaler (RDPI) 1 a multi-dose dry powder inhaler (MDPI), and a metered dose inhaler (MDI).
  • RDPI reservoir dry powder inhaler
  • MDPI multi-dose dry powder inhaler
  • MDI metered dose inhaler
  • reservoir dry powder inhaler By reservoir dry powder inhaler (RDPI) it is meant as an inhaler having a reservoir form pack suitable for comprising multiple (un-metered doses) of medicament in dry powder form and including means for metering medicament dose from the reservoir to a delivery position.
  • the metering means may for example comprise a metering cup or perforated plate, which is movable from a first position where the cup may be filled with medicament from the reservoir to a second position where the metered medicament dose is made available to the patient for inhalation.
  • multi-dose dry powder inhaler is meant an inhaler suitable for dispensing medicament in dry powder form, wherein the medicament is comprised within a multi-dose pack containing (or otherwise carrying) multiple, define doses (or parts thereof) of medicament.
  • the carrier has a blister pack form, but it could also, for example, comprise a capsule-based pack form or a carrier onto which medicament has been applied by any suitable process including printing, painting and vacuum occlusion.
  • the formulation can be pre-metered (eg as in Diskus, see GB 2242134 or Diskhaler, see GB 2178965, 2129691 and 2169265) or metered in use (eg as in Turbuhaler, see EP 69715).
  • An example of a unit-dose device is Rotahaler (see GB 2064336).
  • the Diskus inhalation device comprises an elongate strip formed from a base sheet having a plurality of recesses spaced along its length and a lid sheet hermetically but peelably sealed thereto to define a plurality of containers, each container having therein an inhalable formulation containing a compound of formula (I) preferably combined with lactose.
  • the strip is sufficiently flexible to be wound into a roll.
  • the Hd sheet and base sheet will preferably have leading end portions which are not sealed to one another and at least one of the said leading end portions is constructed to be attached to a winding means. Also, preferably the hermetic seal between the base and lid sheets extends over their whole width.
  • the lid sheet may preferably be peeled from the base sheet in a longitudinal direction from a first end of the said base sheet.
  • the multi-dose pack is a blister pack comprising multiple blisters for containment of medicament in dry powder form.
  • the blisters are typically arranged in regular fashion for ease of release of medicament therefrom.
  • the multi-dose blister pack comprises plural blisters arranged in generally circular fashion on a disk-form blister pack.
  • the multi- dose blister pack is elongate in form, for example comprising a strip or a tape.
  • the multi-dose blister pack is defined between two members peelably secured to one another.
  • US Patents Nos. 5,860,419, 5,873,360 and 5,590,645 describe medicament packs of this general type.
  • the device is usually provided with an opening station comprising peeling means for peeling the members apart to access each medicament dose.
  • the device is adapted for use where the peelable members are elongate sheets which define a plurality of medicament containers spaced along the length thereof, the device being provided with indexing means for indexing each container in turn.
  • the device is adapted for use where one of the sheets is a base sheet having a plurality of pockets therein, and the other of the sheets is a lid sheet, each pocket and the adjacent part of the lid sheet defining a respective one of the containers, the device comprising driving means for pulling the lid sheet and base sheet apart at the opening station.
  • metered dose inhaler it is meant a medicament dispenser suitable for dispensing medicament in aerosol form, wherein the medicament is comprised in an aerosol container suitable for containing a propellant-based aerosol medicament formulation.
  • the aerosol container is typically provided with a metering valve, for example a slide valve, for release of the aerosol form medicament formulation to the patient.
  • the aerosol container is generally designed to deliver a predetermined dose of medicament upon each actuation by means of the valve, which can be opened either by depressing the valve while the container is held stationary or by depressing the container while the valve is held stationary.
  • Spray compositions for topical delivery to the lung by inhalation may for example be formulated as aqueous solutions or suspensions or as aerosols delivered from pressurised packs, such as a metered dose inhaler, with the use of a suitable liquefied propellant.
  • Aerosol compositions suitable for inhalation can be either a suspension or a solution and generally contain the compound of formula (I) optionally in combination with another therapeutically active ingredient and a suitable propellant such as a fluorocarbon or hydrogen-containing chlorofluorocarbon or mixtures thereof, particularly hydrofluoroalkanes, e.g.
  • the aerosol composition may be excipient free or may optionally contain additional formulation excipients well known in the art such as surfactants eg oleic acid or lecithin and cosolvents eg ethanol. Pressurised formulations will generally be retained in a canister (eg an aluminium canister) closed with a valve (eg a metering valve) and fitted into an actuator provided with a mouthpiece.
  • a canister eg an aluminium canister
  • a valve eg a metering valve
  • Medicaments for administration by inhalation desirably have a controlled particle size.
  • the optimum aerodynamic particle size for inhalation into the bronchial system for localized delivery to the lung is usually 1-1 O ⁇ m, preferably 2- 5 ⁇ m.
  • the optimum aerodynamic particle size for inhalation into the alveolar region for achieving systemic delivery to the lung is approximately .5-3 ⁇ m, preferably 1-3 ⁇ m.
  • Particles having an aerodynamic size above 20 ⁇ m are generally too large when inhaled to reach the small airways.
  • Average aerodynamic particle size of a formulation may measured by, for example cascade impaction.
  • Average geometric particle size may be measured, for example by laser diffraction, optical means.
  • the particles of the active ingredient as produced may be size reduced by conventional means eg by controlled crystallization, micronisation or nanomilling .
  • the desired fraction may be separated out by air classification.
  • particles of the desired size may be directly produced, for example by spray drying, controlling the spray drying parameters to generate particles of the desired size range.
  • the particles will be crystalline, although amorphous material may also be employed where desirable.
  • an excipient such as lactose is employed, generally, the particle size of the excipient will be much greater than the inhaled medicament within the present invention, such that the "coarse" carrier is non-respirable.
  • additive materials in a dry powder blend in addition to the carrier may be either respirable, i.e., aerodynamically less than 10 microns, or non- respirable, i.e., aerodynamically greater than 10 microns.
  • Suitable additive materials which may be employed include amino acids, such as leucine; water soluble or water insoluble, natural or synthetic surfactants, such as lecithin (e.g., soya lecithin) and solid state fatty acids (e.g., lauric, palmitic, and stearic acids) and derivatives thereof (such as salts and esters); phosphatidylcholines; sugar esters.
  • Additive materials may also include colorants, taste masking agents (e.g., saccharine), anti-static-agents, lubricants (see, for example, Published PCT Patent Appl. No. WO 87/905213, the teachings of which are incorporated by reference herein), chemical stabilizers, buffers, preservatives, absorption enhancers, and other materials known to those of ordinary skill.
  • Sustained release coating materials e.g., stearic acid or polymers, e.g. polyvinyl pyrolidone, polylactic acid
  • active material or active material containing particles see, for example, Patent Nos. US 3,634,582, GB 1 ,230,087, GB 1 ,381 ,872, the teachings of which are incorporated by reference herein).
  • Intranasal sprays may be formulated with aqueous or non-aqueous vehicles with the addition of agents such as thickening agents, buffer salts or acid or alkali to adjust the pH, isotonicity adjusting agents or anti-oxidants.
  • agents such as thickening agents, buffer salts or acid or alkali to adjust the pH, isotonicity adjusting agents or anti-oxidants.
  • Solutions for inhalation by nebulation may be formulated with an aqueous vehicle with the addition of agents such as acid or alkali, buffer salts, isotonicity adjusting agents or antimicrobials. They may be sterilised by filtration or heating in an autoclave, or presented as a non-sterile product.
  • Preferred unit dosage formulations are those containing an effective dose, as herein before recited, or an appropriate fraction thereof, of the active ingredient.
  • the word 'comprise', and variations such as 'comprises' and 'comprising' will be understood to imply the inclusion of a stated integer or step or group of integers but not to the exclusion of any other integer or step or group of integers or steps. All publications, including but not limited to patents and patent applications, cited in this specification are herein incorporated by reference as if each individual publication were specifically and individually indicated to be incorporated by reference herein as though fully set forth.

