WO2016016772A1 - A novel modified release pharmaceutical composition of dpp-iv inhibitors or pharmaceutically acceptable salt thereof - Google Patents

A novel modified release pharmaceutical composition of dpp-iv inhibitors or pharmaceutically acceptable salt thereof Download PDF

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WO2016016772A1
WO2016016772A1 PCT/IB2015/055556 IB2015055556W WO2016016772A1 WO 2016016772 A1 WO2016016772 A1 WO 2016016772A1 IB 2015055556 W IB2015055556 W IB 2015055556W WO 2016016772 A1 WO2016016772 A1 WO 2016016772A1
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composition
dpp
inhibitor
pharmaceutically acceptable
acceptable salt
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French (fr)
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Mandar Madhukar KODGULE
Amit Bansal
Manohar LALGE
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Wockhardt Limited
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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
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7028Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/13Amines
    • A61K31/155Amidines (), e.g. guanidine (H2N—C(=NH)—NH2), isourea (N=C(OH)—NH2), isothiourea (—N=C(SH)—NH2)
    • 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
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/4985Pyrazines or piperazines ortho- or peri-condensed with heterocyclic ring systems
    • 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
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A61K31/52Purines, e.g. adenine
    • A61K31/522Purines, e.g. adenine having oxo groups directly attached to the heterocyclic ring, e.g. hypoxanthine, guanine, acyclovir
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0002Galenical forms characterised by the drug release technique; Application systems commanded by energy
    • A61K9/0004Osmotic delivery systems; Sustained release driven by osmosis, thermal energy or gas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/2004Excipients; Inactive ingredients
    • A61K9/2022Organic macromolecular compounds
    • A61K9/205Polysaccharides, e.g. alginate, gums; Cyclodextrin
    • A61K9/2054Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/2072Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
    • A61K9/2086Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/2072Pills, tablets, discs, rods characterised by shape, structure or size; Tablets with holes, special break lines or identification marks; Partially coated tablets; Disintegrating flat shaped forms
    • A61K9/2086Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat
    • A61K9/209Layered tablets, e.g. bilayer tablets; Tablets of the type inert core-active coat containing drug in at least two layers or in the core and in at least one outer layer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/28Dragees; Coated pills or tablets, e.g. with film or compression coating
    • A61K9/2806Coating materials
    • A61K9/2833Organic macromolecular compounds
    • A61K9/284Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone
    • A61K9/2846Poly(meth)acrylates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • A61K9/28Dragees; Coated pills or tablets, e.g. with film or compression coating
    • A61K9/2806Coating materials
    • A61K9/2833Organic macromolecular compounds
    • A61K9/286Polysaccharides, e.g. gums; Cyclodextrin
    • A61K9/2866Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose

Definitions

  • the present invention relates to a novel modified release pharmaceutical composition of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof.
  • the present invention relates to a novel modified release composition of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof that achieves desired minimum effective plasma concentration of the DPP-IV inhibitor sufficient for effective glycemic control in patients with type 2 diabetes mellitus.
  • a method of improving glycemic control in adults with type 2 diabetes mellitus and reducing or eliminating fluctuations in plasma concentration of the DPP-IV inhibitor is also provided by the present invention.
  • Type 2 diabetes is the most common form of diabetes and it is one of the most prevalent chronic diseases.
  • Treatment of type 2 diabetes mellitus (T2DM) initially starts with diet and exercise, followed by oral antidiabetic monotherapy. During long-term treatment these regimens do not sufficiently control hyperglycemia in many patients, leading to a requirement for combination therapy within several years following diagnosis.
  • T2DM type 2 diabetes mellitus
  • Drugs of choice for combination therapy include biguanides, DPP-IV inhibitors, sulfonylurea, thiazolidinedione, alphaglucosidase inhibitor, amylin analog, glucagon-like peptide-1 (GLP-1 ) or incretin mimetic, meglitinide and insulin.
  • biguanides and DPP-IV inhibitors are preferred choices for management of type 2 diabetes in the recent past.
  • the DPP-IV inhibitors are specific to reduction of post-prandial elevated glucose level as opposed to the lack of effect on the resting glucose level, combining them with biguanide is preferred.
  • Dipeptidyl peptidase IV (DPP-IV) inhibitors act by inhibiting dipeptidyl peptidase IV (DPP-IV) enzyme, a multifunctional transmembrane glycoprotein enzyme that cleaves N-terminal dipeptides from polypeptides with L-proline or L-alanine at the penultimate position.
  • DPP-IV dipeptidyl peptidase IV
  • the selectivity of DPP-IV inhibitors against other closely- related proline-specific dipeptidyl peptidases, particularly DPP-8 and DPP-9 has been a potential for adverse events associated with non-selective DPP-IV inhibitors.
  • the inhibition of DPP-8 and DPP-9 has been found to be associated with toxicities in rat and dog. Therefore, it is important to demonstrate that DPP- IV inhibitors do not appreciably inhibit these closely related enzymes.
  • Sitagliptin is an orally-active DPP-IV enzyme inhibitor, available as monohydrate of its phosphate salt. Chemically, monohydrate of sitagliptin phosphate is 7-[(3R)- 3-amino-1 -oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8tetrahydro-3- (trifluoromethyl) -1 ,2,4-triazolo [4,3-a] pyrazine phosphate (1 : 1 ) monohydrate with the following structure:
  • linagliptin is 1 H-Purine-2,6-dione, 8-[(3R)-3-amino-1 -piperidinyl]-7-(2-butyn-1 -yl)- 3,7-dihydro-3-methyl-1 -[(4-methyl-2quinazolinyl)methyl] with the following structure:
  • U.S. Patent number US 6,099,862 discloses controlled release tablet containing metformin and glipizide.
  • U.S. Patent RE44,186 discloses a method of treatment for T2DM using DPP-IV inhibitor and one or more other antidiabetic agents such as metformin, glyburide, troglitazone, pioglitazone and rosiglitazone.
  • U.S. Patent 8,414,921 discloses pharmaceutical compositions comprising fixed- dose combinations of a DPP-IV inhibitor and metformin.
  • U.S. Publication number 20070172525 and 20080064701 discloses pharmaceutical compositions comprising an immediate-release DPP-IV inhibitor and a slow-release form of metformin.
  • U.S. Patent 8,329,217 discloses a controlled release osmotic device containing a bi-layered core of at least two different active agents which provides therapeutically effective levels of both the actives for an extended period of time following oral administration.
  • U.S. Publication number 20130059002 discloses a pharmaceutical composition comprising metformin and sitagliptin or pharmaceutically acceptable salt thereof in two separate compartments.
  • the document also discloses a combination composition comprising an extended release metformin HCI and an extended release sitagliptin.
  • European patent publication number EP 1 ,537,880 A1 relates to a sustained release formulation of DPP-IV inhibitor comprising a hydrophilic polymer.
  • DPP-IV activity potentiates the vasodilating action of substance P.
  • DPP-IV activity of nasal mucosa and the density of inflammatory cells in nasal mucosa of patients with chronic rhinosinusitis are in a reverse correlation and DPP-IV activity increases when chronic rhinosinusitis was cured (FASEB, 2002; 16:1 132-1 134). Therefore, strong inhibition of DPP-IV activity in diabetic patients with concurrent chronic inflammation is not considered preferable as it may cause aggravation of the inflammation.
  • the plasma concentration of below 100 nM achieved by 24 hours post administration of 100 mg dose of Januvia ® is sub-therapeutic, which may lead to loss of glycemic control for about last 4 hours with current once daily dosage regimen.
  • Such inadequate glycemic control of about 4 hours after each dose administration may be seen until the steady state plasma concentration is achieved on 10 th day of the once daily dosage regimen.
  • Such inadequate glycemic control should be avoided for effective management of T2DM.
  • the 100 mg immediate release dosage form leads to essentially non required maximum plasma concentration of about 950 nM within 1 .3 hours post administration, since the maximal DPP-IV inhibition occurs at about 125 nM.
  • Such higher plasma concentration achieved by the 100 mg immediate release dosage may aggravate inflammation or lead to depression and anxiety which are not desirable for the diabetic patient as mentioned above.
  • Sitagliptin has average renal clearance of 350 ml/min and volume of distribution of about 198 liters. As sitagliptin is cleared off body mainly through kidney, its dose adjustment prior to initiation of therapy and periodically thereafter is essential in renal function compromised patients and becomes even more essential due to role of renal function in diabetic patients. Specifically patient with renal insufficiency is prescribed lesser dose of sitagliptin than that to normal patient.
  • the existing DPP-IV inhibitor products may suffer from three issues, firstly causing hyperglycemia in last few hours of the day (e.g. last four hours in case of sitagliptin) post administration causing hyperglycemia, secondly exposing the patient for several initial hours to essentially non required maximum plasma concentration following administration, and thirdly require renal function monitoring before and during treatment.
  • a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein once daily administration of said composition to a subject achieves mean steady state plasma concentration (C ss ) of the DPP-IV inhibitor on or before 7 days.
  • C ss mean steady state plasma concentration
  • a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein the DPP-IV inhibitor in composition inhibits activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein the DPP-IV inhibitor in the composition inhibits activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • the DPP-IV inhibitor in the composition exhibit modified release so as to inhibit activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein said composition exhibit an in vitro release profile such that on average no more than about 30% of the DPP-IV inhibitor is dissolved within 1 hour and/or time to reach 50% dissolution is at least 4 hours after placement of the composition in a dissolution test conducted according to USP using Apparatus I at speed of 100 rpm in water at about 37°C.
  • a modified release composition comprising sitagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein said composition exhibit an in vitro release profile such that about 30% to about 70% of sitagliptin is dissolved within 8 hour and/or about 50% to about 90% of sitagliptin is dissolved within 16 hour after placement of the composition in a dissolution test conducted according to USP, using USP Apparatus I at 100 rpm in water at about 37°C.
  • a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent wherein a substantial dose of DPP-IV inhibitor in the composition exhibit zero order release over a period of at least 24 hours after oral administration of single dose of the composition.
  • antidiabetic agent in the modified release composition exhibit immediate and/or extended release from said composition.
  • total dose of the DPP-IV inhibitor in modified release composition is divided into an immediate release part and an extended release part.
  • the extended release part of DPP-IV inhibitor in the modified release composition exhibits zero order release.
  • the modified release composition of the DPP-IV inhibitor further comprises two antidiabetic agents.
  • a modified release composition comprising:
  • a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over at least 24 hours after oral administration of single dose of the composition to a subject.
  • a modified release composition comprising:
  • a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over at least 24 hours after oral administration of single dose of the composition to a subject.
  • DPP-IV inhibitors in the modified release composition may be selected from the group comprising, but not limited to, alogliptin, linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin and/or pharmaceutically acceptable salt thereof.
  • alogliptin linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin and
  • Additional antidiabetic agents may be selected from DPP-IV inhibitors, insulin sensitizers, a-glucosidase inhibitors, biguanides, insulin secretagogues, sodium- glucose co-transporter-2 (SGLT-2) inhibitors, ⁇ 3 agonists, GPR40 agonists, GLP- 1 receptor agonists, amylin agonists, phosphotyrosine phosphatase inhibitors, gluconeogenesis inhibitors, 1 1 ⁇ -hydroxysteroid dehydrogenase inhibitors, adiponectin or agonist thereof, IKK inhibitors, leptin resistance improving drugs, somatostatin receptor agonists, and glucokinase activators.
  • DPP-IV inhibitors insulin sensitizers, a-glucosidase inhibitors, biguanides, insulin secretagogues, sodium- glucose co-transporter-2 (SGLT-2) inhibitors, ⁇ 3 agonists, GPR40 agonists, GLP- 1 receptor agonist
  • Suitable biguanides may be selected from metformin, buformin, phenformin or pharmaceutically acceptable salt thereof.
  • Suitable insulin secretagogues may be selected from acetohexamide, chlorpropamide, tolbutamide, tolazamide, glipizide, glybuzole, gliclazide, glibenclamide, gliquidone, glyclopyramide, glimepiride, neteglinide, repaglinide, mitiglinide or pharmaceutically acceptable salt thereof.
  • Suitable sodium-glucose co-transporter-2 (SGLT-2) inhibitors may be selected from dapagliflozin, canagliflozin, ipragliflozin, tofoglif lozin, empagliflozin, sergliflozin, remogliflozin, ertugliflozin, luseogliflozin, atigliflozin or pharmaceutically acceptable salt thereof.
  • Suitable a-glucosidase inhibitors may be selected from voglibose, acarbose, miglitol, emiglitate or pharmaceutically acceptable salt thereof.
  • Suitable GPR40 agonists may be selected from AMG 837, TAK-875 or pharmaceutically acceptable salt thereof.
  • Suitable GLP-1 receptor agonists may be selected from AMG 837, TAK-875, NN- 221 1 , exendin-4, BIM-51077, CJC-1 131 or pharmaceutically acceptable salt thereof.
  • Suitable gluconeogenesis inhibitors may be selected from glycogen phosphorylase inhibitor, glucose-6-phosphatase inhibitor, glucagon antagonist or pharmaceutically acceptable salt thereof.
  • amylin agonist is pramlintide
  • phosphotyrosine phosphatase inhibitor is sodium vanadate
  • 11 ⁇ -hydroxysteroid dehydrogenase inhibitor is BVT-3498
  • glucokinase activators is Ro-28-1675 or pharmaceutically acceptable salt thereof.
