COMPOSITION AND USE OF SGLT-2 INHIBITOR AND ANGIOTENSIN RECEPTOR BLOCKERS

Information

  • Patent Application
  • 20230346817
  • Publication Number
    20230346817
  • Date Filed
    August 17, 2020
    3 years ago
  • Date Published
    November 02, 2023
    6 months ago
Abstract
The present invention relates to the field of medicine, in particular to a composition and use of an SGLT-2 inhibitor and angiotensin receptor blockers, and specifically to a fixed-dose compound composition and use of a sodium-glucose cotransporter 2 (SGLT-2) inhibitor and angiotensin receptor blockers (ARBs). The fixed-dose compound composition is used for the treatment of patients with diabetes and hypertension, and also benefits patients with chronic kidney diseases, preventing or delaying the deterioration of renal failure in patients with chronic kidney diseases (CKD), and preventing cardiovascular (CV) death or death from kidney diseases. In addition, the fixed-dose compound composition has good synergy and good stability, is convenient to carry or administer, significantly reduces the cost of medication, also avoids the risk of excessive and missing administration, and improves the compliance of patients with medication.
Description
FIELD

The present disclosure relates to the field of medicine, and in particular to a composition of an SGLT-2 inhibitor and an angiotensin receptor blocker and use thereof.


BACKGROUND

Hypertension is a major risk factor for cardiovascular disease, especially for patients still with diabetes considering their synergistic harm on cardiovascular system. An abnormally elevated blood sugar and insulin resistance in patients with type 2 diabetes are independent risk factors for the onset of multiple cardiovascular diseases including hypertension. Meanwhile, controlling blood pressure and avoiding excessive fluctuations of blood pressure in patients with type 2 diabetes have a significant effect in preventing or controlling long-term cardiovascular complications in patients with diabetes. In a case that these risk factors are effectively controlled, the benefits are very obvious. The relevant epidemiological research shows that in recent years, the prevalence of hypertension and diabetes in China has been increasing year by year. 32.9% patients with hypertension in cardiology department also had diabetes, while 58.9% patients with diabetes in endocrinology department also had hypertension. In the general population, 45.3% patients suffer from both hypertension and diabetes. The prevalence of hypertension in patients with diabetes is significantly increased, about twice that in people without diabetes. In the United States, the prevalence of diabetes is the highest among American adults, and about half of patients with diabetes also suffer from hypertension, which undoubtedly increases the cardiovascular burden of patients with diabetes. Diabetes associated with hypertension further increases the risks of left ventricular wall hypertrophy, proteinuria and renal function damage in patients with type 2 diabetes, increases the incidence of adverse cardiovascular events in patients with cardiovascular disease, and increases the economic burden of such patients. Hypertension associated with type 2 diabetes seriously damages the heart, brain, kidneys and other important target organs and the vascular system of the body of patients, leading to complications such as coronary atherosclerotic heart disease, cardiac insufficiency, central nervous system vascular ischemia or hemorrhagic stroke, renal insufficiency and even uremia, which seriously affect the health and quality of life of such patients. Therefore, in a patient suffering from both hypertension and diabetes, controlling blood sugar and blood pressure simultaneously can more effectively reduce the occurrence of complications to reduce the risk of death.


Hypertension and diabetes have high morbidity and mortality, and thus relevant treatment should be carried out in time after diagnosis. However, treating patients with diabetes associated with hypertension brings certain challenges to clinical treatment. There are many clinical methods to treat diabetes with hypertension, among which drug therapy is the most common. However, most patients with diabetes associated with hypertension are elderly, and the drug therapy requires taking drug for life. The treatment of such patients needs to improve the therapeutic effect as much as possible on the one hand, and minimize the occurrence of adverse reactions on the other hand, so as to increase the patient's treatment compliance and obtain a satisfactory treatment effect. Irbesartan (active ingredient A) is an angiotensin receptor blocker with high selectivity, which does not produce agonistic effects while functioning to competitively antagonize, and aims to lower blood pressure by inhibiting the release of aldosterone from the adrenal glands and dilating blood vessels. Irbesartan protects the kidneys by inhibiting the proliferation of cells in mesangium, reducing the content of basal protein in the body and improving the excretion rate of urinary albumin in the body. Irbesartan is used to treat essential hypertension and type 2 diabetic nephropathy associated with hypertension. Clinical studies have proved that irbesartan can benefit the kidneys of patients with hypertension associated with type 2 diabetes.


Dapagliflozin (active ingredient B) is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor with extremely high selectivity and specificity. Upon entering the body, it controls blood sugar by blocking the absorption of glucose in the body by the convoluted tubules, increasing the excretion of the body and reducing the level of glycosylated hemoglobin. What is more exciting is that SGLT-2 inhibitors also show a good prospect in lowering blood pressure, which provides a new and unique idea for the treatment of diabetes and hypertension. Recent clinical trials of SGLT-2 inhibitors have demonstrated that when the systolic blood pressure of patients with diabetes decreased by 4 mmHg, their diastolic blood pressure only decreased by 1.6 mmHg. However, in a case of using the common antihypertensive drugs for monotherapy, when the systolic blood pressure decreased by 9.1 mmHg, the diastolic blood pressure decreased by 5.5 mmHg. Too much reduction in diastolic blood pressure will lead to the risk of cardiac ischemia. In 2019, dapagliflozin was granted fast track designation by the US Food and Drug Administration (FDA) to delay the deterioration of renal failure in patients with chronic kidney disease (CKD) and prevent cardiovascular (CV) and renal death, including CKD patients with or without type 2 diabetes (T2D).




text missing or illegible when filed


For patients with diabetes associated with hypertension, administering an SGLT-2 inhibitor together with an angiotensin receptor antagonist can reduce blood pressure and blood sugar at the same time, benefit the kidneys and cardiovascular system, prevent or delay the deterioration of renal failure in patients with chronic kidney disease (CKD) and prevent cardiovascular (CV) and renal death. At present, the single formulations of the two are given to patients at the same time in clinical practice, causing disadvantages of inconvenience to carry or administer, poor compliance, risks of excessive or missing administration of one drug, potential safety hazards and high drug cost. There is no compound formulation of irbesartan and dapagliflozin on the market or related patents of the compound formulation currently.


