CA2170748C - Pharmaceutical preparations for the targeted treatment of crohn's disease and ulcerative colitis - Google Patents

Pharmaceutical preparations for the targeted treatment of crohn's disease and ulcerative colitis Download PDF

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Publication number
CA2170748C
CA2170748C CA002170748A CA2170748A CA2170748C CA 2170748 C CA2170748 C CA 2170748C CA 002170748 A CA002170748 A CA 002170748A CA 2170748 A CA2170748 A CA 2170748A CA 2170748 C CA2170748 C CA 2170748C
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Prior art keywords
pharmaceutical preparation
preparation according
capsule
cellulose
active agent
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Expired - Fee Related
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CA002170748A
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French (fr)
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CA2170748A1 (en
Inventor
Ulrich Posanski
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Novartis AG
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Novartis AG
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/48Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4891Coated capsules; Multilayered drug free capsule shells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00Drugs for immunological or allergic disorders
    • A61P37/02Immunomodulators
    • A61P37/06Immunosuppressants, e.g. drugs for graft rejection

Abstract

The invention relates to a pharmaceutical preparation, which contains an immunosuppressive active agent in dissolved form in a starch capsule, or hard or soft gelatin capsule which has been coated with one or several polymer films.

The invention further relates to a process for the production of the pharmaceutical preparation.

Description

Pharmaceutical Preparations for the Targeted Treatment of Crohn's Disease and Ulcerative Colitis The invention relates to a pharmaceutical preparation for the enteral treatment of Crohn's disease and ulcerative colitis, which contains an immunosuppressive active agent, which is administered in the form of a special galenic formulation for targeted local activity in the intestinal area, its use and a process for the production thereof.

The therapies known today for the treatment of Crohn's disease and ulcerative colitis are not very effective. At the end of drug treatment, the patient usually faces surgical intervention. There are numerous preparations for extending and improving the therapeutical possibilities, but until now no preparation has been able to meet the medicinal requirements to a maximum degree.

One possibility of local, enteral therapy of inflammatory intestinal infections was opened up with the development and usage of special mesalazine-containing (5-aminosalicyclic acid) preparations, which release the active agent in the distal part of the small intestine and in the large intestine. The preparations concerned are solid forms of administration, which contain the active agent in crystalline form despite its poor solubility.

US Patent 5,206,219 describes pharmaceutical preparations for oral administration, comprising a dosage unit of a proteinase inhibitor and of a protein-like medicament, selected from the group consisting of erythropoietin, insulin, growth hormone, calcitonin, growth-colony-stimulating factor, cyclosporin, vasopressin, vasopressin-agonist, vasopressin antagonist, t-PA, bat's plasminogen, amplificator, urokinase, streptokinase, interferon and interleukin, a phospholipid, cholesterol, a hyrophilic or hydrophobic, surface-active agent and an essentially non-aqueous, non-alcoholic, pre-emulsified emulsifiable solution.
A new possibility is represented by the use of immunosuppressive active agents which are more effective than the salicyclic acid derivatives, but when applied systemically in therapeutically effective dosages have considerable side effects.
The present invention is based on the problem of making available a pharmaceutical preparation for the targeted treatment of Crohn's disease and ulcerative colitis, which contains an immunosuppressive active agent. The activity of the preparation should be targeted at the small and large intestines, and the preparation should ensure local, enteral application of the immunosuppressive active agent at the site of occurrence of the inflammatory disorder.

Surprisingly, an improvement in the rate of effect over the side effects of the immunosuppressive active agent, i.e. a broadening of the therapeutical range, is achieved through the local application of the active agents in the form of a new pharmaceutical preparation, which transports the active agent to the site of occurrence of the inflammatory disorder and allows optimum activity there.

