Ophthalmic compositions comprising ciclosporin

Information

  • Patent Grant
  • 11400132
  • Patent Number
    11,400,132
  • Date Filed
    Tuesday, October 13, 2020
    3 years ago
  • Date Issued
    Tuesday, August 2, 2022
    a year ago
Abstract
The present invention relates to compositions in the form of a clear solution comprising ciclosporin with low residual water content and 1-perfluorobutyl-pentane. The compositions may be used for topical administration to the eye.
Description
BACKGROUND OF THE INVENTION

Ciclosporin is a challenging compound to formulate and to deliver due to its extremely poor solubility in water, and relatively large molecular size. Solubilizing excipients such as surfactants and organic or oil-based solvents are typically required in formulations of this compound.


Many ophthalmic formulations of ciclosporin disclosed in the art are based on oil-in-water emulsions in which the ciclosporin is dissolved in the oily phase (e.g. castor oil). One of the disadvantages of using organic or oil-based solvents or surfactants as a solubilizing agent in ophthalmic formulations is that these may often cause eye irritation such as pain, or stinging sensation when administered to the eye and may be poorly tolerated as a result. In the case of oily excipients, these may also have an inherent negative impact on vision (e.g. blurring) especially when present in substantial amounts, due to substantial differences in refractive index compared to that of physiological tear fluid. Oil-in-water emulsion formulations are also disadvantaged in that they may have limited drug load capacity, since while the active ingredient may have some solubility in the oil phase, this phase is only dispersed in the coherent aqueous phase, so that maximum overall drug concentration in the formulation is limited.


WO2011/073134A1 discloses pharmaceutical compositions in the form of solutions comprising ciclosporin and a semifluorinated alkane as a liquid vehicle which may be administered to the eye of a patient, such as for the treatment of keratoconjunctivitis. It is disclosed ciclosporin has a solubility of 2.54 g/L in the semifluorinated alkane 1-perfluorobutyl-pentane (F4H5) in the absence of any co-solvent. WO2011/073134A1 further teaches that with a small amount of ethanol as a co-solvent, the solubility of ciclosporin in F4H5 increases markedly, for example to 5.65 g/L when 1.0 wt % of ethanol is included in the composition. Ethanol is, generally speaking, not very tolerated by the human eye however it is mentioned that inclusion of a small amount of ethanol such as 1 wt % does not negatively affect tolerability. It would be an advantage, nevertheless, if the use of an additional further excipient and a co-solvent such as ethanol can be avoided.


It is thus an object of the present invention to provide improved compositions comprising ciclosporin which overcome these limitations of the prior art formulations. Further objects of the invention will be clear on the basis of the following description of the invention, examples and claims.


SUMMARY OF THE INVENTION

The invention provides a composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent and the concentration of ciclosporin is greater than about 2.6 mg/mL at 15-25° C., or greater than about 3.0 mg/mL. In a further aspect, the residual water content of the composition is less than about 0.04 mg/mL, or less than about 0.03 mg/mL.


In another aspect, the invention provides a composition in the form of a clear solution, comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.04 mg/ml, or less than about 0.03 mg/mL.


Preferably, the composition of the invention is essentially free of ethanol as a co-solvent. The composition is also preferably thermodynamically stable at 15-25° C.


Furthermore, the invention provides medical uses of these compositions, in particular for use for the treatment of keratoconjunctivitis sicca, meibomian gland dysfunction, or a symptom thereof. In one embodiment, these compositions are for ophthalmic use and are topically administered to the eye, such as in the form of eye drops.


In yet a further aspect, the invention provides for a composition that is obtainable by dissolving ciclosporin with a water content of less than about 1.6 wt %, or more preferably, by dissolving ciclosporin with a water content of less than about 1.0 wt %, based on the total weight of the ciclosporin, in 1-perfluorobutyl-pentane. A method of preparing a composition of the invention is also provided, the method comprising the steps of a) providing ciclosporin with a water content of less than about 1.6 wt %, or more preferably less than about 1.0 wt %, based on the total weight of the ciclosporin, and b) dissolving said ciclosporin in 1-perfluorobutyl-pentane.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 depicts the water sorption of ciclosporin obtained from sorption calorimetry at 25° C. The inset is a zoomed area of the ciclosporin sorption isotherm at the higher relative humidity (RH) levels.



FIG. 2A depicts the solubility of ciclosporin in 1-perfluorobutyl-pentane as a function of relative humidity.



FIG. 2B depicts the solubility of ciclosporin in 1-perfluorobutyl-pentane as a function of water content of the ciclosporin.





DETAILED DESCRIPTION OF THE INVENTION

In a first aspect, the invention relates to a composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent and the concentration of ciclosporin, as determined at 15-25° C., is greater than about 2.6 mg/mL, or more preferably, greater than 3.0 mg/mL.


Ciclosporin (synonyms include cyclosporin A, CsA, or cyclosporine) is a cyclic nonribosomal peptide comprising 11 amino acids with the empirical formula C62H111N11O12 and molecular weight of 1202.61. It is an immunosuppressant drug that is widely used in post-allergenic organ transplant, to reduce the activity of the patient's immune system and thereby, the risk of organ rejection. Ciclosporin is typically provided as a colourless or white powder.


Preferably, the ciclosporin as used for the formulation of the composition and any of the embodiments or preferences as described herein has a water content of less than about 1.6 wt %, based on the total weight of ciclosporin. In another embodiment, the composition of the invention comprises of a total residual water content of less than about 0.04 mg/mL. More preferably, the ciclosporin as used for the formulation of the composition and any of the embodiments or preferences as described herein has a water content of less than about 1.0 wt %, based on the total weight of ciclosporin. In another embodiment, the composition of the invention comprises of a total residual water content of less than about 0.03 mg/mL. In yet a further embodiment, the composition comprises no residual water content.


The term residual water content as used herein refers to the fraction or trace amount of water that may be present in the composition originating from the composition components, such as ciclosporin and 1-perfluorobutyl-pentane.


The predominant contribution to residual water content in the composition can be attributed to water sorption or association with ciclosporin (e.g. not limited to, but for example derived from manufacturing process, or its transport and storage). Ciclosporin, as is usually available for medicinal use and formulation typically has a water content of about 1.6 wt % based on the weight of ciclosporin. The water solubility in 1-perfluorobutylpentane is on the other hand essentially negligible i.e. in very low amounts such as less than 1.20×10−5 wt % based on weight of 1-perfluorobutylpentane.


The residual water content of ciclosporin, 1-perfluorobutyl-pentane, or of the composition of the invention comprising ciclosporin dissolved in 1-perfluorobutyl-pentane may be determined using methods and/or apparatus known in the art for moisture analysis, for example, but not limited to methods such as standard Karl-Fischer titration e.g. volumetric or coulometric.


It has been found that unexpectedly high concentrations of ciclosporin, such as greater than about 2.6 mg/mL, or more preferably greater than about 3.0 mg/mL at room temperature (i.e. 15-25° C.), may be dissolved in 1-perfluorobutyl-pentane without the need of a co-solvent. This has been observed in particular when the total residual water content of the compositions is less than about 0.04 mg/mL, in particularly less than 0.03 mg/mL, such as when the residual water content of ciclosporin is low.


While co-solvents may be useful as an aid for solubilizing ciclosporin and enable higher concentration formulations of ciclosporin to be obtained, it would be preferable if their use can be avoided. In particular, in context of ophthalmic use, co-solvents in the form of liquid solubilizing excipients such as surfactants or non-aqueous organic solvents may cause eye irritation or eye discomfort (e.g. blurred vision, or pain) when topically administered to the eye. Examples of co-solvents which may be used to help solubilize ciclosporin include oils such as glyceride or triglyceride oils (e.g. soybean oil, olive oil, sesame oil, cotton seed oil, castor oil or sweet almond oil), mineral oils (e.g. petrolatum or liquid paraffin), liquid oily fatty acids, fatty alcohols or sorbitol esters, or organic solvents e.g. glycerol, polyethylene glycol, propylene glycol or ethanol.


In a preferred embodiment, the composition of the invention is essentially free of a co-solvent such as defined above. As used herein, the term ‘essentially free’ means that there is no co-solvent in the composition, and if present then in trace or residual amounts such as to confer no technical advantage or relevance in respect of the object of the invention. Most preferably, the compositions as described herein are essentially free of ethanol as a co-solvent.


