Patent Application
20240156839
The present disclosure relates to a drug delivery system for delivery of an active agent to an eye. The present disclosure also relates to pharmaceutical compositions having a reduced ocular side effect profile, and to methods of using such compositions in the ophthalmic field.
Conventional drug therapy for eye diseases is commonly achieved by the administration of solutions or suspensions. The limitations of these dosage forms include rapid clearance and undesired local toxicity.
Lipid-containing particles as drug delivery vehicles modify the pharmacokinetic profile of the drug, where liposomes usually enable sustained drug release, prolonged drug retention, and high administered doses with less frequent drug administration. Studies have demonstrated the enhanced drug retention and prolonged efficacy of the liposomal compositions in the eye (U.S. Pat. Nos. 4,804,539, 8,956,600, and M. Abrishami et al., Retina. 2009 May;29(5):699-703).
However, after administration, particularly via intravitreal injection, of a composition containing large unilamellar vesicles with high encapsulation efficiency to the vitreous humor, patients receiving said composition were reported to have blurred vision, which is associated with the vitreous clouding due to the lipid nanoparticles. It was found that the vision of an eye receiving an intravitreal injection of the indicated liposome-encapsulated ganciclovir declined initially owing to vitreous clouding, and the intravitreally injected liposome-encapsulated ganciclovir appeared as a whitish suspension located in the inferior part of the vitreous (S K Akula et al., Br J Ophthalmol. 1994 September; 78(9): 677-680).
Therefore, there remains an unmet need for a pharmaceutical composition for use in delivery of an active agent to an eye, which can achieve a prolonged therapeutic effect as well as reduced side effects, such as vitreous haze. The present disclosure addresses this need and other needs.
The present disclosure provides a pharmaceutical composition for use in delivery of an active agent to an eye, which may comprise: a lipid mixture comprising one or more lipids (e.g., phospholipids); an effective amount of active agent or a pharmaceutically acceptable salt thereof; and a biocompatible hydrogel; whereby an ocular side effect caused by the delivery of the active agent in said pharmaceutical composition is reduced, compared to the ocular side effect of the same pharmaceutical composition in the absence of the biocompatible hydrogel (e.g., a reference pharmaceutical composition).
To improve the treatment of ophthalmic diseases and to obtain a desired administrability as well as a desired drug release profile, provided is a pharmaceutical composition for use in the delivery of an active agent to an eye. The pharmaceutical composition may include a mixture of a liposomal active agent and a biocompatible hydrogel. Thus, an enhanced treatment of ophthalmic diseases with desired pharmacokinetics as well as reduced side effect in the eye is achieved.
An exemplary biocompatible hydrogel according to the present disclosure comprises at least one polysaccharide, for example an unbranched mucopolysaccharide, including but not limited to, an anionic, non-sulfated glycosaminoglycan, such as hyaluronic acid (HA). Other polysaccharides which may be used include alginate, agarose, chitosan, collagen, chondroitin sulfate, gelatin, sodium cellulose sulfate, or mixtures thereof. In some embodiments, the biocompatible hydrogel according to the present disclosure is present in a concentration ranging from about 0.01% (w/v) to about 0.75% (w/v) of the pharmaceutical composition. In some embodiments, the amount of the one or more lipids (e.g., phospholipids) according to the present disclosure ranges from about 2 μmol to about 200 μmol per mL of the pharmaceutical composition. The pharmaceutical composition according to the present disclosure has a suitable viscosity, in which the lipid nanoparticles would not disperse quickly in the vitreous humor and thus cause less vitreous clouding or haze initially after administration of the pharmaceutical composition. The present pharmaceutical composition also retains the administrability, e.g., injectability. In addition, the provided pharmaceutical composition also exhibits a reduced turbidity even after the lipid nanoparticles have dispersed completely, which efficiently ameliorates the vitreous haze caused by the administration of liposomes alone.
Meanwhile, the pharmaceutical composition according to the present disclosure offers sustained release of the active agent comparable to the same pharmaceutical composition in the absence of the biocompatible hydrogel. It is known that liposomes may modify the pharmacokinetics of the active agent which is a major concern of safety when developing a liposomal drug. The provided pharmaceutical composition shows a sustained release profile similar to that of the same pharmaceutical composition without the biocompatible hydrogel, and thus also maintains desired and prolonged efficacy without undermining safety.
Given the advantages described above, the provided pharmaceutical composition can improve patient outcomes and compliance.
In certain embodiments, the pharmaceutical composition according to the present disclosure is prepared by a process comprising: providing the lipid mixture and the active agent in a suspension; and mixing the suspension with a solution containing the biocompatible hydrogel, whereby a mixture of multilamellar vesicles and the biocompatible hydrogel forms.
The present disclosure also provides a method of delivering an active agent to an eye of a subject in need thereof, comprising administering a pharmaceutical composition in accordance with the present disclosure to the eye of the subject. In a particular embodiment, the step of administering a pharmaceutical composition in accordance with the present disclosure to the eye of the subject in need thereof comprises intravitreally administering the pharmaceutical composition to the vitreous humor of the eye of the subject. The method can achieve both a prolonged efficacy and a reduced turbidity in the vitreous humor after administration of the pharmaceutical composition according to the present disclosure, compared to that of a conventional composition with a prolonged releasing profile of the active agent.