The immunosuppressive active agents from the group of macrolides claimed here are poorly soluble in aqueous media, e.g. in the lumen of the gastrointestinal tract.
The dissolution conditions are extremely unfavourable for poorly soluble active agents owing to the small amount of fluid available, especially in the area being envisaged for activity of the preparation, the distal small intestine and the large intestine. As a consequence thereof, the active agent should advantageously be transported to the site of the disorder in an already dissolved form. To this end, ideally, a solution of the active agent is filled into starch capsules, or hard or soft gelatin capsules. The unmodified gelatin capsule or starch capsule does not survive transit through the stomach and the upper small intestine area.

Undesired dissolution of the capsule shell in the area of the stomach or upper small intestine is prevented by coating the external capsule wall with a polymer film. The choice and usage of appropriate polymers, including additional materials such as softeners and pore-forming agents, control the site of dissolution of the capsule and the release of solution containing the active agent.

The object of the invention is a pharmaceutical preparation which contains one or several immunosuppressive active agent(s) in dissolved form in a starch capsule, or hard or soft gelatin capsule which is coated with one or several polymer films, as a single active substance.

A further object of the invention is a process for the production of the preparation according to the invention, which is characterised in that the active agent is dissolved in a solvent which is suitable for encapsulation into starch or gelatin capsules, or in a mixture of several solvents and optionally solubilizers and/or other excipients, the solution is then filled in a manner known per se into starch capsules, or hard or soft gelatin capsules in a measured dose, the capsules are sealed and the capsules are coated with a solution or dispersion of a polymer or polymer mixture and dried, whereby the coating procedure may be repeated once or several times.

In one particular embodiment there is provided pharmaceutical preparation, containing rapamycin, tacrolimus, cyclosporin A or combinations thereof as immunosuppressive active ingredient in dissolved form in a starch capsule, or hard or soft gelatin capsule, which has been coated with one or several polymer films, whereby the capsule is coated with at least one polymer film which contains at least one pore-forming agent.

- 3a -The preparation according to the invention is suitable for the local, enteral treatment of Crohn's disease and ulcerative colitis. It contains an immunosuppressive active agent which is poorly soluble in water. The preparation according to the invention contains as active agent rapamycin, tacrofimus, cyclosporin A or combinations of these active agents. The solvents that are appropriate for dissolving the active agent are those that are pharmaceutically acceptable and in which the active agent dissolves.

Examples of these are ethanol, 1,2-propylene glycol, glycerol, polyethylene glycol 300/400, benzyl alcohol, medium-chained triglycerides and vegetable oils.
If required, the usual medicament excipients may be added to the solution of active agent and solvent, for example surface-active agents and agents which affect viscosity. Examples of such excipients are mono-/di-fatty acid glycerides, sorbitan fatty acid esters, polysorbates, Mirj 52, lecithin, sodium lauryl sulphate, sodium dioctylsulphosuccinate, Cremophor RH40/EL, AerosilTM and water-soluble cellulose derivatives.

Mixtures of solvents and the above-mentioned excipients may also be used. The concentration of active agent in the solvent or mixture is adjusted such that it lies between 0.2 and 20 % (weight/weight), preferably between 1 and 15 %
(weight/weight), particularly preferred between 2 and 10 % (weight/weight).
The solution of the active agent is filled into a conventional starch capsule, or soft or hard gelatin capsule in an amount of 0.05 ml to 2 ml, preferably in an amount of 0.1 to 1.4 ml. The gelatin capsules or starch capsules employed may be those that are normally used in the pharmaceutical field and that are available commercially. If desired, the capsule may be additionally provided with a sealing strip, in order to prevent the solution of active agent from escaping.
Production of the soft gelatin capsules is effected for example analogously to the known Scherer processes. The starch capsules are available under the commercial name Capill .
To enable local enteral application of the immunosuppressive active agents deoxyspergualin, rapamycin, tacrolimus, and cyclosporin A to take place, after swallowing the capsule, there must be passage of the intact capsule through the stomach and the upper small intestine region. To this end, the soft or hard gelatin capsule is coated with one or several polymer films, whereby the targeted capsule dissolution and release of active agent is achieved through the film composition.
Two principles or a combination of these principles may be offered for this purpose:

4a - 2170748 1. Premature dissolution of the capsule is prevented by coating the capsule with a polymer film containing acid groups, whereby the type of acid and the number of acid groups control dissolution of the film in dependence of the Ph value of the surroundings.

