U.S. patent application number 15/411744 was filed with the patent office on 2017-08-10 for c1-inh compositions and methods for the prevention and treatment of disorders associated with c1 esterase inhibitor deficiency.
The applicant listed for this patent is Shire ViroPharma Incorporated. Invention is credited to Ryan Erik Holcomb, Mark Cornell Manning, Stephen Ruddy.
Application Number | 20170224788 15/411744 |
Document ID | / |
Family ID | 51538486 |
Filed Date | 2017-08-10 |
United States Patent
Application |
20170224788 |
Kind Code |
A1 |
Ruddy; Stephen ; et
al. |
August 10, 2017 |
C1-INH COMPOSITIONS AND METHODS FOR THE PREVENTION AND TREATMENT OF
DISORDERS ASSOCIATED WITH C1 ESTERASE INHIBITOR DEFICIENCY
Abstract
Compositions and methods for the treatment and/or prevention of
disorders associated with C1 esterase inhibitor deficiency are
disclosed.
Inventors: |
Ruddy; Stephen; (Exton,
PA) ; Manning; Mark Cornell; (Johnstown, CO) ;
Holcomb; Ryan Erik; (Fort Collins, CO) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Shire ViroPharma Incorporated |
Lexington |
MA |
US |
|
|
Family ID: |
51538486 |
Appl. No.: |
15/411744 |
Filed: |
January 20, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14855168 |
Sep 15, 2015 |
9616111 |
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15411744 |
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PCT/US14/30309 |
Mar 17, 2014 |
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14855168 |
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61791399 |
Mar 15, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61K 47/02 20130101;
A61K 9/08 20130101; A61K 47/22 20130101; A61K 47/12 20130101; A61K
47/18 20130101; A61K 38/00 20130101; A61K 47/183 20130101; A61P
31/00 20180101; A61K 9/0019 20130101; A61K 38/57 20130101; A61K
38/1709 20130101 |
International
Class: |
A61K 38/57 20060101
A61K038/57; A61K 47/02 20060101 A61K047/02; A61K 9/08 20060101
A61K009/08; A61K 47/12 20060101 A61K047/12 |
Claims
1-15. (canceled)
16. A method for treating hereditary angioedema (HAE), said method
comprising subcutaneously administering to a subject in need
thereof a composition comprising a C1 esterase inhibitor, wherein
the C1 esterase inhibitor is administered at a concentration of at
least about 400 U/mL and a dose of at least about 1000 U.
17. The method of claim 16, wherein the C1 esterase inhibitor is
present in the composition in a concentration of at least about 500
U/mL in the composition.
18. The method of claim 16, further comprising a buffer selected
from citrate or phosphate, and having a pH ranging from
6.5-8.0.
19. The method of claim 16, wherein the buffer is citrate.
20. The method of claim 16, wherein the buffer is phosphate.
21. The method of claim 16, wherein the administration of the
composition comprising the C1 esterase inhibitor increases the
level of C1 esterase inhibitor in the blood of the subject to at
least about 0.4 U/mL.
22. The method of claim 16, wherein the composition is administered
daily, every other day, or every three days.
23. The method of claim 16, wherein the composition is administered
one, two, or three times a week.
24. The method of claim 16, wherein the C1 esterase inhibitor
comprises an amino acid sequence at least about 90% identical to
amino acid sequence SEQ ID NO: 1.
25. The method of claim 24, wherein the C1 esterase inhibitor
comprises an amino acid sequence identical to amino acid residues
23-500 of SEQ ID NO: 1.
26. The method of claim 16, wherein the C1 esterase inhibitor is
human plasma derived.
27. The method of claim 16, wherein the C1 esterase inhibitor is
recombinantly produced.
28. The method of claim 16, wherein the HAE is Type I HAE or Type
II HAE.
29. The method of claim 16, wherein the administration of the
composition comprising a C1 esterase inhibitor results in HAE
prophylactic treatment.
30. The method of claim 16, wherein the administration of the
composition comprising a C1 esterase inhibitor results in treatment
of an HAE attack.
31. The method of claim 16, wherein the administration of the
composition results in at least a reduction in the severity and/or
number of HAE attacks.
32. The method of claim 16, wherein the composition is a liquid
formulation.
33. The method of claim 16, wherein the composition is
reconstituted from a lyophilized powder.
34. The method of claim 16, wherein the composition has a viscosity
of less than about 35 mPa-s.
35. The method of claim 34, wherein the viscosity of the
composition is about between 7-10 mPa-s.
36. A composition for treating hereditary angioedema (HAE) by
subcutaneous administration comprising a C1 esterase inhibitor, a
buffer selected from citrate or phosphate, and having a pH ranging
from 6.5-8.0, wherein the C1 esterase inhibitor has a concentration
of at least about 400 U/mL, and wherein the C1 esterase inhibitor
comprises an amino acid sequence at least 95% identical to residues
23 to 500 of SEQ ID NO: 1.
37. The composition of claim 36, wherein the C1 esterase inhibitor
is present in the composition in a concentration of at least about
500 U/mL.
38. The composition of claim 36, wherein the C1 esterase inhibitor
is purified from plasma.
39. The composition of claim 36, wherein the C1 esterase inhibitor
is recombinantly produced.
40. The composition of claim 36, wherein the C1 esterase inhibitor
comprises the amino acid sequence of residues 23 to 500 of SEQ ID
NO: 1.
