Drug administration

• US 4,746,508 A
• Filed: 05/25/1984
• Issued: 05/24/1988
• Est. Priority Date: 06/06/1983
• Status: Expired due to Fees

• Current Assignee: Brigham and Women's Hospital Incorporated, BETH Israel Medical Center (Mount Sinai Beth Israel)
• Original Assignee: Brigham and Women's Hospital Incorporated, BETH Israel Medical Center (Mount Sinai Beth Israel)
• Inventors: Flier, Jeffrey S., Moses, Alan C., Carey, Martin C.
• Primary Examiner(s): Schenkman, Leonard
• Application Number:
  US06/614,115
• Time in Patent Office: 1,460 Days
• Field of Search: 424/238, 514/4, 514/171
• US Class Current: 424/278.1
• CPC Class Codes: A61K 31/00 Medicinal preparations containing organic active ingredients
• CPC Class Codes: A61K 31/137 Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
• CPC Class Codes: A61K 31/575 substituted in position 17 beta by a chain of three or more carbon atoms, e.g. cholane, cholestane, ergosterol, sitosterol
• CPC Class Codes: A61K 38/24 Follicle-stimulating hormone [FSH]; Chorionic gonadotropins, e.g. HCG; Luteinising hormone [LH]; Thyroid-stimulating hormone [TSH]
• CPC Class Codes: A61K 38/26 Glucagons
• CPC Class Codes: A61K 38/28 Insulins
• CPC Class Codes: A61K 45/06 Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• CPC Class Codes: A61K 47/28 Steroids, e.g. cholesterol, bile acids or glycyrrhetinic acid
• CPC Class Codes: A61K 9/0014 Skin, i.e. galenical aspects of topical compositions non-active ingredients are additionally classified in A61K47/00; A61K9/0009, A61K9/0021, A61K9/7015, A61K9/7023 take precedence; cosmetic preparations A61K8/00, A61Q; preparations for wound dressings or bandages A61L26/00
• CPC Class Codes: A61K 9/0043 Nose
• CPC Class Codes: A61K 9/0048 Eye, e.g. artificial tears

Abstract

Compositions and methods useful for the prevention or treatment of a human or animal disorder or for the regulation of a human or animal physiological condition are provided. The compositions used comprise, in admixture, a biologically-effective amount of a drug specific for the disorder or condition and a biocompatible, water-soluble, amphiphilic steroid, other than a natural bile salt, which is capable of increasing drug permeability of the human or animal body surface across which the drug is to be administered, in an amount effective to increase the permeability of the surface to the drug.

Claims

1. A composition useful for the prevention or treatment of a human or animal disorder or for the regulation of a human or animal physiological condition comprising, in admixture;

as an active ingredient, a biologically-effective amount of a peptide specific for the particular disorder or condition; and

(b) as an adjuvant, a biocompatible, water-soluble, fusidic acid derivative which has the formula;

##STR3## wherein a dashed line represents a single or a double bond;

D represents a group having a molecular weight below about 600 daltons which renders an effective amount of said steroid water-soluble within a range of about pH 2 to about pH 12;

E and G each represent OAc, OH, a lower alkyl group or a lower heteroalkyl group;

W represents OAc or H; and

Q, V and X each represent H or OH, said steroid containing from two to three polar functions, exclusive of the function represented by D;

said adjuvant being capable of increasing peptide permeability of a human or animal mucosal surface across which the peptide is to be administered, in an amount effective to increase the permeability of said mucosal surface to said peptide.

2. The composition of claim 1 wherein said fusidic acid derivative has the formula:

##STR4## wherein a dashed line represents a single or a double bond;

D represents a group having a molecular weight below about 600 daltons which renders an effective amount of said steroid water soluble within a range of about pH 2 to about pH 12;

E represents β

OAc, α

OH, a lower alkyl group in β

position, or a lower heteroalkyl group in β

position;

G represents α

OAc, OH, a lower alkyl group, or a lower heteroalkyl group;

W represents α

OAc or H;

Q represents H or OH, provided that, when W is α

OAc and Q is OH, Q is β

-equatorial;

V represents H or α

OH; and

X represents H or α

OH,

said steroid containing from two to three OH groups.

3. The composition of claim 1 wherein the fusidic acid derivative is in unconjugated form, with D being selected from the group consisting of O^- Na⁺, O^- K⁺, O^- Rb⁺ and O^- Cs⁺.

4. The composition of claim 1 wherein D is a covalently linked organic group which contains at least one carbon atom.

5. The composition of claim 4 wherein the covalently linked organic group is an amino acid containing an ionic function which is dissociated within the range of about pH 2 to about pH 12.

