Title of Invention

NOVEL SUSTAINED RELEASE PHARMACEUTICAL COMPOUNDS TO PREVENT ABUSE OF CONTROLLED SUBSTANCES

Abstract The invention discloses a pharmaceutical composition comprising an opioid selected from hydrocodone and oxycodone covalently attached to the C-terminus of a carrier peptide; wherein said carrier peptide comprises from 1-9 amino acids.
Full Text NOVEL SUSTAINED RELEASE PHARMACEUTICAL
COMPOUNDS TO PREVENT ABUSE OF CONTROLLED SUBSTANCES
BACKGROUND OF THE INVENTION:
(i) Field of the Invention
[001] The present invention relates to novel pharmaceutical compounds and
more particularly to controlled substances that are covalently bound to a chemical
moiety and thus rendered pharmaceutically inactive until broken down by
enzymatic and/or chemical means in a time-dependent manner following oral
administration. Delayed release from the conjugate prevents spiking of drug levels
and affords gradual release over an extended period of time. The enzymatic and/or
chemical conditions necessary for the release of the controlled substance are either
not present or of minimal activity when the novel pharmaceutical compound is
introduced nasally, inhaled, or injected; thus, also preventing spiking when
administered by these routes. Controlled substances with these novel properties are
less likely to be abused due to the diminished "rush" effect of the modified
controlled substance. Consequently, the therapeutic value of these pharmaceuticals
is enhanced by decreasing euphoria while increasing the duration of the analgesic
effect.
(ii) Description of the Related Art
[002] A number of pharmacologically useful compounds are also
commonly abused controlled substances. In particular, analgesics that are prescribed
for the management of acute and chronic pain have become increasingly abused
over the last decades. For example, the increase in prescription of oxycodone in the
last few years led to widespread abuse of this drug. Amphetamines are another
example of controlled substances with important pharmacological uses that are
highly addictive and commonly abused.
[003] There is considerable information readily available to individuals
which teaches how to derive purified forms of controlled substances from

prescription products. These techniques are both simple and well described on
multiple websites. Most of these procedures utilize cold water, although, hot water,
changes in pH and other solvents are described. Examples of these procedures are
described below.
[004] The description of these procedures was found on the web in
February of 2003 at http://codeine.50g.eom/info/extraction.html#ex.coldw and is
paraphrased below. Cold water extraction is used to extract an opiate/opioid
substance from combination tablets. This method subverts the fact that opiates are
generally very soluble in cold water, while paracetamol, aspirin, and ibuprofen are
only very slightly soluble. These techniques are sophisticated enough to recognize
that pseudoephedrine and caffeine are water soluble and will remain in the solution
and that dispersible tablets make it difficult to extract secondary substances. The
description of the equipment required makes it clear that these procedures make
abuse readily available. The equipment includes a minimum two glasses or cups,
paper filters (unbleached coffee filters will do) and a measure glass. Portions of the
procedures are provided below:
1. Crush the tablets and dissolve in cold (20° C) water.
2. Cool the solution down to approximately 5° C stirring occasionally.
3. Leave the solution in a cool place for about 20 minutes.
4. Wet the filter(s) with very cold water to prevent it from absorbing the
solution and put it in the glass. Stick an elastic/rubber band around
the container to keep the filter in place.
5. Pour the solution through the filter to filter out the secondary
substance from codeine.
6. Discard used filters with secondary substance solids left.
[005] However, when these procedures were viewed as not providing
sufficient yields improved method were designed for extracting codeine which
simply require the addition of chloroform or like solvent such as methylene chloride.
This technique utilizes methods which alter the pH aspects of the solution to
improve extraction and even provides instruction on how to re-salt the product.
Portions of the procedure are described below.

1. Place uncrushed T3's or other APAP/codeine product in a small
glass or beaker and cover with enough distilled water so that the
pills will break down into a thin paste.
2. Add dry sodium carbonate to reduce the codeine phosphate to
codeine base. The pH of the mixture should be about 11 or greater.
3. Pour the mixture into the pyrex pan and rinse the beaker with a
few ml of distilled water and add the rinse water to the mix in a
pan.
4. Wrap the dried material in a coffee filter and grind the stuff
5. Pour the dry crushed mixture into a glass bottle with a screw-on
top and pour in enough chloroform to completely cover.
6. Shake and filter.
[006] While there has been considerable effort to provide controlled
substances which are resistance to abuse current products fail to achieve the stability
required to prevent abuse. The present invention however, provides methods and
compositions which retain their stability even when subjected to current abuse
methods, and therefore provide a much needed but less addictive and/or less likely
to be abused product.
SUMMARY OF THE INVENTION
[007] Thus, there is clearly a need in the art for a more "street-safe" version
of controlled substances, which will permit one to obtain the therapeutically
beneficial effects of these substances on the one hand while avoiding the euphoric
effects that lead to substance abuse on the other hand. It is, therefore, a primary
object of the present invention to fulfill this need by providing controlled substances
that have been chemically modified to be released only under selected conditions
and, even then, only at a controlled rate that does not give rise to a euphoric effect.
[008] More particularly, it is an object of the present invention to provide
chemically modified controlled release substances that are themselves inactive and
resistant to absorption until broken down by chemical or enzymatic means at the
desired target location, such as for example under the acidic conditions of the
stomach and/or the enzymatic activity present in the gastrointestinal tract.

[009] It is another object of the invention to provide chemically modified
controlled release substances that are released only in the blood serum, again at
controlled release rates that do not give rise to a euphoric effect.
[010] In a first aspect, the present invention comprises a controlled
substance that has been rendered inactive or substantially inactive comprising said
controlled substance covalently bonded to a chemical moiety comprising an amino
acid or more preferably an oligopeptide. The oligopeptide preferably less than 50
and more preferably less than 6 amino acids.
[011] In a second aspect, the present invention comprises a controlled
substance that has been rendered inactive or substantially inactive comprising said
controlled substance covalently bonded to a chemical moiety comprising an amino
acid or more preferably an oligopeptide which breaks down under the acid
conditions of the stomach and/or the enzymatic activity present in the
gastrointestinal tract.
[012] In the oral composition define above, absorption of the controlled
substance into the bloodstream upon oral delivery occurs in a sustained release
manner and peak concentrations of the drug are decreased as compared to non-
conjugated drug given in a similar dosage and formulation. Sustained release may
further be defined as release of the active agent into systemic blood circulation over
a prolonged period of time relative to the release of the active agent in conventional
formulations through similar delivery routes.
[013] In a third aspect, the present invention relates to a method for
delivering a controlled substance to a patient so as to obtain a therapeutic, but not a
substantial euphoric effect, comprising orally administering the above composition
to the patient.

[014] In a fourth aspect, the present invention relates to a method for
delivering a controlled substance to a patient so as to obtain a therapeutic, but not a
substantial euphoric effect, comprising parenterally administering the above
composition to the patient.
[015] The invention is further illustrated by drawings (figures) and tables of
data. The following is a list of illustrations describing the invention in detail.
BRIEF DESCRIPTION OF THEACCOMPANING DRAWINGS
[016] Fig. 1. illustrates the synthesis of polyserine-naltrexone (carbonate-
linked) conjugates;
[017] Fig. 2. illustrates mean serum concentration curves of rats orally
dosed with BB272 polyserine-naltrexone conjugate vs. naltrexone;
[018] Fig. 3. illustrates mean serum concentration curves of rats orally
dosed with BB301polyserine-naltrexone vs. naltrexone (equal dose) vs. naltrexone
(1/2 dose at 0 hours and at 6.5 hours);
[019] Fig. 4. illustrates Hydrocodone vs. Ethylcarbonate/Hydrocodone
conjugates serum concentration curves;
[020] Fig. 5. illustrates how amino acid/narcotic conjugates may be
synthesized;
[021] Fig. 6 illustrates Oxycodone vs. Glutamate/Oxycodone conjugate
serum concentration curves;
[022] Fig. 7. illustrates Amphetamine vs. Glu-Amphetamine conjugate
serum concentration curves;
[023] Fig. 8. Serum concentration curves of peptide-amphetamine
conjugates vs. amphetamine;
[024] Fig. 9. illustrates Hydrocodone v. GGL-Hydrocodone conjugate
serum concentration curves;

[025] Fig. 10. illustrates Hydrocodone v. EEE-Hydrocodone conjugate
serum concentration curves;
[026] Fig. 11. illustrates Hydrocodone v. ribose-Hydrocodone conjugate
serum concentration curves;
[027] Fig. 12. illustrates Hydrocodone v. E-Hydrocodone v. EE-
Hydrocodone v. EEE-Hydrocodone v. EpE-Hydrocodone v. GGL-Hydrocodone
conjugate serum concentration curves;
[028] Fig. 13. illustrates Hydrocodone v. ribose-Hydrocodone conjugate
serum concentration curves;
[029] Fig. 14. illustrates Hydrocodone vs. Butylated Amino
Acid/Hydrocodone Conjugates Serum Concentration Curves;
[030] Fig. 15. illustrates Paw Lick Latency vs. Time of ProProLeu-HC and
Hydrocodone; and
[031] Fig. 16. illustrates Paw Lick Latency vs. Time of LeuLeuLeu-HC v.
ProProLIIe-HC v. GlyGlyGlyGlyLeu-HC v. GlyGlyGlyGlyLeu-HC(2x) v.
Hydrocodone.

