U.S. patent application number 10/925520 was filed with the patent office on 2005-04-28 for intranasal administration of polypeptides in powdered form.
Invention is credited to Benjamin, Eric J., Fu, Cherng-Chyi, Sanders, Lynda M., Vickery, Brian H..
Application Number | 20050089480 10/925520 |
Document ID | / |
Family ID | 22328950 |
Filed Date | 2005-04-28 |
United States Patent
Application |
20050089480 |
Kind Code |
A1 |
Vickery, Brian H. ; et
al. |
April 28, 2005 |
Intranasal administration of polypeptides in powdered form
Abstract
Pharmaceutical compositions or biologically active polypeptides
in powder form suitable for nasal administration, comprising a
therapeutically effective amount of a biologically active
polypeptide and a water-soluble polysaccharide.
Inventors: |
Vickery, Brian H.;
(Saratoga, CA) ; Benjamin, Eric J.; (Dublin,
OH) ; Fu, Cherng-Chyi; (Saratoga, CA) ;
Sanders, Lynda M.; (Palo Alto, CA) |
Correspondence
Address: |
HELLER EHRMAN WHITE & MCAULIFFE LLP
275 MIDDLEFIELD ROAD
MENLO PARK
CA
94025-3506
US
|
Family ID: |
22328950 |
Appl. No.: |
10/925520 |
Filed: |
August 24, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10925520 |
Aug 24, 2004 |
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10328409 |
Dec 23, 2002 |
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6815424 |
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10328409 |
Dec 23, 2002 |
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07902405 |
Jun 19, 1992 |
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6521597 |
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07902405 |
Jun 19, 1992 |
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07109678 |
Oct 15, 1987 |
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Current U.S.
Class: |
424/46 ;
514/10.3; 514/19.5 |
Current CPC
Class: |
A61K 9/0043 20130101;
A61K 47/36 20130101; A61K 38/09 20130101 |
Class at
Publication: |
424/046 ;
514/014 |
International
Class: |
A61K 038/09; A61L
009/04; A61K 009/14 |
Claims
1-10. (canceled)
11. A powdered pharmaceutical composition for the intranasal
administration of an LHRH analogue selected from the group
consisting of
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Deh-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Mbh-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Pha-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Deh-Pro-D-AlaNH.sub-
.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Mbh-Pro-D-AlaNH.-
sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Bth-Pro-D-Ala-
NH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Pha-Pro-D--
AlaNH.sub.2;
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-L-
eu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-Pal(3)-Ser-T-
yr-D-Pal(3)-Leu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-
-Trp-Ser-Arg-D-Trp-Leu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pa-
l(3)-Ser-Tyr-D-Glu(AA)-Leu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe--
D-Pal(3)-Ser-Arg-D-Glu(AA)-Leu-Bth-Pro-D-AlaNH.sub.2;
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Glu(AA)-Leu-Bth-Pro-D-AlaNH.sub.2-
;
N-Ac-D-pCl-Phe-D-Phe-D-Phe-Ser-Phe-D-Lys(Nic)-Nle-Bth-Pro-GlyNH.sub.2;
N-Ac-.DELTA..sup.3,4Pro-D-Nal(2)-D-Pal(3)-Ser-Pal(3)-D-Lys(pyridylacetyl)-
-Phe-Mpa-D-AlaNH.sub.2;
N-Ac-Pro-D-pNO.sub.2-Phe-D-Trp-Ser-Phe-D-Lys(Nic)--
Leu-Ppa-Pro-D-LeuNH.sub.2;
N-Ac-D-pF-Phe-D-pF-Phe-D-Trp-Ser-Tyr-D-Tyr-Trp--
Bth-Pro-AZaGlyNH.sub.2;
N-Ac-D-Nal(1)-Dpg-D-Pal(3)-Ser-Tyr-D-Pal(3)-Nal(2)-
-Bth-Pro-D-AlaNH.sub.2; and
N-Ac-D-Tmp-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Lys(Nic-
)-Nal(2)-Bth-Pro-NHEt; or a pharmaceutically acceptable salt
thereof to an animal in need of such a treatment, which composition
comprises a therapeutically effective amount of the LHRH analogue
or pharmaceutically acceptable salt thereof in intimate admixture
with a high molecular weight, water-soluble polysaccharide having a
molecular weight greater than about 2000 Daltons.
12. A pharmaceutical composition of claim 11 comprising from about
2 to about 8 weight percent LHRH analogue and from about 98 to
about 92 weight percent water soluble polysaccharide.
13. The composition of claim 11 wherein the water-soluble
polysaccharide is dextran.
14. The composition of claim 13 wherein the pharmaceutically
acceptable salt is the acetate.
15. A pharmaceutical composition for the systemic administration of
the LHRH analogue of claim 11 to an animal in need of such a
treatment, which composition consists essentially of a
therapeutically effective amount of the LHRH analogue in intimate
admixture with dextran, the admixture being in a powder form,
wherein a least 75% of the particles of the powder form have
diameters of between about 60 microns and 100 microns.
16. The composition of claim 11 wherein the powder form includes an
absorption enhancer.
17. The composition of claim 16 wherein the absorption enhancer is
a bile acid surfactant.
18. The composition of claim 16 wherein the absorption enhancer is
sodium glycocholate.
19. A method for the systemic administration of a biologically
active polypeptide comprising contacting the nasal passages of an
animal in need of treatment with a biologically effective amount of
the composition of claim 11.
20. A method of systemic administration of the LHRH analogue of
claim 11 to an animal, which method consists essentially of
contacting with the nasal passages of the animal an intimate
admixture of a therapeutically effective amount of the LHRH
analogue and dextran T70, the admixture being in a powder form,
wherein at least 75% of the particles of the powder form have a
diameter of between 60 microns and 100 microns.
Description
[0001] This invention concerns pharmaceutical compositions. for the
intranasal administration of a biologically active polypeptide in
powder form, and a method of administering such compositions. More
specifically, the invention relates to pharmaceutical compositions
for the intranasal administration of a therapeutically effective
amount of a biologically active polypeptide, especially an
LHRH.analogue, in powder form suitable for intranasal
administration; and to a method of administering such compositions.
The intranasal compositions and methods of this invention provide
effective systemic administration of therapeutically effective
amounts of biologically active polypeptides, particularly in high
doses.
[0002] The traditional and most widely used method of
administration.of therapeutic agents is by the oral route. However,
in the case of polypeptides, such delivery is not feasible due to
several factors, for example because of the hydrolysis of the
peptides by digestive enzymes or because polypeptides are absorbed
very poorly or not at all from the gastrointestinal tract. The
methods most commonly used for administration of polypeptide
therapeutic agents are by repeated njection, intramuscular (IM),
subcutaneous (SC) or intravenous (IV) infusion. These methods are
acceptable in situations where a very limited number of injections
are required, or in treating life-threatening diseases, but are
undesirable for chronic administration. However, the nature of many
of the diseases, disorders and conditions susceptible to
improvement by polypeptide administration is chronic rather than
acute, thus necessitating frequent injections over a prolonged
period of time. There is, therefore, a need for an efficacious and
economical delivery system for polypeptide agents.
[0003] The present invention is particularly useful for the chronic
administration of luteinizing hormone-releasing hormone (LHRH)
analogues. The natural LHRH peptide is a decapeptide comprised of
naturally occuring amino acids (which have the L-configuration
except for the achiral amino acid glycine). Its sequence is as
follows: (pyro)Glu-His-Trp-Ser-Tyr-Gly-- Leu-Arg-Pro-Gly-NH.sub.2.
Many analogues of this natural material have been studied.
Continuous chronic administration of LHRH agonist and antagonist
analogues has been found to block the secretion of gonadotropins in
both male and female animals, thereby suppressing the production of
gonadal steroids and gametes. As a result, such LHRH analogues have
been indicated for controlling fertility, suppressing sexual
behaviour in animals, causing regression of endometriotic lesions
and prostatic cancers, and in the treatment of precocious puberty
and the gynecological diseases. Several methods have been proposed
for the systemic delivery of LHRH analogues, but none of the
methods are regarded as ideal.
[0004] As with most polypeptides, oral administration of LHRH
analogues is extremely inefficient because they are inactivated or
not absorbed in the gastrointestinal tract. Conventional
administration of LHRH analogues includes subcutaneous and
intramuscular injections. However, because LHRH analogues have
short circulatory half-lives ranging from several seconds to a few
hours, frequent injections are necessary to achieve effective
therapeusis, rendering chronic administration difficult,
inconvenient and costly.
[0005] Another approach for chronic administration of polypeptides
including the LHRH.analogues is the implantation or other in situ
application of long acting controlled release systems. However, the
implementation of such systems requires the device to be implanted
and possibly to be removed surgically if interruption of treatment
becomes necessary. A more broadly useful approach would be the
intranasal administration of polypeptides, thus providing effective
systemic administration of therapeutically effective amounts of the
polypeptide without the necessity of daily or more frequent
injections, or the cost and inconvenience of surgery.
[0006] The ability of certain polypeptides to be intranasally
absorbed into the systemic system from nasally administered
solutions in which the polypeptide is dissolved is known.
[0007] U.S. Pat. No. 4,476,116 discloses a nasal spray composition
comprising an LHRH analogue and a chelating agent in an aqueous
solution. The solution gave enhanced absorption compared to nasal
solutions with no chelating agent.
[0008] Hirai, Diabetes, 27, p 296-299 (1978), discloses the nasal
administration of insulin as a solution, optionally containing a
surfactant, for example sodium glycholate.