  • a modified release composition comprising linagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients, and optionally, at least one antidiabetic agent, wherein once daily administration of said composition to a subject provides mean steady state plasma concentration (C ss ) of linagliptin on or before 7 days.
  • a modified release composition comprising linagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients, and optionally, at least one antidiabetic agents, wherein the composition maintains mean plasma concentration of linagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • linagliptin in the composition exhibit modified release so as to inhibit activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • a modified release composition comprising:
  • the minimum therapeutically effective plasma concentration of the DPP-IV inhibitor and optionally, at least one antidiabetic agent in the modified release composition is achieved by their osmotically controlled release from the composition.
  • the modified release composition is in the form of an osmotic dosage form.
  • the modified release composition comprises: (i) a semipermeable wall provided around an osmotic formulation comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof, optionally at least one antidiabetic agent or pharmaceutically acceptable salt thereof, an osmotic agent, and an osmopolymer; and (ii) a passageway.
  • a method of reducing side effects associated with increased plasma concentration of the DPP-IV inhibitor in a patient undergoing T2DM treatment comprises of orally administering single dose of a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof and optionally, at least one antidiabetic agent or pharmaceutically acceptable salt thereof, wherein a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over a period of at least 24 hours.
  • a method of treating type 2 diabetes mellitus comprising administration of the modified release composition to a subject in need thereof as substantially described herein before.
  • FIGURE 1 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 10 mg of immediate release part and 90 mg of extended release part.
  • FIGURE 2 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 25 mg of immediate release part and 75 mg of extended release part.
  • FIGURE 3 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 50 mg of immediate release part and 50 mg of extended release part.
  • the inventors of the present invention have surprisingly found that optimum therapeutic plasma concentration of the DPP-IV inhibitor can be maintained in order to provide optimal glycemic control over 24 hours by administering a novel modified release composition of the DPP-IV inhibitor.
  • Novel modified release composition of the present invention maintains the therapeutically effective plasma concentration of the DPP-IV inhibitor and does not allow it to surpass the optimal level, therefore avoids side effects or problems associated with administration of the DPP-IV inhibitors.
  • the novel modified release composition according to the present invention provides sufficient plasma concentration of the DPP-IV inhibitor over 24 hours after single dose oral administration. Additionally, such compositions achieve steady state concentration of the DPP-IV inhibitors relatively earlier than that achieved by conventional dosage forms.
  • the inventors have surprisingly found that the desired DPP-IV inhibition can be achieved with a once daily dose of DPP-IV inhibitors using the novel modified release composition.
  • the composition achieves more than 80% of the DPP-IV enzyme inhibition over a period of over at least 24 hours after single dose oral administration.
  • the novel modified release composition of the DPP-IV inhibitors in accordance with the present invention achieves optimal plasma concentration, thus avoiding undesirable side effects such as aggravation of inflammation in diabetic patients with concurrent inflammation and depression/anxiety.
  • T2DM can be done by providing modified release composition comprising a DPP-IV inhibitor.
  • modified release composition comprising a DPP-IV inhibitor.
  • DPP-IV inhibitors For providing better glycemic control over at least 24 hours after single dose administration and reducing the side- effects due to undesirably higher C ma x and strong inhibition of the DPP-IV activity by DPP-IV inhibitors is, however, not always required for effective type 2 diabetes therapy.
  • the novel modified release composition of the present invention is capable of appropriately inhibiting the DPP-IV activity and that can be administered once daily. It is also possible to achieve a desired effect by maintaining a minimum effective plasma concentration of the DPP-IV inhibitors by administering the composition of the present invention. Particularly, the modified release composition avoids peaks and valleys (fluctuations) in plasma concentration of the DPP-IV inhibitor alone or in combination with other antidiabetic agent.
  • pharmaceutically acceptable salts are meant those salts in which the anion does not contribute significantly to the toxicity or pharmacological activity of the salt, and, as such, they are the pharmacological equivalents of the bases of the drug compound.
  • DPP-IV inhibitor refers to compounds that are intended to potentiate the endogenous incretin response by preventing the proteolysis of GLP 1 or GIP through the inhibition of one or more of the DPP-IV isoforms in the body (Mcintosh, C. H. S., et al., Regulatory Peptides, 2005; 128:159-65). A number of such agents have been approved, under review at the FDA or in clinical development (Hunziker, D., et al., Curr. Top. Med. Chem., 2005; 5:1623-37; Kim, D., et al., J. Med. Chem., 2005; 48:141 -51 ).
  • modified release as used herein in relation to the composition according to the invention or used in any other context means release, which is not completely immediate release and is taken to encompass controlled release, sustained release, prolonged release, timed release, retarded release, extended release and delayed release.
  • modified release composition as used herein can be described as compositions whose drug-release characteristics of time course and/or location are chosen to accomplish therapeutic or convenience objectives not offered by conventional dosage forms such as a solution or an immediate release dosage form.
  • the modified release composition may exhibit combination of at least two types of releases of the drug.
  • the composition comprising an immediate release part and an extended release part of DPP-IV inhibitor may, overall, exhibit modified release of DPP-IV inhibitor from such dosage form.
  • extended release is used in its conventional sense to refer to a composition that makes the drug available over an extended period after ingestion, and preferably, although not necessarily, results in substantially constant blood levels of the drug over an extended time period.
  • extended release used in context of the present invention includes, but not limited to, zero order release of the drug.
  • rate controlling excipients is used to refer to excipients which modify release of active agent from compositions whose drug-release characteristics of time course and/or location are chosen to accomplish therapeutic or convenience objectives not offered by conventional dosage forms such as a solution or an immediate release dosage form.
  • zero order release includes a zero order release as well as pseudo- zero order release profiles of the drug.
  • a zero order release profile characterizes the release profile of a dosage form that releases a constant amount of drug per unit time.
  • a pseudo-zero order release profile is one that approximates a zero- order release profile.
  • steady state or 'C S s' is meant a pattern of plasma concentration versus time following continuous administration of a constant dose, where the plasma concentration peaks and plasma concentration troughs are essentially identical within each dosing interval.
  • the upper (peak) and lower (trough) values of the steady state concentration are termed as 'steady state maximum concentration' or 'Css (max)' and 'steady state minimum concentration' or 'C SS (min)' respectively.
  • subject or alternatively “individual” includes mammals.
  • mammals include humans, preferably human suffering from diabetes and particularly type 2 diabetes.
  • substantially amount of DPP-IV inhibitor refers to at least 5% and more preferably at least 10% of the total amount of DPP-IV inhibitor in the composition or any amount of the DPP-IV inhibitor that is released at least 1 hour post oral administration of the composition.
  • Substantial release of DPP-IV inhibitor from the composition may be achieved, for example, by providing a composition releasing the DPP-IV inhibitor in at least two separate pulses.
  • Such formulation includes a composition with an immediate release part and an extended release part of the DPP-IV inhibitor.
  • the release profiles of the modified release compositions containing the DPP-IV inhibitor have several potential advantages over its conventional immediate release (IR) formulations. Mainly the gradual release of the DPP-IV inhibitor into the gastrointestinal (Gl) tract provides lower maximum effective concentrations, thus reducing or avoiding unwanted side effects.
  • IR immediate release
  • the novel modified release composition of the present invention exhibits release of the DPP-IV inhibitor in such a way that it achieves and maintains minimum effective concentration of the DPP-IV inhibitor for at least 24 hours after oral administration.
  • the composition maintains about 80% or more inhibition of the DPP-IV inhibitor for at least 24 hours after oral administration of single dose of the composition.
  • the DPP-IV enzyme activity in plasma can be measured by, for example, a method utilizing the "method of Raymond et al., Diabetes, vol. 47, pp. 1253-1258 (1998)".
  • the decrease rate of the DPP-IV enzyme activity in plasma may be different from the determined values as long as it is within the general error range.
  • the decrease rate of the DPP-IV enzyme activity in plasma may be different from the determined values.
  • the decrease rate of the DPP-IV enzyme activity in plasma may be greater than the determined values and, for example, 90% may be a value not less than 95%.
  • a bioluminescent assay for determining DPP-IV enzyme activity by means of detecting the Gly-Pro cleaving activity is provided by Martha O'Brien et al. (Cell Notes, lssue-16, 2006).
  • DPP-IV inhibitors may be selected from the group comprising alogliptin, linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin or pharmaceutically acceptable salt thereof.
  • a preferred salt of sitagliptin is the phosphate salt, most preferably in the form of its monohydrate.
  • a preferred salt of saxagliptin is the hydrochloride salt.
  • a preferred salt of alogliptin is the benzoate salt.
  • Antidiabetic agents may be selected from the group comprising insulin sensitizers (e.g. pioglitazone, rosiglitazone, tesaglitazar, ragaglitazar, muraglitazar, edaglitazone, metaglidasen, naveglitazar), a-glucosidase inhibitors (e.g., voglibose, acarbose, miglitol, emiglitate), biguanides (e.g., metformin, buformin), insulin secretagogues [sulfonylurea e.g., tolbutamide, glibenclamide, gliclazide, chlorpropamide, tolazamide, acetohexamide, glyclopyramide, glimepiride, glipizide, glybuzole;, repaglinide, nateglinide, mitiglinide), sodium- glucose co-transporter-2 (SGLT-
  • gluconeogenesis inhibitors e.g., glycogen phosphorylase inhibitor, glucose-6-phosphatase inhibitor, glucagon antagonist
  • sodium-glucose cotransporter (SGLUT) inhibitors e.g., T-1095
  • 1 1 ⁇ -hydroxysteroid dehydrogenase inhibitors e.g., BVT-3498
  • adiponectin or agonist thereof IKK inhibitors (e.g., AS-2868), leptin resistance improving drugs, somatostatin receptor agonists, glucokinase activators (e.g., Ro-28-1675), GIP (Glucose-dependent insulinotropic peptide) and the like or one or more pharmaceutically acceptable salt, ester, solvates and derivatives thereof.
  • a pharmaceutically acceptable salt of the DPP-IV inhibitor and/or antidiabetic agents especially a salt exhibiting moderate to high solubility in water.
  • Illustrative salts include those prepared using the following acids: hydrochloric, hydrobromic, hydroiodic, phosphoric, sulfuric, methanesulfonic acid, ethanesulfonic, 2-hydroxyethanesulfonic, benzenesulfonic, p-hydroxybenzoic, toluenesulfonic, formic, acetic, propionic, benzoic, anthranilic, tartaric, maleic, malic, citric, isocitric, succinic, ascorbic, lactic, glycolic, gluconic, glucuronic, pyruvic, oxaloacetic, fumaric, aspartic, glutamic, stearic, salicylic, phenylacetic, mandelic, pamoic, pantothenic, sulfanilic
  • Rate controlling excipients are chosen to modify release of active agent from compositions and may be selected from but not limited to osmopolymers, hydrogels, osmogents, hydrophilic, hydrophobic, amphiphilic polymers, inert materials or copolymers or derivatives and or combinations thereof.
  • osmopolymers hydrogels, osmogents, hydrophilic, hydrophobic, amphiphilic polymers, inert materials or copolymers or derivatives and or combinations thereof.
  • Various methods known in the art can be used to determine plasma concentration or in-vitro profile of the novel modified release composition in accordance with present invention.
  • mean steady state plasma concentration (C ss ) of the DPP-IV inhibitor is achieved on or before 7 days on once daily administration of the modified release composition to a subject in accordance with the present invention.
  • the modified release composition comprises linagliptin or pharmaceutically acceptable salt thereof and said composition maintains mean plasma concentration of liagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition.
  • the modified release composition comprises linagliptin or pharmaceutically acceptable salt thereof and said composition provides mean plasma concentration of liagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
  • the modified release composition comprising the DPP- IV or pharmaceutically acceptable salt thereof exhibits an in vitro release profile such that on average no more than about 30% of DPP-IV inhibitor is dissolved within 1 hour and/or time to reach 50% dissolution is at least 4 hours after placement of the composition in a dissolution test conducted according to USP using Apparatus I at 100 rpm in water at about 37°C.
  • the modified release composition comprising sitagliptin or pharmaceutically acceptable salt thereof have maximum plasma concentration (Cmax) and exhibits a mean steady state minimum plasma concentration (C ss (min)) of sitagliptin in the range given below after oral administration of single dose of said composition to a subject.
  • Cmax maximum plasma concentration
  • C ss mean steady state minimum plasma concentration
  • the amount of the DPP-IV inhibitor present in modified release composition is sufficient to provide a daily dose in one to a small plurality, for example one to about 4, of dosage units to be administered at one time. Preferably the full daily dose is delivered in a single dosage unit. An amount of about 1 mg to about 500 mg per dosage unit, or about 0.05% to about 80% by weight of the composition, will generally be suitable.
  • the amount of the DPP-IV inhibitor may be calculated on the basis of its base or salt.
  • an amount of about 25 mg to about 100 mg sitagliptin per dosage unit is present.
  • Specific amounts per tablet contemplated herein include 25, 50, and 100 mg sitagliptin base.
  • an amount of about 2.5 mg and 5 mg saxagliptin base per dosage unit is present.
  • an amount of about 5 mg linagliptin per dosage unit is present.
  • an amount of about 50 mg vildagliptin per dosage unit is present.
  • an amount of about 6.25 mg, 25 mg and 25 mg alogliptin base per dosage unit is present.
  • overages may be added as and when required according to composition and release profile requirements.
  • total dose of the DPP-IV inhibitor in the composition is divided in to an immediate release part and an extended release part.
  • the extended release part in the composition exhibits zero order release of the DPP-IV inhibitor.