DETAILED DESCRIPTION
[032] The present invention provides methods for altering controlled
substances in a manner that decreases their potential for abuse. The novel
compounds may be combined in tablets with suitable excipients or formulated in
solution for oral delivery. When delivered by the oral route the controlled substance
is released in a time-dependent manner (sustained release) by acid hydrolysis and/or
enzymatic cleavage. When administered by injection the controlled substance is
released in a time-dependent manner (sustained release) by way of serum enzymes.
[033] Throughout this application the use of "peptide" is meant to include a
single amino acid, a dipeptide, a tripeptide, an oligopeptide, a polypeptide, or the
carrier peptide. Oligopeptide is meant to include from 2 amino acids to 70 amino
acids. Further, at times the invention is described as being an active agent attached
to an amino acid, a dipeptide, a tripeptide, an oligopeptide, or polypeptide to
illustrate specific embodiments for the active agent conjugate. Preferred lengths of
the conjugates and other preferred embodiments are described herein. In another
embodiment the number of amino acids is selected from 1, 2, 3, 4, 5, 6, or 7 amino
acids. In another embodiment of the invention the molecular weight of the carrier
portion of the conjugate is below about 2,500, more preferably below about 1,000
and most preferably below about 500.
Terms defined
[034] Controlled substance - a substance subject to federal regulation of its
manufacture, sale, or distribution because of the potential for, or proved evidence of,
abuse; because of its potential for psychic or physiological dependence; because it
constitutes a public health risk; because of the scientific evidence of its
pharmacologic effect; or because of its role as a precursor of other controlled
substances.

[035] Chemical moiety - a substance made up of chemical elements and
characterized by a defined molecular composition. It can exist as a part of the drug
conjugate and can be separated from the conjugate. Examples include an amino
acid, an oligopeptide or a polypeptide, but may be any number of other substances.
[036] Although the discussion which follows focuses on oral administration
of the controlled substance, it will be appreciated that the compositions and methods
of the present invention are likewise applicable to injectable administration of the
controlled substance.
[037] Covalent attachment of a chemical moiety to a controlled substance
can render the substance pharmacologically inactive and resistant to absorption.
Removal of the chemical moiety by enzymatic or chemical means, however, can
restore the activity and the ability to be absorbed. The acidic conditions of the
stomach and/or the enzymatic activity present in the gastrointestinal tract can
therefore affect release of the active controlled substance. Provided release does not
occur too rapidly, the pharmacologically active agent will be absorbed into the
bloodstream by a time-release mechanism following oral administration.
[038] One aim of the invention is to decrease potential for abuse by
establishing oral extended release via covalent modification. Although this would
theoretically decrease the potential for abuse, ideally it would probably only
decrease the potential by approximately half for oral administration. For example,
equal AUC with a blunted curve (Cmax - 50%) would only decrease the oral abuse
potential by half (i.e. two anti-abuse pills would presumably induce approximately
the same euphoric effect as one control pill). The DEA reports that abuse started
with oral administration ultimately leads to intranasal or intravenous abuse due to
tolerance. Once tolerance is established the rush effect sought requires the intranasal
or intravenous route.
[039] When abused, controlled substances are typically delivered by means
other than the oral route, namely by: i) parenteral injection; ii) intranasal delivery; or
iii) inhalation. Administration by these routes results in rapid absorption into the

bloodstream and the subsequent "rush" effect sought by the addict. It follows that
an opoid conjugate that produces a significantly diminished euphoric effect when
given by IN or IV, as compared in relative terms to its analgesic effect by oral
administration, is valuable in diminishing its potential for abuse. Thus when given
by these routes, the covalently modified compound of the invention (adopted for
breakdown in the stomach or intestinal tract) is: i) not exposed to the necessary
chemical and/or enzymatic conditions necessary for release of the active agent; or ii)
the required activity is not present in sufficient amounts to affect rapid
release/absorption. The covalently modified controlled substance, therefore, does not
produce me euphoric effect sought by addicts.
[040] While other aspects of the invention, eg. sustained release etc.
provide additional benefits to patients a preferred aspect of the invention is the
design of an opoid conjugate product that has a reasonable shelf life (shelf safe)
which can not be abused through current practices. It is a preferred embodiment of
the invention, however, that the opoid conjugate not release the opoid through
chemical action prior to administration.
[041] There are a number of mechanisms by which the potential for abuse
of an analgesic may be decreased, including:
1. Decrease efficiency of the drugs ability to cross the IN barrier.
2. Decrease efficiency of the drugs ability to cross the blood brain
barrier.
note: 1 and 2 are likely correlated.
3. Increase in the half-life of a conjugate once it reaches the CSF
(provided the conjugate is still effective as an analgesic.
note: requires the drug-conjugate reaching the CSF.
4. Decreased conversion of the opoid conjugate to a more active
metaboloite (e.g. codeine to morphine conversion).
In the case of opoids it may not be necessary (or even desirable) to have all drug
release occur in the intestine. If some, or all, of the drug enters as a conjugate it is
still a valuable therapeutic agent provided it can still reach the CSF and has an
analgesic effect. In this regard "extended release" (more accurately extended
analgesia) may be achieved post absorption. This might be accomplished by: 1)
extended serum half-life 2) extended CSF half-life 3) temporal absorption across the

blood brain barrier (provided it is eventually converted to parent drug and does not
have an adverse effect of its own).
[042] The invention may be comprised of any controlled substance
covalently attached to any chemical moiety, such as narcotics. Preferably, the
controlled substance is an analgesic or stimulant. Further, the controlled substance is
preferably of the group of analgesics comprised of the following: codeine, fentanyl,
hydrocodone, hydromorphone, levorphanol, methadone, oxymorphone, morphine,
oxycodone, propoxyphene, and sufentanyl. The controlled substance may also be
amphetamine or methylphenidate. Examples of other controlled drugs include
barbiturates, benzodiazepines, skeletal muscle relaxants e.g. meprobamate, and
stimulants including amphetamine, methamphetamine, methylphenidate, pemoline,
etc.
[043] In a preferred embodiment the invention provides a carrier and active
agent which are bound to each other but otherwise unmodified in structure. This
embodiment may further be described as the carrier having a free carboxy and/or
amine terminal and/or side chain groups other than the location of attachment for the
active agent. In a more preferred embodiment the carrier, whether a single amino
acid, dipeptide, tripeptide, oligopeptide or polypeptide is comprised only naturally
occurring amino acids.
[044] The chemical moiety comprising the invention may be any chemical
substance that can be attached to the controlled substance in a manner that renders it
pharmacologically inactive. Analgesics and stimulants produce their
pharmacological effects through binding to specific receptors or uptake proteins.
The attachment of certain chemical moieties can therefore prevent the active
substance from binding its receptor(s) or recognition site on its uptake protein.
Further, without being bound by theory, the covalent modification is believed to
prevent the pharmacological effect by preventing the drug from crossing the blood-
brain barrier. Preferably, the attachment of the chemical moiety to the controlled
substance will also prevent or substantially delay the absorption of the compound,
particularly when the compound is delivered by routes other than oral
administration.

[045] Preferably, the attached chemical moiety is an amino acid or more
preferably an oligopeptide. The oligopeptide preferably comprises less than 50
amino acids and more preferably less than 6 amino acids. The oligopeptide may
comprise (i) a homopolymer of one of the twenty naturally occurring amino acids,
(ii) a heteropolymer of two or more naturally occurring amino acids, (iii) a
homopolymer of synthetic amino acids or (iv) a heteropolymer of two or more
synthetic amino acids or (v) a heteropolymer of one or more naturally occurring
amino acids and one or more synthetic amino acids.
[046] The attached chemical moiety may be comprised of other naturally
occurring or synthetic substances. Controlled substances, for example, could also be
attached to lipids, carbohydrates, nucleic acids, or vitamins. These chemical
moieties could be expected to serve the same functions as a polypeptide; namely,
effect delayed release in the gastrointestinal tract and prevent rapid absorption of the
active agent.
[047] In one embodiment, the covalently attached chemical moiety is
removed by the acidic content of the stomach if the controlled substance is attached
through an acid labile bond. More preferably, the covalently attached chemical
moiety can be removed by enzymatic activity encountered by the compound in the
stomach and/or intestinal tract. The stomach and intestinal tract are bathed in
degradative enzymes. For example, the pancreas releases into the small intestine a
myriad of hydrolytic enzymes such as proteases, lipases, and amylases, and
nucleases. Additionally, the intestinal epithelial cells that line the surface of the GI
tract produce various surface associated and intracellular degradative enzymes (e.g.
brush border peptidases, esterases). These enzymes degrade proteins, lipids,
carbohydrates, and nucleic acids contained in ingested food. Thus, it can be expected
that the controlled substance will be released from the attached chemical moiety
when the appropriate enzyme(s) is encountered in the gastrointestinal tract.
[048] In another embodiment of the invention, the chemical moiety is
attached to the controlled substance in a manner in which it is not readily released by
conditions found in the mouth (saliva), the intranasal cavity, the surface of the lungs,
or in the serum. Extreme acid conditions encountered in the stomach are not present