6. The composition of claim 5 wherein the amino acid is selected from the group consisting of glycine, taurine, homoglycine and homotaurine.

7. The composition of claim 5 wherein the amino acid is selected from the group consisting of sulfobetaine and phosphobetaine.

8. The composition of claim 4 wherein the covalently linked organic group is a peptide of two to three amino acids, said peptide containing an ionic function which is dissociated within the range of about pH 2 to about pH 12.

9. The composition of claim 8 wherein the peptide is selected from the group consisting of diglycine and glutathione.

10. The composition of claim 8 wherein the peptide is selected from the group consisting of sarcosylcysteine, hydroxyprolinetaurine, and sarcosyltaurine.

11. The composition of claim 4 wherein the covalently linked organic group is a heteroalkyl group of about three or fewer carbon atoms, said group containing an ionic function which is dissociated within the range of about pH 2 to about pH 12.

12. The composition of claim 4 wherein the covalently linked organic group is a uronic acid of about six or fewer carbon atoms, said uronic acid containing an ionic function which is dissociated within the range of about pH 2 to about pH 12.

13. The composition of claim 4 wherein the covalently linked organic group is a polyether containing between about six and about fourteen carbon atoms, inclusive, said polyether terminating in an ionic function which is dissociated within the range of about pH 2 to about pH 12.

14. The composition of claim 4 wherein the covalently linked organic group is a polyether containing between about sixteen and about twenty-four carbon atoms, inclusive.

15. The composition of claim 4 wherein the covalently linked organic group is a polyether containing between about sixteen and about twenty-four carbon atoms, inclusive, said polyether terminating in an ionic function which is dissociated within the range of about pH 2 to about pH 12.

16. The composition of claim 4 wherein the covalently linked organic group is bonded to C₂₁ of the fusidic acid derivative by an amide or an ester linkage.

17. The composition of claim 4 wherein the covalently linked organic group contains an ionic function, said ionic function being SO₃^-, SO₄^-, or COO^-.

18. The composition of claim 2 wherein the fusidic acid derivative is further characterized in that

(a) its unconjugated derivative is retained on a column for a length of time sufficient to produce a k'"'"' factor value of at least about 4, said k'"'"' factor value being obtained by subjecting a monomeric solution of 1 mg/ml of such unconjugated derivative to high-performance (3,000 psi) liquid column chromatography using a 250×

4.6 mm column having octadecylsilane-coated 5 μ

m silica particles as the stationary phase and a mobile phase, delivered at 1.0 ml/min., consisting of 75% methanol in water, v/v, buffered with 0.005 M KHHD 2PO₄ /H₃ PO₄ to give an apparent pH value, as measured using a glass electrode, of pH 5.0, said k'"'"' factor value being defined by ##EQU2## where t₀ is the retention time in said column of the solvent front and t_r is the retention time in said column of said unconjugated derivative as measured by obtaining the elution profile of said fusidic acid derivative by absorbance at 210 nm;

(b) the critical micellar temperature of an aqueous 1% solution, w/v, of the steroid is below about 37°

C. within the range of about pH 2 to about pH 12; and

(c) the critical micellar concentration of the steroid is less than about 8 mMolar in 0.15M NaCl at 37°

C., as measured by surface tension.

19. The composition of claim 18 wherein the critical micellar temperature of the fusidic acid derivative is below about 20°

C. and the critical micellar concentration is less than about 4 mMolar.

20. The composition of claim 1 wherein the adjuvant is an ionized or partially ionized, water-soluble alkali salt of a fusidic acid or a derivative thereof.

22. The composition of claim 20 wherein the derivative of fusidic acid is 24,25-dihydrofusidic acid.

23. The composition of claim 20 wherein the derivative of fusidic acid is 17,20-24,25-tetrahydrofusidic acid.

24. The composition of claim 20 wherein the derivative of fusidic acid is 3-acetoxyl-fusidic acid.

25. The composition of claim 20, 22, 23 or 24 wherein the fusidic acid or derivative thereof is conjugated at C₂₁.

27. The composition of claim 20 wherein the derivative of fusidic acid is tauro-24,25-dihydrofusidate.

28. The composition of claim 20 wherein the derivative of fusidic acid is tauro-16α

-OH-17,20-24,25-tetrahydrofusidate.

29. The composition of claim 20 wherein the derivative of fusidic acid is tauro-16α

-OH-24,25-dihydrofusidate.

