U.S. patent application number 12/797441 was filed with the patent office on 2011-04-21 for baclofen and r-baclofen gastroretentive drug delivery systems.
This patent application is currently assigned to Intec Pharma Ltd.. Invention is credited to Giora Carni, David Kirmayer, Elena Kluev, Shuher Masri, Eytan Moor, Nadav Navon, Julia Shvetz, Zeev Weiss.
Application Number | 20110091542 12/797441 |
Document ID | / |
Family ID | 42232930 |
Filed Date | 2011-04-21 |
United States Patent
Application |
20110091542 |
Kind Code |
A1 |
Navon; Nadav ; et
al. |
April 21, 2011 |
BACLOFEN AND R-BACLOFEN GASTRORETENTIVE DRUG DELIVERY SYSTEMS
Abstract
A biodegradable, multi-layered controlled release
gastroretentive baclofen or R-baclofen dosage form which is
optionally divided into a first dosage of baclofen or R-baclofen
for immediate release and a second dosage of baclofen or R-baclofen
for controlled release in the stomach and gastrointestinal tract of
a patient, folded into a capsule which disintegrates upon contact
with gastric juice and the dosage form unfolds rapidly upon contact
with gastric juice. The biodegradable, multi-layered
gastroretentive dosage forms of the invention provide fast onset of
baclofen or R-baclofen activity with prolonged absorption and
minimal undesirable side effects.
Inventors: |
Navon; Nadav; (Jerusalem,
IL) ; Shvetz; Julia; (Jerusalem, IL) ; Moor;
Eytan; (Jerusalem, IL) ; Kirmayer; David;
(Maale Adumim, IL) ; Kluev; Elena; (Jerusalem,
IL) ; Masri; Shuher; (Jerusalem, IL) ; Carni;
Giora; (Tel Aviv, IL) ; Weiss; Zeev;
(Jerusalem, IL) |
Assignee: |
Intec Pharma Ltd.
|
Family ID: |
42232930 |
Appl. No.: |
12/797441 |
Filed: |
June 9, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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PCT/IB2009/007419 |
Oct 19, 2009 |
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12797441 |
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61120051 |
Dec 4, 2008 |
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Current U.S.
Class: |
424/458 ;
424/400; 424/457; 514/567 |
Current CPC
Class: |
A61P 25/20 20180101;
A61P 1/00 20180101; A61P 7/00 20180101; A61P 25/24 20180101; A61K
9/0065 20130101; A61K 9/4808 20130101; A61P 25/32 20180101; A61P
25/00 20180101; A61P 25/30 20180101; A61K 9/7007 20130101; A61P
29/00 20180101; A61P 25/06 20180101; A61K 31/195 20130101 |
Class at
Publication: |
424/458 ;
424/400; 424/457; 514/567 |
International
Class: |
A61K 9/54 20060101
A61K009/54; A61K 9/00 20060101 A61K009/00; A61K 9/52 20060101
A61K009/52; A61K 31/195 20060101 A61K031/195; A61P 25/32 20060101
A61P025/32; A61P 25/00 20060101 A61P025/00; A61P 7/00 20060101
A61P007/00; A61P 25/30 20060101 A61P025/30; A61P 29/00 20060101
A61P029/00; A61P 25/06 20060101 A61P025/06; A61P 25/24 20060101
A61P025/24; A61P 1/00 20060101 A61P001/00 |
Claims
1. A biodegradable multi-layered baclofen or R-baclofen
gastroretentive dosage form comprising a first dosage of baclofen
or R-baclofen for controlled release and optionally a second dosage
of baclofen or R-baclofen for immediate release in the stomach and
gastrointestinal tract of a subject, wherein the gastroretentive
dosage form is compacted or folded into a capsule which
disintegrates rapidly upon contact with gastric juice, and wherein
the gastroretentive dosage form, upon disintegration of the
capsule, unfolds rapidly upon contact with the gastric juice.
2. The biodegradable, multi-layered baclofen or R-baclofen
gastroretentive dosage form of claim 1, wherein the dosage form is
designed for oral administration and compacted or folded into a
standard size capsule which is easily swallowed.
3. The biodegradable, multi-layered baclofen or R-baclofen
gastroretentive dosage form of claim 1, comprising: a. a first
dosage of baclofen or R-baclofen for controlled release in an inner
layer; b. a rigid frame layer; and c. one or two outer layers;
wherein the inner layer, frame layer and one or two outer layers
are compacted or folded into a capsule and the capsule is
optionally coated with at least one coating comprising a second
dosage of baclofen or R-baclofen for immediate release.
4. The biodegradable, multi-layered baclofen or R-baclofen
gastroretentive dosage form of claim 1, comprising: a. a rigid
inner layer comprising a first dosage of baclofen or R-baclofen for
controlled release; and b. one or two outer layers; wherein the
inner layer and the one or two outer layers are compacted or folded
into the capsule and wherein the capsule is optionally coated with
at least one layer comprising a second dosage of baclofen or
R-baclofen for immediate release.
5. The biodegradable, multi-layered gastroretentive dosage form of
claim 1, wherein the gastroretentive dosage form comprises a dose
of from about 20 to about 120 mg of baclofen or R-baclofen,
optionally divided into a first dosage for controlled release
between about 15 and about 90 mg of baclofen or R-baclofen, and a
second dosage for immediate-release between about 5 and about 30 mg
of baclofen or R-baclofen.
6. The biodegradable, multi-layered gastroretentive dosage form of
claim 3 or 4, wherein the gastroretentive dosage form has two outer
layers.
7. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the gastroretentive dosage form comprises two
outer layers, a rigid frame layer and an inner layer containing
baclofen or R-baclofen for controlled release, and wherein the
capsule is coated with a coating comprising baclofen or R-baclofen
for immediate release.
8. The biodegradable, multi-layered gastroretentive dosage form of
claim 4, wherein the gastroretentive dosage form comprises two
outer layers and a rigid inner layer containing baclofen or
R-baclofen for controlled release, and wherein the capsule is
coated with a coating comprising baclofen or R-baclofen for
immediate release.
9. The biodegradable, multi-layered gastroretentive dosage form of
claim 3 or 4, wherein the gastroretentive dosage form comprises a
dose of 40 mg of baclofen or R-baclofen, divided into a dose of 10
mg of baclofen or R-baclofen in the coating of the capsule for
immediate release, and a dose of 30 mg in the inner layer for
controlled-release of baclofen or R-baclofen.
10. The biodegradable, multi-layered controlled release
gastroretentive dosage form of claim 1, wherein the gastroretentive
dosage form provides a baclofen or R-baclofen gastric retention
period greater than 6 hours.
11. The biodegradable, multi-layered controlled release
gastroretentive dosage form of claim 1, wherein the gastroretentive
dosage form provides a baclofen or R-baclofen gastric retention
period of up to 24 hours.
12. The biodegradable, multi-layered controlled release
gastroretentive dosage form of claim 1, wherein the active is
baclofen or R-baclofen and wherein the gastroretentive dosage form
provides a R-baclofen gastric retention period between 8 and 14
hours.
13. The biodegradable, multi-layered controlled release
gastroretentive dosage form of claim 1, wherein the active is
baclofen and wherein one administration of a 40 mg GRDF provides
baclofen plasma levels of 50-175 ng/ml for 12-20 hours.
14. A method for providing a therapeutic blood plasma concentration
of baclofen or R-baclofen over a period of up to 24 hours resulting
in improved therapeutic activity which comprises orally
administering to a subject in need thereof a baclofen or R-baclofen
biodegradable, multilayered gastroretentive dosage form, wherein
the gastroretentive dosage form provides a therapeutically
effective blood plasma level of baclofen or R-baclofen from about
half an hour to about 24 hours after administration.
15. A method for reducing sharp peaks in the therapeutic blood
plasma concentration of baclofen or R-baclofen after administration
of baclofen or R-baclofen to a subject in need thereof over a
period of up to 24 hours and improving therapeutic activity, which
comprises orally administering to the subject a baclofen or
R-baclofen biodegradable, multilayered gastroretentive dosage
form.
16. A method for reducing fluctuations in the therapeutic blood
plasma concentration of baclofen after administration of baclofen
or R-baclofen to a subject in need thereof over a period of up to
24 hours, improving baclofen or R-baclofen therapeutic activity and
reducing baclofen side-effects in comparison to side effects
produced by immediate release administration of an equivalent dose
of baclofen or R-baclofen comprising orally administering to the
subject a baclofen or R-baclofen biodegradable multilayered
gastroretentive dosage form.
17. A method for treating a disease selected from the group
consisting of spasticity, spastic diplegia, multiple sclerosis,
amyotrophic lateral sclerosis and trigeminal and glossopharyngeal
neuralgias in a subject in need thereof, comprising orally
administering one or more baclofen or R-baclofen gastroretentive
dosage forms of claim 1 per day.
18. A kit comprising a number of baclofen or R-baclofen
gastroretentive dosage forms of claim 1 and instructions and
precautions for their use.
19. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the outer layers are hydratable at a rate greater
than the frame layer, and comprise at least one polymeric
combination of a hydrophilic polymer and a polymer insoluble in
gastric media.
20. The biodegradable, multi-layered gastroretentive dosage form of
claim 19, wherein the polymer insoluble in gastric media is
selected from the group consisting of one or more types of
polymethacrylate USP.
21. The biodegradable, multi-layered gastroretentive dosage form of
claim 19, wherein the outer layers comprise propylene glycol as a
plasticizer.
22. The biodegradable, multi-layered gastroretentive dosage form of
claim 19, wherein the polymeric combination in the outer layers
comprises gelatin.
23. The biodegradable, multi-layered gastroretentive dosage form of
claim 22, wherein the amount of gelatin in the outer layers is
between about 20% and about 45% of the total outer layer
composition.
24. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the rigid frame layer comprises an enteric polymer
selected from the group consisting of cellulose acetate phthalate,
hypromelose phthalate, hydroxypropyl methylcellulose acetate
succinate, polyvinyl acetate phthalate and
methylmethacrylate-methacrylic acid copolymers.
25. The biodegradable, multi-layered gastroretentive dosage form of
claim 4, wherein the inner layer comprises an enteric polymer
selected from the group consisting of cellulose acetate phthalate,
hypromelose phthalate, hydroxypropyl methylcellulose acetate
succinate, polyvinyl acetate phthalate and
methylmethacrylate-methacrylic acid copolymers.
26. The biodegradable, multi-layered gastroretentive dosage form of
claim 24, wherein the polymer in the rigid frame layer is
polymethacrylate copolymer.
