Patent Application
20140112957
1. Field of the Invention
The present invention features a formulation comprising of sebacoyl dinalbuphine ester and a common pharmaceutical and biodegradable excipient PLGA polymer for treating acute or chronic pain in mammalians, and said formulation is a long-term controlled release formulation which can be easily absorbed in the body with the help from polymer molecules and thus maintains effective serum concentration of nalbuphine, which consequently improves the dosage and frequency of the traditionally used nalbuphine injections.
2. Description of the Prior Art
Pain is a sensation caused by stimulation of nociceptors in peripheral nerve endings, and is usually triggered by either external mechanical, thermal, or chemical stimuli, or by internal chemical or electrical stimuli. The stimulation through chemical or nociceptive pathway activates the cerebral cortex or central nervous system and results in the feeling of pain. Nearly all mammalians and even some invertebrates such as squid can perceive pain, and have developed corresponding responses including withdraw or stay away from the source to cope with the pain. If not controlled or relieved, pain will induce considerable stress and result in the increase of ACTH, cortisol, ADH, catecholamine, and glucose as well as decrease of insulin and testosterone in serum, thereby affecting numerous physiological functions including cardiovascular, respiratory, and metabolic functions, even tissue healing. The pain response is part of a protective reflex system to alert the body of severe situations and tissue damage. Hence, for the patients with constant pain, long-term analgesics are needed, and the long-lasting effect is crucial for patients with acute or chronic pain. The pain may last a few days to several months. For example, acute pain, such as post-surgical pain, pain induced by trauma or burn, may last 4 to 6 days; chronic pain including non-malignant and cancer pain, on the other hand, may persist from weeks to several months. One significant breakthrough in the history of fighting pain is the purification of aspirin and morphine by scientists in the late 19th century. Both drugs are well-documented and are effective analgesics. Yet, the analgesic effect of aspirin is not only mild, but it may cause mucosal damage in stomach, inhibition of platelet aggregation, and even stomach bleeding. Moreover, though morphine exhibits superior analgesic effects, its side effects further restrict the possible applications. Therefore, use with caution and under careful supervision is necessary when treating with these drugs. The new drugs developed in the twentieth century are nonetheless within the scope of non-steroidal anti-inflammatory drugs (for anti-inflammatory and pain relief) and morphine (for morphine receptors in the central nervous system).
At present, the available morphine-like analgesics on the market only act for a limited time and may produce serious health effects; those drugs include sufentanil, remifentanil, fentanyl, and morphine injections. In addition, two to three injections a day are required for long-term treatment, which is inconvenient, and overdose may result in respiratory inhibition and addiction. Therefore, development of an analgesic that has lasting effect and mild side effects is the focus of the present invention. Nalbuphine is a strong analgesic that can be used for treating patients with medium to severe pain. Results from treating post-surgical pain with nalbuphine and morphine have shown that both drugs are equally effective; yet, nalbuphine induces fewer side effects with less respiratory inhibition and addiction. Pharmacologically, Nalbuphine is an opioid receptor kappa agonist, also a partial Mu-receptor antagonist (Schmidt W K et al., 1985); thereby the ceiling effect caused by this mechanism will not give rise to further respiratory inhibition if the amount is over 30 mg. In order to be comparable to the top ten countries that have the most advanced drug/medicine manufactures, the Executive branch of Taiwan issued an announcement, No. 0960004264, stating that nalbuphine is not a controlled drug. The pain-relieving effect of nalbuphine lasts from 3 hrs (serum concentration ˜10 ng/ml) to 6 hrs (˜2.5 ng/ml). Patients who are treated with this drug have to be admitted to the hospital and received multiple injections, which is not only a waste of medical resources, but a hassle for the patients. The prosoft-drug design can improve the half life of drugs and has been widely used in clinical practice with superior results. Nalbuphine is more a hydrophilic drug when compared with a prosoft-drug. Esterification of nalbuphine using long chain carbonic acid increases the lipid solubility of the prodrug, which further allows embedding of the drug with oily or biodegradable substances and prolongs the effects by controlled release of the drug in tissues upon intramuscular injection. Additionally, esterase is found in various tissues and organs such as blood, brain, liver, heart, lung, kidney, and muscle, and the pharmacological effects and safety of nalbuphine prosoft-drug were reported exactly the same as of the prodrug.
