Title of Invention

A PHARMACEUTICAL COMPOSITION

Abstract Disclosed are pharmaceutical compositions comprising an active vitamin D compound in emulsion pre-concentrate formulations, as well as emulsions and sub-micron d xiplet emulsions produced therefrom. The compositions comprise a lipophilic phase component, one or more surfactants, and an active vitamin D compound. The compositions may optionally further comprise a hydrophilic phase component.
Full Text [0001] The present inventior relates to novel pharmaceutical compositions
comprising an active vitamin D compound, wherein the pharmaceutical
compositions are emulsion pre-concentrates The invention-also.relates,to
emulsions and sub-micron dioplet emulsions produced upon dilution of the
emulsion pre-concentrates with an aqueous solution.
Background Art
[0002] Vitamin D is a fat scluble vitamin which is essential as a positive
regulator of calcium homeostas is. (See Harrison's Principles of Internal Medicine:
Part Eleven, "Disorders of Bone and Mineral Metabolism," Chapter 335, pp.
1860-1865, E. Braunwald et a'., (eds.), McGraw-Hill, New York (1987)). The
active form of vitamin D is 1 a; 25-dihydroxyvitamin D3, also known as calcitriol.
Specific nuclear receptors for active vitamin D compounds have been discovered
in cells from diverse organs no involved in calcium homeostasis. (Miller et al.,
Cancer Res. 52:515-520 (1992)). In addition to influencing calcium homeostasis,
active vitamin D compounds have been implicated in osteogenesis, modulation
of immune response, modulal ion of the process of insulin secretion by the
pancreatic B cell, muscle cell function., and the differentiation and growth of
epidermal and hematopoietic tissues.
[0003] Moreover, there have been many reports demonstrating the utility of
active vitamin D compounds in the treatment of cancer. For example, it has been
shown that certain vitamin D, compounds and analogues possess potent
antileukemic activity by virtue of inducing the differentiation of malignant cells
(specifically, leukemic cells) to non-malignant macrophages (monocytes) and are
useful in the treatment of leukemia. (Suda et al, U.S. Patent No. 4,391,802;
Partridge etal, U.S. Patent No. 4,594,340). Antiproliferative and differentiating
actions of calcitriol and other vitamin D, analogues have also been reported with
respect to the treatment of prostate cancer. (Bishop et al., U.S. Patent No.
5,795,882). Active vitamin D compounds have also been implicated in the
treatment of skin cancer (Chic la et al., Cancer Research 45:5426-5430 (1985)),
colon cancer (Disman et al., Cancer Research 47:21 -25 (1987)), and lung cancer
(Sato et al., Tohoku J. Exp. Me i. J 38:445-446 (1982)). Other reports suggesting
important therapeutic uses of active vitamin D compounds are summarized in
Rodriguez et al, U.S. Patent fro. 6,034,079.
[0004] Although the administrition of active vitamin D compounds may result
in substantial therapeutic benefits, the treatment of cancer and other diseases with
such compounds is limited by the effects these compounds have on calcium
metabolism. At the levels requ red in vivo for effective use as anti-proliferative
agents, active vitamin D compounds can induce markedly elevated and
potentially dangerous blood calcium levels by virtue of their inherent calcemic
activity. That is, the clinical use of calcitriol and other active vitamin D
compounds as anti-proliferative agents is precluded, or severely limited, by the
risk of hypercalcemia.
[0005] It has been shown that the problem of systemic hypercalcemia can be
overcome by "pulse-dose" adminstration of a sufficient dose of an active vitamin
D compound such that an anti-proliferative effect is observed while avoiding the
development of severe hypercalcemia. (WO 99/49870). According to WO
99/49870, the active vitamin D compound may be administered no more than
every three days, for example, once a week at a dose of at least 0.12 µg/kg per day
(8.4 µg in a 70 kg person). Pharmaceutical compositions used in the pulse-dose
regimen of WO 99/49870 comprise 5-100 µg of active vitamin D compound and
may be administered in the form for oral, intravenous, intramuscular, topical,
transdermal, sublingual, intranasal, intratumoral or other preparations.
[0006] ROCALTROL is the trade name of a calcitriol formulation sold by Roche
Laboratories. ROCALTROL is available in the form of capsules containing 0.25
and 0.5 µ.g calcitriol and as an oral solution containing 1 ug/mL of calcitriol. All
dosage forms contain butylated hydroxyanisole (BHA) and butylated
hydroxytoluene (BHT) as anioxidants. The capsules also contain a fractionated
triglyceride of coconut oil and the oral solution contains a fractionated
triglyceride of palm seed oi. (Physician's Desk Reference, 54th Edition, pp
2649-2651, Medical Economics Company, Inc., Montvale, NJ (2000)).
[0007J It is known that calctriol is light-sensitive and is especially prone to
oxidation. Moreover, calcitiol and other active vitamin D compounds are
lipophilic, meaning that they are soluble in lipids and some organic solvents,
while being substantially insoluble or only sparsely soluble in water. Because of
the lipophilic nature of active vitamin D compounds, the dispersion of such
compounds in aqueous solutions, such as the gastric fluids of the stomach, is
significantly limited. Accordngly, the pharmacokinetic parameters of active
vitamin D compound formulations heretofore described in the art are sub-optimal
for use with high dose pulse administration regimens. In addition, the active
vitamin D compound formulalions that are currently available tend to exhibit
substantial variability of absorption in the small intestine. Moreover, for oral
administration, the relationship between dosage and blood concentration that is
observed with most active vitamin D compound formulations is not linear; that
is, the quantity of compound ab sorbed into the blood stream does not correlate
with the amount of compound that is administered in a given dose, especially at
higher dosage levels.
[0008] Thus, there is a need for improved pharmaceutical compositions
comprising active vitamin D com pounds, particularly in the context of pulse-dose
treatment regimens that are designed to provide anti-proliferative (e.g., anti-
cancer) benefits while avoiding the consequence of hypercalcemia. In particular,
a need exists in the art for a pharmaceutical composition comprising an active
vitamin D compound that remain; stable over prolonged periods of time, even at
elevated temperatures, while at the same time exhibiting improved
pharmacokinetic parameters for the active vitamin D compound, and reduced
variability in absorption, when ad ministered to a patient.
[0013] The emulsions produced from the emulsion pre-concentrates of the
present invention (upon dilution with water) include both emulsions as
conventionally understood by those of ordinary skill in the art (i.e., a dispersion
of an organic phase in water), is well as "sub-micron droplet emulsions" (i.e.,
dispersions of an organic phase in water wherein the average diameter of the
dispersion particles is less than 000 nm.)
[0014] According to another aspect of the invention, methods are provided for the
preparation of emulsion pre-concentrates comprising active vitamin D
compounds. The methods encompassed within this aspect of the invention
comprise bringing an active vitanin D compound, e.g., calcitriol, into intimate
admixture with a lipophilic phase component and with one or more surfactants,
and optionally, with a hydrophilic phase component.
[0015] In yet another aspect of the invention, methods are provided for the
treatment and prevention of hyperproliferative diseases such as cancer and
psoriasis, said methods comprising administering an active vitamin D compound
in an emulsion pre-concentrate formulation to a patient in need thereof.
Alternatively, the active vitamin D compound can be administered in an emulsion
formulation that is made by diluting an emulsion pre-concentrate of the present
invention with an appropriate quantity of water. In a preferred embodiment of
this aspect of the invention, the administration of the active vitamin D compound
to a patient is accomplished by using, e.g., a pulse dosing regimen. For example,
according to this aspect of the invention, an active vitamin D compound in an
emulsion pre-concentrate formula ion is administered to a patient no more than
once every three days at a dose of at least 0.12 µg/kg per day.
[0016] Fig. 1 is a graphical representation of the mean plasma concentration of
calcitriol in dogs versus time following administration of three different
formulations of calcitriol at a dose of 1 µg/kg.
[0017J Figs. 2A and 2B are graphical representations of the mean plasma
concentration-time curve for calcitriol after escalating doses of semi-solid #3 in
male (Fig. 2A) and female (Fig. 2B) dogs.
[0018] Figs. 3A and 3B are graphical representations of the plasma
concentration-time curve for calcitriol in male (Fig. 3A) and female (Fig. 3B)
dogs after semi-solid #3 dosing.
[0019] Figs. 4A and 4B are graphical representations of the mean serum calcium
after increasing doses of semi-solid #3 in male (Fig. 4A) and female (Fig. 4B)
dogs.
[0020] Figs. 5A-5C are graphical representations of the plasma calcitriol and
serum calcium data following administration of semi-solid #3 in male dogs.
[0021] Fig. 6 is a graphical representation of the mean plasma concentration of
calcitriol by dose group in humans following administration of semi-solid #3.
DETAILED DESCRIPTION OF THE INVENTION
[0022] The present invention is directed to pharmaceutical compositions
comprising active vitamin D compounds in emulsion pre-concentrate
formulations. The compositions c f the invention meet or substantially reduce the
difficulties associated with active vitamin D compound therapy hitherto
encountered in the art including, in particular, undesirable pharmacokinetic
parameters of the compound upor administration to a patient.
[0023] It has been found that the compositions of the invention permit the
preparation of semi-solid and liquid compositions containing an active vitamin
D compound in sufficiently high concentration to permit, e.g., convenient oral