27. The biodegradable, multi-layered gastroretentive dosage form of
claim 24, wherein the rigid frame layer has a mechanical strength
described with Young's modulus ranging from about 0.5 to about 15
Kgf/mm.sup.2 and stress of about 0.03 to about 0.6 Kgf/mm.sup.2
after 1 hour in simulated gastric fluid.
28. The biodegradable, multi-layered gastroretentive dosage form of
claim 24, wherein the frame layer optionally further comprises a
filler, a surface-active agent, an additional plasticizer and other
suitable materials.
29. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the inner layer comprises baclofen or R-baclofen
and at least one polymer, wherein baclofen or R-baclofen is
substantially uniformly dispersed in the polymer or forms a solid
solution therewith and wherein baclofen or R-baclofen is released
from the inner layer upon contact of the gastroretentive dosage
form with gastric medium.
30. The gastroretentive dosage form of claim 29, wherein the at
least one polymer is chosen from hydrogels and polymer compositions
permeable to water.
31. The biodegradable, multi-layered gastroretentive dosage form of
claim 29, wherein the at least one polymer optionally further
comprises a plasticizer.
32. The biodegradable, multi-layered gastroretentive dosage form of
claim 30, wherein the hydrogels are chosen from the group
consisting of carboxymethyl cellulose, including sodium salt,
alginic acid, including sodium salt, hydroxypropyl cellulose,
hydroxyethyl cellulose, hypromelose, a gum, including guar gum,
xanthan gum and others, a protein, including albumin, casein,
gelatin or collagen, and a cross-linked polyacrylic acid.
33. The biodegradable, multi-layered gastroretentive dosage form of
claim 30, wherein the polymer compositions permeable to water are
selected from the group consisting of a polymer, selected from
zein, suitably plasticized ethyl cellulose, cellulose acetate,
cellulose acetate butyrate, polyvinyl acetate, an enteric polymer
and combinations thereof.
34. The biodegradable, multi-layered gastroretentive dosage form of
claim 30, wherein the polymer compositions permeable to water
comprise a mixture of polymers comprising at least one component
soluble in water and at least one component insoluble in water, and
wherein the mixture of polymers is selected from the group
consisting of a mixture of polyvinyl acetate and polyvinyl
pyrrolidone, a mixture of ethyl cellulose and polyethylene glycol
and similar combinations.
35. The biodegradable, multi-layered gastroretentive dosage form of
claim 30, wherein the at least one polymer is chosen from polyvinyl
alcohols and polyethylene oxides.
36. The biodegradable, multi-layered gastroretentive dosage form of
claim 30, wherein the polymer compositions further comprise
buffering agents selected from acidifying agents selected from
citric acid, tartaric acid, sorbic acid, fumaric acid, hydrochloric
acid and sulfuric acid, and alkalizing agents selected from
divalent cations hydroxides, oxides, and their salts, wherein said
divalent cations include but are not limited to calcium, magnesium
and zinc, and their salts are selected from but not limited to
carbonates, sulfates and stearates.
37. The biodegradable, multi-layered gastroretentive dosage form of
claim 29, wherein the inner layer optionally further comprises a
filler, a surface-active agent and/or other inactive
ingredients.
38. The gastroretentive dosage form of claim 3, wherein baclofen or
R-baclofen is released upon contact with gastric media and wherein
the release profile is substantially insensitive to changes of the
environment of release in pH ranges selected from the group
consisting of between about 1.2 and about 5.5, between about 1.2
and about 5.0 and between about 1.2 and about 4.1.
39. The biodegradable, multi-layered gastroretentive dosage form of
claim 1, wherein baclofen or R-baclofen is released upon contact
with gastric media and wherein the release profile is substantially
insensitive to changes of the environment of release in the
presence of ethyl alcohol in an amount selected from the group
consisting of from about 0% to about 30%, from about 0% and about
25% and from about 0% and equal or below 20% v/v.
40. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the inner layer comprises baclofen or R-baclofen
in a form selected from the group consisting of a powder,
granulated powder, miniature tablets, coated powder, semisolid
composition and combinations thereof.
41. The biodegradable, multi-layered gastroretentive dosage form of
claim 4, wherein the inner layer comprises baclofen or R-baclofen
in a form selected from the group consisting of a powder,
granulated powder, miniature tablets, coated powder, and
combinations thereof.
42. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the coating on the capsule comprises at least one
layer.
43. The biodegradable, multi-layered gastroretentive dosage form of
claim 42, wherein the coating comprises at least one polymer which
is instantly soluble in gastric medium.
44. The biodegradable, multi-layered gastroretentive dosage form of
claim 42, wherein baclofen is uniformly dispersed or dissolved in
the coating.
45. The biodegradable, multi-layered gastroretentive dosage form of
claim 42, wherein the coating further comprises a plasticizer or a
combination of plasticizers.
46. The biodegradable, multi-layered gastroretentive dosage form of
claim 42, wherein the coating further optionally comprises at least
one anti-tacking agent.
47. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the inner layer, rigid frame layer and one or two
outer layers are joined together with ultrasonic welding.
48. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the folded multi-layered gastroretentive dosage
form unfolds to a length of at least 20 mm within 15 minutes of
being exposed to gastric fluid.
49. The biodegradable, multi-layered gastroretentive dosage form of
claim 3, wherein the gastroretentive drug formulation is fully
degradable within 3 hours in simulated intestinal fluid.
50. A method for treating a disease selected from the group
consisting of spasticity, spastic diplegia, multiple sclerosis,
amyotrophic lateral sclerosis and trigeminal and glossopharyngeal
neuralgias in a subject in need thereof, comprising orally
administering to the subject one or more baclofen or R-baclofen
gastroretentive dosage forms of claim 3 per day.
51. A method for treating a disease treatable with baclofen or
R-baclofen in a subject in need thereof, comprising orally
administering to the subject one or more baclofen or R-baclofen
gastroretentive dosage forms of claim 1 per day.
52. A method for treating a disease selected from the group
consisting of spasticity, spastic diplegia, alcoholism, alcohol
addiction, dependance or alcohol abuse, gastro-esophageal reflux
disease (GERD), emesis, cough, narcotic addiction or abuse,
nicotine addiction or abuse, neuropathic pain and musculoskeletal
pain, nocturnal acid breakthrough, chronic hiccups, dyspepsia,
gastric motility disorder, migraine, PTSD (Post-traumatic Stress
Disorder), depression, anxiety, lower urinary tract dysfunction,
multiple sclerosis, amyotrophic lateral sclerosis and trigeminal
and glossopharyngeal neuralgias in a subject in need thereof,
comprising orally administering to the subject one or more baclofen
or R-baclofen gastroretentive dosage forms of claim 3 or 4.
53. A method for treating an alcohol or abuse drug addiction in a
subject in need thereof, comprising orally administering to the
subject one or more baclofen or R-baclofen gastroretentive dosage
forms of claim 1.
54. A method for treating gastroesophageal reflux disease in a
subject in need thereof, comprising orally administering to the
subject one or more baclofen or R-baclofen gastroretentive dosage
forms of claim 1.
55. A method for treating a disease selected from the group
consisting of spasticity, spastic diplegia, alcoholism, alcohol
addiction, depndance or abuse, gastro-esophageal reflux disease
(GERD), emesis, cough, narcotic addiction or abuse, nicotine
addiction or abuse, neuropathic pain and musculoskeletal pain,
nocturnal acid breakthrough, chronic hiccups, dyspepsia, gastric
motility disorder, migraine, PTSD (Post-traumatic Stress Disorder),
depression, anxiety, lower urinary tract dysfunction, multiple
sclerosis, amyotrophic lateral sclerosis and trigeminal and
glossopharyngeal neuralgias. in a subject in need thereof,
comprising orally administering to the subject one or more baclofen
or R-baclofen gastroretentive dosage forms of claim 1.
56. A method for treating a disease selected from the group
consisting of gastro-esophageal reflux disease (GERD), cough,
narcotic addiction or abuse, nicotine addiction or abuse,
musculoskeletal pain, migraine, PTSD (Post-traumatic Stress
Disorder), depression, anxiety, lower urinary tract dysfunction in
a subject in need thereof, comprising orally administering to the
subject one or more baclofen gastroretentive dosage forms.
57. The biodegradable, multi-layered baclofen or R-baclofen
gastroretentive dosage form of claim 1, wherein the gastroretentive
dosage form is compacted or folded into a capsule and the second
dosage for immediate release is formed by filling into the capsule
a portion or a whole dose of baclofen or R-baclofen in the form of
a powder, a granulated powder, a coated multi-particulate dosage
form, a mini-tablet, or a combination of one or more thereof, and
wherein the capsule is optionally coated with at least one layer
comprising an additional dosage of baclofen or R-baclofen for
immediate release.
58. The biodegradable, multi-layered baclofen or R-baclofen
gastroretentive dosage form of claim 1, wherein the gastroretentive
dosage form is compacted or folded into a capsule and the second
dosage for immediate release is formed by incorporating a portion
or a whole dose of baclofen or R-baclofen into the capsule shell in
the form of a powder, a granulated powder, a coated
multi-particulate dosage form, or a combination of one or more
thereof during the manufacturing process and wherein the capsule
may be optionally coated with a pharmaceutical coating.
Description
CROSS-REFERENCE TO RELATED PATENT APPLICATIONS
[0001] The present application is a continuation in part of PCT
Application PCT/IB2009/007419, filed Oct. 19, 2009, which claims
priority to U.S. Provisional Patent Application No. 61/120,051,
filed Dec. 4, 2008.
FIELD OF THE INVENTION
[0002] The present invention relates to biodegradable
gastroretentive drug formulations for the immediate release and
sustained release of baclofen. The gastroretentive baclofen or
R-baclofen formulations of the invention may be orally administered
to a subject in need thereof for the treatment of spasticity,
spastic diplegia, alcoholism, alcohol addiction or alcohol
dependence and abuse, gastro-esophageal reflux disease (GERD),
emesis, cough, narcotic addiction or abuse, nicotine addiction or
abuse, neuropathic pain and musculoskeletal pain, nocturnal acid
breakthrough, chronic hiccups, dyspepsia, gastric motility
disorder, migraine, PTSD (Post-traumatic Stress Disorder),
depression, anxiety, lower urinary tract dysfunction, multiple
sclerosis, amyotrophic lateral sclerosis and trigeminal and
glossopharyngeal neuralgias.