SUMMARY

In view of this, the present disclosure provides a composition of an SGLT-2 inhibitor and an angiotensin receptor blocker and use thereof. The composition is used for the treatment of diabetes with hypertension, while benefiting the patient's kidney or cardiovascular system and reducing the risk of cardiovascular and renal complications in patients with type 2 diabetes. The composition according to the present disclosure is convenient to carry or administer, reduces medication cost, avoids the risk of excessive and missing administration, and improves the medication compliance of patients.


In order to achieve the above-mentioned purpose of the present disclosure, the following technical solutions are provided according to the present disclosure.


A composition comprising an SGLT2 inhibitor and an angiotensin II receptor antagonist is provided according to the present disclosure.


In some specific embodiments of the present disclosure, the SGLT-2 inhibitor is selected from the group consisting of dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin, tofogliflozin, ertugliflozin, janagliflozin, bexagliflozin, sotagliflozin, henagliflozin, tianagliflozin, remogliflozin, alligliflozin, remogliflozin etabonate, (1R,2S,3S,4R,5S)-5-(4-chloro-3-(4-ethoxybenzyl)phenyl)-1-((R)-1-hydroxyethyl)-6,8-dioxabicyclo[3.2.1]octane-2,3,4-triol, and a mixture thereof.


In some specific embodiments of the present disclosure, the angiotensin II receptor antagonist is selected from the group consisting of irbesartan, candesartan, valsartan, telmisartan, losartan, iprasartan, olmesartan, azilsartan, and a mixture thereof.


In some specific embodiments of the present disclosure, the SGLT-2 inhibitor is selected from the group consisting of dapagliflozin, a pharmaceutically acceptable salt, ester, cocrystal, complex or solvate of dapagliflozin, and a mixture thereof; and the angiotensin II receptor antagonist is selected from the group consisting of irbesartan, a pharmaceutically acceptable salt or solvate of irbesartan, and a mixture thereof.


In some specific embodiments of the present disclosure, a weight ratio of the SGLT-2 inhibitor to the angiotensin II receptor antagonist is 1:960-300:1, preferably 1:240-75:1, more preferably 1:120-1:7.5, more preferably (8-300):(2-300), and most preferably 8:300, 20:12.3, 40:12.3, 50:4.1, 50:2, 44.8:3.7, 32.5:2.7, 150:12.3, 150:6.15, 75:12.3, 300:6.15 or 300:12.3.


On the basis of the above, use of the composition in the manufacture of a medicament for treating essential hypertension, type 2 diabetic nephropathy associated with hypertension, diabetes, insulin resistance, hyperglycemia, hyperinsulinemia, elevated level of fatty acid or glycerol in blood, hyperlipidemia, dyslipidemia, obesity, or complications of diabetes is further provided according to the present disclosure.


A drug comprising the composition and a pharmaceutically acceptable adjuvant is further provided according to the present disclosure.


In some specific embodiments of the present disclosure, the adjuvant is selected from the group consisting of a filler, binder, disintegrant, antiadherent, adsorbent, glidant, lubricant, surfactant, chelating agent, colorant, taste masking agent, and a mixture thereof.


In some specific embodiments of the present disclosure, the drug is in a dosage form selected from the group consisting of a tablet, capsule, granule, suspension, film, and a mixture thereof, preferably a tablet, dry suspension, capsule or granule.


In some embodiments of the present disclosure, the drug is a tablet, granule or capsule, which comprises:

    • a) an SGLT-2 inhibitor and an angiotensin II receptor blocker;
    • b) optional one or more fillers;
    • c) optional one or more binders;
    • d) optional one or more disintegrants;
    • e) optional one or more antiadherents or adsorbents;
    • f) optional one or more glidants or lubricants;
    • g) optional one or more surfactants;
    • h) optional one or more colorants;
    • i) optional one or more flavoring agents.


Wherein, the SGLT-2 inhibitor is selected from the group consisting of dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin, tofogliflozin, ertugliflozin, janagliflozin, bexagliflozin, sotagliflozin, henagliflozin, tianagliflozin, remogliflozin, alligliflozin, remogliflozin etabonate, (1R,2S,3S,4R, 5S)-5-(4-chloro-3-(4-ethoxybenzyl)phenyl)-1-((R)-1 -hydroxyethyl)-6,8-dioxabicyclo[3.2.1]octane-2,3,4-triol, and a mixture thereof. Dapagliflozin is preferred. Dapagliflozin or a pharmaceutically acceptable salt, ester, cocrystal, complex or solvate thereof is preferred.


The angiotensin II receptor antagonist is selected from the group consisting of irbesartan, candesartan, valsartan, telmisartan, losartan, iprasartan, olmesartan, and azilsartan. Irbesartan or a pharmaceutically acceptable salt, cocrystal, complex or solvate thereof is preferred.


The diluent in the composition according to the present disclosure may be one or more compounds that can provide a desired tablet volume. The ideal diluent includes, but is not limited to, microcrystalline cellulose, lactose, mannitol, erythritol, maltitol, sorbitol, trehalose, sucrose, white sugar, glucose, fructose, corn starch, wheat starch, dextrin, licorice powder, calcium phosphate, calcium hydrogen phosphate, calcium carbonate, calcium citrate, calcium lactate, magnesium oxide, magnesium hydroxide, calcium oxide, magnesium carbonate, potassium carbonate, zinc carbonate, titanium oxide, silicic anhydride, magnesium silicate, calcium silicate, sodium bicarbonate, magnesium sulfate, calcium sulfate, and silicon dioxide.


The binder in the composition according to the present disclosure may be one or more compounds that enable the main drug and adjuvant to become desired free-flowing particles. The ideal binder includes, but is not limited to, hydroxypropyl cellulose, hydroxypropyl methylcellulose, white sugar, gelatin, starch, Arabic gum, astragalus gum, carboxymethyl cellulose, polyvinylpyrrolidone, methyl cellulose, partially pregelatinized starch, pregelatinized starch, polyvinyl alcohol, sodium alginate, pullulan and glycerol.