41. The composition of claim 36, wherein the composition is a
liquid formulation.
42. The composition of claim 36, wherein the composition is
reconstituted from lyophilized powder.
43. The composition of claim 36, wherein the buffer is citrate.
44. the composition of claim 36, wherein the buffer is
phosphate.
45. The composition of claim 36, wherein the composition has a
viscosity of less than about 35 mPa-s.
Description
[0001] This application claims priority under 35 U.S.C.
.sctn.119(e) to U.S. Provisional Patent Application No. 61/791,399,
filed Mar. 15, 2013. The foregoing application is incorporated by
reference herein.
FIELD OF THE INVENTION
[0002] The present invention relates to the field of therapeutic
agents and methods of use thereof. Specifically, the instant
invention provides compositions and methods for the treatment
and/or prevention of disorders associated with C1 esterase
inhibitor deficiency.
BACKGROUND OF THE INVENTION
[0003] Several publications and patent documents are cited
throughout the specification in order to describe the state of the
art to which this invention pertains. Full citations of these
references can be found throughout the specification. Each of these
citations is incorporated herein by reference as though set forth
in full.
[0004] Hereditary angioedema (HAE) is a rare, life-threatening,
genetic disorder caused by a deficiency of the C1 esterase
inhibitor (see generally www.haei.org and www.haea.org). At least
6,500 people in the United States and at least 10,000 people in
Europe have HAE. HAE patients experience recurrent, unpredictable,
debilitating, life-threatening attacks of inflammation and
submucosal/subcutaneous swelling. The inflammation is typically of
the larynx, abdomen, face, extremities, and urogenital tract. This
genetic disorder is a result of a defect in the gene controlling
the synthesis of the C1 esterase inhibitor. Accordingly, restoring
the levels of active C1 esterase inhibitor in these patients to or
near normal levels is an effective measure for treating HAE. Still,
new and improved methods of treating and preventing disorders
associated with a deficiency of the C1 esterase inhibitor, such as
HAE, are desired.
SUMMARY OF THE INVENTION
[0005] In accordance with the instant invention, methods for
inhibiting, treating, and/or preventing a disorder associated with
a deficiency in C1 esterase inhibitor in a subject are provided. In
a particular embodiment, the method comprises administering a
composition comprising at least one C1 esterase inhibitor.
[0006] In accordance with the instant invention, therapeutic
compositions are also provided. In a particular embodiment, the
composition comprises at least one C1 esterase inhibitor and,
optionally, at least one pharmaceutically acceptable carrier for
delivery (e.g. intravenous or subcutaneous delivery). Kits
comprising a composition comprising at least one C1 esterase
inhibitor are also provided herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] FIG. 1 provides an amino acid sequence of human C1 esterase
inhibitor.
[0008] FIG. 2 provides a graph of the effect of protein
concentration on viscosity for initial spin concentration
samples.
DETAILED DESCRIPTION OF THE INVENTION
[0009] The restoration of active C1 esterase inhibitor levels in
patients having a disorder associated with deficient or reduced
levels of active C1 esterase inhibitor (e.g., HAE) is an effective
measure for treating such disorders. Currently, C1 esterase
inhibitor (such as Cinryze.RTM. (ViroPharma, Inc.; Exton, Pa.)) is
administered to a patient intravenously by a medical professional.
Herein, formulations of a C1 esterase inhibitor (such as
Cinryze.RTM.) are provided which are also effective for
subcutaneous (SC) administration. Surprisingly, the subcutaneous
administration of the C1 esterase inhibitor is sufficient to
maintain the blood levels of the C1 esterase inhibitor. The SC
administration of a C1 esterase inhibitor fulfills an unmet medical
need due to the limitations of intravenous administration in HAE
patients.
[0010] In accordance with the instant invention, compositions and
methods for inhibiting (e.g., reducing or slowing), treating,
and/or preventing a disorder associated with C1 esterase inhibitor
deficiency in a subject are provided. In a particular embodiment,
the methods comprise administering (e.g., subcutaneously or
intravenously) to a subject in need thereof at least one C1
esterase inhibitor. In a particular embodiment, the C1 esterase
inhibitor is administered subcutaneously after an initial
administration of the C1 esterase inhibitor intravenously.
[0011] C1 esterase inhibitors are also known as C1 inhibitors (C1
INH). C1 esterase inhibitors are inhibitors of complement C1 and
belong to the superfamily of serine proteinase inhibitors. Human C1
esterase inhibitor is a protein of 500 amino acids, including a 22
amino acid signal sequence (Carter et al. (1988) Eur. J. Biochem.,
173:163). In plasma, the C1 esterase inhibitor is a heavily
glycosylated glycoprotein of approximately 76 kDa (Perkins et al.
(1990) J. Mol. Biol., 214:751). The activity of a C1 esterase
inhibitor may be assayed by known methods (see, e.g., Drouet et al.