[0009] However, conventional practice indicates that aqueous
solutions of polypeptides provide poor bioavailability and
relatively high inter-subject variability when administered
nasally. Vickery et al. have disclosed intranasal administration of
nafarelin acetate in aqueous solution (Transnasal Systemic
Medications, ed. Y. W. Chien, Piscataway, N.J. 1985). However, the
low aqueous solubility of nafarelin acetate (about 2 mg/ml in
saline solution) restricts the usefulness of this approach, as in
the case where a high dose of nafarelin acetate is needed to be
therapeutically useful it is not possible to dissolve the required
amount of nafarelin acetate in the limited amount of aqueous
solution which may be introduced into the nose (about 100 .mu.l for
each nostril). Thus, in the case of nafarelin acetate, the upper
dosage achievable from nasal solution is about 400 .mu.g. As
transport across the nasal membranes from such a solution is very
limited, (giving about 2% bioavailability compared to injection),
the total amount of nafarelin entering the bloodstream is only
about 8 .mu.g per dose.
[0010] Another disadvantage of using an aqueous solution for
intranasal formulations is that polypeptides in general are less
chemically stable in solution than as a solid, thus limiting the
useful shelf life. Aqueous solutions also require the addition of
an agent to kill microorganisms or inhibit their growth. Such
agents may cause damage to nasal mucosa.
[0011] Powdered forms of polypeptides have also been intranasally
administered. However, these compositions have typically required
the presence of a quarternary ammonium salt, starches, sugars,
water-absorbing gum, polymer, cellulose derivative or a
cyclodextrin. All of these excipients have a disadvantage with
regard to nasal administration. The quarternary ammonium salt and
the low molecular weight water-soluble saccharides and
polysaccharides generate an osmotic pressure which impedes
absorption of the polypeptide by pulling water out of the nasal
membranes in the opposite direction of the intended absorption.
Cellulose derivatives and water absorbing/water insoluble
excipients swell in the nasal membrane and present an additional
layer of resistance to absorption. They also pull water out of the
nasal membrane. Cyclodextrins decrease absorption by complexing
with hydrophobic groups in the polypeptide. Cyclodextrins are not
accepted in the World Pharmacopoeias.
[0012] European Patent Application 193,372 discloses a powdery
composition for intranasal administration of polypeptides, such as
calcitonin and insulin. Required in the composition is a
quarternary ammonium salt and a lower alkyl ether of cellulose.
[0013] European Patent Application 122,036 discloses a. formulation
for powdered peptides, including LHRH, suitable for nasal
administration. The formulation includes, as a required ingredient,
a water-absorbing/water-i- nsoluble base such as a starch, protein,
gum or a cross-linked polymer such as polyvinylpyrrolidone,
optionally in the presence of an excipient such as mannitol,
sorbitol, aminoacetic acid, sodium chloride, phospholipids,
etc.
[0014] Nagai, J. Controlled Release, 1, p 15-22 (1984) discloses a
powder formulation of insulin, optionally with an excipient, for
example lactose, cellulose, hydroxypropyl cellulose or carbopol
934, for nasal administration.
[0015] European Patent Application 094,157 discloses a composition
comprising a highly hydrophilic drug, such as a polypeptide,
polysaccharide, aminoglycoside, beta lactam antibiotic, nucleic
acid, etc, in combination with a cyclodextrin, preferably
.alpha.-cyclodextrin, for nasal, vaginal or rectal administration.
Cyclodextrins are composed of cyclicly-linked D-glucopyranose
units, .alpha.-cyclodextrin having six such units with a molecular
weight of 972. Cyclodextrins are naturally occurring clathrates,
i.e. they have hydrophobic cavities that form inclusion compounds
with organic compounds. The cost of cyclodextrins, especially
.alpha.-cyclodextrin, is generally regarded as a deterrent to
widespread-use of such compounds. The nasal compositions in EP
094,157 may be solid, liquid or semi-solid, optionally in
combination with an excipient such as a sugar, cellulose or a
cellulose derivative, polyvinylpyrrolidone, etc.
[0016] U.S. Pat. Nos. 4,010,125 and 4,476,116 disclose the
preparation of certain decapeptides and claim the compounds as LHRH
antagonists. Several different modes of administration of such
compounds are suggested, including nasal administration. Stated to
be preferred for the nasal route is an aqueous solution of the LHRH
analogue. Also mentioned, but not characterized in any way, is the
possibility of nasal or vaginal powders or insufflations, employing
a solid carrier such as a finely-divided polyethylene glycol or
lactose, optionally including other excipients such as
preservatives, buffers, surface-active agents.
[0017] Thus, from an examination of the preceeding publications it
may be seen that there is a need for a nasal composition capable of
delivering a therapeutically useful amount of a polypeptide to an
animal, such composition being a stable, non-aqueous powder free of
preservatives.
SUMMARY OF THE INVENTION
[0018] Accordingly, it is an object of this invention to provide a
stable pharmaceutical composition as a powder, free. of
preservative agents, and suitable for nasal administration of a
biologically active polypeptide. The composition is capable of
introducing a therapeutically useful amount of the biologically
active polypeptide into the system of an animal.
[0019] A critical element in the efficacy of a nasal composition
for systemic.drug delivery is the rate at which the drug is
transported from the composition across the nasal membranes to the
systemic circulation. It is normally expected that a solution of a
drug will provide faster absorption through the nasal mucosa
than.the same drug in a powder form, because a solution can provide
better dispersion over a greater surface area, and the drug is
already.in the required state for transport across nasal membranes
into the system. However, for the reasons delineated above, an
aqueous formulation is not ideal for the nasal administration of
polypeptides.
[0020] Surprisingly, it has now been found that nasal
administration in powder form of a biologically active polypeptide
in admixture with a high molecular weight water-soluble
polysaccharide overcomes the disadvantages of nasal administration
of an aqueous solution or powder formulations discussed above. In
addition, it has surprisingly been found that the extent of
intranasal absorption of a biologically active polypeptide from the
powder composition of our invention is considerably superior to
that obtained from the same dose in an aqueous solution (i.e. it
provides better bioavailability). Thus a lower amount of the
polypeptide is needed in each case to introduce an effective
therapeutic level of the polypeptide into the systemic circulation
as compared to an aqueous solution. More importantly, much higher
systemic levels of a polypeptide can be achieved with the
intranasal powder formulation of our invention than are possible
with an aqueous formulation. Chemical stability, and consequently
shelf life, is greatly extended in the solid state, and no
microbiological preservatives are necessary. High molecular weight
polysaccharides do not have the disadvantages of generating an
osmotic pressure or forming an additional layer of resistance in
nasal mucosa, as do other excipients discussed above.
[0021] As there are no solubility limitations, higher plasma
concentration of an administered polypeptide may be easily achieved
by merely.increasing the proportion of the polypeptide in the
powder formulation. This is important in the treatment of
conditions that requires a high plasma concentration of a
polypeptide, for example prostatic cancer and particularly
precocious puberty. For such conditions it is not possible with an
LHRH analogue to achieve the therapeutic levels necessary for
treatment by using conventional intranasal solution formulations
due to solubility limitations.
[0022] In addition to enabling the above advantages of superior
absorption and higher systemic levels of intranasally administered
polypeptides, the high molecular weight water-soluble
polysaccharide of our invention performs the further function of
providing an admixture such that a therapeutic dose of the
polypeptide powder has sufficient mass for accurate weighing and
delivery. This is important where the delivery is required of low
doses of a highly potent polypeptide, the nasal application of
which as an undiluted powder would require the manipulation of
minute quantities of material.
[0023] It has also been found that the inter-subject variation in
bioavailability is much reduced with the powder formulation of our
invention, as compared to an aqueous solution formulation. This is
a clearly advantageous virtue of the powder formulation, as the
wide variation found in the bioavailability of a drug from
intranasal application of an aqueous formulation gives rise to a
high degree of unpredictability as to the actual therapeutic dose
reaching the systemic circulation of any given subject.
[0024] In one aspect, the invention is a pharmaceutical composition
for the systemic administration of a biologically active
polypeptide or a pharmaceutically acceptable salt thereof to an
animal in need of such a treatment, comprising a therapeutically
effective amount of a biologically active polypeptide or
pharmaceutically acceptable salt thereof in intimate admixture with
a high molecular weight, water-soluble polysaccharide, the
admixture being in a powder form suitable for nasal
administration.
[0025] A preferred aspect of the invention is a pharmaceutical
composition for the systemic administration of an LHRH analogue to
an animal in need of such a treatment, comprising a therapeutically
effective amount of an LHRH analogue or a pharmaceutically
acceptable salt thereof in intimate admixture with a high molecular
weight, water-soluble polysaccharide, the admixture being in powder
form suitable for nasal administration.
[0026] A most preferred aspect of the invention is a pharmaceutical
composition for the systemic administration of nafarelin,
preferably nafarelin acetate.
[0027] Yet another aspect of this invention is a method of systemic
administration of a biologically active polypeptide or a
pharmaceutically acceptable salt thereof to an animal, comprising
contacting with the nasal passages of an animal a therapeutically
effective amount of a biologically active polypeptide or a
pharmaceutically acceptable salt thereof in intimate admixture with
a high molecular weight, water-soluble polysaccharide, the
admixture being in powder form suitable for nasal
administration.
[0028] Another preferred aspect of this invention is a method of
systemic administration of an LHRH analogue to an animal comprising
contacting with the nasal passages of an animal a therapeutically
effective amount of an LHRH analogue or a pharmaceutically
acceptable salt thereof in intimate admixture with a high molecular
weight, water-soluble polysaccharide, the admixture being in powder
form suitable for nasal administration.
[0029] Another most preferred aspect of this invention is a method
of systemic administration of nafarelin, preferably nafarelin
acetate.
DETAILED DESCRIPTION AND PREFERRED EMBODIMENTS OF THE INVENTION
[0030] As used herein, the term "a pharmaceutical composition in
powder form" means a pharmaceutical composition that is in the form
of a powder. The powder form consists of particles, preferably of
which at least 75% are less than 100 microns in diameter, more
preferably between 60 microns and 100 microns. In the practice of
this invention it is preferred that substantially all particles in
the powder dosage form are between 60 microns and 100 microns in
diameter.