  • the antidiabetic agent in the composition exhibits immediate and/or extended release.
  • the particular release and/or PK profile as defined herein can be achieved using one or more release-modifying means, for example, providing the composition in the form of matrix or DPP-IV inhibitor with various rate controlling substances known in the art or by providing coating of rate controlling substances over the DPP-IV inhibitor containing core.
  • dose of the DPP-IV inhibitor can be adjusted considering progression of disease and patient's physiology.
  • dose of sitagliptin in the modified release composition can be adjusted (from 100 mg to 50 mg or 25 mg) in case of renal function compromised patients.
  • the modified release composition comprises " l OOmg sitagliptin or pharmaceutically acceptable salt thereof in which total dose of sitagliptin or pharmaceutically acceptable salt thereof is divided in to about 10 mg to about 50 mg of immediate release part and about 50 mg to about 90 mg of extended release part.
  • Figure 1 to 3 shows the plasma concentration profile of sitagliptin 100 mg composition with immediate and extended release parts in said ranges.
  • the modified release composition may take any form suitable for oral administration, but is typically formulated as a discrete solid dosage unit such as a tablet or capsule, wherein the DPP-IV inhibitor or pharmaceutically acceptable salt thereof is present as solid particles, and is formulated together with one or more pharmaceutically acceptable excipients.
  • the excipients are selected in part to provide a release profile and/or PK profile consistent with those defined above.
  • the modified release composition in the form of a tablet can be of any suitable size and shape, for example round, oval, polygonal or pillow-shaped, and optionally bear nonfunctional surface markings. Especially in the case of coated tablets they are preferably designed to be swallowed whole and are therefore typically not provided with a breaking score.
  • Dosage unit compositions of the invention can be packaged in a container, accompanied by a package insert providing pertinent information such as, for example, dosage and administration information, contraindications, precautions, drug interactions and adverse reactions.
  • the modified release composition may comprises an active core comprised of one or more inert particles, each in the form of a bead, pellet, pill, granular particle, microcapsule, microsphere, microgranule, nanocapsule, or nanosphere coated on its surfaces with the DPP-IV inhibitor in the form of e.g., a DPP-IV inhibitor-containing coating or film-forming composition using, for example, fluid bed techniques or other methodologies known to those of skill in the art.
  • the inert particle can be of various sizes, so long as it is large enough to remain poorly dissolved.
  • the active core may be prepared by granulating and milling and/or by extrusion and spheronization of a polymer composition containing the DPP-IV inhibitor.
  • release-modifying means suitable for use in a composition of the invention include a polymer matrix wherein the DPP-IV inhibitor is dispersed; a release-controlling layer or coating surrounding the whole dosage unit or DPP-IV inhibitor-containing particles, granules, beads or zones within the dosage unit; and an osmotic pump.
  • the modified release composition is provided in the form of an osmotic pump.
  • the hydrophilic polymer matrix may further include an ionic polymer, a non-ionic polymer, or water-insoluble hydrophobic polymer to provide a stronger gel layer and/or reduce pore quantity and dimensions in the matrix so as to slow diffusion and erosion rates and concomitant release of the DPP-IV inhibitor. This may additionally produce a more steady, zero order release of the DPP-IV inhibitor.
  • an ionic polymer, a non-ionic polymer, or water-insoluble hydrophobic polymer known in the art may be used.
  • the modified release composition comprises-
  • a substantial dose of the DPP-IV inhibitor in the composition exhibits zero order release over a period of at least 24 hours after oral administration of single dose of the composition.
  • the modified release composition may comprise pH modifying agent and or suitable pharmaceutically acceptable buffer.
  • both the antidiabetic agent and a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release from said composition.
  • a substantial dose of the DPP-IV inhibitor in the modified release composition exhibits zero order release over at least 24 hours after oral administration of single dose of the composition.
  • the minimum therapeutically effective plasma concentration of the DPP-IV inhibitor and optionally, at least one antidiabetic agent from the modified release composition is achieved by their osmotically controlled release from the composition.
  • the osmotic dosage form comprises: (i) a semipermeable wall provided around an osmotic formulation comprising a DPP-IV inhibitor or pharmaceutically acceptable salt thereof, an osmotic agent, and an osmopolymer; and (ii) a passageway.
  • a capsule based on osmotic release mechanism may be formulated with a single osmotic unit or it may incorporate 2, 3, 4, 5, or 6 push- pull units encapsulated within a hard gelatin capsule, whereby each bilayer push pull unit contains an osmotic push layer and a DPP-IV inhibitor layer, both surrounded by a semi-permeable membrane. One or more orifices are drilled through the membrane next to the DPP-IV inhibitor layer. This membrane may be additionally covered with a ph-dependent enteric coating to prevent release until after gastric emptying. The gelatin capsule dissolves immediately after ingestion.
  • the enteric coating breaks down, which then allows fluid to flow through the semi-permeable membrane, swelling the osmotic push compartment to force DPP-IV inhibitor out through the orifice(s) at a rate precisely controlled by the rate of water transport through the semipermeable membrane. Release of DPP-IV inhibitor can occur over a constant rate for at least up to 24 hours.
  • the osmotic push layer comprises one or more osmotic agents creating the driving force for transport of water through the semi-permeable membrane into the core of the delivery vehicle.
  • osmotic agents include water- swellable hydrophilic polymers, also referred to as “osmopolymers” and “hydrogels,” including, but not limited to, hydrophilic vinyl and acrylic polymers, polysaccharides such as calcium alginate, polyethylene oxide (PEO), polyethylene glycol (PEG), polypropylene glycol (PPG), poly(2-hydroxyethyl methacrylate), poly(acrylic) acid, poly(methacrylic) acid, polyvinylpyrrolidone (PVP), crosslinked PVP, polyvinyl alcohol (PVA), PVA/PVP copolymers, PVA/PVP copolymers with hydrophobic monomers such as methyl methacrylate and vinyl acetate, hydrophilic polyurethanes containing large PEO blocks, sodium croscarmellose
  • osmotic agents include osmogents, which are capable of imbiging water to affect an osmotic pressure gradient across the semi-permeable membrane.
  • exemplary osmogens include, but are not limited to, inorganic salt, such as magnesium sulfate, magnesium chloride, calcium chloride, sodium chloride, lithium chloride, potassium sulfate, potassium phosphates, sodium carbonate, sodium sulfite, lithium sulfate, potassium chloride, and sodium sulfate; sugars, such as dextrose, fructose, glucose, inositol, lactose, maltose, mannitol, raffinose, sorbitol, sucrose, trehalose, and xylitol; organic acids, such as ascorbic acid, benzoic acid, fumaric acid, citric acid, maleic acid, sebacic acid, sorbic acid, adipic acid, edetic acid, glutamic
  • Materials useful in forming the semipermeable membrane include various grades of acrylics, vinyls, ethers, polyamides, polyesters, and cellulosic derivatives that are water-permeable and water-insoluble at physiologically relevant pHs, or are susceptible to being rendered water-insoluble by chemical alteration, such as crosslinking.
  • Suitable osmotic dosage form may be provided in the form of a mono-layer, bi- layer or tri-layer dosage form.
  • the bi-layer oral osmotic dosage forms include a first component layer, comprising at least one drug, one of which is a DPP-IV inhibitor and excipients for forming a deliverable drug composition when hydrated, and a second push layer, comprising a fluid- expandable osmopolymer and excipients, contained within a compartment formed by a semipermeable membrane and having exit means for drug release from the compartment.
  • the two layers are compressed into bi-layer tablet cores before the semipermeable membrane is applied and a suitable orifice for drug release there through is formed.
  • the bi-layer tablet cores are formed when two component layers are compressed together to provide a longitudinally compressed tablet core having a 'capsule-shaped' configuration with a different layer at each narrow end.
  • Bi-layer oral osmotic dosage forms and methods of making and using such dosage forms are known in the art, for example, as described and claimed in the following US Patents, owned by Alza Corporation: U.S. Pat. Nos. 4,327,725; 4,612,008; 4,783,337; and 5,082,668, each of which is incorporated in its entirety by reference herein.
  • the suitable pH modifying agent include malic acid, fumaric acid, adipic acid, succinic acid, lactic acid, acetic acid, oxalic acid, maleic acid, ammonium chloride, preferably tartaric acid, and more preferably citric acid, or a combination of such acids.
  • Jhey may be adsorbed into a particulate carrier material (such as colloidal silica) in order to provide particles comprising the weakly acidic material.
  • the suitable buffer system include materials that, when provided in a composition of the invention, provide a weakly acidic buffer system and are present in a sufficient amount to enable the maintenance of pH buffer forming materials thus include combinations of weak acid and salt of weak acid, such as combinations of the aforementioned acids with alkaline salt of those acids, including sodium citrate, potassium citrate, sodium tartrate, potassium tartrate and the like.
  • Preferred buffer forming materials are citric acid and sodium citrate.
  • a particulate carrier material such as colloidal silica
  • the combination of features including the osmotic properties of the component layers, the fluid flux properties of the semipermeable membrane and the configuration of the tablet core ensures that DPP-IV inhibitor is released at a desired rate over an extended time period, preferably over at least 24 hours.
  • the tri-layer oral osmotic dosage forms include a novel tri-layer tablet core surrounded by a semipermeable membrane and having suitable exit means for releasing at least one drug, one of which is a DPP-IV inhibitor through the semipermeable membrane.
  • the tri-layer tablet core has a first drug-containing layer, a second drug-containing layer and a third push layer.
  • drug is successively released from the first drug-containing layer and then from the second drug-containing layer.
  • Excipients in the drug-containing layers may be varied and adjusted for other purposes such as manufacturing convenience and pharmaceutical elegance. In this manner, dosage forms that exhibit reliable drug release having the desired profile over an extended time period, preferably over at least 24 hours, can be reliably and efficiently manufactured.
  • a method of reducing side effects associated with increased plasma concentration of DPP-IV inhibitor in a patient undergoing T2DM treatment comprises of orally administering single dose of a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof and optionally, at least one antidiabetic agent or pharmaceutically acceptable salt thereof, wherein a substantial dose of DPP-IV inhibitor in the composition exhibits zero order release over a period of at least 24 hours.
  • a method of treatment of a subject having a condition or disorder for which a DPP-IV inhibitor is indicated comprising orally administering to the subject, not more than once daily, a modified release composition as substantially described herein before throughout the specification.
  • Example 1 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate anhydrous, Lactose, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve.
  • the mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro- alcoholic medium.
  • Wet granules were dried in fluidized bed dryer at 60 ⁇ 5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh. Finally, the lubricated blend was compressed using a rotary compress tablet machine.
  • Example 2 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Aqueous dispersion of Eudragit with Triethyl citrate and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C.
  • the extended release coated tablet was dried in coating pan at 45 ⁇ 5° C to remove coating solvent.
  • Aqueous solution of Sitagliptin phosphate anhydrous and Opadry clear in purified water was then sprayed over previously drilled tablets in coater till the desired drug is loaded.
  • Example 3 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate anhydrous, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve.
  • the mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro-alcoholic medium.
  • Wet granules were dried in fluidized bed dryer at 60 ⁇ 5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh.
  • the lubricated blend then compressed using a rotary compress tablet machine.
  • Aqueous dispersion of Polymethyl acrylic acid polymer with Triethyl citrate, HPMC E5/Povidone K30 and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C.
  • the extended release coated tablet was dried in coating pan at 45 ⁇ 5° C to remove coating solvent.
  • Example 4 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate anhydrous, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve.
  • the mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro-alcoholic solution of Povidone.
  • Wet granules were dried in fluidized bed dryer at 60 ⁇ 5°C. The dried granules were then screened through #30 mesh and milled using a multimill.
  • Dried granules were blended in a double cone blender for 3 min with Glyceryl Behenate, colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh.
  • the lubricated blend then compressed using a rotary compress tablet machine.
  • Organic dispersion of ethylcellulose with PEG and Poviodne was prepared using methylene chloride and iso-propyl alcohol or ethanol and iso-propyl alcohol and coated on the tablets in a perforated pan coater while keeping the temperature between 50 ⁇ 5° C.
  • the extended release coated tablet was dried in coating pan at 45 ⁇ 5° C to remove coating solvent.
  • Aqueous dispersion of Eudragit with Triethyl citrate, Polyethylene glycol and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C.
  • the extended release coated tablet was dried in coating pan at 45 ⁇ 5° C to remove coating solvent.
  • Example 5 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate anhydrous, Mannitol, Povidone K 90 and Microcrystalline cellulose were co-sifted using vibro-sifter fitted with 40# ASTM sieve. The mixture was again mixed in a rapid mixer granulator for 5 minutes and then granulated using aqueous/hydro-alcoholic solution of polyethylene glycol 6000. Wet granules were then dried in fluidized bed dryer at about 40-55 ° C. Dried granules were then screened through #20 mesh sieve and the retained granules were milled in a multimill.
  • the milled granules were then blended in a double cone blender for 3 min with a previously sifted [through #60 mesh] mixture of colloidal silicon dioxide and magnesium stearate.
  • the lubricated blend was then compressed using rotary compress tablet machine.
  • Aqueous solution of Polyethylene Glycol (PEG) 400 was prepared in purified water.
  • Cellulose acetate (CA-320S) followed by cellulose acetate (CA-398-10) were added in acetone slowly under continuous stirring.
  • Aqueous solution of PEG 400 was then added in the cellulose acetate-acetone mixture.