2. Dissolution of the capsule is controlled by diffusion mechanisms, whereby the polymer film is insoluble in water and the diffusion operations are influenced by additional substances such as water-soluble pore forming agents and softeners.

Within the sense of this invention, especially suitable polymers for principle 1 are:
Cellulose-acetate trimellitate, -acetate succinate, -acetate phthalate, hydroxypropyl methylcellulose phthalate, -acetate succinate, carboxymethylethyl cellulose (Trade mark e.g. Duodcell ), polyvinyl acetate phthalate (commercial products, e.g.
Coateric0, Opadry Entericft copolymerisates of vinyl acetate and crotonic acid (commercial product, e.g. Coating CE 51420), polymethacrylates, e.g.
copolymerisates of methacrylic acid and methyl-methacrylate, copolymerisates of methacrylic acid and ethyl acrylate (commercial products are e.g. Eudragit UL30D). Mixtures of these polymers may also be used.

Suitable polymers for principle 2 are:

Methylcellulose (Trade mark e.g. Methocel), ethylcellulose (commercial product e.g. Ethocel0, Aquacoat(D ECD30), cellulose acetate, cellulose acetate propionate, cellulose acetate butyrate, polyvinyl derivatives, e.g. polyvinyl alcohol, polyvinyl acetate, vinyl acetate/vinyl pyrrolidone copolymers (commercial products are e.g.
PVP-VA types of GAF), copolymerisates of methacrylic acid and ethyl acrylate (commercial products are e.g. EudragitO RURS/NE30D/RL30D/RS30D), copolymerisates of polymethyl vinyl ether and malonic acid anhydride, copolymerisates of polymethyl vinyl ether and malonic acid or the ethyl-, isopropyl-, n-butylesters thereof (commercial products are e.g. the Gantrez polymers of the series ES/AN/S), or mixtures of these polymers.

Moreover, for both principles, the thickness of the polymer film on the capsule surface is significant for the progress of capsule dissolution and the release of active agent. The required film thickness may differ individually for each polymer. In addition, it depends on other excipients, e.g. softeners, the solvent or dispersing agent used during the film-coating process, the film application technique, and the capsule shape. In practice, the amounts applied lie between 1 mg/cm2 and 100 mg dry film substance / cm2 capsule surface. The proportion by weight of the dried film coating on the whole medicinal substance is normally less than 10% (by weight).

If both principles are used in combination and the polymers are applied separately, then one film serves as an external film corresponding to principle 1. This external film must have a dissolution time of more than 2 hours in the gastric juices.

The properties of the polymer films may be further influenced by additions of pore-forming agents and softeners. Suitable pore-forming agents to form open pores and thus to increase the diffusion rate through the polymer coating are water-soluble substances, e.g. lactose, saccharose, sorbitol, mannitol, glycerol, polyethylene glycol consisting of less than 6000 ethylene oxide units, 1,2-propylene glycol, hydroxypropyl cellulose, hydroxypropyl methylcellulose, methylcellulose, as well as mixtures thereof. The proportion by weight of the pore-forming agents on the dried film coating is less than 20% (weight/weight).

Suitable softeners are the alkyl esters of citric acid, tartaric acid and 1,8-octanedi-carboxylic acid, e.g. triethyl citrate, tributyl citrate, acetyl triethyl citrate, dibutyl tartrate, diethyl sebacate, or resp. esters of phthalic acid, e.g. dimethyl phthalate, diethyl phthalate, dioctyl phthalate, or resp. glycerol esters, e.g. castor oil, sesame oil, acetylated fatty acid glycerides, glycerol triacetate, glycerol diacetate, or resp.
higher alcohols, e.g. glycerol, 1,2-propylene glycol, or resp. polyethers, e.g. poly-ethylene glycols and polyoxyethylene-polypropylene block copolymers, or resp.
wetting agents, e.g. PEG-400 stearate, sorbitan monooleate, PEG-sorbitan mono-oleate.