[0031] The term "nasal administration" means a systemic form of
administration of an active ingredient, whereby a therapeutically
effective.amount of the active ingredient, for example in powdered
form, is propelled or otherwise introduced into the nasal passages
of an animal such that it contacts the nasal mucosa, from which it
is absorbed into the systemic circulation.
[0032] The term "water-soluble polysaccharide" refers to any
high-molecular weight polysaccharide (i.e. with a molecular weight
of over 2000) that is soluble in water and is pharmaceutically
acceptable for nasal application. Examples include dextrans and the
like. A particularly preferred water-soluble polysaccharide is
dextran T70.
[0033] The term "dextran" refers to polysaccharides that are
composed exclusively of .alpha.-D-glucopyranosyl units, differing
only in the degree of branching and chain length. Such materials
are commercially available and are typically labelled to show their
average molecular weight. For example, "dextran T40" refers to a
mixture of such polysaccharides with an average molecular weight of
40,000, and "dextran T70" refers to-a mixture of such
polysaccharides with an average molecular weight of 70,000. Dextran
T70 may be purchased inter alia from Pharmacia Fine Chemicals.
[0034] The term "pharmaceutically acceptable salt" refers to a salt
that retains the desired biological activity of the parent compound
and does not impart any undesired toxicological effects. Examples
of such salts are acid addition salts formed with inorganic acids,
for example hydrochloric acid, hydrobromic acid, sulfuric acid,
phosphoric acid, nitric acid and the like; and salts formed with
organic acids such as, for example, acetic acid, tartaric acid,
succinic acid, maleic acid, fumaric acid, gluconic acid, citric
acid, malic acid, ascorbic acid, benzoic acid, tannic acid, palmoic
acid, alginic acid, naphthalenesulfonic acids,
naphthalenedisulfonic acids and the like.
[0035] The term "intimate admixture" is intended to indicate that
the biologically active polypeptide and the high molecular weight,
water-soluble polysaccharide are intimately admixed such that the
two components are substantially uniformly distributed within each
other. Notwithstanding the use of the term "intimate", the mixture
will not necessarily be entirely homogeneous throughout, but
may.show some variation in the relative concentrations of the two
essential components of the mixture.
[0036] The term "therapeutically effective" as used herein refers
to a rate and means of drug administration of a polypeptide which
provides polypeptide plasma levels which are effective to achieve
the desired pharmacological result. For example, if the plasma
level required to achieve and maintain testosterone suppression in
human males with a particular LHRH analogue is approximately 10
ng/ml, a therapeutically effective dose would be one which provides
average plasma levels of that drug at or above 10 ng/ml.
[0037] The term "animal" as used herein refers to all animals in
which polypeptides display useful pharmacologic effects. These
include, but are not limited to, humans, horses, cattle, pigs and
non-human primates and the like. The systems of this invention have
particular utility in humans, in pets such as dogs and cats, in
animal husbandry species such as cattle, pigs and horses, and in
captive zoo animals such as lions, tigers, primates and the
like.
[0038] The term "biologically active polypeptide" refers to any
polypeptide having useful pharmacologic activity when administered
to an animal. The composition of this invention is particularly
advantageous for delivery of larger polypeptides, particularly
those having molecular weights of 1000 dalton or greater, for
example LHRH analogues. The preferred LHRH analogues have molecular
weights in the range of about 1000 to about 1300 daltons.
[0039] Exemplary classes of polypeptides include, among others,
proteins, enzymes, nucleoproteins, glycoproteins, lipoproteins,
hormonally active polypeptides, and synthetic analogues including
agonists and antagonists of these molecules.
[0040] The protein classes which are suitable for use in this
invention are numerous, including immune modulators, lymphokines,
monokines, cytokines, enzymess antibodies, growth promotants,
growth inhibitory factors, blood proteins, hormones, vaccines
(including.viral, bacterial, parasitic, and rickettsial antigens),
blood coagulation factors and the like, including various precursor
protein forms, muteins, and other analogues.
[0041] Specific examples of polypeptides suitable for incorporation
in the delivery system of this invention include the following
biologically active macromolecules, and muteins and other analogues
thereof: interferons (.alpha.-, .beta.-, .gamma.- and muteins
thereof, such as .beta..sub.ser17), colony stimulating factors (1,
2, 3, GM, .alpha.-, .beta.-, .gamma.-, and the like), interleukins
(IL-1, IL-1.sub..alpha., IL-1.sub..beta., IL-2, IL-3, IL-4, IL-5,
and the like), macrophage activating factors, macrophage peptides,
B cell factors (B cell growth factor and the like), T cell factors,
protein A, suppressive factor of allergy, suppressor factors,
cytotoxic glycoprotein, immunocytotoxic agents, immunotoxins,
immunotherapeutic polypeptides, lymphotoxins, tumor necrosis
factors (.alpha.-, .beta.-, and the like), cachectin, oncostatins,
tumor inhibitory factors, transforming growth factors such as
TGF-.alpha. and TGF-.beta. ), albumin, alpha-1-antitrypsin,
apolipoprotein-.epsilon., erythroid potentiating factors,
erythropoietin, factor VII, factor VIII(c), factor IX, fibrinolytic
agent, hemopoietin-1, kidney plasminogen activator, tissue
plasminogen activator, urokinase, pro-urokinase, streptokinase,
lipocortin, lipomodulin, macrocortin, lung surfactant protein,
protein C, protein 5, C-reactive protein, renin inhibitors,
collagenase inhibitors, superoxide dismutase, epidermal growth
factor, growth hormone, platelet derived growth factor, osteogenic
growth factors, atrial naturetic factor, auriculin, atriopeptin,
bone morphogenic protein, calcitonin, calcitonin precursor,
calcitonin gene-related peptide, cartilage inducing factor,
connective tissue activator protein, fertility hormones (follicle
stimulating hormone, luteinizing hormone, human chorionic
gonadotrbpin), growth hormone releasing factor, osteogenic protein,
insulin, proinsulin, nerve growth factor, parathyroid hormone and
analogues, parathyroid hormone antagonists, relaxin, secretin,
somatomedin C, insulin-like growth factors, somatostatin and
somatostatin analogues, inhibin, adrenocoricotrophic hormone,
glucago.n, vasoactive intestinal polypeptide, gastric inhibitory
peptide, motilin., cholecystokinin, pancreatic polypeptide,.
gastrin releasing.peptide, corticotropin releasing factor, thyroid
stimulating hormone, vaccine antigens including antigens of HTLV-I,
II, HTLV-III/LAV/HIV (AIDS virus), cytomegalovirus, hepatitis A, B,
and non-A/non-B, herpes simplex virus-I, herpes simplex virus II,
malaria, pseudorabies, retroviruses, feline leukemia virus, bovine
leukemia virus, transmissible gastroenteritis virus, infectious
bovine rhinotracheitis, parainfluenza, influenza, rotaviruses,
respiratory syncytial virus, varicella zoster virus, Epstein-Barr
virus, pertussis, and anti-infective antibodies including
monoclonal and polyclonal antibodies to gram negative bacteria,
pseudomonas, endotoxin, tetanus toxin, and other bacterial or viral
or other infectious organisms. The lists of macromolecular
polypeptides recited above are provided only to illustrate the
types of active agents which are suitable for use in practicing the
invention, and are not intended to be exclusive.
[0042] Classes of polypeptides which are preferred in the practice
of this invention include LHRH agonists and antagonists, growth
hormone releasing hormone and its analogues and antagonists, atrial
natriuretic peptide (or factor), renin antagonists, parathyroid
hormone and parathyroid hormone antagonists, somatostatin and
somatostatin analogues, and corticotrophin releasing factor and
corticotrophin releasing factor antagonists. Especially preferred
growth hormone releasing hormone analogues are disclosed in U.S.
Pat. Nos. 4,320,118 and preferred enhancers of immunological
competence, (e.g. for use in treating autoimmune diseases), are
disclosed in U.S. Pat. No. 4,659,693.
[0043] Growth hormone releasing hormone (GHRH) is useful in the
treatment of dwarfism due to hypothalamic insufficiency, and also
for treating congenital short stature. A combination of GHRH and
LHRH agonists or antagonists is particularly useful in the
treatment of these syndromes, as a delay or interruption of
puberty, the completion of which stops further increase in height
due to closure of the epiphyses of the long bones, allows for
maximum benefit from the GHRH. GHRH may also be useful as a growth
promoter in domestic species such as cattle or pigs.
[0044] GHRH antagonists, and somatostatin and its analogues, are
useful for their insulin-sparing effects, giving better control of
blood glucose in diabetics, particularly for those with Type II or
non-insulin dependent diabetes. Given at night they are useful for
the control of or the prevention of the "dawn phenomenon", a
hyperglycemic crisis afflicting diabetics. In addition they are
useful in preventing the progression of the vasculopathies
(atherosclerosis, retinopathy, renopathy) and neuropathies which
are complications of diabetes.
[0045] Atrial natriuretic peptide or factor (ANP or ANF) is useful
in the treatment of congestive heart disease, and also the
reduction of blood pressure and aldosterone in renin-dependent
renovascular hypertension. Renin antagonists are also useful in the
treatment of the latter condition.
[0046] Parathyroid hormone (PTH) is useful at low doses,
particularly in combination with 1,25-dihydroxy vitamin D.sub.3, to
stop or reverse osteoporotic changes in bone, ostereoporosis caused
by renal disease or corticoid therapy, senile osteoporosis and the
osteoporotic changes associated with prolonged inactivity or bed
rest. Calcitonin may also be useful in the treatment of
osteoporosis as well as therapy for Paget's Disease. PTH
antagonists may be useful in the treatment of osteoporosis as well
as hyperparathyroidism and the hypercalcemia associated with
malignancy.
