CN1235545A - Composition, for treatment of asthma, containing loratadine and decongestant - Google Patents

Composition, for treatment of asthma, containing loratadine and decongestant Download PDF

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Publication number
CN1235545A
CN1235545A CN97199404A CN97199404A CN1235545A CN 1235545 A CN1235545 A CN 1235545A CN 97199404 A CN97199404 A CN 97199404A CN 97199404 A CN97199404 A CN 97199404A CN 1235545 A CN1235545 A CN 1235545A
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loratadine
pseudoephedrine
described method
patient
decongestant
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A·G·哈里斯
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Merck Sharp and Dohme Corp
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Schering Corp
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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
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445Non condensed piperidines, e.g. piperocaine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • A61P11/06Antiasthmatics

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Abstract

The invention relates to a method for improving pulmonary function of a patient suffering from asthma, comprising administering to the patient customary rhinitis treatment-effective amounts of loratadine and a decongestant such as pseudoephedrine.

Description

The compositions that is used for the treatment of asthma that contains loratadine and Decongestant
Preface of the present invention
The invention relates to the method that alleviates the anaphylactic disease symptom, more particularly, is about alleviating the method for bronchial asthma disease symptoms.
Asthma is considered to a kind of very serious chronic anaphylaxis disease, and its feature normally respiratory tract is extremely sensitive, the airflow obstruction of Fa Shenging repeatedly, and with cough, pant and the sensation of asphyxia symptom.It is one of modal chronic disease of child, may have influence on nearly 10% child.Asthma has very important influence to economy, because it causes wasting the considerable working and learning time, is one of common cause of seeking help from the doctor, and causes needs to increase many emergency treatment facilities and hospital.Asthma also can cause quite high mortality rate, particularly during malpractice.
It is generally acknowledged that the feature of asthma is the chronic respiratory inflammation, normally reversible respiratory tract obstruction in various degree, and respiratory tract is to the sensitivity increase of various stimulations.During acute exacerbation, can common muscle spasm, the respiratory tract edema, unusual mucus produces, and the inflammatory cell transudate, often is called by the patient " asthma attack ".
Respiratory tract edema and bronchospasm available following bronchodilator are usually successfully treated: epinephrine, and β 2-agonist salbutamol (being also referred to as " Soviet Union must be appropriate "), orciprenaline pirbuterol, terbutaline and salmaterol.Respiratory tract narrows down and can give corticosteroid such as prednisone by general usually, perhaps suck anti-inflammatory agent such as Beconase Nasal Syray, flunisolide, bent peace naphthalene moral, sodium cromoglicate and Nedocromil receive (nedocromil sodium) alleviate.β 2-agonist can be used as keeps administration every day, and can need give at sx the time, as " first aid " administration.The administration of corticosteroid general is curative, and is normally heavy dose of, is used for the treatment of the asthma attack situation, and but then, corticosteroid can be preventative, generally be used for than cases with severe, no matter at that time whether symptom was arranged, regularly, the compartment of terrain administration.These therapeutic agents are to coughing, pant and sensation of asphyxia generation mitigation, also can reduce respiratory tract narrows down in addition, to this improvement by mensuration patient's forced expiratory volume (FEV) or the highest expiratory gas flow (PEF) ratio, can easily carry out quantitative Diagnosis, the mensuration of these parameters and meaning are at The Merck
Manual of Diagnosis and Therapy, the 15th edition, R.Berkow, Ed., Merck Sharp﹠amp; Dohme ResearchLaboratories, Rahway, New Jersey, 1987,584-599 page or leaf, particularly existing argumentation the in the 588-9 page or leaf.Some patient also further needs other oral, injection and/or inhalation, so that control its disease, the final goal of treatment is to eliminate acute exacerbation.