The absence of an organic co-solvent such as ethanol offers the advantages of a simpler two component formulation (essentially consisting of ciclosporin and 1-perfluorobutyl-pentane) as compared to a more complex three component formulation additionally comprising a co-solvent such as ethanol, in terms of factors such as cost, manufacturing, handling, packaging, and also patient compliance.


The higher concentrations of ciclosporin that may be obtained may offer advantages in terms of reducing the dosing frequency required by patients, and may also lead to more effective delivery of ciclosporin to the intended target tissue, for example to the eye. The compositions according to the invention may comprise of ciclosporin dissolved in 1-perfluorobutylpentane at a concentration of greater than about 2.6 mg/mL, as determined at room temperature or ambient temperature, i.e. about 15-25° C. In further embodiments, the concentration of ciclosporin in the composition at 15-25° C. is preferably greater than about 3.0 mg/mL, or may be in the range of from about 2.6 to 4.8 mg/mL, or 2.8 to 4.8 mg/mL, or preferably from about 3.0 to 4.8 mg/mL. In a further preferred embodiment, the concentration of dissolved ciclosporin is about 4.0 mg/mL as determined at 15-25° C. The concentration of ciclosporin dissolved in the solution may be quantified using methods known in the art, such as HPLC. As used herein, the term ‘about’ in reference or connection to a parameter such as the concentration, or concentration range of dissolved ciclosporin, or in relation to the residual water content of ciclosporin, based on the total weight of the ciclosporin, or in relation to the total residual water content in a composition according to the invention, may include the precise value as well as any value falling within the degree of variability usually observed in measuring or determining these parameters using the standard techniques and equipment known in the art and field.


In one embodiment, the ciclosporin as used herein is amorphous and is not crystalline or predominantly in any specific crystal form. Preferably, the ciclosporin that is dissolved in the 1-perfluorobutyl-pentane is obtained by a step of drying to reduce or to remove residual water from the ciclosporin. For example, the ciclosporin used in the preparation of a composition according to the invention, such as with a total residual water content of about 1.0%, is obtained by drying using drying methods known in the art such as drying under vacuum, drying in the presence of a desiccant or a drying agent.


A clear solution, as understood herein, refers to a liquid solution in which all solutes are fully dissolvable or dissolved under room temperature conditions i.e. between 15-25° C. The clear solution does not comprise of any particulate or solid phase components, for example undissolved ciclosporin and preferably has a refractive index approximate to that of water (i.e. 1.333) at room temperature. In one embodiment, the clear solution as presented by the composition of the invention may have a refractive index of between about 1.3 to 1.4.


In particular, the clear solution is thermodynamically stable between 15-25° C., meaning that under equilibrium, all of the dissolved components, including ciclosporin, remain in the dissolved state and that no phase separation, precipitation or changes to the physical form of the solution occurs. Preferably, the composition in the form of a clear solution according to the invention as described herein is thermodynamically stable when stored at 15-25° C. i.e. room temperature for a period of time such as at least about 2 weeks, or about 1 month, or 3 months, or at least about 6 months. Moreover, the invention may provide a composition which when stored at lower temperatures, such as under refrigeration, for example at temperatures between 0-10° C. may partially precipitate, but when brought back to 15-25° C. (room temperature) returns to a thermodynamically stable and clear solution with all previously precipitated components dissolved again.


The liquid carrier of the composition according to the invention, 1-perfluorobutyl-pentane, is a semifluorinated alkane with the chemical formula F(CF2)4(CH2)5H. It is an inert, water-insoluble liquid, with a density of 1.284 g/cm3 at 25° C. and refractive index of 1.3204 at 20° C. Alternative nomenclature for this compound includes F4H5, wherein F denote a linear perfluorinated alkane segment comprising 4 carbon atoms and wherein H denotes a linear and non-fluorinated alkane hydrocarbon segment of 5 carbon atoms.


The 1-perfluorobutyl-pentane as featured in any of the compositions or methods described herein is preferably essentially free of water. In such case, the presence of residual water in the composition according to the invention is derived from the ciclosporin or optionally, if present, one or more excipients that is functionally not a co-solvent. More preferably, the 1-perfluorobutyl-pentane does not comprise of any water, or has a water content of no more than the maximal solubility of water in 1-perfluorobutyl-pentane, for example, has a water-content of less than 1.6×10−4 mg/mL as determined by methods known in the art for moisture analysis, such as Karl-Fischer titration methods.


In another aspect, the invention provides a composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.04 mg/ml.


In a further embodiment, the invention provides a composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.03 mg/ml.


In further embodiments, the composition may have a total residual water content of less than 0.03 mg/mL or of less than 0.025 mg/mL, or of less than 0.02 mg/mL, or of less than 0.015 mg/mL, or less than 0.01 mg/mL.


In particular, the relative ratio of ciclosporin to residual water content as featured in the compositions as described in any of the embodiments and featured herein may be at least greater than about 65 to 1, or preferably, greater than 100 to 1, or greater than 200 to 1.


The concentration of ciclosporin in such compositions at 15-25° C. is preferably from about 0.5 to 4.8 mg/mL. In further embodiments, the concentration of ciclosporin as determined at room temperature of the composition may be in the range of from about 2.6 to 4.8 mg/mL, or preferably from about 3.0 to 4.8 mg/mL. In a particularly further preferred embodiment, the concentration of dissolved ciclosporin at 15-25° C. is about 4.0 mg/mL. Lower concentrations of ciclosporin, such as from about 0.5 to 2.6 mg/mL, or from the range of about 0.5 to 1.0 mg/mL of ciclosporin dissolved in 1-perfluorobutyl-pentane may also contemplated in for the invention. Due to the dependence of solubility in relation to temperature, there is general tendency for active ingredients such as ciclosporin to precipitate out of solution when the solution is stored at lower temperature conditions. The low water content of the ciclosporin such as described for the invention advantageously may provide improved physical stability to the solution formed in 1-perfluorobutylpentane, for example even when the solution is stored at lower temperatures, such as under refrigeration (e.g. at 0-10° C.), any precipitation that may occur will easily dissolve again when the composition is brought back to 15-25° C. (room temperature).


In yet a further embodiment, the composition as described in any of the embodiments or preferences featured herein, including any combinations thereof, consists essentially of 1-perfluorobutyl-pentane and ciclosporin and has a residual water content in an amount of less than about 0.04 mg/mL.


In yet another embodiment, the composition as described in any of the embodiments or preferences featured herein, including any combinations thereof, consists essentially of 1-perfluorobutyl-pentane and ciclosporin and has a residual water content in an amount of less than about 0.03 mg/mL.


The residual water content of the composition may be primarily attributed to the residual water content of ciclosporin, for example, wherein at least 99% of the residual water content of the composition can be attributed to ciclosporin. As used herein, the term “consists” and related terms “consisting” or “consist” is to be understood as meaning that no other features, other than those prefaced by the term are present. The term ‘essentially’ means if present then in trace or residual amounts such as to confer no technical advantage or relevance in respect of the object of the invention.


The composition as described in any of the above embodiments, and embodiments herein, including any combinations or preferences thereof, may be used as a medicine, and for therapeutic use. The use of said compositions in the manufacture of a medicament or medicine for the treatment of a patient in need thereof is also provided for in the context of the present invention.


Particular preferred is the use of the composition for the treatment of keratoconjunctivitis sicca, or a symptom thereof. Keratoconjunctivitis sicca is also known as dry eye disease or syndrome, or dysfunctional tear syndrome. A patient having keratoconjunctivitis sicca may experience any one of, or a combination of tear hyperosmolarity, tear film instability or abnormalities in the lipid layer composition of the tear film. Aqueous-deficient dry eye disease, evaporative dry eye disease, Sjögren syndrome, lacrimal gland insufficiency, meibomian gland dysfunction as understood herein may be considered to be within the scope, for example as sub-types, of keratoconjunctivitis sicca.


Symptoms of keratoconjunctivitis may include any one, or combination of the following: a dry, scratchy, gritty, or sandy feeling in the eye; foreign body sensation; pain or soreness; stinging or burning; itching; increased blinking; eye fatigue; photophobia; blurry vision; redness; mucus discharge; contact lens intolerance; excessive reflex tearing. It is understood that not all patients suffering from keratoconjunctivitis sicca may exhibit all symptoms simultaneously. Hence, there is currently no uniform set of criteria for diagnosing the disease. It is however important to note that, within the scope of the present invention, any of the aspects, symptoms or pathophysiological consequences of keratoconjunctivitis sicca may be addressed.