For application, the polymer or a mixture of polymers is dissolved or dispersed in an organic solvent or in a solvent mixture. Suitable solvents are for example ethanol, isopropanol, n-propanol, acetone, ethyl acetate, methyl ethyl ketone, methanol, methylene chloride, tert.-butanol, propylene glycol monomethyl ether and water.

Solvent mixtures or mixtures of these solvents with water may also be used.
For better processing of the film coatings, the usual excipients may be added to them, for example colloidal silicon dioxide, talcum and magnesium stearate. In order to apply and dry the polymer film, all known processes for applying films to tablet or pellets are suitable, e.g. dip-sword, immersion tube, coating, fluidised bed, Wurster column, Accela-CotaT"", Hi-CoaterTM, DriacoaterTM or ball-coater processes.

The person skilled in the art may determine the properties of the polymer films by means of simple preliminary tests. It is especially important here that, after swallowing the preparation, the intact capsule is allowed to pass through the stomach and the upper small intestine.

For example, the coated capsules undergo a test of the release of active agent according to USP in a "dissolution rate" testing apparatus having a small rotating basket. To this end, the capsules are first of all exposed to artificial gastric juice for two hours. Afterwards, the medium is changed over to artificial intestinal juice pH 6.8. After a further four hours, it is adjusted to artificial intestinal juice pH 7.2.
During the whole duration of the test, the concentration of active agent in the medium is determined continuously e.g. using a suitable HPLC method. During the testing periods, the active agent should not be detectable in the artificial gastric juice nor in the artificial intestinal juice pH 6.8, since otherwise the intact capsule would not be allowed to pass to the site of action.

The following examples illustrate the invention without restricting it.
Exam I

The following solution of active agent is filled into oval soft gelatin capsules of size minims:

Amounts in mg/capsule content after production:

cyclosporin A 25.0 ethanol 96% 25.0 polyoxyethylene-(40)-hydrogenated castor oil 87.5 neutral oil 50.0 di/tri/tetraglycerol fatty acid ester 62.5 Two polymer films are subsequently applied to the dried soft gelatin capsules.
To this end, 250,000 soft gelatin capsules are filled into an Accela-Cota (AC48).
15.0 kg of the first polymer solution are sprayed on, and the solvent is continuously removed during the process. The temperature of the air supply for drying the capsules is 35 C.

The first polymer solution consists of (amounts in % by weight):
ethyl cellulose 5.0 triacetine 1.0 polyethylene glycol 1500 0.6 ethanol 96% 93.4 The second polymer solution consists of (amounts in % by weight):

hydroxypropyl methylcellulose phthalate (HP-55) 8.0 dist. acetylated glycerides 0.8 acetone 46.0 ethanol 95% 45.2 13.5 kg of the second solution are applied in the same apparatus. The air supply temperature is lowered to 30 C. After ending the film application, the temperature is raised to 40 C to remove residual solvents.

Example 2 The following solution of tacrolimus is filled into soft gelatin capsules of size 8 minims:

Amount of capsule content in mg per capsule after production:
tacrolimus 10.0 polysorbate 80 270.0 neutral oil 135.0 sorbitan monolaurate 45.0 A cellulose acetate film is applied to the dried capsules. To this end, 150,000 capsules are filled into a driacoater (DR 1200) having a solvent recovery system. The air supply temperature during film coating is set at 30 C. The sprayed polymer solution has the following composition:

cellulose acetate 5.0 polyethylene glycol 4000 0.3 acetone 80.0 water 14.7 Example 3 A solution containing the active agent rapamycin is filled into hard gelatin capsules of size 1 ". The amounts correspond to the capsule content in mg.

rapamycin 5.0 polysorbate 60 230.0 polyethylene glycol 400 190.0 glycerol 5.0 1,2-propylene glycol 20.0 total content 450.0 In addition to this, there is the weight of the empty capsule at 77 mg. Three polymer solutions are applied in succession to these filled hard gelatin capsules (amounts respectively given in % by weight).