elsewhere in humans. Therefore, any acid dependent release mechanism will occur
only after oral administration. Although, degradative enzymes are present in the
aforementioned environments, they are not generally present in the high
concentrations found in the intestinal tract. Thus, release of the controlled substance
by enzymatic cleavage will not occur rapidly when the novel compounds are
administered by routes other than oral delivery.
[049] In another embodiment of the invention, the analgesic (e.g.
oxycodone or hydrocodone) is attached to a polymer of serine (or other amino acid
containing a hydroxyl side chain e.g. threonine, tyrosine) via side chain hydroxyl
groups. Alternatively, attachment is to a polymer of glutamic acid through the
carboxyl group of the delta carbon of glutamic acid. The resulting ester (carbonate)
linkages can be hydrolysed by lipases (esterases) encountered in the small intestine.
Esterases are not present at high levels in saliva or on the mucosal surfaces of the
nasal cavity, lungs, or oral cavity. Thus, controlled substances attached to
polyglutamic acid by this method would not be rapidly released by saliva or when
delivered intranasally or by inhalation.
[050] In another embodiment of the invention, the analgesic is attached to
an oligopeptide, preferably consisting of between one and five amino acids. In a
further embodiment of the invention the amino acids are a heterogenous mixture of
the twenty naturally occurring amino acids. Hydrophilic amino acids will tend to
prevent passive absorption of the analgesic peptide conjugate through nasal
membranes. Thus it is a preferred embodiment of the invention that hydrophilic
amino acids be included in the oligopeptide. It is a further preferred embodiment of
the invention that lipophilic amino acids be attached closer to the analgesic for
optimum stability. Both lipophilic and hydrophilic properties (i.e., amphiphilic) can
be satisfied with between three and five amino acids. Thus it is a more preferred
embodiment of the invention that the oligopeptide that is attached to the analgesic be
an amphiphilic tripeptide.
[051] Preferred amphiphilic amino acids/oligopeptides may be selected
from (i) hydrophobic amino acids, preferably in positions next to the active agent to
provide increased stability; (ii) amino acid sequences designed to be cleaved by

intestinal enzymes (e.g. pepsin, trypsin, chymotrypsin, elastase, carboxypeptidases
A and B, etc.) provide for increased bioavailability; (iii) peptides longer than three
amino acids for increased stability, increased anti-abuse e.g. less membrane
permeability, and potentially more efficient intestinal digestion e.g. major intestinal
enzymes target proteins and polypeptides, (iv) or mixtures thereof. In one preferred
embodiment the carrier portion of the conjugate is designed for intestinal cleavage.
[052] In a preferred embodiment the cleavage specificity is directed to
pepsin and/or chymotrypsin. Examples of preferred carriers include XXXAA or
XXAAA, where X is selected from any amino acid, except Arg, Lys, His, Pro, and
Met and A is selected from Tyr, Phe, Trp, or Leu. Examples of more preferred
carriers are selected from XXXPheLeu wherein X is Glu; XXXPheLeu wherein X is
Gly; XXPheLeuLeu wherein X is Glu; and XXPheLeuLeu wherein X is Gly.
[053] In another embodiment the cleavage specificity is directed to trypsin.
Examples of preferred carriers include XXXAA or XXAAA wherein X is any amino
acid except Pro and Cys and A is Arg or Lys. Examples of more preferred carriers
are selected from XXXArgLeu wherein X is Glu; XXXArgLeu wherein X is Gly;
XXArgLeuLeu wherein X is Gly; XXXArgLeuLeu wherein X is Gly.
[054] The present invention provides covalent attachment of active agents
to a peptide. The invention may be distinguished from the above mentioned
technologies by virtue of covalently attaching the active agent directly, which
includes, for example, pharmaceutical drugs and nutrients, to the N-terminus, the C-
terminus or to the side chain of an amino acid, an oligopeptide or a polypeptide, also
referred to herein as a carrier peptide.
[055] In another embodiment, the invention provides a composition
comprising a peptide and an active agent covalently attached to the peptide.
Preferably, the peptide is (i) an oligopeptide, (ii) a homopolymer of one of the
twenty naturally occurring amino acids (L or D isomers), or an isomer, analogue, or
derivative thereof, (iii) a heteropolymer of two or more naturally occurring amino
acids (L or D isomers), or an isomer, analogue, or derivative thereof, (iv) a
homopolymer of a synthetic amino acid, (v) a heteropolymer of two or more

synthetic amino acids or (vi) a heteropolymer of one or more naturally occurring
amino acids and one or more synthetic amino acids.
[056] The invention provides compositions comprising a carrier peptide
and an active agent covalently attached to the carrier peptide. Preferably, the carrier
peptide is (i) an amino acid, (ii) a dipeptide, (iii) a tripeptide, (iv) an oligopeptide, or
(v) polypeptide. The carrier peptide may also be (i) a homopolymer of a naturally
occurring amino acids, (ii) a heteropolymer of two or more naturally occurring
amino acids, (iii) a homopolymer of a synthetic amino acid, (iv) a heteropolymer of
two or more synthetic amino acids, or (v) a heteropolymer of one or more naturally
occurring amino acids and one or more synthetic amino acids.
[057] In another embodiment, the invention further provides a composition
comprising a single amino acid, a dipeptide or a tripeptide with an active agent
covalently attached. Preferably, the amino acid, dipeptide or tripeptide are (i) one of
the twenty naturally occurring amino acids (L or D isomers), or an isomer, analogue,
or derivative thereof, (ii) two or more naturally occurring amino acids (L or D
isomers), or an isomer, analogue, or derivative thereof, (iii) a synthetic amino acid,
(iv) two or more synthetic amino acids or (v) one or more naturally occurring amino
acids and one or more synthetic amino acids. In another embodiment the amino
acids are selected from L-amino acids for digestion by proteases.
[058] In another embodiment, the peptide carrier can be prepared using
conventional techniques. A preferred technique is copolymerization of mixtures of
amino acid N-carboxyanhydrides. In another embodiment, the peptide can be
prepared through a fermentation process of recombinant microorganisms followed
by harvesting and purification of the appropriate peptide. Alternatively, if a specific
sequence of amino acids is desired, an automated peptide synthesizer can be used to
produce a peptide with specific physicochemical properties for specific performance
characteristics.
[059] In another embodiment, direct attachment of an active agent to the
carrier peptide may not form a stable compound therefore the incorporation of a
linker between the active agent and the peptide is required. The linker should have a

functional pendant group, such as a carboxylate, an alcohol, thiol, oxime, hydraxone,
hydrazide, or an amine group, to covalently attach to the carrier peptide.
[060] In another embodiment, the invention also provides a method for
delivering an active agent to a patient, the patient being a human or a non-human
animal, comprising administering to the patient a composition comprising a peptide
and an active agent covalently attached to the peptide. In a preferred embodiment,
the active agent is released from the composition by enzyme catalysis. In another
preferred embodiment, the active agent is released in a time-dependent manner
based on the pharmacokinetics of the enzyme-catalyzed release.
[061] In another preferred embodiment, the active agent conjugates can
incorporate adjuvants such that the compositions are designed to interact with
specific receptors so that targeted delivery may be achieved. These compositions
provide targeted delivery in all regions of the gut and at specific sites along the
intestinal wall. In another preferred embodiment, the active agent is released as the
reference active agent from the peptide conjugate prior to entry into a target cell. In
another preferred embodiment, the specific amino acid sequences used are not
targeted to specific cell receptors or designed for recognition by a specific genetic
sequence. In a more preferred embodiment, the peptide carrier is designed for
recognition and/or is not recognized by tumor promoting cells.
[062] In another preferred embodiment, the active agent delivery system
does not require that the active agent be released within a specific cell or
intracellularly. In a preferred embodiment the carrier and/or the conjugate do result
is specific recognition in the body. (e.g. by a cancer cell, by primers, for improving
chemotactic activity, by sequence for a specific binding cite for serum proteins(e.g.
kinins or eicosanoids).
[063] In another embodiment the active agent may be attached to an
adjuvant recognized and taken up by an active transporter. In a more preferred
example the active transporter is not the bile acid active transporter. In another
embodiment, the present invention does not require the attachment of the active
agent to an adjuvant recognized and taken up by an active transporter for delivery.