Also preferred is the use of the composition as defined in any of the embodiments described herein for the treatment of meibomian gland dysfunction, or a symptom thereof. Meibomian gland dysfunction may be characterized by gland obstruction and clogging through hyperkeratinisation of the gland and increased viscosity of the meibum lipid secretions of the meibomian gland ducts. The quantitative or qualitative secretion of the lipid components required for the tear film may be altered in the case of patients with meibomian gland dysfunction. This may lead to a failure in forming a stable and continuous tear film, which may be further followed by evaporative loss and hyperosmolarity. Meibomian gland dysfunction can arise from a primary lid-margin related disease or a secondary disease arising from systemic disorders such as acne rosacea, or seborrheic dermatitis. In addition to any one of the symptoms as described for keratoconjunctivitis sicca as described above, patients with meibomian gland dysfunction may also experience symptoms including any one or combination thereof, of itching, redness, swelling, pain or soreness, discharge accumulation or crusting at the eye lid margins.


The compositions according to the above uses are preferably ophthalmic compositions that are topically administered to the surface of the eye and to any such region or tissue of the eye that may be accessible to topical administration, such as to the cornea or conjunctiva.


The compositions of the invention as described herein may be provided as part of a kit, for example a kit comprising the composition and a container adapted for holding the composition, wherein the container has a dispensing means adapted for topical administration of the composition to the eye or ophthalmic tissue. Optionally, such kit may comprise a water-desiccant or water-desiccating means to safeguard a stable residual water content, for example during storage. An increase in residual water content may the affect solubility of ciclosporin which in turn may affect the stability of the composition and may result in precipitation. Further optionally, instructions for use of the kit in the treatment of keratoconjunctivitis sicca or a symptom thereof, or for use of the kit in the treatment of meibomian gland dysfunction or a symptom thereof may also be included as part of the kit.


In another aspect of the invention, the invention provides for a composition obtainable by dissolving ciclosporin with a water content of less than about 1.6 wt %, based on the total weight of ciclosporin, in 1-perfluorobutyl-pentane. In yet another aspect of the invention, the invention provides for a composition obtainable by dissolving ciclosporin with a water content of less than about 1.0 wt %, based on the total weight of ciclosporin, in 1-perfluorobutyl-pentane. The ciclosporin used for obtaining such compositions may in other embodiments have a water content of less than about 0.8 wt %, or 0.6 wt % or 0.5 wt % or 0.4 wt %, or 0.3 wt %. Particularly preferred is the use of ciclosporin with a water content of 0.4 wt % or less, based on the weight of ciclosporin to obtain a solution in 1-perfluorobutyl-pentane, preferably a clear solution.


Preferably, the composition, including any of its embodiments or preferences as described above is obtained wherein the ciclosporin is dissolved in 1-perfluorobutyl-pentane in the absence of a co-solvent, for example in the absence of ethanol or any of the co-solvents mentioned above. The concentration of ciclosporin that may be dissolved at 15-25° C. to obtain the composition is preferably greater than 2.6 mg/mL. In further embodiments, composition obtained may have a concentration of ciclosporin at 15-25° C. greater than 3.0 mg/mL, or in the range of from about 2.6 to 4.8 mg/mL, or preferably from about 3.0 to 4.8 mg/mL. In a further preferred embodiment, the concentration of dissolved ciclosporin is about 4.0 mg/mL.


Preferably, the composition obtained, including any of its embodiments or preferences as described above provides a clear solution that is thermodynamically stable at 15-25° C.


The composition obtainable according to any of the above embodiments, may be used as a medicament, or used for the manufacture of a medicament. In particular, the composition may be used for use in the treatment of keratoconjunctivitis sicca or a symptom thereof; or for use in the treatment of meibomian gland dysfunction or a symptom thereof. Preferably, the compositions obtainable according to any of the embodiments described herein are ophthalmic compositions, and are used for topical administration to the surface of the eye and to any such region or tissue of the eye that may be accessible to topical administration, such as to the cornea or conjunctiva.


The invention further provides a method of preparing a composition as described in any of the above embodiments or preferences comprising the steps of a) providing ciclosporin with a water content of less than about 1.6 wt % based on the total weight of the ciclosporin, and b) dissolving said ciclosporin in 1-perfluorobutyl-pentane.


Further embodiments of this method may include a method of preparing compositions according to the following embodiments:


1. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent and the concentration of ciclosporin at 15-25° C. is greater than about 2.6 mg/mL.


2. The composition according to item 1, wherein the residual water content of the composition is less than about 0.04 mg/mL.


3. The composition according to any of items 1 or 2, wherein the concentration of ciclosporin at 15-25° C. is in the range of from about 2.6 to 4.8 mg/mL, or preferably from about 3.0 to 4.8 mg/mL.


4. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.04 mg/mL.


5. The composition according to item 4, wherein the concentration of ciclosporin at 15-25° C. is from about 0.5 to 4.8 mg/mL.


6. The composition according any of items 1 to 5, wherein the co-solvent is ethanol.


7. The composition according to any of items 1-6, wherein the solution is thermodynamically stable at 15-25° C.


The invention moreover further provides a method of preparing a composition as described in any of the above embodiments or preferences, namely, a method of preparing a composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, and wherein the composition is essentially free of a co-solvent, the method comprising the steps of a) providing ciclosporin with a water content of less than about 1.0 wt % based on the total weight of the ciclosporin, and b) dissolving said ciclosporin in 1-perfluorobutyl-pentane.


In a further embodiment, step a) may be the provision of ciclosporin having a water content of less than about 0.8 wt %, or 0.7 wt %, or 0.6 wt %, or 0.5 wt % or preferably 0.4 wt % based on the weight of ciclosporin. In another embodiment, step a) may be the provision of ciclosporin having a water content of less than about 0.3 wt %, based on the weight of ciclosporin.


In yet further embodiments, the method as described above may be for preparing the following compositions:


1. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, wherein the concentration of ciclosporin at 15-25° C. is from about 0.5 to 4.8 mg/mL, or more preferably about 0.5 to 3.0 mg/mL, or about 0.5 to 1.0 mg/mL.


2. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, wherein the concentration of ciclosporin at 15-25° C. is in the range of from about 3.0 to 4.8 mg/mL.


3. The composition according to any of item 1 or 2, wherein the co-solvent is ethanol.


4. The composition according to any of items 1 to 3, wherein the solution is thermodynamically stable at 15-25° C.


Moreover, step a) of the method may comprise drying ciclosporin with a water content of about 1.6 wt % or greater than about 1.6 wt % based on the total weight of the ciclosporin.


The step of providing a ciclosporin with low residual water content, such as providing ciclosporin with a water content of less than about 1.0 wt % based on the total weight of the ciclosporin, may include a step of drying ciclosporin which has a higher water content, such as greater than 1.6 wt % based on the total weight of the ciclosporin, or greater than about 1.3 wt %, or about 1.4 wt % or about 1.5 wt %, based on the total weight of the ciclosporin.


In particular, the step of providing ciclosporin having a water content of less than about 1.0 wt %, 0.8 wt %, or 0.6 wt %, or preferably 0.4 wt % may include a step subjecting ciclosporin with a higher water content, preferably ciclosporin with a water content of about 1.6 wt %, or greater than 1.6 wt % based on the total weight of the ciclosporin, to a drying process. Methods of drying include, but are not limited to, drying the ciclosporin under vacuum, optionally in the presence of a water-desiccant or drying agent. The duration, and method of drying may be adapted in order to provide the targeted water content value of ciclosporin.


Further embodiments of the invention may be as follows:


1. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.03 mg/mL.


2. The composition according to item 1, wherein the concentration of ciclosporin at 15-25° C. is from about 0.5 to 4.8 mg/mL.


3. The composition according to any preceding item 1 or 2, wherein the co-solvent is ethanol. 7.


4. The composition according to any preceding item, wherein the solution is thermodynamically stable at 15-25° C.


5. A composition according to any of the preceding items for use as a medicine.


6. The composition for use according to item 5, wherein the composition for use in the treatment of keratoconjunctivitis sicca or a symptom thereof; or for use in the treatment of meibomian gland dysfunction or a symptom thereof.


The following examples serve to illustrate the invention however these are not to be understood as restricting the scope of the invention.