  • the solution was then stirred at slow speed for about 1 h to get a clear/transparent solution.
  • the core tablets as obtained above were coated with extended release coating solution using a perforated pan coater while keeping the temperature between 30-45°C.
  • the extended release coated tablets were dried in coating pan at 45 ⁇ 5°C to remove coating solvent.
  • the extended release coated tablets were drilled mechanically or by means of laser drilling system with orifice size of about 0.5-0.8 mm.
  • Aqueous solution of sitagliptin phosphate anhydrous in hypromellose E3 and purified water was prepared. The solution was sprayed over previously drilled tablets in pan coater till the desired drug is loaded.
  • Example 6 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate Anhydrous was mixed with Polyethylene oxide (Sentry Polyox WSR N80) and then and sifted through #20 ASTM.
  • Hypromellose 2910 (METHOCELTM E5 Premium LV) was and sifted through #30 ASTM.
  • Pre-sifted iron oxide red was added to the drug layer composition for identification.
  • the above mixture was granulated for 10 minutes using isopropyl alcohol.
  • Wet granules were dried in fluidized bed dryer and sifted through #20ASTM followed by blending with pre-sifted magnesium stearate [through #60 ASTM] for 3 min in double cone blender.
  • the above mixture was granulated in rapid mixer granulator for 5 min using isopropyl alcohol. Wet granules then dried in fluidised bed dryer and sifted through #20ASTM followed by blending with pre-sifted magnesium stearate [through #60 ASTM] for 3 min in double cone blender.
  • the blend of drug layer and push layer was compressed to form bi-layer tablets using a bi-layer tabletting machine.
  • Aqueous solution of Polyethylene Glycol (PEG) 3350 was prepared in purified water. Separately cellulose acetate was dissolved in require quantity of acetone and the aqueous solution of PEG 3350 was added into it under stirring. The solution was then stirred at slow speed for about 1 h to get a clear/transparent solution.
  • PEG Polyethylene Glycol
  • the core tablets as prepared above were coated with extended release coating solution of cellulose acetate and polyethylene glycol 3350 in perforated pan coater.
  • the drug layer side of extended release coated tablets were then drilled by using tablet drilling laser system with one preformed passageway (orifice) of 0.7 ⁇ 0.1 mm diameter.
  • Aqueous solution of sitagliptin phosphate anhydrous and Opadry system in purified water was prepared. The solution was sprayed over previously drilled tablets in pan coater till the desired drug is loaded.
  • Example 7 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Sitagliptin phosphate anhydrous, Lactose and Microcrystalline cellulose were co- sifted using vibro-sifter fitted with 40# ASTM sieve. The mixture was again mixed in a rapid mixer granulator for 5 minutes and then granulated using aqueous/hydro-alcoholic solution of povidone K30. Wet granules were then dried in fluidized bed dryer at about 50-60 ° C. Dried granules were then screened through #20 mesh sieve and the retained granules were milled in a multimill. The milled granules were then blended in a double cone blender for 3 min with a previously sifted [through #60 mesh] mixture of colloidal silicon dioxide and magnesium stearate. The lubricated blend was then compressed using rotary compress tablet machine.
  • Aqueous solution of Polyethylene Glycol (PEG) 400 was prepared in purified water. Cellulose acetate (CA-320S) followed by cellulose acetate (CA-398-10) were added in acetone slowly under continuous stirring. Aqueous solution of PEG 400 was then added in the cellulose acetate-acetone mixture. The solution was then stirred at slow speed for about 1 h to get a clear/transparent solution.
  • the core tablets as obtained above were coated with extended release coating solution using a perforated pan coater while keeping the temperature between 30-45°C. The extended release coated tablets were dried in coating pan at 45 ⁇ 5°C to remove coating solvent.
  • Aqueous solution of sitagliptin phosphate anhydrous in hypromellose E3 and purified water was prepared. The solution was sprayed over previously coated tablets in pan coater till the desired drug is loaded.
  • Example 8 Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
  • Example 3 The tablets were prepared according to Example 3 in which the extended release coating composition was prepared by making a solution of polyacrylic resin, Ethyl cellulose, Hydroxylpropyl cellulose and tri-ethyl citrate in alcohol. The solution was then applied on to core tablets as per Example 3.
  • Example 9 Modified release tablet containing 5 mg Linagliptin
  • Example 10 Modified release tablet containing Sitagliptin or Pharmaceutically acceptable salt thereof
  • Example 11 Modified release tablet containing Sitagliptin or Pharmaceutically acceptable salt thereof
  • Example 6 Tablets obtained from example 9 and 10 were subjected to dissolution studies. The results of dissolution studies performed are provided in Table 1 1 and 12 respectively.
  • Example 12 Modified release tablet containing Sitagliptin or pharmaceutically acceptable salt thereof
  • Example 13 Modified release tablet containing Sitagliptin or pharmaceutically acceptable salt thereof

Abstract

The present invention relates to a novel modified release pharmaceutical composition of DPP-IV inhibitors or pharmaceutically acceptable salt thereof. In particular the present invention relates to a novel modified release composition of DPP-IV inhibitors or pharmaceutically acceptable salt thereof that achieves desired minimum effective plasma concentration of the DPP-IV inhibitor sufficient for effective glycemic control in subjects with type 2 diabetes mellitus. A method of improving glycemic control in adults with type 2 diabetes mellitus and reducing or eliminating fluctuations in plasma concentration of DPP-IV inhibitors is also provided by the present invention.

Description

A NOVEL MODIFIED RELEASE PHARMACEUTICAL COMPOSITION OF DPP-IV INHIBITORS OR PHARMACEUTICALLY ACCEPTABLE SALT
THEREOF
PRIORITY DOCUMENT
This patent application claims priority to Indian Provisional Patent Application number 2422/MUM/2014 (filed on Jul 26, 2014), the contents of which are incorporated by reference herein.
Field Of The Invention
The present invention relates to a novel modified release pharmaceutical composition of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof. In particular the present invention relates to a novel modified release composition of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof that achieves desired minimum effective plasma concentration of the DPP-IV inhibitor sufficient for effective glycemic control in patients with type 2 diabetes mellitus. A method of improving glycemic control in adults with type 2 diabetes mellitus and reducing or eliminating fluctuations in plasma concentration of the DPP-IV inhibitor is also provided by the present invention.
Background of the Invention
Type 2 diabetes is the most common form of diabetes and it is one of the most prevalent chronic diseases. Treatment of type 2 diabetes mellitus (T2DM) initially starts with diet and exercise, followed by oral antidiabetic monotherapy. During long-term treatment these regimens do not sufficiently control hyperglycemia in many patients, leading to a requirement for combination therapy within several years following diagnosis.
Drugs of choice for combination therapy include biguanides, DPP-IV inhibitors, sulfonylurea, thiazolidinedione, alphaglucosidase inhibitor, amylin analog, glucagon-like peptide-1 (GLP-1 ) or incretin mimetic, meglitinide and insulin. Out of these classes of drugs, biguanides and DPP-IV inhibitors are preferred choices for management of type 2 diabetes in the recent past. As the DPP-IV inhibitors are specific to reduction of post-prandial elevated glucose level as opposed to the lack of effect on the resting glucose level, combining them with biguanide is preferred.
Dipeptidyl peptidase IV (DPP-IV) inhibitors act by inhibiting dipeptidyl peptidase IV (DPP-IV) enzyme, a multifunctional transmembrane glycoprotein enzyme that cleaves N-terminal dipeptides from polypeptides with L-proline or L-alanine at the penultimate position. The selectivity of DPP-IV inhibitors against other closely- related proline-specific dipeptidyl peptidases, particularly DPP-8 and DPP-9, has been a potential for adverse events associated with non-selective DPP-IV inhibitors. The inhibition of DPP-8 and DPP-9 has been found to be associated with toxicities in rat and dog. Therefore, it is important to demonstrate that DPP- IV inhibitors do not appreciably inhibit these closely related enzymes.
Sitagliptin is an orally-active DPP-IV enzyme inhibitor, available as monohydrate of its phosphate salt. Chemically, monohydrate of sitagliptin phosphate is 7-[(3R)- 3-amino-1 -oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8tetrahydro-3- (trifluoromethyl) -1 ,2,4-triazolo [4,3-a] pyrazine phosphate (1 : 1 ) monohydrate with the following structure:
Figure imgf000003_0001
It is marketed in United States in the form of tablets under brand name Januvia®. Fixed dose combination of sitagliptin phosphate with metformin is also available under the brand name Janumet® and Janumet XR® which, respectively, exhibits immediate and extended release of metformin. Linagliptin is another orally-active DPP-IV enzyme inhibitor. Chemically, linagliptin is 1 H-Purine-2,6-dione, 8-[(3R)-3-amino-1 -piperidinyl]-7-(2-butyn-1 -yl)- 3,7-dihydro-3-methyl-1 -[(4-methyl-2quinazolinyl)methyl] with the following structure:
Figure imgf000004_0001
It is marketed in United States in the form of tablets under brand name Tradjenta®. Fixed dose combination of linagliptin with metformin is also available under the brand name Jentadueto® which exhibits immediate release of both linagliptin and metformin.
There are several drug combinations commercially available for management of
T2DM.
U.S. Patent number US 6,099,862 discloses controlled release tablet containing metformin and glipizide.
U.S. Patent RE44,186 discloses a method of treatment for T2DM using DPP-IV inhibitor and one or more other antidiabetic agents such as metformin, glyburide, troglitazone, pioglitazone and rosiglitazone.
U.S. Patent 8,414,921 discloses pharmaceutical compositions comprising fixed- dose combinations of a DPP-IV inhibitor and metformin.
U.S. Publication number 20070172525 and 20080064701 discloses pharmaceutical compositions comprising an immediate-release DPP-IV inhibitor and a slow-release form of metformin. U.S. Patent 8,329,217 discloses a controlled release osmotic device containing a bi-layered core of at least two different active agents which provides therapeutically effective levels of both the actives for an extended period of time following oral administration.
U.S. Publication number 20130059002 discloses a pharmaceutical composition comprising metformin and sitagliptin or pharmaceutically acceptable salt thereof in two separate compartments. The document also discloses a combination composition comprising an extended release metformin HCI and an extended release sitagliptin.
European patent publication number EP 1 ,537,880 A1 relates to a sustained release formulation of DPP-IV inhibitor comprising a hydrophilic polymer.
Even though antidiabetic combinations have been proven effective for diabetes management, existing once daily formulations still may fall short by exhibiting sub-therapeutic plasma concentrations or expose to undesired higher plasma concentrations of antidiabetic agents than that required for safe glycemic control and may ultimately failing to provide round the clock diabetes management. This variation in plasma levels of the antidiabetic agents may be attributed to their varying solubilities, different physiological targets and pharmacokinetic (PK) profiles.
Despite of its therapeutic benefits, strong inhibition of DPP-IV activity by DPP-IV inhibitors in living organisms potentiates the vasodilating action of substance P. Moreover, DPP-IV activity of nasal mucosa and the density of inflammatory cells in nasal mucosa of patients with chronic rhinosinusitis are in a reverse correlation and DPP-IV activity increases when chronic rhinosinusitis was cured (FASEB, 2002; 16:1 132-1 134). Therefore, strong inhibition of DPP-IV activity in diabetic patients with concurrent chronic inflammation is not considered preferable as it may cause aggravation of the inflammation. It was also reported that an interferon-a treatment of patients with hepatitis C is characterized by decrease in serum DPP-IV activity and the treatment is associated with side effects such as depression and anxiety. Therefore, the severity of depression and anxiety can be correlated with decreased serum DPP-IV activity (Mol. Psychiatry, 2001 , 6:475- 480) and which may be aggravated further by strong DPP-IV inhibition.
The developmental report of Januvia® 100 mg submitted to EMEA demonstrates relation between plasma concentration of sitagliptin and its pharmacokinetic or pharmacodynamic profile. In report, a single dose study of sitagliptin in T2DM patients suggested that near-maximal reduction of post-challenge glucose excursion was associated with three factors, viz. sitagliptin plasma concentrations of approximately 100 nM or higher, plasma DPP-IV inhibition of 80% or higher, and augmentation of post-challenge active GLP-1 levels of 2-fold or higher. It was further reasoned that for optimal chronic glucose lowering in T2DM patients, plasma DPP-IV inhibition should be 80% or greater at steady state trough. According to the report, once daily single dose administration of immediate release sitagliptin phosphate 100mg (Januvia®) tablet provides a maximum plasma concentration (Cmax) of 950 nM within 1 .3 hours that decreases to less than 100 nM by 24 hours post administration which leads to the following two issues.
Firstly, as the EC8o for sitagliptin is 100 nM, the plasma concentration of below 100 nM achieved by 24 hours post administration of 100 mg dose of Januvia® is sub-therapeutic, which may lead to loss of glycemic control for about last 4 hours with current once daily dosage regimen. Such inadequate glycemic control of about 4 hours after each dose administration may be seen until the steady state plasma concentration is achieved on 10th day of the once daily dosage regimen. Such inadequate glycemic control should be avoided for effective management of T2DM. Secondly, the 100 mg immediate release dosage form leads to essentially non required maximum plasma concentration of about 950 nM within 1 .3 hours post administration, since the maximal DPP-IV inhibition occurs at about 125 nM. Such higher plasma concentration achieved by the 100 mg immediate release dosage may aggravate inflammation or lead to depression and anxiety which are not desirable for the diabetic patient as mentioned above.