[064] In a preferred embodiments the active agent conjugate is not bound to
an immobilized carrier, rather it is designed for transport and transition through the
digestive system.
[065] While microsphere/capsules may be used in combination with the
compositions of the invention, the compositions are preferably not incorporated with
microspheres/capsules and do not require further additives to improve sustained
release.
[066] In a preferred embodiment the active agent is not a hormone,
glutamine, methotrexate, daunorubicin, a trypsin-kallikrein inhibitor, insulin,
calmodulin, calcitonin, L-dopa, interleukins, gonadoliberin, norethindrone, tolmetin,
valacyclovir, taxol, or silver sulfadiazine. In a preferred embodiment wherein the
active agent is a peptidic active agent it is preferred the active agent is unmodified
(e.g. the amino acid structure is not substituted).
[067] In a preferred embodiment the invention provides a carrier and active
agent which are bound to each other but otherwise unmodified in structure. In a
more preferred embodiment the carrier, whether a single amino acid, dipeptide,
tripeptide, oligopeptide or polypeptide is comprises only naturally occurring amino
acids.
[068] In a preferred embodiment the carrier is not a protein transporter (e.g.
histone, insulin, transferrin, IGF, albumin or prolactin), Ala, Gly, Phe-Gly, or Phe-
Phe. In a preferred embodiment the carrier is also preferably not a amino acid
copolymerized with a non-amino acid substitute such as PVP, a poly(alkylene oxide)
amino acid copolymer, or an alkyloxycarbonyl (polyaspartate/polyglutamate) or an
aryloxycarbonylmethyl (polyaspartate/polyglutamate).
[069] In a preferred embodiment neither the carrier or the conjugate are
used for assay purification, binding studies or enzyme analysis.
[070] In another embodiment, the carrier peptide allows for multiple active
agents to be attached. The conjugates provide the added benefit of allowing
multiple attachments not only of active agents, but of active agents in combination
with other active agents, or other modified molecules which can further modify
delivery, enhance release, targeted delivery, and/or enhance adsorption. In a further

embodiment, the conjugates may also be combined with adjuvants or be
microencapsulated.
[071] In another preferred embodiment, the composition of the invention is
in the form of an ingestible tablet or capsule, an intravenous preparation, an
intramuscular preparation, a subcutaneous preparation, a depot implant, a
transdermal preparation, an oral suspension, a sublingual preparation, an intranasal
preparation, inhalers, or anal suppositories. In another embodiment, the peptide is
capable of releasing the active agent from the composition in a pH-dependent
manner. In another preferred embodiment the active agent is prepared and/or
administered through means other than implantation and/or injectables.
[072] Embodiments of the present invention preferably are not bound to an
adjuvant recognized and/or taken up by active transporters. Preferably, the active
agent conjugates of the present invention are not attached to active transporters, or
antigenic agents such as receptor recognizing sequences found on cells and tumors.
Preferably, the active agent conjugate of the present invention is not connected to or
constitutes an implantable polymer, which would not biodegrade in less than 48
hours, preferably between 12 and 24 hours. The active agent conjugates of the
present invention are preferably designed to release the active agent into the blood,
after absorption from the gut, as the reference active agent.
[073] One embodiment of the invention relates to long acting narcotic
drugs having significantly reduced abuse potential. The active agent is covalently
bound to a peptide/oligopeptide or amino acid, which renders the active agent
pharmaceutically inactive until released. Preferably the release mechanism is
enzymatic action. Following oral administration the intestinal enzymes release the
drug. The enzymatic and/or chemical conditions necessary for the release of the
controlled substances is either not present or is minimally active when the drug-
peptide conjugate is introduced by inhalation or injection. Thus it is expected that
no euphoric effect will occur when the drug-peptide conjugate is inhaled or injected.
Further, extending the release of the narcotic prevents spiking of drug levels which
provide the desired analgesic effect with a lower or absent euphoria. Controlled
substances with these novel properties are less likely to be abused due to the

diminished "rush" effect of the modified controlled substance. Consequently,
decreasing euphoria while increasing the duration of the analgesic effect enhances
and reducing the likelihood of abuse increases the therapeutic value of these
pharmaceuticals. The invention also provides for reproducible methods for
compositions which are abuse-free for controlled substances, stable under a variety
of chemical conditions, reduced euphoric effect and extended absorption into the
bloodstream.
[074] The following examples are given by way of illustration and in no
way should be construed as limiting as to the full scope of the invention.
EXAMPLES
Example 1; Naltrexone
[075] Naltrexone, an opoid antagonist, was chosen as a model compound
for testing conjugates for the hypothesis that conjugates of opoid drugs can afford
extended release, while also lowering the potential for abuse. Naltrexone is
chemically similar to orally delivered analgesics such as oxycodone and
hydromorphone and therefore amenable to synthesizing conjugates for testing in
vitro and in vivo performance.
Synthesis
[076] Polyserine-naltrexone (carbonate-linked) conjugates were
synthesized by the following method:
1) Polymer activation. N-acetylated polyserine-methyl ester (0.69 g, 7.9 mmol) was
dissolved in N-methylpyrolidinone (15 ml) and allowed to stir under argon at
ambient temperature. Carbonyldiimmidazole (CDI, 1.93g, 11.9mmol) was added
and the reaction allowed to stir over night under argon. Then, 100 ml of acetonitrile
were added and the mixture allowed to sit at 4 °C for 2 hours. The precipitate that
formed was collected by centrifugation and the resulting pellet then resuspended in
acetonitrile. This suspension was then centrifuged and the pellet dried over night
under a vacuum.

2) Tetrabutvlammonium salt of naltrexone. Naltrexone hydrochloride (1.5g,
3.979mmol) was dissolved in water (~50ml) and this solution titrated with IN LiOH
to a pH of -11-12. Tetrabutylammonium chloride (2.6g, 4.0mmol) was then added.
The aqueous solution was then extracted with 3 equal volumes of chloroform (20ml
each). The organic solutions were pooled and dried with magnesium sulfate. The
solvent was then removed using a rotovap, and the resulting solid dried over night
under a high vacuum.
3) Conjugation reaction. The solid material from step 1 was dissolved/suspended in
15 ml of N-methylpyrrolidinone and the resulting solution placed under argon. The
naltrexone salt from step 2 was then added, and the reaction then allowed to warm to
-50-60 °C. The reaction was then allowed to stir two days under these conditions, at
which point water was added (-200 ml). The aqueous solution was then
concentrated by ultrafiltration (1000 mw cutoff). The concentrated solution (-5 ml)
was then diluted to a volume of 50 ml with water. The aqueous solution was then
titrated to pH 3 with IN HC1 and then concentrated by ultrafiltration. This process
was repeated two more times. Following the final concentration, the aqueous
solution (~5ml) was then freed of solvent using a rotovap and high vacuum. The
resulting solid was then stored over night under high vacuum. This afforded 50 mg
of brown solid. A serine:naltrexone ratio of approximately 1:6 (BB272) and 1:10
(BB301) was estimated by nuclear magnetic resonance (NMR). A schematic of
synthesis is shown in Fig. 1.
Example 2: In vivo performance of polyserine-naltrexone conjugate (rat model)
[077] Polyserine-naltrexone conjugates were tested in Sprague-dawley rats
(~ 250 g). Defined doses were delivered orally in gelatin capsules containing
purified dry powder polyserine-naltrexone conjugates or naltrexone. No excipients
were added to the capsules.
[078] Content of naltrexone in the polyserine-naltrexone conjugate BB272
was estimated to be 30% as based on the 1:6 ratio of naltrexone:serine determined

by NMR. Polyserine-naltrexone conjugate was given to four rats at a dose of 12 mg
which contained 3.6 mg of naltrexone. Doses of naltrexone (3.6 mg) equivalent to
the naltrexone content of the conjugate were also given to four rats. Capsules were
delivered orally to rats at time-zero using a capsule dosing syringe. Serum was
collected from rats 2, 4, 6, 9, and 12 hours after capsule delivery. Serum naltrexone
concentrations were determined by ELISA using a commercially available kit
(Nalbuphine, product #102819, Neogen Corporation, Lansing MI).

[079] Serum levels of individual animals are shown in Table 1. Mean
serum levels are shown in Table 3. (Example 2). As shown in Fig. 2, serum levels
spiked earlier for naltrexone (2 hours) than for the drug administered as a
polyserine-naltrexone conjugate (4 hours). Serum levels of naltrexone for the
polyserine-naltrexone conjugate remained elevated considerably longer than for
naltrexone. Additionally, the peak level was significantly lower for the polyserine-
naltrexone conjugate. It should be noted that the 2 hour time point was the first
measurement of naltrexone serum levels. Since this was the peak level measured for
naltexone it can not be determined whether or not levels peaked at a higher
concentration earlier. Consequently, it was not possible to accurately determine the
Cmax or area under serum concentration curve (AUC) for naltrexone in this
experiment.

Example 3: In vivo performance of polyserine-naltrexone conjugate
[080] Polyserine-naltrexone conjugates were tested in Sprague-dawley rats
(~ 250 g). Defined doses were delivered orally in gelatin capsules containing
purified dry powder polyserine-naltrexone conjugates or naltrexone. No excipients
were added to the capsules.
[081] Content of naltrexone in the polyserine-naltrexone conjugate BB272
was estimated to be 30% as based on the 1:6 ratio of naltrexone:serine determined
by NMR. Polyserine-naltrexone conjugate was given to five rats at a dose of 12.9
mg which contained 3.6 mg of naltrexone. Doses equivalent to the naltrexone
contained in the batch of polyserine-naltrexone (BB 301) were also given to five
rats. Additionally, half the equivalent dose (1.8 mg) was given at time-zero,
followed by a second half-dose at 6.5 hours to five rats.
[082] Capsules were delivered orally to rats at time-zero using a capsule
delivery syringe. Serum was collected at 0.5, 1.5, 3, 5, 8, 12, 15 and 24 hours after
capsule delivery for the polyserine-naltrexone (BB301) and equivalent naltrexone
dosed rats. Serum was collected at 0.5, 1.5, 3, 5, 8, 11.5, 14.5 and 24 hours after
capsule delivery for rats dosed with half-equivalent doses at 0 and 6.5 hours. Serum
naltrexone concentrations were determined by ELISA using a commercially
available kit (Nalbuphine, product #102819, Neogen Corporation, Lansing MI).