30. The composition of claim 20 wherein the derivative of fusidic acid is tauro-17,20-24,25-tetrahydrofusidate.

31. The composition of claim 20 wherein the derivative of fusidic acid is glyco-24,25-dihydrofusidate.

32. The composition of claim 20 wherein the derivative of fusidic acid is tauro-16-O-methyl-ether-24,25-dihydrofusidate.

33. The composition of claim 20 wherein the derivative of fusidic acid is tauro-16-O-methyl-ether-17,20-24,25-tetrahydrofusidate.

34. The composition of claim 1, 20 or 21 wherein said peptide has a molecular weight between about 100 and about 300,000 daltons.

35. The composition of claim 1, 20 or 21 wherein said peptide is a hormone or a precursor or inhibitor thereof.

36. The composition of claim 1, 20 or 21 wherein said peptide is an enzyme or a precursor or an inhibitor thereof.

37. The composition of claim 34 wherein said peptide is a glycoprotein.

38. The composition of claim 1, 20 or 21 wherein said peptide is selected from the group consisting of proinsulin glucagon, parathyroid hormone, parathyroid hormone antagonist, calcitonin, vasopressin, renin, prolactin, growth hormone, thyroid stimulating hormone, corticotropin, corticotropin-releasing factor, follicle stimulating hormone, luteinizing hormone, chorionic gonadotropin, atrial peptides, interferon, tissue plasminogen activator, gammaglobulin, Factor VIII, growth hormone releasing hormone, luteinizing hormone releasing hormone and somatostatin.

39. The composition of claim 35 wherein the hormone is glucagon.

40. The composition of claim 35 wherein the hormone is human chorionic gonadotropin.

41. The composition of claim 35 wherein the hormone is corticotropin-releasing factor.

46. A pharmaceutical preparation suitable for use as a nasal spray or nose drops comprising a solution or suspension of the composition of claim 1, 20, 21, 42, 43, or 44 in a physiologically acceptable carrier.

47. The pharmaceutical preparation of claim 46 wherein the physiologically acceptable carrier is a sodium phosphate buffer, a sodium phosphate buffered sodium chloride solution, or a sodium chloride solution.

48. A pharmaceutical preparation suitable for use as eye drops comprising a solution or suspension of the composition of claim 1, 20, 21 or 42 in a physiologically acceptable carrier.

21. A composition useful for the prevention or treatment of a human or animal disorder or for the regulation of a human or animal physiological condition comprising, in admixture:

(a) as an active ingredient, a biologically-effective amount of a peptide specific for the disorder or condition;

(b) as an adjuvant, an ionized or partially ionized, water-soluble alkali salt of cephalosporin P₁, P₂, P₃, P₄ or P₅ or a derivative thereof, said cephalosporin or derivative being capable of increasing peptide permeability of a human or animal mucosal surface across which the peptide is to be administered, in an amount effective to increase the permeability of said mucosal surface to said peptide.

26. The composition of claim 21 wherein the cephalosporin or derivative is conjugated at C₂₁.

42. A composition useful for regulating blood glucose and free fatty acid levels comprising, in admixture:

(a) as an active ingredient, a medically-effective amount of glucagon; and

(b) as an adjuvant, an effective amount of a salt of tauro-24,25-dihydrofusidate.

45. The composition of claim 42, 43, or 44 wherein the salt is a sodium salt.

43. A composition useful for affecting human pregnancy comprising, in admixture:

(a) as an active ingredient, a medically-effective amount of human chorionic gonadotropin; and

(b) as an adjuvant, an effective amount of a salt of tauro-24,25-dihydrofusidate.

69. A method of administering human chorionic gonadotropin which comprises applying to a nasal mucosal surface for absorption across said surface the composition of claim 43 formulated as a nasal spray or nose drops.

44. A composition useful for regulating adrenocorticotropin synthesis and release comprising, in admixture:

(a) as an active ingredient, a medically-effective amount of corticotropin-releasing hormone; and

(b) as an adjuvant, an effective amount of a salt of tauro-24,25-dihydrofusidate.

70. A method of administering corticotropin-releasing factor which comprises applying to a nasal mucosal surface for absorption across said surface the composition of claim 44 formulated as a nasal spray or nose drops.

49. A pharmaceutical preparation in the form of a nasal spray or nose drops useful for the treatment of diabetes comprising a solution or suspension in a physiologically buffered sodium chloride solution of an admixture of a medically-effective amount of insulin as active ingredient and an effective amount of sodium tauro-24,25-dihydrofusidate as adjuvant.