(1988) Clin. Chim. Acta., 174:121-30). In a particular embodiment,
the C1 esterase inhibitor is human. An amino acid sequence of human
C1 esterase inhibitor is provided in GenBank Accession No. CAA30314
(see also GeneID: 710, which also provides nucleotide sequences of
the C1 esterase inhibitor) and FIG. 1. A C1 esterase inhibitor for
use in the methods of the instant invention may have an amino acid
sequence that has at least 65, 70, 75, 80, 85, 90, 95, 98, 99, or
100% identity with the amino acid sequence of FIG. 1. The C1
esterase inhibitor may be isolated or purified from plasma (e.g.,
human plasma) or recombinantly produced. When purified from plasma,
the C1 esterase inhibitor may be nanofiltered and pasteurized. In a
particular embodiment, the plasma-derived C1 esterase inhibitor is
Cinryze.RTM.. In a particular embodiment, the C1 esterase inhibitor
is present in the compositions of the instant invention at high
concentration. Indeed, compositions comprising very high levels of
C1 esterase inhibitor have been determined to be surprisingly
stable and active. In a particular embodiment, the C1 esterase
inhibitor is present at about 250 U/ml to about 1000 U/ml, about
400 U/ml to about 600 U/ml, or about 500 U/ml.
[0012] In a particular embodiment, the compositions of the instant
invention do not contain citrate or citric acid. The compositions
lacking citrate and citric acid are particularly useful for the
subcutaneous administration of the C1 esterase inhibitor as
citrate/citric acid can cause an injection site reaction. In a
particular embodiment, the buffer of the instant compositions is
sodium phosphate (e.g., about 5 mM to about 50 mM sodium phosphate,
about 10 mM to about 30 mM sodium phosphate, or about 20 mM sodium
phosphate). In a particular embodiment (e.g., for intravenous
administration), the buffer of the instant compositions comprises a
carboxylic group. For example, the buffer may be, without
limitation, citrate, succinate, tartarate, maleate, acetate, and
salts thereof. In a particular embodiment, the buffer of the
instant composition is citrate or sodium citrate (e.g., about 5 mM
to about 50 mM sodium citrate, about 10 mM to about 30 mM sodium
citrate, or about 20 mM sodium citrate).
[0013] The compositions of the instant invention may have a pH
range of about 6.5 or higher, particularly about 6.5 to about 8.0,
particularly about 6.5 to about 7.5, and more particularly about
6.5 to about 7.0.
[0014] The compositions of the instant invention may also comprise
polysorbate 80 (TWEEN). Compositions comprising polysorbate 80 are
particularly useful as they reduce/mitigate protein aggregation.
Polysorbate 80 can also limit protein interactions when the
composition comes into contact with silicon containing
lubricants/oils such as those used in syringes and other
administration devices. Compositions comprising polysorbate 80 are
also useful for lyophilized preparations. In a particular
embodiment, the polysorbate 80 is present at a concentration of
about 0.01% to about 0.1%, particularly about 0.025% to about
0.075%, particularly about 0.05%.
[0015] The compositions of the instant invention may also comprise
sucrose. Sucrose can be added as a "bulking" agent as well as a
lyo-protectant. In a particular embodiment, sucrose is added to
compositions to be lyophilized. In a particular embodiment, the
compositions comprise about 25 mM to about 125 mM sucrose,
particularly about 50 mM to about 100 mM sucrose.
[0016] The compositions of the instant invention may also comprise
at least one amino acid or salt thereof, particularly methionine
and/or arginine. Arginine carries a positive charge on its side
chain can be used to buffer solutions with phosphate. Methionine
acts as a stabilizer (e.g., by limiting oxidation). The amino acids
may be present in the composition as individual amino acids or
present as short peptides (e.g., 2 to about 5 amino acids,
particularly di-peptides or tri-peptides).
[0017] As stated hereinabove, the instant invention encompasses
methods of treating, inhibiting, and or preventing any condition or
disease associated with an absolute or relative deficiency of
functional C1 esterase inhibitor. Such disorders include, without
limitation, acquired angioedema (AAE) and hereditary angioedema
(HAE). In a particular embodiment, the disorder is HAE and/or the
attacks associated therewith. As stated hereinabove, HAE is a
life-threatening and debilitating disease that manifests as
recurrent, submucosal/subcutaneous swelling attacks due to a
deficiency of C1 esterase inhibitor (Zuraw, B. L. (2008) N. Engl.
J. Med., 359:1027-1036). In a particular embodiment, the hereditary
angioedema is type I or type II.
[0018] Both type I and type II have a defective gene for the
synthesis of C1 esterase inhibitor that produce either no C1
inhibitor (HAE type I) or a dysfunctional C1 inhibitor (HAE type
II) (Rosen et al. (1965) Science 148: 957-958; Bissler et al.
(1997) Proc. Assoc. Am. Physicians 109: 164-173; Zuraw et al.
(2000) J. Allergy Clin. Immunol. 105: 541-546; Bowen et al. (2001)
Clin. Immunol. 98: 157-163).