The present disclosure also provides a pharmaceutical composition for use in the treatment of an eye disease. In particular, the present disclosure provides the use of the pharmaceutical composition in the manufacture of a medicament for the treatment of the eye disease where reduction of an ocular side effect is further improved by delivery of the active agent by the pharmaceutical composition according to the present disclosure.
Other objectives, advantages, and novel features of the disclosure will become apparent from the following detailed description when taken in conjunction with the accompanying drawings.
As employed above and throughout the disclosure, the following terms, unless otherwise indicated, shall be understood to have the following meanings.
As used herein, the singular forms “a”, “an” and “the” include the plural reference unless the context clearly indicates otherwise.
All numbers herein may be understood as modified by “about,” which, when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of ±10%, preferably ±5%, more preferably ±1%, and even more preferably ±0.1% from the specified value, as such variations are appropriate to obtain a desired amount of liposomal composition, unless otherwise specified.
The term “treating,” “treated,” or “treatment” as used herein includes, but not limited to preventive (e.g., prophylactic), palliative, and/or curative uses or results.
The term “effective amount” as used herein denotes a dose of the pharmaceutical composition that is sufficient to reduce, prevent or eliminate the symptoms or signs of a disease, syndrome, disorder or condition.
The term “pharmaceutically acceptable salts” of the active agent of the present disclosure are salts of an acidic active agent formed with bases, namely base addition salts such as alkali and alkaline earth metal salts, e.g., sodium, lithium, potassium, calcium, magnesium, as well as ammonium salts, e.g., ammonium, trimethyl-ammonium, diethylammonium, and tris-(hydroxymethyl)-methyl-ammonium salts. Similarly acid addition salts, such as of mineral acids, organic carboxylic and organic sulfonic acids, e.g., hydrochloric acid, methanesulfonic acid, maleic acid, are also possible provided to a basic active agent.
The term “subject” includes a vertebrate having ophthalmic diseases affecting ocular function. In some embodiments, the subject is a warm-blooded animal, such as mammals, including humans.
In certain embodiments, the phospholipid amount or concentration of liposome and liposomal composition could be determined by assaying the phosphorus content of liposome and liposomal drug samples using a phosphorus assay (adapted from G. Rouser et al., Lipids 1970, 5, 494-496).
As used herein, the term “% (w/v)” refers to percent weight/volume, which is defined as mass of a solute in grams present in 100 ml of solution.
As used herein, the term “ocular side effect” refers to active agent-induced side effects including, but not limited to, elevated ocular pressure, glaucoma, cataract formation, delayed wound healing, increased susceptibility to infection, vitreous haze and vision problems. As used herein, the term “vitreous haze” refers to the appearance of diffused turbidity or milkiness in the vitreous humor which may cause vision problems. Eye examination for vitreous humor can be done using a direct or indirect ophthalmoscope for speculating opacification via arbitrary index. As much of the fundus as is visible, including the retina, macula, fovea, vessels, and optic disk and its margins, is examined to see the entire fundus (i.e., to see a peripheral retinal detachment).
As used herein, the term “turbidity” means cloudiness or haziness of a fluid caused by suspended particles. The turbidity could be, but not limited to be measured using a spectrophotometer.
The lipid mixture of the pharmaceutical composition provided herein comprises at least one lipids, for example, but not limited to: a phospholipid or a mixture of phospholipids. The lipid mixture includes, but not limited to, film, cake, granules, powders or solution before being added to the pharmaceutical composition.
In one embodiment, the phospholipid or the mixture of phospholipids, with or without cholesterol, are pre-formed into liposomes before further processing into a lipid mixture.
In another embodiment, the phospholipid or mixture of phospholipids, with or without cholesterol, are not pre-formed into liposomes before further processing into a lipid mixture.
The lipid mixture in accordance with the present disclosure can be prepared from a variety of lipids capable of either forming or being incorporated into a unilayer or bilayer structure. The lipids used in the present disclosure include one or more phospholipids, including but are not limited to, phosphatidylcholine (PC), phosphatidylglycerol (PG), phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidic acid (PA), phosphatidylinositol (PI) or combinations thereof.