administration, while at the same time achieving improved pharmacokinetic
parameters for the active vitamin D compound. For example, as compared to
ROCALTROL, the compositions of the present invention exhibit a Cmax that is at
least 1.5 to two times greater than the Cmax that is observed with ROCALTROL,
and a shorter Tmax than that which is observed with ROCALTROL. Preferably,
the pharmaceutical compositions of the present invention provide a Cmax of at
least about 900 pg/mL plasma, more preferably about 900 to about 3000 pg/mL
plasma, more preferably about 1500 to about 3000 pg/mL plasma. In addition,
the compositions of the invention preferably provide a Tmax of less than about 6.0
hours, more preferably about 1.0 to about 3.0 hours, more preferably about 1.5 to
about 2.0 hours. In addition, the compositions of the invention preferably provide
a T1/2 of less than about 25 hours, more preferably about 2 to about 10 hours,
more preferably about 5 to about 9 hours.
[0024] The term Cmax is defined as the maximum concentration of active vitamin
D compound achieved in the serum following administration of the drug. The
term Tmax is defined as the time at which CmiU is achieved. The term T1/2 is
defined as the time required for the concentration of active vitamin D compound
in the serum to decrease by half. ' the disclosed values for pharmacokinetic data
apply to the population of recipients of a composition comprising an active
vitamin D compound as a whole, not individual recipients. Thus, any individual
receiving a composition of the pre sent invention may not necessarily achieve the
preferred pharmacokinetic parameters. However, when a composition of the
present invention is administered to a sufficiently large population of subjects, the
pharmacokinetic parameters will approximately match the values disclosed
herein.
[0025] According to one aspect of the present invention, a pharmaceutical
composition is provided comprisin g (a) a lipophilic phase component, (b) one or
more surfactants, (c) an active vitamin D compound; wherein said composition
is an emulsion pre-concentrate, which upon dilution with water, in a water to
composition ratio of about 1:1 or more of said water, forms an emulsion having
an absorbance of greater than 0.3 at 400 nm. The pharmaceutical composition of
the invention may further comprise a hydrophilic phase component.
[0026] In another aspect of the invention, a pharmaceutical emulsion composition
is provided comprising water (o • other aqueous solution) and an emulsion pre-
concentrate.
[0027J The term "emulsion pre-concentrate," as used herein, is intended to mean
a system capable of providing an emulsion upon contacting with, e.g., water. The
term "emulsion," as used herein., is intended to mean a colloidal dispersion
comprising water and organic components including hydrophobic (lipophilic)
organic components. The term "emulsion" is intended to encompass both
conventional emulsions, as understood by those skilled in the art, as well as "sub-
micron droplet emulsions," as defined immediately below.
[0028] The term "sub-micron droplet emulsion," as used herein is intended to
mean a dispersion comprising water and organic components including
hydrophobic (lipophilic) organic components, wherein the droplets or particles
formed from the organic components have an average maximum dimension of
less than about 1000 nm.
[0029] Sub-micron droplet emuls ions are identifiable as possessing one or more
of the following characteristics. They are formed spontaneously or substantially
spontaneously when their components are brought into contact, that is without
substantial energy supply, e.g., in the absence of heating or the use of high shear
equipment or other substantial agitation.
[0030] The particles of a sub-micron droplet emulsion may be spherical, though
other structures are feasible, e.g. liquid crystals with lamellar, hexagonal or
isotropic symmetries. Generally, sub-micron droplet emulsions comprise droplets
or particles having a maximum dimension (e.g., average diameter) of between
about 50 nm to about 1000 nm, and preferably between about 200 nm to about
300 nm.
[0031] The term "pharmaceutical composition" as used herein is to be understood
as defining compositions of which the individual components or ingredients are
themselves pharmaceutically acceptable, e.g., where oral administration is
foreseen, acceptable for oral use and, where topical administration is foreseen,
topically acceptable.
(0032] The pharmaceutical compositions of the present invention will generally
form an emulsion upon dilution with water. The emulsion will form according
to the present invention upon the dilution of an emulsion pre-concentrate with
water in a water to composition ratio of about 1:1 or more of said water.
According to the present invention, the ratio of water to composition can be, e.g.,
between 1:1 and 5000:1. For ex unple, the ratio of water to composition can be
about 1:1,2:1, 3:1,4:1,5:1,10:1,200:1, 300:1, 500:1,1000:1, or 5000:1. The
skilled artisan will be able to readily ascertain the particular ratio of water to
composition that is appropriate for any given situation or circumstance.
(0033] According to the present invention, upon dilution of said emulsion pre-
concentrate with water, an emulsion will form having an absorbance of greater
than 0.3 at 400 ran. The absorbance at 400 nm of the emulsions formed upon
1:100 dilution of the emulsion pie-concentrates of the present invention can be,
e.g., between 0.3 and 4.0. For example, the absorbance at 400 nm can "be, e.g.,
about 0.4, 0.5, 0.6, 1.0, 1.2, 1.6 2.0, 2.2, 2.4, 2.5, 3.0, or 4.0. Methods for
determining the absorbance of a iquid solution are well known by those in the
art. The skilled artisan will be able to ascertain and adjust the relative proportions
of the ingredients of the emulsior s pre-concentrates of the invention in order to
obtain, upon dilution with water, an emulsion having any particular absorbance
encompassed within the scope of the invention.
[0034] The pharmaceutical compsitions of the present invention can be, e.g., in
a semi-solid formulation or in a liquid formulation. Semi-solid formulations of
the present invention can be any semi-solid formulation known by those of
ordinary skill in the art, including, e.g., gels, pastes, creams and ointments.
[0035] The pharmaceutical compositions of the present invention comprise a
lipophilic phase component. Suitable components for use as lipophilic phase
components include any pharmaceutically acceptable solvent which is non-
miscible with water. Such solvents will appropriately be devoid or substantially
devoid of surfactant function.
[0036] The lipophilic phase component may comprise mono-, di- or triglycerides.
Mono-, di- and triglycerides that may be used within the scope of the invention
include those that are derived fr'om C6, C8 C10, C12, Cl4, Cl6, C18, C20 and C22 fatty
acids. Exemplary diglycerides include, in particular, diolein, dipalmitolein, and
mixed caprylin-caprin diglycerides. Preferred triglycerides include vegetable oils,
fish oils, animal fats, hydrogenated vegetable oils, partially hydrogenated
vegetable oils, synthetic triglycerides., modified triglycerides, fractionated
triglycerides, medium and long chain triglycerides, structured triglycerides, and
mixtures thereof.
I0037J Among the above-listed triglycerides, preferred triglycerides include:
almond oil; babassu oil; borage oil; blackcurrant seed oil; canola oil; castor oil;
coconut oil; corn oil; cottonseed oil; evening primrose oil; grapeseed oil;
groundnut oil; mustard seed oil olive oil; palm oil; palm kernel oil; peanut oil;
rapeseed oil; safflower oil; sesame oil; shark liver oil; soybean oil; sunflower oil;
hydrogenated castor oil; hydrogenated coconut oil; hydrogenated palm oil;
hydrogenated soybean oil; hydrogenated vegetable oil; hydrogenated cottonseed
and castor oil; partially hydrogenated soybean oil; partially soy and cottonseed
oil; glyceryl tricaproate; glyceryl tricaprylate; glyceryl tricaprate; glyceryl
triundecanoate; glyceryl trilaurate glyceryl trioleate; glyceryl trilinoleate; glyceryl
trilinolenate; glyceryl tricaprylate caprate; glyceryl tricaprylate/caprate/laurate;
glyceryl tricaprylate/caprate/linoleate; and glyceryl tricaprylate/caprate/stearate.
[0038] A preferred triglyceride is the medium chain triglyceride available under
the trade name LABRAFAC CC Other preferred triglycerides include neutral
oils, e.g., neutral plant oils, in particular fractionated coconut oils such as known
and commercially available under the trade name MIGLYOL, including the
products: MIGLYOL 810; MIGLYOL 812; MIGLYOL 818; and CAPTEX 355.
[0039] Also suitable are caprylic capric acid triglycerides such as known and
commercially available under the rade name MYRITOL, including the product
MYRITOL 813. Further suitable products of this class are CAPMUL MCT,
CAPTEX 200, CAPTEX 300, CAPTEX 800, NEOBEE M5 and MAZOL 1400.
[0040] Especially preferred as lipophilic phase component is the product
MIGLYOL 812. (See U.S. Patent No. 5,342,625).
[0041] Pharmaceutical compositions of the present invention may further
comprise a hydrophilie phase component. The hydrophilic phase component may
comprise, e.g., a pharmaceuticaliy acceptable C1-5 alkyl or tetrahydrofurfuryl di-
or partial-ether of a low molecular weight mono- or poly-oxy-alkanediol.
Suitable hydrophilic phase components include, e.g., di- or partial-, especially
partial-, -ethers of mono- or poly-, especially mono- or di-, -oxy-alkanediols
comprising from 2 to 12, especially 4 carbon atoms. Preferably the mono- or
poly-oxy-alkanediol moiety is straight-chained. Exemplary hydrophilic phase
components for use in relation to the present invention are those known and
commercially available under the trade names TRANSCUTOL and
COLYCOFUROL. (See U.S. Patent No. 5,342,625).
[0042] In an especially preferred embodiment, the hydrophilic phase component
comprises 1,2-propyleneglycol.
[0043] The hydrophilic phase component of the present invention may of course
additionally include one or more additional ingredients. Preferably, however, any
additional ingredients will comprise materials in which the active vitamin D