[0019] The methods of the instant invention encompass the
administration of at least one C1 esterase inhibitor. Compositions
comprising at least one C1 esterase inhibitor and, optionally, at
least one pharmaceutically acceptable carrier (e.g., one suitable
for subcutaneous or intravenous administration) are encompassed by
the instant to invention. Such compositions may be administered, in
a therapeutically effective amount, to a patient in need thereof
for the treatment of a disorder associated with C1 esterase
inhibitor deficiency. The instant invention also encompasses kits
comprising at least one composition of the instant invention, e.g.,
a composition comprising at least one C1 esterase inhibitor and,
optionally, at least one pharmaceutically acceptable carrier (e.g.,
one suitable for intravenous or subcutaneous administration). The
kits may further comprise at least one of reconstitution buffer(s),
syringes (e.g., disposable) for parenteral (e.g., subcutaneous)
injection, and instruction material. In a particular embodiment,
the kit comprises at least one pre-loaded syringe comprising the C1
esterase inhibitor and at least one pharmaceutically acceptable
carrier. For example, a syringe may be loaded with at least one C1
esterase inhibitor with at least one pharmaceutically acceptable
carrier for administration (e.g., intravenous or subcutaneous
administration). Alternatively, a single syringe may be loaded with
lyophilized C1 esterase inhibitor. In a particular embodiment, the
preloaded syringes have a pharmaceutical composition that contains
polysorbate 80 as a component (e.g., in an amount that prevents
protein-silicone interaction or protein aggregation).
[0020] The agents and compositions of the present invention can be
administered by any suitable route, for example, by injection
(e.g., for local (direct) or systemic administration. In a
particular embodiment, the composition is administered
subcutaneously or intravenously. In general, the pharmaceutically
acceptable carrier of the composition is selected from the group of
diluents, preservatives, solubilizers, emulsifiers, adjuvants
and/or carriers. The compositions can include diluents of various
buffer content (e.g., Tris HCl, acetate, phosphate), pH and ionic
strength; and additives such as detergents and solubilizing agents
(e.g., Tween 80, Polysorbate 80), antioxidants (e.g., ascorbic
acid, sodium metabisulfite), preservatives (e.g., Thimersol, benzyl
alcohol) and bulking substances (e.g., lactose, mannitol). The
pharmaceutical composition of the present invention can be
prepared, for example, in liquid form, or can be in dried powder
form (e.g., lyophilized for later reconstitution).
[0021] In a particular embodiment, the compositions are formulated
in lyophilized form. Where the compositions are provided in
lyophilized form, the compositions are reconstituted prior to use
(e.g., within an hour, hours, or day or more of use) by an
appropriate buffer (e.g., sterile water, a sterile saline solution,
or a sterile solution comprising the appropriate pharmaceutically
acceptable carriers (e.g., to reconstitute the compositions as
described hereinabove). The reconstitution buffer(s) may be
provided in the kits of the instant invention or may be obtained or
provided separately.
[0022] As used herein, "pharmaceutically acceptable carrier"
includes any and all solvents, dispersion media and the like which
may be appropriate for the desired route of administration of the
pharmaceutical preparation, as exemplified in the preceding
paragraph. The use of such media for pharmaceutically active
substances is known in the art. Except insofar as any conventional
media or agent is incompatible with the molecules to be
administered, its use in the pharmaceutical preparation is
contemplated.
[0023] Selection of a suitable pharmaceutical preparation depends
upon the method of administration chosen. In this instance, a
pharmaceutical preparation comprises the molecules dispersed in a
medium that is compatible with the tissue to which it is being
administered. Methods for preparing parenterally or subcutaneously
administrable compositions are well known in the art (see, e.g.,
Remington's Pharmaceutical Science (E.W. Martin, Mack Publishing
Co., Easton, Pa.)).
[0024] As stated hereinabove, agents of the instant invention are
administered parenterally--for example by intravenous injection
into the blood stream and/or by subcutaneous injection.
Pharmaceutical preparations for parenteral, intravenous, and
subcutaneous injection are known in the art. If parenteral
injection is selected as a method for administering the molecules,
steps should be taken to ensure that sufficient amounts of the
molecules reach their target cells to exert a biological
effect.
[0025] Pharmaceutical compositions containing a compound of the
present invention as the active ingredient in intimate admixture
with a pharmaceutical carrier can be prepared according to
conventional pharmaceutical compounding techniques. The carrier may
take a wide variety of forms depending on the form of preparation
desired for administration, e.g., parenterally or subcutaneous. For
parenterals, the carrier will usually comprise sterile water,
though other ingredients, for example, to aid solubility or for
preservative purposes, may be included. Injectable suspensions may
also be prepared, in which case appropriate liquid carriers,
suspending agents and the like may be employed.
[0026] A pharmaceutical preparation of the invention may be
formulated in dosage unit form for ease of administration and
uniformity of dosage. Dosage unit form, as used herein, refers to a
physically discrete unit of the pharmaceutical preparation
appropriate for the patient undergoing treatment. Each dosage
should contain a quantity of active ingredient calculated to
produce the desired effect in association with the selected
pharmaceutical carrier. Dosage units may be proportionately
increased or decreased based on the weight of the patient.
Appropriate concentrations for alleviation of a particular
pathological condition may be determined by dosage concentration
curve calculations. Appropriate dosage unit may also be determined
by assessing the efficacy of the treatment.
[0027] The pharmaceutical preparation comprising the molecules of
the instant invention may be administered at appropriate intervals,
for example, daily, every other day, every three days, five out of
every 7 days, or at least one, two or three times a week or more
until the pathological symptoms are reduced or alleviated, after
which the dosage may be reduced to a maintenance level. The
appropriate interval in a particular case would normally depend on
the condition of the patient.