[083] Serum levels of individual animals are shown in Table 2. Mean
serum levels are shown in Table 3. As shown in Fig. 3, naltrexone serum levels
spiked earlier (0.5 hours) for naltrexone than for the drug administed as a
polyserine-naltexone conjugate (5 hours). Serum levels of naltrexone for the
polyserine-naltrexone conjugate remained elevated considerably longer (> 12 hours)
than for the monomelic naltrexone control ( crossed at approximately 7 hours. Additionally, the mean of the peak level
concentration (Cmax) was significantly lower for the conjugated naltrexone (Table 4).

Further, the mean time to peak concentration (Tmax) was significantly longer for the
polyserine-naltrexone conjugate (Table 4). The mean AUC of the polyserine-
naltrexone conjugate was approximately 75% of the naltrexone mean AUC (Table
4). Statistically the mean AUCs were not significantly different (P levels of rats fed one-half-dose (1.8 mg) at time zero and at 6.5 hours were
compared to those of rats fed polyserine-naltrexone conjugate. Concentration levels
remained elevated for the conjugate past those for the second naltrexone dose, with
the curves crossing at approximately 2.5 hours and again at approximately 11 hours
(double cross-over of the serum concentration curves).

Example 4; Synthesis of an Analog of Hydrocodone
[084] A synthesized analog of hydrocodone, the compound, 6-0-
ethoxycarbonyl hydrocodone (EtOCOhydrocodone), was prepared by reaction of the
enolate of hydrocodone with ethylchloroformate. The hydrocodone portion was not
released under a wide range of pH's and temperatures. EtOCOhydrocodone was
studied in a rat model and its pharmacokinetics was nearly identical to that of the
reference drug (Figure 4). Ethoxycarbonylhydrocodone's AUC is 90% of
hydrocodone's AUC. EtOCOhydrocodone meets the criteria for an abuse-free
narcotic (i.e., stability and in vivo release) when injected.
[085] Further, the C-terminus of glutamic acid, leucine, proline, lysine,
serine and glycine where attached to the 6-0 position of hydrocodone and the C-
terminus of glutamic acid to the 6-0 position of oxycodone. Figure 5 shows a
general scheme for how amino acid/narcotic conjugates are synthesized using
oxycodone and hydrocodone as examples. The anion of oxycodone (or
hydrocodone) was reacted with the protected N-hydroxysuccinimide ester (OSu) of
the respective amino acid, which is fully deprotected in HCl/dioxane to yield the

final product. For example, the enolate of oxycodone is reacted with
BocGlu(OtBu)OSu to yield 6-0-BocGlu(OtBu)-oxycodone, which when
deprotected gives 6-0,a -glutamyloxycodone. This oxycodone derivative showed
similar pharmacokinetics and had 20% greater AUC relative to the parent drug in a
rat model. (Figure 6).

Boc-Ser(CO-Methyl Naltrexone)-OtBu
[086] To a solution of methyl naltrexone (1.00g, 2.82 mmol) in THF at -
78°C was added LiN(SiMe3)2 (1.0M in THF, 5.92 mmol) dropwise via syringe.
This solution was stirred at -78°C for 1 hour. In a separate reaction, Boc-Ser-OtBu
(0.220g, 0.84mmol) was dissolved in THF (5 ml) with NMM (0.10 ml, 0.92 mmol)
and triphosgene (0.250 g, 0.84 mmol) added. This solution was stirred at -78°C for
30 minutes. The first reaction was added slowly to the second at -78°C. The
combined reaction was allowed to warm to ambient temperature and stirred for 18
hours. After this, water (10 ml) was added. Solvent was removed and residue was
partitioned between CHCls/water (50 ml each) and was extracted twice with CHCI3
(50 ml). Combined organics were washed with brine(50 ml), pH 8 water(50 ml),

dried with MgS04 and solvent removed. A preparative TLC was taken (100%
CHC13). NMR of TLC material confirmed the presence of product.
[087] The results of examples 1 through 3 show that conjugation of
naltrexone to a polymer of serine via a carbonate linkage can prevent spiking of the
drug (decrease Cmax) and afford sustained release (increase Tmax while maintaining
approximately equal AUC). Further, example 4 shows that carbonate linked
compounds are substantially resistant to release of naltrexone by exposure to acid,
base and protease. Other opoid conjugates can be synthesized in a similar manner to
obtain similar characteristics. Example 5 provides an additional memod of synthesis
by which opoid carbonate conjugates can be synthesized. In particular, this method
allows for conjugation to oxycodone via a carbonate linkage.
Example 6: Synthetic Protocol for Amino Acid Conjugate of (S)-amphetamine
[088] Synthesis of Protected Conjugate, Example = BOC-Glu(OtBu)-
SAMP The starting material for all these syntheses is dextroamphetamine sulfate
which was obtained from Sigma/Aldrich. Since the relative configuration denoted
by the term "dextro" may not be relevant to the conjugates, the material is referred
to here as the (S)-isomer. This absolute configuration does not change during the
reaction sequences.
[089] To a solution of S-amphetamine sulfate (750 mg, 4.07 mmol) in 5 mL
of anhydrous DMF stirring at room temperature in an oven-dried 50 mL flask under
an Ar atmosphere was added 2.11 mL of diisopropylethylamine (DIPEA, 12.21
mmol). After 5 minutes, BOC-Glu(OtBu)-OSu (1.709 g, 4.07 mmol) in 10 mL of
anhydrous EtOAc was added and the mixture was allowed to stir at room
temperature overnight. The tic (9/1 CHCl3/MeOH) indicates that the amphetamine
starting material is gone since the UV-active spot on the baseline is no longer
present.


[090] The reaction mixture was poured into 30 mL of EtOAc and washed
with 2 X 50 mL of dilute HC1 in water (pH 3) and 50 mL of saturated NaCl. After
drying over MgSO4, the solution was filtered and the solvent reduced by rotary
evaporation. The residue was taken up in a minimum amount of methylene chloride
and run through a silica flash column eluting with 50/1 CH2Cl2/MeOH (adding
progressively more MeOH) to 30/1 CH2Cl2/MeOH. The fast running product was
easily separated from the more polar components. After rotary evaporation of the
solvent and drying overnight by high vacuum, the purified product (1.625 g, 95%)
was ready for the next reaction. The NMR in CDCI3 was consistent with the
structure.
[091] Synthesis of Deprotected Conjugate, Example = Glu-SAMP-HCl
[092] A mixture of BOC-Glu(OtBu)-SAMP (1.36 g, 3.23 mmol) and 10
mL of 4M HC1 in dioxane was stirred at room temperature in an oven-dried flask
under an Ar atmosphere overnight. At this time, the fast-moving protected
intermediate was no longer visible on tic. The solvent was removed by rotary
evaporation and the material was dried under high vacuum leaving 886 mg (91%) of
the HC1 salt. The nmr (dmso-d6) was consistent with the product.


[093] Data from Rat Pharmakinetic Experiments Comparing Amphetamine
with Peptide Conjugates
[094] Experiments involved male Sprague-Dawley rats (weight 250-300g)
dosed at time zero by oral gavage with a solution of d-amphetamine sulfate
(amphetamine) or an equimolar solution of one of the peptide conjugates. Serum
samples were obtained by eye bleeds and concentrations determined by ELISA
assays. (Figures 7 and 8).
Example 7: In Vivo Performance Of Amphetamine Conjugates
[095] Pharmacokinetcis by Oral Administration
Peptide-amphetamine conjugates and an equivalent amount of parent
amphetamine contained in the conjugate were orally administered separately to male
Sprague-Dawley rats (-250 g). Drugs were delivered as oral solutions in water. The
amphetamine content of each conjugate was determined by NMR analysis. Serum
levels of amphetamine were analyzed by ELISA (Neogene, Lexington, KY,
Amphetamine kit. 109319).
[096] GluGlu-amphetamine and Phe-amphetamine had nearly equal Cmax
and AUC to those of the parent drug (Table 5). The serum concentration curves are
shown in Fig. 8. No change in the shape of the curve was observed for the
amphetamine conjugates.