compound is sufficiently soluble, such that the efficacy of the hydrophilic phase
as an active vitamin D compound carrier medium is not materially impaired.
Examples of possible additional hydrophilic phase components include lower
(e.g., C1-5) alkanols, in particular ethanol.
[0044] Pharmaceutical compositions of the present invention also comprise one
or more surfactants. Surfactants that can be used in conjunction with the present
invention include hydrophilic or lipophilic surfactants, or mixtures thereof.
Especially preferred are non-icnic hydrophilic and non-ionic lipophilic
surfactants.
[0045] Suitable hydrophilic surfactants include reaction products of natural or
hydrogenated vegetable oils and ethylene glycol, i.e. polyoxyethylene glycolated
natural or hydrogenated vegetable oils, for example polyoxyethylene glycolated
natural or hydrogenated castor oils Such products may be obtained in known
manner, e.g., by reaction of a natural or hydrogenated castor oil or fractions
thereof with ethylene oxide, e.g., in a molar ratio of from about 1:35 to about
1:60, with optional removal of free polyethyleneglycol components from the
product, e.g., in accordance with the methods disclosed in German
Auslegeschriften 1,182,388 and 1,518,819.
[0046] Suitable hydrophilic surfactants for use in the present pharmaceutical
compounds also include polyoxye thylene-sorbitan-fatty acid esters, e.g., mono-
and trilauryl, palmityl, stearyl ard oleyl esters, e.g., of the type known and
commercially available under the trade name TWEEN; including the products:
TWEEN 20 (polyoxyethylene(20)sorbitanmonolaurate),
TWEEN 40 (polyoxyethylene(20)sorbitanmonopalmitate),
TWEEN 60 (polyoxyethylene(20) sorbitanmonostearate),
TWEEN 80 (polyoxyethylene(20)sorbitanmonooleate),
TWEEN 65 (polyoxyethylene(20)sorbitantristearate),
TWEEN 85 (polyoxyethylene(20)sorbitantrioleate),
TWEEN 21 (polyoxyethylene(4)sorbitanmonolaurate),
TWEEN 61 (polyoxyethylene(4)sc rbitanmonostearate), and
TWEEN 81 (polyoxyethylene(5)scrbitanmonooleate).
[0047] Especially preferred products of this class for use in the compositions of
the invention are the above product; TWEEN 40 and TWEEN 80. (See Hauer, et
ah, U.S. Patent No. 5,342,625).
[0048] Also suitable as hydrophilic surfactants for use in the present
pharmaceutical compounds are polyoxyethylene alkylethers; polyoxyethylene
glycol fatty acid esters, for example polyoxythylene stearic acid esters;
polyglycerol fatty acid esters; polyoxyethylene glycerides; polyoxyethylene
vegetable oils; polyoxyethylene hydrogenated vegetable oils; reaction mixtures
of polyols and, e.g., fatty acids, glycerides, vegetable oils, hydrogenated vegetable
oils, and sterols; polyoxyetiiylene-polyoxypropylene co-polymers;
polyoxyethylene-polyoxypropylene block co-polymers; dioctylsuccinate,
dioctylsodiumsulfosuccinate, di-[2-ehylhexyl]-succinate or sodium lauryl sulfate;
phospholipids, in particular lecithins such as, e.g.t soya bean lecithins; propylene
glycol mono- and di-fatty acid esters such as, e.g., propylene glycol dicaprylate,
propylene glycol dilaurate, propylene glycol hydroxystearate, propylene glycol
isostearate, propylene glycol laurate, propylene glycol ricinoleate, propylene
glycol stearate, and, especially preferred, propylene glycol caprylic-capric acid
diester; and bile salts, e.g., alkali metal salts, for example sodium taurocholate.
[0049] Suitable lipophilic surfactants include alcohols; polyoxyethylene
alkylethers; fatty acids; bile acids; glycerol fatty acid esters; acetylated glycerol
fatty acid esters; lower alcohol f atty acids esters; polyethylene glycol fatty acids
esters; polyethylene glycol glycerol fatty acid esters; polypropylene glycol fatty
acid esters; polyoxyethylene glyerides; lactic acid esters of mono/diglycerides;
propylene glycol diglycerides; sorbitan fatty acid esters; polyoxyethylene sorbitan
fatty acid esters; polyoxyethylene-polyoxypropylene block copolymers; trans-
esterified vegetable oils; sterols; sugar esters; sugar ethers; sucroglycerides;
polyoxyethylene vegetable oils; polyoxyethylene hydrogenated vegetable oils;
reaction mixtures of polyols and at least one member of the group consisting of
fatty acids, glycerides, vegetable oils, hydrogenated vegetable oils, and sterols;
and mixtures thereof.
[0050] Suitable lipophilic surfactants for use in the present pharmaceutical
compounds also include trans-esterification products of natural vegetable oil
triglycerides and polyalkylene polyols. Such trans-esterification products are
known in the art and may be obtained e.g., in accordance with the general
procedures described in U.S. Pat. No. 3,288,824. They include trans-esterification
products of various natural (e.g., non-hydrogenated) vegetable oils for example,
maize oil, kernel oil, almond oil, ground nut oil, olive oil and palm oil and
mixtures thereof with polyethylene glycols, in particular polyethylene glycols
having an average molecular weight of from 200 to 800. Preferred are products
obtained by trans-esterification of 2 molar parts of a natural vegetable oil
triglyceride with one molar part of polyethylene glycol (e.g., having an average
molecular weight of from 200 to 800). Various forms of trans-esterification
products of the defined class are known and commercially available under the
trade name LABRAFIL.
[0051 ] Additional lipophilic sur factants that are suitable for use with the present
pharmaceutical compositions nclude oil-soluble vitamin derivatives, e.g.,
tocopherol PEG-1000 succinate ("vitamin E TPGS").
[0052] Also suitable as lipophilic surfactants for use in the present
pharmaceutical compounds are mono-, di- and mono/di-glycerides, especially
esterification products of capryli c or capric acid with glycerol; sorbitan fatty acid
esters; pentaerythritol fatty acid e sters and polyalkylene glycol ethers, for example
pentaerythrite- -dioleate, -distcarate, -monolaurate, -polyglycol ether and -
monostearate as well as pentaerythrite-fatty acid esters; monoglycerides, e.g.,
glycerol monooleate, glycerol monopalmitate and glycerol monostearate; glycerol
triacetate or (l,2,3)-triacetin; and sterols and derivatives thereof, for example
cholesterols and derivatives thereof, in particular phytosterols, e.g., products
comprising sitosterol, campesterol or stigmasterol, and ethylene oxide adducts
thereof, for example soya sterols and derivatives thereof.
[0053] It is understood by those of ordinary skill in the art that several
commercial surfactant compositions contain small to moderate amounts of
triglycerides, typically as a resul t of incomplete reaction of a triglyceride starting
material in, for example, a trans- esterification reaction. Thus, the surfactants that
are suitable for use in the present pharmaceutical compositions include those
surfactants that contain a triglyceride. Examples of commercial surfactant
compositions containing triglycerides include some members of the surfactant
families GELUCIRES, MAISINES, AND IMWITORS. Specific examples of
these compounds are GELUCIRE 44/14 (saturated polyglycolized glycerides);
GELUCIRE 50/13 (saturated polyglycolized glycerides); GELUCIRE 53/10
(saturated polyglycolized glycerides); GELUCIRE 33/01 (semi-synthetic
triglycerides of C8 -C18 saturatec fatty acids); GELUCIRE 39/01 (semi-synthetic
glycerides); other GELUCIRE, such as 37/06,43/01,35/10,37/02,46/07,48/09,
50/02, 62/05, etc.; MAISINE 85-I (linoleic glycerides); and IMWITOR 742
(caprylic/capric glycerides). (See U.S. Patent No. 6,267,985).
[0054] Still other commercial surfactant compositions having significant
triglyceride content are known to those skilled in the art. It should be appreciated
that such compositions, which contain triglycerides as well as surfactants, may
be suitable to provide all or part of the lipophilic phase component of the of the
present invention, as well as all or part of the surfactants.
[00S5] The pharmaceutical compositions of the present invention also comprise
an active vitamin D compound. The term "active vitamin D compound," as used
herein, is intended to refer to vitamin D which has been hydroxylated in at least
the carbon-1 position of the A ring, e.g., 1a-hydroxyvitamin D3. The preferred
active vitamin D compound in relation to the composition of the present
invention is l a,25-hydroxyvitaminD3, also known as calcitriol. A large number
of other active vitamin D compounds are known and can be used in the practice
of the invention. Examples include la-hydroxy derivatives with a 17 side chain
greater in length than the cholesterol or ergosterol side chains (see U.S. Patent
No. 4,717,721); cyclopentano-vitamin D analogs (see U.S. Patent No. 4,851,401);
vitamin D3 analogues with alkyr yl, alkenyl, and alkanyl side chains (see U.S.
Patent Nos. 4,866,048 and 5,145,846); trihydroxycalciferol (see U.S. Patent No.
5,120,722); fluoro-cholecalciferc 1 compounds (seeU.S. Patent No.5,547,947);
methyl substituted vitaminD (see U.S. Patent No. 5,446,035); 23-oxa-derivatives
(see U.S. Patent No. 5,411,949); 19-nor-vitamin D compounds (see U.S. Patent
No. 5,237,110); and hydroxylated 24-homo-vitamin D derivatives (see U.S.
Patent No. 4,857,518). Particular examples include ROCALTROL (Roche
Laboratories); CALCIJEX injectable calcitriol; investigational drugs from Leo
Pharmaceuticals including EB 10 89 (24a,26a,27a-trihomo-22,24-diene-laa,25-
(OH)2-D3, KH 1060 (20-epi-22-oxa-24a:,26a,27a-trihomo-la,25-(OH)2-D3),
Seocalcitol,MC 1288 (l,25-(OH): -20-epi-D3,) and MC 903 (calcipotriol, la24s-
(OH)2-22-ene-26,27-dehydro-D3); loche Pharmaceutical drugs that include 1,25-
(OH)2-16-ene-D3, l,25-(OH)2-16-ene-23-yne-D3, and 25-(OH)2-16-ene-23-yne-
D3; Chugai Pharmaceuticals 22-ox icalcitriol (22-oxa-1a,25-(OH)2-D3; 1 a-(OH)-
D5 from the University of Illinos; and drugs from the Institute of Medical
Chemistry-Schering AG that include ZK161422 (20-methyl-l ,25-(OH)2-D3) and
ZK 157202 (20-methyl-23-ene-l,25.'HOH)2-D:3); la-(OH)-D2; la-(OH)-D3and la-
(OH)-D4. Additional examples include la,25-(OH)2-26,27-d6-D3; la,25-(OH)2-
22-ene-D3; la,25-(OH)2-D3.1a,25-(OH)2-D2; la,25-(OH)2-D4; la,24,25-(OH)3-D3;
la,24,25-(OH)3-D2; la,24,25-(OH)3-D4; la-(OH)-25-FD3; la-(OH)-25-FD4; la-