BACKGROUND OF THE INVENTION
[0003] Spasticity or muscular hypertonicity is a disorder of the
central nervous system (CNS) in which muscles continually tighten
and contract, causing stiffness or tightness of the muscles and
affecting gait, movement and sometimes speech. Spasticity is
characterized by an increased muscle tone, causing resistance to
movement. This severe neurological disorder is caused by several
diseases and conditions and may be found in most patients suffering
from multiple sclerosis (MS), cerebral palsy (CP) and chronic
spinal cord injuries. Stroke and traumatic brain injury (TBI) are
another common cause of spasticity.
[0004] Spastic diplegia inhibits the proper development of upper
motor neuron function, impacting the motor cortex, the basal
ganglia and the cortico-spinal tract. The muscles constantly
rigidly contract and become permanently hypertonic, creating
difficulty with voluntary and passive movement, pain and
deformities.
[0005] Multiple sclerosis is an autoimmune disease that affects the
brain and spinal cord, causing loss of balance, numbness, pain,
vision loss, and impairing brain functions.
[0006] Glossopharyngeal neuralgia is a condition in which there are
repeated episodes of severe pain in the tongue, throat, ear and
tonsils.
[0007] Since there is no known cure for these diseases, therapies
focus on controlling the symptoms. Medicines that reduce muscle
spasms include baclofen, tizanidine, and benzodiazepines. Baclofen
is a GABA (gamma-amino butyric acid) derivative which is indicated
for the treatment of spasticity, spastic diplegia, multiple
sclerosis, amyotrophic lateral sclerosis and trigeminal and
glossopharyngeal neuralgias, and is commercially available in the
US under the trade name Lioresal.RTM. as 0.05, 0.5 and 2 mg/ml
intrathecal injectable formulation, or as 10 and 20 mg tablets and
oral disintegrating tablets (Kemstro.RTM.). Although baclofen has
two known optical isomers, R-baclofen and S-baclofen, only the
racemic baclofen is approved for therapeutic use.
[0008] Unfortunately, baclofen is associated with significant and
frequent side effects. The most common are sedation (somnolence,
drowsiness), weakness (asthenia, fatigue) and dizziness. These
undesired side effects might be associated with its considerable
fluctuation of blood levels. Moreover, the drug must be
administered 3 or 4 times a day, which is a drawback.
[0009] Baclofen has also been shown to be effective for the
treatment of alcohol and cocaine addiction in several human
studies. However, its usage for these indications is very limited
due to its current daily regimen of 3-4 times a day administration.
This frequent dosing may result in very poor compliance among
alcohol and cocaine abusers.
[0010] Baclofen and other GABA.sub..beta. receptor agonists may
also be used as reflux inhibitors for the prevention and treatment
of gastrooesophageal reflux disease (GERD), also named "acid reflux
disease." However, the required frequent dosing and side effects of
baclofen pose a problem and limit its usage.
[0011] Attempts to provide reduced daily treatment with baclofen
have encountered two main hurdles: (1) baclofen has a short half
life; and (2) the absorption of baclofen into the blood stream is
mainly confined to the small intestines by a specialized transport
mechanism, whereas its absorption in the colon is negligible (see
"Evidence of a specialized transport mechanism for the intestinal
absorption of baclofen," Merino et al. Drug Dispos. 10-3: (1989)
279-97). Therefore, typical extended release formulations of
baclofen cannot provide a true long-acting baclofen. Once the
dosage form has passed the small intestines the drug is poorly
absorbed in the distal parts of the GI tract, regardless of its
controlled release in the colon.
[0012] Accordingly, there is an urgent need in the art to develop
formulations of baclofen with reduced daily dose regimen.
SUMMARY OF THE INVENTION
[0013] It is therefore an object of the invention to provide
solutions to the aforementioned deficiencies in the art, enabling
the administration of baclofen or R-baclofen with a reduced daily
regimen, Another object of this invention is to provide a drug
which may be administered fewer times a day, preferably once a day,
to a patient in need thereof.
[0014] Further to this object, the invention provides a degradable
multi-layered gastroretentive dosage form of baclofen or R-baclofen
with a prolonged retention in the stomach and the gastrointestinal
tract. In one aspect of the invention, the gastroretentive dosage
form provides for the controlled release of baclofen or R-baclofen
in the stomach and gastrointestinal tract of a patient. In a
preferred aspect of the invention, the gastroretentive dosage form
of baclofen or R-baclofen comprises a first dosage of baclofen or
R-baclofen for immediate release and a second dosage of baclofen or
R-baclofen for controlled release, and the gastroretentive dosage
form of baclofen or R-baclofen is compacted or folded into a
capsule which is easily swallowed and disintegrates rapidly upon
contact with gastric juice. Once the capsule disintegrates, the
gastroretentive dosage form of baclofen or R-baclofen unfolds
rapidly upon contact with the gastric juice. In an even more
preferred aspect of the invention, the gastroretentive dosage form
of baclofen or R-baclofen is compacted or folded into a capsule,
wherein said gastroretentive dosage form comprises an internal
layer comprising a first dosage of baclofen or R-baclofen for
controlled release; a rigid frame layer; and one or two outer
layers; and the capsule is coated with at least one layer
comprising a second dosage of baclofen or R-baclofen for immediate
release. In another preferred aspect of the invention, the
gastroretentive dosage form of baclofen or R-baclofen comprises an
internal layer comprising a first dosage of baclofen or R-baclofen
for controlled release and one or two outer layers, and is
compacted or folded into a capsule coated with at least one layer
comprising a second dosage of baclofen or R-baclofen for immediate
release. The capsule disintegrates rapidly upon contact with
gastric juice, and the gastroretentive dosage form unfolds rapidly
upon contact with the gastric juice. In another preferred
embodiment, the gastroretentive dosage form of baclofen or
R-baclofen comprises a rigid internal layer comprising a first
dosage of baclofen or R-baclofen for controlled release and two
outer layers, and is compacted or folded into a capsule coated with
at least one layer comprising a second dosage of baclofen for
immediate release.
[0015] In one embodiment, the gastroretentive dosage form comprises
a dose from about 20 to about 120 mg of baclofen, or R-baclofen
divided into a first dosage for immediate release between about 5
and about 30 mg of baclofen or R-baclofen, and a second dosage for
controlled-release between about 15 and about 90 mg of baclofen or
R-baclofen. In a preferred embodiment, the gastroretentive dosage
form comprises a baclofen or R-baclofen dose of 40 mg, divided into
a dose of 10 mg in the coating of the capsule for immediate
release, and a dose of 30 mg in the inner layer for
controlled-release of baclofen.
[0016] In one embodiment, the outer layers in the gastroretentive
dosage form of baclofen or R-baclofen are hydratable at a rate
greater than the frame layer, and comprise at least one polymeric
combination of a hydrophilic polymer and a polymer insoluble in
gastric media. In a preferred embodiment, the polymer insoluble in
gastric media comprises one or more types of polymethacrylate
USP.
[0017] In another preferred embodiment, the outer layers comprise
propylene glycol as a plasticizer. In yet another preferred
embodiment, the polymeric combination in the outer layers comprises
gelatin, and the amount of gelatin is between about 20% and about
45% of the total outer layer composition.
[0018] In an additional aspect of the invention, the polymer in the
frame layer of the gastroretentive dosage form of baclofen or
R-baclofen is an enteric polymer selected from the group consisting
of cellulose acetate phthalate, hypromelose phthalate,
hydroxypropyl methylcellulose acetate succinate, polyvinyl acetate
phthalate and methylmethacrylate-methacrylic acid copolymers. In an
even more preferred embodiment, the polymer in the frame layer is a
polymethacrylate copolymer.
[0019] In one embodiment, the frame layer has a mechanical strength
described with Young's modulus ranging from about 0.5 to about 15
Kgf/mm.sup.2 and a stress of about 0.03 to about 0.6 Kgf/mm.sup.2
after 1 hour in simulated gastric fluid.
[0020] In a further aspect of the invention, the composition of the
frame layer optionally further comprises a filler, a surface-active
agent, an additional plasticizer and other suitable materials.
[0021] In one embodiment, the inner layer in the gastroretentive
dosage form of baclofen or R-baclofen comprises baclofen and at
least one polymer or a combination of polymers. The baclofen or
R-baclofen may be substantially uniformly dispersed in the
polymer(s) or may form a solid solution therewith, such that the
baclofen or R-baclofen is released from the inner layer upon
contact of the gastroretentive dosage with the gastric medium. In
one embodiment, the polymer in the inner layer is a hydrogel or a
polymer composition permeable to water. In a preferred embodiment,
the hydrogel is chosen from the group consisting of carboxymethyl
cellulose, including sodium salt, alginic acid, including sodium
salt, hydroxypropyl cellulose, hydroxyethyl cellulose, hypromelose,
a gum, including guar gum, xanthan gum and others, a protein,
including albumin, casein, gelatin or collagen, and a cross-linked
polyacrylic acid. In another preferred embodiment, the polymer
composition that is permeable to water is chosen from the group
consisting of a single polymer selected from zein, suitably
plasticized ethyl cellulose, cellulose acetate, cellulose acetate
butyrate, polyvinyl acetate, an enteric polymer and combinations
thereof. In a further preferred embodiment, the polymer composition
permeable to water comprises a mixture of polymers comprising at
least one component soluble in water and at least one component
insoluble in water. In yet another preferred embodiment, the
mixture of polymers is selected from the group consisting of a
mixture of polyvinyl acetate and polyvinyl pyrrolidone, a mixture
of ethyl cellulose and polyethylene glycol and other similar
combinations. In another preferred embodiment, the polymer in the
internal layer is chosen from polyvinyl alcohols and polyethylene
oxides. In a further aspect of the invention, the polymer
composition further comprises buffering agents selected from
acidifying agents selected from citric acid, tartaric acid, sorbic
acid, fumaric acid, hydrochloric acid and sulfuric acid, and
alkalizing agents selected from divalent cations, hydroxides,
oxides, and their salts, wherein said divalent cations include, but
are not limited to, calcium, magnesium and zinc, and their salts
may be selected from carbonates, sulfates and stearates, or other
similar salts known to one of skill in the art.
[0022] In yet another embodiment, the inner layer composition
optionally further comprises a filler, a surface-active agent,
and/or other inactive agents.
[0023] In one aspect of the invention, the inner layer comprises
baclofen or R-baclofen in the form of a powder, granulated powder,
miniature tablets, coated powder, semisolid composition or any
other form known to those skilled in the art.
[0024] In one aspect of the invention, a coating comprising at
least one layer comprising baclofen is applied onto the capsule of
the gastroretentive dosage form. In one embodiment, the coating
comprises at least one polymer, which is preferably instantly
soluble in the gastric medium. In an additional embodiment,
baclofen or R-baclofen is uniformly dispersed or dissolved in the
coating. In a further embodiment, the coating further comprises a
plasticizer or a combination of plasticizers. In yet another
embodiment, the coating further optionally comprises at least one
anti-tacking agent.