In some embodiments, the lipid mixture comprises egg phosphatidylcholine (EPC), egg phosphatidylglycerol (EPG), egg phosphatidylethanolamine (EPE), egg phosphatidylserine (EPS), egg phosphatidic acid (EPA), egg phosphatidylinositol (EPI), soy phosphatidylcholine (SPC), soy phosphatidylglycerol (SPG), soy phosphatidylethanolamine (SPE), soy phosphatidylserine (SPS), soy phosphatidic acid (SPA), soy phosphatidylinositol (SPI) or combinations thereof. In another embodiments, the lipid mixture comprises dipalmitoylphosphatidylcholine (DPPC), 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine (DOPC), dimyristoylphosphatidylcholine (DMPC), dip almitoylphosphatidylglycerol (DPPG), dioleoylphosphatidylglycerol (DOPG), dimyristoylphosphatidylglycerol (DMPG), hexadecylphosphocholine (HEPC), hydrogenated soy phosphatidylcholine (HSPC), distearoylphosphatidylcholine (DSPC), distearoylphosphatidylglycerol (DSPG), dioleoylphosphatidylethanolamine (DOPE), palmitoylstearoylphosphatidylcholine (PSPC), palmitoylstearoylphosphatidylglycerol (PSPG), monooleoylphosphatidylethanolamine (MOPE), 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine (POPC), polyethyleneglycol distearoylphosphatidylethanolamine (PEG-DSPE), dipalmitoylphosphatidylserine (DPPS), 1,2-dioleoyl-sn-glycero-3-phosphatidylserine (DOPS), dimyristoylphosphatidylserine (DMPS), distearoylphosphatidylserine (DSPS), dipalmitoylphosphatidic acid (DPPA), 1,2-dioleoyl-sn-glycero-3 -phosphatidic acid (DOPA), dimyristoylphosphatidic acid (DMPA), distearoylphosphatidic acid (DSPA), dipalmitoylphosphatidylinositol (DPPI), 1,2-dioleoyl-sn-glycero-3-phosphatidylinositol (DOPI), dimyristoylphosphatidylinositol (DMPI), distearoylphosphatidylinositol (DSPI), or combinations thereof.
In some embodiments, the lipid mixture comprises a first phospholipid and a second phospholipid. In some embodiments, the first phospholipid is selected from the group consisting of EPC, EPE, SPC, SPE, DPPC, DOPC, DMPC, HEPC, HSPC, DSPC, DOPE, PSPC, MOPE, POPC; and the second phospholipid is selected from the group consisting of PG, PS, PA, PI, EPG, EPS, EPA, EPI, SPG, SPE, SPS, SPA, SPI, DPPG, DOPG, DMPG, DSPG, PSPG, DPPS, DOPS, DMPS, DSPS, DPPA, DOPA, DMPA, DSPA, DPPI, DOPI, DMPI, DSPI, and a hydrophilic polymer with a long chain of highly hydrated flexible neutral polymer attached to a phospholipid molecule. Examples of the hydrophilic polymer include, but are not limited to, polyethylene glycol (PEG) with a molecular weight about 2,000 to about 5,000 daltons, methoxy PEG (mPEG), ganglioside GM1, polysialic acid, polylactic acid (also termed polylactide), polyglycolic acid (also termed polyglycolide), polylacticpolyglycolic acid, polyvinyl alcohol, polyvinylpyrrolidone, polymethoxazoline, polyethyloxazoline, polyhydroxyethyloxazoline, polyhydroxypropyloxazoline, polyaspartamide, polyhydroxypropyl methacrylamide, polymethacrylamide, polydimethylacrylamide, polyvinylmethylether, polyhydroxyethyl acrylate, derivatized celluloses such as hydroxymethylcellulose or hydroxyethylcellulose and synthetic polymers.
In a particular embodiment, the lipid mixture further comprises a sterol. Sterol used in the present disclosure is not particularly limited, with examples thereof including cholesterol, phytosterol (sitosterol, stigmasterol, fucosterol, spinasterol, brassicasterol, and the like), ergosterol, cholestanone, cholestenone, coprostenol, cholesteryl-2′-hydroxyethyl ether, and cholesteryl-4′-hydroxybutyl ether. The sterol component of the lipid mixture, when present, can be any of those sterols conventionally used in the field of lipid particle preparation.
In a more particular embodiment, the lipid mixture further comprises a cholesterol. In some embodiments, the lipid mixture comprises about 10 mole % to about 33 mole % of cholesterol, about 15 mole % to about 30 mole % of cholesterol, about 18 mole % to about 28 mole % of cholesterol, or about 20 mole % to about 25 mole % of cholesterol.
In a particular embodiment, the lipid mixture comprises the first phospholipid, the second phospholipid and the sterol at a mole percent ratio of 29.5% to 90%:3% to 37.5%:10% to 33%.
In a particular embodiment, the first phospholipid is DOPC, POPC, SPC, or EPC and the second phospholipid is PEG-DSPE, or DOPG.
In a more particular embodiment, the lipid mixture comprises DOPC and DOPG.
In one embodiment, the lipid mixture is substantially free of fatty acid or cationic lipid (i.e., a lipid carrying a net positive charge a physiological pH).
In one embodiment, the lipid mixture optionally comprises a lipid-conjugate of an antibody or a peptide that acts as a targeting moiety to enable liposomes thereof to specifically bind to a target cell bearing a target molecule. Examples of the target molecules include, but are not limited to, TNF-α and B cell surface antigen, such as CD20. Other antigens, such as CD19, HER-3, GD2, Gp75, CS1 protein, mesothelin, c-Myc, CD22, CD4, CD44, CD45, CD28, CD3, CD123, CD138, CD52, CD56, CD74, CD30, Gp75, CD38, CD33, GD2, vascular endothelial growth factor (VEGF), or transforming growth factor (TGF) may also be used.