EXAMPLES
Example 1

Isothermal sorption calorimetry of ciclosporin at 25° C. was determined using a 28 mm two-chamber calorimetric cell inserted in a double-twin microcalorimeter. A dry sample, prepared by drying ciclosporin for one day under vacuum and over molecular sieves was placed in the upper (sorption) chamber and pure water was injected in the lower (vaporization) chamber. The water activity was calculated from the power of evaporated water registered in the vaporization chamber. It was found that ciclosporin may comprise of up to about 8 wt % water when exposed to a relative humidity of 99% RH.



FIG. 1 depicts the water sorption of ciclosporin obtained in sorption calorimetry at 25° C. The inset in the FIG. 1 is a zoomed area of the ciclosporin sorption isotherm at higher relative humidity (RH) levels. The water content of ciclosporin at 99.25% RH is approximately 7.41 wt %.


The solubility of ciclosporin in 1-perfluorobutyl-pentane was then determined as a function of its water content. Samples, dried as above were incubated for 5 days in desiccators at different fixed relative humidity at room temperature. The various relative humidity was regulated in the desiccators using saturated salt solutions (LiCl, MgCl2, Mg(NO3)2, NaCl, K2SO4).


After incubation, excess ciclosporin of each sample were added to 1-perfluorobutyl-pentane and each sample was sealed and incubated for 3 days at constant agitation and temperature (room temperature) using an orbital shaker (IKA KS130 Basic, IKA®-Werke GmbH & Co). The resulting saturated solutions were filtered through a 0.2 μm PTFE syringe filter and diluted with acetonitrile (dilution factor of 50, 100 or 200) prior to determination of concentration by reversed phase HPLC-UV. The concentration of ciclosporin was calculated from calibration curves of standard solutions (10-100 μg/mL) prepared in acetonitrile. Based on the water sorption isotherm for ciclosporin, the solubility of ciclosporin in 1-perfluorobutyl-pentane as a function of the water content of ciclosporin could be determined. Table 1 depicts the dataset obtained.











TABLE 1





Relative
Water



Humidity
content,
CsA solubility


(RH) %
wt %
in F4H5 (mg/mL)

















0
0.00
4.75 ± 0.025


11
0.40
3.88 ± 0.027


33
0.76
2.75 ± 0.167


52
1.57
2.64 ± 0.099


53
1.60
2.00 ± 0.099


75
3.05
1.10 ± 0.061


97
6.00
0.90 ± 0.073


100
n.a.
0.52 ± 0.021










FIG. 2A depicts the solubility of ciclosporin in 1-perfluorobutyl-pentane as a function of relative humidity and FIG. 2B depicts the solubility of ciclosporin in 1-perfluorobutyl-pentane as a function of water content in the ciclosporin. It was observed that ciclosporin solubility in 1-perfluorobutyl-pentane starts to rapidly increase from when the water content residue in the ciclosporin is less than 1.6 wt % based on the total weight of the ciclosporin (FIG. 2B).


Karl-Fischer titration measurements of ciclosporin prior to the drying procedure (i.e. not treated) and after drying (i.e. for one day under vacuum and in the presence of molecular sieves, as described above) were also obtained, and maximal solubility in 1-perfluorobutyl-pentane were analogously determined. The results are summarized in Table 2.












TABLE 2







Residual




CsA
water content



Water
in CsA-F4H5



content
composition1
CsA Solubility


Ciclosporin
(wt %)
(mg/mL)
in F4H5 (mg/ml)


















As supplied
1.56 ± 0.06
0.0412
2.64 ± 0.10


Dried
0.40
0.0163
4.08 ± 0.39






1Values expressed excluding the negligible residual water in F4H5 of <1.6 × 10−4 mg/mL.







Significantly higher concentrations, i.e. greater than about 2.6 mg/mL, and up to 4.8 mg/mL of ciclosporin dissolved in 1-perfluorobutyl-pentane can be obtained when ciclosporin with a low and reduced water-content, such as less than about 1.6 wt %, and in particular less than 1.0 wt % is used. An approximately 1.6-fold unexpected increase in solubility of the ciclosporin in 1-perfluorobutyl-pentane was observed using ciclosporin with a reduced water content, of about 0.4 wt % based on the weight of the ciclosporin.

Claims
  • 1. A composition in the form of a clear solution comprising ciclosporin dissolved in 1-perfluorobutyl-pentane, wherein the composition is essentially free of a co-solvent, and wherein the composition has a residual water content of less than about 0.03 mg/mL, and wherein the ciclosporin has a water content of less than about 1.0 wt.% based on the total weight of the ciclosporin.
  • 2. A method for the preparation of a composition according to claim 1, the method comprising the steps of a) providing ciclosporin with a water content of less than about 1.0 wt % based on the total weight of the ciclosporin, and b) dissolving said ciclosporin in 1-perfluorobutyl-pentane.
  • 3. The method according to claim 2, wherein step a) of providing ciclosporin with a water content of less than about 1.0 wt% based on the total weight of ciclosporin, comprises a step of drying ciclosporin with a water content of about 1.6 wt %, or greater than about 1.6 wt % based on the total weight of the ciclosporin.
  • 4. A pharmaceutical kit, comprising: (i.) a composition according to claim 1;(ii.) a container adapted for holding the composition, wherein the container has a dispensing means adapted for topical administration of the composition to the eye or ophthalmic tissue;(iii.) optionally, a water-desiccant; and(iv.) optionally, instructions for use of the kit in the treatment of kerato-conjunctivitis sicca or a symptom thereof, or for use of the kit in the treatment of meibomian gland dysfunction or a symptom thereof.
  • 5. The composition according to claim 1, wherein the composition consists of ciclosporin and 1-perfluorobutylpentane.
  • 6. The composition according to claim 1, wherein the relative ratio of ciclosporin water content to the residual water content of the composition is greater than about 65 to 1.
  • 7. A method for treating a patient, the method comprising a step of administering a composition according to claim 1 to a patient in need thereof.
  • 8. The method of treatment according to claim 7, wherein the composition is administered to a patient having keratoconjunctivitis sicca or a symptom thereof, or meibomian gland dysfunction or a symptom thereof.
  • 9. The method of treatment according to claim 8, wherein the symptom of keratoconjunctivitis sicca is selected from dry, scratchy, gritty, or sandy feeling in the eye; foreign body sensation; pain or soreness; stinging or burning; itching; increased blinking; eye fatigue; photophobia; blurry vision; redness; mucus discharge; contact lens intolerance; excessive reflex tearing and any combinations thereof.
  • 10. The method of treatment according to claim 8, wherein the symptom of meibomian gland dysfunction is selected from itching, redness, swelling, pain or soreness, discharge accumulation or crusting at the eye lid margins and any combinations thereof.
  • 11. The method of treatment according to claim 7, wherein the composition is topically administered to the surface of the eye or to any region or tissue of the eye accessible to topical administration.
  • 12. The method of treatment according to claim 7, wherein the composition consists essentially of 1-perfluorobutyl-pentane and ciclosporin.
  • 13. The method of treatment according to claim 7, wherein the concentration of ciclosporin in the composition at 15-25° C. is from about 0.5 to 4.8 mg/mL.
  • 14. The method of treatment according to claim 11, wherein the composition is topically administered to the cornea or conjunctiva.
Priority Claims (1)
Number Date Country Kind
16190431.3 Sep 2016 EP regional
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. application Ser. No. 16/336,005, filed on Mar. 22, 2019, which is a U.S. national stage application filed under 35 U.S.C. § 371 of International Application No. PCT/EP2017/074079, filed on Sep. 22, 2017, which claims priority to, and the benefit of, European Application No. 16190431.3, filed Sep. 23, 2016, the contents of each of which are incorporated herein by reference in their entireties.