(OH)-25-FD2; la,24-(OH)2-D4; 1a,24-(OH)2-D3; la,24-(OH)2-D2; la,24-(OH)2-
25-FD4; la,24-(OH)2-25-FD3; la,24-(OH)2-25-FD2; la,25-(OH)2-26,27-F6-22-
ene-D3.1a,25-(OH)2-26,27-F6-D3.1a,25S-(OH)2-26-F3-D3; 1a,25-(OH)2-24-F2-D3.
1a,25S,26-(OH)2-22-ene-D3. la,25R,26-(OH)2-22-ene-D3; la,25-(OH)2-D2;
la,25-(OH)2-24-epi-D3; la,25 -(OH)2-23-yne-D3. la,25-(OH)2-24R-F-D3;
la,25S,26-(OH)2-D3. la,24R-(OH)2-25F-D3; la,25-(OH)2-26,27-F6-23-yne-D3.
1a,25R-(OH)2-26-F3-D3. la,25,28-(OH)rD2; la,25-(OH)2-16-ene-23-yne-D3.
la,24R,25-(OH)3-D3. la,25-(OH): -26,27-F6-23-ene-D3. la,25R-(OH)2-22-ene-26-
F3-D3. la,25S-(OH)2-22-ene-26-F3-D3. la,25R-(OH)2-D3-26,26,26-d3; la,25S-
(OH)2D3-26,26,26-d3; and la,25R-(OH)222-ene-D3-26,26,26-d3. Additional
examples can be found in WO 99/49870. See also, e.g., U.S. Patent Nos.
5,457,217, 5,447,924, 5,446,034 5,414,098, 5,403,940, 5,384,313, 5,374,629,
5,373,004, 5,371,249, 5,430,196 5,260,290, 5,393,749, 5,395,830, 5,250,523,
5,247,104, 5,397,775, 5,194,431 5,281,731, 5,254,538, 5,232,836, 5,185,150,
5,321,018, 5,086,191, 5,036,061: 5,030,772, 5,246,925, 4,973,584, 5,354,744,
4,927,815, 4,804,502, 4,857,518, 4,851,401, 4,851,400, 4,847,012, 4,755,329,
4,940,700, 4,619,920, 4,594,192; 4,588,716, 4,564,474, 4,552,698, 4,588,528,
4,719,204, 4,719,205, 4,689,180, 4,505,906, 4,769,181, 4,502,991, 4,481,198,
4,448,726, 4,448,721, 4,428,946, 4,411,833, 4,367,177, 4,336,193, 4,360,472,
4,360,471, 4,307,231, 4,307,02 5, 4,358,406, 4,305,880, 4,279,826, and
4,248,791.
(0056] The pharmaceutical compositions of the present invention may further
comprise one or more additives. Additives that are well known in the art include,
e.g., detackifiers, anti-foaming agents, buffering agents, antioxidants {e.g.,
ascorbyl palmitate, butyl hydroxy anisole (BHA), butyl hydroxy toluene (BHT)
and tocopherols, e.g., a-tocopherol (vitamin E)), preservatives, chelating agents,
viscomodulators, toniciflers, flavorants, colorants odorants, opacifiers,
suspending agents, binders, fillers, plasticizers, lubricants, and mixtures thereof.
The amounts of such additives can be readily determined by one skilled in the art,
according to the particular properties desired.
|0057] The additive may also comprise a thickening agent. Suitable thickening
agents may be of those known and employed in the art, including, e.g.,
pharmaceutically acceptable polymeric materials and inorganic thickening agents.
Exemplary thickening agents for use in the; present pharmaceutical compositions
include polyacrylate and polyacrylate co-polymer resins, for example poly-acrylic
acid and poly-acrylic acid/methacrylic acid resins; celluloses and cellulose
derivatives including: alkyl celluloses, e.g., methyl-, ethyl- and propyl-celluloses;
hydroxyalkyl-celluloses, e.g., hydroxypropyl-celluloses and hydroxypropylalkyl-
celluloses such as hydroxypropyl-methyl-celluloses; acylated celluloses, e.g.,
cellulose-acetates, cellulose-acctatephthallates, cellulose-acetatesuccinates and
hydroxypropylmethyl-cellulose phthallates; and salts thereof such as sodium-
carboxymethyl-celluloses; poly inylpyrrolidones, including for example poly-N-
vinylpyrrolidones and vinylpyn olidone co-polymers such as vinylpyrrolidone-
vinylacetate co-polymers; poly vinyl resins, e.g., including polyvinylacetates and
alcohols, as well as other polymeric materials including gum traganth, gum
arabicum, alginates, e.g., alginic acid, and salts thereof, e.g., sodium alginates;
and inorganic thickening agents such as; atapulgite, bentonite and silicates
including hydrophilic silicon dioxide products, e.g., alkylated (for example
methylated) silica gels, in partic alar colloidal silicon dioxide products.
[0058] Such thickening agents as described above may be included, e.g., to
provide a sustained release effect. However, where oral administration is
intended, the use of thickening agents as aforesaid will generally not be required
and is generally less preferred. Use of thickening agents is, on the other hand,
indicated, e.g., where topical application is foreseen.
(0059] Compositions in accordance with the present invention may be employed
for administration in any appropriate manner, e.g., orally, e.g., in unit dosage
form, for example in a solution in hard or soft encapsulated form including
gelatin encapsulated form, e.g., parenterally or topically, e.g., for application to
the skin, for example in the form of a cream, paste, lotion, gel, ointment, poultice,
cataplasm, plaster, dermal patch or the like, or for ophthalmic application, for
example in the form of an eye-drop, -lotion or-gel formulation. Readily flowable
forms, for example solutions and emulsions, may also be employed e.g., for
intralesional injection, or may the administered rectally, e.g., as an enema.
(0060] When the composition of the present invention is formulated in unit
dosage form, the active vitamin D compound will preferably be present in an
amount of between 10 and 75 µg per unit dose. More preferably, the amount of
active vitamin D compound per unit dose will be about 10 µg, 15 µg, 20 µg, 25
µg, 30 µg, 35 µg, 40 µg, 45 µg, 50 µg, 55 µg, 60 µg, 65 µg, 70 µg, or 75 µg.
[0061] When the unit dosage form of the composition is a capsule, the total
quantity of ingredients present n the capsule is preferably about 10-1000 µL.
More preferably, the total quantity of ingredients present in the capsule is about
100-300 µL.
[0062] The relative proportion or ingredients in the compositions of the invention
will, of course, vary considerably depending on the particular type of composition
concerned. The relative proportions will also vary depending on the particular
function of ingredients in the composition. The relative proportions will also vary
depending on the particular ingredients employed and the desired physical
characteristics of the product composition, e.g., in the case of a composition for
topical use, whether this is to be a free flowing liquid or a paste. Determination
of workable proportions in any particular instance will generally be within the
capability of a person of ordinary skill in the art. All indicated proportions and
relative weight ranges described below are accordingly to be understood as being
indicative of preferred or individually inventive teachings only and not as not
limiting the invention in its broacest aspect.
[0063] The lipophilic phase component of the invention will suitably be present
in an amount of from about 30% to about 90% by weight based upon the total
weight of the composition. Preferably, the lipophilic phase component is present
in an amount of from about 50% to about 85% by weight based upon the total
weight of the composition.
[0064] The surfactant or surfactants of the invention will suitably be present in
an amount of from about 1 % to 50% by weight based upon the total weight of the
composition. Preferably, the su rfactant(s) is present in an amount of from about
5% to about 40% by weight based upon the total weight of the composition.
[0065] The amount of active vitamin D compound in compositions of the
invention will of course vary, e.g., depending on the intended route of
administration and to what extent other components are present. In general,
however, the active vitamin D compound of the invention will suitably be present
in an amount of from about 0.005 % to 20% by weight based upon the total weight
of the composition. Preferably, :he active vitamin D compound is present in an
amount of from about 0.01% to 15% by weight based upon the total weight of
the composition.
[0066] The hydrophilic phase component of the invention will suitably be present
in an amount of from about 2% to about 20% by weight based upon the total
weight of the composition. Preferably, the hydrophilic phase component is
present in an amount of from about 5% to 15% by weight based upon the total
weight of the composition.
[0067] The pharmaceutical composition of the invention may be in a semisolid
formulation. Semisolid formulations within the scope of the invention may
comprise, e.g., a lipophilic phase component present in an amount of from about
60% to about 80% by weight bas ;d upon the total weight of the composition, a
surfactant present in an amount of from about 5% to about 35% by weight based
upon the total weight of the composition, and an active vitamin D compound
present in an amount of from about 0.01% to about 15% by weight based upon
the total weight of the composition
[0068] The pharmaceutical compositions of the invention may be in a liquid
formulation. Liquid formulations within the scope of the invention may
comprise, e.g., a lipophilic phase component present in an amount of from about
50% to about 60% by weight based upon the total weight of the composition, a
surfactant present in an amount of from about 4% to about 25% by weight based
upon the total weight of the composition, an active vitamin D compound present
in an amount of from about 0.01% to about 15% by weight based upon the total
weight of the composition, and a hydrophilic phase component present in an
amount of from about 5% to about 10% by weight based upon the total weight of
the composition.
[0069] In addition to the foregoing the present invention also provides a process
for the production of a pharmaceutical composition as hereinbefore defined,
which process comprises bringing the individual components thereof into
intimate admixture and, when required, compounding the obtained composition
in unit dosage form, for example filling said composition into gelatin, e.g., soft
or hard gelatin, capsules, or non -gelatin capsules.
[0070] In a more particular embodiment, the invention provides a process for the
preparation of a pharmaceutica composition, which process comprises bringing
an active vitamin D compourd, e.g., calcitriol, into close admixture with a
lipophilic phase component and a surfactant as hereinbefore defined, the relative
proportion of the lipophilic phase component and the surfactant being selected
relative to the quantity of active vitamin D compound employed, such that an
emulsion pre-concentrate is obtained.
[0071] The present invention also provides methods for the treatment and
prevention of hyperproliferative diseases such as cancer and psoriasis, said