As used herein, “lipid-containing particle” or “lipid nanoparticle (LNP)” in accordance with the present disclosure includes, but is not limited to, a population of particles comprising a lipid and additionally other biocompatible excipients for forming a vehicle for delivery of an active agent. A variety of lipid-containing nanoparticles have been demonstrated, such as liposomes, micelles, or other lipid-containing nanoparticles. Method of producing the lipid nanoparticle formulation can influence and/or dictate distribution of certain components within the lipid nanoparticles, and that this distribution can influence and/or dictate physical (e.g., stability) and/or biological (e.g. efficacy, intracellular delivery, immunogenicity) properties of the lipid nanoparticles as desired.
As used herein, the term “lipid nanoparticle” includes, but is not limited to, a delivery vehicle comprising one or more lipids and formulated into a form of particles having an average size or diameter of nanometer to micrometer to deliver one or more active agents to a subject in need thereof. Examples of suitable lipids include cationic lipids, non-cationic lipids, and PEG-modified lipids.
In a group of embodiments, the lipid nanoparticles in accordance with the present disclosure are liposomes. The liposome in accordance with the present disclosure includes, but is not limited to, a lipid bilayer surrounding an internal aqueous agent-carrying component. Non-limiting examples of liposomes include small unilamellar vesicles (SUV), large unilamellar vesicles (LUV), multivesicular liposome (MVL) and multi-lamellar vesicles (MLU).
The liposomes prepared in this disclosure can be generated by conventional techniques used to prepare vesicles. These techniques include the ether injection method (Deamer et al., Acad. Sci. (1978) 308: 250), the surfactant method (Brunner et al., Biochim. Biophys. Acta (1976) 455: 322), the freeze-thaw method (Pick et al., Arch. Biochim. Biophys. (1981) 212: 186), the reverse-phase evaporation method (Szoka et al., Biochim. Biophys. Acta. (1980) 601: 559 71), the ultrasonic treatment method (Huang et al., Biochemistry (1969) 8: 344), the ethanol injection method (Kremer et al., Biochemistry (1977) 16: 3932), the extrusion method (Hope et al., Biochim. Biophys. Acta (1985) 812:55 65), the French press method (Barenholz et al., FEBS Lett. (1979) 99: 210) and methods detailed in Szoka, F., Jr., et al., Ann. Rev. Biophys. Bioeng. 9:467 (1980). All of the above processes are basic technologies for the formation of vesicles and these processes are incorporated by reference herein. After sterilization, the pre-formed liposomes can be placed aseptically into a container and then lyophilized to form a powder or a cake. In the embodiment where the lipid mixture comprises pre-formed liposomes, said liposomes can be obtained by solvent injection method and followed by lyophilization to form the lipid mixture. The lipid mixture optionally comprises one or more bulking agent. In one embodiment, the lipid mixture further comprises one or more buffering agents.
The bulking agents include, but are not limited to, polyols or sugar alcohols such as mannitol, glycerol, sorbitol, dextrose, sucrose, and/or trehalose; amino acids such as histidine, and glycine. One preferred bulking agent is mannitol.
The buffering agents include, but are not limited to, sodium phosphate monobasic dihydrate and sodium phosphate dibasic anhydrous.
In the embodiment where the lipid mixture comprises lipids that are not pre-formed into liposomes, the lipid mixture can be prepared by dissolving in a suitable organic solvent, including, but not limited to, ethanol, methanol, t-butyl alcohol, ether and chloroform, and drying by heating, vacuum evaporation, nitrogen evaporation, lyophilization, or other conventional means of solvent removal.
The term “active agent” as used herein includes a therapeutic agent or an imaging agent.
The active agent of the preset disclosure can be mixed either in ddH2O or a suitable buffer as a solution containing the active agent for suspending the lipid mixture to obtain the pharmaceutical composition according to the present disclosure. In some embodiments, the active agent is not covalently bound to a lipid such as phospholipid or a fatty acid, such as palmitate.
In one aspect, the therapeutic agent refers to a substance that induces a desired pharmacological or physiological effect, which alleviates a symptom of or prevents development of a disease or disorder.
The therapeutic agent that can be used in the pharmaceutical composition disclosed herein comprises one or more of an anti-angiogenesis agent, an anti-inflammatory agent, an immunosuppressive agent, an antimicrobial agent, or an antiviral agent.
Examples of the anti-angiogenesis agent include, but are not limited to, bevacizumab (Avastin®, Genentech), ranibizumab (Lucentis®, Genentech), aflibercept (Eylea®, Regeneron), brolucizumab (Beovu®, Novartis), and pegaptanib (Macugen®, Valeant).