The disintegrant in the composition according to the present disclosure may be one or more compounds that facilitate the disintegration of the composition upon contact with an aqueous medium. The preferred disintegrant includes, but is not limited to, corn starch, partially pregelatinized starch, hydroxypropyl starch, carboxymethyl cellulose, sodium carboxymethyl cellulose, calcium carboxymethyl cellulose, sodium carboxymethyl starch, low-substituted hydroxypropyl cellulose, cross-linked sodium carboxymethyl cellulose, and crospovidone.


The antiadherent or adsorbent in the composition according to the present disclosure refers to one or more compounds that can reduce the viscosity of the formulation or adsorb the liquid component in the formulation to prevent it from adhering to a metal surface. The antiadherent or adsorbent includes, but is not limited to, silicon dioxide, magnesium silicate, talc, and calcium hydrogen phosphate.


The glidant in the composition according to the present disclosure may be one or more compounds that can reduce the friction between particles, improve the fluidity of powder and help reduce weight differences. The glidant includes, but is not limited to, talcum powder and silicon dioxide.


The lubricant in the composition according to the present disclosure may be one or more compounds that can reduce the friction between a material and a die wall and ensure the smooth progress of pushing for tablets, filling for capsules or sub-packaging for granules. The lubricant includes, but is not limited to, magnesium stearate, stearic acid, calcium stearate, sodium stearyl fumarate, polyethylene glycol, hydrogenated vegetable oil, polyethylene glycol and sodium dodecyl sulfate.


The surfactant in the composition according to the present disclosure refers to one or more compounds that can improve the wettability and/or promote dissolution of the formulation. The surfactant includes, but is not limited to, poloxamer, sodium dodecyl sulfate, Tween and Span.


The colorant in the composition according to the present disclosure refers to one or more compounds capable of imparting a desired color to the formulation prepared from the composition. The colorant includes, but is not limited to, amaranth red, carmine red, erythrosine red, new red, tartrazine, sunset yellow, quinoline yellow, indigo, brilliant blue, beet red, shellac red, cowberry red, capsicum red, and red rice red.


The flavoring agent in the composition according to the present disclosure refers to one or more compounds used to improve or shield the bad smell and taste of drugs. The flavoring agent includes, but is not limited to, sucrose, mannitol, sorbitol, sodium citrate, aspartame, peppermint oil, essence, sodium alginate and gum arabic.


In some specific embodiments of the present disclosure, the SGLT-2 inhibitor and the angiotensin II receptor antagonist are mixed:

    • (1) by directly mixing; or
    • (2) as an internal component or an external component separately; or
    • (3) as an internal component simultaneously.


In some specific embodiments of the present disclosure, the angiotensin II receptor antagonist is used as an internal component, and the SGLT-2 inhibitor is used as an external component.


A method for preparing the drug is further provided according to the present disclosure, which comprises directly mixing raw and auxiliary materials.


A method for preparing the drug is further provided according to the present disclosure, which comprises the steps of mixing, granulating, sizing and blending.


A method for preparing the drug is further provided according to the present disclosure, which comprises the steps of mixing, granulating, drying, sizing and blending.


Moreover, in the method for preparing the drug according to the present disclosure, the SGLT-2 inhibitor and the angiotensin II receptor antagonist are mixed:

    • (1) by directly mixing; or
    • (2) as an internal component or an external component separately; or
    • (3) as an internal component simultaneously.


In some specific embodiments of the present disclosure, in the method for preparing the drug according to the present disclosure, the angiotensin II receptor antagonist is used as an internal component, and the SGLT-2 inhibitor is used as an external component.


Use of the drug or a drug prepared by the method in the manufacture of a medicament for treating essential hypertension, type 2 diabetic nephropathy associated with hypertension, diabetes, insulin resistance, hyperglycemia, hyperinsulinemia, elevated level of fatty acid or glycerol in blood, hyperlipidemia, dyslipidemia, obesity, or complications of diabetes is further provided according to the present disclosure.


The composition of an SGLT-2 inhibitor and an angiotensin II receptor antagonist at a fixed dose is provided according to the present disclosure. The composition is used for the treatment of diabetes with hypertension, while benefiting kidneys, preventing or delaying the deterioration of renal failure in patients with chronic kidney disease (CKD) and preventing cardiovascular (CV) and renal death. In addition, the compound composition at a fixed dose according to the present disclosure has good synergy and good stability, is convenient to carry or administer, significantly reduces medication cost, avoids the risk of excessive and missing administration, and improves the medication compliance of patients.





BRIEF DESCRIPTION OF DRAWINGS

In order to more clearly illustrate the technical solutions in the examples of the present disclosure or in the prior art, the drawings required in the examples or the prior art will be briefly introduced below.



FIG. 1 shows a cumulative dissolution rate (%) of active ingredient A in hydrochloric acid solution with pH1.0; and



FIG. 2 shows a cumulative dissolution rate (%) of active ingredient B in hydrochloric acid solution with pH1.0.





DETAILED DESCRIPTION

A compound composition of a sodium-glucose co-transporter 2 (SGLT-2) inhibitor and an angiotensin receptor blocker (ARB) at a fixed dose and use thereof are disclosed according to the present disclosure. Those skilled in the art can implement the present disclosure by learning from the content herein and appropriately improving the process parameters. It should be particularly noted that all similar substitutions and modifications are obvious to those skilled in the art, and are considered to be included in the present disclosure. Although the method and use of the present disclosure have been described through the preferred embodiments, it is obvious for relevant persons that the method and use described herein may be changed or appropriately modified and combined without departing from the content, spirit and scope of the present disclosure to achieve and apply the technique of the present disclosure.


The raw and auxiliary materials used in the compound composition of a sodium-glucose co-transporter 2 (SGLT-2) inhibitor and an angiotensin receptor blocker (ARB) at a fixed dose and use thereof according to the present disclosure can be purchased from the market.