Studies show that about 11% has the patient of nasal allergy symptom also to suffer from asthma, and nearly 80% bronchial asthma patient may also there be allergic rhinitis.Histamine is as pathogenic medium, and is all relevant with upper respiratory disease and lower respiratory illness, carried out the research of mensuration histamine H 1 receptor antagonist " hydryllin " to the symptoms of asthma effect.Have the antihistaminic old medicine of " calmness " property because some are usually thought, find that their anticholinergic effect is normally deleterious to asthmatic patient,, make the antihistaminic taboo be used for asthmatic patient so just be based on this consideration routinely.Representational suggestion be J.E.Donnelly etc. at " father and mother are to the misunderstanding of asthma administration " Annalsof Allergy, narration among the Vo1.62, p337-341 (1989), wherein in p338-9, write:
Can find, for the treatment asthma has given antibiotics to considerable infant, hydryllin and Decongestant ...This three classes medicine is to the not effect of treatment childhood asthma.
But, have the appearance of the hydryllin (as cetirizine) and the non-sedating hydryllin (as terfenadine and loratadine) of less sedation, remotivated interest with hydryllin treatment asthma.At R.E.Rakel, ed., Conn ' s Current Therapy1995, W.B.Saunders Co., Philadelphia, Pennsylvania, 1995, p.682-691 in, 686 pages, inscribe one's name in the chapters and sections into " childhood asthma disease ", P.V.Williams etc. write:
Hydryllin is weak bronchodilator, and newer medicament has some anti-inflammatory characteristics, and many in them can't have been bought in the U.S..They do not resemble other commercially available medicine effective to the treatment asthma.But, here to the description of these medicines with in many comprehensive publications, see should not to be used for the viewpoint of asthmatic patient about hydryllin inconsistent.If the patient suffers from asthma, will not avoid that they are used for these and suffer from upper respiratory tract patient hypersensitive, they may also useful effect to asthma.
Comprise with having in the research infra review literary composition that less sedation antihistamine drug cetirizine carries out of allergic rhinitis therapeutic dose commonly used and reporting: G.Bruttman etc., " cetirizine is to suffering from pollen asthma patient's protective effect ", Annals of Allergy, Vol.64,224-228 page or leaf (1990); J.H.Dijkman etc., " cetirizine is to the preventive therapy of the pollenogenic asthma of grass ", Clinical and Experimental Allergy, Vol.20, p483-490 (1990); J.A.Grant etc., " cetirizine is to suffering from seasonal rhinitis and concomitant asthma patient's effect: predetermined, and the controlled experiment of randomized and placebo ", The Journal of Allergy and Clinical Immunology, Vol.95, p923-932 (1995); And D.W.Aaronson, " cetirizine is to the evaluation of allergic rhinitis and asthmatic patient effect for many years ", Annals of Allergy, Asthma and Immunology, Vol.76, p440-446 (1996).Usually find that cetirizine can cause asthma symptom such as uncomfortable in chest, pant, some improvement of short of breath and cough, slow release rhinitis symptom simultaneously.But, do not show that pulmonary function has significant improvement, as by FEV value and finding that other parameter is measured.
Terfenadine is also studied, such as in following document report: A.Taytard etc., " treating bronchial asthma with terfenadine; randomized controlled experiment ", BritishJournal of Clinical Pharmacology, Vol.24, p.743-746 (1987); P.Rafferty etc., " terfenadine, a kind of effective histamine H that is used for the treatment of grass pollen hypersensitivity asthma 1-receptor antagonist ", British Journal ofClinical Pharmacology, Vol.30, p.229-235 (1990); And R.Wood-Baker etc., " specificity histamine H 1-receptor antagonist terfenadine is to double blinding, the research of placebo controlled experiment of the sick effect of serious chronic asthma ", British Journal ofClinical Pharmacology, Vol.39, p.671-675 (1995).With doubling dose to the allergic rhinitis common dose, perhaps 120mg every day 2 terfenadines, pulmonary function is also had only slight positive effect at most.But, the dosage range that Rafferty etc. are used, 180mg causes in the morning that the PEF value has increased by 5.5% every day 3 times, has increased by 6.2% at night.Because this medicine is known may to have cardiac toxicity, unusual heavy dose of conventional administration may be irrational.
A.Dirksen etc., " non-sedating hydryllin (loratadine) is to the effect of moderate asthma ", Allergy, Vol.44, p.566-571 in (1989), reported and given the rhinitis normal therapeutic dosage loratadine result of study of (10mg, every day 1 time) asthmatic patient.The patient shows, and along with treatment asthma symptom alleviates, still, demonstrates and has only less pulmonary function to improve, and being considered to does not have significance,statistical.
The Decongestant medicine also is usually used in treatment of allergic rhinitis.Wherein the most important thing is to have the sympathomimetic drug amine of alpha-adrenergic stimulating activity.Wherein the medicine of more widely used oral administration is N-cathine, ephedrine and pseudoephedrine.Decongestant merges the rhinitis that is applied to treat anaphylaxis and other type with hydryllin for a long time, and point out in above-mentioned some document, for auxiliary relief of symptoms once allowed the patient in the hydryllin clinical research to use pseudoephedrine about cetirizine and terfenadine research.But, be attributable to this dose regimen without any pennies from heaven.
