U.S. patent application number 10/619983 was filed with the patent office on 2004-01-22 for cross-linked high amylose starch for use in controlled-release pharmaceutical formulations and processes for its manufacture.
Invention is credited to Beck, Roland Herwig Friedrich, Chouinard, Francois, Desevaux, Cyril, Hopcke, Reiner, Lenaerts, Vincent, Van Bogaert, Elsie.
Application Number | 20040013726 10/619983 |
Document ID | / |
Family ID | 24427807 |
Filed Date | 2004-01-22 |
United States Patent
Application |
20040013726 |
Kind Code |
A1 |
Lenaerts, Vincent ; et
al. |
January 22, 2004 |
Cross-linked high amylose starch for use in controlled-release
pharmaceutical formulations and processes for its manufacture
Abstract
The present invention relates to a novel form of cross-linked
high amylose starch and processes for its manufacture. Such
cross-linked high amylose starch is useful as an excipient in a
controlled-release pharmaceutical formulation when compressed with
pharmaceutical agent(s) in a tablet. Such cross-linked high amylose
starch is prepared by (a) cross-linking and chemical modification
of high amylose starch, (b) gelatinization, and (c) drying to
obtain a powder of said controlled release excipient. In a
preferred embodiment, such cross-linked high amylose starch is
prepared in the following steps: (1) granular cross-linking and
additional chemical modification (e.g., hydroxypropylation) of
high-amylose starch; (2) thermal gelatinization of the starch from
step (1); and (3) drying the starch from step (2) to yield a powder
capable of being used as a controlled release excipient.
Inventors: |
Lenaerts, Vincent;
(Montreal, CA) ; Beck, Roland Herwig Friedrich;
(Valparaiso, IN) ; Van Bogaert, Elsie; (Bornem,
BE) ; Chouinard, Francois; (Lorriane, CA) ;
Hopcke, Reiner; (Kleve, DE) ; Desevaux, Cyril;
(Saint-Bruno, CA) |
Correspondence
Address: |
PENNIE AND EDMONDS
1155 AVENUE OF THE AMERICAS
NEW YORK
NY
100362711
|
Family ID: |
24427807 |
Appl. No.: |
10/619983 |
Filed: |
July 14, 2003 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10619983 |
Jul 14, 2003 |
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09606399 |
Jun 29, 2000 |
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6607748 |
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Current U.S.
Class: |
424/465 ;
536/106 |
Current CPC
Class: |
C08B 33/00 20130101;
A61P 31/04 20180101; A61K 9/2059 20130101; A61K 9/0024 20130101;
A61P 25/04 20180101 |
Class at
Publication: |
424/465 ;
536/106 |
International
Class: |
A61K 009/20; C08B
031/00 |
Claims
We claim:
1. A process for manufacturing, in an aqueous medium, a controlled
release excipient consisting primarily of cross-linked high amylose
starch, for use in preparation of tablets, said process comprising
(a) cross-linking high amylose starch thereby forming a reaction
medium containing a reaction product consisting of a cross-linked
high amylose starch slurry; (b) subjecting said cross-linked high
amylose starch slurry from step (a) to chemical modification at a
temperature of about 10 to about 90.degree. C. for about 1 to about
72 hours; (c) neutralizing said reaction medium obtained in step
(b) with an acid, washing the slurry formed and optionally
dewatering or to form a starch cake or a dry powder; (d) diluting
said slurry or re-slurrifying said starch cake or said dry powder
from step (c) with water to form a slurry at a concentration of
about 2% to about 40% w/w, adjusting pH to a desired value between
about 3 and about 12, and gelatinizing said slurry at a temperature
of about 80 to 180.degree. C. for about 1 second to about 120
minutes; and (e) drying the thermally treated product obtained in
step (d) to obtain said controlled release excipient consisting
mainly of chemically modified and cross-linked high amylose starch
in form of a powder.
2. The process according to claim 1, wherein steps (a) and (b) are
performed at the same time.
3. The process according to claim 1 comprising, (a) cross-linking
high amylose starch containing at least 70% w/w of amylose with
about 0.005 g to about 0.3 g cross-linking reagent per 100 g of
dry-based high amylose starch in an aqueous medium at a temperature
of about 10 to about 90.degree. C. thereby forming a reaction
medium containing a reaction product consisting of a cross-linked
high amylose starch slurry; (b) subjecting said cross-linked high
amylose starch slurry from step (a) to hydroxypropylation with
propylene oxide at a temperature of about 10 to about 90.degree. C.
for about 1 to about 72 hours to yield a reaction medium containing
a hydroxypropylated cross-linked high amylose starch slurry; (c)
neutralizing said reaction medium obtained in step (b) with a
dilute aqueous acid, washing slurry formed and optionally
dewatering to obtain a starch cake or a dry powder; (d) diluting
said slurry, or re-slurrifying starch cake or dry powder from step
(c) with water to form a slurry at a concentration of about 2% to
about 40% w/w, adjusting pH to about 4.0 to about 9.0, and
gelatinizing said slurry formed in current step at a temperature of
about 80 to about 180.degree. C. for about 1 second to about 120
minutes; and (e) drying said thermally treated product obtained in
step (d) to obtain said controlled release excipient consisting
mainly of hydroxypropylated and cross-linked high amylose starch in
form of a powder.
4. The process of claim 3, wherein, in step (a), said cross-linking
reagent is phosphorous oxychloride in an amount of between about
0.01 and about 0.2 g per 100 g starch dry basis or sodium
trimetaphosphate in an amount of between about 0.05 and about 0.3 g
per 100 g starch dry basis.
5. The process of claim 3 wherein step (a) is performed in an
aqueous alkaline medium.
6. The process of claim 4, wherein, in step (a), said cross-linking
is carried out at a pH of about 10 to about 14 and at a temperature
of about 15 to about 90.degree. C. for about 0.2 to about 40
hours.
7. The process of claim 3, wherein, in step (b), said
hydroxypropylation is carried out with up to 10% propylene oxide at
a temperature of about 40 to about 80.degree. C. for about 10 to
about 72 hours.
8. The process of claim 3, wherein, in step (c), said
neutralization of said reaction medium is carried out with dilute
sulfuric acid or hydrochloric acid.
9. The process of claim 3, where, in step (d), said gelatinization
is carried out by direct steam injection into an aqueous suspension
of said cross-linked high amylose starch.
10. The process of claim 3, wherein, in step (d), said pH is
adjusted to about 6.0 and said temperature is kept at about 80 to
about 180.degree. C. for about 2 to about 10 minutes.
11. The process of claim 3, wherein, in step (e), said drying is
carried out by spray-drying.
12. The process of claim 11, wherein, in step (e), inlet
temperature is from about 60 to about 350.degree. C., and outlet
temperature is set from about 40 to about 210.degree. C.
13. A process for manufacturing, in an aqueous medium, a controlled
release excipient consisting primarily of cross-linked high amylose
starch, for use in preparation of tablets, said process comprising
(a) subjecting high amylose starch to chemical modification at a
temperature of about 10 to about 90.degree. C. for about 1 to about
72 hours thereby forming a reaction medium containing a chemically
modified high amylose slurry; (b) cross-linking said chemically
modified high amylose starch in said slurry obtained in step (a);
(c) neutralizing said slurry obtained in step (b) with an acid,
washing the slurry formed and optionally dewatering to form a
starch cake or drying to form dry powder; (d) diluting said slurry,
or re-slurrifying said starch cake or said dry powder from step (c)
with water to form a slurry at a concentration of about 2% to about
40% w/w, adjusting pH to a desired value between about 3 and about
12, and gelatinizing said slurry at a temperature of about 80 to
180.degree. C. for about 1 second to about 120 minutes; and (e)
drying the thermally treated product obtained in step (d) to obtain
said controlled release excipient consisting mainly of chemically
modified and cross-linked high amylose starch in form of a
powder.
14. The process according to claim 13, wherein steps (a) and (b)
are performed at the same time.
15. The process according to claim 13 comprising (a) subjecting
high amylose starch containing at least 70% w/w of amylose to
hydroxypropylation with propylene oxide at a temperature of about
10 to about 90.degree. C. for about 1 to about 72 hours to yield a
reaction medium containing a reaction product of consisting
primarily of a hydroxypropylated high amylose starch slurry; (b)
cross-linking said hydroxypropylated high amylose starch slurry
with about 0.005 g to about 0.3 g cross-linking reagent per 100 g
of dry-based high amylose starch in an aqueous medium at a
temperature of about 10 to about 90.degree. C. to yield a reaction
medium containing a cross-linked hydroxypropylated high amylose
starch slurry; (c) neutralizing said reaction medium obtained in
step (b) with a dilute aqueous acid, washing slurry formed and
optionally dewatering to obtain a starch cake or a dry powder; (d)
diluting said slurry, or re-slurrifying said starch cake or said
dry powder from step (c) with water to form a slurry at a
concentration of about 2% to about 40% w/w, adjusting pH to about
4.0 to about 9.0, and gelatinizing said slurry formed in current
step at a temperature of about 80 to about 180.degree. C. for about
1 second to about 120 minutes; and (e) drying said thermally
treated product obtained in step (d) to obtain said controlled
release excipient consisting mainly of hydroxypropylated and
cross-linked high amylose starch in form of a powder.
16. The process of claim 15, wherein, in step (a), said
cross-linking reagent is phosphorous oxychloride in an amount of
between about 0.01 and about 0.2 g per 100 g starch dry basis or
sodium trimetaphosphate in an amount of between about 0.05 and
about 0.3 g per 100 g starch dry basis.
17. The process of claim 15 wherein step (b) is performed in an
aqueous alkaline medium.
18. The process of claim 16, wherein, in step (b), said
cross-linking is carried out at a pH of about 10 to about 14 and at
a temperature of about 15 to about 90.degree. C. for about 0.2 to
about 40 hours.
