CN1756545A - Use of omega-3-fatty acids in the treatment of diabetic patients - Google Patents

Use of omega-3-fatty acids in the treatment of diabetic patients Download PDF

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Publication number
CN1756545A
CN1756545A CNA2004800055600A CN200480005560A CN1756545A CN 1756545 A CN1756545 A CN 1756545A CN A2004800055600 A CNA2004800055600 A CN A2004800055600A CN 200480005560 A CN200480005560 A CN 200480005560A CN 1756545 A CN1756545 A CN 1756545A
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epa
dha
patient
diabetes
medicine
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R·厄尔策
C-N·韦尔博姆
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Abbott Products GmbH
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Solvay Pharmaceuticals GmbH
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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
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/20Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
    • A61K31/202Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids having three or more double bonds, e.g. linolenic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00Drugs for disorders of the metabolism
    • A61P3/08Drugs for disorders of the metabolism for glucose homeostasis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00Drugs for disorders of the metabolism
    • A61P3/08Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system

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  • Health & Medical Sciences (AREA)
  • Diabetes (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Emergency Medicine (AREA)
  • Obesity (AREA)
  • Epidemiology (AREA)
  • Hematology (AREA)
  • Endocrinology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

The invention concerns the use of essential fatty acids with a high content in eicosapentaenoic acid ethyl ester (EPA) or docosahexaenoic acid ethyl ester (DHA) useful for preventing of cardiovascular events in patients with diabetes mellitus.