[0025] In one aspect of the invention, the layers in the
gastroretentive dosage form of baclofen or R-baclofen are joined
together with ultrasonic welding.
[0026] In another aspect of the invention, the folded multi-layered
gastroretentive dosage form of baclofen or R-baclofen unfolds to a
length of at least 20 mm within 15 minutes of being exposed to
gastric fluid.
[0027] In a further aspect of the invention, the gastroretentive
drug formulation of baclofen or R-baclofen is fully degradable
within 3 hours in simulated intestinal fluid.
[0028] In a preferred embodiment, the gastroretentive dosage form
of baclofen or R-baclofen releases baclofen or R-baclofen upon
contact with gastric media and the release profile is substantially
insensitive to changes of the environment of release in pH ranges
selected from the group consisting of between about 1.2 and about
5.5, between about 1.2 and about 5.0 and between about 1.2 and
about 4.1. In another preferred embodiment, the multi-layered
gastroretentive dosage form releases baclofen or R-baclofen upon
contact with gastric media and the release profile is substantially
insensitive to changes of the environment of release in the
presence of ethyl alcohol in an amount selected from the group
consisting of from about 0% to about 30%, from about 0% and about
25% and from about 0% and equal or below 20% v/v.
[0029] In one embodiment, the controlled release gastroretentive
dosage form of baclofen or R-baclofen provides a gastric retention
period greater than 6 hours. In a preferred embodiment, the
controlled release gastroretentive dosage form of baclofen or
R-baclofen provides a gastric retention period of up to 24
hours.
[0030] In a further aspect, the invention provides a method for
administering baclofen or R-baclofen and maintaining a
therapeutically effective blood plasma concentration of baclofen or
R-baclofen over a period of up to 24 hours comprising orally
administering to a subject in need thereof a multilayered
gastroretentive dosage form of baclofen or R-baclofen. In one
aspect of the invention, the method provides a therapeutically
effective blood plasma level of baclofen or R-baclofen from about
half an hour to about 24 hours after administration.
[0031] In another aspect, the invention provides a method for
reducing sharp peaks in the blood plasma concentration of baclofen
or R-baclofen after administration of baclofen or R-baclofen to a
subject in need thereof over a period of up to 24 hours and can
improve therapeutic activity, which comprises orally administering
to a subject in need thereof a multilayered gastroretentive dosage
form of baclofen or R-baclofen.
[0032] In yet another embodiment, the invention provides a method
for reducing fluctuations in the blood plasma concentration of
baclofen or R-baclofen after administration of baclofen or
R-baclofen to a subject in need thereof over a period of up to 24
hours, potentially improving baclofen or R-baclofen therapeutic
activity and reducing baclofen or R-baclofen side-effects in
comparison to side effects produced by immediate release
administration of an equivalent dose of baclofen or R-baclofen,
comprising orally administering to the subject a baclofen or
R-baclofen biodegradable multilayered gastroretentive dosage
form.
[0033] In another aspect, the invention provides a method for
treating a disease selected from the group consisting of
spasticity, spastic diplegia, multiple sclerosis, amyotrophic
lateral sclerosis and trigeminal and glossopharyngeal neuralgias in
a subject in need thereof, comprising orally administering one or
more baclofen or R-baclofen gastroretentive dosage forms per
day.
[0034] In a different aspect, the invention provides a kit
comprising a number of gastroretentive dosage forms of baclofen or
R-baclofen and instructions and precautions for their use.
[0035] In one aspect, the invention provides a method for treating
a disease treatable with baclofen or R-baclofen in a subject in
need thereof, comprising orally administering to the subject one or
more baclofen or R-baclofen gastroretentive dosage forms per
day.
[0036] In another aspect, the invention provides a method for
treating an alcohol or abuse drug addiction in a subject in need
thereof, comprising orally administering to the subject one or more
baclofen or R-baclofen gastroretentive dosage forms.
[0037] In yet another aspect, the invention provides a method for
treating gastroesophageal reflux disease in a subject in need
thereof, comprising orally administering to the subject one or more
baclofen or R-baclofen gastroretentive dosage forms.
[0038] In a further aspect, the invention provides a method for
treating a disease selected from the group consisting of
spasticity, spastic diplegia, alcoholism, alcohol addiction,
dependence or alcohol abuse, gastro-esophageal reflux disease
(GERD), emesis, cough, narcotic addiction or abuse, nicotine
addiction or abuse, neuropathic pain and musculoskeletal pain,
nocturnal acid breakthrough, chronic hiccups, dyspepsia, gastric
motility disorder, migraine, PTSD (Post-traumatic Stress Disorder),
depression, anxiety, lower urinary tract dysfunction, multiple
sclerosis, amyotrophic lateral sclerosis and trigeminal and
glossopharyngeal neuralgias.in a subject in need thereof,
comprising orally administering to the subject one or more baclofen
or R-baclofen gastroretentive dosage forms.
[0039] The foregoing general description and following brief
description of the drawings and the detailed description are
exemplary and explanatory and are intended to provide further
explanation of the invention as claimed. Other objects, advantages,
and novel features will be readily apparent to those skilled in the
art from the following detailed description of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[0040] FIG. 1 shows a schematic drawing of the film components of a
Baclofen or R-baclofen GRDF and their approximate dimensions.
[0041] FIG. 2 shows the dissolution profile of a 40 mg baclofen
GRDF-A
[0042] FIG. 3 provides the dissolution profile of a 40 mg baclofen
GRDF-B.
[0043] FIG. 4 depicts the mean plasma concentrations of baclofen
for single dose 40 mg Baclofen GRDF A, single dose 40 mg Baclofen
GRDF B and single dose 40 mg (4.times.10 mg) Lioresal.RTM. as
described in Example 5.
[0044] FIG. 5 provides the dissolution profile of 40 mg Baclofen
GRDF-C, a combination of 10 mg immediate release and 30 mg
controlled release.
[0045] FIG. 6 provides the pharmaco-kinetics of baclofen GRDF
formulation of 40 mg baclofen (10IR/30CR) vs. 10 mg Lioresal in two
food protocols
DETAILED DESCRIPTION OF THE INVENTION
[0046] Because of the undesirable side effects and the inconvenient
mode of administration of the baclofen commercial product (3-4
times a day), there is a great need for an effective controlled
release formulation of baclofen or R-baclofen that can provide
steady therapeutic levels. The baclofen or R-baclofen
gastroretentive dosage forms of this invention are designed to
release baclofen or R-baclofen by a combination of immediate and
controlled release mechanisms to provide quick onset and steady
therapeutic level of baclofen or R-baclofen over time. Accordingly,
the invention provides for the first time successful
gastroretentive formulations of baclofen or R-baclofen that can be
taken under a regular calorie diet.
[0047] Due to the design flexibility afforded by the complex
structure of the gastroretentive dosage forms (GRDFs) of this
invention, the GRDFs can conveniently release baclofen or
R-baclofen in a sustained profile or in a combined immediate and
sustained profile over a prolonged period, while maintaining
relevant drug plasma levels for extended time intervals.
DEFINITIONS
[0048] As used herein, "Gastroretentive dosage form(s)" (GRDF or
GRDFs in the plural) refers to dosage forms with delayed gastric
emptying or longer retention in the stomach as compared to food.
The GRDFs of this invention are also named "Accordion Pills" or
"AP". "Gastroretentive" or "gastric-retentive" dosage forms denote
dosage forms comprising multilayer structures including an inner
layer, a rigid frame layer and one or two outer layers, or
comprising an inner layer, a rigid frame layer, one or two outer
layers and one or two supra-outer layers, or comprising the
foregoing structures folded or compacted into a capsule. The
capsule disintegrates rapidly upon contact with gastric fluid and
the structures unfold rapidly upon contact with gastric juice and
reside in the stomach of a mammal, preferably a human, for
prolonged periods of time, preferably longer than food and small
indigestible particles of size below 10 mm in either dimension.
"Gastric retention" is therefore the maintenance or withholding of
a drug in stomach, for a time period longer than the time it would
have been retained in the stomach when delivered in a free form or
within a gastro-intestinal (GI) delivery vehicle which is not
considered gastroretentive. Gastroretentivity may be characterized
by retention in the stomach for a period that is longer than the
normal emptying time from the stomach, i.e. longer than about 2
hours, particularly longer than about 3 hours and usually more than
about 4, 6, 8 or 10 hours. Gastroretentivity typically means
retention in the stomach from about 3, 4, 6, 8, 10, 15, 18 hours
and up to about 24 hours.
[0049] In the context of this invention, "baclofen" means racemic
baclofen, and the isolated optical isomers of baclofen are
designated "R-baclofen" and "S-baclofen". R-baclofen is
(R)-4-amino-3-(4-chlorophenyl)butanoic acid, in the free base or
salt form. One of the possible salts is the hydrochloride salt.
[0050] R-baclofen in the context of this invention means R-baclofen
of substantial optical purity, from 80% to 99.99% optical purity.
"Controlled-release drug delivery system" or "CR" as used herein
denotes a dosage form of baclofen, or R-baclofen which releases
baclofen or R-baclofen in a controlled manner over designable time
intervals at needed quantities to produce a prolonged, sustained or
delayed pharmacological effect that is otherwise unattainable
through conventional non-modified-release dosage forms.
[0051] "Immediate-release drug delivery system" or "instant
release" or "IR" as used herein denotes a dosage form of baclofen
or R-baclofen which releases most of the baclofen or R-baclofen in
a quick or instantaneous way, such as during the first half hour or
hour after administration.
[0052] "Simulated gastric fluid" (SGF) and "Simulated intestinal
fluid" (SIF) as used herein refers to "Gastric fluid, Simulated,
TS" and "Intestinal fluid, Simulated, TS" solutions as defined by
the United States Pharmacopeia 30 National Formulary, without
enzymes.
[0053] "Gastric medium" and "Intestinal medium" as used herein
denote a biological medium of the stomach and intestines,
respectively, or an artificial medium, used to mimic the
environment of the stomach or intestines.
[0054] The term "biodegradable" as used herein is intended as
capable of being chemically and/or physically reduced or broken
down in the body of a patient and within a relevant time
period.
[0055] The phrase "polymer which is not instantly soluble in
gastric fluid" as used herein refers to a polymer that will
gradually dissolve in the GI tract during its residence
therein.