US Referenced Citations (142)
Number Name Date Kind
2616927 Kauck et al. Nov 1952 A
5077036 Long, Jr. Dec 1991 A
5152997 Elbert et al. Oct 1992 A
5254338 Sakai et al. Oct 1993 A
5326566 Parab Jul 1994 A
5336175 Mames Aug 1994 A
5370313 Beard Dec 1994 A
5518731 Meadows May 1996 A
5667809 Trevino Sep 1997 A
5851544 Penska et al. Dec 1998 A
5874469 Maniar et al. Feb 1999 A
5874481 Weers Feb 1999 A
5980936 Krafft et al. Nov 1999 A
5981607 Ding Nov 1999 A
6042845 Sun et al. Mar 2000 A
6060085 Osborne May 2000 A
6113919 Cronelus Sep 2000 A
6159977 Reeves Dec 2000 A
6177477 George et al. Jan 2001 B1
6197323 Georgieff Mar 2001 B1
6224887 Samour et al. May 2001 B1
6262126 Meinert Jul 2001 B1
6294563 Garst Sep 2001 B1
6372243 Kobuch et al. Apr 2002 B2
6391879 Reeves May 2002 B1
6458376 Meadows Oct 2002 B1
6486212 Meinert Nov 2002 B2
6489367 Meinert Dec 2002 B1
6528086 Zhang Mar 2003 B2
6730328 Maskiewicz May 2004 B2
7001607 Menz Feb 2006 B1
7026359 Gross Apr 2006 B1
7258869 Berry Aug 2007 B1
7740875 Dechow Jun 2010 B2
8029977 Meinert et al. Oct 2011 B2
8222292 Goskonda et al. Jul 2012 B2
8470873 Chen Jun 2013 B2
8614178 Theisinger et al. Dec 2013 B2
8796340 Theisinger et al. Aug 2014 B2
8916157 Krause et al. Dec 2014 B2
8986738 Meinert Mar 2015 B2
9241900 Wilson Jan 2016 B2
9308262 Wilson Apr 2016 B2
9757459 Theisinger et al. Sep 2017 B2
9757460 Günther et al. Sep 2017 B2
9770508 Günther et al. Sep 2017 B2
9968678 Theisinger et al. May 2018 B2
10045996 Theisinger et al. Aug 2018 B2
10058615 Günther et al. Aug 2018 B2
10064944 Wilson Sep 2018 B2
10130707 Gunther et al. Nov 2018 B2
10273298 Günther et al. Apr 2019 B2
10369117 Günther et al. Aug 2019 B2
10449164 Günther et al. Oct 2019 B2
10507132 Graf et al. Dec 2019 B2
10525062 Theisinger et al. Jan 2020 B2
10555953 Theisinger et al. Feb 2020 B2
10576154 Günther et al. Mar 2020 B2
10682315 Scherer et al. Jun 2020 B2
10813976 Loscher Oct 2020 B2
10813999 Günther et al. Oct 2020 B2
11154513 Scherer et al. Oct 2021 B2
11160865 Theisinger et al. Nov 2021 B2
20020004063 Zhang Jan 2002 A1
20020128527 Meinert Sep 2002 A1
20030018044 Peyman Jan 2003 A1
20030027833 Cleary et al. Feb 2003 A1
20030170194 Piotrowiak Nov 2003 A1
20040044045 Burk Mar 2004 A1
20040082660 Ueno Apr 2004 A1
20040101551 Selzer May 2004 A1
20040265362 Susilo Dec 2004 A1
20040266702 Dawson Dec 2004 A1
20050075407 Dov et al. Apr 2005 A1
20050079210 Gupta Apr 2005 A1
20050175541 Lanza et al. Aug 2005 A1
20050274744 Spada et al. Dec 2005 A1
20050288196 Horn Dec 2005 A1
20060153905 Carrara et al. Jul 2006 A1
20080050335 Faour et al. Feb 2008 A1
20080153909 Dana et al. Jun 2008 A1
20080207537 Turner et al. Aug 2008 A1
20080234389 Mecozzi et al. Sep 2008 A1
20080260656 Mallard Oct 2008 A1
20090136430 Dugger May 2009 A1
20090149546 Chang Jun 2009 A1
20090169601 Koch et al. Jul 2009 A1
20100006600 Dascanio Jan 2010 A1
20100008996 Meinert Jan 2010 A1
20100016814 Gokhale et al. Jan 2010 A1
20100226997 Bowman et al. Sep 2010 A1
20100274215 Wong et al. Oct 2010 A1
20100310476 Tamarkin et al. Dec 2010 A1
20110269704 Seigfried Nov 2011 A1
20120010280 Aleo et al. Jan 2012 A1
20120095097 Tabuchi et al. Apr 2012 A1
20120238639 Theisinger et al. Sep 2012 A1
20120244177 Theisinger Sep 2012 A1
20130046014 Theisinger et al. Feb 2013 A1
20130084250 Hagedorn et al. Apr 2013 A1
20130266652 Theisinger et al. Oct 2013 A1
20130303473 Wilson Nov 2013 A1
20130336557 Cruzat et al. Dec 2013 A1
20140004197 Theisinger et al. Jan 2014 A1
20140100180 Günther et al. Apr 2014 A1
20140140942 Günther et al. May 2014 A1
20140186350 Ghosh et al. Jul 2014 A1
20140369993 Günther et al. Dec 2014 A1
20150045282 Elsohly et al. Feb 2015 A1
20150224064 Günther et al. Aug 2015 A1
20150238605 Günther et al. Aug 2015 A1
20160000941 Thorsten et al. Jan 2016 A1
20160101178 Wilson Apr 2016 A1
20160159902 Günther et al. Jun 2016 A1
20160243189 Gu et al. Aug 2016 A1
20170020726 Labombarbe et al. Jan 2017 A1
20170087100 Scherer et al. Mar 2017 A1
20170087101 Scherer et al. Mar 2017 A1
20170182060 Wiedersberg et al. Jun 2017 A1
20180360908 Beier et al. Dec 2018 A1
20190274970 Günther et al. Sep 2019 A1
20190328717 Günther et al. Oct 2019 A1
20190343793 Günther et al. Nov 2019 A1
20200060987 Günther et al. Feb 2020 A1
20200129543 Löscher et al. Apr 2020 A1
20200188318 Günther et al. Jun 2020 A1
20200206241 Theisinger et al. Jul 2020 A1
20200246463 Günther et al. Aug 2020 A1
20200268648 Günther et al. Aug 2020 A1
20200268682 Günther et al. Aug 2020 A1
20200338015 Scherer et al. Oct 2020 A1
20200360285 Theisinger et al. Nov 2020 A1
20210069014 Löscher et al. Mar 2021 A1
20210100904 Günther et al. Apr 2021 A1
20210106558 Löscher et al. Apr 2021 A1
20210121471 Löscher et al. Apr 2021 A1
20210228595 Löscher et al. Jul 2021 A1
20210236591 Leo et al. Aug 2021 A1
20210315832 Scherer et al. Oct 2021 A1
20210340248 Günther et al. Nov 2021 A1
20210346313 Beier et al. Nov 2021 A1
20220008397 Xu et al. Jan 2022 A1
Foreign Referenced Citations (68)
Number Date Country
1147213 Apr 1997 CN
200977281 Nov 2007 CN
202136470 Feb 2012 CN
203524843 Apr 2014 CN
0 089 815 Sep 1983 EP
0593552 Apr 1994 EP
0 670 159 Sep 1995 EP
0 965 329 Dec 1999 EP
0 965 334 Dec 1999 EP
1 152 749 Nov 2001 EP
0 939 655 Jun 2002 EP
2 110 126 Oct 2009 EP
2 332 525 Jun 2011 EP
2 335 735 Jun 2011 EP
2 462 921 Jun 2012 EP
S6452722 Feb 1989 JP
2000511157 Aug 2000 JP
2001158734 Jun 2001 JP
2008505177 Feb 2008 JP
2011006348 Jan 2011 JP
2011024841 Feb 2011 JP
WO 9210231 Jun 1992 WO
WO 1995033447 Dec 1995 WO
WO 9640052 Dec 1996 WO
WO 9712852 Apr 1997 WO
WO 1998005301 Dec 1998 WO
WO 0010531 Mar 2000 WO
WO 00024376 May 2000 WO
WO 00054588 Sep 2000 WO
WO 200249631 Jun 2002 WO
WO 2003099258 Dec 2003 WO
WO 2005018530 Mar 2005 WO
WO 2005099718 Oct 2005 WO
WO 2005099752 Oct 2005 WO
WO 2005123035 Dec 2005 WO
WO 2006007510 Jan 2006 WO
WO 2006042059 Apr 2006 WO
WO 2006048242 May 2006 WO
WO 2007052288 May 2007 WO
WO 2008019146 Feb 2008 WO
WO 2008060359 May 2008 WO
WO 2009013435 Jan 2009 WO
WO 2009065565 May 2009 WO
WO 2010062394 Jun 2010 WO
WO 2010146536 Dec 2010 WO
WO 2011009436 Jan 2011 WO
WO 2011073134 Jun 2011 WO
WO 2011113855 Sep 2011 WO
WO 2012052418 Apr 2012 WO
WO 2012062834 May 2012 WO
WO 2012093113 Jul 2012 WO
WO 2012121754 Sep 2012 WO
WO 2012160179 Nov 2012 WO
WO 2012160180 Nov 2012 WO
WO 2013110621 Aug 2013 WO
WO 2014041055 Mar 2014 WO
WO 2014041071 Mar 2014 WO
WO 2014154531 Oct 2014 WO
WO 2015011199 Jan 2015 WO
WO 2015053829 Apr 2015 WO
WO 2015074137 May 2015 WO
WO 2016025560 Feb 2016 WO
WO 2016109531 Jul 2016 WO
WO 2017220625 Dec 2017 WO
WO 2018054932 Mar 2018 WO
WO 2018060282 Apr 2018 WO
WO 2018114557 Jun 2018 WO
WO 2018115097 Jun 2018 WO
Non-Patent Literature Citations (135)
Entry
Ahmed, et al., “Disposition of Timolol and Inulin in the Rabbit Eye Following Corneal Versus Non-Corneal Absorption,” International Journal of Pharmaceutics, 1987, 38:9-21.
Baerdemaeker, “Pharmacokinetics in Obese Patients,” Continuing Education in Anesthesia, Critical Care & Pain, 2004, 4:152-155.