19. The process of claim 15, wherein, in step (a), said
hydroxypropylation is carried out with up to 10% propylene oxide at
a temperature of about 40 to about 80.degree. C. for about 10 to
about 72 hours.
20. A controlled release tablet comprising a compressed blend of at
least two dry powders, including a powder of at least one
pharmaceutical agent and a powder of a controlled release
excipient; wherein said controlled release excipient comprises a
chemically-modified, cross-linked high amylose starch prepared by a
method comprising: (a) cross-linking high amylose starch, followed
by (b) chemically modifying the cross-linked high amylose starch,
followed by (c) gelatinization, and (d) drying to obtain a powder
of said controlled release excipient; wherein said cross-linked
high amylose starch is characterized in that upon solubilization in
90% DMSO at 80.degree. C. for about three days and gel permeation
chromatography, the height of the peak corresponding to amylose in
said cross-linked high amylose starch is at least 90% of that of
the peak corresponding to amylose in said high amylose starch prior
to (a).
Description
1. CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of co-pending U.S. patent
application Ser. No. 09/606,399 filed on Jun. 29, 2000.
2. FIELD OF INVENTION
[0002] The present invention relates to a novel form of
cross-linked high amylose starch and processes for its manufacture.
Such cross-linked high amylose starch is useful as an excipient in
a controlled-release pharmaceutical formulation when compressed
with a pharmaceutical agent(s) in a tablet.
3. BACKGROUND OF THE INVENTION
[0003] One of the critical factors influencing the rate of
absorption of a drug administered as a tablet or other solid dosage
form is the rate of dissolution of the dosage form in the body
fluids of human or animal.
[0004] This factor is the basis for the so-called
controlled-release, extended-release, sustained-release or
prolonged-action pharmaceutical preparations that are designed to
produce slow, uniform release and absorption of the drug over a
period of hours, days, week, months, or years. Advantages of
controlled-release formulations are a reduction in frequency of
administration of the drug as compared with conventional dosage
forms (often resulting in improved patient compliance), maintenance
of a therapeutic effect over a set period of time, and decreased
incidence and/or intensity of undesired side effects of the drug by
elimination of the peaks in plasma concentration that often occur
after administration of immediate-release dosage forms.
[0005] Many systems have been proposed and developed as matrices
for the release of drugs. For example, polymeric materials such as
polyvinyl chloride, polyethylene amides, ethyl cellulose, silicone
and poly (hydroxymethyl methacrylate), have been proposed as
vehicles for the slow release of drugs. See U.S. Pat. No. 3,087,860
to Endicott et al.; U.S. Pat. No. 2,987,445 to Levesque et al.;
Salomon et al., Pharm. Acta Helv., 55, 174-182 (1980); Korsmeyer,
Diffusion Controlled Systems: Hydrogels, Chap. 2, pp 15-37 in
Polymers for Controlled Drug Delivery, Ed. Tarcha, CRC Press, Boca
Raton, Fla. USA (1991); Buri et al., Pharm. Acta Helv. 55, 189-197
(1980).
[0006] A substantial need exists for a controlled release
composition that can deliver a variety of drugs, both hydrophilic
and hydrophobic, in a consistent and reliable manner. Further, this
composition should be amenable to all facets of tableting
requirements, including, but not limited to, direct compression,
appropriate hardness and resistance to friability, and
compatibility with the active ingredient(s) contained in the
tablet. Also, the composition should be easy to synthesize,
biodegradable and non-toxic upon release of the drug.
[0007] One of the most widely studied compounds for
controlled-release use has been starch, partially because it is
biodegradable and is naturally metabolized by the human body [Kost
et al., Biomaterials 11, 695-698 (1990)]. Starch has many uses in
pharmaceutical products. It can act as a diluent, filler, carrier,
binder, disintegrant, coating, thickener, and moisture sink. See
U.S. Pat. No. 2,938,901 to Kerr et al., which discloses the use of
granular starch cross-linked with sodium trimetaphosphate as a
surgical dusting powder; U.S. Pat. No. 3,034,911 to McKee et al.,
which discloses the use of a cold water swelling and cold water
insoluble starch in intact granular form as a disintegrant; U.S.
Pat. No. 3,453,368 to Magid, which discloses the use of
pregelatinized starches, optionally modified as binders for
compressed ascorbic acid tablets; U.S. Pat. No. 3,490,742 to
Nichols et al., which discloses a non-granular amylose (at least
50%) obtained from the fractionation of corn starch for use as a
binder disintegrant in direct compression and dry granulation
tablets; U.S. Pat. No. 3,622,677 to Short et al., which discloses
the use of a partially cold water soluble and cold-water swelling
starch, derived from a compacted granular starch, as a
binder-disintegrant; U.S. Pat. No. 4,072,535 to Short et al., which
discloses a pre-compacted starch having birefringent granules,
non-birefringent granules, and some aggregates and fragments for
use as a binder-disintegrant; U.S. Pat. No. 4,026,986 to Christen
et al., which discloses the use of water-soluble starch ethers
(e.g., hydroxyalkyl ethers) containing at least 50% amylose for use
in forming capsule shells; U.S. Pat. No. 4,308,251 to Dunn et al.,
which discloses the use of corn, rice, potato and modified starches
as an erosion-promotion agent in controlled release formulations
prepared by wet granulation; U.S. Pat. No. 4,551,177 to Trabiano et
al., which discloses the use of acid- and/or alpha-amylase
converted starches as tablet binders; U.S. Pat. No. 4,904,476 to
Mehta et al., which discloses the use of sodium starch glycolate as
a disintegrant; U.S. Pat. No. 4,818,542 to DeLuca et al., which
discloses starch as a biodegradable or bioerodible polymer for
porous microspheres possibly coated with a cross-linking agent to
inhibit or control drug release; U.S. Pat. No. 4,888,178 to Rotini
et al., which discloses the use of starch, preferably maize starch,
and sodium starch glycolate as disintegrants in the immediate
release of a programmed release Naproxen.RTM. formulation
containing immediate release and controlled release granulates in
the form of tablets, capsules, or suspension in a suitable liquid
media; U.S. Pat. No. 5,004,614 to Staniforth, et al., which
discloses the use of starches as pharmaceutical fillers in
controlled release devices containing an active agent and a release
agent and the use of cross-linked or un-cross-linked sodium
carboxymethyl starch for the coating. U.S. Pat. No. 4,369,308 to
Trubiano et al. discloses modified starches which are low swelling
in cold water and which are suitable for use as disintegrants in
compressed tablets. This is achieved by cross-linking and
pregelatinizing in the presence of water, a cold-water insoluble,
granular starch, drying the cross-linked, pregelatinized starch if
necessary, and then pulverizing the dry starch. No controlled
release properties are disclosed or claimed for these starches.
[0008] Cross-linked starch has been previously evaluated as a
sustained release agent. Visavarungroj et al. [Drug Development And
Industrial Pharmacy, 16(7), 1091-1108 (1990)] discloses the
evaluation of different types of cross-linked starches and
pregelatinized cross-linked starches for their use as hydrophilic
matrices. It was determined that cross-linked starches demonstrated
a poor swelling power and dispersion viscosity in comparison to
pre-gelatinized starch and pregelatinized cross-linked starch. The
study concluded that cross-linked modified waxy corn starches,
either pregelatinized or not, in comparison to purely
pregelatinized waxy corn starch are not suitable to use as a
hydrophilic matrix in sustained release formulation.
[0009] Nakano et al. [Chem. Pharm. Bull. 35(10), 4346-4350, (1987)]
disclose the use of physically modified starch (pregelatinized
starch) as an excipient in sustained-release tablets. This article
does not mention the specific role of amylose present in starch nor
does it even mention amylose.
[0010] Van Aerde et al. [Int. J. Pharm., 45, 145-152, (1988)]
disclose the use of modified starches obtained by drum-drying or
extrusion pregelatinization, particle hydrolysis or cross-linking
with sodium trimetaphosphate, as an excipient in sustained-release
tablets. Once again, the article does not mention the specific role
of amylose present in starch nor does it even mention amylose.
[0011] Herman et al. [Int. J. Pharm., 56, 51-63 & 65-70, (1989)
and Int. J. Pharm., 63 201-205, (1990)] disclose the use of
thermally modified starches as hydrophilic matrices for controlled
oral delivery. This article discloses that thermally modified
starches containing a low amount of amylose (25% and lower) give
good sustained release properties, contrary to high amylose content
starches which present bad controlled release properties.
[0012] U.S. Pat. No. 3,490,742 to Nichols et al. discloses a
binder-disintegrant comprising non-granular amylose. This material
is prepared either by fractionating starch or by dissolving
granular high amylose starch in water at an elevated temperature.
No controlled release properties are disclosed.
[0013] U.S. Pat. No. 5,108,758 to Alwood et al. discloses an oral
delayed release composition comprising an active compound and
glassy amylose. The composition is particularly adapted for
achieving selective release of the active compound into the colon.
The delayed release is due to a coating. Glassy amylose is one of
the two forms of predominantly amorphous amylose, the other being a
rubbery form. Here, the glassy amylose delays the release of the
active compound from the composition in an aqueous environment but
allows its release on exposure to an enzyme capable of cleaving the
amylose. The amylose used in this composition is isolated from
smooth-seeded pea starch and purified by precipitation from aqueous
solution as a complex with n-butanol. The alcohol is then removed
from an aqueous dispension of that complex by blowing through a
suitable heated inert gas. As aforesaid, the release mechanism is
based on an enzymatic reaction. There is no continuous release
through the gastrointestinal tractus, but only a delayed release
due to the degradation of the coating into the colon. Moreover, it
is disclosed that the glassy amylose should preferably not contain
hydroxy groups in a derivative form.