[0056] The terms "inert" or "inactive" or "inactive ingredient" as
used herein refer to components in the internal layer or
compartment, outer membranes, optional layers and/or the immediate
release layers that do not react with the active ingredient or
affect its properties, or cause any biological effect upon
administration to a subject.
[0057] The phrase "prolonged period" as used herein intends a
period of delivery of at least 80% of the dose that lasts for
several hours to about 24 hours.
[0058] The terms "swellable" and "swelling" mean, with respect to a
polymer, that the polymer is capable of imbibing fluid and
expanding when in contact with fluid present in the environment of
use.
[0059] A "patient" or "subject" as referenced herein is an animal
who may receive the gastroretentive drug formulations of the
present invention. In a preferred aspect of the invention, the
"patient" or "subject" is a human or non-human mammal.
[0060] "Treating" or "treatment," and the like are used herein to
refer to obtaining a desired pharmacological and physiological
effect. The effect may be prophylactic for preventing or partially
preventing a disease, symptom or pathological condition and/or may
be therapeutic for a partial or complete cure of a disease,
condition, symptom or adverse effect attributed to a pathological
condition. Thus, "treatment" covers any treatment of a disease in a
mammal, particularly a human, and includes: (a) preventing a
pathological condition from occurring in an individual which may be
predisposed to develop a pathological condition but has not yet
been diagnosed as having it, i.e., causing the clinical symptoms of
a pathological condition not to develop in a subject that may be
predisposed to develop the condition but does not yet experience or
display symptoms of the condition; (b) inhibiting, i.e., arresting
or reducing the development of the pathological condition or its
clinical symptoms; or (c) relieving symptoms associating with the
pathological condition.
[0061] "Drug," "active pharmaceutical ingredient," "API," "active
agent," "active ingredient," "active," and the like, are used in
connection with the present invention as pure chemical substances,
mixtures of pure chemical substances or crude extracts from various
sources, which are used to treat pathological conditions of a
person in need or such treatment. "Inactive ingredient,"
"excipient," "material," "component," "ingredient," "inactive
material," "inactive," "agent," and the like as used
interchangeably herein, refer to materials or ingredients that are
not drugs, but are employed in pharmaceutical compounding in
connection with the present invention with intention to impart the
final dosage form specific characteristics, as known to the skilled
in the art.
[0062] "Film" or "layer" or membrane" is used interchangeably in
connection with the components of the multi-layered GRDF of this
invention and their formulation and preparation is described
herein.
[0063] As used in the specification and claims, the forms "a," "an"
and "the" include singular as well as plural references unless the
context clearly dictates otherwise.
[0064] Further, as used herein, the term "comprising" is intended
to mean that the system includes the recited elements, but not
excluding others which may be optional in the design of the system,
such as fillers and the like. The term "consisting essentially of"
is used to define a system that includes the recited elements but
exclude other elements that may have an essential significant
effect on the performance of the system. "Consisting of" shall thus
mean excluding more than traces of other elements. Embodiments
defined by each of these transition terms are within the scope of
this invention.
[0065] Pro-drugs of R-baclofen have been suggested as possible
treatment for a disease selected from spasticity, gastro-esophageal
reflux disease, emesis, cough, narcotic addiction or abuse, alcohol
addiction or abuse, nicotine addiction or abuse, neuropathic pain
and musculoskeletal pain (US Patent Application 2009/0197958).
[0066] Various drug delivery forms of R-baclofen or enriched
R-baclofen have been suggested for use in treating gastroparesis
and nonulcer dyspepsia (US Patent Application No.
2009/0246233).
[0067] The baclofen or R-baclofen GRDFs of this invention are
provided in the form ocapsule containing a multi-layer planar
structure composed of films, folded in a wavy way ("Accordion Pill"
or AP), which unfolds rapidly upon contact with gastric juice and
releases baclofen or R-baclofen in the stomach for prolonged time
periods. The "Accordion Pill" technology has been described in
detail in previous publications, for example U.S. Pat. No.
6,685,962, PCT application WP 2007/093999 and PCT application
WO07083309, which are incorporated herein by reference in their
entirety.
[0068] The "Accordion Pill" technology, however, cannot uniformly
be applied to any drug. Each "Accordion Pill" is a product in
itself, because different actives require different solutions, due
to the different physicochemical properties of the active, the
pharmacokinetic requirements, bioavailability, dosages, etc.
[0069] Pharmacokinetic requirements specific to each active require
different, innovative solutions that fit the specific product.
These solutions vary according to case and they may involve
different dosages, drug delivery by more than one mechanism (like
immediate release and delayed release), with or without supra-outer
layers, with or without coating, with or without orifices in
various numbers, positions and sizes, different layer compositions,
layer thicknesses and sizes and combinations of the above. The
possible combinations are endless and success cannot be accurately
predicted.
[0070] It was an aim of this invention to develop baclofen or
R-baclofen GRDFs that would have a rapid onset of action and an
extended period of relevant baclofen or R-baclofen blood levels.
The inventors of the present application overcome baclofen or
R-baclofen formulations problems by devising GRDF formulations that
combine the special physicochemical properties of baclofen or
R-baclofen with extended gastric retention, to obtain a baclofen or
R-baclofen GRDF that is slowly releasing the active in controlled
manner and result in more stable plasma levels for prolonged time,
which may result in improved therapeutic activity with reduced
frequent daily dosing and reduced undesirable side effects.
[0071] The present invention provides a baclofen or R-baclofen
gastroretentive dosage form that exhibit prolonged retention in the
stomach and gastrointestinal tract and are suitable for the
treatment of a number of diseases and disorders.
Treatment of Ethanol and Drug Addiction
[0072] In some embodiments, the baclofen or R-baclofen GRDFs of
this invention have the following advantages over the commercial
products containing baclofen:
[0073] 1. The controlled release profile of the present invention
is substantially insensitive to ethyl alcohol presence in the
dissolution medium with concentrations increasing from 0% v/v up to
20-30%.
[0074] 2. The pharmacokinetic (PK) profile of the system of the
present invention is superior to the pharmacokinetic (PK) profile
of the marketed baclofen products, affords reduced dosing frequency
and improves compliance to the treatment.
Spasticity
[0075] Spasticity or muscular hypertonicity is a disorder of the
central nervous system (CNS) in which certain muscles continually
receive a stimulation to tighten and contract. Spasticity is most
common in spastic diplegia and other forms of spastic cerebral
palsy. It is also present in multiple sclerosis and in most
neuromuscular diseases, both progressive and not. The GRDF of this
invention enables longer baclofen or R-baclofen absorption through
retention in stomach and gastrointestinal tract and, as a result,
enables administration of the drug once or twice daily instead of
3-4 times daily, reducing baclofen or R-baclofen blood level
fluctuations and potentially reducing the side-effects encountered
with the current commercial baclofen products.
Gastrooesophageal Reflux Disease (GERD)
[0076] GERD is being treated mainly by proton pump inhibitors (PPI)
and gastric histamine (H.sub.2) receptor blocker.
[0077] The baclofen or R-baclofen GRDFs of this invention can
provide products for GERD treatment.
Other Diseases
[0078] The baclofen or R-baclofen GRDFs of the invention provide
treatment of additional diseases, including but not limited to
nocturnal acid breakthrough, chronic hiccups, emesis, dyspepsia,
gastric motility disorder, migraine, PTSD (Posttraumatic Stress
Disorder), depression, anxiety, lower urinary tract dysfunction and
neuropathic pain, with high efficiency and potentially reduced
undesirable side effects.
The Development of Baclofen or R-Baclofen GRDFs
[0079] The aim of the present invention was to develop a baclofen
or R-baclofen GRDF that would have a rapid onset of action and an
extended period of relevant baclofen or R-baclofen blood plasma
levels, and exhibit no or short lag-time and a sustained-release
effect over a longer period of time than the commercial baclofen
product on the market (Lioresal.RTM.).
[0080] The first attempt to produce a baclofen GRDF used an outer
layer-inner layer-outer layer GRDF configuration, without a frame
layer (Baclofen GRDF-A) and a total baclofen dosage of 40 mg, all
of which was in the internal layer. The inner layer possessed
substantially rigid properties that are usually found in the frame
layer. FIG. 1 depicts a general GRDF configuration that includes
the frame layer and Example 1 details the compositions of the
formulations of the inner and outer layers. FIG. 2 shows the
dissolution profile of the baclofen GRDF A configuration at very
acidic pH (1.2) and moderately acid pH (4.1). As shown in FIG. 2,
the extended release was seen for 4 hours at pH 1.2 and for more
than 16 for pH 4.1.
[0081] A further attempt used an outer-frame inner outer layers
GRDF configuration (Baclofen GRDF-B), at a total baclofen dosage of
40 mg. Example 3 shows the compositions of the layers. FIG. 3 shows
the dissolution profile of the Baclofen GRDF B configuration at
very acidic pH (1.2) and moderately acidic pH (4.1). As shown in
FIG. 3, the extended release was seen for 5 hours at pH 1.2 and for
12 hours at pH 4.1 (see also Example 4).
[0082] In order to evaluate the advantages and disadvantages of the
baclofen GRDFs, a single-dose, three-way crossover study comparing
the pharmacokinetics of gastric retentive controlled release
baclofen (Accordion Pill Baclofen or AP-BC) versus Lioresal.RTM.
was carried on in 12 healthy volunteers (see Example 5). The
primary objective was to evaluate of pharmacokinetic parameters
(Cmax, Tmax and AUC) from plasma concentrations of following oral
administration of the test formulations and reference. Study design
was a single center, single-dose, open label, three-way crossover,
comparative pharmacokinetic study in healthy volunteers.
Test Formulation:
[0083] GRDF-BC 40 mg A--Example 1 [0084] GRDF-BC 40 mg B--Example 3
[0085] Reference Formulation Lioresal.RTM. Novartis Pharma S.p.A 40
mg (4.times.10 mg baclofen) immediate release.
[0086] All oral formulations were swallowed whole with 240 ml water
after a medium calorie breakfast. Standardized meals were given to
all subjects throughout the study days.
[0087] Venous blood samples was drawn before dosing and then at
frequent intervals to match the pharmacokinetic behavior of the
drug. Baclofen plasma levels were analyzed. The results of the
study, shown in Example 5 and in FIG. 4, indicated that:
[0088] 1. Both GRDF formulations increased the absorption phase for
5 hours in comparison to 2 hours in the instant release (IR)
formulation Lioresal.RTM.;
[0089] 2. Both GRDF formulations decreased the Cmax and maintained
the AUC constant in comparison to the IR formulation.
[0090] 3. The results were achieved under a regular calorie
diet.