Barata-Vallejo et al., “(Me3Si)3SiH-Mediated Intermolecular Radical Perfluoroalkylation Reactions of Olefins in Water,” J. Org. Chem., 2010, 75:6141-6148.
Bardin et al., “Long-Range Nanometer-Scale Organization of Semifluorinated Alkane Monolayers at the Air/Water Interface,” Langmuir, 2011, 27:13497-13505.
Bertilla et al., “Semifluorinated Alkanes as Stabilizing Agents of Fluorocarbon Emulsions,” Springer, Tokyo, 2005, International Symposia for Life Sciences and Medicine, vol. 12, pp. 237-251.
Blackie et al., “MGD: Getting to the Root Cause of Dry Eye,” Review of Optometry, 2012, pp. 1-12.
Broniatowski, M. et al., “Langmuir Monolayers Characteristics of (Perfluorodecyl)-Alkanes,” Journal of Physical Chemistry B, 2004, 108:13403-13411.
Chemical Book, 5-Fluorouracil, available at <http://www.chemicalbook.com/ChemicalProductProperty_EN_CB8162744.htm>, accessed Mar. 7, 2014, 1 page.
Chhadva et al., “Meibomian Gland Disease The Role of Gland Dysfunction in Drye Eye Disease,” Ophthalmology (2017) 124(11 Supplement): S20-S26.
Costa Gomes et al., “Solubility of dioxygen in seven fluorinated liquids,” Journal of Fluorine Chemistry, 2004, 125:1325-1329.
Davies, “Biopharmaceutical Considerations in Topical Ocular Drug Delivery,” Clin. Exper. Pharmacol. Physiol., 2000, 27:558-562.
Dembinski et al., Semi-fluorinated Alkanes as Carriers for Drug Targeting in Acute Respiratory Failure, Experimental Lung Research, 2010, 36(8):499-507.
Dias et al., “Solubility of oxygen in liquid perfluorocarbons,” Fluid Phase Equilibria, 2004, 222-223:325-330.
Dutescu et al., “Semifluorinated alkanes as a liquid drug carrier system for topical ocular drug delivery,” European Journal of Pharmaceutics and Biopharmaceutics, 2014, 88(1):123-128, Abstract Only (2 pages).
Elkeeb, R. et al., “Transungual Drug Delivery: Current Status,” International Journal of Pharmaceutics, 2010, 384:1-8.
English-language machine translation of EP0670159 (A1) issued in U.S. Appl. No. 14/122,025, filed Apr. 1, 2015, 10 pages.
Freiburger Dokumentenserver (FreiDok), Albert-Ludwigs, Unversitat Feiburg im Breisgau, retrieved from the Internet, date accessed: Feb. 5, 2014, 2 pages URL: <http://www.freidok.uni-freiburg.de/volltexte/5682>.
Gayton, J., “Etiology, Prevalence, and Treatment of Dry Eye Disease,” Clinical Ophthalmology, 2009, 3:405-412.
Gehlsen et al., “A semifluorinated alkane (F4H5) as novel carrier for cyclosporine A: a promising therapeutic and prophylactic option for topical treatment of dry eye,” Graefe's Arch. Clin. Exp. Ophthalmol., (2017) 255(4):767-775.
Gehlsen. U., et al., “Cyclosporine A using F4H5 as liquid drug carrier is effective in treating experimental dry-eye disease,” Investigative Ophthalmology & Visual Science, 2015, 56(7):319, Abstract Only (2 pages).
Gerdenitsch, “Emulsions—established and promising drug carriers for parenteral administration,” retrieved from Internet, date accessed: Jun. 20, 2016, 2 pages URL: <http:/ipimediaworld.com/wp-content/uploads/2012/05/Pages-from-IPI-Volume-2-Issue-1-11.pdf.>.
Gopal et al., “Use of intravitreal injection of triamcinolone acetonide in the treatment of age-related macular degeneration,” Indian J Ophthalmol., 2007, 55(6):431-435, (8 pages).
Griffin, W., “Classification of Surface-Active Agnets by ‘HLB’,” Journal Of The Society of Cosmetic Chemists,1949, 1:311-326.
Hardung, H., “Semifluorierte und perfluorierte Vergindungen zur topischen und parenteralen Anwendung,” 2008, 188 pages, retrieved from Internet, date accessed: Oct. 10, 2011, URL: <http://www.freidok.uni-freiburg.de/volltexte/5682/pdf/Dissertation_Hardung.pdf>.
Hardung, H., “Semifluorierte und perfluorierte Verbindungen zur topischen und parenteralen Anwendung,” 2008, English Language Abstract, 2 pages, retrieved from https://freidok.uni-freiburg.de/data/5682 (retrieved on Jul. 10, 2017).
Hoerauf et al., “Combined Use of Partially Fluorinated Alkanes, Perfluorocarbon Liquids and Silicone Oil: An Experimental Study,” Graefe's Archive For Clinical And Experimental Ophthalmology, 2001, 239(5):373-381.
Holm, R. et al., “A novel excipient, 1-perfluorohexyloctane shows limited utility for the oral delivery of poorly water-soluble drugs,” European Journal of Pharmaceutical Sciences, 2011, 42: 416-422.
International Preliminary Report on Patentability dated Apr. 23, 2013, for International Patent Application PCT/EP2011/068141, 4 Pages.
International Preliminary Report on Patentability dated Sep. 18, 2012, for International Patent Application PCT/EP2011/053949, 9 Pages.
International Preliminary Report on Patentability dated May 14, 2013, for International Patent Application PCT/EP2011/069795, 8 Pages.
International Preliminary Report on Patentability dated Jul. 10, 2013, for International Patent Application PCT/EP2012/050043, 5 Pages.
International Preliminary Report on Patentability dated Nov. 26, 2013, for International Patent Application PCT/EP2012/059787, 9 Pages.
International Preliminary Report on Patentability dated Nov. 26, 2013, for International Patent Application PCT/EP2012/059788, 8 Pages.
International Preliminary Report on Patentability dated Jul. 29, 2014, for International Application No. PCT/EP2013/051163, 7 pages.
International Preliminary Report on Patentability dated Mar. 17, 2015, for International Application No. PCT/EP2013/068882, 5 pages.
International Preliminary Report on Patentability dated Mar. 17, 2015, for International Application No. PCT/EP2013/068909, 7 pages.
International Preliminary Report on Patentability dated Dec. 25, 2018, for International Application No. PCT/EP2017/065163, 6 pages.
International Preliminary Report on Patentability dated Jan. 26, 2016, for International Application No. PCT/EP2014/065840, 11 pages.
International Preliminary Report on Patentability dated Mar. 26, 2019, for International Application No. PCT/EP2017/073697, 7 pages.
International Preliminary Report on Patentability dated Mar. 26, 2019, for International Application No. PCT/EP2017/074079, 7 pages.
International Preliminary Report on Patentability dated Apr. 2, 2019, for International Application No. PCT/EP2017/074545, 7 pages.
International Preliminary Report on Patentability dated Jun. 25, 2019, for International Application No. PCT/EP2017/082739, 7 pages.
International Search Report for International Application No. PCT/EP2011/053949 dated Sep. 6, 2011, 5 pages.
International Search Report for International Application No. PCT/EP2011/068141 dated Dec. 14, 2011, 2 pages.
International Search Report for International Patent Application PCT/EP2011/069795 dated Jan. 16, 2012, 3 pages.
International Search Report for International Patent Application PCT/EP2012/050043 dated Apr. 24, 2012, 2 pages.
International Search Report for International Application No. PCT/EP2012/059787 dated Dec. 5, 2012, 4 pages.
International Search Report for International Application No. PCT/EP2012/059788 dated Dec. 3, 2012, 4 pages.
International Search Report for International Application No. PCT/EP2013/051163 dated Mar. 4, 2013, 4 pages.
International Search Report for International Application No. PCT/EP2013/068882 dated Oct. 30, 2013, 4 pages.