[0014] European patent application No. EP-A-499,648 to Wai-Chiu et
al. discloses a tablet excipient. More particularly, they disclose
a starch binder and/or filler useful in manufacturing tablets,
pellets, capsules or granules. The tablet excipient is prepared by
enzymatically debranching starch with an a-1,6 D-glucanohydrolase
to yield at least 20% by weight of "short chain amylose." No
controlled release properties are claimed for this excipient.
Moreover, starch (unmodified, modified or cross-linked) must be
enzymatically treated with an .alpha.-1,6-D-glucanohydrolase to be
debranched and to yield the so-called "short chain amylose". Thus,
starch with a high content of amylopectin is obviously preferred
and amylose is rejected as not suitable because it is impossible to
debranch amylose, since amylose has no branching. The role of
amylose is not only ignored but considered negatively.
[0015] Mateescu et al. [U.S. Pat. No. 5,456,921] and Lenaerts et
al. [J. Controlled Rel. 15, 39-46, (1991)] disclose that
cross-linked amylose is a very efficient tool for controlled drug
release. Cross-linked amylose is produced by reaction of amylose
with a cross-linking agent such as epichlorohydrin, in an alkaline
medium. Different degrees of cross-linking can be obtained by
varying the ratio of epichlorohydrin to amylose in the reaction
vessel. Tablets prepared by direct compression of a dry mixture of
cross-linked amylose and a drug swell in solution and show a
sustained release of the drug. Depending on the degree of
cross-linking of the matrix, different degrees of swelling are
obtained. Increasing the degree of cross-linking of amylose first
generates an increase of drug-release time, followed by a decrease
of drug-release time. The peak drug-release time is observed at a
cross-linking degree value of 7.5. A further increase in the degree
of cross-linking leads to an accelerated drug release from the
cross-linked amylose tablets as a consequence of the erosion
process. For cross-linking degree equal or greater than 7.5,
increasing the degree of cross-linking of amylose generates a
decrease of drug-release time. With degrees of cross-linking above
11, the swollen polymeric matrix presents in vitro disintegration
over a period of approximately 90 minutes.
[0016] Mateescu et al. [International laid-open patent application
No. WO 94/02121] and Dumoulin et al. [Intern. Symp. Control. Rel.
Bioact. Mater. 20, 306-307, (1993)] disclose an
enzymatically-controlled drug release system based on the addition
of .alpha.-amylase within the cross-linked amylose tablet.
a-amylase is able to hydrolyse .alpha.-1,4-glucosidic bonds present
in the cross-linked amylose semi-synthetic matrix. Increasing the
amount of a-amylase (5 to 25 EU) within the tablets induces a
significant decrease in release time from 24 to 6 hours. Hence,
drug release is controlled by two sequential mechanisms: (a)
hydration and swelling of cross-linked amylose tablets followed by
(b) internal enzymatic hydrolysis of the hydrated gel phase.
[0017] Cartilier et al. [International laid-open patent application
WO 94/21236] disclose powders of cross-linked amylose having a
specific cross-linking degree for use as a tablet binder and/or
disintegrant. The tablets are prepared by direct compression. The
concentration of cross-linked amylose in the tablets is lower than
35% by weight. Degrees of cross-linking from 6 to 30 and more
particularly from 15 to 30 are preferred when disintegration
properties are required.
[0018] U.S. Pat. No. 5,830,884 to Kasica et al. discloses thermally
inhibited starches which are used in pharmaceutical products as a
diluent, filler, carrier, binder, disintegrant, thickening agent,
and coating. They are prepared by dehydrating the starch to a
substantially anhydrous or anhydrous state and heat treating the
anhydrous or substantially anhydrous starch for a period of time
and at a temperature sufficient to inhibit the starch. Starches
that are substantially thermally inhibited resist gelatinization
and only mimic chemically cross-linked starch.
[0019] U.S. Pat. No. 5,879,707 to Cartilier et al. relates to the
use of substituted amylose as a matrix for sustained drug release.
The sustained release matrix is made of substituted amylose,
prepared by reacting in an alkaline medium, amylose, with an
organic substituent having a reactive functionality that reacts
with the hydroxy groups of the amylose molecule. This substituent
is preferably an epoxy or halogen alkane or alcohol. However, only
linearly substituted amylose is used and is distinguished from
cross-linked amylose which is used in the present invention.
[0020] Dumoulin et al. [International laid-open patent application
No. WO 98/35992] disclose a process for the manufacture of a slow
release excipient consisting mainly of cross-linked amylose having
controlled-release properties, for use in the preparation of
tablets or pellets. A starch containing a high amount of amylose
(high amylose starch) is first subjected to gelatinization. The
gelatinized high amylose starch is cross-linked with 1-5 grams of a
cross-linking agent per 100 g of dry-based gelatinized high amylose
starch in an alkali medium, creating a reaction medium containing a
reaction product consisting of a cross-linked high amylose starch
slurry. The obtained reaction medium is then neutralized, thereby
forming by-products consisting of salts, which are removed from the
reaction medium. The recovered cross-linked high amylose starch
slurry is then subjected to a thermal treatment at a temperature of
at least 60.degree. C. and the thermally treated product is dried
to obtain the slow-release excipient which contains a substantial
amount of impurities.
[0021] Lenaerts et al. [J. Controlled Release 53, 225-234 (1998)]
have demonstrated that gelatinized cross-linked high amylose
starches are useful excipients for the formulation of
controlled-release solid dosage forms for the oral delivery of
drugs. These excipients exhibit a lack of erosion, limited swelling
and the fact that increasing cross-linking degrees results in
increase water uptake, drug release rate and equilibrium swelling.
These investigators were also able to demonstrate that cross-linked
high amylose starch matrices have the lowest inter-subject
variability amongst the systems tested and demonstrate a total
absence of food effect. Lenaerts et al. were also able to conclude
that as the degree of cross-linking increased, the drug would be
released faster. The authors concluded that for the gelatinized
cross-linked high amylose starch to possess the characteristics
needed to have a controlled release of the incorporated drugs, it
is necessary that the surface of amylopectin clusters be coated by
amylose chemically bound to amylopectin by the cross-linking
procedure. This structure is indeed the one obtained by first
gelatinizing the high amylose starch to extract amylose from the
granules and then carrying out the chemical reaction to chemically
bind amylose to the surface of amylopectin clusters, such as when
using the process described by Dumoulin et al. in WO 98/35992.
[0022] All of the above references which relate to cross-linked
high amylose starch teach that the starting amylose material be
gelatinized prior to cross-linking. The integrity of starch
granules in the dry state is dependent upon the hydrogen bonding
between amylopectin and amylose. When an aqueous suspension of
starch is heated to a certain temperature, the hydrogen bonding
between amylopectin and amylose weakens and the granule swells
until collapsing. This process is referred to as "gelatinization."
This first step of the process permits leaching of the amylose from
the starch granules prior to reaction with a cross-linking reagent,
which then creates a cross-linked amylose with controlled-release
properties. Moreover, it has been stated that gelatinization of
high-amylose starch before cross-linking is required in order to
prepare a product possessing the desired controlled-release
property. See Dumoulin et al., WO 98/35992.
4. SUMMARY OF THE INVENTION
[0023] It has now been surprisingly found that high amylose starch
can be subjected to chemical treatment (i.e., cross-linking and
hydroxypropylation) in the granular state using very low
concentrations of chemical reagent, followed by gelatinization and
drying to yield a controlled-release excipient superior in release
properties to high-amylose starch excipients produced by a process
in which the high amylose starch is subjected to gelatinization as
a first step, followed by chemical treatment and drying.
[0024] The novel processes, compositions and controlled release
activity described herein is counterintuitive to what has been
generally known to those skilled in the art. By exposing high
amylose starch to chemical treatment (i.e., cross-linking) prior to
gelatinization, one skilled in the art would not expect the
production of a product exhibiting controlled-release
characteristics. Cross-linking of high-amylose starch prior to
gelatinization would likely lead to material that would not exhibit
controlled release properties, but would resemble an immediate
release profile as the cross-linked high amylose starch would be
unable to support a matrix capable of controlled release thereby
demonstrating essential structural differences between the two
cross-linked products. According to Lenaerts et al. (J. Controlled
Rel., 1998) such structural differences would lead to an incapacity
of the material to have controlled release properties. Jane et al.
[Cereal Chemistry, 69(4), 405-409 (1992)] disclose that
cross-linking of pregelatinized and dispersed starch causes less
difference in the proportion of soluble amylose and amylopectin
than did the cross-linking of native granular starch. Jane et al.
report no increase in the size of amylose as a result of
cross-linking between two or more amylose molecules after the
starch had been cross-linked in the granular form and do not
mention any controlled release property of the starches
cross-linked in the granular form. In addition, Mateescu et al.
(U.S. Pat. No. 5,456,921) describe that optimal controlled release
is obtained at an amount of cross-linking agent of 7.5 g per 100 g
dry starch whereas in the present invention the cross-linking
reagent can be added at an amount lower than 0.3 g per 100 g dry
starch. This low amount of cross-linking reagent is preferred
because it also allows the product to be covered by the monographs
for modified food starch of the US Food and Drug Administration and
the Food Chemicals Codex as well as the European Parliament and
Council Directive Nr/95/2/EC of Feb. 20, 1995 on Food additives
other than Colours and Sweeteners (Miscellaneous Directive).
[0025] Remarkably, it has been discovered that a novel
controlled-released excipient may be prepared in following
steps:
[0026] (1) granular cross-linking and additionally chemical
modification (e.g., hydroxypropylation) of high-amylose starch;
[0027] (2) Thermal gelatinization of the starch from step (1);
and
[0028] (3) Drying the starch from step (2) to yield a powder
capable of being used as a controlled release excipient.