Lactose (FOREMOST), mannitol (ROQUETTE), sucrose (Sichuan Boliheng), calcium carbonate (Shanghai Nuocheng), magnesium oxide (Hebei Baxter), crospovidone (BASF), cross-linked sodium carboxymethyl cellulose (Asahi Kasei), hydroxypropyl methylcellulose (Dow Chemical), microcrystalline cellulose (JRS), silicon dioxide (Huzhou Zhanwang), magnesium stearate (Huzhou Zhanwang), low-substituted hydroxypropyl cellulose (Shin-Etsu Chemical), hydroxypropyl cellulose (Nippon Soda Co., Ltd.), pregelatinized starch (Asahi Kasei), talcum powder (Guangxi Longsheng Huamei), sodium stearyl fumarate (Shanghai Chineway), gelatin hollow capsule (Suzhou Capsugel Co., Ltd.), hydroxypropyl methylcellulose hollow capsule (Suzhou Capsugel Co., Ltd.).


Hereinafter, the present disclosure will be further described in conjunction with examples.


EXAMPLES 1-15









TABLE 1







Formulation Composition in Weight Percentage (%)













Component
Example 1
Example 2
Example 3
Example 4
Example 5
Example 6
















Active
50.0
50.0
50.0
50.0
50.0
50.0


ingredient A


Active
4.1
4.1
4.1
4.1
4.1
4.1


ingredient B


Lactose
21.7
/
/
/
/
21.7


Mannitol
/
21.7
/
/
/
/


Sucrose
/
/
21.7
/
/
/


Calcium carbonate
/
/
/
21.7
/
/


Magnesium oxide
/
/
/
/
21.7
/


Crospovidone
7.5
7.5
7.5
7.5
7.5
/


Cross-linked
/
/
/
/
/
7.5


sodium


carboxymethyl


cellulose


Hydroxypropyl
2.0
2.0
2.0
2.0
2.0
2.0


methylcellulose


Microcrystalline
9.7
9.7
9.7
9.7
9.7
9.7


cellulose


Silicon dioxide
4.0
4.0
4.0
4.0
4.0
4.0


Magnesium stearate
1.0
1.0
1.0
1.0
1.0
1.0


Total
100.0
100.0
100.0
100.0
100.0
100.0
















TABLE 2







Formulation Composition in Weight Percentage (%)













Component
Example 7
Example 8
Example 9
Example 10
Example 11
Example 12
















Active
50.0
50.0
50.0
50.0
50.0
50.0


ingredient A


Active
4.1
4.1
4.1
4.1
4.1
4.1


ingredient B


Lactose
21.7
21.7
21.7
21.7
21.7
21.7


Crospovidone
/
7.5
7.5
7.5
7.5
7.5


Low-substituted
7.5
/
/
/
/
/


hydroxypropyl


cellulose


Hydroxypropyl
2.0
/
2.0
2.0
2.0
2.0


methylcellulose


Hydroxypropyl
/
2.0
/
/
/
/


cellulose


Microcrystalline
9.7
9.7
/
9.7
9.7
9.7


cellulose


Pregelatinized
/
/
9.7
/
/
/


starch


Silicon dioxide
4.0
4.0
4.0
/
4.0
4.0


Talcum powder
/
/

4.0
1.0
/


Magnesium stearate
1.0
1.0
1.0
1.0
/
/


Sodium stearyl
/
/
/
/
/
1.0


fumarate








Total
100.0
100.0
100.0
100.0
100.0
100.0









Preparation Process

The raw and auxiliary materials were weighed based on the formulation amount and mixed well. The mixed powder of each example was wrapped separately in a clean weighing paper, sealed in an aluminum foil bag, and placed at 50° C. for 10 days. Samples were then taken, determined for related substances and compared with the comparative example. Since active ingredient B was relatively stable with no increase in impurities after placed under the influencing factor, only the related substances of active ingredient A are listed herein.









TABLE 3







Formulation Composition in Weight Percentage (%)











Exam-
Exam-
Exam-


Component
ple 13
ple 14
ple 15














Internal
Active ingredient A
50
44.8
32.5



Lactose
17
9.0
11.0



Cross-linked sodium
2
/
/



carboxymethyl cellulose



Crospovidone
/
1.8
1.3



Hydroxypropyl methylcellulose
2
1.8
1.1



Sucrose
/
9.0
/


External
Active ingredient B
2.0
3.7
2.7



Microcrystalline cellulose
22.0
23.2
37.1



Lactose
/
/
10.8



Cross-linked sodium
2
/
/



carboxymethyl cellulose



Crospovidone
/
/
2.2



Silicon dioxide
2
6.0
0.8



Magnesium stearate
1
0.9
0.5










Total
100.0
100.0
100.0









Preparation Process

Example 13: The internal raw and auxiliary materials were weighed based on the formulation amount of 100 granules, mixed for 15 min in a bag, then added with purified water to prepare into soft materials, granulated with a 40-mesh sieve, or dried at 50° C., and sized with a 40-mesh sieve, where the moisture content was controlled at 2% or below. The external raw and auxiliary materials were weighted at a converted amount, mixed for 10 min in a bag, and packaged into gelatin capsules.


Example 14: The internal raw and auxiliary materials were weighed based on the formulation amount of 50 tablets, mixed well, prepared into soft materials with purified water, granulated with a 80-mesh sieve, dried at 40° C., and sized with a 80-mesh sieve, where the moisture content was controlled at 2% or below. The external raw and auxiliary materials were weighted at a converted amount, passed through a 80-mesh sieve, mixed for 8 times, then added with corresponding dry particles, mixed well, and tableted.


Example 15: The internal raw and auxiliary materials were weighed based on the formulation amount of 50 granules, mixed well, prepared into soft materials with purified water, granulated with a 40-mesh sieve, dried at 50° C., and sized with a 40-mesh sieve. The external raw and auxiliary materials were weighted at a converted amount, mixed well, granulated with a 30-mesh sieve by the dry method. The internal and external raw and auxiliary materials were mixed well in proportion, and packaged into hydroxypropyl methylcellulose capsules.