[0028] In a particular embodiment, the C1 esterase inhibitor is
present in the composition or is administered in the range of about
100 Units to about 10,000 Units; about 500 Units to about 5,000
Units; about 1,000 Units to about 3,500 Units, or about 1,500 Units
to about 2,500 Units. In a particular embodiment, at least about
2,000 Units is used. In a particular embodiment, a high initial
dose of the C1 esterase inhibitor (as listed above (may be
administered intravenously)) is used, followed by lower maintenance
doses. For example, the high initial dose may be at least 1.5, 2,
3, 4, or 5 times the subsequent doses. In a particular embodiment,
the C1 esterase inhibitor is present in the maintenance composition
or is administered for maintenance in the range of about 100 Units
to about 5,000 Units; about 250 Units to about 2,000 Units; about
250 Units to about 1,000 Units; or about 500 Units. The high
initial does of the C1 esterase inhibitor is optional in the
methods of the instantly claimed invention (e.g., may be optional
with prophylactic methods).
[0029] In a particular embodiment, the C1 esterase inhibitor is
administered with a frequency and dosage so as to increase the C1
esterase inhibitor level to at least about 0.3 or, more
particularly, 0.4 U/ml or more up to about 1 U/ml (1 Unit/ml is the
mean quantity of C1 inhibitor present in 1 ml of normal human
plasma) in the blood of the subject. For example, the C1 esterase
inhibitor level may be kept at or above 0.4 U/ml for at least 50%,
at least 75%, at least 90%, at least 95% or more of time or all of
the time (e.g., the time during which drug is being administered).
For example, the administration of a 2000 U initial dose of C1
esterase inhibitor followed by 250 U everyday or 500 U every other
day results in the maintenance of just below 0.4 U/ml in blood.
Further, the administration of a 2000 U initial dose of C1 esterase
inhibitor followed by 1000 U every 3 days results in the
maintenance of about 0.4 U/ml in blood. Notably, for ease of use by
the patient, less frequent administrations may be preferred. The
administration of a 2000 U initial dose of C1 esterase inhibitor
followed by 500 U everyday with weekend holidays from
administration (i.e., 5 out of 7 days) also results in the
maintenance of about 0.4 U/ml or higher in blood. Notably, the
administration of only the maintenance doses leads to increased and
physiologically relevant blood levels of the C1 esterase inhibitor,
but delayed compared to those receiving an initial high dose.
Definitions
[0030] The singular forms "a," "an," and "the" include plural
referents unless the context clearly dictates otherwise.
[0031] As used herein, the term "about" may refer to .+-.5%,
.+-.2%, or .+-.1%.
[0032] As used herein, the terms "host," "subject," and "patient"
refer to any animal, including humans.
[0033] As used herein, the term "prevent" refers to the
prophylactic treatment of a subject who is at risk of developing a
condition (e.g., HAE or HAE attack) resulting in a decrease in the
probability that the subject will develop the condition.
[0034] The term "treat" as used herein refers to any type of
treatment that imparts a benefit to a patient afflicted with a
disorder, including improvement in the condition of the patient
(e.g., in one or more symptoms), delay in the progression of the
condition, etc. In a particular embodiment, the treatment of HAE
results in at least a reduction in the severity and/or number of
HAE attacks.
[0035] The phrase "effective amount" refers to that amount of
therapeutic agent that results in an improvement in the patient's
condition. A "therapeutically effective amount" of a compound or a
pharmaceutical composition refers to an amount effective to
prevent, inhibit, treat, or lessen the symptoms of a particular
disorder or disease.
[0036] "Pharmaceutically acceptable" indicates approval by a
regulatory agency of the Federal or a state government or listed in
the U.S. Pharmacopeia or other generally recognized pharmacopeia
for use in animals, and more particularly in humans.
[0037] A "carrier" refers to, for example, a diluent, adjuvant,
preservative (e.g., Thimersol, benzyl alcohol), anti-oxidant (e.g.,
ascorbic acid, sodium metabisulfite), solubilizer (e.g., TWEEN 80,
Polysorbate 80), emulsifier, buffer (e.g., Tris HCl, acetate,
phosphate), water, aqueous solutions, oils, bulking substance
(e.g., lactose, mannitol), cryo-/lyo-protectants, tonicity
modifier, excipient, auxilliary agent or vehicle with which an
active agent of the present invention is administered. Suitable
pharmaceutical carriers are described in "Remington's
Pharmaceutical Sciences" by E.W. Martin (Mack Publishing Co.,
Easton, Pa.); German), A. R., Remington: The Science and Practice
of Pharmacy, (Lippincott, Williams and Wilkins); Liberman, et al.,
Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y.;
and Kibbe, et al., Eds., Handbook of Pharmaceutical Excipients,
American Pharmaceutical Association, Washington.
[0038] The term "isolated" may refer to protein, nucleic acid,
compound, or cell that has been sufficiently separated from the
environment with which it would naturally be associated (e.g., so
as to exist in "substantially pure" form). "Isolated" does not
necessarily mean the exclusion of artificial or synthetic mixtures
with other compounds or materials, or the presence of impurities
that do not interfere with the fundamental activity, and that may
be present, for example, due to incomplete purification.
[0039] The term "substantially pure" refers to a preparation
comprising at least 50-60% by weight of a given material (e.g.,
nucleic acid, oligonucleotide, protein, etc.). In certain
embodiments, the preparation comprises at least 75% by weight,
particularly 90-95% or more by weight of the given compound. Purity
is measured by methods appropriate for the given compound (e.g.
chromatographic methods, agarose or polyacrylamide gel
electrophoresis, HPLC analysis, and the like).