Example 8: In Vivo Performance Of Narcotics Conjugates
Pharmacokinetics by Oral Administration
[097] Peptide-narcotic conjugates and an equivalent amount of parent
narcotic (hydrocodone or oxycodone) contained in the conjugate were orally
administered separately to male Sprague-Dawley rats (-250 g). Drugs were
delivered as oral solutions in water or phosphate buffered saline or as solids in
gelatin capsules. The narcotic content of each conjugate was determined by HPLC
analysis. Serum levels of hydrocodone and oxycodone were analyzed by ELISA
(Neogene, Lexington, KY, Oxymorphone/Oxycodone kit. 102919 and
Hydromorphone/Hydrocodone kit. 106610-1).



include 13 peptide conjugates, 2 monosaccharide conjugates, and 2 lipid conjugates.
Eleven of the nine peptide conjugates had 60% or greater bioavailability based on
AUC. Examples, which when compared to an equivalent dose of the parent drug,
include: Glu-Oxycodone which was 121% bioavailable (Fig. 6); GlyGlyLeu-
Hydrocodone which was 82% bioavailable (Fig. 9), and GluGluGlu-HC which was
117% bioavailable (Fig. 10). The Ribose-HC conjugate had 106% when compared
to an equivalent dose of the parent drug (Fig 11).
Oral Kinetics
[099] A sustained release profile was observed with one of the amino acid
conjugates Glu-Oxycodone (Fig. 6). The compound showed a blunted curve
(decrease in Cmax) combined with a 2- fold increase in time to peak concentration
(Tmax) and approximately equivalent AUC. Glu-Oxycodone, however, is not
sufficiently stable to warrant consideration as an anti-abuse product. No other
narcotics compounds tested to date showed sustained release kinetics with equal
AUC. One other compound, protected Glu-Leu-HC, showed an increase in Tmax
without equal AUC.
Pharmacokinetcis by Intranasal Administration
Table 7. In Vivo Performance of Opoid Conjugates Administered Intranasally


Intranasal Bioavailability
[0100] Intranasal (IN) studies are summarized in Table 7. All peptide
conjugates tested thus far had decreased absorption by the intranasal route.
Preliminary data suggests that inhibition of absorption is correlated with 1) length of
peptide, 2) polarity, and 3) charge. GluGlu-HC and GluGluGlu-HC were inhibited
more than Glu-HC. A relatively lipophilic tripeptide GlyGlyLeu was not inhibited as
much as the more polar tripeptide GluGluGlu-HC. GlupyroGlu-HC was absorbed
more rapidly that GluGlu-HC, which has a greater net (negative) charge (Fig. 12).

[0101] The IN absorption of Ribose-HC (Fig. 13) was significantly inhibited
(approximately 80%). This particular compound still contained small amounts of
free hydrocodone; therefore, inhibition of absorption may have been essentially
complete.
[0102] The IN model was used to test the absorption of EEE-HC in water
and in saline (PBS, pH 7.4). The inhibition of IN absorption was more significantly
inhibited in PBS than in water. Therefore other compounds should be tested in the
IN model in water and perhaps other buffers.
Example 9: Stability of Narcotic Conjugates
[0103] It is also possible to further stabilize any unstable conjugates by
tethering to a larger peptide. To illustrate this point, the synthetic precursors, 6-0-
BocGlu(OtBu)hydrocodone and 6-0-BocLys(NHBoc)-hydrocodone, which are
completely stable in water at room temperature and under heated conditions as
shown in Table 8 and Table 9. The conjugates are also stable at a wide range of





[0105] The protected amino acid-hydrocodone compounds were tested in a
typical rat model. Biphasic absorption of hydrocodone in rat sera fed 6-0-
BocGlu(OtBu)-hydrocodone and 6-0-BocLys(NHBoc)hydrocodone was observed
(Figure 14). The AUC's for both amino acid/hydrocodone conjugates are 75% of
hydrocodone's AUC.
[0106] The stability of the amino acid/narcotic conjugates can be increased
by tethering it to a larger peptide via the nitrogen on the amino acid residue. This
will also extend the absorption of the orally administered drug. For instance, the
dipeptides added to hydrocodone include GluGlu, LeuGlu, AlaPro, GluPro and
GluLeu.
Example 10: Preparation of Ala-Pro-Hydrocodone


Ala-Pro-Hydrocodone
[0107] To a solution of Pro-Hydrocodone in DMF was added NMM
followed by Boc-Ala-OSu. The solution was stirred at ambient temperatures for
18hours. Solvent was removed. Crude material was purified using preparative
HPLC (Phenomenex Luna C18, 30X250mm, 5uM, 100A; Gradient: 100 water/0
0.1% TFA-MeCN → 0/100; 30ml/min.). Solid was collected as a slightly yellow
powder (0.307g, 85% yield): 1H NMR (DMSO-d6) δ 1.16 (d, 3H), 1.35 (s, 9H), 1.51
(m, 2H), 1.86-2.10 (m, 6H), 2.50 (m, 1H), 2.54 (m, 1H), 2.69 (m, 1H), 2.88 (s, 3H),
3.02 (dd, 1H), 3.26 (d, 1H), 3.55 (m, 1H), 3.67 (m, 1H), 3.72 (s, 3H), 3.80 (s, 1H),
4.25 (m, 1H), 4.43 (d, 1H), 5.01 (s, 1H), 5.59 (d, 1H), 6.75 (d, 1H), 6.88 (d, 1H),
6.99 (t, 1H), 9.91 (br s, 1H).
[0108] To the Boc-Ala-Pro-Hydrocodone (0.100g) was added 10ml of 4N
HC1 in dioxane. The resulting mixture was stirred at ambient temperatures for 18
hours. Solvent was removed and final product dried under vacuum. Solid was
collected as a slightly yellow solid (0.56g, 71% yield): 1H NMR (DMSO-d6) δ 1.38
(s, 3H), 1.48 (t, 1H), 1.80-2.29 (m, 8H), 2.65 (m, 1H), 2.80 (s, 3H), 2.96 (m, 3H),
3.23 (m, 2H), 3.76 (s, 3H), 3.92 (s,lH), 4.22 (s, 1H), 4.53 (s, 1H), 5.00 (s, 1H), 5.84
(d, 1H), 6.77 (d, 1H), 6.86 (d, 1H), 8.25 (br s, 3H).
Example 11; Preparation of Glv-Glv-Glv-Gly-Leu-Hvdrocodone


Gly-Gly-Gly-Gly-Leu-Hydrocodone
[0109] To a solution of Gly-Gly-Leu-Hydrocodone in DMF was added
NMM followed by Boc-Gly-Gly-OSu. The solution was stirred at ambient
temperatures for 18hours. Solvent was removed. Crude material was purified using
preparative HPLC (Phenomenex Luna C18, 30X250mm, 5µM, 100A; Gradient: 85
water/15 0.1% TFA-MeCN → 50/50; 30ml/min.). Solid was collected as a slightly
yellow powder (0.304g, 37% yield).
[0110] To the Boc-Gly-Gly-Gly-Gly-Leu-Hydrocodone (0.304g) was added
25ml of 4N HC1 in dioxane. The resulting mixture was stirred at ambient
temperatures for 18 hours. Solvent was removed and final product dried under
vacuum. Solid was collected as a slightly yellow solid (0.247g, 97% yield): *H
NMR (DMSO-dg) 8 0.87 (m, 6H), 1.23 (s, 1H), 1.51-1.86 (m, 4H), 2.18 (m, 1H),
2.71 (m, 2H), 2.77 (s, 3H), 2.96 (m, 2H), 3.17 (m, 2H), 3.61 (s, 3H), 3.81-3.84 (m,
10H), 4.22 (m, 1H), 4.36 (m, 1H), 5.09 (m, 1H), 5.59 (d, 1H), 6.74 (dd, 2H), 8.16 (br
s, 4H), 8.38 (br s, 1H), 8.74 (br s, 1H), 11.42 (br s, 1H).
Example 12: Preparation of GIv-Gly-Leu-Hvdrocodone

Gly-Gly-Leu-Hydrocodone
[0111] To a solution of Leu-Hydrocodone in DMF was added NMM
followed by Boc-Gly-Gly-OSu. The solution was stirred at ambient temperatures
for 18hours. Solvent was removed. Crude material was purified using preparative
HPLC (Phenomenex Luna C18, 30X250mm, 5uM, 100A; Gradient: 90 water/10

0.1% TFA-MeCN → 0/100; 30ml/min.). Solid was collected as a slightly yellow
powder (2.08g, 73% yield): 1H NMR (DMSO-d6) δ 0.88 (dd, 6H), 1.38 (s, 9H),
1.53-1.72 (m, 5H), 1.89 (d, 1H), 2.15 (m, 1H), 2.67 (m, 2H), 2.94 (s, 3H), 3.05 (m,
2H), 3.25 (m, 2H), 3.56 (d, 3H), 3.76 (s, 6H), 3.98 (s, 1H), 4.35 (q, 1H), 5.04 (s,
1H), 5.59 (d, 1H), 6.77 (d, 1H), 6.85 (d, 1H), 7.04 (t, 1H), 8.01 (t, 1H), 8.30 (d, 1H),
9.99 (brs, 1H).
[0112] To the Boc-Gly-Gly-Leu-Hydrocodone (2.08g) was added 50ml of
4N HC1 in dioxane. The resulting mixture was stirred at ambient temperatures for
18 hours. Solvent was removed and final product dried under vacuum. Solid was
collected as a slightly yellow solid (1.72g, 86% yield): 'H NMR (DMSO-d^) 5 0.89
(dd, 6H), 1.50-1.87 (m, 5H), 2.26 (m, 2H), 2.66 (m, 2H), 2.82-2.97 (m, 5H), 3.21
(m, 2H), 3.60 (m, 4H), 3.88 (m, 5H), 4.37 (m, 1H), 5.04 (s, 1H), 5.60 (s, 1H), 6.79
(d, 2H), 8.07 (br s, 3H), 8.54 (br s, 1H), 8.66 (br s, 1H), 11.29 (br s, 1H).
Example 13: Preparation of Leu-Hydrocodone

Leu-Hydrocodone
[100] To a solution of hydrocodone in THF was added LiN(TMS)2 in THF
via syringe. The solution was stirred at ambient temperatures for 5 minutes then
Boc-Leu-OSu was added. The resulting reaction mixture was stirred at ambient
temperatures for 18 hours. Reaction was neutralized to pH 7 with 6M HC1. Solvent
was removed. Crude material was taken up in CHCl3 (100ml), washed with sat.