[0029] The advantages of this excipient include, but are not
limited to: (1) ease in processing, (2) avoidance of any organic
solvents in the process, (3) ability to obtain high purity products
meeting FDA regulations and the Food Chemical Codex as well as the
European Parliament and Council Directive Nr 95/2/EC of Feb. 20,
1995 on Food additives other than Colours and Sweeteners
(Miscellaneous Directive), (4) the ability to make direct
compression tablets, (5) compatibility with hydrophilic and
hydrophobic drugs, (6) compatibility with a large range of drug
concentrations and solubilities, (7) the safety of cross-linked
high amylose starch, (8) an excellent robustness vis--vis
production and dissolution parameters, (9) an excellent
batch-to-batch reproducibility, and (10) a simple and predictable
scale-up.
[0030] Most particularly, it has been discovered that the
controlled release of a drug can be achieved with high-amylose
starch that undergoes the sequential transformation described above
to produce a powder excipient. Use of this modified starch as a
matrix in a tablet produces a remarkable, almost linear release
profile and a release time of 2 hours to 24 hours.
[0031] It has also been found that this modified starch can be used
for the production of implants for local sustained delivery of
drugs with an in vivo release extending to periods of 1 to 3 days
to 3 to 4 weeks.
[0032] In accordance with the invention, there is provided a
pharmaceutical formulation comprising a controlled release tablet,
further comprising a direct compression blend of a powder of
cross-linked and additionally modified high amylose starch as the
controlled-release excipient for the drug and powder of at least
one drug. The controlled release matrix consists essentially of
cross-linked high amylose starch obtained by cross-linking high
amylose starch with a suitable cross-linking agent. Additionally,
the cross-linked high amylose starch is chemically modified. The
sequence of the two reactions (i.e., cross-linking reaction and
additional chemical modification) may be performed alternatively in
the reverse order or at the same time.
[0033] The cross-linked high amylose starch may be obtained with a
preferred range of amount of cross-linker between about 0.005 to
0.3 g per 100 g dry starch.
[0034] When the pharmaceutical drug(s) used in this invention are
very slightly soluble in water, the powder of such drug(s) may
represent up to about 70% to about 90% of the weight of the tablet.
If the pharmaceutical drug(s) used is highly soluble, it should not
exceed about 30% to about 50% of the weight of the tablet.
[0035] The tablet according to the invention can also be of the dry
coated type. In this case, the core of the tablet contains most of
the powder of said drug(s). The outside shell will consist
primarily of the controlled release excipient except if special
delivery profiles (e.g. Biphasic or double pulse) are
necessary.
[0036] Thus, the invention as broadly defined provides a process
for the manufacture of a novel controlled release excipient
consisting mainly of cross-linked high amylose starch for use in
the preparation of tablets. Such process comprises:
[0037] (a) cross-linking high amylose starch (preferably such high
amylose starch contain at least 70% w/w of amylose), preferably
with about 0.005 g to about 0.3 g, more preferably about 0.01 g to
about 0.12 g, even more preferably about 0.04g to about 0.1 g, most
preferably about 0.075 g, cross-linking reagent per 100 g of
dry-based high amylose starch in an alkaline aqueous medium at a
suitable temperature (preferably about 10.degree. C. to about
90.degree. C., more preferably about 20.degree. C. to about
80.degree. C., even more preferably 20.degree. C. to about
60.degree. C., and most preferably about 30.degree. C.), for a
suitable reaction time period (preferably about 1 minute to about
24 hours, more preferably of about 15 minutes to about 4 hours,
even more preferably of about 30 minutes to about 2 hours, and most
preferably of about 60 minutes), thereby forming a reaction medium
containing a reaction product consisting of a cross-linked high
amylose starch slurry (preferably of a concentration of about 5% to
about 45%, more preferably of about 20% to about 42%; even more
preferably of about 30% to about 40%, and most preferably of about
35%).
[0038] (b) subjecting the cross-linked high amylose starch slurry
from step (a) to chemical modification (e.g., hydroxypropylation
with propylene oxide, preferably about 0.5% to 20%, more preferably
about 1 to about 10%, even more preferably of about 3 to 9%, and
most preferably of about 6% propylene oxide), at a temperature of
about 10.degree. C. to about 90.degree. C., preferably of about
20.degree. C. to about 80.degree. C., more preferably of about
20.degree. C. to about 50.degree. C., and most preferably of about
40.degree. C., for a time period of about 1 hour to about 72 hours,
preferably of about 2 hours to about 48 hours, more preferably of
about 10 hours to about 40 hours, and most preferably for about 29
hours;
[0039] Alternatively, steps (a) and (b) are performed in the
reverse order or at the same time
[0040] (c) neutralizing the reaction medium obtained in step (b)
with an acid (preferably a dilute aqueous inorganic acid), washing
the slurry formed and optionally dewatering or drying;
[0041] (d) forming a slurry at a concentration of about 2% w/w to
about 40% w/w, preferably of about 5% w/w to about 35% w/w, more
preferably of about 5% w/w to about 25% w/w, and most preferably of
about 9% w/w, adjusting the pH to a desired value between 3 and 12
(preferably about 6.0), and gelatinizing the slurry at a
temperature of about 80.degree. C. to about 180.degree. C.,
preferably of about 120.degree. C. to about 170.degree. C., more
preferably of about 140.degree. C. to about 165.degree. C., and
most preferably of about 16.degree. C., for about 1 second to about
120 minutes, preferably of about 30 seconds to about 60 minutes,
more preferably of about 1 minute to about 20 minutes, and most
preferably of about 8 minutes; and
[0042] (e) drying the thermally treated product obtained in step
(d) to obtain the controlled release excipient consisting mainly of
chemically modified and cross-linked high amylose starch in the
form of a powder.
5. DESCRIPTION OF THE DRAWINGS
[0043] FIG. 1: Release profiles under standard dissolution
conditions for formulation LP-1443 and Zydol SR 100.RTM..
[0044] FIG. 2: Target and actual in-vitro dissolution profiles for
formulation LP-1473. In-vitro profile was obtained under standard
dissolution conditions.
[0045] FIG. 3: Target and in-vitro dissolution profile for
Tramadol.RTM. HCl 200 mg.
[0046] FIG. 4: Human pharmacokinetics of tablets LP-1443 versus
Tramal Long 100.RTM..
[0047] FIG. 5: Human pharmacokinetics of tablets LP-1473 (with film
coating).
[0048] FIG. 6: Effect of pH of dissolution medium on the
dissolution profile of formulation LP-1443.
[0049] FIG. 7: Effect of a-Amylase Bacillus in dissolution medium
on the dissolution profile of formulation LP-1443.
[0050] FIG. 8: Effect of dissolution medium ionic strength on the
dissolution profile of formulation LP-1443.
[0051] FIG. 9: Effect of agitation rate on the dissolution profile
of formulation LP-1443.
[0052] FIG. 10: Effect of pH of dissolution medium on the
dissolution profile of formulation LP-1473 (without film
coating).
[0053] FIG. 11: Effect of a-Amylase Bacillus in dissolution medium
on the dissolution profile of formulation LP-1473 (without film
coating).
[0054] FIG. 12: Effect of dissolution medium ionic strength on the
dissolution profile of formulation LP-1473 (without film
coating).
[0055] FIG. 13: Effect of agitation rate on the dissolution profile
of formulation LP- 1473 (without film coating).
[0056] FIG. 14: Quasi-reversible visco-elastic properties of
Cerestar tablet.
[0057] FIG. 15: Stress-relaxation curves obtained from the 1%
strain step application.
[0058] FIG. 16: SEM: Surface of free-dried Cerestar water swollen
tablet.
[0059] FIG. 17: SEM: Freeze-dried supernatant suspension present
around a water swollen Cerestar tablet.
[0060] FIG. 18: SEM: Rougier tablets at equilibrium swelling in
water at 37.degree. C.
[0061] FIG. 19: GPC result, % carbohydrate in Amylogel 3003,
Contramid-Rougier 333, Cerestar Batches 3808, 1903, 3825; as a
function of fraction.
[0062] FIG. 20: GPC result, % carbohydrate in Amylogel 3003,
Contramid-Rougier 333, Cerestar Batches 3808, 1903, 3825; as a
function of log [g/M].
[0063] FIG. 21: In vitro cumulative Ciprofloxacin HCl release with
3 different implant loadings.
[0064] FIG. 22: Serum Ciprofloxacin concentrations.
[0065] FIG. 23: Muscle Ciprofloxacin concentrations.
6. DETAILED DESCRIPTION OF THE INVENTION
[0066] Starch is one of the most ubiquitous biopolymers on earth.
Starch is mainly a carbohydrate which is composed of two distinct
fractions: amylose which is essentially a linear polymer of
glucopyranose units linked through .alpha.-D-(1,4) linkages. The
second component is amylopectin which is a highly branched polymer
which is linked to the C-6 hydroxyl position of certain glucose
moieties in amylose, via .alpha.-D-(1,6) linkages. Amylose contains
about 4,000 glucose units. Amylopectin contains about 100,000
glucose units.
[0067] Cross-linking of starch represents a powerful method for
modifying starch. Usually, starch granules are cross-linked to
increase resistance of the paste to shear or heat. Such chemically
cross-linked starches provide a desirable smooth texture and
possess viscosity stability throughout processing operations and
normal shelf life. As mentioned, in accordance with the invention,
it has been discovered that the cross-linking of high amylose
starch followed by gelatinization is highly desirable. More
specifically, it has been found that cross-linking high amylose
starch with additional chemical modification (e.g.,
hydroxypropylation) prior to gelatinization produces a novel
excipient possessing the desired controlled release properties.