[0091] 4. Both GRDF formulations presented a lag time of about 1.5
hours in their PK profiles.
[0092] An additional clinical study was carried out in order to
evaluate the pharmacokinetic profiles of a gastric retentive IR/CR
GRDF (Accordion Pill-Baclofen or AP-BC) vs. IR baclofen (Lioresal)
in healthy volunteers. This study was meant to compare the
pharmacokinetic profiles of 40 mg Baclofen, following oral
administration of a single-dose of an IR/CR gastric retentive
formulation with those obtained following oral ingestion of a
single-dose of the reference formulation, Baclofen IR 10 mg
(Lioresal), using different diets and, in addition, to monitor the
subjects for adverse events during the study period and to compare
the safety of the test formulation with the reference
formulation.
[0093] This study proved that the absorption phase of Baclofen was
prolonged, by using the Accordion Pill, to 11 hours in comparison
to the 2.5 hours provided by the marketed Lioresal.RTM..
[0094] One administration of an Accordion Pill-Baclofen (40 mg)
provided drug plasma levels of 50-175 ng/ml for 16.5 hours. These
plasma levels are currently provided by TID administration of 10 mg
Lioresal.RTM.. In one embodiment, there are provided biodegradable,
multi-layered controlled release gastroretentive dosage form of
this invention, wherein the active is baclofen or R-baclofen and
wherein the gastroretentive dosage form provides a R-baclofen
gastric retention period between 8 and 14 hours.
[0095] In another embodiment, there are provided biodegradable,
multi-layered controlled release gastroretentive dosage form of
this invention, wherein the active is baclofen or R-baclofen and
wherein one administration of a 40 mg GRDF provides baclofen plasma
levels of 50-175 ng/ml for 12-20 hours.
[0096] In yet another embodiment, there is provided a method for
treating a disease selected from the group consisting of
gastro-esophageal reflux disease (GERD), cough, narcotic addiction
or abuse, nicotine addiction or abuse, musculoskeletal pain,
migraine, PTSD (Post-traumatic Stress Disorder), depression,
anxiety, lower urinary tract dysfunction in a subject in need
thereof, comprising orally administering to the subject one or more
baclofen or R-baclofen gastroretentive dosage forms.
[0097] The Baclofen or R-Baclofen GRDF Formulations of the
Invention
[0098] The present inventors devised a combination of a first
baclofen or R-baclofen dosage in the inner GRDF layer with a second
baclofen or R-baclofen dosage applied as a coating on the GRDF's
capsule, which resulted in baclofen or R-baclofen GRDFs with
attractive in-vitro release profile, as shown in Examples 6 and 7
and FIG. 5. Specific layer formulations, GRDF configurations, layer
thicknesses, dosages, and other design and formulation particulars
lead to the best results, as detailed herein.
[0099] As shown in FIG. 5, the immediate release occurred within 10
minutes and the extended release was seen for 16 hours for both pH
1.2 and 4.1.
[0100] In a preferred embodiment, the baclofen or R-baclofen
gastroretentive dosage forms of this invention comprise two outer
layers, a frame layer and an inner layer comprising baclofen or
R-baclofen and additional ingredients for the controlled-delivery
of baclofen or R-baclofen. This structure is compacted or folded
into a capsule and unfolds rapidly upon contact with gastric juice.
A schematic of this GRDF is detailed in FIG. 1.
[0101] In another preferred embodiment, the baclofen or R-baclofen
GRDFs of this invention comprise in addition to the above an
external coating of the capsule, comprising a second dose of
baclofen or R-baclofen and additional ingredients, for the
immediate release of baclofen or R-baclofen.
[0102] In one embodiment, there is provided a degradable
multi-layered baclofen or R-baclofen gastroretentive dosage form
for the controlled release of baclofen or R-baclofen in the stomach
and gastrointestinal tract of a patient comprising a first dosage
of baclofen or R-baclofen for immediate release and a second dosage
of baclofen for controlled release, and compacted or folded into a
capsule which disintegrates rapidly upon contact with gastric
juice, such that the gastroretentive dosage form unfolds rapidly
upon contact with gastric juice.
[0103] In another embodiment, the above gastroretentive baclofen
dosage form is designed for oral administration and compacted or
folded into a standard size capsule, which is easily swallowed.
[0104] In a preferred embodiment, there is provided a degradable
multi-layered baclofen or R-baclofen gastroretentive dosage forms
comprising
[0105] a. a first dosage of baclofen or R-baclofen for controlled
release in an internal layer;
[0106] b. a rigid frame layer; and
[0107] c. one or two outer layers;
[0108] wherein the gastroretentive dosage form is compacted or
folded into a capsule which is coated with at least one layer
comprising a second dosage of baclofen or R-baclofen for immediate
release, the capsule disintegrates and the gastroretentive dosage
form unfolds rapidly upon contact with gastric juice.
[0109] In another preferred embodiment, there is provided a
degradable, multi-layered baclofen or R-baclofen gastroretentive
dosage form comprising
[0110] a. a first dosage of baclofen or R-baclofen for controlled
release in a rigid internal layer; and
[0111] b. one or two outer layers;
[0112] wherein the gastroretentive dosage form is compacted or
folded into a capsule which is coated with at least one layer
comprising a second dosage of baclofen or R-baclofen for immediate
release, the capsule disintegrates and the gastroretentive dosage
form unfolds rapidly upon contact with gastric juice.
[0113] In other embodiments, the gastroretentive dosage form is
compacted or folded into a capsule and the second dosage for
immediate release is formed by filling into the capsule a portion
or a whole dose of baclofen or R-baclofen in form of a powder, a
granulated powder, a coated multi-particulate dosage form, a
mini-tablet, or a combination of one or more thereof, wherein the
capsule is optionally coated with at least one layer comprising an
additional dosage of baclofen or R-baclofen for immediate
release.
[0114] In further embodiments, the gastroretentive dosage form is
compacted or folded into a capsule and the second dosage for
immediate release is formed by incorporating a portion or a whole
dose of baclofen or R-baclofen into the capsule shell in form of a
powder, a granulated powder, a coated multi-particulate dosage
form, or a combination of one or more thereof during the
manufacturing process. The capsule may be optionally coated with a
pharmaceutical coating.
[0115] Preferably, the biodegradable multi-layered baclofen
gastroretentive dosage forms comprises a total baclofen dose
between about 20 and about 120 mg, divided into a first dosage for
immediate release between 5-30 mg of baclofen and a second dosage
for controlled-release between 15-90 mg of baclofen.
[0116] Replacing racemic baclofen with R-baclofen in the above
GRDFs may allow reducing the dosage as compared to the racemic
baclofen GRDFs, possibly halving the dosage. As we envisage that
S-baclofen is not only inactive but also possibly having a negative
effect, a further dosage decrease may be possible, between one half
and one quarter of the racemic baclofen dosage.
[0117] The biodegradable multi-layered R-baclofen gastroretentive
dosage forms may comprise a total R-baclofen dose between about 10
and about 60 mg, divided into a first dosage for immediate release
between 2.5-15 mg of R-baclofen and a second dosage for
controlled-release between 7.5-45 mg of R-baclofen.
[0118] Alternatively, the biodegradable multi-layered R-baclofen
gastroretentive dosage forms may comprise a total R-baclofen dose
between about 5 and about 30 mg, divided into a first dosage for
immediate release between 1.25-7.5 mg of R-baclofen and a second
dosage for controlled-release between 3.75-22.5 mg of
R-baclofen.
[0119] In a preferred embodiment, the biodegradable multi-layered
baclofen or R-baclofen gastroretentive dosage form has two outer
layers.
[0120] In a preferred embodiment, the biodegradable multi-layered
baclofen or R-baclofen gastroretentive dosage form comprises two
outer layers, a frame and an inner layer containing baclofen or
R-baclofen for controlled release, and is folded into a capsule
coated with a coating comprising baclofen or R-baclofen for
immediate release.
[0121] In another preferred embodiment, the biodegradable
multi-layered baclofen or R-baclofen gastroretentive dosage form
comprises two outer layers and a rigid inner layer containing
baclofen or R-baclofen for controlled release, and is folded into a
capsule coated with a coating comprising baclofen or R-baclofen for
immediate release.
[0122] In another embodiment, the biodegradable multi-layered
baclofen gastroretentive dosage form comprises a total baclofen
dose of 40 mg divided into an immediate release coating of the
capsule containing 10 mg of baclofen and a controlled-release inner
layer containing 30 mg of baclofen.
[0123] In yet another embodiment, the biodegradable multi-layered
R-baclofen gastroretentive dosage form comprises a total R-baclofen
dose of 20 mg divided into an immediate release coating of the
capsule containing 5 mg of R-baclofen and a controlled-release
inner layer containing 15 mg of R-baclofen. Alternatively, the
biodegradable multi-layered R-baclofen gastroretentive dosage form
comprises a total R-baclofen dose of 10 mg divided into an
immediate release coating of the capsule containing 2.5 mg of
R-baclofen and a controlled-release inner layer containing 7.5 mg
of R-baclofen.
[0124] In one embodiment, the biodegradable gastroretentive dosage
form of the invention provides a baclofen or R-baclofen gastric
retention period greater than 6 hours.
[0125] In another embodiment, the biodegradable gastroretentive
dosage form provides a baclofen or R-baclofen gastric retention
period of up to 24 hours.
[0126] In one embodiment, there is provided a method for providing
a therapeutic blood plasma concentration of baclofen or R-baclofen
over a period of up to 24 hours, potentially resulting in improved
therapeutic activity, which comprises orally administering to a
subject in need thereof a baclofen or R-baclofen multilayered
gastroretentive dosage form, which maintains a therapeutically
effective blood plasma level of baclofen or R-baclofen from about
0.5 hours to about 24 hours.
[0127] In another embodiment, there is provided a method for
reducing sharp peaks in the blood plasma concentration of baclofen
or R-baclofen after administration of baclofen or R-baclofen to a
subject in need thereof over a period of up to 24 hours with
potentially improved therapeutic activity, which comprises orally
administering to the subject a baclofen or R-baclofen multilayered
gastroretentive dosage form.
[0128] In yet another embodiment, there is provided a method for
reducing fluctuations in the blood plasma concentration of baclofen
or R-baclofen after administration of baclofen or R-baclofen to a
subject in need thereof over a period of up to 24 hours with
potentially improved therapeutic activity and reduced undesirable
side-effects compared to an equivalent dose of an immediate release
formulation, which comprises administering orally to the subject a
baclofen or R-baclofen multilayered gastroretentive dosage
form.