[0047] Somatostatin (a tetradecapeptide) and its agonist analogues
have the ability to suppress the secretion of a very wide range of
both exocrine and endocrine secretions, and also to affect
gastrointestinal motility and uptake of nutrients (see Moreau and
DeFeudis, Life Sciences, Vol. 40, pp. 419-437, 1987). Their
utilities stem from these inhibitory activities (as reviewed by
Lamberts, Acta Endocrinologica, Suppl. Vol. 276, pp. 41-55, 1986).
Examples include treatment of accromegally, insulin sparing
effects, treatment of long term complications of diabetes and
treatment of various endocrine secreting tumors.
[0048] Corticotrophin releasing factor (CRF) is useful in the
treatment of adrenal insufficiency of hypothalamic origin. CRF
antagonists may be useful for treating Addison's Disease and
Cushing's Syndrome, as well as for amelioration of stress and its
consequences, for example shipping fever (Bovine respiratory
syndrome) or ulcers, and for alleviation of stress-induced
immunosuppression.
[0049] A particularly preferred class of polypeptides are the LHRH
agonists and antagonists. For convenience in describing and naming
the various nona- and decapeptides within the class of LHRH agonist
and antagonist analogues, the conventional abbreviations for
individual amino acids are used which are recommended by the
IUPAC-IUB Commission on Biochemical Nomenclature, Biochemistry,.11,
1726 (1972) and as generally accepted in the peptide art. As used
herein, the abbreviations represent L-amino acids unless otherwise
noted, and all peptide sequences are written.according to the
generally accepted convention whereby the N-terminal acid is shown
on the left, and the C-terminal acid is shown on the right. Thus,
"nafarelin" is a non-proprietary USAN for
L-pyroglutamyl-L-histidyl-L-tryptophyl-L-seryl-L-tyrosyl-D-3-(2-naphthyl)-
alanyl-L-leucyl-L-arginyl-L-prolyl-glycinamide.
[0050] Certain other abbreviations are used describing many of the
LHRH analogues which are advantageously incorporated in the
invention. These LHRH analogues contain replacements of amino acids
in the natural LHRH peptide by amino acids which do not occur in
nature. Particularly commonly employed among these are the
following:
1 Amino acid residue Abbreviation 3-(2-naphthyl)-alanyl Nal(2)
3-(p-fluorophenyl)-alanyl pF-Phe 3-(p-chlorophenyl)-alanyl pCl-Phe
3-(3-pyridyl)-alanyl Pal(3) N,N'-guanidino-(dimethyl)- Dmh, or
hArg(Me).sub.2 homoarginyl N,N'-guanidino-(diethyl)- Deh, or
hArg(Et).sub.2 homoarginyl N,N'-guanidino-(dipropyl)- Dph, or
hArg(Pr).sub.2 homoarginyl N,N'-guanidino-(diisopropyl)- Dih, or
hArg (iPr).sub.2 homoarginyl N,N'-guanidino-(dihexyl)- Dhh, or
hArg(hexyl).sub.2 homoarginyl N,N'-guanidino-(ethano)- Eha or
hArg(CH.sub.2).sub.2 homoarginyl N,N'-guanidino-(propano)- Pha, or
hArg(CH.sub.2).sub.3 homoarginyl N,N'-guanidino-bis-(2,2,2- Bth, or
hArg(CH.sub.2CF.sub.3).sub.2 trifluoroethyl)- homoarginyl
N-guanidino-(ethyl)- Meh, or hArg(Et) homoarginyl
N-guanidino-(propyl)- Prh, or hArg(propyl) homoarginyl
N-guanidino-(isopropyl)- Iph, or hArg(iPr) homoarginyl
N-guanidino-(butyl)- Mbh, or hArg(Bu) homoarginyl
N,N'-guanidino-(dicyclohexyl)- Dch, or homoarginyl
hArg(cyclohexyl).sub.2 N-guanidino-(heptyl)- Hha, or hArg(heptyl)
homoarginyl N-guanidino-(ethyl)-arginyl Mea, or Arg(Et)
N,N'-guanidino-(diisopropyl)- Dia, or Arg(iPr).sub.2 arginyl
N,N'-guanidino-(dicyclohexyl)- Dca, or arginyl
Arg(cyclohexyl).sub.2 3-(3-piperidyl)-alanyl 3-Pia
3-(4-piperidyl)-alanyl 4-Pia 3-((N.sup..epsilon.-methyl)piperid-4-
-yl)- Mpa alanyl 3-((N.sup..epsilon.-pentyl)piperid-4-yl)- Ppa
alanyl 3-((N.sup..epsilon.-benzyl)piperid-4-yl)- Bpa alanyl
N.sup..epsilon.-Nicotinyl-D-lysyl Lys(Nic)
N.sup..epsilon.-(3-Pyridyl)acetyl-D-lysyl Lys(pyridylacetyl)
3-(2,4,6-trimethylphenyl)alanyl Tmp 2,2-diphenylglycyl Dpg
[0051] LHRH analogues comprise a large group of structurally
related nona-and decapeptide analogues of naturally occurring LHRH.
They are all water-soluble, polar molecules having molecular
weights of about 1000-1300. The naturally occurring LHRH peptide
(pyro)Glu-His-Trp-Ser-Tyr- -Gly.-Leu-Arg-Pro-Gly-NH.sub.2 is
produced in the hypothalamic region of the brain and controls the
reproductive cycle of animals by acting on the anterior pituitary
gland to effect release of luteinizing hormone (LH) and follicle
stimulating hormone (FSH) which in turn act on the gonads to
stimulate the synthesis of steroid hormones and to stimulate gamete
maturation. The pulsatile release of LHRH thereby controls the
reproductive cycle in animals. Additionally, LHRH has effects in
the placenta, in releasing chorionic gonadotropin, directly on the
gonads in rats, and on breast cancer cells.
[0052] Thus, the pharmaceutical composition of this invention
may.be used for a wide variety of different therapeutic
applications in humans and other animals. With the particularly
preferred polypeptide class, the LHRH analogues, particularly
nafarelin acetate, these include, but are not limited to
contraception, fertility control, suppression or interruption of
heat, treatment of ovarian cysts, precocious puberty, prostatic
hyperplasia and tumors, gynecologic diseases, and termination of
pregnancy. The knowledge of specific utilities of LHRH analogues in
various species is rapidly growing; one purpose of this invention
is to provide a practical means of delivering an LHRH analogue,
without being limited to any particular therapeutic application.
However, specific utilities for which the invention may be
particularly advantageous include the control of fertility in dogs,
cats, cattle, horses, zoo animals and the like. For a summary of
other potential therapeutic utilities of LHRH analogues, see
Endocrine Reviews, Vol. 7, No. 1, 115-124 (1986).
[0053] Agonist analogues of LHRH are useful for the control of
fertility by two mechanisms of action. Low doses of LHRH analogues
can stimulate ovulation and are useful in the treatment of
hypothalamic and ovulatory infertility. Additionally they can be
used for hypogonadal conditions and impotence, and to stimulate
spermatogenesis and androgen production in the male.
[0054] Paradoxically, larger doses of highly potent and
long-lasting agonist analogues of LHRH (and LHRH itself) have an
opposite effect, blocking ovulation in the female and suppressing
spermatogenesis in the male. Related to these effects is a
suppression of normal circulating levels of sexual steroids of
gonadal origin, causing reduction in accessory organ weight in the
male and female. In domestic animals this paradoxical effect
promotes weight gain in a feed-lot situation, stimulates abortion
in pregnant animals and in general, acts as a chemical sterilant.
LHRH agonists, particularly nafarelin, methods of preparing LHRH
agonists, and methods of use of such LHRH agonists are disclosed in
U.S. Pat. No. 4,234,571, which is hereby incorporated in full
herein by reference. A full (but not exhaustive) list of the
paradoxical high dose effects of LHRH agonists is set out
therein.
[0055] The most significant modification of the natural LHRH
molecule with respect to LHRH agonists is obtained by changing the
6-position residue from Gly to a D-amino acid, for example, D-Ala,
D-Leu, D-Phe or D-Trp. Antagonist activity can be best realized by
substituting the,naturally occurring 2-position His amino acid
residue with with a D-amino acid residue. These analogues show
increased activity relative to LHRH.
[0056] In addition to modifications at position 6, increased
agonist activity may be obtained by the following modifications:
modifying position 10 to afford a nonapeptide as an alkyl-,
cycloalkyl- or fluoroalkyl-amine, or by replacing Gly-NH.sub.2 by
an a-azaglycine amide; substituting N-methyl-leucine for leucine in
position 7; replacing tryptophan in position 3 by
3-(1-naphthyl)-L-alanine; substituting the position 5 tyrosine
residue with phenylalanine or 3-(l-pentafluorophenyl)- -L-alanine;
and the substitution at position 6 of unnatural D-amino acid
residues containing two or more carbocyclic (or perhydroaryl) rings
or a phenyl (or cyclohexyl) ring which is highly alkyl
substituted.
[0057] The LHRH agonist compounds of particular interest herein are
from the last mentioned group wherein the 6-position of the
naturally occurring LHRH material is replaced with a specific
non-natural D-amino residue containing lipophilic carbocyclic
residues, particularly residues containing two or more highly alkyl
substituted carbocyclic aryl (or perhydroaryl) rings or a phenyl
(or cyclohexyl) ring. These particular polypeptides are the subject
of U.S. Pat. No. 4,234,571 and are prepared in accordance with the
procedures set forth therein. That patent is incorporated in full
herein by reference and made a part of this application. Reference
is made to that application for a full description of the synthetic
nonapeptides and decapeptides of most interest herein. A full
description of the formulas, nomenclature and synthetic methods for
preparing these compounds are found therein. The compounds set out
in U.S. Pat. No. 4,234,571 are preferred synthetic LHRH analogues
for incorporation into the delivery systems of this invention.