In one embodiment, the anti-inflammatory agents include, but are not limited to, steroid, particularly ocular steroid, a derivative thereof, a pharmaceutically acceptable salt thereof, or a prodrug thereof. The steroid useful in the present disclosure includes any naturally occurring steroid hormones, synthetic steroids and their derivatives. In a particular embodiment, the anti-inflammatory agent is corticosteroid. Examples of the steroid include, but are not limited to, cortisone, hydrocortisone, hydrocortisone acetate, tixocortol pivalate, fluocinolone, prednisolone, methylprednisolone, prednisolone, triamcinolone acetonide, triamcinolone, mometasone, amcinonide, budesonide, desonide, fluocinonide, fluocinolone acetonide, halcinonide, betamethasone, betamethasone sodium phosphate, dexamethasone, dexamethasone sodium phosphate (DSP), fluocortolone, hydrocortisone-17-butyrate, hydrocortisone-17-valerate, alclometasone dipropionate, betamethasone valerate, betamethasone dipropionate, prednicarbate, clobetasone-17-butyrate, clobetasol-17-propionate, fluocortolone caproate, fluocortolone pivalate, fluprednidene acetate, difluprednate, loteprednol, fluorometholone, medrysone rimexolone, beclomethasone, cloprednol, cortivazol, deoxycortone, difluorocortolone, fluclorolone, fludrocortisone, flumethasone, flunisolide, flurandrenolone, meprednisone, methylprednisolone and paramethasone. In certain embodiments, the ocular steroid is a water soluble steroid. In certain embodiments, the water soluble steroid is DSP.
Examples of the immunosuppressive agent include, but are not limited to, methotrexate, azathioprine, mycophenolate mofetil, cyclosporine, tacrolimus, voclosporin, cyclophosphamide, chlorambucil, etanercept, infliximab, adalimumab, rituximab, abatacept, anakinra, and daclizumab.
Examples of the antimicrobial agent include, but are not limited to, vancomycin, ceftazidime, amikacin, amphotericin, and voriconazole.
Examples of the antiviral agent include, but are not limited to, ganciclovir, foscarnet, cidofovir, and fomivirsen.
In some embodiments, the therapeutic agent is selected from the group consisting of bevacizumab, ranibizumab, aflibercept, brolucizumab, pegaptanib, cortisone, hydrocortisone, hydrocortisone acetate, tixocortol pivalate, fluocinolone, prednisolone, methylprednisolone, prednisolone, triamcinolone acetonide, triamcinolone, mometasone, amcinonide, budesonide, desonide, fluocinonide, fluocinolone acetonide, halcinonide, betamethasone, betamethasone sodium phosphate, dexamethasone, dexamethasone sodium phosphate (DSP), fluocortolone, hydrocortisone-17-butyrate, hydrocortisone-17-valerate, alclometasone dipropionate, betamethasone valerate, betamethasone dipropionate, prednicarbate, clobetasone-17-butyrate, clobetasol-17-propionate, fluocortolone caproate, fluocortolone pivalate, fluprednidene acetate, difluprednate, loteprednol, fluorometholone, medrysone rimexolone, beclomethasone, cloprednol, cortivazol, deoxycortone, difluorocortolone, fluclorolone, fludrocortisone, flumethasone, flunisolide, flurandrenolone, meprednisone, methylprednisolone, paramethasone, methotrexate, azathioprine, mycophenolate mofetil, cyclosporine, tacrolimus, voclosporin, cyclophosphamide, chlorambucil, etanercept, infliximab, adalimumab, rituximab, abatacept, anakinra, daclizumab, vancomycin, ceftazidime, amikacin, amphotericin, voriconazole, ganciclovir, foscarnet, cidofovir, and fomivirsen.
In some embodiments, the therapeutic agent is an antagonist specific to VEGF, which can be an antibody specific to VEGF, a VEGF receptor, a nucleic acid binding to VEGF, or a small molecule that interferes with the interaction between VEGF and its cognate receptor and blocks the VEGF signaling pathway. The term “antibody” used herein refers to a naturally-occurring immunoglobulin, a functional fragment thereof, or a genetically modified immunoglobulin, such as humanized antibody, chimeric antibody, or fully human antibody.
In some embodiments, the therapeutic agent is an antibody specific to VEGF. Such antibody specific to VEGF may be a complete antibody molecule having full length heavy and light chains or a functional fragment, such as Fab, Fab′, F(ab)2, F(ab′)2, scFv, di-scFv, scFv-Fc, single domain antibody, diabody, and triabody.
In another aspect, the imaging agent refers to a substance useful for imaging applications. Examples of the imaging agent include, but are not limited to, radioconjugate, fluorescent agents, gadolinium-DTPA (Gd-DTPA), iron oxide, manganese oxide, and quantum dots.
The term “biocompatible hydrogel” as used herein refers to a substance which is not toxic to living cells and in which polymers form a network structure (e.g., by chemical bonding) and a large amount of water is retained in the network.
In one embodiment, the biocompatible hydrogel comprises a polymer selected from the group consisting of polysaccharide, polyphosphazene, poly(acrylic acids), poly(methacrylic acids), poly(alkylene oxides), poly(vinyl acetate), polyvinylpyrrolidone (PVP), and copolymers and blends thereof.