[0129] In one embodiment, there is provided a method of treatment
of a disease in a subject in need thereof, comprising orally
administering one or more baclofen or R-baclofen gastroretentive
dosage forms of the invention per day.
[0130] In another embodiment, there is provided a kit comprising a
number of baclofen or R-baclofen gastroretentive dosage forms of
this invention and instructions and precautions for their use.
[0131] The outer layers comprise at least one polymeric combination
of a hydrophilic polymer and a polymer insoluble in gastric media,
and said layers are hydratable at a rate greater than the frame
layer.
[0132] In one embodiment, a polymer insoluble in gastric acid media
in the outer layer is selected from the group consisting of one or
more types of polymethacrylate USP.
[0133] The outer layers may further comprise propylene glycol as a
plasticizer.
[0134] The polymeric combination in the outer layers may comprise
gelatin. The amount of gelatin in the outer layer is between about
20% and about 45% of the total outer layer composition.
[0135] The frame layer may comprise an enteric polymer selected
from the group consisting of cellulose acetate phthalate,
hypromelose phthalate, hydroxypropyl methylcellulose acetate
succinate, polyvinyl acetate phthalate and
methylmethacrylate-methacrylic acid copolymers. In further
preferred embodiments, the frame layer may comprise a suitable
plasticizer.
[0136] The rigid inner layer may comprise an enteric polymer
selected from the group consisting of cellulose acetate phthalate,
hypromelose phthalate, hydroxypropyl methylcellulose acetate
succinate, polyvinyl acetate phthalate and
methylmethacrylate-methacrylic acid copolymers.
[0137] The polymer in the frame layer may be a polymethacrylate
copolymer USP.
[0138] In one embodiment, the frame layer or the rigid inner layer
in the gastroretentive dosage form have a mechanical strength
described with Young's modulus ranging from about 0.5 to 15
Kgf/mm.sup.2 and stress of about 0.03 to about 0.6 Kgf/mm.sup.2
after 1 hour in simulated gastric fluid.
[0139] In another embodiment, the composition of the frame layer
optionally further comprises a filler, a surface-active agent, an
additional plasticizer and other materials suitable for such
composition.
[0140] In one embodiment, the inner layer comprises baclofen or
R-baclofen and at least one polymer, whereas baclofen or R-baclofen
is substantially uniformly dispersed in the polymer or forms a
solid solution therewith and wherefrom baclofen or R-baclofen is
released upon subjecting the gastroretentive dosage form into a
gastric medium. The at least one polymer is chosen from hydrogels
and polymer compositions, permeable to water. The film or layer may
optionally further comprise a plasticizer.
[0141] The hydrogels are chosen from carboxymethyl cellulose,
including sodium salt, alginic acid, including sodium salt,
hydroxypropyl cellulose, hydroxyethyl cellulose, hypromelose, a
gum, i.e. guar gum, xanthan gum and others, a protein, i.e.
albumin, casein, gelatin or collagen, or a cross-linked polyacrylic
acid.
[0142] The polymer compositions permeable to water are chosen from
a polymer such as zein, suitably plasticized ethyl cellulose,
cellulose acetate, cellulose acetate butyrate, polyvinyl acetate,
an enteric polymer and combinations thereof.
[0143] Alternatively, the polymer compositions permeable to water
comprise a mixture of polymers, wherein at least one component is
soluble in water and at least one component is insoluble in water,
such as a mixture of polyvinyl acetate and polyvinyl pyrrolidone, a
mixture of ethyl cellulose and polyethylene glycol and similar
combinations.
[0144] In another embodiment, the polymer is chosen from polyvinyl
alcohols and polyethylene oxides.
[0145] The polymers composition may further comprise buffering
agents selected from acidifying agents selected from citric acid,
tartaric acid, sorbic acid, fumaric acid, hydrochloric acid and
sulfuric acid, or alkalizing agents selected from divalent cations
selected from but not limited to calcium, magnesium, zinc and
others, hydroxides, oxides, and their salts selected from but not
limited to carbonates, sulfates and stearates.
[0146] The inner layer composition optionally may further comprise
a filler, a surface-active agent and/or other inactive
ingredients.
[0147] In a preferred embodiment, baclofen or R-baclofen is
released from the gastroretentive dosage forms of the invention
upon contact with gastric media and the release profile is
substantially insensitive to changes of the environment of release
in pH ranges between 1.2 and 5.5, or more preferably between 1.2
and 5.0 or even more preferably between 1.2 and 4.1.
[0148] In another embodiment, baclofen or R-baclofen is released
from the gastroretentive dosage forms of this invention upon
contact with gastric media and the release profile is substantially
insensitive to changes of the environment of release in the
presence of ethyl alcohol from 0% to about 30% or between 0% and
25% or between 0% and equal or below 20% v/v.
[0149] The inner layer of the gastroretentive dosage forms of the
invention comprises baclofen, whereas baclofen or R-baclofen is
present in form of a powder, granulated powder, miniature tablets,
coated powder, semisolid composition or any other form known to
those skilled in the art.
[0150] In some embodiments, the coating comprising baclofen or
R-baclofen is applied onto the capsule of the gastroretentive
dosage forms of this invention, and the coating comprises at least
one layer.
[0151] The coating comprises at least one polymer, whereof the at
least one polymer is instantly soluble in gastric medium.
[0152] In one embodiment, baclofen or R-baclofen is uniformly
dispersed or dissolved in the coating.
[0153] The coating may further optionally comprise a plasticizer or
a combination of plasticizers.
[0154] The coating may further optionally comprise at least one
anti-tacking agent.
[0155] In one embodiment, there is provided a method for joining
together the layers of the gastroretentive dosage forms of this
invention with ultrasonic welding. In other embodiments, the
layered are joined together with a solvent, with a suitable
adhesive composition or due to sufficient tackiness of one or more
of the said layers.
[0156] In another embodiment, the folded multilayered
gastroretentive dosage form unfolds to a length of at least 20 mm
within 15 minutes of being exposed to gastric fluid.
[0157] In yet another embodiment, the gastroretentive drug
formulation of this invention is fully degradable within 3 hours in
simulated intestinal fluid.
[0158] In one embodiment, there is provided a method of treatment
of a disease in a subject in need thereof, comprising administering
to the subject one or more gastroretentive dosage forms of this
invention per day.
[0159] In another embodiment, there is provided a method of
treatment of a disease in a subject in need thereof suffering from
a disease treatable with baclofen or R-baclofen, which comprises
administering orally to the subject a baclofen or R-baclofen
multilayered gastroretentive dosage form of this invention with
improved therapeutic activity.
[0160] In one embodiment, there is provided a method of treatment
of a spasticity disease selected from spasticity, spastic diplegia,
multiple sclerosis, amyotrophic lateral sclerosis and trigeminal
and glossopharyngeal neuralgia in a subject in need thereof, which
comprises administering orally to the subject a baclofen or
R-baclofen multilayered gastroretentive dosage form of this
invention.
[0161] In another embodiment, there is provided a method of
treatment of alcohol or abuse drug addiction in a subject in need
thereof, which comprises administering orally to the subject a
baclofen or R-baclofen multilayered gastroretentive dosage form of
this invention.
[0162] In yet another embodiment, there is provided a method of
treatment of gastrooesophageal reflux disease in a subject in need
thereof, which comprises administering orally to the subject a
baclofen or R-baclofen multilayered gastroretentive dosage form of
this invention.
[0163] In a further embodiment, there is provided a method of
treatment of a disease selected from nocturnal acid breakthrough,
chronic hiccups, emesis, dyspepsia, gastric motility disorder
migraine, PTSD (Posttraumatic Stress Disorder), depression,
anxiety, lower urinary tract dysfunction or neuropathic pain in a
subject in need thereof, which comprises administering orally to
the subject a baclofen or R-baclofen multilayered gastroretentive
dosage form of this invention.
[0164] All films, layers and membranes of this invention were made
by methods that are well known to those of skill in the art.
[0165] In a preferred embodiment, the films of this invention are
prepared by the film casting technique. A solution or suspension of
the film composition is cast on trays and dried in an oven until
the solvent evaporates. The dried film in then cut according to the
needed shape.
[0166] In the preferred current embodiments, the gastroretentive
dosage form of this invention includes a frame layer, an internal
layer and two outer layers. The outer layers are two films which
are slightly larger than the frame layer and which are sealed or
welded together around their perimeter and completely envelope the
frame and the internal layer. Along with welding which connects the
outer layers together, the outer portion of the frame layer is also
welded to the outer layers. The compositions, ingredients and
structure of the various layers forming the GRDF are detailed in
the following illustrative examples of the formulations.
[0167] In some embodiments, the rigid frame layer of the GRDF (also
referred to as "frame" or "backbone") provides mechanical strength
to the GRDF.
[0168] The gastroretentive dosage form may comprise a baclofen or
R-baclofen--comprising coating applied onto the capsule of the
gastroretentive dosage form, and said coating comprises at least
one layer.
[0169] Some of the GRDF of this invention may have in addition to
the inner layer, frame layer and outer layer or layers, one or two
additional external layers, named "supra-outer layers."
[0170] In current embodiments, the gastroretentive dosage form may
optionally comprise an additional layer covering each outer layer
or each supra-outer layer, comprising a powder or a film that
prevents adherence of the outer membrane onto itself when folded
inside the capsule, wherein said layer comprises a powder, a
polymer, or a combination thereof.
[0171] In another embodiment, the one or two supra-outer layers are
affixed to the outer layers on one or two sides of the
gastroretentive dosage form, and comprise baclofen or R-baclofen
and one or more inactive ingredients selected from the group
consisting of polymers, preferably water soluble polymers, a
plasticizer, a solubilizing agent intended for immediate release of
the drug in the stomach, a disintegrant and a glidant, or any
combination of ingredients capable of performing one or more of the
said functions.
[0172] The detailed description of the present invention is further
illustrated by the following examples, which are illustrative only
and are not to be construed as limiting the scope of the invention.
Variations and equivalents of these examples will be apparent to
those skilled in the art in light of the present disclosure, the
drawings and the claims herein.
[0173] It is appreciated that certain features of the invention
which are, for clarity, described in the context of separate
embodiments, may also be provided in combination in a single
embodiment. Conversely, various features of the invention, which
are, for brevity, described in the context of a single embodiment,
may also be provided separately or in any suitable
subcombination.
[0174] Although the invention has been described in conjunction
with specific embodiments thereof, it is evident that many
alternatives, modifications and variations will be apparent to
those skilled in the art. Accordingly, it is intended to embrace
all such alternatives, modifications and variations that fall
within the spirit and broad scope of the appended claims.