NaHCO3 (3X100ml), dried over MgSO4, filtered, and solvent removed. Solid was
collected as a yellow powder (1.98g, 95% yield): 1H NMR (DMSO-d6) δ 0.86 (dd,
6H), 1.31 (s, 9H), 1.46 (s, 2H), 1.55 (m, 2H), 1.69 (m, 1H), 1.87 (dt, 1H), 2.07 (dt,
2H), 2.29 (s, 3H), 2.43 (m, 2H), 2.93 (d, 1H), 3.11 (s, 1H), 3.72 (s, 3H), 3.88 (dt,
1H), 4.03 (dt, 1H), 4.87 (s, 1H), 5.51 (d, 1H), 6.65 (d, 1H), 6.73 (d, 1H), 6.90 (s,
1H).
[101] To the Boc-Leu-Hydrocodone was added 25ml of 4N HC1 in
dioxane. The resulting mixture was stirred at ambient temperatures for 18 hours.
Solvent was removed and final product dried under vacuum. Solid was collected as
a slightiy yellow soUd (1.96g, 97% yield): 1H NMR (DMSO-d6) δ 0.94 (d, 6H), 1.52
(m, 1H), 1.75-1.90 (m, 4H), 2.22 (dt, 1H), 2.34 (dt, 1H), 2.64 (q, 1H), 2.75 (s, 3H),
2.95-3.23 (m, 4H), 3.74 (s, 3H), 3.91 (d, 1H), 4.07 (s, 1H), 5.10 (s, 1H), 5.72 (d,
1H), 6.76 (d, 1H), 6.86 (d, 1H), 8.73 br s, 3H).

Example 14: Analgesia of GlvGlvGlu-HC and ProProLeu-HC vs. HC
Subcutaneously Injected
[102] Peptide-narcotic conjugates GlyGlyGlu-HC and ProProLeu-HC and
an equivalent amount of HC contained in the conjugates were subcutaneously
administered separately to male Sprague-Dawley rats (~250 g). The level of
analgesia was scored by the PLL (paw lick latency) method using the hot plate
nociceptive model as described (Tomkins, D.M., et al. J Pharmacol Experimental
Therapeutics, 1997, 280:1374-1382). Table 10 shows the latency response of
GlyGlyGlu-HC vs. HC. Basal PLL times of untreated rats were subtracted from the
conjugate and hydrocodone PLLs. At thirty minutes analgesia of GlyGlyGlu-HC
was 54 % and at 45 minutes was 8 %, when PPLs above basal level were compared
to HC indicating that analgesia was significantly inhibited by the attached tripeptide.
The latency response of ProProLeu-HC vs. HC is shown in Fig. 15 and Table 11.
PLL times above 0 hour basal level of pretreated rats is was scored at 15, 30,45, and
60 minutes. At the thirty minute peak of analgesia ProProLeu-HC was 9 % of that
for hydrocodone. The PPL latency score of ProProLeu-HC gradually rose over time,
however, at 60 minutes was still only 43% of the hydrocodone. (note: a cutoff time
of 45 seconds was used in the PLL scoring in order to minimaize any harm to the
animals. Most of the hydrocodone treated animals reached the maximum 45 seconds
at peak analgesia).


[0113] The latency response of LeuLeuLeu-HC, ProProIle-HC,
GlyGlyGlyGlyLeu-HC, and GlyGlyGlyGly-HC (2X the equivalent dose) is shown
in Table 12 and Fig. 16. PLL times above 0 hour basal level of pretreated rats was
scored at 15, 30, and 60 minutes. At the thirty minute peak of analgesia

Example 15: Active Agent List
[103] The active agent that is attached to the carrier peptide can have one or
more of different functional groups. The functional groups include an amine,
carboxylic acid, alcohol, ketone, amido (or its chemical equivalent),thiol or sulfate.
Examples of these active agents, their functional groups and site of attachment to the
carrier peptide is provided in the section below. One skilled in the art would
recognize the techniques necessary to covalently attach a peptide to the active agents
as described through the application.
Acetaminophen with Codeine
[104] Acetaminophen is a known pharmaceutical agent that is used in the
treatment of minor aches and pains. Its chemical name is N-acetyl-p-aminophenol.
It is often used in combination with codeine, whose chemical name is 7,8-
didehydro-4,5-a-epoxy-3-methoxy-17-methylmephorninan-6a-ol. Both are

commercially available and readily manufactured using published synthetic schemes
by those of ordinary skill in the art.
[105] In the present invention, both acetaminophen and codeine are
covalently attached to the peptide via their hydroxyl groups.
Codeine
[106] Codeine is a known pharmaceutical agent that is used in the treatment
of pain. The composition of the invention comprises codeine covalently attached to
a peptide.
[107] In the present invention, codeine is covalently attached to the peptide
via the hydroxyl group.
Dihydrocodeine
[108] Dihydrocodeine is a known pharmaceutical agent that is used in the
treatment of pain. The composition of the invention comprises dihydrocodeine
covalently attached to a peptide.
[109] In the present invention, dihydrocodeine is covalently attached to the
peptide via the hydroxyl group.
Codeine and guaifenesin
[110] Codeine and guaifenesin is a known pharmaceutical agent that is used
in the treatment of coughs. The composition of the invention comprises codeine and
guaifenesin covalently attached to a peptide via the hydroxyls of either active agent.
Codeine and promethazine
[111] Codeine and promethazine are known pharmaceutical agents used in
the treatment of coughs. The composition of the invention comprises codeine and
promethazine covalently attached to a peptide via functional groups specified in the
active agent's respective catagory.

Codeine, guaifenesin and pseudoephidrine
[112] Codeine, guaifenesin and pseudoephidrine are used in die treatment
of coughs and colds. The composition of the invention comprises codeine,
guaifenesin and pseudoephidrine covalently attached to a peptide peptide via
functional groups specified in the active agent's respective catagory.
Codeine, phenylephrine and promethazine
[113] Codeine, phenylephrine and promethazine is a known pharmaceutical
agent that is used in the treatment of coughs and colds. The composition of the
invention comprises codeine, phenylephrine and promethazine covalently attached
to a peptide via functional groups specified in the active agent's respective catagory.
Fentanyl
[114] Fentanyl is a known pharmaceutical agent that is used in the
treatment of pain. It is both commercially available and readily manufactured using
published synthetic schemes by diose of ordinary skill in the art. Its structure is:

[115] In the present invention, the fentanyl or modified fentanyl is
covalently attached to the peptide via a linker. This linker may be a small molecule
containing 2-6 carbons and one or more functional groups (such as amines, amides,
alcohols, or acids) or may be made up of a short chain of either amino acids or
carbohydrates.
Acetaminophen and hydrocodone
[116] Acetaminophen and hydrocodone is a known pharmaceutical agent
that is used in the treatment of pain. The chemical name of acetaminophen is N-

acetyl-p-aminophenol. The composition of the invention comprises acetaminophen
and hydrocodone covalently attached to a peptide.
Chlorpheniramine and hydrocodone
[117] Chlorpheniramine and hydrocodone is a known pharmaceutical agent
that is used in the treatment of pain. The composition of the invention comprises
chlorpheniramine and hydrocodone covalently attached to a peptide.
Guaifenesin and hydrocodone
[118] Guaifenesin and hydrocodone is a known pharmaceutical agent that is
used in the treatment of coughs. The composition of the invention comprises
guaifenesin and hydrocodone covalently attached to a peptide using functional
groups specifally described in the active agents respective category.
Himatropine and hydrocodone
[119] Himatropine and hydrocodone is a known pharmaceutical agent that
is used in the treatment of pain. The composition of the invention comprises
himatropine and hydrocodone covalently attached to a peptide using functional
groups specifally described in the active agents respective category.
Hydrocodone and phenylpropanolamine
[120] Hydrocodone and phenylpropanolamine are used in the treatment of
coughs and colds. The composition of the invention comprises hydrocodone and
phenylpropanolamine covalently attached to a peptide.
[121] In the present invention, hydrocodone and phenylpropanolamine is
covalently attached to the peptide via one of the hydroxyl groups. Alternatively,
phenylpropanolamine can be covalently attached to the peptide via the amino group.
Ibuprofen and hydrocodone
[122] Ibuprofen and hydrocodone are used in the treatment of pain. The
structure of ibuprofen is:


The composition of the invention comprises ibuprofen and hydrocodone covalently
attached to a peptide using functional groups specifically described in the active
agents respective category.
Hydrocodone
[123] Hydrocodone is a known pharmaceutical agent that is used in the
treatment of pain. The composition of the invention comprises hydrocodone
covalently attached to a peptide.
[124] In the present invention, hydrocodone is covalently attached to the
peptide via a ketone group and a linker. This linker may be a small linear or cyclic
molecule containing 2-6 atoms with one or more heteroatoms and one or more
functional groups (such as amines, amides, alcohols or acids). For example, glucose
would be suitable as a linker. Alternatively, hydrocodone may be attached directly
through an enolate.
Hydromorphone
[125] Hydromorphone is a known pharmaceutical agent that is used in the
treatment of cough and pain. Its structure is:

[126] The composition of the invention comprises hydromorphone
covalently attached to a peptide.
[127] In the present invention, hydromorphone is covalently attached to the
peptide via the hydroxyl group.