[0068] The cross-linking of high amylose starch may be realized
according to procedures described in the art. For example,
cross-linking of amylose can be carried out in the manner described
in Mateescu [BIOCHEMIE, 60, 535-537 (1978)] by reacting amylose
with epichlorohydrin in an alkaline medium. In the same manner,
starch can also be cross-linked with a reagent selected from the
group consisting of epichlorohydrin, adipic acid anhydride, sodium
trimetaphosphate and phosphorous oxychloride or other cross-linking
agents including, but not limited to, 2,3-dibromopropanol, linear
mixed anhydrides of acetic and di- or tribasic carboxylic acids,
vinyl sulfone, diepoxides, cyanuric chloride,
hexahydro-1,3,5-trisacryloyl-s-triazine, hexamethylene
diisocyanate, toluene 2,4-diisocyanate, N,N-methylenebisacrylamide,
N,N'-bis (hydroxymethyl) ethyleneurea, mixed carbonic-carboxylic
acid anhydrides, imidazolides of carbonic and polybasic carboxylic
acids, imidazolium salts of polybasic carboxylic acids, and
guanidine derivatives of polycarboxylic acids.
[0069] The reaction conditions employed will vary with the type and
amount of the cross-linking agent that is used, as well as the base
concentration, amount and type of starch.
[0070] All available starches containing more than 40% w/w amylose
can be used, e.g., pea and wrinkled pea starch, bean starch,
hybrids or genetically modified tapioca or potato starch, or any
other root, tuber or cereal starch. Preferably, high amylose starch
containing about 70% w/w amylose is used as the base material. In
the current examples 1 and 2, high amylose starch, C AmyloGel 03003
(Cerestar U.S.A. Inc.) is applied. The reaction is usually
performed in the presence of a sodium salt such as sodium sulfate
or sodium chloride and a sodium base. These reagents are dispersed
in water to a slurry of about 35% to about 42% dry substances. The
slurry is then heated or cooled to temperature of about 10.degree.
C. to about 90.degree. C., preferably about 20.degree. C. to about
80.degree. C., more preferably 20.degree. C. to about 40.degree.
C., and most preferably about 30.degree. C. For the present
invention, it is preferred to use for the cross-linking step about
0.005% to about 0.3% w/w of cross-linking reagent, phosphorous
oxychloride in an amount of between 0.01 and 0.2% (w/w) or sodium
trimetaphosphate (STMP) in an amount of between 0.05 and 0.3%
(w/w). In example 1 an amount of 0.075% phosphorous oxychloride is
used and in example 2 an amount of 0.15% of sodium trimetaphosphate
is used.
[0071] The cross-linking reaction is performed in an aqueous
alkaline medium, of a pH of 10 to 14 for about 0.2 to 40 hours
(preferably of about 15 minutes to about 4 hours, more preferably
of about 30 minutes to about 2 hours, and most preferably of about
60 minutes) at a temperature of about 15 to about 90.degree. C. A
reaction mixture containing a cross-linked high amylose starch
slurry is formed. The slurry concentration is preferably about 5%
to about 45%, more preferably of about 20% to about 42%, and most
preferably of about 30% to about 40%.
[0072] The cross-linked high amylose starch is additionally
chemically modified. A preferred modification is hydroxypropylation
with propylene oxide in a concentration of about 0.5% to about 20%,
preferably about 1 to about 10% on d.b. The reaction mixture is
kept at a temperature of about 10.degree. C. to about 90.degree.
C., preferably of about 20.degree. C. to about 80.degree. C., more
preferably of about 20.degree. C. to about 50.degree. C., and most
preferably of about 40.degree. C., for a time period of about 1
hour to about 72 hours, preferably of about 2 hours to about 48
hours, more preferably of about 10 hours to about 40 hours, and
most preferably for about 20 hours. Alternatively the cross-linking
and chemical modification can be performed in the reverse order or
at the same time. The reaction mixture is neutralized with a dilute
aqueous acid. Sulfuric acid and hydrochloric acid are the preferred
acids for neutralization.
[0073] The cross-linking reaction carried out in an alkaline medium
followed by neutralization leads to the formation of by-products
mainly consisting of salts. Numerous methods can be used to remove
salts from the aqueous slurry of cross-linked high amylose starch,
including filtration, centrifugation, decantation, or continuous
Dorr Clones washing.
[0074] In accordance with the present invention, any of these known
methods could be used. The obtained starch slurry or cake can
optionally be dewatered or dried to obtain a starch cake or a dry
powder.
[0075] Starch granules are held together by the hydrogen bonding
that occurs between starch molecules. When an aqueous suspension of
starch is heated to a certain temperature, this hydrogen bonding
weakens and the granules swell until collapsing. This process is
called gelatinization.
[0076] Numerous methods of gelatinization are known in the art.
They include indirect or direct heating or steam injection of an
aqueous dispersion of starch, by chemical treatment of such
dispersions using strong alkali, or a combination of mechanical and
heat treatment.
[0077] In accordance with the invention, gelatinization of the
cross-linked high amylose starch is preferably realized by diluting
the starch slurry, starch cake or powder in water in order to form
a slurry at a concentration of about 2 to 40% w/w. The pH of the
modified starch slurry is adjusted to a desired value to about 3 to
about 12. In the present case a pH of about 6.0 is desired. The
slurry is then heated to about 80.degree. C. to about 180.degree.
C., preferably of about 120.degree. C. to about 170.degree. C.,
more preferably of about 140.degree. C. to about 165.degree. C.,
and most preferably of about 160.degree. C., by direct steam
injection. The preferred method of gelatinization is by continuous
pressure cooking of the starch slurry. The slurry is then held at
this temperature for a time period of about 1 second to about 120
minutes, preferably of about 30 seconds to about 60 minutes, more
preferably of about 1 minute to about 20 minutes, and most
preferably of about 2-10 minutes, at a temperature of about
80.degree. C. to about 180.degree. C., preferably of about
120.degree. C. to about 170.degree. C., more preferably of about
140.degree. C. to about 165.degree. C., and most preferably of
about 160.degree. C. This procedure can be performed in a
continuous system including a holding column (see Example 1).
[0078] The gelatinized product can be dried by lyophilization, by
spray drying techniques using a spray nozzle or atomization disc,
or in a heated chamber. In accordance with the invention, the
cross-linked high amylose starch is spray-dried by using a
spray-drying tower equipped with a nozzle. The inlet temperature is
fixed at about 60.degree. C. to about 350.degree. C., preferably of
about 150.degree. C. to about 300.degree. C., more preferably of
about 200.degree. C. to about 270.degree. C., and most preferably
of about 245.degree. C. The air outlet temperature is set at about
40.degree. C. to about 210.degree. C., preferably of about
60.degree. C. to about 190.degree. C., more preferably of about
80.degree. C. to about 170.degree. C., and most preferably of about
120.degree. C. The obtained powder is a controlled release
excipient with the below described powder properties:
1 Properties Moisture Content 2-15% Bulk Density 100-350 g/l Packed
Density 150-600 g/l pH 4-7 Particle Size Peak Value 20-250 .mu.m
(Laser Particle Sizer- Sympatec)
[0079] Applicants have found that the modified cross-linked high
amylose starch of the present invention is useful as a carrier
polymer for pharmaceutical agents that are administered orally, in
view of the resistance of tablets to degradation by digestive
amylase and enhanced dissolution properties. Such modified
cross-linked high amylose starch confers desirable slow-release
properties to orally administered tablets containing pharmaceutical
agents.
[0080] Applicants further found that tablets implanted
subcutaneoulsy or intramuscularly were very well tolerated and
highly biocompatible. They were totally scavenged by macrophages
over a 1 to 3 month period. Such tablets were also shown to allow
the controlled release of drugs locally for periods ranging from
about I to about 3 days to about 3 to about 4 weeks.
[0081] Accordingly, the invention provides a solid
controlled-release pharmaceutical dosage unit in the form of a
tablet. A tablet, as understood by one skilled in the art, can be
administered by various routes, e.g., ingested orally, used in the
oral cavity, or used for implantation, etc. A tablet can also be in
a variety of forms, e.g., uncoated , dry coated, or film coated,
etc. A comprehensive discussion of tablets can be found in
references such as The Theory and Practice of Industrial Pharmacy
by Lachman et al., 3rd Ed. (Lea & Febiger, 1986). The solid
controlled-release pharmaceutical dosage unit of the present
invention comprises a blend of about 0.01% to about 80% by weight
of a pharmaceutical agent, and of about 20% to about 99.99% by
weight of the modified cross-linked high amylose starch described
above. The pharmaceutical agent is preferably in the form of a dry
powder.
[0082] Such pharmaceutical agent is any drug that can be orally
administered. Preferably, the pharmaceutical agent is, but more
limited to, pseudoephedrine hydrochloride, acetaminophen or
diclofenac sodium, verapamil, glipizide, nifedipine, felodipine,
betahistine, albuterol, acrivastine, omeprazole, misoprostol,
tramadol, oxybutynin, trimebutine, ciprofloxacin, and salts
thereof. In addition, the pharmaceutical agent can be an antifungal
agent, such as ketoconazole, or an analgesic agent such as
acetylsalicylic acid, acetaminophen, paracetamol, ibuprofen,
ketoprofen, indomethacin, diflunisol, naproxen, ketorolac,
diclofenac, tolmetin, sulindac, phenacetin, piroxicam, mefamanic
acid, dextromethorphan, other non-steroidal anti-inflammatory drugs
including salicylates, pharmaceutically acceptable salts thereof or
mixtures thereof.
[0083] The solid controlled-release pharmaceutical dosage unit may
further include a pharmaceutically acceptable carrier or vehicle.
Such carriers or vehicles are known to those skilled in the art and
are found, for example, in Remington's Pharmaceutical Sciences,
18th Ed. (1990). Examples of such carriers or vehicles include
lactose, starch, dicalcium phosphate, calcium sulfate, kaolin,
mannitol and powdered sugar. Additionally, when required, suitable
binders, lubricants, disintegrating agents and coloring agents can
be included. If desired, dyes, as well as sweetening or flavoring
agents can be included.