Description

The application of omega-3-fatty acid in the treatment diabetics
Invention field
The present invention relates to the application of pharmaceutical composition in suffering from the patient of diabetes, described pharmaceutical composition contains the mixture of the ethyl ester class of (the 20:5 ω 3) eicosapentaenoic acid (EPA) of the essential fatty acid ethyl ester class, particularly high concentration that derive from fish oil and (22:6 ω 3) docosahexenoic acid (DHA).
Background of invention
Some essential fatty acid that contains in the well-known fish oil is in prevention and treatment cardiovascular disease, such as treating hypertension, thrombosis, hypercholesterolemia, arteriosclerosis, cerebral infarction; Patient's sudden death behind the prevention myocardial infarction; Improve in endothelial function and the hyperlipemia and have therapeutical effect.
Can quote U.S. Pat 5,502,077, US 5,656,667 and US 5,698,594 as an example.Cardiovascular disease, the prevention in the mortality of acute myocardial infarction (AMI) hospital stay survival especially is described in the International Patent Application WO 00/48592.
The relevant ω of belonging to-3 fatty acid of family is provided in the above-mentioned prior art especially, is the application in the above-mentioned disease of treatment of (20:5 ω 3) eicosapentaenoic acid (EPA) and (22:6 ω 3) docosahexenoic acid (DHA) in particular.
As the fatty acid EPA of PGI 3 and TxA3 precursor produce prevention can suppress owing to cyclo-oxygenase (effect similar) to aspirin and/or with the platelet aggregation effect and the blood coagulation resisting function of arachidonic acid competition this kind of enzyme, subsequently as the PGE2 of well-known platelet aggregating agent with TxA2 is synthetic reduces.
On the other hand, fatty acid DHA be in National People's Congress's cephalopin most important composition and or the constituent of platelet cell, it gets involved the platelet increasing flowability indirectly, plays an important role in anticoagulating active thus.
The industrial method that extracts the mixture with high-load polyunsaturated acid class from animal and/or vegetable oil has been described in the International Patent Application WO 89/11521 especially, described polyunsaturated acid class comprises EPA and DHA and ethyl ester class thereof, and the document is incorporated herein by reference.
Report the fatty acid mixt, the especially EPA/DHA that obtain according to WO89/11521 and be used in particular for treating cardiovascular disease.
Yet the verified Therapeutic Method that is used for people's therapy at present is not enough to be used to suffer from the patient of diabetes, particularly also needs those patients of angiocardiopathy preventing simultaneously.Suffer from diabetes (diabetes) as everyone knows, the patient who particularly suffers from malnutrition type diabetes (diabetesmellitus) is in the cardiovascular disease and dead danger of increase basically.
Therefore, still exist to using medicine to improve and effectively treatment, especially for the obvious demand of these palindromias of prevention.The object of the present invention is to provide this class of diabetics is improved and effective Therapeutic Method.
Summary of the invention
The essential fatty acid that the present invention has proposed to have high-load EPA-ethyl ester or DHA-ethyl ester or its high concentration mixture thus is used for the treatment of new application in the patient's who suffers from diabetes the medicine in preparation.The present invention be more particularly directed to prevent suffer from the method for the cardiovascular disease of diabetics.
For ease of describing, also " EPA-ethyl ester " and " DHA-ethyl ester " is called " EPA " and " DHA " in this article.
The essential fatty acid that The present invention be more particularly directed to contain the mixture of EPA-E (EPA) and docosahexaenoic acid ethyl (DHA) is used for the treatment of the patient who suffers from diabetes in preparation, preferably suffer from application in patient's cardiovascular disease of diabetes in prevention, wherein EPA and the DHA content in this class mixture is higher than 25% weight.
The essential fatty acid that the present invention has high-load EPA or DHA preferably contains 25% above weight, this class ester of particularly about 60-about 100%.Can obtain these chemical compounds by known method.
In the essential fatty acid with high concentration EPA and DHA mixture, preferably this class mixture has EPA and DHA content is higher than 25% weight, about 100% weight of particularly about 30-, preferred about 85% weight.In the EPA/DHA mixture, the preferred content percentage ratio of EPA is about 40-60% weight and the DHA preferred percent is about the about 45-50% of 25-.In any situation, the preferred ratio of EPA/DHA is about 0.9/1.5 in this class EPA/DHA mixture.
The pharmacology
Diabetes have become the more prevalent disease in the whole world.The sickness rate of diabetes is increasing fast and the individual amount (accounting for the 80-90% among whole diabetes patients) of suffering from type ii diabetes according to reports can reach 3,000,000,000 people in 2025, accounts for 5.4% of global population.In addition, cardiovascular disease is to suffer from the major reason of patient's M ﹠ M of diabetes.The death risk that causes because of cardiovascular disease is 2-6 times that does not suffer among the diabetes patient in suffering from the patient of diabetes.Die from coronary heart disease above 50% diabetics at present.Opposite with non-diabetic people, the mortality rate of coronary heart disease death rate in diabetic population do not descend.Type ii diabetes has been eliminated the defensive advantage of women to the coronary heart disease death rate.The prognosis of coronary heart disease is poor in diabetic population than in non-diabetic people.Behind acute myocardial infarction in 1 year, 44.2% type ii diabetes male and 36.9% type ii diabetes women death.