SDE is one prosoft-drug of nalbuphine which can be used to effectively treat acute, chronic, and post-surgical pain. In present invention, nalbuphine prosoft-drug SDE and PLA, a biocompatible and biodegradable polymer, were combined and used to produce a long-term controlled-release formulation form. The purpose of producing drugs with long-term efficacy and controlled release is to prolong the effective time of a single dose treatment, which requires fewer dosage, reduces the possibility of missing a dose, and helps to maintain a steady serum concentration of the drugs and improve the efficacy. Patients who require long-term use of analgesics usually hope they can be discharged from the hospitals and return to home or loved ones. Hence, after years of meticulous research, the inventors hereby reported a novel method for sebacoyl dinalbuphine ester synthesis with its chemical structure in Taiwan patent no. 085106156 (nalbuphine ester). The present invention is founded on the prior invention (Taiwan patent no. 089109293, a new formulation containing nalbuphine dinalbuphine ester prodrug for oral administration) that traditional methods cannot prolong the effect duration of nalbuphine particularly. The inventors successfully developed a controlled-release formulation form as described in the present invention, which comprises of the pro-soft drug sebacoyl dinalbuphine ester and a pharmaceutically acceptable and biodegradable PLGA polymer with prolonged efficacy in vivo, and a single dose of administration every two weeks or even every few months is sufficient for treatment. Furthermore, the inventors have published the discovery in several well-recognized international journals including electrically assisted method of transdermal delivery of other long-lasting and controlled released nalbuphine derivatives (Jeng-Fen Huang et al., 2005), plant oil injections (Pao L. H. et al.,2005) and other nalbuphine pro-soft drugs such as nalbuphine decanoate, nalbuphine enanthate, nalbuphine pivalate, nalbuphine propionate as well as implants mentioned in the present invention using pharmaceutically acceptable and biodegradable PLGA polymer formulation (Sung K. C. et al., 1998), and controlled-release of microspheres (Fang-I. Liu et al., 2003). However, the aims of prolonged duration of drugs or reduced dosage have not been accomplished. As mentioned previously, subcutaneous injection of PLGA microspheres containing nalbuphine, nalbuphine propionate, nalbuphine pivalate, or nalbuphine decanoate (50 mg/rabbit; three mice each group) have shown that the effective serum concentration lasted only 4 days which is significantly shorter than expected (Fang-I. Liu et al., 2003) and may due to the insolubility in lipid of these pro-soft drugs. Nevertheless, later studies from the inventors suggested that injection of the long-term controlled release sebacoyl dinalbuphine ester-PLGA formulation with better lipid solubility (150 mg/kg of SDE, in rats, n=7) can regulate drug concentration and maintain effective concentration at 2.5 ng/ml for up to two weeks or even several months by taking the advantages of the PLGA polymer, e.g. PLA/PGA ratio and average molecular weight, etc. (as shown in Table 1). Hence, based on the abovementioned results, the finding of a formulation comprising of sebacoyl dinalbuphine ester (a pro-soft drug) and a biodegradable polymer PLGA (commonly used pharmaceutical excipient) for treating acute or chronic pain in mammalians is novel and inventive.
The purpose of the present invention is to provide a long-term controlled release formulation form of nalbuphine that can solve the traditional efficacy duration problems and substantially prolong the effects of nalbuphine so as to improve its efficacy when compared with traditional single dose treatment. The advantages of this formulation is to reduce the dosage, avoid patients missing a dose, and improve efficacy and maintain stable serum levels after administration.
To achieve the forgoing aims, the present invention provides a pro-soft drug, a long-term controlled release formulation form of sebacoyl dinalbuphine ester. The use of PLGA which is a common pharmaceutical and biodegradable excipient in the formulation notably reduces traditional nalbuphine injection dosage. Moreover, the present invention also provides a proper long-term controlled release formulation form of the pro-soft drug, sebacoyl dinalbuphine ester, a common pharmaceutical and biodegradable PLGA excipient formulation wherein the PLGA excipient includes at least one relevant derivative of polylactic acid (PLA), polylactic glycolic acid (PGA), polylactic acid (PLA), poly glycolic acid (PGA), or their combinations thereof. Related derivatives of polylactic acid (PLA) and polylactic glycolic acid (PGA) include poly butylene succinate (PBS), polyhydroxyalkanoate (PHA), polycaprolactone acid lactone (PCL), polyhydroxybutyrate (PHB), glycolic amyl (PHV), PHB and PHV copolymer (PHBV), and