[0084] Binders suitable for use in pharmaceutical compositions and
dosage forms include, but are not limited to, corn starch, potato
starch, or other starches, gelatin, natural and synthetic gums such
as xantham gum, acacia, sodium alginate, alginic acid, other
alginates, powdered tragacanth, guar gum, cellulose and its
derivatives (e.g., ethyl cellulose, cellulose acetate,
carboxymethyl cellulose calcium, sodium carboxymethyl cellulose),
polyvinyl pyrrolidone, methyl cellulose, pre-gelatinized starch,
hydroxypropyl methyl cellulose, (e.g., Nos. 2208, 2906, 2910),
microcrystalline cellulose, polyethylene oxide and mixtures
thereof.
[0085] Suitable forms of microcrystalline cellulose include, for
example, the materials sold as AVICEL-PH-101, AVICEL-PH-103 AVICEL
RC-581, and AVICEL-PH-105 (available from FMC Corporation, American
Viscose Division, Avicel Sales, Marcus Hook, Pa., U.S.A.). An
exemplary suitable binder is a mixture of microcrystalline
cellulose and sodium carboxymethyl cellulose sold as AVICEL RC-581.
Suitable anhydrous or low moisture excipients or additives include
AVICEL-PH-103.TM., Starch 1500 LM and C Pharm DC 93000.
[0086] Examples of suitable fillers for use in the pharmaceutical
compositions and dosage forms disclosed herein include, but are not
limited to, talc, calcium carbonate (e.g., granules or powder),
microcrystalline cellulose, powdered cellulose, dextrates, kaolin,
mannitol, silicic acid, sorbitol, starch, pre-gelatinized starch,
and mixtures thereof. The binder/filler in pharmaceutical
compositions of the present invention is typically present in about
50 to about 99 weight percent of the pharmaceutical
composition.
[0087] Disintegrants that can be used to form pharmaceutical
compositions and dosage forms of the invention include, but are not
limited to, agar-agar, alginic acid, calcium carbonate,
microcrystalline cellulose, croscarmellose sodium, crospovidone,
polacrilin potassium, sodium starch glycolate, potato or tapioca
starch, pre-gelatinized starch, other starches, clays, other
algins, other celluloses, gums or mixtures thereof.
[0088] Lubricants which can be used to form pharmaceutical
compositions and dosage forms of the invention include, but are not
limited to, calcium stearate, magnesium stearate, mineral oil,
light mineral oil, glycerin, sorbitol, mannitol, polyethylene
glycol, other glycols, stearic acid, sodium lauryl sulfate, talc,
hydrogenated vegetable oil (e.g., peanut oil, cottonseed oil,
sunflower oil, sesame oil, olive oil, corn oil, and soybean oil),
zinc stearate, ethyl oleate, ethyl laureate, agar, or mixtures
thereof. Additional lubricants include, for example, a syloid
silica gel (AEROSIL 200, manufactured by W.R. Grace Co. of
Baltimore, Md.), a coagulated aerosol of synthetic silica (marketed
by Degussa Co. of Plano, Tex.), CAB-O-SIL (a pyrogenic silicon
dioxide product sold by Cabot Co. of Boston, Mass.), or mixtures
thereof. A lubricant can optionally be added, typically in an
amount of less than about 1 weight percent of the pharmaceutical
composition.
[0089] Once the pharmaceutical agent and modified cross-linked high
amylose starch are blended, generally by conventional means,
including, but not limited to, powder blending, dry or wet
granulation, the resulting blend is compressed to form a tablet.
Preferably, the pressure used to compress the blend is equal to or
exceeds 0.16 T/cm2.
[0090] The present invention will be more readily understood by
referring to the following test methods and examples which are
given to illustrate the invention rather than limit its scope.
7. EXAMPLES
[0091] The following procedures were used as test methods to
evaluate the properties of the products prepared in the
examples.
Example 1
[0092] Preparation of Controlled Release Excipient
[0093] A. Preparation of Cross-Linked High Amylose Starch
[0094] High amylose starch (30.0 kg) containing about 70% w/w of
amylose (CI AmyloGel 03003) is placed in a reactor. To this reactor
is added water (55.0 1) containing sodium hydroxide (30.0 g) and
sodium sulfate (2.40 kg). The resulting slurry is heated to a
temperature of 30.degree. C. Phosphorus oxychloride (22.5 g) is
added to the reaction mixture which is reacted for one hour.
[0095] B. Preparation of Hydroxypropylated Cross-Linked High
Amylose Starch
[0096] The crude reaction mixture from Part A is transferred into a
hydroxypropylation reactor. The reaction mixture is heated to
40.degree. C. over 30 minutes and the reaction is purged with
nitrogen. After a full purge, propylene oxide (1.80 kg) is added.
The reaction mixture is kept at 40.degree. C. for 20 hours. The
reaction mixture is neutralized with 0.1N H2SO4 (1:2 v/v) to a pH
of 5.5. The starch slurry is washed with a basket-centrifuge at a
speed of 1200 rpm. The obtained starch cake is re-slurrified in 351
of water and centrifuged a second time. The resulting starch cake
is dried in a flash dryer at an inlet temperature of 160.degree. C.
and an outlet temperature of 60.degree. C.
[0097] C. Gelatinization
[0098] The modified granular starch cake is diluted in
demineralized water in order to form a slurry at a concentration of
about 8% calculated on dry substance. The resulting slurry has a
relative density of 1.032 kg/l compared to water. The pH of the
modified starch slurry is adjusted to 6.0. The slurry is then
heated to 160.degree. C. by direct steam injection (Schlick Model
825). The temperature variation is not higher than +1.degree. C.
The slurry is held in a holding column for a period of 4 minutes at
a temperature of 160.degree. C. and a pressure of about 5.5 bar.
The pressure is then reduced to atmospheric by passing through a
flash. The slurry is then contained at 95.degree. C. in a hold
tank.
[0099] D. Spray-Drying
[0100] The drying of the slurry from Part C is carried out using a
Niro FSD 4 spray-drying tower equipped with a 0.8 mm nozzle and fed
at 10 1/hour. The inlet temperature is fixed at 300.degree. C. and
the outlet temperature of 120.degree. C. The obtained powder is a
controlled release excipient with the following properties:
2 Properties Moisture Content .sup. 4.5% Bulk Density 150 g/l
Packed Density 210 g/l pH .sup. 5.4 Particle Size Peak Value 50
.mu.m (Laser Particle Sizer-Sympatec)
[0101] The starch sample obtained through (A)-(D) is hereafter
referred to as "Cerestar."
Example 2
[0102] Preparation of Controlled Release Excipient
[0103] A. Preparation of Cross-Linked High Amylose Starch
[0104] High amylose starch (30.0 kg) containing about 70% w/w of
amylose (CI AmyloGel 03003) is placed in a reactor. To this reactor
is added water (55.0 1) containing sodium hydroxide (30.0 g) and
sodium sulfate (2.40 kg). The resulting slurry is heated to a
temperature of 30.degree. C. Sodium trimetaphosphate (45 g) is
added to the reaction mixture which is reacted for one hour.
[0105] B. Preparation of Hydroxypropylated Cross-Linked High
Amylose Starch
[0106] The crude reaction mixture from Part A is transferred into a
hydroxypropylation reactor. The reaction mixture is heated to
40.degree. C. over 30 minutes and the reaction is purged with
nitrogen. After a full purge, propylene oxide (1.80 kg) is added.
The reaction mixture is kept at 40.degree. C. for 20 hours. The
reaction mixture is neutralized with 0.1N H2SO4 (1:2 v/v) to a pH
of 5.5. The starch slurry is washed with a basket-centrifuge at a
speed of 1200 rpm. The obtained starch cake is re-slurrified in 35
l of water and centrifuged a second time. The resulting starch cake
is dried in a flash dryer at an inlet temperature of 160.degree. C.
and an outlet temperature of 60.degree. C.
[0107] C. Gelatinization
[0108] The modified granular starch cake is diluted in
demineralized water in order to form a slurry at a concentration of
about 8% calculated on dry substance. The resulting slurry has a
relative density of 1.032 kg/l compared to water. The pH of the
modified starch slurry is adjusted to 6.0. The slurry is the heated
to 160.degree. C. by direct steam injection (Schlick Model 825).
The temperature variation is not higher than 1.degree. C. The
slurry is held in a holding column for a period of 4 minutes at a
temperature of 160.degree. C. and a pressure of about 5.5 bar. The
pressure is then reduced to atmospheric by passing through a flash.
The slurry is then contained at 95.degree. C. in a hold tank.
[0109] D. Spray-Drying
[0110] The slurry from Part C is carried out using a Niro FSD 4
spray-drying tower equipped with a 0.8 mm nozzle and fed at 10
l/hour. The inlet temperature is fixed at 300.degree. C. and the
outlet temperature of 120.degree. C. The obtained powder is a
controlled release excipient with the following properties:
3 Properties Moisture Content .sup. 5.2% Bulk Density 103 g/l
Packed Density 155 g/l pH .sup. 5.3 Particle Size Peak Value 70
.mu.m (Laser Particle Sizer-Sympatec)
Example 3
[0111] Preparation of Controlled Released Tramadol HCl 100 mg
Tablets
[0112] Tramadol HCl 100 mg tablets were prepared in a matrix dosage
form (Formulation LP- 1443) with cross-linked high amylose starch
prepared as described in Example 1. The components of Formulation
LP-1443 are listed in Table 1. The Formulation LP-1443 tablets have
a diameter of 9.53 mm. The shape of an LP-1443 tablet is round and
biconvex. For comparison, Tramal Long 100.RTM. (manufactured by
Grunenthal, Germany) was used. Tramal Long 100.RTM. contains 100 mg
of Tramadol HCl and are in a matrix dosage form with a diameter of
10.15 mm. The shape of Tramal Long 100.RTM. is round and
biconvex.