All of coronary heart disease show at least 2 times that are generally among the patient who suffers from diabetes in the non-diabetic individuality.In addition, the tight mutual relation of diabetes and cardiovascular disease (suffering from coronary heart disease at least) has obtained illustrating recently.Confirmed in many researchs that 28% patient who suffers from known coronary heart disease suffers from the patient that diabetes and as many as 70% suffer from acute coronary syndrome and has the abnormal glucose metabolism, form is that diabetes or glucose tolerance reduce.The main harm factor of suffering from coronary heart disease among the patient of diabetes is:
1. disadvantageous lipoprotein distributes, and it is characterized in that the serum triglycerides class increases;
2. hypertension;
3. be easy to form thrombosis, comprise following performance: high concentration activator of plasminogen-1 and cytokine;
4. Endothelin dependency vasodilation is impaired;
5. the heart self-discipline is unusual, causes the decline of avascular pain sensation, high heart rate and heart rate variability to descend, and increases the danger of sudden death thus.
The effect of Therapeutic Method of the present invention by enough early stages clinical and clinical evidence be confirmed:
1.EPA+DHA induce patient's triglyceride and C-VLDL (VLDL) level of suffering from hypertriglyceridema to reduce;
2.EPA+DHA reduce really and suffer from hypertensive patient's blood pressure;
3. meals EPA and DHA regulate platelet derived growth factor-A and the gene expression of platelet derived growth factor-B in the person monocytic cell down;
4. use EPA+DHA to replenish the process of suffering from coronary atherosclerosis in the patients with coronary heart disease of having alleviated;
5.EPA and DHA has improved heart transplantation receiver's endothelial function;
6. experimentation has confirmed EPA and the antiarrhythmic effect of DHA in several animal models, may be because of due to the specificity of ion current regulates;
7.EPA and DHA increases healthy volunteer and myocardial infarction survivor's heart rate;
8.EPA+DHA reduce myocardial infarction survivor's sudden death incidence rate.
The evidence that above-mentioned risk factor descends shows the invention provides and is used for the treatment of diabetics and especially for the novelty and the valuable treatment means of prevent diabetes patient cardiovascular disease.
Therefore, the present invention also provides and has been used for the treatment of diabetics, preferably suffers from the patient of malnutrition type diabetes and especially for the prevent diabetes patient, the method of preferably suffering from the cardiovascular disease among the patient of malnutrition type diabetes, comprise the medicine of this class patient being treated effective dose, this medicine contains the essential fatty acid with high-load EPA-ethyl ester or DHA-ethyl ester or its high concentration mixture.
Essential fatty acid of the present invention can have high-load, for example the EPA of 25% above weight or DHA or its mixture.Yet EPA and DHA-ethyl ester preferably exist as form of mixtures, and EPA wherein and the content of DHA are higher than 25% weight, about 100% weight of particularly about 30-, preferred about 85% weight.
Based on available evidence, to be the essential fatty acid that contains EPA with 85% gravimetric titration amount and DHA mixture can change between the about 6g of about 0.7g-every day the dosage of patient's oral administration in preferred aspect of the present invention, preferred every day about 1g.
Can with this as the amount of the product of EPA and DHA mixture (or independent EPA or independent DHA) in all day with the fractionated dose administration or preferably with single administering mode administration so that obtain required blood drug level.Obviously the clinicist can consider to adjust the dosage of product according to patient age, body weight and ordinary circumstance.
Can prepare medicine of the present invention, for example pharmaceutical compositions according to method as known in the art.Preferred route of administration is oral, and but, the clinicist can consider to allow optional route of administration, such as the gastrointestinal place by way of.
Further define preferred variation of the present invention in the dependent claims.
The following example has been explained the preferred oral administration preparation, but limits the present invention never in any form.
Capsule
Be prepared as follows according to known pharmaceutical technology and form and every capsules contains the capsule of 1g active component (EPA and DHA, 85% titer).
Preparation 1
EPA-ethyl ester 525mg/ capsule
DHA-ethyl ester 315mg/ capsule
D-alpha tocopherol 41U/ capsule
Gelatin 246mg/ capsule
Glycerol 118mg/ capsule
Iron sesquioxide 2.27mg/ capsule
Yellow iron oxide 1.27mg/ capsule
Preparation 2
The ethyl ester class of polyunsaturated fatty acid ethyl ester class and ω-beta-unsaturated esters more than 3
Content (eicosapentaenoic acid EPA, docosahexenoic acid DHA) 1000mg
850mg
D-1-alpha tocopherol 0.3mg
Gelatin succinate 233mg
Glycerol 67mg
P-hydroxybenzoic acid sodium 1.09mg
Sodium Propyl Hydroxybenzoate 0.54mg