Sitagliptin has average renal clearance of 350 ml/min and volume of distribution of about 198 liters. As sitagliptin is cleared off body mainly through kidney, its dose adjustment prior to initiation of therapy and periodically thereafter is essential in renal function compromised patients and becomes even more essential due to role of renal function in diabetic patients. Specifically patient with renal insufficiency is prescribed lesser dose of sitagliptin than that to normal patient.
Similarly, in case of linagliptin, 5 mg once daily dose achieves a DPP-IV inhibition of around 66% at 24 hours post single dose administration and such inadequate glycemic control may be seen until the steady state plasma concentration is achieved on 12th day of the once daily dosage regimen.
Thus, as a result, the existing DPP-IV inhibitor products may suffer from three issues, firstly causing hyperglycemia in last few hours of the day (e.g. last four hours in case of sitagliptin) post administration causing hyperglycemia, secondly exposing the patient for several initial hours to essentially non required maximum plasma concentration following administration, and thirdly require renal function monitoring before and during treatment.
None of the currently available therapies, however, address the requirement of providing better glycemic control for 24 hours after single dose administration and reducing the side-effects due to undesirably higher Cmax of DPP-IV inhibitors achieved by the current marketed dosage form. Hence, there still exists an enduring need for alternate and improved compositions of DPP-IV inhibitors which may address aforesaid objectives for effective T2DM management.
Summary Of The Invention
In one general aspect, there is provided a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein once daily administration of said composition to a subject achieves mean steady state plasma concentration (Css) of the DPP-IV inhibitor on or before 7 days.
In another general aspect, there is provided a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein the DPP-IV inhibitor in composition inhibits activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
In another general aspect, there is provided a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein the DPP-IV inhibitor in the composition inhibits activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
In another general aspect, the DPP-IV inhibitor in the composition exhibit modified release so as to inhibit activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject. In another general aspect, there is provided a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein said composition exhibit an in vitro release profile such that on average no more than about 30% of the DPP-IV inhibitor is dissolved within 1 hour and/or time to reach 50% dissolution is at least 4 hours after placement of the composition in a dissolution test conducted according to USP using Apparatus I at speed of 100 rpm in water at about 37°C.
In another general aspect, there is provided a modified release composition comprising sitagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent, wherein said composition exhibit an in vitro release profile such that about 30% to about 70% of sitagliptin is dissolved within 8 hour and/or about 50% to about 90% of sitagliptin is dissolved within 16 hour after placement of the composition in a dissolution test conducted according to USP, using USP Apparatus I at 100 rpm in water at about 37°C.
In another general aspect, there is provided a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; one or more rate controlling excipients and optionally, at least one antidiabetic agent wherein a substantial dose of DPP-IV inhibitor in the composition exhibit zero order release over a period of at least 24 hours after oral administration of single dose of the composition.
In another general aspect, antidiabetic agent in the modified release composition exhibit immediate and/or extended release from said composition. In another general aspect, total dose of the DPP-IV inhibitor in modified release composition is divided into an immediate release part and an extended release part.
In another general aspect, the extended release part of DPP-IV inhibitor in the modified release composition exhibits zero order release.
In another general aspect, the modified release composition of the DPP-IV inhibitor further comprises two antidiabetic agents.
In another general aspect, there is provided a modified release composition comprising:
(a) at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof,
(b) one or more rate controlling excipients,
(c) optionally one or more a-glucosidase inhibitors or biguanide or pharmaceutically acceptable salt thereof;
wherein a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over at least 24 hours after oral administration of single dose of the composition to a subject.
In another general aspect, there is provided a modified release composition comprising:
(a) at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof,
(b) one or more rate controlling excipients,
(c) at least one biguanide or pharmaceutically acceptable salt thereof, and
(d) optionally one or more a-glucosidase inhibitors or pharmaceutically acceptable salt thereof;
wherein a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over at least 24 hours after oral administration of single dose of the composition to a subject. In another general aspect, there is provided a modified release composition comprising:
(a) at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof,
(b) at least one biguanide or pharmaceutically acceptable salt thereof; and
(c) optionally one or more a-glucosidase inhibitors or pharmaceutically acceptable salt thereof;
wherein once daily administration of the composition to a subject provides mean steady state plasma concentration (Css) of said DPP-IV inhibitor on or before 7 days.
DPP-IV inhibitors in the modified release composition may be selected from the group comprising, but not limited to, alogliptin, linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin and/or pharmaceutically acceptable salt thereof.
Additional antidiabetic agents may be selected from DPP-IV inhibitors, insulin sensitizers, a-glucosidase inhibitors, biguanides, insulin secretagogues, sodium- glucose co-transporter-2 (SGLT-2) inhibitors, β3 agonists, GPR40 agonists, GLP- 1 receptor agonists, amylin agonists, phosphotyrosine phosphatase inhibitors, gluconeogenesis inhibitors, 1 1 β -hydroxysteroid dehydrogenase inhibitors, adiponectin or agonist thereof, IKK inhibitors, leptin resistance improving drugs, somatostatin receptor agonists, and glucokinase activators.
Suitable biguanides may be selected from metformin, buformin, phenformin or pharmaceutically acceptable salt thereof.
Suitable insulin secretagogues may be selected from acetohexamide, chlorpropamide, tolbutamide, tolazamide, glipizide, glybuzole, gliclazide, glibenclamide, gliquidone, glyclopyramide, glimepiride, neteglinide, repaglinide, mitiglinide or pharmaceutically acceptable salt thereof. Suitable sodium-glucose co-transporter-2 (SGLT-2) inhibitors may be selected from dapagliflozin, canagliflozin, ipragliflozin, tofoglif lozin, empagliflozin, sergliflozin, remogliflozin, ertugliflozin, luseogliflozin, atigliflozin or pharmaceutically acceptable salt thereof.
Suitable a-glucosidase inhibitors may be selected from voglibose, acarbose, miglitol, emiglitate or pharmaceutically acceptable salt thereof.
Suitable GPR40 agonists may be selected from AMG 837, TAK-875 or pharmaceutically acceptable salt thereof.
Suitable GLP-1 receptor agonists may be selected from AMG 837, TAK-875, NN- 221 1 , exendin-4, BIM-51077, CJC-1 131 or pharmaceutically acceptable salt thereof.
Suitable gluconeogenesis inhibitors may be selected from glycogen phosphorylase inhibitor, glucose-6-phosphatase inhibitor, glucagon antagonist or pharmaceutically acceptable salt thereof.
In another general aspect, amylin agonist is pramlintide, phosphotyrosine phosphatase inhibitor is sodium vanadate, 11 β -hydroxysteroid dehydrogenase inhibitor is BVT-3498 and glucokinase activators is Ro-28-1675 or pharmaceutically acceptable salt thereof.
In another general aspect, there is provided a modified release composition comprising linagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients, and optionally, at least one antidiabetic agent, wherein once daily administration of said composition to a subject provides mean steady state plasma concentration (Css) of linagliptin on or before 7 days. In another general aspect, there is provided a modified release composition comprising linagliptin or pharmaceutically acceptable salt thereof; one or more rate controlling excipients, and optionally, at least one antidiabetic agents, wherein the composition maintains mean plasma concentration of linagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
In another general aspect, linagliptin in the composition exhibit modified release so as to inhibit activity of the DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
In another general aspect, there is provided a modified release composition comprising:
(a) at least one component exhibiting extended release of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof;
(b) at least one component exhibiting extended release of metformin or pharmaceutically acceptable salt thereof, and optionally
(c) at least one component exhibiting immediate release of metformin and/or sitagliptin or salt thereof;
wherein once daily administration of said composition to a subject provides mean steady state plasma concentration (Css) of the DPP-IV inhibitor on or before 7 days.
In another general aspect, the minimum therapeutically effective plasma concentration of the DPP-IV inhibitor and optionally, at least one antidiabetic agent in the modified release composition is achieved by their osmotically controlled release from the composition.
In another general aspect, the modified release composition is in the form of an osmotic dosage form. In another general aspect, the modified release composition comprises: (i) a semipermeable wall provided around an osmotic formulation comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof, optionally at least one antidiabetic agent or pharmaceutically acceptable salt thereof, an osmotic agent, and an osmopolymer; and (ii) a passageway.
In another general aspect, there is provided a method of reducing side effects associated with increased plasma concentration of the DPP-IV inhibitor in a patient undergoing T2DM treatment, which method comprises of orally administering single dose of a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof and optionally, at least one antidiabetic agent or pharmaceutically acceptable salt thereof, wherein a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release over a period of at least 24 hours.
In another general aspect, there is provided a method of treating type 2 diabetes mellitus comprising administration of the modified release composition to a subject in need thereof as substantially described herein before.
BRIEF DESCRIPTION OF THE FIGURES:
FIGURE 1 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 10 mg of immediate release part and 90 mg of extended release part.
FIGURE 2 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 25 mg of immediate release part and 75 mg of extended release part. FIGURE 3 is a graph showing plasma concentration profile of modified release 100 mg sitagliptin composition with 50 mg of immediate release part and 50 mg of extended release part.
Detailed Description Of The Invention
The inventors of the present invention have surprisingly found that optimum therapeutic plasma concentration of the DPP-IV inhibitor can be maintained in order to provide optimal glycemic control over 24 hours by administering a novel modified release composition of the DPP-IV inhibitor. Novel modified release composition of the present invention maintains the therapeutically effective plasma concentration of the DPP-IV inhibitor and does not allow it to surpass the optimal level, therefore avoids side effects or problems associated with administration of the DPP-IV inhibitors. The novel modified release composition according to the present invention provides sufficient plasma concentration of the DPP-IV inhibitor over 24 hours after single dose oral administration. Additionally, such compositions achieve steady state concentration of the DPP-IV inhibitors relatively earlier than that achieved by conventional dosage forms.
The inventors have surprisingly found that the desired DPP-IV inhibition can be achieved with a once daily dose of DPP-IV inhibitors using the novel modified release composition. Particularly, the composition achieves more than 80% of the DPP-IV enzyme inhibition over a period of over at least 24 hours after single dose oral administration. Further, the novel modified release composition of the DPP-IV inhibitors in accordance with the present invention achieves optimal plasma concentration, thus avoiding undesirable side effects such as aggravation of inflammation in diabetic patients with concurrent inflammation and depression/anxiety.
The management of T2DM can be done by providing modified release composition comprising a DPP-IV inhibitor. For providing better glycemic control over at least 24 hours after single dose administration and reducing the side- effects due to undesirably higher Cmax and strong inhibition of the DPP-IV activity by DPP-IV inhibitors is, however, not always required for effective type 2 diabetes therapy.
The novel modified release composition of the present invention is capable of appropriately inhibiting the DPP-IV activity and that can be administered once daily. It is also possible to achieve a desired effect by maintaining a minimum effective plasma concentration of the DPP-IV inhibitors by administering the composition of the present invention. Particularly, the modified release composition avoids peaks and valleys (fluctuations) in plasma concentration of the DPP-IV inhibitor alone or in combination with other antidiabetic agent.
The term "pharmaceutically acceptable salts" are meant those salts in which the anion does not contribute significantly to the toxicity or pharmacological activity of the salt, and, as such, they are the pharmacological equivalents of the bases of the drug compound.
The term "DPP-IV inhibitor" refers to compounds that are intended to potentiate the endogenous incretin response by preventing the proteolysis of GLP 1 or GIP through the inhibition of one or more of the DPP-IV isoforms in the body (Mcintosh, C. H. S., et al., Regulatory Peptides, 2005; 128:159-65). A number of such agents have been approved, under review at the FDA or in clinical development (Hunziker, D., et al., Curr. Top. Med. Chem., 2005; 5:1623-37; Kim, D., et al., J. Med. Chem., 2005; 48:141 -51 ).
The term "modified release" as used herein in relation to the composition according to the invention or used in any other context means release, which is not completely immediate release and is taken to encompass controlled release, sustained release, prolonged release, timed release, retarded release, extended release and delayed release. The term "modified release composition" as used herein can be described as compositions whose drug-release characteristics of time course and/or location are chosen to accomplish therapeutic or convenience objectives not offered by conventional dosage forms such as a solution or an immediate release dosage form. The modified release composition may exhibit combination of at least two types of releases of the drug. For example, the composition comprising an immediate release part and an extended release part of DPP-IV inhibitor may, overall, exhibit modified release of DPP-IV inhibitor from such dosage form.
The term "extended release" is used in its conventional sense to refer to a composition that makes the drug available over an extended period after ingestion, and preferably, although not necessarily, results in substantially constant blood levels of the drug over an extended time period. The term extended release used in context of the present invention includes, but not limited to, zero order release of the drug.
The term "rate controlling excipients" is used to refer to excipients which modify release of active agent from compositions whose drug-release characteristics of time course and/or location are chosen to accomplish therapeutic or convenience objectives not offered by conventional dosage forms such as a solution or an immediate release dosage form.
The term "zero order release" includes a zero order release as well as pseudo- zero order release profiles of the drug. A zero order release profile characterizes the release profile of a dosage form that releases a constant amount of drug per unit time. A pseudo-zero order release profile is one that approximates a zero- order release profile.
By "steady state" or 'CSs' is meant a pattern of plasma concentration versus time following continuous administration of a constant dose, where the plasma concentration peaks and plasma concentration troughs are essentially identical within each dosing interval. The upper (peak) and lower (trough) values of the steady state concentration are termed as 'steady state maximum concentration' or 'Css (max)' and 'steady state minimum concentration' or 'CSS (min)' respectively.