[0058] More specifically LHRH polypeptide agonists of particular
interest in this invention include nonapeptides and decapeptides of
the formula:
(pyro)Glu-His-V-Ser-W-X-Y-Arg-Pro-Z (1)
[0059] and the pharmaceutically acceptable salts thereof
wherein:
[0060] V is tryptophyl, phenylalanyl or
3-(l-naphthyl)-L-alanyl;
[0061] W is tyrosyl, phenyalanyl or
3-(pentatafluoro-phenyl)-L-alanyl;
[0062] X is a D-amino acid residue 1
[0063] wherein R is
[0064] (a) a carbocyclic aryl-containing radical selected from the
group consisting of naphthyl, anthryl, fluorenyl, phenanthryl,
biphenyl, benzhydryl and phenyl substituted with three or more
straight chain lower alkyl groups; or
[0065] (b) a saturated carbocyclic radical selected from the group
consisting of cyclohexyl substituted with three or more straight
chain lower alkyl groups, perhydro-naphthyl, perhydrobiphenylyl,
perhydro-2,2-diphenylmethyl and adamantyl;
[0066] Y is leucyl, isoleucyl, nor-leucyl or N-methylleucyl;
[0067] Z is glycinamide or -NH-R.sub.1, wherein R.sub.1 is lower
alkyl, cycloalkyl, fluoro lower alkyl or 2
[0068] R.sub.2 is hydrogen or lower alkyl.
[0069] The most preferred LHRH-active synthetic nona- and
decapeptides agonists of this invention are those compounds of
formula 1 wherein X is 3-(2-naphthyl)-D-alanyl or
3-(2,4,6-trimethylphenyl)-D-alanyl-D-Deh; Z is azaglycine amide or
glycinamide; V is tryptophyl or phenylalanyl; W is tyrosyl and Y is
leucyl or N-methyl-leucyl.
[0070] The synthesis of LHRH analogues in general is disclosed in
Endocrine Reviews, 7, p.44-66 (1986).
[0071] Particularly preferred LHRH agonists for use in this
invention are analogues of the naturally occurring LHRH, and the
pharmaceutically acceptable salts thereof, which have been modified
at the 6-position residue by replacement with a natural or
synthetic D-amino acid, These, listed by formula and
non-proprietary USAN name, include:
2 Non-proprietary Formula of LHRH analog USAN name
6-[3-(2-naphthalenyl)-D-alanine]LHRH; Nafarelin
6-[3-(2-naphthalenyl)-D-alanine]- 10-azaglycinamide LHRH;
6-D-tryptophan LHRH; Tryptorelin 6-D-tryptophan-7-(N-methyl-L-
-leucine)- Lutrelin 9-(N-ethyl-L-prolinamide)-10- desglycinamide
LHRH; 6-D-tryptophan-9-(N-ethyl-L- prolinamide)-10-desglycinamide
LHRH; 6-D-leucine-9-(N-ethyl-L- Leuprorelin
prolinamide)-10-desglycinamide LHRH; (Luprolide)
6-[0-(1,1-dimethylethyl)-D-serine]- Buserelin
9-(N-ethyl-L-prolinamide)-10- desglycinamide LHRH;
6-[0-(1,1-dimethylethyl)-D-serine]- Goserelin 10-azaglycinamide
LHRH; and 6-[1-(phenylmethyl)-D-histidine]-9- Histrelin
(N-ethyl-L-prolinamide)-10- desglycinamide LHRH.
[0072] There is also the group of LHRH analogues termed
antagonists. These polypeptides antagonize the effect of endogenous
LHRH at low dose levels relative to naturally occurring LHRH. Such
compounds are to be included within the scope of this
invention.
[0073] Particularly potent LHRH antagonists are described in U.S.
Pat. Nos. 4,481,190 and 4,581,169, and in U.S. patent application
Ser. No. 495,226 filed May 20, 1983, each of which is incorporated
by reference herein. Preferred LHRH antagonists useful in this
invention include:
[0074] [N-Ac-.DELTA..sup.3-Pro.sup.1, D-pF-Phe.sup.2, Detirelix
D-Trp.sup.3,6, NMeLeu.sup.7]LHRH;
[0075] [N-Ac-.DELTA..sup.3-Pro.sup.1, D-pF-Phe.sup.2,
D-Nal(2).sup.3,6]LHRH;
[0076] [N-Ac-Pro.sup.1, D-pF-Phe.sup.2, D-Nal(2).sup.3,6]LHRH;
[0077] [N-Ac-Ala.sup.1, D-pF-Phe.sup.2, D-Trp.sup.3,6]LHRH;
[0078] [N-Ac-D-Trp.sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Phe.sup.6, D-Ala.sup.10]LHRH;
[0079] [N-Ac-D-Trp.sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Arg.sup.6, D-Ala.sup.10]LHRH;
[0080] [N-Ac-D-pCl-Phe.sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Arg.sup.6, D-Ala.sup.10]LHRH;
[0081] [N-Ac-D-Nal(2).sup.1, D-pF-Phe.sup.2, D-Trp.sup.3,
D-Arg.sup.6]LHRH;
[0082] [N-Ac-D-Nal(2).sup.1, D-pF-Phe.sup.2, D-Trp.sup.3,
oCl-Phe.sup.5, D-Arg.sup.6]LHRH;
[0083] [N-Ac-D-pBr-Phe.sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Arg.sup.6, D-Ala.sup.10]LHRH;
[0084] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Arg.sup.6, D-Ala.sup.10]LHRH;
[0085] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Pal(3).sup.3,
D-Arg.sup.6, D-Ala.sup.10]LHRH;
[0086] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Pal(3).sup.3,
D-Arg.sup.6, D-Trp.sup.7, D-Ala.sup.10]LHRH;
[0087] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Pal(3).sup.3,
D-Arg.sup.6, D-Ile.sup.7, D-Ala.sup.10]LHRH;
[0088] [N-Ac-D-Nal(2).sup.1, D-.alpha.Me,pCl-Phe.sup.2,
D-Trp.sup.3, Arg.sup.5, D-Tyr.sup.6, D-Ala.sup.10]LHRH;
[0089] [N-Ac-D-Nal(2).sup.1, D-.alpha.Me,pCl-Phe.sup.2,
D-Pal(3).sup.3, D-Arg.sup.6, N-iPrLys.sup.8, D-Ala.sup.10]LHRH;
[0090] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Oeh.sup.6, D-Ala.sup.10]LHRH;
[0091] [N-Ac-D-Nal(2).sup.1, D-pF-Phe.sup.2, D-Trp.sup.3,
D-Deh.sup.6, D-Ala.sup.10]LHRH;
[0092] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-F-Deh.sup.6, D-Ala.sup.10]LHRH; and
[0093] [N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3,
D-Deh.sup.6, Aza-Gly.sup.10]LHRH.