[0040] The following example is provided to illustrate various
embodiments of the present invention. The example is illustrative
and is not intended to limit the invention in any way.
EXAMPLE
Spin Concentration Studies
[0041] The protein was loaded into the spin concentrators and
rotated at 10,500 rpms for 5 to 10 minutes. When the samples
stopped rotating, the final volumes in the spin concentrators were
recorded and a rough protein concentration was calculated for each
one. Additional protein was added to the spin concentrators and
rotated until the desired protein concentration was reached, at
which point a UV measurement was made. At each target protein
concentration a UV and viscosity measurement was performed. The
above procedure continued until the viscosity of the protein
prevented the sample from being further concentrated.
Viscosity Measurements
[0042] Viscosity was determined by measuring the amount of time the
sample took to be drawn to a predetermined distance in a gel
loading pipette tip. In order to calculate the sample viscosity, a
standard curve was first prepared using a set of standards with
known viscosities. Sucrose (or Brix) solutions are suitable for
preparing such a curve, but any material with known viscosity at a
defined temperature should be appropriate.
[0043] In order to make a measurement, the pipette plunger is
depressed, the pipette tip is inserted into the sample vial, the
plunger is released, and the time for the fluid to travel a
predetermined distance in the pipette tip was measured with a stop
watch. The distance used for these experiments was 30 .mu.L of
water. In important note, a pipette tip is only reliable for a
single measurement, so multiple tips are used to make replicate
measurements of a sample. Also, the volume to be drawn into the
pipette tip should be larger than the volume marked on the tip to
ensure a uniform pull on the sample during a measurement. For a 30
.mu.L volume mark on the pipette tip, the micropipette was set to
draw 42 .mu.L.
Results
[0044] The instant example determined the ability to develop a
higher concentration liquid formulation of C1 INH as a
monoformulation. The initial studies focused on concentration of
the stock solution of C1 INH using a spin concentration method. The
solutions were initially adjusted for pH but no other excipient was
added. Three pH values were investigated (pH 5.9, 6.9, and 7.9).
Upon spin concentration, all of the solutions remained clear up to
concentrations up .about.500 U/ml (approximately 100 nm/ml) for all
pH values tested (Table 1). While the solubility limit was not
reached in these studies, there were measurable increases in
viscosity as the concentrations exceeded 300 U/ml (FIG. 2). At all
pH values, the viscosity begins to increase markedly when the C1
INH concentration goes above 400 U/ml.
TABLE-US-00001 TABLE 1 Final concentrations (in U/mL) and
viscosities for samples prepared during the spin concentration
experiments. These values were based on the initial 160 U/mL
concentration of the initial bulk drug. 7.9 6.9 5.9 U/mL viscosity
U/mL viscosity U/mL viscosity 93.12 0.99 182.4 4.23 187.2 2.36
415.18 3.95 289.4 4.90 296.9 7.71 454.81 13.74 378.6 12.08 396.7
5.46 501.17 30.43 479.0 14.67 478.8 24.09
[0045] A larger feasibility study was performed examining different
buffers (20 mM phosphate, 20 mM citrate, and 20 mM Tris) at each of
the three target values. Samples of both 400 U/ml and 500 U/ml were
prepared and evaluated for stability after one week at 40.degree.
C. and after two weeks at 25.degree. C. The initial viscosity
levels were well above the values for pure water (.about.1 mPa-s),
but well within the limits usually set for use as an injectable
product (Table 2). The viscosity values for the 400 U/ml samples
were less than at 500 U/ml, usually by 7 to 10 mPa-s. Upon storage
at 40.degree. C. for one week, the viscosity of all of the samples
increased. At pH 5.9, all of the same gelled, likely due to
thermally induced aggregation. For the remaining formulations, the
viscosity increased to some degree. In some cases these values
exceeded 30 mPa-s. The increase in viscosity was less upon
25.degree. C. storage than at 40.degree. C. There was little, if
any change, for the samples at pH 6.9, indicating that pH 6.9 may
be more favorable for long-term storage stability.
TABLE-US-00002 TABLE 2 Viscosity at t0 and after one week of
storage at 40.degree. C. (t1). Viscosity is reported in mPa-s. pH
[C1 INH] Buffer t0 t1 t2 5.9 400 phosphate 13.3 .+-. 0.6 gel 17.4
.+-. 2.1 500 24.6 .+-. 1.5 gel 36.9 .+-. 7.3 400 histidine 14.7
.+-. 0.8 gel 19.1 .+-. 2.5 500 27.7 .+-. 3.8 gel 27.7 .+-. 3.8 6.9
400 phosphate 12.2 .+-. 1.5 16.1 .+-. 0.6 11.9 .+-. 3.0 500 20.8
.+-. 2.0 35.3 .+-. 2.1 32.1 .+-. 7.7 400 citrate 7.4 .+-. 0.8 9.2
.+-. 0.7 7.1 .+-. 0.6 500 14.4 .+-. 3.2 19.8 .+-. 1.1 12.6 .+-. 0.5
7.9 400 phosphate 8.2 .+-. 1.2 12.8 .+-. 0.7 22.0 .+-. 3.5 500 16.2
.+-. 1.4 23.1 .+-. 2.1 25.5 .+-. 7.5 400 tris 14.1 .+-. 0.7 18.7
.+-. 0.7 30.0 .+-. 3.8 500 20.5 .+-. 0.9 33.3 .+-. 6.2 31.0 .+-.