Morphine
[128] Morphine is a known pharmaceutical agent that is used in the
treatment of pain. Its structure is:

[129] The composition of the invention comprises morphine covalently
attached to a peptide.
[130] In the present invention, morphine is covalently attached to the
peptide via any of the hydroxyl groups.
Diacetylmorphine
[131] Diacetylmorphine is a known pharmaceutical agent that is used in the
treatment of pain. The composition of the invention comprises diacetylmorphine
covalently attached to a peptide.
[132] In the present invention, diacetylmorphine or modified
diacetylmorphine is covalently attached to the peptide via a linker. This linker may
be a small molecule containing 2-6 carbons and one or more functional groups (such
as amines, amides, alcohols, or acids) or may be made up of a short chain of either
amino acids or carbohydrates.
Dihydromorphine
[133] Dihydromorphine is a known pharmaceutical agent that is used in the
treatment of pain. The composition of the invention comprises dihydromorphine
covalently attached to a peptide.
[134] In the present invention, dihydromorphine is covalently attached to
the peptide via the hydroxyl group.

Ethylmorphine
[135] Ethylmorphine is a known pharmaceutical agent that is used in the
treatment of pain. The composition of the invention comprises ethylmorphine
covalently attached to a peptide.
[136] In the present invention, ethylmorphine is covalently attached to the
peptide via the hydroxyl group.
Oxycodone and acetaminophen
[137] Oxycodone and acetaminophen are used together in the treatment of
pain.
[138] The composition of the invention comprises oxycodone and
acetaminophen covalently attached to a peptide.
Oxycodone
[139] Oxycodone is a known pharmaceutical agent that is used in the
treatment of pain. The structure of oxycodone is:

[140] The composition of the invention comprises oxycodone covalently
attached to a peptide.
[141] In the present invention, oxycodone is covalently attached to the
peptide via a ketone group and a linker. This linker may be a small linear or cyclic
molecule containing 2-6 atoms with one or more heteroatoms and one or more
functional groups (such as amines, amides, alcohols or acids). For example, glucose

would be suitable as a linker. Alternatively, oxycodone may be attached directly
through an enolate.
Propoxyphene
[142] Propoxyphene is a known pharmaceutical agent that is used in the
treatment of pain. It is a mild narcotic analgesic. It is both commercially available
and readily manufactured using published synmetic schemes by those of ordinary
skill in the art. The structure of propoxyphene is

[143] The composition of the invention comprises propoxyphene
covalently attached to a peptide. In the present invention, propoxyphene or
modified propoxyphene is covalently attached to the peptide via a linker. This
linker may be a small molecule containing 2-6 carbons and one or more functional
groups (such as amines, amides, alcohols, or acids) or may be made up of a short
chain of either amino acids or carbohydrates.
Dextroamphetamine
[144] Dextroamphetamine is a known pharmaceutical agent that is used in
the treatment of narcolepsy and attention deficit hyperactivity disorder. It is both
commercially available and readily manufactured using published synthetic schemes
by those of ordinary skill in the art. Its structure is:



[145] In the present invention, dextroamphetamine is covalently attached to
the peptide via the amino group.
D-Methylphenidate
[146] D-methylphenidate is a known pharmaceutical agent that is used in
the treatment of attention deficit disorder. Its chemical name is (aR,2R)-a-phenyl-
2-piperidineacetic acid methyl ester. Its structure is:

[147] D-methylphenidate is the subject of U.S. Patent Number 2,507,631
(1950) and WO 99/16439 (1999), based on US application Number 937684 (1997),
each of which is herein incorporated by reference, which describes how to make that
drug.
[148] In the present invention, D-methylphenidate is covalently attached to
the peptide via the amino group.
Methylphenidate
[149] Methylphenidate is a known pharmaceutical agent that is used in the
treatment of attention deficit disorder. Its structure is:

[150] The composition of the invention comprises methylphenidate
covalently attached to a peptide.
[151] In the present invention, methylphenidate is covalently attached to
the peptide via the amino group.

We Claim:
1. A pharmaceutical composition comprising:
an opioid selected from hydrocodone and oxycodone covalently attached to
the C-terminus of a carrier peptide;
wherein said carrier peptide comprises from 1-9 amino acids.
2. The composition of claim 1, wherein the compositions is in a form
suitable for oral administration that is resistant to release when inhaled or injected,
but is released following oral administration.
3. The composition of any preceding claim, wherein said carrier peptide
comprises 6 amino acids.
4. The composition as claimed in any of claim. 1 or 2, wherein said carrier
peptide comprises 5 amino acids.
5. The composition as claimed in any of claim 1 or 2, wherein said carrier
peptide comprises 4 amino acids.
6. The composition as claimed in any of claim 1 or 2, wherein said carrier
peptide comprises 3 amino acids.
7. The composition as claimed in any of claim 1 or 2, wherein said carrier
peptide comprises 2 amino acids.
8. The composition of any of claims 1, 2, or 4, wherein said carrier peptide
has the formula XXXAA or XXAAA, where X is selected from any amino acid,
except Arg, Lys, His, Pro, and Met and A is selected from Tyr, Phe, Trp, or Leu.
9. The composition of claim 1, wherein said opioid is attached to an amino
acid.

10. The composition as claimed in any preceeding claim, wherein the said
composition is an oral composition useful for delivering an opioid to a patient so as
to obtain a therapeutic, but not a substantial euphoric effect
11. The composition as claimed in any of claims 1-9, wherein the said
composition is an oral composition useful for delivering an opioid to a patient to
treat pain.
12. A pharmaceutical composition comprising:
an opioid covalently attached to the C-terminus of a carrier peptide,
wherein said carrier peptide comprises from 1 to 9 amino acids and the opioid is
selected from the group consisting of codeine, fentanyl, hydromorphone,
levorphanol, oxymorphone, morphine and sufentanyl.

The invention discloses a pharmaceutical composition comprising an opioid selected
from hydrocodone and oxycodone covalently attached to the C-terminus of a carrier peptide;
wherein said carrier peptide comprises from 1-9 amino acids.

Documents:

1300-KOLNP-2004-CERTIFIED COPIES(OTHER COUNTRIES).pdf

1300-KOLNP-2004-CORRESPONDENCE 1.1.pdf

1300-KOLNP-2004-CORRESPONDENCE.pdf

1300-KOLNP-2004-FORM 16.pdf

1300-KOLNP-2004-FORM 27.pdf

1300-KOLNP-2004-FORM-27-1.pdf

1300-KOLNP-2004-FORM-27.pdf

1300-kolnp-2004-granted-abstract.pdf

1300-kolnp-2004-granted-assignment.pdf

1300-kolnp-2004-granted-claims.pdf

1300-kolnp-2004-granted-correspondence.pdf

1300-kolnp-2004-granted-description (complete).pdf

1300-kolnp-2004-granted-drawings.pdf

1300-kolnp-2004-granted-examination report.pdf

1300-kolnp-2004-granted-form 1.pdf

1300-kolnp-2004-granted-form 13.pdf

1300-kolnp-2004-granted-form 18.pdf

1300-kolnp-2004-granted-form 3.pdf

1300-kolnp-2004-granted-form 5.pdf

1300-kolnp-2004-granted-gpa.pdf

1300-kolnp-2004-granted-reply to examination report.pdf

1300-kolnp-2004-granted-specification.pdf

1300-KOLNP-2004-PA.pdf


Patent Number 231459
Indian Patent Application Number 1300/KOLNP/2004
PG Journal Number 10/2009
Publication Date 06-Mar-2009
Grant Date 04-Mar-2009
Date of Filing 08-Sep-2004
Name of Patentee NEW RIVER PHARMACEUTICALS INC.
Applicant Address THE GOVERNOR TYLER, 1881 GROVE AVENUE, RADFORD, VIRGINIA 24141
Inventors:
# Inventor's Name Inventor's Address
1 PICCARIELLO THOMAS 203 MURPHY STREET, BLACKSBURG, VA 24060-2534
2 KIRK RANDAL J P.O. BOX 3426, RADFORD, VIRGINIA 24143-3526
PCT International Classification Number A61K 38/00
PCT International Application Number PCT/US2003/05525
PCT International Filing date 2003-02-24
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/358,368 2002-02-22 U.S.A.
2 60/362,082 2002-03-07 U.S.A.