Summary of the invention
The present invention relates to a kind of method that is used to improve the asthmatic patient pulmonary function, this method comprises loratadine and the Decongestant that gives patient's routine treatment of rhinitis effective dose.
Preferred Decongestant is a pseudoephedrine, and in order to obtain the result of requirement of the present invention, at present preferred treatment every day comprises and give 10mg loratadine, and one of following Drug therapy: the 240mg pseudoephedrine, with effectively suitably slow releasing preparation administration in 24 hours; Perhaps give 5mg loratadine and 120mg pseudoephedrine every day for 2 times with effective slow releasing preparation administration in 12 hours; Perhaps with the nearly immediate release formulations administration of 4 gradation administrations in 24 hours, total amount is 10mg loratadine and 240mg pseudoephedrine.Particularly use immediate release formulations, each medicine can separate administration or with the combination dosage form administration.
The accompanying drawing summary
Fig. 1 diagram is illustrated in the PEF data in morning that obtain in the clinical trial of embodiment.
Fig. 2 diagram is illustrated in the PEF data in night that obtain in the clinical trial of embodiment.
Fig. 3 diagram is illustrated in the FEV data that obtain in the clinical trial of embodiment.
Detailed Description Of The Invention
Mean by any about management organization (such as U.S. food and drug administration) drug dose approval, that be used for the treatment of the allergic rhinitis symptom at this medicine of quoting " conventional treatment of rhinitis effective dose ". Mean this " improving PFT " of quoting and to comprise and promote gas exchange process in the lung, particularly improved clinically shownly by the FEV that measures the patient and/or PEF value, these improve usually will be with the rapid impression of minimizing patient respiratory.
Loratadine is a kind of very widely used no calmness antihistamine drug, has fabulous security, its chemical constitution is ethyl-4-(8-chloro-5,6-dihydro-11H-benzo [5,6] ring heptan also [1,2-b] pyridine-11-subunit)-1-piperidine carboxylic acid salt, molecular formula is C22H 23ClN 2O 2, molecular weight 382.89. In the United States Patent (USP) 4,282,233 of Vilani, this active drug and preparation method thereof has been described. At United States Patent (USP) 4,731, the method described in 447 also can prepare this medicine easily according to Schumacher etc. In order to be used for the present invention, Loratadine can be by any formulation administration in following several formulations (comprise but do not limit to): tablet, capsule, syrup, perhaps by injection, patient for convenience is as most medicines, preferably with the form oral administration of tablet or capsule.
The effective hydryllin weight range of loratadine is about every day of 5~40mg.In view of loratadine and effective half-life in the body of metabolite thereof, daily dose can be once to give in per 24 hours, perhaps preferably is divided into 2,3 or 4 equal portions, with the administration that is complementary of the administration number of times of congestion medicine.For alleviating the symptom of allergic rhinitis, the typical daily dose of loratadine is 10mg.The Schering company of New Jersey Kenilworth sells a kind of with CLARITIN 10mg loratadine tablet for trade mark.
Effectively the congestion medicine comprises topical Decongestant and whole body administration Decongestant.Local Decongestant generally is the form administration with drop or aerosol such as nasal spray, and contains following medicine: oxymetazoline, phenylephrine, naphazoline, xylometazoline, ephedrine, epinephrine, tuaminoheptane, tetrahydrozoline and xylometazoline.For long-term treatment, local Decongestant is not preferred, and its reason is because the untoward reaction that can only finally may occur by the rhinitis medicine of intermittent administration treatment usually.
Be applicable to the decongestant drug compounds of implementing whole body administration of the present invention, comprise sympathomimetic drug amine such as N-cathine, ephedrine, pseudoephedrine and phenylephrine, in case of necessity, at this medicine of quoting also particularly including its salt that pharmaceutically is suitable for.In view of the suitable balance to its effect and safety, wherein the most widely used is pseudoephedrine, and normally with its water-soluble hydrochloride salt, sulfate or other salt are used for formulated product.The pseudoephedrine sulfate chemical name is [S (R *, R *)]-α-[1 (methylamino) ethyl] benzyl alcohol sulfate, molecular formula is (C 10H 15NO) 2H 2SO 4, molecular weight 428.54.From Herba Ephedrae, extract this chemical compound, and the chemosynthesis of this chemical compound, all be well known in the art.In order to be used for the present invention, pseudoephedrine sulfate can be by any dosage form administration in following several dosage forms, include but is not limited to tablet, capsule, syrup is perhaps by injection, for convenience of the patient, as most medicines, preferably with tablet or capsular form oral administration.