The term "subject" or alternatively "individual" includes mammals. Non-limiting examples of mammals include humans, preferably human suffering from diabetes and particularly type 2 diabetes.
The term "substantial amount of DPP-IV inhibitor" refers to at least 5% and more preferably at least 10% of the total amount of DPP-IV inhibitor in the composition or any amount of the DPP-IV inhibitor that is released at least 1 hour post oral administration of the composition. Substantial release of DPP-IV inhibitor from the composition may be achieved, for example, by providing a composition releasing the DPP-IV inhibitor in at least two separate pulses. Such formulation includes a composition with an immediate release part and an extended release part of the DPP-IV inhibitor.
As to the release profiles of the modified release compositions containing the DPP-IV inhibitor have several potential advantages over its conventional immediate release (IR) formulations. Mainly the gradual release of the DPP-IV inhibitor into the gastrointestinal (Gl) tract provides lower maximum effective concentrations, thus reducing or avoiding unwanted side effects.
The novel modified release composition of the present invention exhibits release of the DPP-IV inhibitor in such a way that it achieves and maintains minimum effective concentration of the DPP-IV inhibitor for at least 24 hours after oral administration. Preferably, the composition maintains about 80% or more inhibition of the DPP-IV inhibitor for at least 24 hours after oral administration of single dose of the composition. The DPP-IV enzyme activity in plasma can be measured by, for example, a method utilizing the "method of Raymond et al., Diabetes, vol. 47, pp. 1253-1258 (1998)". The decrease rate of the DPP-IV enzyme activity in plasma may be different from the determined values as long as it is within the general error range. Moreover, depending on the measurement method of the DPP-IV enzyme activity in plasma, the decrease rate of the DPP-IV enzyme activity in plasma may be different from the determined values. For example, when, of the measurement conditions of the DPP-IV enzyme activity in plasma, the kind of substrate, substrate concentration, reaction time, dilution fold of the plasma and the like are different from the method described in the above-mentioned reference, the decrease rate of the DPP-IV enzyme activity in plasma may be greater than the determined values and, for example, 90% may be a value not less than 95%. Several methods of determining serum DPP-IV enzyme activity are also known in the art. For example, a bioluminescent assay for determining DPP-IV enzyme activity by means of detecting the Gly-Pro cleaving activity is provided by Martha O'Brien et al. (Cell Notes, lssue-16, 2006).
DPP-IV inhibitors may be selected from the group comprising alogliptin, linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin or pharmaceutically acceptable salt thereof. A preferred salt of sitagliptin is the phosphate salt, most preferably in the form of its monohydrate. A preferred salt of saxagliptin is the hydrochloride salt. A preferred salt of alogliptin is the benzoate salt.
Antidiabetic agents may be selected from the group comprising insulin sensitizers (e.g. pioglitazone, rosiglitazone, tesaglitazar, ragaglitazar, muraglitazar, edaglitazone, metaglidasen, naveglitazar), a-glucosidase inhibitors (e.g., voglibose, acarbose, miglitol, emiglitate), biguanides (e.g., metformin, buformin), insulin secretagogues [sulfonylurea e.g., tolbutamide, glibenclamide, gliclazide, chlorpropamide, tolazamide, acetohexamide, glyclopyramide, glimepiride, glipizide, glybuzole;, repaglinide, nateglinide, mitiglinide), sodium- glucose co-transporter-2 (SGLT-2) inhibitors (e.g. Dapagliflozin, Canagliflozin, Ipragliflozin, Tofogliflozin Empagliflozin, Sergliflozin, Remogliflozin, Ertugliflozin, Luseogliflozin, Atigliflozin), β3 agonists (e.g., AJ-9677), GPR40 agonists, GLP-1 receptor agonists (e.g., GLP-1 , GLP-1 MR agent, N,N-221 1 , AC-2993 (exendin- 4), BIM-51077, CJC-1 131 ), amylin agonists (e.g., pramlintide), phosphotyrosine phosphatase inhibitors (e.g. sodium vanadate), gluconeogenesis inhibitors (e.g., glycogen phosphorylase inhibitor, glucose-6-phosphatase inhibitor, glucagon antagonist), sodium-glucose cotransporter (SGLUT) inhibitors (e.g., T-1095), 1 1 β -hydroxysteroid dehydrogenase inhibitors (e.g., BVT-3498), adiponectin or agonist thereof, IKK inhibitors (e.g., AS-2868), leptin resistance improving drugs, somatostatin receptor agonists, glucokinase activators (e.g., Ro-28-1675), GIP (Glucose-dependent insulinotropic peptide) and the like or one or more pharmaceutically acceptable salt, ester, solvates and derivatives thereof.
It is preferred to use a pharmaceutically acceptable salt of the DPP-IV inhibitor and/or antidiabetic agents, especially a salt exhibiting moderate to high solubility in water. Illustrative salts include those prepared using the following acids: hydrochloric, hydrobromic, hydroiodic, phosphoric, sulfuric, methanesulfonic acid, ethanesulfonic, 2-hydroxyethanesulfonic, benzenesulfonic, p-hydroxybenzoic, toluenesulfonic, formic, acetic, propionic, benzoic, anthranilic, tartaric, maleic, malic, citric, isocitric, succinic, ascorbic, lactic, glycolic, gluconic, glucuronic, pyruvic, oxaloacetic, fumaric, aspartic, glutamic, stearic, salicylic, phenylacetic, mandelic, pamoic, pantothenic, sulfanilic, cyclohexylaminosulfonic, algenic, β- hydroxybutyric, galactaric and galacturonic acids.
Rate controlling excipients are chosen to modify release of active agent from compositions and may be selected from but not limited to osmopolymers, hydrogels, osmogents, hydrophilic, hydrophobic, amphiphilic polymers, inert materials or copolymers or derivatives and or combinations thereof. Various methods known in the art can be used to determine plasma concentration or in-vitro profile of the novel modified release composition in accordance with present invention.
It is preferred that mean steady state plasma concentration (Css) of the DPP-IV inhibitor is achieved on or before 7 days on once daily administration of the modified release composition to a subject in accordance with the present invention.
In an embodiment, the modified release composition comprises linagliptin or pharmaceutically acceptable salt thereof and said composition maintains mean plasma concentration of liagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition.
In an embodiment, the modified release composition comprises linagliptin or pharmaceutically acceptable salt thereof and said composition provides mean plasma concentration of liagliptin of at least about 4 nM over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
In a further embodiment, the modified release composition comprising the DPP- IV or pharmaceutically acceptable salt thereof exhibits an in vitro release profile such that on average no more than about 30% of DPP-IV inhibitor is dissolved within 1 hour and/or time to reach 50% dissolution is at least 4 hours after placement of the composition in a dissolution test conducted according to USP using Apparatus I at 100 rpm in water at about 37°C.
In an embodiment, the modified release composition comprising sitagliptin or pharmaceutically acceptable salt thereof have maximum plasma concentration (Cmax) and exhibits a mean steady state minimum plasma concentration (Css (min)) of sitagliptin in the range given below after oral administration of single dose of said composition to a subject. IR/ER dose (mg)
Time (Hrs) 10/90 25/75 50/50
Plasma Concentration (Cmax in nM)
24h 250-400 225-375 300-500
Day 2 300-500 400-600 600-800
Day 3 300-500 450-650 600-800
Day 4 (Steady State achieved by Day 3)
Css (max) 419 522 699
Css (min) 361 314 242
The amount of the DPP-IV inhibitor present in modified release composition is sufficient to provide a daily dose in one to a small plurality, for example one to about 4, of dosage units to be administered at one time. Preferably the full daily dose is delivered in a single dosage unit. An amount of about 1 mg to about 500 mg per dosage unit, or about 0.05% to about 80% by weight of the composition, will generally be suitable. The amount of the DPP-IV inhibitor may be calculated on the basis of its base or salt.
Preferably an amount of about 25 mg to about 100 mg sitagliptin per dosage unit is present. Specific amounts per tablet contemplated herein include 25, 50, and 100 mg sitagliptin base. Preferably an amount of about 2.5 mg and 5 mg saxagliptin base per dosage unit is present. Preferably an amount of about 5 mg linagliptin per dosage unit is present. Preferably an amount of about 50 mg vildagliptin per dosage unit is present. Preferably an amount of about 6.25 mg, 25 mg and 25 mg alogliptin base per dosage unit is present. However overages may be added as and when required according to composition and release profile requirements.
It is preferred that total dose of the DPP-IV inhibitor in the composition is divided in to an immediate release part and an extended release part. In an embodiment, the extended release part in the composition exhibits zero order release of the DPP-IV inhibitor.
In a further embodiment, the antidiabetic agent in the composition exhibits immediate and/or extended release.
The particular release and/or PK profile as defined herein can be achieved using one or more release-modifying means, for example, providing the composition in the form of matrix or DPP-IV inhibitor with various rate controlling substances known in the art or by providing coating of rate controlling substances over the DPP-IV inhibitor containing core.
It would be appreciated to the person skilled in the art that dose of the DPP-IV inhibitor can be adjusted considering progression of disease and patient's physiology. For example, dose of sitagliptin in the modified release composition can be adjusted (from 100 mg to 50 mg or 25 mg) in case of renal function compromised patients.
In an embodiment, the modified release composition comprises "l OOmg sitagliptin or pharmaceutically acceptable salt thereof in which total dose of sitagliptin or pharmaceutically acceptable salt thereof is divided in to about 10 mg to about 50 mg of immediate release part and about 50 mg to about 90 mg of extended release part. Figure 1 to 3 shows the plasma concentration profile of sitagliptin 100 mg composition with immediate and extended release parts in said ranges.
The modified release composition may take any form suitable for oral administration, but is typically formulated as a discrete solid dosage unit such as a tablet or capsule, wherein the DPP-IV inhibitor or pharmaceutically acceptable salt thereof is present as solid particles, and is formulated together with one or more pharmaceutically acceptable excipients. The excipients are selected in part to provide a release profile and/or PK profile consistent with those defined above. The modified release composition in the form of a tablet can be of any suitable size and shape, for example round, oval, polygonal or pillow-shaped, and optionally bear nonfunctional surface markings. Especially in the case of coated tablets they are preferably designed to be swallowed whole and are therefore typically not provided with a breaking score. Dosage unit compositions of the invention can be packaged in a container, accompanied by a package insert providing pertinent information such as, for example, dosage and administration information, contraindications, precautions, drug interactions and adverse reactions.
In an embodiment, the modified release composition may comprises an active core comprised of one or more inert particles, each in the form of a bead, pellet, pill, granular particle, microcapsule, microsphere, microgranule, nanocapsule, or nanosphere coated on its surfaces with the DPP-IV inhibitor in the form of e.g., a DPP-IV inhibitor-containing coating or film-forming composition using, for example, fluid bed techniques or other methodologies known to those of skill in the art. The inert particle can be of various sizes, so long as it is large enough to remain poorly dissolved. Alternatively, the active core may be prepared by granulating and milling and/or by extrusion and spheronization of a polymer composition containing the DPP-IV inhibitor.
Illustratively, release-modifying means suitable for use in a composition of the invention include a polymer matrix wherein the DPP-IV inhibitor is dispersed; a release-controlling layer or coating surrounding the whole dosage unit or DPP-IV inhibitor-containing particles, granules, beads or zones within the dosage unit; and an osmotic pump. In a preferred embodiment, the modified release composition is provided in the form of an osmotic pump.
In an embodiment, the hydrophilic polymer matrix may further include an ionic polymer, a non-ionic polymer, or water-insoluble hydrophobic polymer to provide a stronger gel layer and/or reduce pore quantity and dimensions in the matrix so as to slow diffusion and erosion rates and concomitant release of the DPP-IV inhibitor. This may additionally produce a more steady, zero order release of the DPP-IV inhibitor. Various ionic polymer, a non-ionic polymer, or water-insoluble hydrophobic polymer known in the art may be used.
In an embodiment, the modified release composition comprises-
(a) at least one component exhibiting extended release of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof;
(b) at least one component exhibiting extended release of metformin or pharmaceutically acceptable salt thereof, and optionally
(c) at least one component exhibiting immediate release of metformin and/or sitagliptin or pharmaceutically acceptable salt thereof.
It is preferred that a substantial dose of the DPP-IV inhibitor in the composition exhibits zero order release over a period of at least 24 hours after oral administration of single dose of the composition.
In an embodiment, the modified release composition may comprise pH modifying agent and or suitable pharmaceutically acceptable buffer.
In an embodiment, both the antidiabetic agent and a substantial dose of the DPP-IV inhibitor in the composition exhibit zero order release from said composition.
In a further embodiment, a substantial dose of the DPP-IV inhibitor in the modified release composition exhibits zero order release over at least 24 hours after oral administration of single dose of the composition.
In a further embodiment, the minimum therapeutically effective plasma concentration of the DPP-IV inhibitor and optionally, at least one antidiabetic agent from the modified release composition is achieved by their osmotically controlled release from the composition.
In an embodiment, the osmotic dosage form comprises: (i) a semipermeable wall provided around an osmotic formulation comprising a DPP-IV inhibitor or pharmaceutically acceptable salt thereof, an osmotic agent, and an osmopolymer; and (ii) a passageway.