4TABLE 1 Description of formulation LP-1443 Ingredients Quantity
per tablet (mg) % (w/w) Tramadol HCl 100 30.77 cross-linked high
amylose 188.6 59.03 starch Xanthan gum 32.5 9 Talc (USP) 3.25 1
SiO.sub.2 0.65 0.2 TOTAL 325 100
Example 4
[0113] Preparation of Controlled Released Tramadol HCl 200 mg
Tablets without Immediate Release Film Coating [LP-1473 Without
Film Coating]
[0114] Tramadol HCl 200 mg tablet without film coating were
prepared according to Table 2. First, tramodol HCl powder,
cross-linked high amylose starch, Talc, and SiO2 were mixed and
compressed to form the core of the tablet. Next, tramadol HCl,
cross-linked high amylose starch, xantham gum, Talc and SiO2 were
mixed and compressed to form a dry-coating outside the tablet core.
A biphasic tablet containing 170mg tramadol HCl was formed. Such a
tablet is referred to as LP-1473 without film coating.
5TABLE 2 Description of formulation LP-1473 (200 mg TRAMADOL HCl)
(without the 30 mg tramadol immediate release film coating)
Ingredients Quantity per tablet (mg) % (w/w) CORE Tramadol HCL 85
42.5 cross-linked high amylose 188.6 56.3 starch Talc (USP) 3.25 1
SiO.sub.2 0.65 0.2 TOTAL 200 100 Dry Coating Tramadol HCl 85 21.25
cross-linked high amylose 230.2 57.55 starch Xanthan gum 80 20 Talc
(USP) 4 1 SiO.sub.2 0.8 0.2 TOTAL 400 100
Example 5
[0115] Preparation of Film Coated Formulation LP-1473
[0116] Drycoated tablets of formulation code LP-1473 discussed in
Example 4 were further coated with a film containing 30 mg of
tramadol HCl. The film consists of a first coating containing 30 mg
tramadol HCl mixed with 8 mg Opadry Clear.RTM. YS-3-7065. This
subcoat was then covered with 13 mg of white Opadry II.RTM.
Y-22-7719. Opadry Clear.RTM. and Opadry II.RTM. are manufactured by
Colorcon, Inc., West Point, Pa.
Example 6
[0117] Determination of Tramadol HCl Concentration After
Dissolution
[0118] Concentration of tramadol HCl released in dissolution
vessels was assayed directly by UV-Visible spectrophotometry using
a Spectrophotometer UV-Visible HP-8453. Collected fractions were
analyzed by measuring UV absorption in the range 269 to 273 nm
using a 1 nm displacement, against a reference signal measured in
the range of 380 to 384 nm using a 1 nm displacement. Calibrations
curves in U.S.P. standard buffer pH 1.2 and pH 7.5 were determined
in the concentration range of 0.0300 mg/mL to 0.800 mg/mL. The
curves at both pH values being identical, the curve determined at
pH 1.2 was used for all assays.
Example 7
[0119] Testing Dissolution Under Standard Dissolution
Conditions
[0120] All tests were conducted on a Vankel BioDiss (U.S.P. type
III) dissolution test station. To conduct test under standard
dissolution conditions, the BioDiss was configured with four rows
of dissolution vessels. The vessels were filled each with 250.0 g
of dissolution medium. The dissolution medium was either U.S.P.
standard buffer pH 1.2, U.S.P. standard buffer pH 6.8 (50 mM), or
U.S.P. standard buffer pH 7.5 (50 mM). The enzyme used was
a-Amylase Bacillus from Sigma Chemicals. The cells containing the
tablets were fitted with a 40 mesh screen in the lower caps and a
20 mesh screen in the upper caps. To mimic in vivo condition,
dissolution tests were conducted at 37.degree. C. for 24 hours as
outlined below:
6 TIME Enzyme Agitation (hours) pH (I.U./L) (dips/min) 00:30 1.2 0
15 00:30 6.8 4500 15 04:00 7.5 0 15 19:00 7.5 0 5
[0121] Each dissolution medium was sampled at specific time points.
Each aliquot was filtered through a 2 m filter (Millex AP) prior to
assay using a UV-Visible spectrophotometer (see Example 6). The
dissolution profiles under standard dissolution condition of
LP-1443, Tramal Long 100.RTM. (also known as Zydol SR 100.RTM. in
the United Kingdom), LP-1473 (without film coating) and LP-1473
(with film coating) were obtained.
[0122] FIG. 1 shows the release profile obtained for a 100 mg
tramadol HCl formulation (formulation code LP-1443). The figure
also contains the profile of the reference product, Zydol SR
100.RTM.. The data show that formulation LP-1443 and the references
have comparable dissolution profiles.
[0123] FIG. 2 shows the target and actual release profiles obtained
with formulation LP-1473 (without film coating) for the 170 mg
tramadol HCl slow release component of the overall 200 mg
formulation.
[0124] FIG. 3 contains the in-vitro dissolution profile of the film
coated 200 mg tramadol HCl formulation, along with the target
release profile for the overall 200 mg tramadol HCl tablet.
[0125] The target curves were computed from a target
pharmacokinetic profile, the latter being defined by a quick onset
of action (concentration in excess of 100 ng/mL in less than 1
hour), a 16 hour plateau in the 100 to 300 ng/mL range of
concentrations and a slow decay with a concentration at 24 hour
around 100 ng/mL.
Example 8
[0126] In Vivo Bioavailability
[0127] The bioavailability of Tramal Long 100.RTM., LP-1443 tablets
and LP-1473 (with film coating) tablets was assessed under in vivo
conditions in an open-label, single-dose, randomized, cross-over
pharmacokinetic study performed in 14 healthy human volunteers.
[0128] The plasma concentration curves for tramadol, as indicators
of the release profile of these tablets are illustrated in FIG. 4
and FIG. 5.
[0129] The release profile of tablets LP-1443, containing 100 mg of
tramadol, was equivalent to Tramal Long 100.RTM..
[0130] For LP-1473 tablets (with film coating) containing 200 mg of
tramadol, the targeted sustained release profile was attained, with
plasma concentrations in the 100 to 300 ng/mL range from around 30
min to around 24 hours post-dose.
Example 9
[0131] Robustness Evaluation
[0132] Robustness is defined as a limited dependence of dissolution
profile of active ingredient upon changes in the production or
dissolution testing conditions. All tests for robustness were
conducted on a Vankel BioDiss (U.S.P. type III) dissolution test
station. To test under dissolution conditions for robustness
evaluation, the BioDis was configured with two rows of dissolution
vessels. The vessels were filled each with 250.0 g of dissolution
medium. The dissolution medium was either U.S.P. standard buffer pH
1.2, U.S.P. standard buffer pH 6.8 (50 mM), or U.S.P. standard
buffer pH 7.5 (50 mM). The enzyme used was a-Amylase Bacillus from
Sigma Chemicals. The cells containing the tablets were fitted with
a 40 mesh screen in the lower caps and a 20 mesh screen in the
upper caps. Dissolution tests were conducted at 37.degree. C. for
24 hours. The method used is outlined below for each of the
individual tests.
7 Tests: pH 1.2, pH 6.8 (without enzyme), and pH 7.5: TIME (hours)
Dissolution medium Agitation (dips/min) 05:00 pH 1.2, or 6.8, or
7.5 15 19:00 5 Tests: pH 6.8 + 4500 IU/L (or 18000 IU/L): TIME
(hours) Enzyme (I.U./L) Agitation (dips/min) 05:00 4500 or 18000 15
19:00 5 Tests: agitation 5 dips/min, 15 dips/min: TIME (hours)
Dissolution medium Agitation (dips/min) 05:00 pH 6.8 without enzyme
5 or 15 19:00 pH 6.8 without enzyme 5 or 15
[0133] Each dissolution medium was sampled at specific time points.
Each aliquot was filtered through a 2 m filter (Millex AP) prior to
assay using a UV-Visible spectrophotometer (see Example 6). The
dissolution profiles of LP-1443, LP-1473 (without film coating)
under various pH, agitation, and enzymatic conditions were
obtained.
[0134] FIG. 6 shows that variation of dissolution medium pH had no
significant effect on the release profile of formulation
LP-1443.
[0135] FIG. 7 shows the effect of enzyme on the dissolution
profile. Whilst the release profiles under standard dissolution
conditions and at pH 6.8 are comparable, the release rate increased
marginally when the enzyme was used throughout the test. This
increase appeared to be dependent upon enzyme concentration.
[0136] FIG. 8 shows that variation of dissolution medium ionic
strength had no significant effect on the release profile of
formulation LP-1443.
[0137] FIG. 9 shows that variation in the rate of agitation during
dissolution had no effect within the range tested.
[0138] FIG. 10 shows the dissolution profiles of formulation
LP-1473 (without film coating) at different pH values. The
dissolution profiles at pH 1.2, pH 6.8 or pH 7.5 were not
significantly different from that under standard conditions.
[0139] FIG. 11 shows the effect of enzyme on the dissolution
profile. Whilst the release profiles under standard dissolution
conditions and at pH 6.8 are comparable, the release rate increased
marginally and non-significantly when the enzyme was used
throughout the test. This increase appeared to be dependent upon
enzyme concentration.
[0140] FIG. 12 shows that variation of dissolution medium ionic
strength had no significant effect on the release profile of
formulation LP-1473 (without film coating).
[0141] FIG. 13 shows that variation in the rate of agitation during
dissolution had no effect on formulation LP-1473 (without film
coating) within the tested range.
Example 10
[0142] Rheological Observation on Swollen Cross-Linked Starches
[0143] Cross-linked high amylose starch (CLHAS) made by the process
of the present invention as disclosed in Example 1 (Cerestar) is
different from that made by the process disclosed by Rougier
(Rougier) in Dumoulin et al. WO 98/35992. When swollen in water,
the Cerestar tablets swell about 20% in width and 79% in thickness,
compared to the 29% and 72%, respectively for the Rougier tablet.