[0094] Further preferred LHRH antagonists are those disclosed in
U.S. patent application Ser. No.010,923, filed Feb. 5, 1987, the
entirety of incorporated herein by reference. Of the following are
particularly preferred LHRH incorporation in the formulation of
this
[0095] N-Ac -0-Nal (2) -0-pCl-Phe-D-Pal (3)-Ser-
Leu-Deh-Pro-D-AlaNH.sub.2- ;
[0096]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Bth-Pro-D-Ala-
NH.sub.2;
[0097]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Mbh-Pro-D-Ala-
NH.sub.2;
[0098]
N-Ac-D-Nal(2)-D-pCl-Phe-O-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Pha-Pro-D-Ala-
NH.sub.2;
[0099]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0100]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0101]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0102]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0103]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Deh-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0104]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Mbh-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0105]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Bth-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0106]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Pha-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0107]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Deh-Leu-Deh-Pro-D-AlaNH.-
sub.2;
[0108]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Mbh-Leu-Mbh-Pro-D-AlaNH.-
sub.2;
[0109]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Bth-Leu-Bth-Pro-D-AlaNH.-
sub.2;
[0110]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Pha-Leu-Pha-Pro-D-AlaNH.-
sub.2;
[0111]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0112]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0113]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0114]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0115]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Bth-Pro-D-Ala-
NH.sub.2;
[0116]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-SeT-Arg-D-Pal(3)-Leu-Mbh-Pro-D-Ala-
NH.sub.2;
[0117]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Oeh-Pro-D-Ala-
NH.sub.2;
[0118]
N-Ac-D-Nal(2)-D-pCl-Phe-O-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Pha-Pro-D-Ala-
NH.sub.2;
[0119]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Tyr-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0120]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Tyr-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0121]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Tyr-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0122]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Tyr-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0123]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Tyr-Leu-Bth-Pro-D-AlaNH.-
sub.2;
[0124]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Tyr-Leu-Mbh-Pro-D-AlaNH.-
sub.2;
[0125]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Tyr-Leu-Deh-pro-D-AlaNH.-
sub.2;
[0126]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Tyr-Leu-Pha-Pro-D-AlaNH.-
sub.2;
[0127]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Deh-D-Tyr-Leu-Oeh-Pro-D-AlaNH.sub-
.2;
[0128]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Mbh-D-Tyr-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0129]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Bth-D-Tyr-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0130]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Pha-D-Tyr-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0131]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Deh-D-Trp-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0132] N-Ac-D-Nal(2)-D-pCl
-Phe-D-Trp-Ser-Mbh-D-Trp-Leu-Mbh-Pro-D-AlaNH.su- b.2;
[0133]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Bth-D-Trp-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0134]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Pha-D-Trp-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0135]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Deh-D-Pal(3)-Leu-Deh-Pro-D-Ala-
NH.sub.2;
[0136]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Mbh-D-Pal(3)-Leu-Mbh-Pro-D-Ala-
NH.sub.2;
[0137]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Bth-D-Pal(3)-Leu-Bth-Pro-D-Ala-
NH.sub.2;
[0138]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Pha-D-Pal(3)-Leu-Pha-Pro-D-Ala-
NH.sub.2;
[0139]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Deh-D-Nal(2)-Leu-Deh-Pro-D-AlaNH.-
sub.2;
[0140]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Mbh-D-Nal(2)-Leu-Mbh-Pro-D-AlaNH.-
sub.2;
[0141]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Bth-D-Nal(2)-Leu-Bth-Pro-D-AlaNH.-
sub.2;
[0142]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Pha-D-Nal(2)-Leu-Pha-Pro-D-AlaNH.-
sub.2;
[0143]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Pal(3)-D-Pal(3)-Leu-Deh-Pro-D--
AlaNH.sub.2;
[0144]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Pal(3)-D-Pal(3)-Leu-Bth-Pro-D--
AlaNH.sub.2;
[0145]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Pal(3)-D-Pal(3)-Leu-Pha-Pro-D--
AlaNH.sub.2;
[0146]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Pal(3)-D-Pal(3)-Leu-Mbh-Pro-D--
AlaNH.sub.2;
[0147]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Mbh-Leu-Bth-Pro-D-AlaNH.-
sub.2;
[0148]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Mbh-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0149]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Oeh-Pro-D-AlaN-
H.sub.2;
[0150]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Sth-Pro-D-AlaN-
H.sub.2;
[0151]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Deh-Pro-D-AlaNH.sub.-
2;
[0152]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Tyr-D-Trp-Leu-Bth-Pro-D-AlaNH.sub.-
2;
[0153]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Tyr-D-Deh-Leu-Deh-Pro-D-AlaNH.sub.-
2;
[0154]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Tyr-D-Bth-Leu-Bth-Pro-D-AlaNH.sub.-
2;
[0155]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Deh-Leu-Deh-Pro-D-AlaNH.s-
ub.2;
[0156]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Bth-Leu-Bth-Pro-D-AlaNH.s-
ub.2;
[0157]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Deh-Pro-D-AlaNH.sub.-
2;
[0158]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Bth-Pro-D-AlaNH.sub.-
2;
[0159]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Bth-Pro-D-AlaN-
H.sub.2;
[0160]
N-Ac-D-Nal(2)-D-pF-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Deh-Pro-D-AlaN-
H.sub.2;
[0161]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Deh-D-Tyr-Leu-Deh-Pro-D-AlaNH.sub.-
2; and
[0162]
N-Ac-D-Nal(2)-D-pF-Phe-D-Trp-Ser-Bth-D-Tyr-Leu-Bth-Pro-D-AlaNH.sub.-
2.
[0163] The scope of the instant invention also includes LHRH
analogues that may not necessarily fall within the aforementioned
preferred classes, such as:
[0164]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Deh-Pro-D-AlaNH.sub-
.2;
[0165]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Mbh-Pro-D-AlaNH.sub-
.2;
[0166]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Bth-Pro-D-AlaNH.sub-
.2;
[0167]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Tyr-D-Tyr-Leu-Pha-Pro-D-AlaNH.sub-
.2;
[0168]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Deh-Pro-D-Ala-
NH.sub.2;
[0169]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Mbh-Pro-D-Ala-
NH.sub.2;
[0170]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Bth-Pro-D-Ala-
NH.sub.2;
[0171]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Nal(2)-Leu-Pha-Pro-D-Ala-
NH.sub.2;
[0172]
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-Pal(3)-Ser-Arg-D-Pal(3)-Leu-Bth-
-Pro-D-AlaNH.sub.2;
[0173]
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Bth-
-Pro-D-AlaNH.sub.2;
[0174]
N-Ac-D-Nal(2)-D-.alpha.Me,pCl-Phe-D-Trp-Ser-Arg-D-Trp-Leu-Bth-Pro-D-
-AlaNH.sub.2;
[0175]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Glu(AA)-Leu-Bth-Pro-D-Al-
aNH.sub.2;
[0176]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Arg-D-Glu(AA)-Leu-Bth-Pro-D-Al-
aNH.sub.2;
[0177]
N-Ac-D-Nal(2)-D-pCl-Phe-D-Trp-Ser-Arg-D-Glu(AA)-Leu-Bth-Pro-D-AlaNH-
.sub.2;
[0178]
N-Ac-D-pCl-Phe-D-Phe-D-Phe-Ser-Phe-D-Lys(Nic)-Nle-Bth-Pro-GlyNH.sub-
.2;
[0179]
N-Ac-.DELTA..sup.3,4Pro-D-Nal(2)-D-Pal(3)-Ser-Pal(3)-D-Lys(pyridyla-
cetyl)-Phe-Mpa-D-AlaNH.sub.2;
[0180]
N-Ac-Pro-D-pNO.sub.2-Phe-D-Trp-Ser-Phe-D-Lys(Nic)-Leu-Ppa-Pro-D-Leu-
NH.sub.2;
[0181]
N-Ac-D-pF-Phe-D-pF-Phe-D-Trp-Ser-Tyr-D-Tyr-Trp-Bth-pro-AzaGlyNH.sub-
.2;
[0182]
N-Ac-D-Nal(1)-Dpg-D-Pal(3)-Ser-Tyr-D-Pal(3)-Nal(2)-Bth-Pro-D-AlaNH.-
sub.2; and
[0183]
N-Ac-D-Tmp-D-pF-Phe-D-Pal(3)-Ser-Tyr-D-Lys(Nic)-Nal(2)-Bth-Pro-NHEt-
.
[0184] These specific compounds represent some of the more useful
fertility affecting LHRH type polypeptides which have been
developed to date. This is not intended to be an exhaustive or
exclusive list of all LHRH active polypeptides which have been made
or which can or may be made. They are simply set out to illustrate
the type of compounds which are the subject of this invention. Any
or all of them can be interchangeably substituted into the
compositions of this invention.
[0185] The preferred LHRH agonist of the present invention is
nafarelin. and salts of nafarelin, particularly nafarelin acetate.
The preferred LHRH antagonists of the present invention are:
[N-Ac-D-Nal(2).sup.1, D-pCl-Phe.sup.2, D-Trp.sup.3, D-Deh.sup.6,
D-Ala.sup.10]LHRH,
N-Ac-D-Nal(2)-D-pCl-Phe-D-Pal(3)-Ser-Tyr-D-Deh-Leu-Deh-Pro
D-AlaNH.sub.2,
N-Ac-D-Nal(2)-D-pCl-Phe-0-Pal(3)-Ser-Tyr-D-Pal(3)-Leu-Deh-Pro-D-AlaNH.sub-
.2; and the pharmaceutically acceptable salts thereof.
[0186] A preferred embodiment of this invention is nafarelin
acetate in powdered form in admixture with a water soluble
polysaccharide excipient in powdered form. A particularly preferred
polysaccharide is dextran, more particularly dextran T70.
[0187] In a most preferred embodiment, the nafarelin acetate and
dextran T70 intimately admixed are in the form of a powder in which
at least 75% of the particles in the powder are below 100 microns
in diameter, preferably between 60 microns and 100 microns,
especially where substantially all of the particles in the powder
are between 60 microns and 100 microns in diameter.
[0188] The relative proportions of polypeptide and polysaccharide
components within the formulation can be varied depending on the
polypeptide to be administered and the dosage level desired. The
polypeptide active agent may comprise up to about 40 weight percent
of the formulation. The precise amount will depend on such factors
as the potency of the particular active agent, its physicochemical
and pharmacokinetic behaviour, its. stability and the condition
being treated.
[0189] A preferred composition for the formulation comprises, by
weight:
[0190] (a) 60 to 99.9999 percent polysaccharide; and
[0191] (b) 0.0001 to 40 percent biologically active
polypeptide.
[0192] The present invention is well-suited to the controlled
delivery of LHRH analogues. The amount of LHRH analogue
incorporated with the polysaccharide will preferably be 20%, or
less, depending on the particular LHRH analogue and the other
factors listed above. A presently preferred composition comprises,
by weight:
[0193] (a) 80 to 99.999 percent polysaccharide; and
[0194] (b) 0.001 to 20 percent LHRH analogue.
[0195] A more preferred composition comprises, by weight:
[0196] (a) 80 to 99.999 percent dextran T70; and
[0197] (b) 0.001 to 20 percent LHRH analogue.
[0198] A most preferred composition comprises, by weight:
[0199] (a) 92 to 98 percent dextran T70; and
[0200] (b) 2 to 8 percent nafarelin acetate.
[0201] The powder compositions of this invention may also 25
include an absorption enhancer. A second preferred composition for
such a formulation comprises, by weight:
[0202] (a) 50 to 99.8999 percent polysaccharide;
[0203] (b) 0.0001 to 40 percent biologically active polypeptide;
and
[0204] (c) 0.1 to 10 percent absorption enhancer.
[0205] A more preferred composition comprises, by weight:
[0206] (a) 75 to 98.999 percent dextran T70;
[0207] (b) 0.001 to 20 percent LHRH analog; and
[0208] (c) 1 to 5 percent bile acid surfactant.
[0209] A most preferred composition comprises, by weight:
[0210] (a) 89 to 97 percent dextran T70;
[0211] (b) 2 to 8 percent nafarelin acetate; and
[0212] (c) 1 to 3 percent sodium glycocholate.
[0213] As used herein, the term "absorption enhancer" refers to a
material or compound which, when incorporated in the powder
mixture, causes further enhancement of the total amount of the
polypeptide absorbed intranasally into the systemic circulation
from the powder formulation.