Usually in order to alleviate the hyperemia of allergic rhinitis, pseudoephedrine sulfate or hydrochlorate are 120-360mg to the daily dose of adult's administration, are 60-180mg to child's daily dose.But the intravital half-life of pseudoephedrine is significantly shorter than the half-life of loratadine.When using immediate release formulations, once give 60mg usually, give 4 times in per 24 hours adult patients.But the solid preparation that multiple slow release is arranged known in the art is for example made the medicine of 120mg, effectively surpasses 12 hours, and contains the 240mg medicine, continues whole 24 hours effective preparations.
The unnecessary while administration of loratadine and Decongestant.For example, loratadine can be administered once every day, and congestion medicine administration number of times is more, so that keep drug disposition treatment concentration.Even during administration simultaneously, they are present in same preparation or the same dosage form.
Well known preparation with antihistamine drug and congestion medicine formulated in combination.For loratadine, comprise a kind of 5mg of containing loratadine and 60mg pseudoephedrine sulfate in these preparations, the preparation that can from tablet coating, discharge immediately, it also contains 60mg and discharges with controlled release speed from be subject to the aggressivity tablet matrix, the pseudoephedrine that surpasses 12 hours effects is provided, and can buy trade mark from the Schering company of New Jersey Kenilworth in the U.S. is CLARITIN-D Effective product of 12HOUR.Another kind of preparation has added the loratadine that 10mg can discharge immediately from tablet coating, and 240mg discharges with controlled release speed from be subject to the aggressivity tablet matrix, and the pseudoephedrine that surpasses 24 hours effects is provided; Described this technology in the United States Patent (USP) 5,314,697 of Kwen etc., in the U.S., can buy trade mark from Schering company is CLARITIN-D Effective product of 24HOUR.Because convenient, most patients can preferred this based composition preparation.
Will the invention will be further described by following embodiment, still, its intention is limited the scope of claims by any way.
Embodiment
Carried out clinical trial in autumn hypersensitive, 193 adult patients random packet of suffering from asthma and rhinitis are accepted above-mentioned CLARITIN-D -12 HOUR product or placebo, continued for 6 weeks at every day 2 times.All patients are using the bronchodilator salbutamol, will continue to use at duration of test, so that the control symptoms of asthma, by doctor's prescription regulation, with the compression aerosol inhaler administration of limiting dose.In addition, the patient does not allow to use other any rhinitis or asthma medicament at duration of test.
Before on-test, especially by measuring, FEV and PEF ratio obtain basic data, the patient is made an appraisal, and at duration of test, repeat evaluating and measuring weekly once.
Find to compare with the patient who only accepts placebo, the patient who accepts combination medicament experiences the rhinitis and the asthma symptom of obvious minimizing.
Fig. 1 shows patient's (solid line) who accepts loratadine and pseudoephedrine sulfate and the patient's (dotted line) who accepts placebo, measures the result of PEF ratio morning.Ordinate is the PEF average of relatives change from basic value, to rise/minute expression.As seen at duration of test because the drug regimen administration, have tangible significance,statistical to improve.
Fig. 2 represents the patient is measured night the result of PEF ratio similarly, and the patient divides into groups the same.The result of drug regimen administration is that duration of test has tangible significance,statistical improvement.
Secondary was by measuring FEV (" FEV before Fig. 3 was illustrated in 1") the further result of the test that obtains.Ordinate shows from basic FEV 1The average change of value is to rise expression.From the data that the patient who accepts loratadine and pseudoephedrine sulfate obtains, represent with solid post, and, represent with open tubular column from the data that the patient who only accepts placebo obtains.Because the drug regimen administration, having very significantly at duration of test, the significance,statistical pulmonary function improves.
No matter whether the patient suffers from rhinitis, improve degree at this shown pulmonary function, peaceful significant to asthmatic patient.