poly lactic acid (PLA)-polyethylene glycol (PEG) copolymers (PLEG). The PLGA polymer formulation form can regulate the drug release rate via the characteristics of the polymer (e.g. PLA/PGA ratio and average molecular weight, etc.) and be used as analgesics. As for improvements of traditional nalbuphine injections, the results indicated that administration of long-term controlled release form of sebacoyl dinalbuphine ester, SDE-PLGA, (150 mg/kg of SDE) in SD rats can maintain the effective concentration at 2.5 ng/ml for two 2 weeks or even several months, and the serum concentration of the drug is regulated by different PLGA excipient combinations. For example, given PLGA at the ratio of 50:50 5 k (n=5) can maintain the effective drug concentration at 2.5 ng/ml for around 21 days, whereas administration of PLGA (75:25 10 k) (n=7) can uphold the same concentration for nearly 30 days. Lipid soluble drugs that contain long-term controlled release PLGA have higher matrix molecular weight and those drugs containing high percentage of PLA have lower release rate (PLA/PGA ratio and the range of molecular weights are PLA 50˜100%/PGA 0˜50% and 5 k˜20 K, respectively). The in vivo experiments also demonstrated that combination of the pro-soft drug (sebacoyl dinalbuphine ester) and the common pharmaceutical and biodegradable PLGA polymer as excipient can significantly reduce the dosage of traditional nalbuphine injections. Therefore, the formulation is novel and inventive. The purpose of the present invention is to develop a long-term controlled release formulation form that can achieve the abovementioned aims. This new formulation of sebacoyl dinalbuphine ester developed in the present invention may include a pharmaceutically acceptable excipient such as diluents, fillers, binders, disintegrating agents, or lubricants. Moreover, the long-term controlled release formulation can be prepared in one of the following forms: tablets, capsules, soft capsules, pills, suspensions, microspheres, oral implants, emulsion injection, implantation agent and other pharmaceutically acceptable long-term controlled release formulation forms.
The foregoing summary, as well as the following detailed description of the invention, will be better understood when read in conjunction with the appended drawings. It should be understood, however, that the invention is not limited to the preferred embodiments shown.
The present invention will now be described more specifically with reference to the following embodiments, which are provided for the purpose of demonstration rather than limitation.
Experimental Design and Description:
1. Formulation of the Long-Term Controlled Release SDE-PLGA: microsphere was used here as an example (
Active Substance
Sebacoyl dinalbuphine ester (SDE) is a pro-soft drug of nalbuphine. The pro-soft drug design can improve the half life of SDE which has become a common and effective drug used clinically.
Excipients
The excipient used herein is made of a combination of polylactide (PLA) and polyglycolide (PGA) in various ratios with superior biodegradability and biocompatibility.
2. Determination of Drug Loading (%) and Encapsulation (%) of SDE-PLGA Drug Using Microsphere as the Example:
3. Determination of Microsphere Diameter by Laser:
Six biodegradable PLG polymer excipients (50:50 5 k, 75:25 10 k, 75:25 15 k, 75:25 18 k, 75:25 20 k, and 100:0 10 k) were used for studying drug encapsulation, successful encapsulation rate, and average microsphere diameter variation at the same homogeneous speed (1800 RPM) and the same API/polymer ratio (400 mg/300 mg). The results indicated that no significant differences was found in either drug encapsulation (45-60%) or average diameter differences (60-70 nm) at the same speed and with the same API/polymer ratio (400 mg/300 mg) (Table 2).
2. Chromatographic Conditions for High Performance Liquid Chromatography (HPLC) Analysis:
In vitro analysis such as determination of drug loading and encapsulation of SDE-PLGA as well as in vitro dissolution test were used for precise quatitification of drug concentration.
HPLC mobile phase consists of 25% acetate buffer (5 μmol/L) and 75% ACN with 0.07% (volume ratio V/V) and 0.1% Triethylamine, a Thermo Hypersil Betasil Silica column (150×4.6 mm, 3 nm, 30° C.) was utilized for separation. The UV wavelength and flow rate were 210 nm and 1.3 ml/min, respectively, and the sample analyzing time was 7 min per sample.
3. Preparation of Drug Loading Curve
The pro-soft drug, nalbuphine dinalbuphine ester, and its prodrug were mixed in ACN solution to make standard solutions at 250, 500, 1000, 1500, 2000, 3500, 5000, 7500, and 10000 (ng/ml).
After analysis with HPLC, the peak area and its corresponding concentrations obtained from graphs of nalbuphine dinalbuphine ester, and its prodrug were plot to prepare two verification curves for determination of accuracy and precision using standard deviation (SD), variance coefficient (CV) and error.