1.8
[0046] Notably, at pH 6.9, citrate formulations had lower viscosity
values than for phosphate, while at pH 7.9, phosphate buffer
produced lower viscosities than his buffer. Higher viscosities will
mean greater force will be required to deliver a specified volume
of the drug within a certain time frame.
[0047] The purity by RP HPLC was initially near 86 to 87% for the
formulations at pH 6.9 and above (Table 3). The initial levels were
lower at pH 5.9, suggesting that some degradation had already
occurred just in the process of preparing the samples. Upon storage
for one week at 40.degree. C., the pH 5.9 samples gelled, making
analysis by RP HPLC impossible. For all of the other samples, the
percent purity was essentially unchanged, indicating that little,
if any, chemical degradation occurs for storage under these
conditions.
TABLE-US-00003 TABLE 3 Percent purity by RP HPLC upon storage at
25.degree. C. (t2) or 40.degree. C. (t1). pH [C1 INH] Buffer t0 t1
t2 5.9 400 phosphate 82.87 .+-. 0.75 gel 81.10 .+-. 2.11 500 84.74
.+-. 1.24 gel 83.61 .+-. 1.02 400 histidine 84.11 .+-. 1.53 gel
85.34 .+-. 1.55 500 86.36 .+-. 0.76 gel 82.99 .+-. 0.64 6.9 400
phosphate 87.14 .+-. 0.67 88.59 .+-. 0.29 85.19 .+-. 2.00 500 86.44
.+-. 1.49 85.65 .+-. 1.32 84.07 .+-. 1.24 400 citrate 86.67 .+-.
1.36 82.92 .+-. 1.48 86.03 .+-. 0.87 500 86.89 .+-. 1.24 86.74 .+-.
0.88 84.42 .+-. 1.19 7.9 400 phosphate 86.09 .+-. 1.14 85.29 .+-.
0.84 85.98 .+-. 0.90 500 86.47 .+-. 1.15 83.57 .+-. 1.33 84.00 .+-.
0.97 400 tris 87.14 .+-. 0.98 81.74 .+-. 7.89 86.14 .+-. 0.81 500
88.74 .+-. 0.82 87.24 .+-. 1.47 87.30 .+-. 0.95
[0048] For samples stored for two weeks at 25.degree. C., there
were small losses, comparable to what was seen at t1. Together, the
RP HPLC data indicate that there are small losses due to chemical
degradation. Higher pH seems to diminish the rate of degradation
and there may be some sensitivity to buffer composition.
[0049] While the chemical stability of C1 INH seems to be unchanged
upon storage, there is come physical instability observed as
indicated by SEC (Table 4). There are other proteins present in the
C1 INH mixture, leading to an overall `purity` of about .about.67%
at t0. Upon storage at 40.degree. C. for one week (t1), the overall
monomer content of the samples decreased to 54-56% for the samples
with pH 6.9 and higher. There was little difference between the two
different pH conditions, the different buffers and the two protein
concentrations. When stored for two weeks at 25.degree. C. (t2),
the pH 5.9 samples did not gel, as they did at the higher storage
temperature. However, there was appreciably higher degradation,
especially with histidine buffer. For these at pH 6.9 or 7.9, the
loss as measured by SEC was about 2% or so, compared to the 10-12%
loss at the higher temperature for half of the time.
TABLE-US-00004 TABLE 4 Monomer content by SEC upon storage at
25.degree. C. (t2) or 40.degree. C. (t1). pH [C1 INH] Buffer t0 t1
t2 5.9 400 phosphate 68.32 .+-. 1.04 gel 62.56 .+-. 0.94 500 67.19
.+-. 0.14 gel 61.46 .+-. 0.14 400 histidine 64.68 .+-. 0.42 gel
46.58 .+-. 1.09 500 66.60 .+-. 0.08 gel 44.48 .+-. 1.04 6.9 400
phosphate 67.85 .+-. 0.22 55.29 .+-. 0.36 500 67.41 .+-. 0.36 54.79
.+-. 0.14 65.45 .+-. 0.23 400 citrate 67.82 .+-. 0.07 56.14 .+-.
0.41 65.49 .+-. 0.16 500 67.43 .+-. 0.30 56.59 .+-. 0.33 65.03 .+-.
0.36 7.9 400 phosphate 67.85 .+-. 0.09 54.96 .+-. 0.52 61.31 .+-.
0.25 500 67.58 .+-. 0.40 55.57 .+-. 0.56 64.98 .+-. 0.50 400 tris
67.63 .+-. 0.27 55.40 .+-. 0.30 65.70 .+-. 0.56 500 67.67 .+-. 0.47
56.18 .+-. 0.64 66.19 .+-. 0.84
[0050] The data indicate that the rate of degradation will be about
13-fold to 35-fold slower at 4.degree. C. than at 25.degree. C. The
higher estimate comes from using an Arrhenius plot. The lower
estimate comes from determine the average loss as the temperature
is decreased by 5.degree. C. and extrapolating to a storage
temperature of 40.degree. C. Using the current data as an
indicator, this predicts a loss of about 3 to 10% loss after two
years at refrigerated temperatures. In other words, a liquid
formulation appears to be quite stable based on these data.
Furthermore, the degradation rates are roughly comparable to
between the 400 U/mL and 500 U/mL samples, suggesting that
developing the higher concentration formulation is just as
viable.