In an embodiment, the biocompatible hydrogel comprises a polysaccharide selected from the group consisting of hyaluronic acid, alginate, agarose, chitosan, collagen, chondroitin sulfate, gelatin, sodium cellulose sulfate, and combinations thereof.
Exemplary biocompatible hydrogels according to the present disclosure include, but are not limited to, polysaccharides, particularly unbranched mucopolysaccharides. In certain embodiments, the biocompatible hydrogel according to the present disclosure is O-linked or N-linked glycosaminoglycan, particularly non-sulfated glycosaminoglycan. In certain embodiments, the biocompatible hydrogel according to the present disclosure includes, but is not limited to, an anionic, non-sulfated glycosaminoglycan.
In an embodiment, the biocompatible hydrogel comprises hyaluronic acid.
In some embodiments, the biocompatible hydrogel has a molecular weight of about 4 kDa to about 8000 kDa, optionally about 4 kDa to about 7000 kDa, optionally about 50 kDa to about 8000 kDa, optionally about 50 kDa to about 7000 kDa, optionally about 50 kDa to about 6000 kDa, optionally about 50 kDa to about 5000 kDa, optionally about 50 kDa to about 4000 kDa, optionally about 50 kDa to about 3000 kDa, optionally about 50 kDa to about 2500 kDa, optionally about 50 kDa to about 2000 kDa, optionally about 100 kDa to about 2500 kDa, optionally about 100 kDa to about 2000 kDa, optionally about 1500 kDa to about 1800 kDa.
The pharmaceutical composition of the present disclosure is suitable for delivery of an active agent to an eye and comprises a lipid mixture comprising one or more lipids (e.g., phospholipids); an effective amount of the active agent or a pharmaceutically acceptable salt thereof; and a biocompatible hydrogel; wherein the ocular side effect of said pharmaceutical composition is reduced, compared to the ocular side effect of a reference pharmaceutical composition without the biocompatible hydrogel. The reference pharmaceutical composition includes, but is not limited to, the one or more lipids, and the active agent or a pharmaceutically acceptable salt thereof of the present disclosure but in the absence of the biocompatible hydrogel (where the reference pharmaceutical composition causes the ocular side effect). After intravitreal administration of the present pharmaceutical composition, the ocular side effect is reduced by about 10% to about 100%, about 10% to 40%, or about 20% to 40%, particularly by at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45% and at least 50%, compared to that of a reference pharmaceutical composition in the absence of the biocompatible hydrogel.
In one embodiment, the amount of the one or more lipids (e.g., phospholipids) ranges from about 2 μmol to about 200 μmol per mL of the pharmaceutical composition, optionally from about 10 μmol to about 200 μmol per mL of the pharmaceutical composition, optionally from about 10 μmol to about 150 μmol per mL of the pharmaceutical composition, optionally from about 20 μmol to about 150 μmol per mL of the pharmaceutical composition, optionally from about 20 μmol to about 125 μmol per mL of the pharmaceutical composition, optionally from about 30 μmol to about 125 μmol per mL of the pharmaceutical composition, optionally from about 30 μmol to about 100 μmol per mL of the pharmaceutical composition, optionally from about 40 μmol to about 100 μmol per mL of the pharmaceutical composition, optionally from about 50 μmol to about 100 μmol per mL of the pharmaceutical composition, optionally from about 60 μmol to about 100 μmol per mL of the pharmaceutical composition.
In one embodiment, the biocompatible hydrogel is present in a concentration ranging from about 0.01% (w/v) to about 0.75% (w/v), optionally about 0.05% (w/v) to about 0.75% (w/v), optionally about 0.01% (w/v) to about 0.6% (w/v), optionally about 0.05% (w/v) to about 0.6% (w/v), optionally about 0.01% (w/v) to about 0.5% (w/v), optionally about 0.05% (w/v) to about 0.5% (w/v), optionally about 0.06% (w/v) to about 0.5% (w/v), optionally about 0.07% (w/v) to about 0.5% (w/v), optionally about 0.08% (w/v) to about 0.5% (w/v), optionally about 0.09% (w/v) to about 0.5% (w/v), optionally about 0.0912% (w/v) to about 0.456% (w/v) of the pharmaceutical composition.
In one embodiment, the pharmaceutical composition is prepared by a process comprising: providing the lipid mixture and the active agent in a suspension; and mixing the suspension with a solution containing the biocompatible hydrogel, whereby a mixture of lipid-containing particles and the biocompatible hydrogel forms.
In a particular embodiment, said suspension is prepared by reconstituting a lyophilized lipid cake comprising the lipid mixture with an aqueous solution comprising the active agent. In another particular embodiment, said suspension is prepared by reconstituting a lyophilized combination of the lipid mixture and the active agent with an aqueous solution.