International Search Report for International Application No. PCT/EP2013/068909 dated Dec. 5, 2013, 4 pages.
International Search Report for International Application No. PCT/EP2014/065840 dated Oct. 7, 2014, 4 pages.
International Search Report for International Application No. PCT/EP2016/073262 dated Nov. 18, 2016, 5 pages.
International Search Report for International Application No. PCT/EP2016/073263 dated Dec. 23, 2016, 3 pages.
International Search Report for International Application No. PCT/EP2017/065163, dated Aug. 8, 2017, 3 pages.
International Search Report for International Application No. PCT/EP2017/073697 dated Nov. 6, 2017, 4 pages.
International Search Report for International Application No. PCT/EP2017/074079 dated Dec. 22, 2017, 4 pages.
International Search Report for International Application No. PCT/EP2017/074545 dated Nov. 28, 2017, 3 pages.
International Search Report for International Application No. PCT/EP2017/082739 dated Mar. 6, 2018, 3 pages.
International Search Report for International Application No. PCT/EP2017/083770 (revised version) dated Jul. 6, 2018, 4 pages.
International Search Report and Written Opinion for International Application No. PCT/EP2017/083770 dated Jul. 6, 2018, 14 pages.
Ishizaki et al., “Treatment of Diabetic Retinopathy,” Forum: Complication, Practice, 2009, 26(5): 474-476 (3 pages).
Jonas et al., “Intravitreal triamcinolone acetonide for exudative age-related macular degeneration,” Br J Ophthalmol, 2003, 87:462-468.
Joussen et al., “The concept of heavy tamponades—chances and limitations,” Graefes Arch Exp Ophthalmol, 2008, 246:1217-1224.
JP 2000511157A, English Machine Translation of the Abstract, Description, and Claims, Espacenet, Date Accessed: Feb. 10, 2016, 15 pages.
JPS6452722, English Machine Translation of the Abstract, Description, and Claims, Espacenet, Date Accessed: Feb. 10, 2016, 4 pages.
Kaercher et al., “NovaTears® as new Therapy in Dry Eye Results from three prospective, multicenter, non-interventional studies in different patient populations,” TFOS Conference (Tear Film & Ocular Surface), Sep. 7-10, 2016, Montpellier, France, Poster Session II, Poster No. 60, 1 page.
Knepp et al., “Stability of Nonaqueous Suspension Formulations of Plasma Derived Factor IX and Recombinant Human Alpha Interferon at Elevated Temperatures,” Pharmaceutical Research, 1998, 15 (7):1090-1095.
Kociok, N., “Influence on Membrane-Mediated Cell Activation by Vesicles of Silicone Oil or Perfluorohexyloctane,” Graefe's Archive for Clinical and Experimental Ophthalmology, 2005, 243, 345-358.
Lallemand et al., “Cyclosporine A delivery to the eye: a pharmaceutical challenge,” European Journal of Pharmaceutics and Biopharmaceutics, 2003, 56(3):307-318, Abstract Only (1 page).
Lemp, M., “Management of Dry Eye Disease,” The American Journal of Managed Care, 2008, 14 (3):S88-S101.
Lin, H. et al., “Dry eye disease: A review of diagnostic approaches and treatments,” Saudi Journal of Ophthalmology, 2014, 28:173-181.
Mackiewicz, J. et al., “In Vivo Retinal Tolerance of Various Heavy Silicone Oils,” Investigative Ophthalmology & Visual Science, 2007, 48 (4):1873-1883.
Matieucci et al., “Biocompatibility assessment of liquid artificial vitreous replacements: relevance of in vitro studies,” Survey of Ophthalmology, 2007, 52(3):289-299, Abstract Only (1 page).
Meinert, H. et al., “Semifluorinated Alkanes—A New Class of Compounds with Outstanding Properties for Use in Ophthalmology,” European Journal of Ophthalmology, 2000, 10(3), 189-197.
Meinert, H. et al., “The Use of Semifluorinated Alkanes in Blood-Substitutes,” Biomaterials, Artificial Cells, and Immobilization Biotechnology, 1993, 21 (5):583-595.
Messmer, E.M., “The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease,” (2015) Deutsches Arzteblatt International, 112(5):71-82.
Messmer et al., “Semifluorierte Alkane als Therapie bei Meibomdrüsen-Dysfunktion Ergebnisse einer prospektiven, multizentrischen Beobachtungsstudie”, Presentation, DOG-Kongress, Sep. 29-Oct. 2, 2016, Berlin DOG (Deutsche Ophtalmologische Gesellschaft), Poster No. PSa03-02, 1 page (German language version).
Messmer et al., “Semifluorinated Alkanes as a Therapy for Meibomian Gland Dysfunction Results of a prospective, multi-centered observational study”, Presentation, DOG-Kongress, Sep. 29, 2016-Oct. 2, 2016, Berlin DOG (Deutsche Ophtalmologische Gesellschaft), Poster No. PSa03-02, English Translation, 6 pages.
Messmer et al. “Semifluorinated Alkanes as a Therapy for Meibomian Gland Dysfunction Results of a prospective, multi-centered observational study”, Presentation, DOG-Kongress, Sep. 29, 2016-Oct. 2, 2016, Berlin DOG (Deutsche Ophtalmologische Gesellschaft), Ophthalmologe, Aug. 2016 Poster No. PSa03-02, English Translation of Abstract, p. 138.
Murdan, S., “Enhancing the Nail Permeability of Topically Appied Drugs,” Expert Opinion on Drug Delivery, 2008, 5 (11):1267-1282.
O'Rourke, M. et al., “Enhancing Delivery of Topical Ocular Drops,” Cataract & Refractive Surgery Today Europe, 2016, 2 pages.
Perry, “Dry Eye Disease: Pathophysiology, Classification, and Diagnosis,” The American Journal of Managed Care, 2008, 14(3):S79-S87.
Pflugfelder et al., “Treatment of Blepharitis: Recent Clinical Trials,” 2014, 12(4):273-284, Abstract Only (2 pages).
Pflugfelder et al., “The Pathophysiology of Dry Eye Disease What We Know and Future Directions for Research,” Ophthalmology (2017) 124(11 Supplement): S4-S13.
Pinarci, E. et al., “Intraocular Gas Application in the Diagnosis and Treatment of Valsalva Retiopathy in Case with Premacular Hemorrhage,” XP002625604, Retina Vitreus, 2009, 17 (2):153-155, 1 page, abstract only.
Plassmann, M. et al., “Trace Analytical Methods for Semifluorinated n-Alkanes in Snow, Soil, and Air,” Analytical Chemistry, 2010, 82(11):4551-4557.
Plassmann, M. et al., “Theoretical and Experimental Simulation of the Fate of Semifluorinated n-Alkanes During Snowmelt,” Environmental Science & Technology, 2010, 44(17):6692-6697.
Rosca-Casian, O. et al., “Antifungal Activity of Aloe vera Leaves,” Fitoterapia, 2007, 28, 219-222.
Rosenberg, A., “Effects of Protein Aggregates: An Immunologic Perspective,” The AAPS Journal, 2006, 8 (3), E501-E507.
Sall, K. et al. “Two Multicenter, Randomized Studies of the Efficacy and Safety of Cyclosporine Ophthalmic Emulsion in Moderate to Severe Dry Eye Disease,” Ophthalmology, 2000, 107(4):631-639.
Sato et al., “Vitrectomy and Intraocular Lens Implantation for Cytomegalovirus Retinitis in a Patient with Acquired Immunodeficiency Syndrome,” Presented by Medical Online, New Ophthalmology, 1999, 16(7): 995-998 (4 pages).
Schmutz et al., “Fluorinated Vesicles Made from Combinations of Phospholipids and Semifluorinated Alkanes. Direct Experimental Evidence of the Location of the Semifluorinated Alkane within the Bilayer,” Langmuir, 2003, 19:4889-4894.
Schnetler et al., “Lipid composition of human meibum: a review,” S Afr Optom, 2013, 72(2), 86-93.