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Abstract

L'invention concerne des antagonistes du récepteur d'acétylcholine muscarinique et des méthodes permettant de les utiliser.
PCT/US2005/044033 2004-12-06 2005-12-05 Combinaisons medicales Ceased WO2006062931A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US63361804P 2004-12-06 2004-12-06
US60/633,618 2004-12-06

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WO2006062931A2 true WO2006062931A2 (fr) 2006-06-15
WO2006062931A3 WO2006062931A3 (fr) 2007-04-19

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EP2080523A1 (fr) * 2008-01-15 2009-07-22 CHIESI FARMACEUTICI S.p.A. Compositions comprenant un agent anti-muscarinique et un bêta-agoniste longue action
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US7767691B2 (en) 2005-08-18 2010-08-03 Glaxo Group Limited Muscarinic acetylcholine receptor antagonists containing an azoniabiocyclo[2.2.1] heptane ring system
EP2080523A1 (fr) * 2008-01-15 2009-07-22 CHIESI FARMACEUTICI S.p.A. Compositions comprenant un agent anti-muscarinique et un bêta-agoniste longue action
WO2009090010A1 (fr) * 2008-01-15 2009-07-23 Chiesi Farmaceutici S.P.A. Compositions comprenant un antimuscarinique et un bêta-agoniste à action prolongée
US8084449B2 (en) 2008-02-06 2011-12-27 Glaxo Group Limited Dual pharmacophores—PDE4-muscarinic antagonistics
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UY29245A1 (es) 2006-05-31
TW200633715A (en) 2006-10-01
WO2006062931A3 (fr) 2007-04-19
PE20060826A1 (es) 2006-10-08

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