By way of example, a capsule based on osmotic release mechanism may be formulated with a single osmotic unit or it may incorporate 2, 3, 4, 5, or 6 push- pull units encapsulated within a hard gelatin capsule, whereby each bilayer push pull unit contains an osmotic push layer and a DPP-IV inhibitor layer, both surrounded by a semi-permeable membrane. One or more orifices are drilled through the membrane next to the DPP-IV inhibitor layer. This membrane may be additionally covered with a ph-dependent enteric coating to prevent release until after gastric emptying. The gelatin capsule dissolves immediately after ingestion. As the push pull unit(s) enter the small intestine, the enteric coating breaks down, which then allows fluid to flow through the semi-permeable membrane, swelling the osmotic push compartment to force DPP-IV inhibitor out through the orifice(s) at a rate precisely controlled by the rate of water transport through the semipermeable membrane. Release of DPP-IV inhibitor can occur over a constant rate for at least up to 24 hours.
The osmotic push layer comprises one or more osmotic agents creating the driving force for transport of water through the semi-permeable membrane into the core of the delivery vehicle. One class of osmotic agents includes water- swellable hydrophilic polymers, also referred to as "osmopolymers" and "hydrogels," including, but not limited to, hydrophilic vinyl and acrylic polymers, polysaccharides such as calcium alginate, polyethylene oxide (PEO), polyethylene glycol (PEG), polypropylene glycol (PPG), poly(2-hydroxyethyl methacrylate), poly(acrylic) acid, poly(methacrylic) acid, polyvinylpyrrolidone (PVP), crosslinked PVP, polyvinyl alcohol (PVA), PVA/PVP copolymers, PVA/PVP copolymers with hydrophobic monomers such as methyl methacrylate and vinyl acetate, hydrophilic polyurethanes containing large PEO blocks, sodium croscarmellose, carrageenan, hydroxyethyl cellulose (HEC), hydroxypropyl cellulose (HPC), hydroxypropyl methyl cellulose (HPMC), carboxymethyl cellulose (CMC) and carboxyethyl, cellulose (CEC), sodium alginate, polycarbophil, gelatin, xanthan gum, and sodium starch glycolate.
Another class of osmotic agents includes osmogents, which are capable of imbiging water to affect an osmotic pressure gradient across the semi-permeable membrane. Exemplary osmogens include, but are not limited to, inorganic salt, such as magnesium sulfate, magnesium chloride, calcium chloride, sodium chloride, lithium chloride, potassium sulfate, potassium phosphates, sodium carbonate, sodium sulfite, lithium sulfate, potassium chloride, and sodium sulfate; sugars, such as dextrose, fructose, glucose, inositol, lactose, maltose, mannitol, raffinose, sorbitol, sucrose, trehalose, and xylitol; organic acids, such as ascorbic acid, benzoic acid, fumaric acid, citric acid, maleic acid, sebacic acid, sorbic acid, adipic acid, edetic acid, glutamic acid, p-toluenesulfonic acid, succinic acid, and tartaric acid; urea; and mixtures thereof.
Materials useful in forming the semipermeable membrane include various grades of acrylics, vinyls, ethers, polyamides, polyesters, and cellulosic derivatives that are water-permeable and water-insoluble at physiologically relevant pHs, or are susceptible to being rendered water-insoluble by chemical alteration, such as crosslinking.
Suitable osmotic dosage form may be provided in the form of a mono-layer, bi- layer or tri-layer dosage form. In an embodiment, the bi-layer oral osmotic dosage forms include a first component layer, comprising at least one drug, one of which is a DPP-IV inhibitor and excipients for forming a deliverable drug composition when hydrated, and a second push layer, comprising a fluid- expandable osmopolymer and excipients, contained within a compartment formed by a semipermeable membrane and having exit means for drug release from the compartment. The two layers are compressed into bi-layer tablet cores before the semipermeable membrane is applied and a suitable orifice for drug release there through is formed. Alternatively, the bi-layer tablet cores are formed when two component layers are compressed together to provide a longitudinally compressed tablet core having a 'capsule-shaped' configuration with a different layer at each narrow end.
Bi-layer oral osmotic dosage forms and methods of making and using such dosage forms are known in the art, for example, as described and claimed in the following US Patents, owned by Alza Corporation: U.S. Pat. Nos. 4,327,725; 4,612,008; 4,783,337; and 5,082,668, each of which is incorporated in its entirety by reference herein.
The suitable pH modifying agent include malic acid, fumaric acid, adipic acid, succinic acid, lactic acid, acetic acid, oxalic acid, maleic acid, ammonium chloride, preferably tartaric acid, and more preferably citric acid, or a combination of such acids. The skilled person will appreciate that, when weak acids are employed which are not solids (and therefore not particulate) at or around room temperature and atmospheric press u re, Jhey may be adsorbed into a particulate carrier material (such as colloidal silica) in order to provide particles comprising the weakly acidic material.
The suitable buffer system include materials that, when provided in a composition of the invention, provide a weakly acidic buffer system and are present in a sufficient amount to enable the maintenance of pH buffer forming materials thus include combinations of weak acid and salt of weak acid, such as combinations of the aforementioned acids with alkaline salt of those acids, including sodium citrate, potassium citrate, sodium tartrate, potassium tartrate and the like. Preferred buffer forming materials are citric acid and sodium citrate. The skilled person will appreciate that, when materials are employed which are not solids (and therefore not particulate) at or around room temperature and atmospheric pressure, they may be adsorbed into a particulate carrier material (such as colloidal silica) in order to provide particles comprising the weakly-acidic buffer forming materials.
The combination of features including the osmotic properties of the component layers, the fluid flux properties of the semipermeable membrane and the configuration of the tablet core ensures that DPP-IV inhibitor is released at a desired rate over an extended time period, preferably over at least 24 hours.
The tri-layer oral osmotic dosage forms include a novel tri-layer tablet core surrounded by a semipermeable membrane and having suitable exit means for releasing at least one drug, one of which is a DPP-IV inhibitor through the semipermeable membrane. In an embodiment, the tri-layer tablet core has a first drug-containing layer, a second drug-containing layer and a third push layer. In operation, through the cooperation of the dosage form components, drug is successively released from the first drug-containing layer and then from the second drug-containing layer. Excipients in the drug-containing layers may be varied and adjusted for other purposes such as manufacturing convenience and pharmaceutical elegance. In this manner, dosage forms that exhibit reliable drug release having the desired profile over an extended time period, preferably over at least 24 hours, can be reliably and efficiently manufactured.
There is also provided a method of reducing side effects associated with increased plasma concentration of DPP-IV inhibitor in a patient undergoing T2DM treatment, which method comprises of orally administering single dose of a modified release composition comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof and optionally, at least one antidiabetic agent or pharmaceutically acceptable salt thereof, wherein a substantial dose of DPP-IV inhibitor in the composition exhibits zero order release over a period of at least 24 hours.
There is also provided a method of treatment of a subject having a condition or disorder for which a DPP-IV inhibitor is indicated, the method comprising orally administering to the subject, not more than once daily, a modified release composition as substantially described herein before throughout the specification.
Examples
Example 1 : Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 1
Figure imgf000030_0001
Process:
Sitagliptin phosphate anhydrous, Lactose, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve. The mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro- alcoholic medium. Wet granules were dried in fluidized bed dryer at 60±5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh. Finally, the lubricated blend was compressed using a rotary compress tablet machine.
Example 2: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 2
Figure imgf000031_0001
Process:
(I) Core Tablets Preparation: Sitagliptin phosphate anhydrous, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve. The mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro-alcoholic medium. Wet granules were dried in fluidized bed dryer at 60±5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh. The lubricated blend then compressed using a rotary compress tablet machine.
(II) Extended Release Coating:
Aqueous dispersion of Eudragit with Triethyl citrate and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C. The extended release coated tablet was dried in coating pan at 45±5° C to remove coating solvent.
(III) Immediate Release Part Coating:
Aqueous solution of Sitagliptin phosphate anhydrous and Opadry clear in purified water was then sprayed over previously drilled tablets in coater till the desired drug is loaded.
(IV) Film Coating:
Finally, the tablets were coated with Opadry system for aesthetic purpose.
Example 3: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 3
Figure imgf000032_0001
5 Magnesium Stearate 1 .600 1 .600 3.200
Core Tablets Wt (mg) 160.000 180.000 360.000
Extended Release Coating Composition
6 Polymethyl acrylic acid polymer 9.60 10.80 17.28
7 Triethyl citrate 1 .92 2.16 2.88
8 HPMC E5/Povidone K30 3.84 4.32 5.76
9 Silicon dioxide 1 .92 2.16 2.88
Total Coated Tablet Wt (mg) 173.440 195.120 383.040
Process:
(I) Core Tablets Preparation:
Sitagliptin phosphate anhydrous, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve. The mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro-alcoholic medium. Wet granules were dried in fluidized bed dryer at 60±5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh. The lubricated blend then compressed using a rotary compress tablet machine.
(II) Extended Release Coating:
Aqueous dispersion of Polymethyl acrylic acid polymer with Triethyl citrate, HPMC E5/Povidone K30 and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C. The extended release coated tablet was dried in coating pan at 45±5° C to remove coating solvent.
Example 4: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 4 Qty/Tablet (mg)
Sr. No. Ingredients
A B C
1 Sitagliptin Phosphate Anhydrous 31 .015 62.031 124.062
2 Microcrystalline Cellulose 59.985 28.969 57.938
3 Hydroxy propyl cellulose 3.000 3.000 6.000
4 Povidone 2.000 2.000 4.000
5 Glyceryl Behenate 2.000 2.000 4.000
6 Colloidal silicon Dioxide 1 .000 1 .000 2.000
7 Magnesium Stearate 1 .000 1 .000 2.000
Core Tablet Wt (mg) 100.000 100.000 200.000
Extended Release Coating I Composition
8 Ethyl cellulose l OOcps 7.20 7.20 1 1 .20
9 Polyethylene glycol 2.40 2.40 2.40
10 Povidone K30 2.40 2.40 2.40
Coated Tablet Wt (mg) 1 12.000 1 12.000 216.000
Extended Release Coating II Composition
1 1 Eudragit L30D55 5.824 5.824 1 1 .232
12 Triethyl Citrate 0.896 0.896 1 .728
13 Polyethylene glycol 0.896 0.896 1 .728
14 Silicon Dioxide 1 .344 1 .344 2.592
Coated Tablet Wt (mg) 120.960 120.960 233.280
Process:
(I) Core Tablets Preparation:
Sitagliptin phosphate anhydrous, Microcrystalline cellulose, Hypromellose (HPMC K4M) and Hypromellose (HPMC K100M) were co-sifted together using vibro-sifter fitted with 40# ASTM sieve. The mixture was granulated in a rapid mixer granulator for 5-10 min by spraying aqueous/hydro-alcoholic solution of Povidone. Wet granules were dried in fluidized bed dryer at 60±5°C. The dried granules were then screened through #30 mesh and milled using a multimill. Dried granules were blended in a double cone blender for 3 min with Glyceryl Behenate, colloidal silicon dioxide and magnesium stearate, both previously sifted through #60 mesh. The lubricated blend then compressed using a rotary compress tablet machine.
(II) Extended Release Coating I:
Organic dispersion of ethylcellulose with PEG and Poviodne was prepared using methylene chloride and iso-propyl alcohol or ethanol and iso-propyl alcohol and coated on the tablets in a perforated pan coater while keeping the temperature between 50±5° C. The extended release coated tablet was dried in coating pan at 45±5° C to remove coating solvent.
(II) Extended Release Coating II:
Aqueous dispersion of Eudragit with Triethyl citrate, Polyethylene glycol and Silicon dioxide was prepared and coated on the tablets in a perforated pan coater while keeping the temperature between 50-60° C. The extended release coated tablet was dried in coating pan at 45±5° C to remove coating solvent.
Example 5: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 5
Figure imgf000035_0001
8 Cellulose Acetate (CA-320S) 6.47 6.65 13.67
9 Cellulose Acetate (CA-398-10) 10.80 10.80 14.40
10 Polyethylene Glycol 400 0.90 0.90 1 .44
Total ER Coated Tab wt (mg) 198.00 198.00 388.80
Immediate Release Part
1 1 Sitagliptin Phosphate Anhydrous 3.102 6.203 12.406
12 Hypromellose E3 6.798 3.697 7.034
IR Part Coated Tablets 207.900 207.900 408.240
Film Coating
13 Opadry Biege (mg) 12.474 12.474 24.494
Total Film Coated tab wt (mg) 220.374 220.374 432.734
Process:
(I) Core Tablets Preparation:
Sitagliptin phosphate anhydrous, Mannitol, Povidone K 90 and Microcrystalline cellulose were co-sifted using vibro-sifter fitted with 40# ASTM sieve. The mixture was again mixed in a rapid mixer granulator for 5 minutes and then granulated using aqueous/hydro-alcoholic solution of polyethylene glycol 6000. Wet granules were then dried in fluidized bed dryer at about 40-55°C. Dried granules were then screened through #20 mesh sieve and the retained granules were milled in a multimill. The milled granules were then blended in a double cone blender for 3 min with a previously sifted [through #60 mesh] mixture of colloidal silicon dioxide and magnesium stearate. The lubricated blend was then compressed using rotary compress tablet machine.
(II) Extended Release Coating:
Aqueous solution of Polyethylene Glycol (PEG) 400 was prepared in purified water. Cellulose acetate (CA-320S) followed by cellulose acetate (CA-398-10) were added in acetone slowly under continuous stirring. Aqueous solution of PEG 400 was then added in the cellulose acetate-acetone mixture. The solution was then stirred at slow speed for about 1 h to get a clear/transparent solution. The core tablets as obtained above were coated with extended release coating solution using a perforated pan coater while keeping the temperature between 30-45°C. The extended release coated tablets were dried in coating pan at 45±5°C to remove coating solvent.