Claims (29)

1. the essential fatty acid that contains the mixture of EPA-E (EPA) and docosahexaenoic acid ethyl (DHA) is used for the treatment of the patient who suffers from diabetes in preparation, preferably suffer from application in the medicine of the cardiovascular disease among the patient of diabetes in prevention, wherein EPA and the DHA content in this class mixture is greater than 25% weight.
2. the application of claim 1, wherein said medicine are used for preventing suffering from the patient's of malnutrition type diabetes cardiovascular disease.
3. claim 1 or 2 application, wherein EPA and the DHA content in this class mixture is about about 100% weight of 30-.
4. claim 1 or 2 application, wherein EPA and the DHA content in this class mixture is about 85% weight.
5. any one application among the claim 1-4, wherein said medicine is used for oral administration.
6. the application of claim 4, wherein said medicine is used for oral administration, and dosage is about the about 6g of 0.7g-every day.
7. the application of claim 6, wherein EPA and the DHA ratio in EPA and DHA mixture is about 0.9/1.5.
8. the essential fatty acid that contains EPA-E (EPA) or docosahexaenoic acid ethyl (DHA) is used for the treatment of the patient who suffers from diabetes in preparation, preferably suffer from application in the medicine of the cardiovascular disease among the patient of diabetes in prevention, wherein the content of EPA and DHA is greater than 25% weight.
9. the application of claim 8, wherein said medicine are used for preventing suffering from the patient's of malnutrition type diabetes cardiovascular disease.
10. claim 8 or 9 application, wherein EPA or DHA content are about about 100% weight of 60-.
11. any one application among the claim 8-10, wherein said medicine is used for oral administration.
12. treatment suffers from the patient of diabetes, preferred malnutrition type diabetes, the patient who suffers from diabetes especially for prevention, the method of preferably suffering from patient's central vessel disease of malnutrition type diabetes, comprise the medicine that contains essential fatty acid of described patient being treated effective dose, described essential fatty acid contains the mixture of EPA-E (EPA) and docosahexaenoic acid ethyl (DHA), and wherein EPA and the DHA content in this class mixture is greater than 25% weight.
13. the method for claim 12, wherein EPA and the DHA content in this class mixture is about about 100% weight of 30-.
14. the method for claim 12, wherein EPA and the DHA content in this class mixture is about 85% weight.
15. claim 12,13 or 14 method are wherein by the described medicine of orally give.
16. the method for claim 14 wherein gives described medicine by oral dosage with the about 6g of about 0.7g-every day.
17. the method for claim 16, wherein the ratio of EPA/DHA in EPA and DHA mixture is about 0.9/1.5.
18. treatment suffers from the patient of diabetes, preferred malnutrition type diabetes, the patient who suffers from diabetes especially for prevention, the method of preferably suffering from patient's central vessel disease of malnutrition type diabetes, comprise the medicine that contains essential fatty acid of described patient being treated effective dose, described essential fatty acid contains the mixture of EPA-E (EPA) and docosahexaenoic acid ethyl (DHA), and wherein EPA and the DHA content in this class mixture is greater than 25% weight.
19. the method for claim 18, wherein EPA and the DHA content in this class mixture is about about 100% weight of 30-.
20. the method for claim 18, wherein EPA and the DHA content in this class mixture is about 85% weight.
21. claim 18,19 or 20 method are wherein by the described medicine of orally give.
22. the method for claim 20 wherein gives described medicine by oral dosage with the about 6g of about 0.7g-every day.
23. the method for claim 22, wherein the EPA/DHA ratio in EPA and DHA mixture is about 0.9/1.5.
24. treatment suffers from the patient of diabetes, preferred malnutrition type diabetes, the patient who suffers from diabetes especially for prevention, preferred malnutrition type suffers from the method for patient's central vessel disease of diabetes, comprise the medicine that contains essential fatty acid of described patient being treated effective dose, the content of EPA-E that described essential fatty acid has (EPA) or docosahexaenoic acid ethyl (DHA) is greater than 25% weight.
25. the method for claim 24, wherein the content of EPA or DHA is about about 100% weight of 60-.
26. the method for claim 24 or 25 is wherein by the described medicine of orally give.
27. treatment suffers from diabetes, the patient of preferred malnutrition type diabetes, the patient who suffers from diabetes especially for prevention, the method of preferably suffering from patient's central vessel disease of malnutrition type diabetes, comprise the medicine that contains essential fatty acid of described patient being treated effective dose, the content of EPA-E that described essential fatty acid has (EPA) or docosahexaenoic acid ethyl (DHA) is greater than 25% weight.
28. the method for claim 27, wherein EPA or DHA content are about about 100% weight of 60-.
29. the method for claim 27 or 28 is wherein by the described medicine of orally give.
CNA2004800055600A 2003-03-05 2004-03-02 Use of omega-3-fatty acids in the treatment of diabetic patients Pending CN1756545A (en)

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EP03004792.2 2003-03-05

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AU (1) AU2004216856A1 (en)
BR (1) BRPI0408006A (en)
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WO2004078166A2 (en) 2004-09-16
AU2004216856A1 (en) 2004-09-16
JP2006519244A (en) 2006-08-24
WO2004078166A3 (en) 2004-10-28
BRPI0408006A (en) 2006-02-14

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