methods comprising administering an active vitamin D compound in an emulsion
pre-concentrate formulation to a patient in need thereof. Alternatively, the active
vitamin D compound can be administered in an emulsion formulation that is
made by diluting an emulsion pre-concentrate of the present invention with an
appropriate quantity of water.
[0072] Cancers which can be treated with the formulations of the invention
include any cancer treatable by an active vitamin D compound. Such cancers
include without limitation cancers of the prostate, breast, colon, lung, head and
neck, pancreas, endometrium, bladder, cervix, ovaries, squamous cell carcinoma,
renal cell carcinoma, myeloid and lymphocytic leukemia, lymphoma, medullary
thyroid carcinoma, melanoma, multiple myeloma, retinoblastoma and sarcomas
of the soft tissues and bone.
|0073] Preferably, the cancers are treated according to the pulse dose protocols
disclosed in WO 99/49870. In this embodiment, the formulations are
administered no more than once every three days, more preferably, no more than
once a week, more preferably, 10 more than once every ten days. Preferably,
about 5 to about 100 µg of calcitriol, more preferably, about 10 to 60 µg, more
preferably, about 40-50 µg of calcitriol, or an equivalent amount of another active
vitamin D compound, is administered to an animal in need thereof.
[0074] Animals which may be treated according to the present invention include
all animals which may benefit from administration of the formulations of the
present invention. Such animals include humans, pets such as dogs and cats, and
veterinary animals such as cows, pigs, sheep, goats and the like.
(0075] The following examples are illustrative, but not limiting, of the method
and compositions of the presen invention. Other suitable modifications and
adaptations of the variety of conditions and parameters normally encountered in
clinical therapy and which are obvious to those skilled in the art are within the
spirit and scope of the invention.
EXAMPLES
EXAMPLE 1
Relative Chemical Compatibility of Calcitriol With Selected Components
[0076] In this example, the relative chemical compatibility of calcitriol with
selected lipophilic, hydrophilic and surfactant components was evaluated by
measuring the percent recovery of; ntact calcitriol after storage at 40°C and 60°C.
Calcitriol recovery was determined based on analyses of high-pressure liquid
chromatography (HPLC). The results are presented in Table 1.
(0077] The recovery data suggest that the most compatible components are
Miglyol 812 (with or without BHT and BHA), Labrafac CC and Captex 200 in
the lipophilic component group propylene glycol in the hydrophilic group, and
vitamin E TPGS and GELUCIRE 44/14 in the surfactant group.
EXAMPLE 2
Stability of Liquid and Semi-Solid Calcitriol Formulations
I. Introduction
[0078] In this Example, the stability of the active vitamin D compound calcitriol
was measured in nine different formulations (four liquid formulations and five
semisolid formulations).
II. Preparation of Calcitriol Formulations
A. Liquid Formulatians
[0079J Four liquid calcitriol formulalations (L1-L4) were prepared containing the
ingredients listed in Table 2. The final formulation contains 0.208 mg calcitriol
per gram of liquid formulation.
B. Semi-Solid Formulations
[0080] Five semi-solid calcitriol formulations (SS1-SS5) were prepared
containing the ingredients listed in Table 3. The final formulation contains 0.208
mg calcitriol per gram of semi-sc lid formulation.
C. Method of Mating the Liquid and Semi-Solid Calcitriol
Formulations
1. Preparation of Vehicles
[0081] One hundred gram quanti ties of the four liquid calcitriol formulations (LI -
L4) and the five semi-solid calcitriol formulations (SS1-SS5) listed in Tables 2
and 3, respectively, were prepared as follows.
[0082] The listed ingredients, except for calcitriol, were combined in a suitable
glass container and mixed until homogeneous. Vitamin E TPGS and GELUCIRE
44/14 were heated and homogerized at 60°C prior to weighing and adding into
the formulation.
2. Preparation of Active Formulations
[0083] The semi-solid vehicles were heated and homogenized at = 60°C. Under
subdued light, 12 ± 1 mg of calcitriol was weighed out into separate glass bottles
with screw caps, one bottle for each formulation. (Calcitriol is light-sensitive;
subdued light/red light should be used when working with calcitriol/calcitriol
formulations.) The exact weight was recorded to 0.1 mg. The caps were then
placed on the bottles as soon as the calcitriol had been placed into the bottles.
Next, the amount of each vehic e required to bring the concentration to 0.208
mg/g was calculated using the following formula:
Cw/0.208 = required weight of vehicle
Where Cw = weight of calcitriol, in mg, and
0.208 = final concentration of calcitriol (mg/g).
[0084] Finally, the appropriate amount of each vehicle was added to the
respective bottle containing the culcitriol. The formulations were heated (s 60°C)
while being mixed to dissolve the calcitriol
III. Stability of Calcitriol For mulations
[0085] The rune calcitriol formulations (L1-L4 and SS1-SS5) were analyzed for
stability of the calcitriol component at three different temperatures. Sample of
the nine formulations were each placed at 25°C, 40°C, and 60°C. Samples from
all three temperatures for all nine formulations were analyzed by HPLC after 1,
2 and 3 weeks. In addition, samp] es from the 60°C experiment were analyzed by
HPLC after 9 weeks. The percent of the initial calcitriol concentration remaining
at each time point was determined for each sample and is reported in Table 4
(liquid formulations) and Table 5 (semi-solid formulations).
[0086] As illustrated by Tables 4 and 5, calcitriol remained relatively stable with
very little degradation in all of the formulations (liquid and semi-solid) analyzed.
EXAMPLE 3
Appearance and UV/Visible Absorption Study of Calcitriol Formulations
[0087] Calcitriol formulations L1 and SS3 were prepared prior to this study and
stored at room temperature protected from light. Table 6 below shows the
quantities of ingredients used to prepare the formulations.
[0088] The formulations were w armed to 55°C prior to use. Both formulations
(liquid #1 and semi-solid #3) were mixed well with a vortex mixer and appeared
as clear liquids. Each calcitriol formulation (=250 µL) was added to a 25 mL
volumetric flask. The exact weigh ts added were 249.8 mg for Liquid-1 and 252.6
mg for semi-solid #3. Upon contact with the glass, the semi-solid-3 formulation
became solidified. Deionized wa;er was then added to the 25 mL mark and the
solutions were mixed with a vortex mixer until uniform. The appearance was
observed at this point and the absorbance of the resulting mixtures at 400 nm was
determined by UV/visible spectrophotometry. Deionized water was used as a
blank and the measurements were taken at 400 nm. Each sample was measured
10 times over a period of 10 minutes. The results are summarized in Table 7.
Both formulations formed were w lite and opaque.
EXAMPLE 4
Diameter of Emulsion Droplets Formed From the Liquid and Semi-Solid
Formulation Vehicles (without calcitriol)
[0089] In this example, the average diameter of emulsion droplets was measured
after dilution of the liquid (L1-14) and semi-solid (SS1-SS5) emulsion pre-
concentrate vehicles (not containing calcitriol) with simulated gastric fluid (SGF)
lacking enzyme. The average dianeter of the droplets was determined based on
light scattering measurements. The appearance of the pre-concentrates and the
resulting emulsions, determined by visual inspection, was also noted. The results
are summarized in Table 8.
[0090] From the results presented above, it is concluded that the droplets
(particles) formed from the emulsion preconcentrate formulations were of sub-
micron droplet size despite having an opaque appearance.
EXAMPLE 5
Diameter of Emulsion Droplets Formed From Liquid and Semi-Solid
Calcitriol Formulation
[0091 ] In this example, the average diameter of emulsion droplets was measured
after dilution of the liquid #1 (L1) and semi-solid #3 (SS3) emulsion pre-
concentrates in simulated gastric fluid (SGF) without enzyme. The formulations
used in this example contained calcitriol at a concentration of 0.2 mg calcitriol/g
of formulation. The diameter of the droplets was determined based on light
scattering measurements. The appearance of the resulting emulsions, determined
by visual inspection, was also noted. The results are summarized in Table 9.
EXAMPLE 6
In Vitro Dispersion of Calcitriol From Emulsion Pre-Concentrates
[0092] In this Example, the extent of calcitriol dispersion in various formulations
in gelatin capsules was determined. A single capsule containing 250 mg of a
calcitriol formulation in a size-2 gelatin capsule (each capsule containing 0.2mg
calcitriol/g formulation) was added to 200 mL of simulated gastric fluid (SGF)
without enzyme at 37°C and was mixed by a paddle at 200 RPM. Samples were
then filtered through a 5 µm filter and analyzed for calcitriol concentration at 30,
60, 90, and 120 minutes by HPLC. The results are shown in Table 10.
TABLE 10: Percent Calcitriol Obtained in Filtrate After Dispersion in SGF
and Filtration Through a 5 µm Filter
[0093] As this Example illustrates, the dispersion of calcitriol in simulated gastric
fluid from capsules containing either the L1 or the SS3 formulations was much
more extensive than that which was observed with capsules containing the
Comparison Formulation (which is similar to the ROCALTROL formulation
available from Roche Laboratories).
EXAMPLE 7
Plasma Concentrations ar d Pharmacokinetics of Calcitriol in Dogs
[0094] A pharmacokinetics study in dogs compared the plasma levels of calcitriol
after administration of 1.0 µg/kg using 3 different formulations: ROCALTROL,
a liquid formulation (liquid #1, and a semi-solid formulation (semi-solid #3).
Four dogs received 1.0 µg/kg orally of ROCALTROL, the semi-solid
formulation, or the liquid formulation. When dogs were used for more than one
formulation a minimum 7-day washout period separated dosing with each
formulation.
[0095] Blood samples were obtained pre-dose, and 0.5, 1,2,4, 6, 8, 10,12,24,