After uptaking water, the Cerestar tablets has a weight increase of
2.55 times the original weight of the dry Cerestar tablet. Rougier
tablets increase weight by 3.11 times of the dry Rougier tablets.
The effect of temperature on swelling is less pronounced for the
Cerestar tablet, i.e., water uptake increment is less than for the
Rougier tablets.
[0144] Comparing the swelling behavior of a Cerestar and a Rougier
tablets that have the same thickness reveals that Cerestar tablets
demonstrate a more rapid increase in stiffness when plunged in
water (FIG. 14). At different intervals of time, a compression of
1% was applied to the tablets and only the peak load was recorded.
Afterward, the tablet was allowed to reswell to equilibrium in an
unconfined state. Experiments were conducted on a Mach-1.TM.
instrument with tablets of 3 mm thickness. Stress-relaxation curves
(FIG. 15) obtained from the 1% strain step application indicate
that the Cerestar tablets are much stiffer than the Rougier
tablets, i.e. Cerestar tablets have more pronounced resistance to a
1% strain compression. Cerestar tablets exhibit a peak resistance
about 1.5 times bigger than for the Rougier tablets (from about 15
g to 25 g load per 1% compression).
Example 11
[0145] SEM Micrographs of Water Swollen Cerestar and Rougier
Tablets
[0146] Scanning Electron Microscope (SEM) technique was used to
examine the morphology of Cerestar and Rougier tablets and revealed
a great distinction between the two. FIG. 16 shows the SEM
micrographs of the surface of freeze-dried Cerestar water swollen
tablet. FIG. 17 shows the SEM micrographs of freeze-dried
supernatant suspension present around a water swollen Cerestar
tablet. For comparison, FIG. 18 show the SEM of Rougier tablets at
equilibrium swelling in water at 37.degree. C.
Example 12
[0147] Gel Permeation Chromatography Analysis
[0148] Five starch samples:(1) C Amylogel03003 HA Starch is the 70%
amylose starch which is the a raw material for Cerestar, (2)
Contramid Lot 333 is crosslinked HA starch made by the Rougier
process, (3) Cerestar modified HA starch batch 1903 (manufactured
as disclosed in Example 1), (4) Cerestar modified HA starch batch
HE 3825 (manufactured as disclosed in Example 1), and (5) Cerestar
modified HA starch batch HE 3808 (manufactured as disclosed in
Example 1) were analyzed by gel permeation chromatography
(GPC).
[0149] GPC analysis was conducted in the following 4 steps:
[0150] 1) Dissolution of the samples in 90% DMSO (15 mg/ml, 3 days
at 80.degree. C.) and dilution of the solution with lubricant
(0.005M Na2CO3) 2:1);
[0151] 2) Fractioning of the samples on column system I
(Sephacryl-columns). Sample volume: 1.6 ml;
[0152] 3) Analysis of the fractions on iodine coloring (640 nm and
525 nm) and total carbohydrate; and
[0153] 4) Calibration of the column system with a widely dispersed
molecule standard (BDS-HES).
[0154] GPC results for each of the five samples are as follows:
[0155] (1) C amylogelGel 03003 HA Starch (Amylogel 3003)
[0156] It contains ca. 20% high molecular parts, ration 640/525 nm
between 0.4 and 0.6, which correspond to amylopectin structures.
The low molecular parts have their elution maximum at the fraction
90, whereas the molecular scale here is 300000 Dalton [g/M]. From
the ratio 640/525 nm it is clear that there are differently
branching structures, in the maximum the ratio is between 1.6 and
2, which corresponds to long chain branched structures.
[0157] (2) Rougier Lot 333
[0158] This starch product has very wide dispersion with parts of
different structural composition. A bigger proportion of high
molecular components contains a ratio 640/525 nm at 1 (ca. 50%).
The low molecular part contains a high proportion of differently
branching structures where a ratio between 1.2 and 1.6 can be
observed.
[0159] (3) Cerestar modified HA starch (Batch 1903)
[0160] This modified HA starch has wide molecular dispersion, in
which the proportion of high molecular components is relatively
small, and the ratio 640/525 nm is between 1 and 1.6. The iodine
coloring indicates branched structures with medium length of
segments.
[0161] (4) Cerestar modified HA starch (Batch 3825)
[0162] This modified starch also consists of wide molecular
dispersion, where the proportion of high molecular components is
significantly higher. The iodine coloring shows similar structure
characteristics, the ratio 640/525 nm is of the same scale between
1 and 1.6.
[0163] (5) Cerestar modified HA starch (Batch 3808)
[0164] High molecular components are missing in this batch. The
proportion of low molecular components is significantly higher than
that of Batch 1903 and 3825. The found values for the ratio 640/525
nm are very much uniform in the scale of 1.5, which indicates
equally branched structures with medium branched segment
length.
[0165] The marked difference between crosslinked HA starch made by
the Rougier process (contramid (Rougier) 333) and those by the
process of the present invention (Batch 3808, 1903, 3825) are
illustrated in FIGS. 19 and 20. In the Rougier product, a
significant amount of amylose has been eluted together with
amylopectin indicating that covalent links were created by the
chemical treatment. In the Cerestar products, the peak at high
molecular weight is smaller, which may result from a breakdown of
the amylopectin in smaller subunits. The quantity of amylose bound
to amylopectin is smaller than in the Rougier. This may be due to
either the fact that cross-linking takes place preferentially
between amylose molecules rather than between amylose and
amylopectin or that the degree of cross-linking is lower (Cerestar
uses 0.075% phosphorus oxychloride whereas Rougier uses 3.25%
sodium trimetaphosphate).
Example 13
[0166] Preparation of Implants
[0167] Dry blends of cross-linked high amylose starch,
Lubritab.RTM. (Penwest Pharmaceuticals Co.) and Ciprofloxacin HCl
were prepared with the following compositions:
8 Type A Type B Type C (2.5% Cipro- (5% Cipro- (7.5% Cipro-
floxacin HCl) floxacin HCl) floxacin HCl) cross-linked high 97%
94.5% 92% amylose starch Ciprofloxacine 2.5% 5.0% 7.5% HCl Lubritab
.RTM. 0.5% 0.5% 0.5%
[0168] These blends were compressed using a 7.1 mm round-punch to
provide 5 mm thick implants in the form of a tablet. The weight of
each of the tablets formed (Type A, or B, or C) is 200 mg.
Example 14
[0169] In Vitro Drug Release of Implants
[0170] Experiments were carried out over 21 days with 2.5%, 5% and
7.5% Ciprofloxacin HCl (Cipro) implants (Type A, Type B, Type C as
described in Example 13, respectively) individually immersed in 20
mL of isotonic phosphate buffered saline (PBS), pH 7.4. Watertight
vessels were maintained at 37.degree. C. in a shaking bath.
Implants were transferred into 20 mL of fresh PBS every 24 hours.
Ciprofloxacin HCl was assayed by UV spectrometry (277 nm).
[0171] As shown in FIG. 21, Ciprofloxacin HCl release was obtained
over 21 days with a good reproducibility. Surprisingly,
Ciprofloxacin HCl initial release rate decreased with increasing
drug loading.
Example 15
[0172] In Vivo Study of Implants
[0173] Eighteen 2 kg New Zealand white rabbits were used to
evaluate systemic and local antibiotic release of Ciprofloxacin HCl
from implants. Animals were randomly allotted into two groups (2.5%
and 7.5% Ciprofloxacin HCl). The right hind leg was aseptically
prepared for each rabbit. Skin and lateral femoral fascia were
incised to expose femur diaphysis. Each rabbit was given 30 mg of
Ciproflocaxin HCl, in the form of cross-linked high amylose starch
implants (either type A or C, as described in Example 13). The
implants were placed between quadriceps and femur and then the
fascia and skin were sutured. Animals were monitored daily.
Euthanasia was performed on days 3, 7, 14, 21 and 28
post-implantation. Quadriceps and femur were collected for
Ciprofloxacin HCl assay and histology examination. Blood samples
were taken on days 0, 1, 2, 3, 5, 7, 10, 14, 21 and 28 on all
remaining animals for Ciprofloxacin HCl assay by HPLC.
[0174] As an implantable form, the good biocompatibility of
cross-linked high amylose starch upon subcutaneous implantation had
already been demonstrated in rats (C. Desevaux, et al. Proceed.
Int'l. Symp. Control. Rel. Bioact. Mater. 26 (1999) 635-636).
Likewise, in this study in rabbits, no adverse local reaction nor
health effect occurred. Post-mortem macroscopic inflammation was
slight and limited to implantation sites. Heterophils and
macrophages were observed inside and around cross-linked high
amylose starch implants, respectively.
[0175] As shown in FIG. 22, serum Ciprofloxacin HCl was always
detected at a low level until day 21 limiting the possibility of
toxic effects. In line with in vitro data, initial release was more
controlled and reproducible with Ciprofloxacin HCl implants type
C.
[0176] As shown in FIG. 23, elevated antibiotic levels were found
in the muscles over a long period (21 d) with C type implants. In
line with the in vitro data, the local concentrations following
implantation of the A implants were lower after 14 days.
[0177] In conclusion, the type C implants can be used safely and
efficiently for the local treatment or prevention of bone
infection, such as for example after a trauma or following a
surgical procedure.
[0178] While it is apparent that the embodiments of the invention
herein disclosed are well suited to fulfill the objectives stated
above, it will be appreciated that numerous modifications and other
embodiments may be implemented by those skilled in the art, and it
is intended that the appended claims cover all such modifications
and embodiments that fall within the true spirit and scope of the
present invention.
[0179] A number of references have been cited and the entire
disclosures of which are incorporated herein by reference.
* * * * *