[0051] The degradation rate is much faster at pH 5.9, leading to
gelation at 40.degree. C. and greater losses at 25.degree. C. Thus,
further pH/buffer screening will focus on the pH 6.5 to 8.0 range.
There is a clear buffer effect on viscosity and possibly also on
stability. The studies demonstrated that there is not a solubility
limit to preparing C1 INH at concentrations up to 500 U/ml. There
is an increase in viscosity once the concentrations reach the
400-500 U/ml range (which is buffer dependent with citrate being
better than phosphate which is better than Tris), but they are
manageable and still allow facile delivery by injection for
standard syringe systems. In general, C1 INH is relatively stable
to chemical degradation, as determined by RP HPLC.
[0052] While certain of the preferred embodiments of the present
invention have been described and specifically exemplified above,
it is not intended that the invention be limited to such
embodiments. Various modifications may be made thereto without
departing from the scope and spirit of the present invention, as
set forth in the following claims.
Sequence CWU 1
1
11500PRTHomo sapiens 1Met Ala Ser Arg Leu Thr Leu Leu Thr Leu Leu
Leu Leu Leu Leu Ala 1 5 10 15 Gly Asp Arg Ala Ser Ser Asn Pro Asn
Ala Thr Ser Ser Ser Ser Gln 20 25 30 Asp Pro Glu Ser Leu Gln Asp
Arg Gly Glu Gly Lys Val Ala Thr Thr 35 40 45 Val Ile Ser Lys Met
Leu Phe Val Glu Pro Ile Leu Glu Val Ser Ser 50 55 60 Leu Pro Thr
Thr Asn Ser Thr Thr Asn Ser Ala Thr Lys Ile Thr Ala 65 70 75 80 Asn
Thr Thr Asp Glu Pro Thr Thr Gln Pro Thr Thr Glu Pro Thr Thr 85 90
95 Gln Pro Thr Ile Gln Pro Thr Gln Pro Thr Thr Gln Leu Pro Thr Asp
100 105 110 Ser Pro Thr Gln Pro Thr Thr Gly Ser Phe Cys Pro Gly Pro
Val Thr 115 120 125 Leu Cys Ser Asp Leu Glu Ser His Ser Thr Glu Ala
Val Leu Gly Asp 130 135 140 Ala Leu Val Asp Phe Ser Leu Lys Leu Tyr
His Ala Phe Ser Ala Met 145 150 155 160 Lys Lys Val Glu Thr Asn Met
Ala Phe Ser Pro Phe Ser Ile Ala Ser 165 170 175 Leu Leu Thr Gln Val
Leu Leu Gly Ala Gly Glu Asn Thr Lys Thr Asn 180 185 190 Leu Glu Ser
Ile Leu Ser Tyr Pro Lys Asp Phe Thr Cys Val His Gln 195 200 205 Ala
Leu Lys Gly Phe Thr Thr Lys Gly Val Thr Ser Val Ser Gln Ile 210 215
220 Phe His Ser Pro Asp Leu Ala Ile Arg Asp Thr Phe Val Asn Ala Ser
225 230 235 240 Arg Thr Leu Tyr Ser Ser Ser Pro Arg Val Leu Ser Asn
Asn Ser Asp 245 250 255 Ala Asn Leu Glu Leu Ile Asn Thr Trp Val Ala
Lys Asn Thr Asn Asn 260 265 270 Lys Ile Ser Arg Leu Leu Asp Ser Leu
Pro Ser Asp Thr Arg Leu Val 275 280 285 Leu Leu Asn Ala Ile Tyr Leu
Ser Ala Lys Trp Lys Thr Thr Phe Asp 290 295 300 Pro Lys Lys Thr Arg
Met Glu Pro Phe His Phe Lys Asn Ser Val Ile 305 310 315 320 Lys Val
Pro Met Met Asn Ser Lys Lys Tyr Pro Val Ala His Phe Ile 325 330 335
Asp Gln Thr Leu Lys Ala Lys Val Gly Gln Leu Gln Leu Ser His Asn 340
345 350 Leu Ser Leu Val Ile Leu Val Pro Gln Asn Leu Lys His Arg Leu
Glu 355 360 365 Asp Met Glu Gln Ala Leu Ser Pro Ser Val Phe Lys Ala
Ile Met Glu 370 375 380 Lys Leu Glu Met Ser Lys Phe Gln Pro Thr Leu
Leu Thr Leu Pro Arg 385 390 395 400 Ile Lys Val Thr Thr Ser Gln Asp
Met Leu Ser Ile Met Glu Lys Leu 405 410 415 Glu Phe Phe Asp Phe Ser
Tyr Asp Leu Asn Leu Cys Gly Leu Thr Glu 420 425 430 Asp Pro Asp Leu
Gln Val Ser Ala Met Gln His Gln Thr Val Leu Glu 435 440 445 Leu Thr
Glu Thr Gly Val Glu Ala Ala Ala Ala Ser Ala Ile Ser Val 450 455 460
Ala Arg Thr Leu Leu Val Phe Glu Val Gln Gln Pro Phe Leu Phe Val 465
470 475 480 Leu Trp Asp Gln Gln His Lys Phe Pro Val Phe Met Gly Arg
Val Tyr 485 490 495 Asp Pro Arg Ala 500
* * * * *
References