TABLE 4







Determination Results of Related Substances


of Active Ingredient A (%)











Example/Comparative

Total


Time
example
RRT 0.85
impurities





Day 0
Example 1
Not detected
0.036



Example 2
Not detected
0.023



Example 3
Not detected
0.029



Example 4
Not detected
0.052



Example 5
Not detected
0.041



Example 6
Not detected
0.025



Example 7
Not detected
0.039



Example 8
Not detected
0.038



Example 9
Not detected
0.028



Example 10
Not detected
0.052



Example 11
Not detected
0.040



Example 12
Not detected
0.063



Example 13
Not detected
0.046



Example 14
Not detected
0.052



Example 15
Not detected
0.053



Comparative
0.034
0.119



example/Avapro(DT04448)Note 1


50° C.
Example 1
Not detected
0.026


for 10 days
Example 2
Not detected
0.029



Example 3
Not detected
0.034



Example 4
Not detected
0.032



Example 5
Not detected
0.028



Example 6
Not detected
0.015



Example 7
Not detected
0.031



Example 8
Not detected
0.032



Example 9
Not detected
0.031



Example 10
Not detected
0.051



Example 11
Not detected
0.030



Example 12
Not detected
0.031



Example 13
Not detected
0.049



Example 14
Not detected
0.057



Example 15
Not detected
0.056



Comparative example/
0.074
0.165



Avapro(DT04448)






Note 1Avapro is a commercial reference product for active ingredient A single tablet, with a batch number of DT04448.







Conclusion: The results of related substances of active ingredient A show that the comparative example at RRT 0.85 had an increase in impurities after being placed at high temperature, while Examples 1-15 had no obvious increase in impurities after being placed at high temperature, and the total impurities were also less.


EXAMPLES 16-18









TABLE 5







Formulation Composition of Unit Formulation (mg/tablet)











Exam-
Exam-
Exam-


Component
ple 16
ple 17
ple 18














Internal
Active ingredient A
150
150
150



Active ingredient B
12.3
12.3
12.3



Lactose
30.75
0
30.75



Pregelatinized starch
37.7
0
0



Microcrystalline cellulose
/
66.95
22.7



PH101



Cross-linked sodium
7.5
/
/



carboxymethyl cellulose



Crospovidone
/
7.5
15



Poloxamer 188
9
9
9



Silicon dioxide
6
6
6



Magnesium stearate
/
3
1.5


External
Microcrystalline cellulose
34
34
34



PH102



Cross-linked sodium
7.5
/
/



carboxymethyl cellulose



Crospovidone
/
7.5
15



Silicon dioxide
2.25
2.25
2.25



Magnesium stearate
3
1.5
1.5










Total weight
300
300
300









Preparation Process

Active ingredient B, anhydrous lactose, cross-linked sodium carboxymethyl cellulose, poloxamer 188 and silicon dioxide were weighed based on the formulation amount of 50 tablets, passed through a 65-mesh sieve, and mixed for 6 times. Then active ingredient A and pregelatinized starch were added, passed through a 65-mesh sieve, and mixed for 8 times. Granulation was performed by the dry method. The external auxiliary materials were weighted at a converted amount, mixed well and tableted. The dissolution rate was investigated in hydrochloric acid medium with pH1.0 in 15 min. Dissolution method: hydrochloric acid solution with pH1.0, paddle method, medium volume of 900 ml, temperature of 37° C., and rotation speed of 50 rpm. Determination method: Both the reference formulations of active ingredient A and active ingredient B single tablets have a dissolution rate of above 85% in 15 min, and the dissolution requirements of the examples are consistent with those of the reference formulation, so the target value is also above 85%.


EXAMPLES 19-20









TABLE 6







Formulation Composition of Unit Formulation (mg/tablet)









Component
Example 19
Example 20













Internal
Active ingredient A
150
150



Active ingredient B
12.3
12.3



Lactose
72.7
72.7



Cross-linked sodium
7.5
7.5



carboxymethyl cellulose



Hydroxypropyl
6
6



methylcellulose



Silicon dioxide
1.5
1.5



Magnesium stearate
0
1.5


External
Microcrystalline cellulose
38
38



PH102



Cross-linked sodium
7.5
7.5



carboxymethyl cellulose



Silicon dioxide
1.5
1.5



Magnesium stearate
3
1.5









Total weight
300
300









Preparation Process

The internal raw and auxiliary materials were weighed based on the formulation amount of 50 tablets, sieved and mixed well. In Example 19, the materials were prepared into soft materials with 10% hydroxypropyl methylcellulose aqueous solution, granulated with a 65-mesh sieve, dried at 40° C., sized with a 65-mesh sieve, added with the external auxiliary materials at a converted amount, and mixed well. In Example 20, the materials were granulated by the dry method, added with the external auxiliary materials at a converted amount, and mixed well. The dissolution rate was determined in hydrochloric acid medium with pH1.0 in 15 min. Determination method: paddle method, medium volume of 1000 ml, temperature of 37° C., and rotation speed of 50 rpm. Unless otherwise specified, the dissolution performed in the following examples was determined by this method.


EXAMPLES 21-24









TABLE 7







Formulation Composition of Unit Formulation (mg/tablet)












Exam-
Exam-
Exam-
Exam-


Component
ple 21
ple 22
ple 23
ple 24















Internal
Active ingredient A
150
150
150
150



Lactose
72.7
65.2
65.2
51



Cross-linked sodium
15
/
/
/



carboxymethyl cellulose



Crospovidone
/
7.5
7.5
20



Hydroxypropyl
2
9
7.5
12



methylcellulose


External
Active ingredient B
12.3
12.3
12.3
12.3



Microcrystalline cellu-
25
/
/
/



lose PH102



Microcrystalline cellu-
/
32
15.5
30.7



lose PH112



Crospovidone
/
15
15
6



Silicon dioxide
20
6
24
15



Magnesium stearate
3
3
3
3











Total weight
300
300
300
300









Preparation Process

The internal raw and auxiliary materials were weighed based on the formulation amount of 50 tablets and mixed well. In Example 21, the materials were added with purified water to prepare into soft materials, granulated with a 40-mesh sieve, dried at 50° C., sized with a 40-mesh sieve, added with the external auxiliary materials at a converted amount, mixed in a bag for 10 min, and tableted. The mixed materials, in Example 22, were added with hydroxypropyl methylcellulose aqueous solution to prepare into soft materials and, in Examples 23 and 24, were added with purified water to prepare into soft materials, granulated with a 80-mesh sieve, dried at 40° C., and sized with a 80-mesh sieve, where the moisture content was controlled at 2% or below. The external raw and auxiliary materials were weighted at a converted amount, passed through a 80-mesh sieve, mixed for 8 times, then added with corresponding dry particles, mixed well, and tableted. The dissolution rate was determined in hydrochloric acid medium with pH1.0 in 15 min.