[0175] All publications, patents and patent applications mentioned
in this specification are herein incorporated in their entirety by
reference into the specification, to the same extent as if each
individual publication, patent and patent application was
specifically and individually indicated to be incorporated herein
by reference. In addition, citation or identification of any
reference in this application shall not be construed as an
admission that such reference is available as prior art to the
present invention.
EXAMPLES
Racemic Baclofen Examples
Example 1
AP-Baclofen 40 mg Formulation A
[0176] GRDF Type: Outer-Inner-Outer
TABLE-US-00001 TABLE 1 mg Outer Film 4.1 Potassium hydroxide 63.9
Propylene glycol 63.9 Gelatin (Fish) 16 Eudragit L100-55 16
Eudragit L100 32 Eudragit S100
TABLE-US-00002 TABLE 2 mg Inner film 25.0 PEG 400 71.5 Lutrol F127
178.5 Eudragit L100 40.0 Baclofen
Example 2
GRDF-Baclofen 40 mg A Release Profile
[0177] In order to illustrate the ability of the GRDF to provide
controlled release of active ingredient, the release profile for
the above (Example 1) Baclofen GRDF was determined. Baclofen was
present in a total amount of 40 mg, all of which is in the internal
layer.
[0178] Experiments were conducted in SGF (USP) pH 1.2 and in
Acetate buffer (USP) pH 4.1 in a USP Apparatus 2, 50 rpm.
[0179] As shown in FIG. 2, the extended release was seen for 4
hours at pH 1.2 and for more than 16 for pH 4.1.
Example 3
AP-Baclofen 40 mg Formulation B
[0180] GRDF Type: Outer-Frame-Inner-Outer
TABLE-US-00003 TABLE 3 mg Outer Film 4.1 Potassium hydroxide 63.9
Propylene glycol 63.9 Gelatin (Fish) 16 Eudragit L100-55 16
Eudragit L100 32 Eudragit S100
TABLE-US-00004 TABLE 4 mg Frame film 50 Lutrol F127 29.2 Eudragit
L100-55 117.1 Eudragit L100 62.3 Lactose 15.6 Talc
TABLE-US-00005 TABLE 5 mg Inner film 8.97 PEG 400 89.74 Klucel EF
67.31 CMC 7H3SXF 40.0 Baclofen
Example 4
GRDF-Baclofen 40 mg B Release Profile
[0181] In order to illustrate the ability of the GRDF to provide
controlled release of active ingredient, the release profile for
the above (Example 3) Baclofen GRDF was determined. Baclofen was
present in total amount of 40 mg which are all in the internal
layer.
[0182] Experiments were conducted in SGF (USP) pH 1.2 and in
Acetate buffer (USP) pH 4.1 in a USP Apparatus 2, 50 rpm.
[0183] As shown in FIG. 3, the extended release was seen for 5
hours at pH 1.2 and for 12 hours for pH 4.1.
Example 5
Evaluation of the Pharmacokinetic Profiles of Gastric Retentive,
Controlled Release, Accordion Pill-Baclofen (AP-BC) Vs. Immediate
Release Baclofen in Healthy Volunteers
[0184] The primary objective was to evaluate of pharmacokinetic
parameters (Cmax, Tmax, AUC) from plasma concentrations of baclofen
following oral administration of the test formulations and
reference.
[0185] Study design was a single center, single-dose, open label,
three-way crossover, comparative pharmacokinetic study in healthy
volunteers.
Test Formulation:
[0186] A) GRDF-BC 40 mg A--Example 1
[0187] B) GRDF-BC 40 mg B--Example 3
[0188] Reference Formulation: Lioresal.RTM. Novartis Pharma S.p.A.
40 mg (4.times.10 mg) immediate release.
[0189] All oral formulations were swallowed whole with 240 ml water
after a medium calorie breakfast. Standardized meals were given to
all subjects throughout the study days.
[0190] Venous blood samples was drawn before dosing and then at
frequent intervals to match the pharmacokinetic behavior of the
drug. Baclofen plasma levels were analyzed.
[0191] The results of the study are shown in the Tables below and
in FIG. 4:
TABLE-US-00006 TABLE 6 GRDF-BC 40 mg GRDF-BC 40 mg B A IR dose 2750
2747 2865 AUC (.mu.g*h/L)t.fwdarw.0 2953 2944 3021 AUC
(.mu.g*h/L)t.fwdarw..infin. 97.7% 97.4% -- FIR (%) 352.8 361.0
427.0 C.sub.max ng/ml 5.55 5.49 5.54 t1/2 (h)
The results indicated the following: [0192] Both formulations
increased the absorption phase for 5 hours in comparison to 2 hours
in the IR formulation. [0193] In both formulations Cmax was
decreased while the AUC was preserved in comparison to the IR
formulation. [0194] Results were achieved under a regular calorie
diet. [0195] There is a lag time of about 1.5 hours in both PK
profile.
[0196] In order to further improve the PK profile by increasing the
time of steady plasma levels and decreasing the lag time, there was
a need to add an IR component to the GRDF and to prolong of the CR
release profile. These changes were implemented in the formulation
described in example 6.
Example 6
AP-Baclofen-C 40 mg Formulation
[0197] GRDF Type: IR Capsule Coating, Outer-Frame-Inner-Outer
TABLE-US-00007 TABLE 7 (mg per capsule) IR by Coating 2.0 Triethyl
Citrate (TEC) 1.0 PEG 400 10.0 Eudragit E PO 4 Talc Extra fine 10.0
Baclofen
TABLE-US-00008 TABLE 8 Outer Film mg KOH 4.1 Propylene glycol 63.9
Gelatin (Fish) 63.9 Eudragit L100-55 16 Eudragit L100 16 Eudragit
S100 32
TABLE-US-00009 TABLE 9 Frame film mg Lutrol F127 43.9 Eudragit
L100-55 29.2 Eudragit L100 117.1 Lactose 62.3 Talc 15.6
TABLE-US-00010 TABLE 10 Inner film mg Kollidon .RTM. SR 125.0
Magnesium Hydroxide 50.0 Baclofen 30.0
Example 7
GRDF-Baclofen-C 40 mg Release Profile
[0198] In order to illustrate the ability of the GRDF to provide
both immediate release and controlled release of active ingredient,
the release profile for the above (Example 6) baclofen GRDF was
determined. Baclofen present in total amount of 40 mg.
Specifically, there are 10 mg Baclofen in the immediate release
coating layer of the capsule and 30 mg in the internal layer which
are provided to the patient as a controlled release.
[0199] Experiments were conducted in SGF (USP) pH 1.2 and in
Acetate buffer (USP) pH 4.1 in a USP Apparatus 2, 50 rpm.
[0200] As shown in FIG. 5, immediate release occurred within 10
minutes and extended release was seen for 16 hours for both pH 1.2
and 4.1.
R-Baclofen Examples
Example 8
AP-Baclofen-C 20 mg Formulation
[0201] GRDF type: IR Capsule Coating, Outer-Frame-Inner-Outer
TABLE-US-00011 TABLE 7 (mg per capsule) IR by Coating 1.0 Triethyl
Citrate (TEC) 0.5 PEG 400 5.0 Eudragit E PO 2 Talc Extra fine 5.0
R-Baclofen
TABLE-US-00012 TABLE 8 Outer Film mg KOH 4.1 Propylene glycol 63.9
Gelatin (Fish) 63.9 Eudragit L100-55 16 Eudragit L100 16 Eudragit
S100 32
TABLE-US-00013 TABLE 9 Frame film mg Lutrol F127 43.9 Eudragit
L100-55 29.2 Eudragit L100 117.1 Lactose 62.3 Talc 15.6
TABLE-US-00014 TABLE 10 Inner film mg Kollidon .RTM. SR 62.5
Magnesium Hydroxide 25.0 R-Baclofen 15.0
Example 9
GRDF-Baclofen-C 20 mg Release Profile
[0202] In order to illustrate the ability of the GRDF to provide
both immediate release and controlled release of active ingredient,
the release profile for the above (Example 8) R-baclofen GRDF was
determined. R-baclofen present in total amount of 20 mg.
Specifically, there are 5 mg R-baclofen in the immediate release
coating layer of the capsule and 15 mg in the internal layer which
are provided to the patient as a controlled release.
[0203] Experiments are to be conducted in SGF (USP) pH 1.2 and in
Acetate buffer (USP) pH 4.1 in a USP Apparatus 2, 50 rpm.
Examples 10-11
GRDF-R-Baclofen Formulations A, B, C-10 mg
[0204] These examples are to be carried out according to the
procedures detailed in Examples 8-9, with half their total and
layer dosages.
Example 12
Pharmacokinetic Clinical Study: AP-Baclofen 40 mg (10 mg IR, 30 mg
CR
[0205] The PK study had three arms crossover, and was carried out
on 12 healthy volunteers (full crossover on 9 volunteers, in arm
2). The volunteers were healthy males aged between 18-55 years
inclusive. 12 subjects participated in periods 1 and 2. Out of
those 9 subjects also participated in period 3. Three new subjects
were enrolled for period 3.
[0206] Pharmacokinetic parameters (Cmax, Tmax and AUC) were
determined from plasma concentrations of Baclofen following oral
administration of each of the drug administrations.
[0207] The three arms were:
[0208] 1. AP-BC 40 mg (10 mg IR, 30 mg CR), Food protocol 1
[0209] 2. AP-BC 40 mg (10 mg IR, 30 mg CR), Food protocol 2
[0210] 3. Lioresal 10 mg IR, Food protocol 1
[0211] Hours of blood sampling: Pre dose, 0.5, 1.0, 1.5, 2.0, 2.5,
3.0, 3.5, 4.0, 5.0 6.0, 7.0, 8.0, 9.0, 10.0, 11.0, 12.0, 13.0,
14.0, 15.0, 16.0, 18.0, 22.0 24.0, 26.0 except for--Arm 1 and 3 had
sampling at hour 26 but not at 22. Arm 2 had sampling at hour 22
but not at 26.
TABLE-US-00015 PK results AP-BC 40 mg AP-BC 40 mg Lioresal .RTM. 10
mg Food protocol 1 Food protocol 2 Food protocol 1 AUC 0-t 2254
2033 824 AUCinf 2673 2646 861 Cmax (ng/mL) 211 168 134 Tmax (hour)
4.75 4.48 1.88 .lamda..sub.z (1/hour) 0.0920 0.0813 0.1169 T1/2
(hour) 8.80 10.2 6.09 MRT 0-t (hour) 9.38 10.2 6.79 MRT inf (hour)
13.6 16.4 8.00
See also FIG. 6.
* * * * *