In an embodiment, the step of providing the lipid mixture and the active agent in a suspension comprises reconstituting the lipid mixture and the active agent in an aqueous solution to form lipid nanoparticles in the suspension. In the mixing step, a mixture of lipid nanoparticles and the biocompatible hydrogel forms in the pharmaceutical composition. After administration of the pharmaceutical composition to a subject in need thereof, the release profile of the active agent of the pharmaceutical composition is sustained in the vitreous humor of the subject without causing haze. In some embodiments, the lipid nanoparticles include multi-lamellar vesicles and a portion of the active agent is associated with the multi-lamellar vesicles.
In one embodiment, the pharmaceutical composition is for use in the delivery of an active agent to an eye via intravitreal injection, subconjunctival injection, subretinal injection, intracameral injection or topical administration. In a particular embodiment, the pharmaceutical composition is for use in the delivery of an active agent to the vitreous humor of an eye via injection, particularly via intravitreal injection.
In one embodiment, the ocular side effect comprises vitreous haze. Vitreous haze may be observed after administration of a liposomal composition to the vitreous humor of an eye where the composition comprises a lipid mixture comprising one or more phospholipids; and an effective amount of the active agent or a pharmaceutically acceptable salt thereof.
The pharmaceutical composition of the present disclosure may have a greater viscosity than a reference pharmaceutical composition without the biocompatible hydrogel. The lipid nanoparticles together with the biocompatible hydrogel in the formed mixture of the present pharmaceutical composition are retained in the vitreous humor and lead to a reduction in vitreous haze initially after intravitreal injection of the pharmaceutical composition, compared to a reference ophthalmic pharmaceutical composition having the same components but without the biocompatible hydrogel. In particular, the reference ophthalmic pharmaceutical composition may be a suspension of lipid nanoparticles. In another aspect, after intravitreal administration, the present pharmaceutical composition is retained in the vitreous humor of a subject in need thereof for a retention time, which may be after the lipid nanoparticles, e.g. multi-laminar vesicles, are well-dispersed in the vitreous humor. After administration of the present pharmaceutical composition, the vitreous humor may show a lower turbidity relative to that of one administered with the reference ophthalmic pharmaceutical composition.
One aspect of this disclosure is a method of delivering an active agent to the vitreous humor of a subject in need thereof, comprising administering a pharmaceutical composition as described above.
The pharmaceutical composition according to the present disclosure is for use in the treatment of ophthalmic diseases or disorders.
In one embodiment, the subject in need thereof according to the present disclosure is suffering from at least one ophthalmic disease or disorder. Examples of the ophthalmic disease or disorder include, but are not limited to, macular degeneration, cystoid macular edema (CME), diabetic maculopathy, proliferative diabetic retinopathy (PDR), diabetic macular edema, retinal vein occlusions (RVO), neovascular glaucoma (NVG), retinal vascular tumors, choroidal hemangiomas, choroidal melanoma, vasoproliferative ocular tumor, Iris melanoma, radiation retinopathy, central serous chorioretinopathy (CSR), retinopathy of prematurity (ROP), endophthalmitis, uveitis, and retinitis.
In one embodiment, administering the pharmaceutical composition comprises intravitreally administering the pharmaceutical composition to the vitreous humor.
One aspect of this disclosure is a method of delivering an active agent to the vitreous humor of a subject in need thereof and reducing the ocular side effect of a liposomal composition, comprising administering a pharmaceutical composition as described above.
In one embodiment, administering the pharmaceutical composition comprises intravitreally administering the pharmaceutical composition to the vitreous humor.
In one embodiment, the ocular side effect comprises vitreous haze. An increase in vitreous turbidity is observed after administration of a liposomal composition without a biocompatible hydrogel to the vitreous humor. However, administering the present pharmaceutical composition to the vitreous humor reduces the vitreous turbidity, compared to administering the same pharmaceutical composition in the absence of the biocompatible hydrogel.
In certain embodiments, the pharmaceutical composition in accordance with the present disclosure has a phospholipid concentration ranging from about 50 mM to about 150 mM and the biocompatible hydrogel at an amount of about 0.05% to 1% (w/v), about 0.1% to 0.9% (w/v) or about 0.2% to 0.5% (w/v). After intravitreal administration of the pharmaceutical composition, the vitreous turbidity is reduced by about 10% to about 100%, about 10% to 40%, or about 20% to 40%, particularly by at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45% and at least 50%, compared to that of a reference pharmaceutical composition in the absence of the biocompatible hydrogel. The viscosity of the pharmaceutical composition in accordance with the present disclosure could be 15 to 220 mPa·S at 20° C. or/and 5 to 100 mPa·S at 37° C.; 10 to 45 mPa·S at 20° C. or/and 5 to 30 mPa·S at 37° C.; 45 to 220 mPa·S at 20° C. or/and 25 to 100 mPa·S at 37° C.
The following examples further illustrate the present disclosure. These examples are intended merely to be illustrative of the present disclosure and are not to be construed as being limiting.
The following examples illustrate the preparation and properties of certain embodiments of the present disclosure.