TABLE 8







Dissolution Rate Results of Examples 16-24










Active
Active


Dissolution Rate (%)
ingredient A
ingredient B





Example 16
94.2
93.5


Example 17
93.7
87.0


Example 18
93.8
94.7


Example 19
95.5
92.8


Example 20
95.6
93.0


Example 21
99.0
94.6


Example 22
89.8
86.2


Example 23
97.7
90.0


Example 24
91.0
88.8


Comparative Example/Avapro(8A430)
92.6
/


Comparative Example/FORXIGA (KJ3245)
/
97.4









Conclusion: The dissolution rates in 15 min of active ingredient A and active ingredient B of each example were more than 85%, consistent with the dissolution rate of the corresponding comparative example.


EXAMPLES 25-30









TABLE 9







Formulation Composition of Unit Formulation (mg/tablet)













Component
Example 25
Example 26
Example 27
Example 28
Example 29
Example 30

















Internal
Active
150
75
150
300
75
300



ingredient A



Lactose
51
25.5
51
102
25.5
102



Crospovidone
6
3
6
12
3
12



Hydroxypropyl
6
3
6
12
3
12



methylcellulose


External
Active
12.3
6.15
6.15
12.3
12.3
6.15



ingredient B



Microcrystalline
53.7
26.85
59.85
119.7
20.7
125.85



cellulose



Crospovidone
6
3
6
12
3
12



Silicon dioxide
12
6
12
24
6
24



Magnesium stearate
3
1.5
3
6
1.5
6













Total weight
300
150
300
600
150
600









Preparation Process

Active ingredient A, cross-linked povidone, lactose monohydrate and hydroxypropyl methylcellulose were weighed based on the formulation amount, mixed well, added with purified water to prepare into soft materials, granulated with a 80-mesh sieve, dried at 40° C., sized with a 80-mesh sieve, where the moisture content was controlled at 2% or below. The external raw and auxiliary materials were weighted at a converted amount, passed through a 80-mesh sieve, mixed for 8 times, then added with dry particles, mixed well, and tableted. The dissolution rate was determined in hydrochloric acid medium with pH1.0 in 15 min.









TABLE 10







Dissolution Rate Results of Examples 25-30










Active
Active


Dissolution Rate (%)
ingredient A
ingredient B












Example 25
99.0
95.8


Example 26
98.5
88.9


Example 27
98.6
96.4


Example 28
93.5
95.2


Example 29
100.6
88.0


Example 30
95.8
92.1


Comparative Example/
90.0
/


Avapro (ET01506, Specification: 75 mg)


Comparative Example/
92.6
/


Avapro (DT04448, Specification: 150 mg)


Comparative Example/
93.2
/


Avapro(DT03090A, Specification: 300 mg)


Comparative Example/
/
92.1


FORXIGA(LB0143, Specification: 5 mg)


Comparative Example/
/
91.8


FORXIGA(KJ3245, Specification: 10 mg)









EXAMPLES 31-33









TABLE 11







Formulation Composition of Unit Formulation (mg/tablet)











Exam-
Exam-
Exam-


Component
ple 31
ple 32
ple 33














Internal
Active ingredient A
300
300
300



Active ingredient B
/
/
12.3



Lactose
102
102
102



Cross-linked sodium
/
12
12



carboxymethyl cellulose



Crospovidone
12
/
/



Hydroxypropyl
10
/
8



methylcellulose



Hydroxypropyl cellulose
/
24
/


External
Active ingredient B
12.3
12.3
/



Microcrystalline cellulose
31.7
119.7
329.7



Lactose
/
/
/



Cross-linked sodium
/
12
20



carboxymethyl cellulose



Crospovidone
15
/
/



Silicon dioxide
12
12
8



Magnesium stearate
5
6
8










Total weight
500
600
800









Preparation Process

Example 31: The internal raw and auxiliary materials were weighed based on the formulation amount of 100 tablets, mixed well, prepared into soft materials with purified water, granulated with a 40-mesh sieve, dried at 50° C., sized with a 40-mesh sieve, added with the external raw and auxiliary materials at a converted amount, mixed well, and tableted.


Example 32: The internal raw and auxiliary materials were weighed based on the formulation amount of 25 tablets, mixed well, prepared into soft materials with purified water, granulated with a 40-mesh sieve, dried at 60° C., sized with a 40-mesh sieve, added with the external raw and auxiliary materials at a converted amount, mixed well, and tableted.


Example 33: The internal raw and auxiliary materials were weighed based on the formulation amount of 25 tablets, mixed well, prepared into soft materials with purified water, granulated with a 40-mesh sieve, dried at 40° C., sized with a 40-mesh sieve, added with the external raw and auxiliary materials at a converted amount, mixed well, and tableted.


The dissolution rate of each example was determined in hydrochloric acid medium with pH1.0 in 15 min. The results were as follows:









TABLE 12







Dissolution Rate Results of Examples 31-33









Dissolution Rate (%)
Active ingredient A
Active ingredient B





Example 31
97.1
94.8


Example 32
89.7
86.5


Example 33
86.7
87.9









EXAMPLES 34-40









TABLE 13







Formulation Composition of Unit Formulation (mg/tablet)












Exam-
Exam-
Exam-
Exam-


Component
ple 34
ple 35
ple 36
ple 37















First
Telmisartan
40
/
/
/


layer
Losartan potassium
/
50
/
/



Candesartan
/
/
8
1



Azilsartan
/
/
/
40



Sodium hydroxide
3.36
/
/
0.69



Povidone
12
/
/
/



Meglumine
12
/
/
/



Sorbitol
168.64
/
/
/



Microcrystalline cellu-
/
52.5
/
18



lose



Lactose monohydrate
/
25.5
89.4
/



Pregelatinized starch
/
20.95
/
/



Calcium carboxymethyl
/
/
5.6
/



cellulose



Hydroxypropyl
/
/
4
/



methylcellulose



Corn starch
/
/
20
/



Polyethylene glycol
/
/
2.6
/



Mannitol
/
/
/
95.63



Fumaric acid
/
/
/
2



Hydroxyproline
/
/
/
5.4



Cross-linked sodium
/
/
/
13.8



carboxymethyl cellulose



Magnesium stearate
4
1.05
0.4
1.8


Second
Active ingredient B
12.3
/
12.3
12.3


layer
Canagliflozin
/
300
/
/



Microcrystalline cellu-
171.45
242.9
171.45
171.45



lose



Anhydrous lactose
50
100
50
50



Crospovidone
10
30
10
10



Silicon dioxide
3.75
20
3.75
3.75



Magnesium stearate
2.5
5
2.5
2.5
















TABLE 14







Formulation Composition of Unit Formulation (mg/tablet)