36, and 48 hours post-dose for analysis of calcitriol levels. Blood samples for
clinical chemistry were obtained pre-dose, and at 24 and 48 hours post-dose for
the ROCALTROL group; samples were obtained pre-dose, and at 4, 24,48, 72,
96, and 120 hours for the semi-solid and liquid formulations. Samples were
analyzed for calcitriol by radioimmunoassay and subjected to pharmacokinetics
analyses.
[0096] Plasma concentrations of calcitriol over time for the three formulations
are shown graphically in Figure 1.
[0097] A summary of the pharmacokinetics of calcitriol as one of three different
formulations at a common dose of 1.0 µg/kg is presented in Tables 11-14.
[0098] The results of this study show that there were some differences and
similarities in the pharmacokinetics between these particular inventive
formulations and ROCALTROL as follows:
• Cma)t was approximately three times higher with the liquid and semi-solid
formulations than with the ROCALTROL formulation.
• Cmax was achieved sooner (1 to 2 hours) with the liquid and semi-solid
formulations than with the ROCALTROL formulation (2 to 4 hours).
• The overall systemic exposure (AUC0.00 )was comparable with the three
formulations, although systemic exposure in the first 24-48 hours was
greater with the liquid and semi-solid formulations than with
ROCALTROL.
[0099] The foregoing results show that the liquid #1 formulation produces the
highest Cmax and the largest AUC calcitriol values, followed closely by the semi-
solid #3 formulation. The ROCALTROL formulation has the lowest Cmax and
AUC values. It appears that the liquid #1 and semi-solid #3 formulations were
absorbed much faster and produced higher plasma concentration during the first
twelve hours and a faster rate of elimination.
EXAMPLE 8
Pharmacokinetics of the Semi-Solid #3 Formulation After Escalating Doses
[0100] In this study the pharmacokinetics of the semi-solid formulation after
escalating oral doses was studiec in dogs. Three male and three female Beagle
dogs were dosed orally with single doses of 0.5 jig/kg (all six dogs), 0.1 ug/kg (1
male and 1 female), 5.0 µg/kg (2 males and 2 females), and 10.0 µg/kg (all dogs).
After the 10.0 µg/kg dose, 2 dogs per sex were euthanized. The remaining male
and female dogs continued on study and received doses of 30.0 µg/kg and 100.0
µg/kg. After each dose the aninnls were held for a 6-day recovery period.
[0101] Blood samples (approximately 1 mL) were collected from each dog pre-
dose and at 0, 2 (in all but the 0.5 µg/kg dose), 4, 8, 24, 48, and 96 hours
following dose administration. Samples: were analyzed for calcitriol by
radioimmunoassay and subjected to pharmacokinetic analyses. Plasma
concentrations of calcitriol are shown graphically for males and females in
Figs. 2A and 2B.
[0102] After dosing with semi-sol id #3, maximum plasma concentrations usually
occurred at the two hour sampling timepoint. At doses above 0.1 µg/kg, plasma
concentrations appeared to decline at a more rapid rate during the first 8 hours
than during the 24 to 96 hour time period.
[0103] At the lowest dose of 0.1 µg/kg, plasma concentrations of calcitriol fell
below the limit of quantitation after 24 hours. At 0.5 µg/kg and above,
measurable concentrations of calcitriol persisted at the 96 hour sampling
timepoint. There did not appear to be any remarkable differences between the
male and the female dogs.
[0104] Pharmacokinetic parameters for semi-solid #3 at doses ranging from 0.1
to 100.0 µg/kg are summarized in Table 15.
[0105] These pharmacokinetic results indicate the following:
• The systemic exposure of calcitriol appeared to be fairly linear throughout
the tested dose range of 0 1 to 100.0 µg/kg. No saturation of absorption
was observed.
• The half-life of calcitriol appeared to be dose-dependent. Formulations
having a half life of greater than 24 hours are less suitable for high dose
pulse administration.
• Weekly dosing with semi-solid #3 at 5.0 µg/kg and above resulted in
some accumulation in the plasma. Accumulation was not consistently
observed at the lower doses of 0.1 and 0.5 µg/kg.
EXAMPLE 9
A 28 Day Oral Toxicity Study in Dogs with Semi-Solid #3
[0106] In this study a 28-day repeated dose toxicology study of semi-solid #3 was
conducted in dogs to assess the pharmacokinetics of calcitriol after weekly oral
capsule dosing. Semi-solid #3 or control article capsules were administered on
study days 0,7,14,21, and 28. Twelve dogs (6 male, 6 female) received vehicle
control (group 1), eight dogs (4 m ale, 4 female) received 0.1 µg/kg semi-solid #3
(group 2), and eight dogs (4 male, 4 female) received 1.0 µg/kg semi-solid #3
(group 3). Twelve dogs (6 male, 5 female) received 30.0 µg/kg semi-solid #3 on
day 0 (group 4). Due to the severity of the clinical response observed after the
first 30 µg/kg dose on day 0, dose levels were reduced in this group to 10 µg/kg
(males on days 7,14,21, and 28) or 5 µg/kg (females on days 7,14,21, and 28).
Blood samples were collected on each dog pre-dose and at 1,2,4,6,8,24, and 48
hours following dosing on study days 0 (first dose) and 21 (fourth weekly dose).
All animals were sacrificed on study day 29.
[0107] The pharmacokinetic results for plasma calcitriol for groups 2-4 are
summarized in Table 16.
[0108] Figs. 3A and 3B show the adjusted plasma concentration-time curve for
calcitriol after oral capsule dosing with semi-solid #3 on study days 0 and 21 in
male (Fig. 3A) and female (Fig. 3B) Beagle dogs. Calcitriol values at time 0 on
day 0 were subtracted from all subsequent timepoints to adjust for endogenous
(baseline) plasma calcitriol
[0109J The results of the study indicate that following:
• After oral capsule dosing with semi-solid #3, plasma concentrations of
calcitriol rose fairly rapidly, reaching peak plasma concentrations within
two hours.
• Plasma concentrations o f calcitriol decreased at a more rapid rate during
the first 8 hours post-dosing than during the later timepoints (24-48
hours), possibly indicating redistribution of calcitriol to extravascular
spaces, with subsequent slow release of calcitriol back into the vascular
spaces. This observation was more apparent at the higher dose levels than
at the lower dose levels.
• At 24 hours post-dosing, plasma concentration of calcitriol had declined
to near-baseline values at the low dose of 0.1 µg/kg. However, at the
higher doses of calcitriol, dose-related residual concentrations of calcitriol
were still evident at the last sampling timepoint (48 hours), although all
values returned to pre-dose (baseline) values by one week post-dosing.
• Values for Cmax and AUC were fairly proportional to dose throughout the
dose range tested (0.1-30 0 µg/kg).
• Values for AUCo.24 at the low dose, which was the no observable adverse
effect level (0.1 µg/kg) ranged from 1840.6 - 3283.0 pg-hr/mL.
• Values for AUC0-24 at the mid dose, which was the maximum tolerated
dose (1.0 µg/kg) ranged from 12,947.3 -23,259.7 pghr/mL.
• Values for AUC0-24 at doses associated with weight loss and moderate
signs of toxicity, ranged fiom 46,878.1 pg-hr/mL(5.0 µg/kg; females) to
173,597.2pghr/mL(10.0 µg/kg; males).
• Values for AUC0.24 at a dose associated with mortality (30.0 µg/kg)
ranged from 323,573.1 - 496,044.6 pg-hr/mL.
• There were no consistent sex differences in any pharmacokinetic
parameter.
(0110] Overall, the animals appeared to handle calcitriol similarly after the first
dose and after repeated once-weeky dosing, with a few exceptions such as higher
values for Cmax and AUC on Day 0 compared to Day 21 in the 1.0 µg/kg females
(not evident in the males).
EXAMPLE 10
Acute Toxicity Stucy of Three Different Formulations
[0111 ] In the study described in Example 7, several in-life parameters, including
clinical chemistry parameters, vere monitored to assess the toxicity of the
calcitriol formulations. Blood simples were analyzed for calcium, phosphorus,
blood urea nitrogen (BUN), glucose, albumin, bilirubin (total), aspartate
aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase
(AP), and creatinine.
[0112] No clinical toxicity was seen in any dog with any of the three
formulations.
[0113] Hypercalcemia was seer after dosing with 1.0 µg/kg with all three
formulations. The group mean and the individual range of serum calcium levels
of each of the three different formulations are presented in Table 17.
[0114) In addition to elevations of calcium, elevations of ALT, AST, BUN, and
creatinine were observed in all groups.
[0115) In summary, the results of this study indicated that:
• No treatment-related clinical signs were evident in any dog after dosing
with any of the formula ions (ROCALTROL, liquid, or semi-solid).
• Hypercalcemia at 1.0 µg/kg PC) was seen in dogs with all three
formulations.
• Time course of the hypercalcemia was comparable among all three
formulations up to 48 hours; sampling for the ROCALTROL group did
not extend beyond 48 hours.
• Severity of the hypercalcemia was comparable among the three
formulations; the highest serum calcium (17.0 mg/dL) occurred at 24
hours in dogs receiving the liquid ibrmulation.
• Mean values for ALT, AST, BUN, and creatinine were observed to be
outside the historical nnge in all treatment groups at one or more
timepoints.
• Elevations for BUN and c 'eatinine were greater in the liquid or semi-solid
groups; in the absence of a concurrent control group, the significance of
this observation is unclear.
EXAMPLE 11
Acute Maximium Tolerated Dose Study
[0116] In the study described above in Example 8, the acute toxicity and
hypercalcemia effects of semi-solid #3 were also assessed to estimate the
maximum tolerated dose and to provide data for dose selection of future studies.
[0117] Calcium levels were increased in a dose-related manner at all dose levels
in males (Fig. 4A) and females (Fig. 4B). Serum calcium data for the 0.001 and
1.0 µ,g/kg dose was obtained in male dogs in the study describe in Example 10,
and is included here for completeness.
[0118) In summary, this study of semi-soliid #3 administered orally via a capsule
to male and female Beagle dogs at 0.1, 0.5, 5.0, 10.0, 30.0, and 100.0 µg/kg
showed:
• Dose dependent hypetcalcemia was the most common laboratory
abnormality.