The composition of the first solution:
hydroxypropyl cellulose 7.5 polyethylene glycol 1500 0.5 ethanol 96% 92.0 This polymer film is applied to seal the capsules and assists the remaining processing stages (undercoat).

The composition of the second solution:
Eudragit RS 30D 27.0 Eudragit RL 30D 6.0 triethyl citrate 2.0 talcum 2.5 water 62.5 The composition of the third solution:

hydroxypropyl methylcellulose acetate succinate 10.0 triethyl citrate 3.0 talcum 3.0 wate r 84.0 Film coating is effected in a fluidised bed apparatus. The air supply temperature during film application is 48 C. The spray rate and air diffusion are set such that the outgoing air temperature remains at 21 C.

Claims (15)

CLAIMS:
1. Pharmaceutical preparation, containing rapamycin, tacrolimus, cyclosporin A or combinations thereof as immunosuppressive active ingredient in dissolved form in a starch capsule, or hard or soft gelatin capsule, which has been coated with one or several polymer films, whereby the capsule is coated with at least one polymer film which contains at least one pore-forming agent.
2. Pharmaceutical preparation according to claim 1, wherein the capsule coating consists of a polymer selected from the group of cellulose derivatives, methacrylic acid derivatives, polyvinyl derivatives and mixtures thereof.
3. Pharmaceutical preparation according to claim 1 or 2, wherein the hard or soft gelatin capsules are coated with a polymer film or several polymer films selected from the group consisting of methyl cellulose, ethyl cellulose, cellulose acetate, cellulose acetate butyrate, cellulose acetate phthalate, cellulose acetate trimellitate, cellulose acetate propionate, hydroxypropyl methyl cellulose, hydroxypropyl cellulose, hydroxypropyl methyl cellulose phthalate, hydroxypropyl methyl cellulose acetate succinate, polyvinyl alcohol, polyvinyl acetate, polyvinyl acetate phthalate, methylacrylic acid / methyl-methacrylate copolymers, methacrylic acid / ethyl acrylate copolymers, polymethyl vinyl ether / malonic acid anhydride copolymers, polymethyl vinyl ether / malonic acid-ethyl,-isopropyl,-n-butylester copolymers and mixtures thereof.
4. Pharmaceutical preparation according to any one of claims 1 to 3, wherein the concentration (w/w) of active agent in the encapsulated solution lies between 0.2 and 20%.
5. Pharmaceutical preparation according to any one of claims 1 to 3, wherein the concentration (w/w) of active agent in the encapsulated solution lies between 1 and 15%.
6. Pharmaceutical preparation according to any one of claims 1 to 3, wherein the concentration (w/w) of active agent in the encapsulated solution lies between 2 and 10%.
7. Pharmaceutical preparation according to any one of claims 1 to 6, wherein the dissolved active agent is released from the capsule in the small and/or large intestinal area of humans.
8. Pharmaceutical preparation according to any one of claims 1 to 7, wherein the pore-forming agent is soluble in water.
9. Pharmaceutical preparation according to claim 8, wherein the pore-forming agent is lactose, saccharose, sorbitol, mannitol, glycerol, polyethylene glycol consisting of less than 6000 ethylene oxide units, 1,2-propylene glycol, hydroxypropyl cellulose, hydroxypropyl methyl cellulose, methyl cellulose, or mixtures thereof.
10. Pharmaceutical preparation according to any one of claims 1 to 9, wherein the proportion by weight of the pore-forming agent on the dried film coating is less than 20% (weight/weight).
11. Pharmaceutical preparation according to any one of claims 1 to 10, wherein the polymer film additionally contains a softener.
12. Pharmaceutical preparation according to claim 11, wherein the softener is an alkyl ester of citric acid, tartaric acid, 1,8-octanedicarboxylic acid, phthalic acid, a glycerol ester, a higher alcohol, a polyether or a wetting agent.
13. Process for the production of a pharmaceutical preparation according to any one of claims 1 to 12, wherein the active agent is dissolved in a solvent which is suitable for encapsulation into starch or gelatin capsules, or in a mixture of several solvents and other excipients, the solution is then filled into starch capsules, or hard or soft gelatin capsules in a measured dose, the capsules are sealed and the capsules are coated with a solution or dispersion of a polymer or polymer mixture and dried, wherein the coating procedure may be repeated once or several times.
14. Use of a pharmaceutical preparation according to any one of claims 1 to 12, for the production of a medicament for treating Crohn's disease or ulcerative colitis.
15. Use of a pharmaceutical preparation according to any one of claims 1 to 12, for treating Crohn's disease or ulcerative colitis.
CA002170748A 1993-09-01 1994-08-10 Pharmaceutical preparations for the targeted treatment of crohn's disease and ulcerative colitis Expired - Fee Related CA2170748C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE4329503A DE4329503A1 (en) 1993-09-01 1993-09-01 Pharmaceutical preparations for the targeted treatment of Crohn's disease and ulcerative colitis
DEP4329503.7 1993-09-01
PCT/EP1994/002643 WO1995006464A1 (en) 1993-09-01 1994-08-10 Pharmaceutical preparations for the targeted treatment of morbus crohn and colitis ulcerosa