Claims (16)

1. method that is used to improve the asthmatic patient pulmonary function, this method comprises loratadine and the Decongestant that the patient is given conventional treatment of rhinitis effective dose.
2. the described method of claim 1, wherein Decongestant is selected from the N-cathine, ephedrine, phenylephrine, pseudoephedrine, or their compositions.
3. the described method of claim 1, wherein Decongestant comprises pseudoephedrine.
4. the described method of claim 3, wherein pseudoephedrine is the dosed administration by about 60-360mg every day.
5. the described method of claim 3, wherein pseudoephedrine is the dosed administration by about 120-240mg every day.
6. the described method of claim 1, wherein loratadine is the dosed administration by about 5-40mg every day.
7. the described method of claim 1, wherein loratadine is the dosed administration by about 10mg every day.
8. the described method of claim 1, this method comprise and give the 10mg loratadine every day, and about 120-240mg pseudoephedrine.
9. the described method of claim 1, wherein loratadine and Decongestant are with independently preparation administration.
10. the described method of claim 1, wherein loratadine and Decongestant are to be combined in the same preparation.
11. comprising, a method that is used to improve the asthmatic patient pulmonary function, this method give about 5-40mg loratadine every day to the patient, and about 60-360mg pseudoephedrine.
12. the described method of claim 11, wherein loratadine and pseudoephedrine are with independently preparation administration.
13. the described method of claim 11, wherein loratadine and pseudoephedrine are to be combined in the same preparation.
14. the described method of claim 11, wherein loratadine and pseudoephedrine are present in the same tablet, and in this tablet, loratadine and part pseudoephedrine exist with the coating form, and remaining pseudoephedrine is present in the easy aggressivity substrate.
15. the described method of claim 11, wherein loratadine and pseudoephedrine are present in the same tablet, and in this tablet, loratadine exists with the coating form, and pseudoephedrine is present in the easy aggressivity substrate.
16. comprising, a method that is used to improve the asthmatic patient pulmonary function, this method give about 10mg loratadine and about 240mg pseudoephedrine every day to the patient.
CN97199404A 1996-10-31 1997-10-29 Composition, for treatment of asthma, containing loratadine and decongestant Pending CN1235545A (en)

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CN101495100A (en) * 2006-06-01 2009-07-29 先灵-普劳健康护理产品公司 Sustained release pharmaceutical formulation comprising phenylephrine
CN101081224B (en) * 1999-12-20 2012-05-30 先灵公司 Stable extended release oral dosage composition
CN101134038B (en) * 1999-12-20 2013-11-06 默沙东公司 Extended release oral dosage composition

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PA8481801A1 (en) * 1998-09-10 2000-09-29 Schering Corp METHODS AND COMPOSITIONS FOR TREATING SINUSITIS, OTITIS MEDIA AND OTHER RELATED DISORDERS USING ANTIHISTAMINES
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CA2405238C (en) * 2000-04-14 2014-03-18 J-Med Pharmaceuticals, Inc. Single-dose antihistamine/decongestant formulations for treating rhinitis
PE20020055A1 (en) * 2000-05-25 2002-02-12 Schering Corp STABLE LIQUID AND SOLID FORMULATIONS INCLUDING A NON-SEDATING ANTIHISTAMINE AND A NASAL DECONGESTANT
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NZ541960A (en) 2005-06-17 2010-01-29 Aft Pharmaceuticals Ltd Novel pharmaceutical composition and its use in a method for treatment of patients with upper respiratory mucosal congestion
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CN101081224B (en) * 1999-12-20 2012-05-30 先灵公司 Stable extended release oral dosage composition
CN101134038B (en) * 1999-12-20 2013-11-06 默沙东公司 Extended release oral dosage composition
CN101495100A (en) * 2006-06-01 2009-07-29 先灵-普劳健康护理产品公司 Sustained release pharmaceutical formulation comprising phenylephrine

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