[0214] The preferred agents optionally used for enhancing the
absorption of polypeptides across the nasal membrane from the
powder formulations are bile acid surfactants, or a
pharmaceutically acceptable salt thereof.
[0215] These acids are, for example, glycocholic acid, cholic acid,
taurocholic acid, cholanic acid, ethocholic acid, desoxycholic
acid, chenodesoxycholic acid, dehydrocholic acid and
glycodeoxy-cholic acid. One or more acids or salts may be used, but
preferably a single pharmaceutically acceptable acid salt is used
in the powder formulation.
[0216] The pharmaceutically acceptable surfactant salt will be any
salt which retains the phenomena of enhanced peptide absorption, as
well as the compound's surfactant characteristics, and which are
not deleterious to the subject or otherwise contraindicated. Such
salts are for example those salts derived from inorganic bases
which include sodium, potassium, ammonium, calcium, ferrous, zinc,
manganous, ferric, manganic salts and the like. Particularly
preferred are the ammonium, potassium, sodium, calcium and
magnesium salts. Salts derived from pharmaceutically acceptable
organic non-toxic bases include salts of primary, secondary, and
tertiary amines, substituted amines including naturally occurring
substituted amines, cyclic amines and basic ion exchange resins,
such as isopropylamine, trimethylamine, diethylamine,
triethylamine, tripropylamine, ethanolamine,
2-dimethylaminoethanol, 2-diethylaminoethanol, tromethamine,
dicyclohexylamine, lysine, arginine, histidine, caffeine, procaine,
hydrabamine, choline, betaine, ethylenediamine, glucosamine,
methylglucamine, theobromine, purines, piperazine, piperidine,
N-ethylpiperidine, polyamine resins and the like. Particularly
preferred organic non-toxic bases are isopropylamine, diethylamine,
ethanolamine, tromethamine, dicyclohexylamine, choline and
caffeine.
[0217] More preferably, the surfactant used in the practice of this
invention will be an alkali metal salt of glycocholic acid, most
preferably sodium glycocholate.
[0218] The amount of surfactant, when used in the practice of this
invention, is in the range between about 0.2 and 15%. It is
preferred that the surfactant be present in an amount between about
0.5 to 4 percent by weight, most preferably about 2 percent by
weight.
Methods of Preparation
[0219] The powder formulations of this invention are made by
conventional techniques. For a discussion of the state of the art,
see, for example, Remington's Pharmaceutical Sciences, Mack
Publishing Company, Easton, Pa., 18th Edition, 1975, particularly
from page 1554 to page 1575. Preferred methods include freeze
drying a solution and precipitating the powder from solution.
[0220] For example, a suitable formulation of a polypeptide in
powdered form is made by first forming a solution of the
polypeptide. The solution preferably also contains the high
molecular weight polysaccharide, for example dextran, as required
in the final formulation, and optionally the absorption enhancer,
for example sodium glycocholate. The solvent is preferably largely
composed of water, although the water may contain amounts of other
polar solvents, for example, methanol or ethanol.
[0221] The solvent is then removed by lyophilization, or the like,
or the solids are precipitated and removed by filtration or similar
techniques. If the particles of the resulting solid are too large
for nasal administration, the solid must be processed further. The
next step in the process is pulverization. Suitable methods for
pulverization include cutting, chopping, crushing, grinding,
milling, micronization, screening, trituration, or the like.
[0222] The resulting particles are then size classified. Suitable
size classification methods include screening, sieving and the
like. Particles of the preferred size in the powder of this
invention, i.e. particles that are less than 100 microns in
diameter, preferably between 60 microns and 100 microns in
diameter, are obtained by passing the powder through a #200
standard mesh.
[0223] The preceding discussion is not exhaustive. Alternate
methods can be used to form the composition of the present
invention. For example, powders of ingredients of the desired
particle size can first be made independently and then subsequently
mixed, thereby forming a powder form of the composition of this
invention.
Utility
[0224] One aspect of the present invention is a method of nasally
administering polypeptides useful for treating physiological
conditions requiring the systemic administration of a polypeptide.
Examples of physiological conditions or diseases that are treatable
with systemically administered polypeptides, especially LHRH
analogues, include malignancies, especially prostatic cancer, and
breast cancer; hormonally-dependent disorders of the reproductive
organs, especially endometriosis, polycystic ovarian syndrome,
uterine leiomyata, pre-menstrual syndrome, and fibrocystic breast
disease; benign prostatic hyperplasia; precocious puberty; delay of
normal puberty; treatment of male infertility; treatment of female
infertility; and female contraception. The nasally administered
powder may contain more than one active ingredient. For example, an
LHRH medication for prostatic cancer might include an anti-androgen
to combat androgen elevation often seen at the beginning of LHRH
therapy, or an LHRH medication for breast cancer might include an
anti-estrogen. Two polypeptides, for example an LHRH agonist or
antagonist combined with GHRH, may be used in the treatment of
dwarfism or short stature. While therapeutic dose levels of the
polypeptides will vary greatly depending on the potency or
pharmacological properties of the particular analogue and the
nature of the therapy being provided, the following statements
provide an indication of the general broad ranges of dose levels
that are presently understood to be useful:
[0225] Dose levels in the pharmaceutical composition of the present
invention of an LHRH analogue useful in the treatment of prostatic
cancer in men are generally between about 100 .mu.g and 4 mg,
preferably between about 300 .mu.g and 2 mg.
[0226] Dose levels in the pharmaceutical composition of the
present.invention of an LHRH nalogue useful in the treatment of
endometriosis or other gynecological disorders in women are
generally between about 100 .mu.g and 1 mg.
[0227] Dose levels in the pharmaceutical composition of the present
invention of an LHRH analogue useful for blocking ovulation in
women are.generally between about 100 .mu.g and 1 mg.
[0228] Dose levels in the pharmaceutical composition of the present
invention of an LHRH analogue useful for treating precocious
puberty are generally between about 200 .mu.g and 4 mg.
[0229] However, ascertaining or defining the required dose level of
a particular polypeptide is a routine aspect of the art and is well
within the level of ordinary skill. It should be understood that
the limiting amount for nasal administration of a powder is
probably about 10 mg per nostril.
Method of Administration
[0230] The powder formulation, once made, is preferably propelled
into the nasal passages of the subject animal. Any suitable
apparatus and/or method for placing a pharmaceutical dose into the
nasal passages of a subject animal that can be adapted to the
delivery of a powder, can be used. Such apparatus or method
preferably propels the powder into the nostril under positive
pressure. For example, the powdered formulation is placed in an L
shaped glass tube with a nozzle tip. The tube is connected to a
source of a controlled amount of slightly compressed air, for
example to a syringe with an extended plunger, by a flexible
connection. The tip is placed in the nostril of the subject animal
and the powder is propelled into the subject's nasal passages under
positive external pressure, for example, by depressing the
plunger.
[0231] The following Preparations and Examples are provided to
further illustrate practical means and/or tests for carrying out
the invention described and claimed herein, and should not be
interpreted as limiting it in any way. From the foregoing
description, one of ordinary skill can easily ascertain and adapt
the essential characteristics of the invention to particular needs
or situations without departing from the spirit and scope
thereof.
Preparation 1
Standard Reference Solution
[0232] An amount of nafarelin acetate equivalent to 2.0 mg of
nafarelin as the free base, 50 mg sorbitol, 0.1 mg benzalkonium
chloride, 1.2 mg acetic acid and enough purified water to bring the
volume of the solution to 1 ml are mixed together. This solution is
referred to as the standard solution hereinafter.
EXAMPLE 1
Freeze Dried Powder Formulation
[0233] An amount of nafarelin acetate equivalent to 10 mg of
nafarelin as the free base and 240 mg of dextran T70 were dissolved
together in purified water. A powdered formulation having 4 wt. %
nafarelin (weight of nafarelin as the free base) was then made by
freeze drying the solution, grinding the product in a pestle and
mortar and passing the resultant powder through a #200 standard
mesh.
[0234] Similarly, by varying the proportion of nafarelin acetate to
dextran T70 and following the procedure above, 2 wt % and 8 wt. %
powdered formulations were prepared.
[0235] Similarly, by substituting other polypeptides, for example
leuprorelin, somatostatin analogues or detirelix, for nafarelin
acetate in the above description, other pharmaceutical compositions
of our invention are made.
EXAMPLE 1A
Freeze Dried Powder Formulation Containing an Absorption
Enhancer
[0236] An amount of nafarelin acetate equivalent to 10 milligrams
of nafarelin as the free base, 235 mg of dextran T70 and 5 mg of
sodium glycocholate were dissolved together in purified water. A
powdered formulation having 4 wt. % of nafarelin (weight of
nafarelin as the free base) and 2 wt. % of sodium glycocholate was
then made by freeze drying the solution, grinding the product in a
pestle and mortar and passing the resultant powder through a #200
standard mesh.
[0237] Similarly, by varying the proportion of nafarelin acetate to
dextran T70 and following the procedure above, 2 wt % and 8 wt. %
powdered formulations were prepared.
[0238] Similarly, by substituting other polypeptides, for example.
leuprorelin, somatostatin analogues or detirelix, for nafarelin
acetate in the above description and optionally substituting
various quantities of other absorption enhancers for sodium
glycocholate, other pharmaceutical compositions of our invention
are made.
EXAMPLE 2
Method of Administration of Powder
[0239] The powdered formulation (5 mg) of Example 1 or 1A was
weighed accurately and transferred quantitatively into an L shaped
glass tube with a nozzle tip. The tube was connected using rubber
tubing to a 5 ml syringe with the plunger pulled out. The nozzle
was placed in the nostril of the subject animal and the powder
propelled into the nostril by pushing the plunger all the way down
in one quick motion. This was repeated with another tube containing
the powder for the second nostril. The total delivery was 10 mg of
powder. This device and technique gave consistent and complete
delivery of the powder formulation.