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CA2170748A1 CA2170748A1 (en) 1995-03-09
CA2170748C true CA2170748C (en) 2008-10-28

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EP (2) EP1110545A3 (en)
JP (1) JP3712005B2 (en)
AT (1) ATE207743T1 (en)
AU (1) AU693470B2 (en)
CA (1) CA2170748C (en)
CY (1) CY2340B1 (en)
DE (2) DE4329503A1 (en)
DK (1) DK0716598T3 (en)
ES (1) ES2166781T3 (en)
NZ (1) NZ271655A (en)
PT (1) PT716598E (en)
WO (1) WO1995006464A1 (en)

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US9220681B2 (en) 2012-07-05 2015-12-29 Sigmoid Pharma Limited Formulations
US9278070B2 (en) 2009-05-18 2016-03-08 Sigmoid Pharma Limited Composition comprising oil drops
US9387179B2 (en) 2007-04-04 2016-07-12 Sigmoid Pharma Limited Pharmaceutical cyclosporin compositions

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Publication number Priority date Publication date Assignee Title
US9387179B2 (en) 2007-04-04 2016-07-12 Sigmoid Pharma Limited Pharmaceutical cyclosporin compositions
US9585844B2 (en) 2007-04-04 2017-03-07 Sigmoid Pharma Limited Oral pharmaceutical composition
US9278070B2 (en) 2009-05-18 2016-03-08 Sigmoid Pharma Limited Composition comprising oil drops
US9220681B2 (en) 2012-07-05 2015-12-29 Sigmoid Pharma Limited Formulations

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JPH09501939A (en) 1997-02-25
ES2166781T3 (en) 2002-05-01
EP0716598A1 (en) 1996-06-19
EP1110545A3 (en) 2001-07-04
AU693470B2 (en) 1998-07-02
EP1110545A2 (en) 2001-06-27
WO1995006464A1 (en) 1995-03-09
DE59409929D1 (en) 2001-12-06
NZ271655A (en) 1997-09-22
AU7535494A (en) 1995-03-22
PT716598E (en) 2002-04-29
CY2340B1 (en) 2004-02-06
DK0716598T3 (en) 2002-02-18
ATE207743T1 (en) 2001-11-15
DE4329503A1 (en) 1995-03-02
EP0716598B1 (en) 2001-10-31
CA2170748A1 (en) 1995-03-09
JP3712005B2 (en) 2005-11-02

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