Exam-
Exam-
Exam-


Component
ple 38
ple 39
ple 40














First
Valsartan
40
/
/


layer
Olmesartan
/
20
/



Active ingredient A
/
/
300



Hydroxypropyl methylcellulose
/
/
10



Microcrystalline cellulose
72.5
128
/



Lactose monohydrate
30
40
102



Cross-linked sodium
/
10
12



carboxymethyl cellulose



Cross-linked povidone
6
/
/



Magnesium stearate
1.5
2
5


Second
Active ingredient B
12.3
12.3
12.3


layer
Microcrystalline cellulose
171.45
171.45
171.45



Anhydrous lactose
50
50
50



Crospovidone
10
10
10



Silicon dioxide
3.75
3.75
3.75



Magnesium stearate
2.5
2.5
2.5









Preparation Process

Examples 34 and 37: a) The raw and auxiliary materials for the first layer except sodium hydroxide and magnesium stearate were weighed based on the formulation amount of 100 tablets, mixed well, and prepared into soft materials with sodium hydroxide aqueous solution, granulated with a 40-mesh sieve, dried at 40° C., sized with a 40-mesh sieve, added with magnesium stearate at a converted amount, and mixed well; b) The raw and auxiliary materials for the second layer were weighed and mixed well; and c) The blended particles of the first layer and the mixed powder of the second layer were pressed into a double-layer tablet.


Examples 35 and 36: a) The raw and auxiliary materials for the first layer were weighed based on the formulation amount of 100 tablets and mixed well; b) The raw and auxiliary materials for the second layer were weighed and mixed well; and c) The mixed powder of the first layer and the mixed powder of the second layer were pressed into a double-layer tablet.


Examples 38-40: a) Part of magnesium stearate and all other raw and auxiliary materials for the first layer were weighed based on the formulation amount of 100 tablets, mixed well, granulated by the dry method, then added with the remaining magnesium stearate, and mixed well; b) Part of silicon dioxide and magnesium stearate and all other raw and auxiliary materials for the second layer were weighed, mixed well, granulated by the dry method, then added with the remaining silicon dioxide and magnesium stearate, and mixed well; and c) The blended particles of the first layer and the mixed powder of the second layer were pressed into a double-layer tablet.


The dissolution rate of some examples was determined in hydrochloric acid medium with pH1.0 in 15 min. The results were as follows:









TABLE 15







Dissolution Rate Results of Examples 39 and 40












Active
Active


Dissolution Rate (%)
Olmesartan
ingredient A
ingredient B





Example 39
85.6
/
89.8


Example 40
/
87.3
90.1









Effect Example









TABLE 16







Formulation Composition of Unit Formulation (mg/tablet)










Exam-
Exam-


Component
ple 41
ple 42













Internal
Active ingredient A
300
300



Active ingredient B
/
12.3



Lactose monohydrate
102
102



Cross-linked sodium carboxymethyl
12
/



cellulose



Crospovidone
/
12



Hydroxypropyl methylcellulose
12
10


External
Active ingredient B
12.3
/



Microcrystalline cellulose
131.7
54.7



Cross-linked sodium carboxymethyl
12
/



cellulose



Crospovidone
/
12



Silicon dioxide
12
12



Magnesium stearate
6
5









Weight of tablet core/content
600
520









Preparation Process

The internal raw and auxiliary materials were weighed based on the formulation amount of 100 tablets, mixed in a bag for 15 min, added with purified water to prepare into soft materials, granulated with a 40-mesh sieve, dried at 40° C. (Example 42) or 50° C. (Example 41), sized with a 40-mesh sieve, where the moisture content was controlled at 2% or below. The external raw and auxiliary materials were weighted at a converted amount, mixed in a bag for 15 min, and tableted. The dissolution curve of the examples was determined in hydrochloric acid medium with pH1.0.









TABLE 17







Cumulative Dissolution Rate (%) of Active Ingredient


A in Hydrochloric Acid Solution with pH 1.0









Cumulative Dissolution Rate (%)












Time
Exam-
Exam-
Comparative Example/



(min)
ple 41
ple 42
Avapro (DT03090A)
















10
95.4
84.7
76.5



15
98.6
99.4
93.6



20
97.6
101.2
96.3



30
98.3
101.6
97.0



45
99.0
102.7
97.9



60
100.1
101.4
99.7

















TABLE 18







Cumulative Dissolution Rate (%) of Active Ingredient


B in Hydrochloric Acid Solution with pH 1.0









Cumulative Dissolution Rate (%)












Time
Exam-
Exam-
Comparative Example/



(min)
ple 41
ple 42
FORXIGA (LA2242)
















10
91.5
81.6
88.9



15
95.5
96.0
91.8



20
95.0
97.6
93.1



30
96.0
97.4
93.2



45
97.1
99.1
94.8



60
99.7
97.9
95.4

















TABLE 19







Determination Results of Related Substances


of Active Ingredient A (%)











Example/Comparative

Total


Time
Example
RRT 0.85
impurities





Day 0
Example 41
Not detected
0.042



Example 42
Not detected
0.041



Comparative Example/
0.034
0.119



Avapro (DT04448)


50° C. for 10 days
Example 41
Not detected
0.045



Example 42
Not detected
0.048



Comparative Example/
0.074
0.165



Avapro (DT04448)









The self-made formulations of Examples 41 and 42 and reference formulation were subjected to PK research in Beagle dogs. A 3-perid 3-crossover study was conducted by using three beagle dogs (11.6-14.8 kg), in which single reference formulation A and reference formulation B were administered simultaneously. Blood samples were taken at 0.25 h, 0.5 h, 0.75 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4 h, 6 h, 8 h, 12 h and 24 h after administration, and detected by LC-MS. The results were as follows:









TABLE 20







Animal Experimental Results of Active Ingredient A









Example










Example 41
Example 42












Cmax Ratio
AUC0-24 Ratio
Cmax Ratio
AUC0-24 Ratio


Animal
Cmax self-made/
AUC0-24 self-made/
Cmax self-made/
AUC0-24 self-made/


Number
Cmax reference
AUC0-24 reference
Cmax reference
AUC0-24 reference














dog-#1
123.21
107.43
124.61
121.11


dog-#2
104.66
84.69
115.37
123.11


dog-#3
94.78
118.27
115.36
119.38


(n = 3) Mean
107.55
103.46
118.45
121.20


SD
14.43
17.14
5.34
1.87


CV %
13.4
16.6
4.5
1.5
















TABLE 21







Animal Experimental Results of Active Ingredient B









Example










Example 41
Example 42












Cmax Ratio
AUC0-24 Ratio
Cmax Ratio
AUC0-24 Ratio


Animal
Cmax self-made/
AUC0-24 self-made/
Cmax self-made/
AUC0-24 self-made/


Number
Cmax reference
AUC0-24 reference
Cmax reference
AUC0-24 reference














dog-#1
98.58
101.79
104.46
113.85


dog-#2
119.63
87.14
101.87
103.95


dog-#3
110.78
120.59
97.25
96.99


(n = 3) Mean
109.66
103.17
101.20
104.93


SD
10.57
16.77
3.65
8.47


CV %
9.6
16.3
3.6
8.1









Conclusion: It can be seen from the above results the Cmax Ratio and AUC0-24 Ratio of the self-made formulation and the original formulation in beagle dogs are both in the range of 80%-125%, indicating that the self-made formulation and the original formulation are bioequivalent in beagle dogs.


The composition of an SGLT-2 inhibitor and an angiotensin receptor blocker and use thereof according to the present disclosure are described in detail above. The principle and implementation of the present disclosure are illustrated by using specific embodiments herein. The above descriptions of the embodiments are only used to facilitate understanding of the method and the core idea of the present disclosure. It should be noted that, several improvements and modifications may be made by those skilled in the art to the present disclosure without departing from the principle of the present disclosure, and these improvements and modifications also fall within the protection scope of the claims of the present disclosure.

Claims
  • 1. A composition, comprising an SGLT-2 inhibitor and an angiotensin II receptor antagonist; wherein the SGLT-2 inhibitor is selected from the group consisting of dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin, tofogliflozin, ertugliflozin, janagliflozin, bexagliflozin, sotagliflozin, henagliflozin, tianagliflozin, remogliflozin, alligliflozin, remogliflozin etabonate, (1R,2S,3S,4R,5S)-5-(4-chloro-3-(4-ethoxybenzyl)phenyl)-1-((R)-1-hydroxyethyl)-6,8-dioxabicyclo[3.2.1]octane-2,3,4-triol, and a mixture thereof; andthe angiotensin II receptor antagonist is selected from the group consisting of irbesartan, candesartan, valsartan, telmisartan, losartan, iprasartan, olmesartan, azilsartan, and a mixture thereof.
  • 2. (canceled)
  • 3. (canceled)
  • 4. The composition according to claim 1, wherein the SGLT-2 inhibitor is selected from the group consisting of dapagliflozin, a pharmaceutically acceptable salt, ester, cocrystal, complex or solvate of dapagliflozin, and a mixture thereof; and the angiotensin II receptor antagonist is selected from the group consisting of irbesartan, a pharmaceutically acceptable salt or solvate of irbesartan, and a mixture thereof.
  • 5. The composition according to claim 1, wherein a weight ratio of the SGLT-2 inhibitor to the angiotensin II receptor antagonist is 1:960-300:1, preferably 1:240-75:1, more preferably 1:120-1:7.5, more preferably (8-300):(2-300), and most preferably 8:300, 20:12.3, 40:12.3, 50:4.1, 50:2, 44.8:3.7, 32.5:2.7, 150:12.3, 150:6.15, 75:12.3, 300:6.15 or 300:12.3.
  • 6. Use of the composition according to claim 1 in the manufacture of a medicament for treating essential hypertension, type 2 diabetic nephropathy associated with hypertension, diabetes, insulin resistance, hyperglycemia, hyperinsulinemia, elevated level of fatty acid or glycerol in blood, hyperlipidemia, dyslipidemia, obesity, or complications of diabetes.
  • 7. A drug, comprising the composition according to claim 1 and a pharmaceutically acceptable adjuvant.
  • 8. The drug according to claim 7, wherein the adjuvant is selected from the group consisting of a filler, binder, disintegrant, antiadherent, adsorbent, glidant, lubricant, surfactant, chelating agent, colorant, taste masking agent, and a mixture thereof.
  • 9. The drug according to claim 8, wherein the drug is in a dosage form selected from the group consisting of a tablet, capsule, granule, suspension, film, and a mixture thereof, preferably a tablet, dry suspension, capsule or granule.
  • 10. The drug according to claim 9, wherein the SGLT2 inhibitor and the angiotensin II receptor antagonist are mixed: (1) by directly mixing; or(2) as an internal component or an external component separately; or(3) as an internal component simultaneously; or(4) by separately tableting and then pressing into a double-layer tablet.
  • 11. The drug according to claim 10, wherein the angiotensin II receptor antagonist is used as an internal component and the SGLT-2 inhibitor is used as an external component.
  • 12. A method for preparing the drug according to claim 7, comprising directly mixing raw and auxiliary materials.
  • 13. (canceled)
  • 14. (canceled)
  • 15. Use of the drug according to claim 7 for treating essential hypertension, type 2 diabetic nephropathy associated with hypertension, diabetes, insulin resistance, hyperglycemia, hyperinsulinemia, elevated level of fatty acid or glycerol in blood, hyperlipidemia, dyslipidemia, obesity, or complications of diabetes.
PCT Information
Filing Document Filing Date Country Kind
PCT/CN2020/109533 8/17/2020 WO