The extended release coated tablets were drilled mechanically or by means of laser drilling system with orifice size of about 0.5-0.8 mm.
(III) Immediate Release Part Coating:
Aqueous solution of sitagliptin phosphate anhydrous in hypromellose E3 and purified water was prepared. The solution was sprayed over previously drilled tablets in pan coater till the desired drug is loaded.
(IV) Film Coating:
Finally, the tablets were coated with Opadry system for aesthetic purpose.
Example 6: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 6
Figure imgf000037_0001
Magnesium Stearate 0.350 0.700 0.700
Isopropyl alcohol q.s. q.s. q.s.
Core Tablet Wt (mg) 170.000 340.000 340.000
Extended Release Coating Composition
Cellulose Acetate (CA-398-10) 19.788 25.840 25.840
Polyethylene Glycol 3350 0.816 1 .360 1 .360
Extended Release Tablet Weight (mg) 197.200 374.000 367.200
Immediate Release Part Coating Composition
Sitagliptin Phosphate Anhydrous 7.754 15.508 31 .015
Opadry II Biege 7.494 13.868 13.049
IR Coated Tablet Weight (mg) 205.852 396.576 41 1 .265
Film Coating
Opadry Clear 6.176 1 1 .897 12.338
Film Coated Tablet Weight (mg) 212.027 408.473 423.602
Process:
(I) Preparation of Drug Layer:
Sitagliptin phosphate Anhydrous was mixed with Polyethylene oxide (Sentry Polyox WSR N80) and then and sifted through #20 ASTM. Hypromellose 2910 (METHOCEL™ E5 Premium LV) was and sifted through #30 ASTM. Pre-sifted iron oxide red was added to the drug layer composition for identification.
The above mixture was granulated for 10 minutes using isopropyl alcohol. Wet granules were dried in fluidized bed dryer and sifted through #20ASTM followed by blending with pre-sifted magnesium stearate [through #60 ASTM] for 3 min in double cone blender.
(II) Push Layer Preparation:
Polyethylene oxide (Sentry Polyox WSR N80), Hypromellose and sodium chloride were sifted through #20 ASTM. Pre-sifted iron oxide red [through #60ASTM] was added to the push layer composition.
The above mixture was granulated in rapid mixer granulator for 5 min using isopropyl alcohol. Wet granules then dried in fluidised bed dryer and sifted through #20ASTM followed by blending with pre-sifted magnesium stearate [through #60 ASTM] for 3 min in double cone blender.
The blend of drug layer and push layer was compressed to form bi-layer tablets using a bi-layer tabletting machine.
(III) Extended Release Coating:
Aqueous solution of Polyethylene Glycol (PEG) 3350 was prepared in purified water. Separately cellulose acetate was dissolved in require quantity of acetone and the aqueous solution of PEG 3350 was added into it under stirring. The solution was then stirred at slow speed for about 1 h to get a clear/transparent solution.
The core tablets as prepared above were coated with extended release coating solution of cellulose acetate and polyethylene glycol 3350 in perforated pan coater. The drug layer side of extended release coated tablets were then drilled by using tablet drilling laser system with one preformed passageway (orifice) of 0.7±0.1 mm diameter.
(IV) Immediate Release Part Coating:
Aqueous solution of sitagliptin phosphate anhydrous and Opadry system in purified water was prepared. The solution was sprayed over previously drilled tablets in pan coater till the desired drug is loaded.
(V) Film Coating:
Finally, the tablets were coated with Opadry system for aesthetic purpose.
Example 7: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 7
Figure imgf000039_0001
3 Lactose Anhydrous 56.000 56.000 1 12.000
4 Microcrystalline cellulose PH 102 93.692 78.185 156.370
5 Povidone K 30 12.000 12.000 24.000
6 Colloidal silicon dioxide 1 .000 1 .000 2.000
7 Magnesium stearate 1 .800 1 .800 3.600
Core Tablet Wt (mg) 200.000 200.000 400.000
Extended Release Coating Composition
8 Cellulose Acetate-320S 8.40 8.40 12.00
9 Cellulose Acetate -398-10 14.00 14.00 20.00
10 Polyethylene Glycol 400 /6000 5.60 5.60 8.00
ER Coated Tab wt (mg) 228.00 228.00 440.00
Immediate Release Part Coat
1 1 Sitagliptin Phosphate Anhydrous 15.508 31 .015 62.031
12 Hypromellose 7.292 14.585 25.969
IR Part Coated Tablets 250.800 273.601 528.000
Film Coating
13 Opadry Biege (mg) 10.032 10.944 21 .120
Total Film Coated tab wt (mg) 260.832 284.545 549.120
Process:
(I) Core Tablets Preparation:
Sitagliptin phosphate anhydrous, Lactose and Microcrystalline cellulose were co- sifted using vibro-sifter fitted with 40# ASTM sieve. The mixture was again mixed in a rapid mixer granulator for 5 minutes and then granulated using aqueous/hydro-alcoholic solution of povidone K30. Wet granules were then dried in fluidized bed dryer at about 50-60°C. Dried granules were then screened through #20 mesh sieve and the retained granules were milled in a multimill. The milled granules were then blended in a double cone blender for 3 min with a previously sifted [through #60 mesh] mixture of colloidal silicon dioxide and magnesium stearate. The lubricated blend was then compressed using rotary compress tablet machine.
(II) Extended Release Coating: Aqueous solution of Polyethylene Glycol (PEG) 400 was prepared in purified water. Cellulose acetate (CA-320S) followed by cellulose acetate (CA-398-10) were added in acetone slowly under continuous stirring. Aqueous solution of PEG 400 was then added in the cellulose acetate-acetone mixture. The solution was then stirred at slow speed for about 1 h to get a clear/transparent solution. The core tablets as obtained above were coated with extended release coating solution using a perforated pan coater while keeping the temperature between 30-45°C. The extended release coated tablets were dried in coating pan at 45±5°C to remove coating solvent.
(III) Immediate Release Part Coating:
Aqueous solution of sitagliptin phosphate anhydrous in hypromellose E3 and purified water was prepared. The solution was sprayed over previously coated tablets in pan coater till the desired drug is loaded.
(IV) Film Coating:
Finally, the tablets were coated with Opadry system for aesthetic purpose.
Example 8: Modified release tablet containing 25, 50 and 100mg Sitagliptin or pharmaceutically acceptable salt thereof
Table 8
Figure imgf000041_0001
8 Polyacrylic resin (Eudragit) 8.50 8.60 12.28
9 Ethylcellulose 14.16 14.33 20.47
10 Hydroxylpropyl cellulose 4.25 4.30 6.14
1 1 Triethyl citrate 1 .42 1 .43 2.87
ER Coated Tab wt (mg) 229.24 231.87 448.19
Immediate Release Part Coat
12 Sitagliptin Phosphate Anhydrous 3.102 6.203 12.406
13 Hypromellose 6.034 12.332 23.108
IR Part Coated Tablets 238.376 250.405 483.704
Film Coating
14 Opadry Biege (mg) 14.442 15.304 29.580
Total Film Coated tab wt (mg) 252.818 265.709 513.284
Process: The tablets were prepared according to Example 3 in which the extended release coating composition was prepared by making a solution of polyacrylic resin, Ethyl cellulose, Hydroxylpropyl cellulose and tri-ethyl citrate in alcohol. The solution was then applied on to core tablets as per Example 3.
Example 9: Modified release tablet containing 5 mg Linagliptin
Table 9
Figure imgf000043_0001
Process:
The modified release tablets of linagliptin were prepared according to the process of Example 7. Example 10: Modified release tablet containing Sitagliptin or Pharmaceutically acceptable salt thereof
Table 10
Figure imgf000044_0001
Process: The tablets were prepared according to Example 5 Example 11 : Modified release tablet containing Sitagliptin or Pharmaceutically acceptable salt thereof
Table 11
Figure imgf000045_0001
Process: The tablets were prepared according to Example 6 Tablets obtained from example 9 and 10 were subjected to dissolution studies. The results of dissolution studies performed are provided in Table 1 1 and 12 respectively.
Table 11 : Dissolution profile
Figure imgf000046_0001
Table 12: Dissolution profile
Figure imgf000046_0002
Example 12: Modified release tablet containing Sitagliptin or pharmaceutically acceptable salt thereof
Table 12
Figure imgf000047_0001
Process: The tablets were prepared according to Example 5 Example 13: Modified release tablet containing Sitagliptin or pharmaceutically acceptable salt thereof
Table 13
Figure imgf000048_0001
Process: The tablets were prepared according to Example 6

Claims

Claims We Claim:
1 . A modified release composition comprising: a) at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; and b) one or more rate controlling excipients, wherein once daily administration of said composition to a subject provides mean steady state plasma concentration (Css) of DPP-IV inhibitor or pharmaceutically acceptable salt thereof on or before 7 days.
2. A modified release composition comprising: a) at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof; and b) one or more rate controlling excipients, wherein said DPP-IV inhibitor or pharmaceutically acceptable salt thereof in the composition inhibits activity of DPP-IV enzyme by 80% or more over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
3. The modified release composition of claim 1 or 2, wherein the DPP-IV inhibitor or pharmaceutically acceptable salt thereof in the composition exhibit extended release over a period of at least 24 hours after oral administration of single dose of the said composition to a subject.
4. The modified release composition of any of the preceding claim, wherein a substantial dose of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof in the composition exhibit zero order release over a period of at least 24 hours after oral administration of single dose of the composition to a subject.
5. The modified release composition of any of the preceding claims, wherein total dose of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof in the composition is divided into an immediate release part and an extended release part.
6. The modified release composition of claim 5, wherein said extended release part of DPP-IV inhibitor exhibits zero order release.
7. The modified release composition of any of the preceding claim, wherein said composition exhibit an in vitro release profile such that on average no more than about 30% of DPP-IV inhibitor is dissolved within 1 hour and/or time to reach 50% dissolution is at least 4 hours after placement of the composition in a dissolution test conducted according to USP using Apparatus I at 100 rpm in water at about 37°C.
8. The modified release composition of any of the preceding claim, wherein said composition further comprises at least one antidiabetic agent.
9. The modified release composition of claim 8, wherein the DPP-IV inhibitor and the antidiabetic agent in the composition exhibit extended release over a period of at least 24 hours after oral administration of single dose of the said composition to a subject.
10. The modified release composition of claim 8 or 9, wherein said antidiabetic agent is selected from insulin sensitizers, a-glucosidase inhibitors, biguanides, insulin secretagogues, sodium-glucose co- transporter-2 (SGLT-2) inhibitors, β3 agonists, GPR40 agonists, GLP-1 receptor agonists, amylin agonists, phosphotyrosine phosphatase inhibitors, gluconeogenesis inhibitors, sodium-glucose cotransporter (SGLUT) inhibitors, 1 1 β -hydroxysteroid dehydrogenase inhibitors, adiponectin or agonist thereof, IKK inhibitors, leptin resistance improving drugs, somatostatin receptor agonists, and glucokinase activators.
1 1 . The modified release composition of claim 10, wherein the DPP-IV inhibitor is selected from alogliptin, linagliptin, vildagliptin, sitagliptin, saxagliptin, dutogliptin, gemigliptin, denagliptin, evogliptin, gosogliptin, omarigliptin, teneligliptin, trelagliptin, anagliptin and melogliptin or pharmaceutically acceptable salt thereof.
12. The modified release composition of claim 1 1 , wherein said DPP-IV inhibitor is sitagliptin or or pharmaceutically acceptable salt thereof.
13. The modified release composition of claim 12, wherein the amount of sitagliptin or pharmaceutically acceptable salt thereof in the composition ranges from about 25mg to about 100mg.
14. The modified release composition of claim 10, wherein said antidiabetic agent is selected from a biguanides, an a-glucosidase inhibitor or combinations thereof.
15. The modified release composition of claim 14, wherein said biguanide is metformin or pharmaceutically acceptable salt thereof.
16. The modified release composition of claim 14, wherein said a-glucosidase inhibitor is voglibose or pharmaceutically acceptable salt thereof.
17. The modified release composition of claim 15, wherein the composition comprises:
(a) at least one component exhibiting extended release of the DPP-IV inhibitor or pharmaceutically acceptable salt thereof;
(b) at least one component exhibiting extended release of metformin or pharmaceutically acceptable salt thereof, and optionally
(c) at least one component exhibiting immediate release of metformin and/or DPP-IV inhibitor or salt thereof.
18. The modified release composition of any of the preceding claims, wherein said composition is in the form of an osmotic dosage form.
19. The osmotic dosage form of claim 18, wherein said osmotic dosage form comprises:
(i) a semipermeable wall provided around an osmotic formulation comprising at least one DPP-IV inhibitor or pharmaceutically acceptable salt thereof, an osmotic agent, and an osmopolymer; and
(ii) a passageway.
20. A method of treating type 2 diabetes mellitus comprising administration of the modified release composition of any of the preceding claim to a subject in need thereof.
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IT201800011119A1 (en) 2018-12-14 2020-06-14 Dpl Pharma S P A SOLID ORAL PHARMACEUTICAL COMPOSITIONS FOR THE CHRONOTROPIC ADMINISTRATION OF SITAGLIPTIN
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US9902751B2 (en) 2013-12-30 2018-02-27 Mylan Laboratories Limited Process for the preparation of empagliflozin
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