• Elevations of creatinine, urea nitrogen, cholesterol, erythrocytes,
hemoglobin, hematocrit, and neutrophils, and a decrease in lymphocytes
were seen at doses of 5.0 µg/kg or higher.
• Body weights and food consumption decreased markedly after receiving
the 30.0 and 100.0 µg/kg doses; after 100.0 µg/kg, dogs had a noticeable
thin appearance and obvious decreased activity.
[0119] Based on these results, the maximum tolerated dose of semi-solid #3 in
dogs appeared to be 5.0 µg/kg.
EXAMPLE 12
A 28 Day Repeated Dose Toxicity Study
[0120] In the study described above in Example 9, the dogs were also assessed
for potential toxicity of the semi-solid #3 formulation when administered to dogs
by the oral (capsule) route once every seven days for 28 days. The study included
assessments of clinical signs, body weights, food consumption, toxicokinetics,
clinical pathology including biochemistry, hematology, coagulation, and
urinalysis, ophthalmology, cardielogy, gross necropsy, organ weight, and full
histopathology on all animals. The study design is summarized in Table 18.
[0121] Four of the group 4 arimals (1 male and 3 females) died or were
euthanized moribund during the rist three days of the study. No deaths occurred
following reduction of the dose level on day 7; there were no deaths in groups 1,
2 or 3.
[0122] In the group 4 animals that died, the: most notable clinical abnormalities
preceding death primarily included red vomitus, few/no feces, soft stools
containing red material, red nasal discharge, shallow/rapid breathing, decreased
activity and lateral recumbency.
[0123] Dose-related body weight oss, decreased weight gain, and decreased food
consumption were observed in grc up 3 and 4 animals; group 3 animals were ~11 -
12% below controls; group 4 animals were 17-24% below controls. No effects
on weight gain or food consumption were apparent in group 2 animals.
[0124] There was a trend towards an increase in several RBC and WBC
parameters in the group 4 animals at day 29; no toxicologically significant
hematological abnormalities were apparent in the group 2 and 3 animals.
[0125] Dose related hypercalcemia was noted in group 3 and 4 animals. Calcium
levels were increased by 6 hours )ost-dose, achieved a maximum by 24 hours
post-dose, and decreased gradually at 48 and 96 hours post-dose. Other clinical
chemistry abnormalities, in group 3 and 4 animals included increased serum
proteins, cholesterol and kidney function parameters and decreased electrolytes
and urine specific gravity. No toxicologically significant clinical chemistry
abnormalities or notable increases in serum calcium were observed in group 2
animals.
[0126] There were no treatment- elated changes observed in the ocular tissues on
study days 22/23 and there wen: no treatment-related changes observed in the
ECG and blood pressure data obtained on this study.
[0127] The most notable gross necropsy abnormalities occurred in group 4
animals that were found dead or were euthanized and included lesions in the
digestive system and related organs; dark red omentum, reddened to dark red
mucosa, red fluid in the small intestine and stomach, reddened to dark red mucosa
in the esophagus and large intestine, stained and thickened gall bladder, a
thrombus in the heart, dark red and mottled areas on the lungs, a reddened to dark
red pancreas, a dark red thymus, thickened urinary bladder and a pale spleen.
Gross abnormalities were less severe in group 3 animals; no notable gross
abnormalities were observed in the group 2 animals.
[0128] The primary histopathobgical abnormality was dose related chronic
interstitial nephritis: mild to moderate in group 3 animals and moderate to marked
in group 4 animals. Other microscopic findings in these animals appeared to be
secondary to chronic interstitial nephritis and included mineralization of various
organs/tissues. No microscopic lesions were observed in the group 2 animals.
[0129] The highest values for serum calcium usually occurred within 24 hours
post-dose and returned to baseline levels by the next pre-dose sampling interval.
Selected data (males on Day 21) or serum calcium along with plasma calcitriol
are shown in Figs. 5A-5C. These data show that the maximum plasma
concentrations of calcitriol usually occurred well in advance of the maximum
serum concentrations of calcium.
[0130] In summary, this study of >emi-solid #3 administered orally to dogs once
every 7 days to male and female Beagle dogs at 0,1.0 and 5.0 (females) or 10.0
(males) ug/kg following the initii il dose of 30.0 u.g/kg showed:
The no observed adverse effect level was 0.1 µg/kg; the maximum
tolerated dose was 1.0 µg/kg; mortality was seen at 30 µg/kg.
» Dose related lesions in he digestive system and related organs, reduced
weight gain and decreased food consumption were seen in groups 3 and
4.
• Dose related chronic interstitial nephritis was seen in groups 3 and 4.
EXAMPLE 13
Human Pharmacokinetic Study
[0131) Pharmacokinetics of semi-solid #3 in humans was evaluated in a clinical
trial. Patients received semi-solid #3 on this study at doses of calcitriol up to 90
µg. Preliminary pharmacokinetic results are discussed below.
[0132] Blood samples were obtained pre-dose and at 0.5, 1.0,1.5, 2, 3, 4, 6, 8,
12,24,48 and 72 hours post initial dose of semi-solid #3. Calcitriol levels were
analyzed using a commercial radioimmunoassay, with limited validation for
dilution integrity.
[0133] Mean plasma concentration-time curves were plotted for each group (Fig.
6). Non-compartmental pharmacokinetic parameters were calculated for each
subject and then averaged (Table 19). Baseline calcitriol values were subtracted
from the post-dosing values to adjust for endogenous calcitriol.
[0134] Based on these data, pharmacokinetics of semi-solid #3 appear linear and
predictable. There was no evidence of saturation of absorption.
EXAMPLE 14
Safety Results with Semi-Solid #3
[0135] The safety of semi-solid 3 in humans was evaluated in a clinical trial.
As of May 8,2002,12 patients received semi-solid #3 on this study: 3 in group
1 (15 µg), 3 in group 2 (30 µg), and 6 in group 3 (60 µg). Preliminary
pharmacokinetic results on the first 9 patients are discussed below.
[0136] No deaths have occurred. Thirty-four (34) adverse events occurred in 8
of the 9 patients; 20 of 34 adverse events were deemed possibly of probably
related to semi-solid #3. One serious adverse event occurred in group 3 that was
deemed not related by the Investigator. This patient developed a transient grade
1 fever on day 1 that prolonged hospitalization. Grade 2 or 3 adverse events
deemed related to study drug are presented in Table 20.
[0137] The preliminary results from the phase 1 trial with semi-solid #3
demonstrate:
The maximum tolerated dose of semi-solid #3 has not yet been
determined in the phase 1 trial; additional patients are being evaluated in
group 3 (60 µg).
Pharmacokinetics of semi -solid #3 appeared linear and predictable across
the first three dose group:.
[0138] Having now fully described this invention, it will be understood by those
of ordinary skill in the art that the same can be performed within a wide and
equivalent range of conditions, formulations and other parameters without
affecting the scope of the invention or any embodiment thereof. All patents,
patent applications and publications cited herein are fully incorporated by
reference herein in their entirety.
WE CLAIM:
1. A pharmaceutical composition consisting essentially of an active vitamin D
compound, about 50% MIGLYOL 812, about 50% vitamin E TPGS, and one or more
antioxidants.
2. The pharmaceutical composition as claimed in claim 1, wherein said active
vitamin D compound is calcitriol.
3. The pharmaceutical composition as claimed in claim 1, containing butyl hydroxy
anisole and butyl hydroxy toluene.
4. The pharmaceutical composition of any one as claimed in claims 1-3, in the form
of a unit dose.
5. The pharmaceutical composition els claimed in claim 4, wherein said unit dose
contains about 10 µg to about 75 µg of calcitriol.
6. The pharmaceutical composition as claimed in claim 5, wherein said unit dose
contains about 45 µ.g of calcitriol.
7. The pharmaceutical composition as claimed in claim 6, wherein said unit dose
contains about 45 µg of calcitriol, about i 0% MIGLYOL 812, about 50% vitamin E TPGS, butyl
hydroxy anisole, and butyl hydroxy toluene.
8. The pharmaceutical composition as claimed in claim 4, wherein said unit dose
form is a capsule.
9. The pharmaceutical composition as claimed in claim 8, wherein said capsule is a
gelatin capsule.
10. The pharmaceutical composition as claimed in claim 8, wherein the total volume of
ingredients in said capsule is 10-1000 µl.
11. The pharmaceutical composition of any one as claimed in claims 1-10, wherein the
pharmaceutical composition is useful for the treatment or prevention of a hyperproliferative
disease.
12. The pharmaceutical composition as claimed in claim 11, wherein said
hyperproliferative disease is cancer.
13. The pharmaceutical composition as claimed in claim 12, wherein said pharmaceutical
composition is administered by pulse-dose, wherein said pulse-dose comprises the administration
of said pharmaceutical composition to a patient no more than once every three days.
14. The pharmaceutical composition as claimed in claim 13, wherein said pharmaceutical
composition is administered to a patient no more than once a week.
15. The pharmaceutical composition as claimed in claim 11 wherein said treatment or
prevention comprises administering the composition to a patient once a week.
16. The pharmaceutical composition as claimed in claim 11 wherein the
hyperproliferative disease is cancer.
17. The pharmaceutical composition as claimed in claim 11 wherein the
hyperproliferative disease is a member selected from the group consisting of: prostate cancer,
breast cancer, colon cancer, lung cance r, head and neck cancer, pancreatic cancer, endometrial
cancer, bladder cancer, cervical cancel, ovarian cancer, squamous cell carcinoma, renal cell
carcinoma, myeloid leukemia, Iymphocytic leukemia, lymphoma, medullary thyroid carcinoma,
melanoma, multiple myeloma, retinoblastoma, sarcoma of the soft tissues and sarcoma of the
bone.