50. In a method of administering a peptide which comprises applying to a human or animal mucosal surface for absorption across said body surface a composition comprising, as an active ingredient, a peptide specific for a disorder or condition, the improvement which comprises:

applying the peptide to the mucosal surface in admixture with biocompatible, water-soluble, fusidic acid derivative which has the formula;

##STR5## wherein a dashed line represents a single or a double bond;

D represents a group having a molecular weight below about 600 daltons which renders an effective amount of said steroid water-soluble within a range of about pH 2 to about pH 12;

E and G each represent OAc, OH, a lower alkyl group or a lower heteroalkyl group;

W represents OAc or H; and

Q, V and X each represent H or OH, said steroid containing from two or three polar functions, exclusive of the function represented by D;

which biocompatible, water-soluble fusidic acid derivative acts an adjuvant being capable of increasing peptide permeability of the human or animal muscosal surface across which the peptide is to be administered, in an amount effective to increase the permeability of said mucosal surface to said peptide.

51. The method of claim 50 wherein the mucosal surface is a nasal mucosal surface.

52. The method of claim 50 wherein the mucosal surface is a conjunctival surface.

53. The method of claim 50 wherein the mucosal surface is an oropharyngeal, nasopharyngeal or respiratory tract surface.

54. The method of claim 50 wherein the mucosal surface is a vaginal, cervical or endometrial surface.

55. The method of claim 50 wherein the mucosal surface is a rectal, colonic, gastric or intestinal surface.

56. The method of claim 50 wherein the mucosal surface is a urethral or urinary bladder surface.

57. The method of claim 50 wherein the human or animal body surface is an ear canal or tympanic membrane surface.

58. The method of claim 50 wherein the composition is applied in the form of a nasal spray or nose drops.

59. The method of claim 50 wherein the composition is applied in the form of eye drops.

60. The method of claim 50 wherein the composition is applied in the form of a suppository.

61. The method of claim 50 wherein the composition is applied in the form of a spray, salve, ointment or cream.

62. The method of claim 50 wherein the drug is a peptide.

63. The method of claim 50 wherein the peptide is a hormone or a precursor or inhibitor thereof.

64. The method of claim 63 wherein the hormone is selected from the group consisting of proinsulin, glucagon, parathyroid hormone, calcitonin, vasopressin, renin, prolactin, growth hormone, thyroid stimulating hormone, corticotropin, corticotropin-releasing factor, follicle stimulating hormone, luteinizing hormone, growth hormone releasing hormone, luteinizing hormone releasing hormone and somatostatin or an antagonist thereof.

65. The method of claim 50 wherein the peptide is selected from the group consisting of interferon, tissue plasminogen activator, atrial peptides, natriuretic peptide, gammaglobulin and Factor VIII.

66. The method of claim 50 wherein the peptide is a glycoprotein.

67. The method of claim 66 wherein the glycoprotein is chorionic gonadotropin.

68. A method of administering glucagon for the regulation of blood glucose and free fatty acid levels which comprises applying to a nasal mucosal surface for absorption across said surface the composition of claim 66 formulated as a nasal spray or nose drops.

72. The method of claim 50 wherein the composition is applied in a long term release dosage form.

73. The method of claim 72 wherein the long term release dosage form is a slow, continuous or intermittent form.

74. The method of claim 72 wherein the long term release dosage form is selected from the group consisting of a polymer form, a microcapsule form, a microsphere form, an osmotic diffusion device or a membrane release device.

75. The method of claim 50 in which the biocompatible, water-soluble, fusidic acid derivative is an ionized or partially ionized, water-soluble alkali salt of fusidic acid or a derivative thereof.

76. The method of claim 50 in which the biocompatible, water-soluble, fusidic acid derivative is an ionized or partially ionized, water-soluble alkali salt of cephalosporin P₁, P₂, P₃, P₄ or P₅ or a derivative thereof.

71. A method of administering a vaccine to a human being or animal to immunize said human being or animal against a particular disease which comprises applying to a human or animal mucosal surface for absorption across said muscosal surface a composition comprising, in admixture:

(a) as a vaccinating agent, a biologically-effective amount of a peptide antigen or fragment thereof, said peptide antigen or fragment thereof, said peptide antigen being capable of eliciting an immune response protective against the particular disease; and

(b) as an adjuvant, a biocompatible, water-soluble, fusidic acid derivative which has the formula;

##STR6## wherein a dashed line represents a single or a double bond;

D represents a group having a molecular weight below about 600 daltons which renders an effective amount of said steroid water-soluble within a range of about pH 2 to about pH 12;

E and G each represent OAc, OH, a lower alkyl group or a lower heteroalkyl group;

W represents OAc or H; and

Q, V and X each represent H or OH, said steroid containing from two to three polar functions, exclusive of the function represented by D;

said adjuvant being capable of increasing peptide antigen permeability of a human or animal mucosal surface across which the peptide is to be administered, in an amount effective to increase the permeability of said mucosal surface to said peptide.