[0240] Alternatively, the powder formulation can be suspended in an
aerosolizing vehicle such as freon, or other fluorocarbons, and
delivered into the nasal passages as a fine mist or vapor.
EXAMPLE 3
[0241] Plasma Levels of Nafarelin in Rhesus Monkeys Following
Intranasal Administration of Solution and Powder Formulations
[0242] TABLE 1 compares the peak blood levels of nafarelin in
rhesus monkeys after they were given doses of nafarelin in standard
solution form, prepared as shown in Preparation 1, and powder forms
containing different percentages of active ingredient, prepared as
shown in Example 1 (i.e. without an absorption enhancer). The
powder forms were applied using the technique described in Example
2, and the solution was applied as a divided dose administered to
each nostril, suitably by means of a spray. Suitably a spray bottle
with a metered dose (conveniently 100 .mu.l per spray) pump
attachment was used.
[0243] The serum levels of nafarelin in the subject rhesus monkeys
were measured by radio-immunoassay for nafarelin. The technique is
described in Analytical Biochemistry, 141, p10-16, (1984). All the
serum levels of nafarelin were measured in the same way.
[0244] As can be seen from the table, the powder formulation gives
higher peak blood levels of nafarelin (about three times more) than
the standard solution formulation containing an identical amount of
nafarelin acetate.
[0245] The dose level of 800 .mu.g is not achievable by the
solution formulation, since only 100 .mu.l of solution can be
administered to each nostril, and nafarelin acetate is
insufficiently soluble to give more than a maximum of about 200
.mu.g in 100 .mu.l of solution.
[0246] The theoretical values shown in TABLE 1 are calculated based
on the assumption that if the dose and concentration of nafarelin
is doubled, the peak blood levels should be doubled. Thus it can be
seen that the actually observed values show an unexpected result:
as the dose of nafarelin is doubled the blood level of nafarelin
increases at.a much greater rate than doubling.
3TABLE 1 Peak Blood Levels in Rhesus Monkeys Dosage No. in Peak
Blood Formulation (.mu.g) Group Levels (ng/ml) Observed 2% powder
200 3 6 .+-. 4 4% powder 400 3 22 .+-. 8 8% powder 800 3 76 .+-. 8
Theoretical 2% powder 200 6 4% powder 400 12 8% powder 800 24
Solution Standard 400 6 8 .+-. 7 Solution
[0247] TABLE 2 shows the Area Under the Curve (AUC) for blood
levels achieved from various doses of nafarelin in a powdered
formulation and a solution formulation. Again much more nafarelin
absorption than theoretically expected is seen in the blood levels
in the higher doses.
[0248] AUC is the area under t.he plasma concentration-time curve.
This area is directly proportional to the total amount of unchanged
drug that has entered the systemic circulation, and is an important
measure of bioavailability.
4TABLE 2 Area Under the Curve (AUC) Formulation No. in Dose AUC 8
hours Strength Group (.mu.g) ng/Hr/ml Observed 2% powder 3 200 10
.+-. 3 4% powder 3 400 39 .+-. 4 8% powder 3 800 127 .+-. 9
Theoretical 2% powder 200 10 4% powder 400 20 8% powder 800 40
Standard Solution Standard 6 400 14 .+-. 5 solution
[0249] Table 3 shows the inter-subject variability of the peak
height and the AUC for various formulations in rhesus monkeys.
Lower numbers in.the table for the % coefficient of variation
demonstrates less variation in peak height and the AUC from subject
to subject for the same dose. The table shows that the powder
formulation of this invention provides a substantially smaller %
coefficient of variation than the standard solution.
5TABLE 3 Inter-subject variation of the absorption of nafarelin %
COEFFICIENT OF VARIATION DOSE NUMBER Peak AUC SPECIES FORMULATION
.mu.g IN GROUP Height 8 Hrs Standard Solution 400 6 89 34 Rhesus 4%
nafarelin + 400 3 20 11 dextran T70 8% nafarelin + 800 3 11 7
Dextran T70
EXAMPLE 4
Comparison in Humans of the Efficacy of Single-Dose Administration
of Solution and Powder Formulations of Nafarelin Acetate
[0250] The table below compares the area under the curve (AUC) for
nafarelin in humans after being given doses of nafarelin acetate in
powder form, prepared as shown in Example 1 (i.e. without
absorption enhancer), or standard solution form described as
described in Preparation 1. The powder form was administered using
the technique described in Example 2. The solution form was
administered using the conventional technique as described in
Example 3. As the table shows, the powder form gave substantially
higher. blood levels than the solution having the same amount of
nafarelin acetate. The AUC achieved with the 800 .mu.g powder dose
is not attainable by administration of a solution, due to the low
solubility of nafarelin acetate, as discussed in more detail in
Example 3.
[0251] The serum levels of nafarelin were measured by
radio-immunoassay for nafarelin. The technique is described in
Analytical Biochemistry, 141, p10-16, (1984).
6 Nafarelin Number 0-8 hr AUC Value Formulation Dose (.mu.g) in
Study (ng/ml per hr) Standard Solution 400 6 3.2 4% nafarelin + 400
6 4.6 dextran T70 8% nafarelin + 800 6 8.0 Dextran T70
EXAMPLE 5
Comparison of Efficacy of Two Different Powder Formulations
[0252] The table shows the difference between the plasma evels of
nafarelin for two different formulations. The ame amount of each
formulation was tested in a series of he same three rhesus monkeys.
The powder form was administered using the technique described in
Example 2. The values in the table are the average values for all
three monkeys. Formulation #1 is made as described in Example 1,
but with 4 wtX nafarelin acetate in polyvinylpyrrolidone in place
of dextran T70. Formulation #2 was made as in Example 1 with 4 wt %
nafarelin in dextran T70.
[0253] As the table below shows, the nafarelin is far more
bioavailable in the dextran T70 (formulation #2) than the
polyvinylpyrrolidone (formulation #1), indicating that the high
molecular weight water-soluble polysaccharides of our invention are
superior formulating agents for nasal dosage forms of
nafarelin.
7 Plasma Concentrations of Nafarelin (ng/ml) TIME FORMULATION #1
FORMULATION #2 5 MIN 0.02 2.24 15 MIN 0.12 18.07 30 MIN 0.29 22.17
1 HOUR 0.93 14.7 2 HOURS 0.54 6.03 4 HOURS 0.21 1.74 8 HOURS 0.06
0.64
EXAMPLE 6
Enhancement of the Absorption of Nafarelin in Rhesus Monkeys from a
Powder Formulation by Incorporation of Sodium Glycocholate
[0254] The powder formulations prepared as described in Examples I
and IA were administered as single 100 mg doses to rhesus monkeys.
Resulting peak blood levels of nafarelin are given in the following
table which shows that nafarelin is more bioavailable in the
enhanced powder formulation than in the standard powder
formulation.
8 Dosage No. in Peak Blood Formulation (.mu.g) Group Levels (ng/ml)
Observed 4% powder 400 3 22 .+-. 8 4% powder + 2% 400 3 76 .+-. 8
sodium glycocholate
EXAMPLE 7
[0255]
9 Comparison of the Absorption of Leuprorelin in Rhesus Monkeys
when administered as a Powder Formulation No. in Peak Blood
Formulation Dosage Group Levels (ng/ml) Observed 10% Luprorelin 1
mg 3 <40 90% Dextran T70 20% Luprorelin 2 mg 3 89 .+-. 20 80%
Dextran T70
[0256] No blood levels of leuprorelin were detected in following
the administration of 10% leuprorelin in Dextran T70. It is shown
as less than 40 ng/ml in the table above, as 40 ng/ml of
leuprorelin is the lower limit of detection of Leuprolide by the
method used. For the same reason, no comparison with solution
formulations of leuprorelin are possible, as the dose level of
leuprorelin required to produce detectable amounts of leuprorelin
in the blood (i.e. 40 ng/ml) are not attainable with solution
formulations, being beyond the upper limit of solubility of
leuprorelin in such formulations.
[0257] Thus it can be seen that a twofold increase of leuprorelin
in the administered dose gives more than a twofold increase in
leuprorelin found in the peak blood level.
EXAMPLE 8
Plasma Levels of Detirelix in Rhesus Monkeys Following Intranasal
Administration of Solution and Powder Formulations
[0258]
10 Plasma Levels of Detirelix in Rhesus Monkeys following
Intranasal Administration of Solution and Powder Formulations
Dosage No. in Peak Blood Formulation (.mu.g) Group Levels (ng/ml)
Observed Detirelix 0.17% in 340 6 3.9 .+-. 0.9 sorbitol, glacial
acetic acid and water (solution) Detirelix 3.4% in 340 9 5.4 .+-.
0.6 Dextran T70 (powder)
[0259] The table shows that detirelix is more bioavailable as a
powder formulation than as a standard aqueous solution
formulation.
EXAMPLE 9
Plasma Levels of GHRH in Rhesus Monkeys Following -Intranasal
Administration of Solution and Powder Formulations
[0260] This was an internally coontrolled study using the same
animals (designated as (1) or (2)), thus minimizing the influence
of variables such as individual differences in anatomy or disease
which might otherwise affect absorption.
11 Dosage Peak Blood Formulation (.mu.g) Levels (ng/ml) Observed
GHRH 2.0 mg/ml 400 39.8 (1) in 5% sorbitol, 400 43.5 (2) glacial
acetic acid and water (solution) GHRH 4% in 400 81.6 (1) Dextran
T70 400 93.4 (2) (powder) (GHRH is Growth Hormone Releasing
Hormone.)
[0261] As can be seen from the above table, GHRH is absorbed more
than twice as efficiently from the powder formulation as compared
to the solution formulation.
* * * * *