Disclosed are pharmaceutical compositions comprising an active vitamin D compound in emulsion pre-concentrate
formulations, as well as emulsions and sub-micron d xiplet emulsions produced therefrom. The compositions comprise a lipophilic
phase component, one or more surfactants, and an active vitamin D compound. The compositions may optionally further comprise
a hydrophilic phase component.

Documents:

822-KOLNP-2004-(06-02-2012)-CORRESPONDENCE.pdf

822-kolnp-2004-granted-abstract.pdf

822-kolnp-2004-granted-claims.pdf

822-kolnp-2004-granted-correspondence.pdf

822-kolnp-2004-granted-description (complete).pdf

822-kolnp-2004-granted-drawings.pdf

822-kolnp-2004-granted-examination report.pdf

822-kolnp-2004-granted-form 1.pdf

822-kolnp-2004-granted-form 13.pdf

822-kolnp-2004-granted-form 18.pdf

822-kolnp-2004-granted-form 3.pdf

822-kolnp-2004-granted-form 5.pdf

822-kolnp-2004-granted-gpa.pdf

822-kolnp-2004-granted-reply to examination report.pdf

822-kolnp-2004-granted-specification.pdf


Patent Number 228805
Indian Patent Application Number 822/KOLNP/2004
PG Journal Number 07/2009
Publication Date 13-Feb-2009
Grant Date 11-Feb-2009
Date of Filing 15-Jun-2004
Name of Patentee NOVACEA, INC.
Applicant Address 601 GATEWAY BOULEVARD, SUITE 450, SOUTH SAN FRANCISCO, CA
Inventors:
# Inventor's Name Inventor's Address
1 CHEN ANDREW-XIAN 4646 BRYSON TERRACE, SAN DIEGO, CA 92130
2 FAN JUN 10566 GIFFIN WAY, SAN DIEGO, CA 92126
3 YU XI-YUN 11441 CREEKSTONE LANE, SAN DIEGO, CA 92128
4 WHITEHOUSE MARTHA J 151 UPPER TERRACE, SAN FRANCISCO, CA 94117
PCT International Classification Number A61K 31/59
PCT International Application Number PCT/US02/38483
PCT International Filing date 2002-12-03
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/334,554 2001-12-03 U.S.A.