Spöler et al., “Towards a New in vitro Model of Dry Eye: The ex vivo Eye Irritation Test,” Developments in Ophthalmology, 2010, 45, 93-107.
Steven, P. et al. “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease—A Prospective, Multicenter Noninterventional Study,” Investigative Ophthalmology & Visual Science, 2015, 56:4493, Abstract Only (1 page).
Steven, P. et al. “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease—A Prospective, Multicenter Noninterventional Study” Journal of Ocular Pharmacology and Therapeutics, 2015, 31(8):498-503.
Steven et al., “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease Due to Meibomian Gland Disease,” Journal of Ocular Pharmacology and Therapeutics, 2017, 33(9):1-8.
Stevenson, C., “Characterization of Protein and Peptide Stability and Solubility in Non-Aqueous Solvents,” Current Pharmaceutical Biotechnology, 2000, 1, 165-182.
Tiffany, J.M., “Individual Variations in Human Meibomian Composition,” Exp. Eye Res., 1978, 27, 289-300.
Troiano et al., “Effect of Hypotonic .4% Hyaluronic Acid Drops in Dry Eye Patients: A Cross-Study,” Cornea 27(10): 1126-1130, 1 page (Abstract Only).
Wang, W., “Lyophilization and Development of Solid Protein Pharmaceuticals,” International Journal of Pharmaceutics, 2000, 203, 1-60.
Wirta, David L. et al., “A Clinical Phase II Study to Assess Efficacy, Safety and Tolerability of Waterfree Cyclosporine Formulation for the Treatment of Dry Eye Disease,” Ophthalmology 126:792-800 (2019).
“What is retinal vitrectomy?” Presented by: Medical Online, Obesity and Diabetes Mellitus, 2005, 4(2): 284-286 (3 pages).
Wong et al., “Perfluorocarbons and Semifluorinated Alkanes,” Seminars in Ophthalmology; vol. 15 (1), 2000, p. 25-35.
Wu et al., “Physicochemical characterization and aerosol dispersion performance of organic solution advanced spray-dried cyclosporine A multifunctional particles for dry powder inhalation aerosol delivery,” International Journal of Nanomedicine, 2013, 8:1269-1283.
Xalatan, Latanoprost Ophthalmic Solution, 50 μg/mL Prostaglandin F2α analogue, Product Monograph, Jul. 21, 2014, 30 pages.
Zhang et al., “Surface micelles of semifluorinated alkanes in Langmuir-Blodgett monolayers,” Phys. Chem. Chem. Phys., 2004, 6:1566-1569.
Agarwal et al., “Modern Approaches to the Ocular Delivery of Cyclosporine A,” Drag Discovery Today, 2016, vol. 21, No. 6, pp. 977-988; doi: 10.1016/j.drudis.2016.04.002.
Agrahari et al., “A comprehensive insight on ocular pharmacokinetics,” Drug Delivery and Translational Research, 2016, 6(6):735-754.
Al-Amri, et al., “Long-term use of 0.003% tacrolimus suspension for treatment of vernal keratoconjunctivitis,” Oman Journal of Ophthalmology, 2017, 10(3):145-149.
Astellas Pharma US, Inc. (2019). PROGRAF(R); Highlights of Prescribing Information. Northbrook, IL: Astellas Pharma US, Inc.
Chaglasian et al., “Recycling Cyclosporine,” Review of Cornea & Contact Lenses, 2016, 5 pages.
Chao, W. et al., “Report of the Inaugural Meeting of the TFOS i2 = initiating innovation Series: Targeting the Unmet Need for Dry Eye Treatment,” (London, United Kingdom, Mar. 21, 2015) Accepted Manuscript, Accepted Date: Nov. 11, 2015, 94 pages.
Chen et al., “Persistent Inflammation Subverts Thrombospondin-1-Induced Regulation of Retinal Angiogenesis and Is Driven by CCR2 Ligation,” The American Journal of Pathology, 2012, 180:235-245.
Dutescu et al., “Semifluorinated alkanes as a liquid drug earner system for topical ocular drug delivery,” European Journal of Pharmaceutics and Biopharmaceutics, 2014, 88(1): 123-128.
Fischer, K.M., et al., “Effects of a topically applied 2% delta-9-tetrahydrocannabinol ophthalmic solution on intraocular pressure and aqueous humor flow rate in clinically normal dogs,” American Journal of Veterinary Research, 2013, 74(2):275-280, Abstract Only (2 pages).
Galvao, et al., “Unexpected low-dose toxicity of the universal solvent DMSO,” FASEB Journal, 2014, 28(3):1317-1330.
Gehisen, U. et al., “Omega-3 Fatty Acids Using F6H8-Carrier as Topical Therapy in Experimental Dry-Eye Disease,” Investigative Ophthalmology & Visual Science, 2016, 57:417, Abstract Only (1 page).
German, E.J et al., “Reality of drop size from multi-dose eye drop bottles: is it cause for concern?” Eye, 1999, 13:93-100.
Goureau et al., “Increased nitric oxide production in endotoxin-induced uveitis. Reduction of uveitis by an inhibitor of nitric oxide synthase.” The Journal of Immunology, 1995, 154(12): 6518-6523.
Grotenhermen, F., “Cannabinoids for therapeutic use—Designing systems to increase efficacy and reliability,” American Journal of Drug Delivery, 2004, 2(4):229-240, Abstract Only (19 pages).
Kheirkhah, A., et al., “Topical 0.005% tacrolimus eye drop for refractory vernal keratoconjunctivitis,” Eye (London, England), 2011, 25(7):872-880.
Moscovici, et al., “Clinical treatment of dry eye using 0.03% tacrolimus eye drops,” Cornea, 2012, 31(8):945-949.
Murphy et al., “Cyclosporine vs Tacrolimus Therapy for Posterior and Intermediate Uveitis,” Arch Ophthalmol. 2005, 123:634-641.
Novaliq GmbH Begins Phase II Clinical Trial of Cyclasol for the Treatment of Moderate to Severe Dry Eye Disease, (online), 5 pages, (2016); retrieved on Jan. 8, 2021 from the Internet: https://www.biospace.com/article/releases/novaliq-gmbh-begins-phase-ii-clinical-trial-of-cyclasol-for-the-treatment-of-moderate-to-severe-dry-eye-disease-/.
Ohashi, et al., “A randomized, placebo-controlled clinical trial of tacrolimus ophthalmic suspension 0.1% in severe allergic conjunctivitis,” Journal of ocular pharmacology and therapeutics, 2010, 26(2):165-174.
Rosenbaum et al., “Contrasting Ocular Effects of Local versus Systemic Endotoxin,” Investigative Ophthalmology & Visual Science, 2011, 52(9), 6472-6477.
Scherer et al., “Eyesol: A Novel Topical Ocular Drug Delivery System for Poorly Soluble Drugs,” Drug Development & Delivery, 2013, vol. 13, No. 1, pp. 40-44.
Tamura et al., “Tacrolimus is a class II low-solubility high-permeability drug: The effect of P-glycoprotein efflux on regional permeability of tacrolimus in rats,” Journal of Pharmaceutical Sciences, 2002, 91(3):719-729, Abstract Only (1 page).
Torkildsen et al., “A Clinical Phase 2 Study to Assess Safety, Efficacy, and Tolerability of CyclASol for the Treatment of Dry Eye Disease,” Poster Presentation at AAO, 2017.
Xu et al., “A clinical grading system for retinal inflammation in the chronic model of experimental autoimmune uveoretinitis using digital fundus images,” Experimental Eye Research, 2008, 87(4):319-326.
Yazu, et al., “The efficacy of 0.1% tacrolimus ophthalmic suspension in the treatment of severe atopic keratoconjunctivitis,” Annals of allergy, asthma & immunology, 2019, 122(4):387-392.
Zeng, Y., “Atlas of Clinical Keratoconjunctival Disease,” Hubei Science and Technology Press, 2011, 288-293.
Zeng, Y., “Atlas of Clinical Keratoconjunctival Disease,” Hubei Science and Technology Press, 2011, English Translation, 287-299.
Related Publications (1)
Number Date Country
20210023166 A1 Jan 2021 US
Continuations (1)
Number Date Country
Parent 16336005 US
Child 17069417 US