Results:
Comparison of the dissolution results of SDE-PLGA microspheres with the same PLA/PGA ratios and different molecular weights including (75/25 10 k), (75/25 15 k), (75/25 18 k), and (75/25 20 k) indicated the lower the molecular weight, the higher the drug release rate. The drug release rate of 75/25 10 k, 75/25 15 k, 75/25 18 k, and 75/25 20 k at day 30 was 87.71%±13.81%, 56.64%±6.40%, 57.30%±14.33%, and 42.78%±5.42%, respectively (mean±SD are presented, n=3) (
Experimental Design and Description:
The aim of the present study is to determine and compare the absorption, distribution, and elimination of a single dose of different prescription drugs and formulation forms in rats. Analysis of plasma nalbuphine and SDE collected from rats intramuscular injected with a single dose of controlled release SDE-PLGA revealed the information of distribution, metabolism, and elimination of different formulation forms in rats as well as provided the evidence showing the selected formulation is effective for at least a month.
1. Pharmacokinetics Studies of Controlled Release SDE-PLGA Formulation Form after Intramuscular Injection in Small Animal Rats
Experiment period: The rats were subjected to observation and the blood samples were collected after administration of the drug until no nalbuphine was detected (about a month).
Administration routes and methods: A single dose of long-term controlled release SD-PLGA adjusted according to the body weight was intramuscular injected.
Analysis of drug formulation: The prepared drug is further analyzed for its chemical strength as well as for its uniformity and stability which is essential for any formulation.
Blood samples were collected from the tail vein and the rats were placed in a restraining device to reduce stress induced by drug administration and sample collection. Afterwards, 150 mg per kg of SDE-PLGA microspheres were given to the rats. Blood samples (0.5 ml) were collected at 0.5, 1, 2, 6, 24, 30, 48, 54, 72, 96, 102, 120, 168, 240 hr and 12, 14, 16, 18, 20, 24, 26, 28 days after administration of the drug, and mixed with heparin (1/10, v/v). After centrifugation, the supernatant was transferred and stored at −80° C. During the experiment, rats exhibited critical conditions were subjected to euthanasia using carbon dioxide.
Sample analysis: A well-developed Ultra Performance Liquid Chromatography (UPLC/Ms/Ms) was used to analyze nalbuphine and SDE in collected samples.
Data analysis: The serum variations of the administered drugs are presented in the graphs and figures. In addition, the in vivo pharmacokinetics results of nalbuphine and SDE including relative bioavailability in rats, is calculated with software.
Ultra Performance Liquid Chromatography (UPLC) analysis: a Mass/Mass UPLC/MS/MS interfaced with a triple quadrupole tandem and equipped with ionspray (API 3000 Applied biosystems, U.S.A.) was used for analysis:
The chromatographic separation was achieved using an ACQUITY UPLC/BEH HILIC/2.1×column (100 mm/173 um/40° C). The mobile phase consisted of water (13%) and acetonitrile (87%) (containing 2 mM ammonium acetate and 0.1% formic acid), was injected at a flow rate of 0.25 ml/min and the injection volume was 5 uL. The precursor ion and the product ion used for analyze sebacoyl dinalbuphine ester, nalbuphine, ethyl morphine, and naloxone were 441.5(m/z) and 423.5(m/z), c358.3(m/z) and 340.3(m/z), 314.2(m/z) and 183.1(m/z), and 328.3(m/z) and 310.3 (m/z), respectively.
The mixtures of pro-soft drug sebacoyl dinalbuphine ester and the prodrug nalbuphine were formulated at concentrations of 10, 25, 50, 100, 250, 500, 1000, 2500, and 5000 ng/ml in standard solvent, ACN. From each mixture, 10 μl was transferred and mixed with 90 μl plasma (10× dilution) for further sample processing.
Following UPLC/MS/MS analysis, the peak areas and their corresponding concentrations shown in the chromatography of sebacoyl dinalbuphine ester and nalbuphine were used to plot two calibration curves, and the accuracy and precision of the curves were further examined using standard deviation (SD), coefficient of variation (% CV), and error (%).
The obtained results indicated that drug concentration can be regulated by adjusting the polymer characteristics (e.g. PLA/PGA ratio and average molecular weight) which is consistent with the previous theory. Moreover, the drug release rate (decreased in the order of 50:50 5 k>75:25 10 k>75:25 18 k) can regulate drug concentrations and therefore maintain an effective serum concentration at 2.5 ng/ml for two weeks or up to several months (
In summary, the pro-soft drug mentioned in the invention is a formulation comprising of sebacoyl dinalbuphine ester and a common pharmaceutical and biodegradable excipient, PLGA polymer. The said formulation can be prepared in a controlled release form. Polymer allows the sustained release of the drug, which subsequently prolongs the effective concentration of nalbuphine in blood and dramatically reduces the frequency of traditional nalbuphine injections. Hence, present invention is considered novel and inventive.