A lipid mixture of one or more lipids, including DOPC, DOPG and cholesterol, as formed at a molar ratio of 67.5:7.5:25 (DOPC:DOPG:cholesterol) and dissolved in absolute ethanol at about 40° C. A tabletop ultrasonic bath was used for lipid dissolution. The dissolved lipid solution was then added to a 1 mM of sodium phosphate solution to form a pro-liposome suspension, followed by extrusion of the pro-liposome suspension through a polycarbonate membrane with a pore size of 0.2 μm with 6 to 10 extrusion passes to form a liposome suspension. The liposome suspension was dialyzed and concentrated by a tangential flow filtration system (Spectrum® Hollow Fiber Filter Modules; MIDIKROS membrane: mPES, 100 kDa, 115 cm2) against 1 mM of sodium phosphate solution and then sterilized using a 0.2 μm sterile filter to obtain a sterilized liposome suspension. The phospholipid concentration of the sterilized liposome suspension was quantified by a phosphorus assay. The sterilized liposome suspension was subsequently formulated with a cryoprotectant, 2 w/w % mannitol (aseptic), and filled aseptically into vials for lyophilization to form a lipid cake.
The liposomal active agent composition (liposome-drug composition) comprising the lipid mixture can be prepared by reconstitution of the lipid cake (prepared in Example 1A) with an active agent, such as a therapeutic agent or an imaging agent. In the present example, exemplary active agents are dexamethasone sodium phosphate (DSP) and bevacizumab.
The liposomal DSP composition (also denoted as liposome-DSP composition) was prepared by reconstitution of the lipid cake (prepared in Example 1A) with a DSP solution, which comprises DSP (13.2 mg/mL) and sodium citrate (4.6 mg/mL) in an aqueous phase. The phospholipid concentration of the reconstituted liposome-DSP composition is 100 mM or 167 mM depending on the added volume of DSP solution.
The liposomal bevacizumab (an antibody specific to VEGF) composition (liposome-bevacizumab composition) was prepared by reconstitution of the lipid cake (prepared in Example 1A) with a bevacizumab solution comprising a suitable amount of bevacizumab in an aqueous phase. The bevacizumab concentration of the reconstituted liposome-bevacizumab composition can be, for example, 25 mg/mL.
The hydrogel solution in the present example was an aqueous solution comprising a biocompatible hydrogel which was prepared as described below, where the biocompatible hydrogel comprised hyaluronic acid. Hyaluronic acid powder (Hyaluronic acid sodium salt from Streptococcus equi, Sigma) was dissolved in ddH2O (Milli-Q purification system, Millipore) or buffers (10 mM HEPES/145 mM NaCl, 10 mM L-histidine/145 mM NaCl or PBS (Gibco®/Thermo Fisher Scientific), etc.) at an indicated concentration (see Table 1), and stirred at 4° C. overnight for a comprehensive dissolution and cross-linking of HA. The buffers for HA dissolution were prepared as follows:
The hydrogel solution and reconstituted liposome-drug composition were mixed to obtain a pharmaceutical composition comprising hydrogel and the liposomal active agent (also denoted as hydrogel/liposome-drug composition).
The HA solution and reconstituted liposome-DSP composition as prepared by the method according to the previous examples were mixed in the volume ratio of 2:3 to form the HA/liposome-DSP composition. The final contents of HA and phospholipid in the HA/liposome-DSP compositions are listed in Table 4.
The HA solution and reconstituted liposome-bevacizumab composition were mixed to form the HA/liposome-bevacizumab composition.
The viscosities of the samples were determined by a viscometer equipped with a HVROC-T/Temperature controller (μVIS™/HVROC-S, RheoSense). Before measurement, the temperature of the viscometer was set to 20° C. or 37° C. and balanced until steady state. 400 μL of the sample was loaded into a disposable viscometer pipette and mounted to the viscometer for measurement. Three repeated measurements were applied for each sample. The injectability assessment of the samples was applied on 24G (withdrawal) and 30G (injection) of needles. The results of viscosity and injectability of the samples are listed in Table 2 to Table 4.
As shown in Table 4, as the concentration of HA increased, the viscosity of HA/liposome-DSP composition also increased. The viscosity of the HA/liposome-DSP composition had an impact on its injectability. Therefore, an injectable hydrogel/liposome-drug composition has an indicated concentration range of hydrogel suitable for the present disclosure.
The dispersion behavior of the liposome-DSP composition and HA/liposome-DSP compositions in a medium was visually inspected. 30 μL of the liposome-DSP composition or 50 μL of the HA/liposome-DSP compositions was slowly added to 2 mL of saline in a transparent glass vial, where the total amounts of phospholipids in the liposome-DSP composition and the HA/liposome-DSP compositions were the same. The vials were incubated at 37° C. and the dispersion behaviors of the samples were recorded at each indicated time point after incubation for (A) 0 h, (B) 1 h, (C) 2 h, (D) 3 h and (E) 24 h. Sample labels (from left to right) (1) Liposome-DSP composition; (2) 0.228% HA (PBS)/liposome-DSP composition; (3) 0.228% HA (HEPES/NaCl)/liposome-DSP composition; (4) 0.456% HA (PBS) /liposome-DSP composition; (5) 0.456% HA (HEPES/NaCl) /liposome-DSP composition. The samples were incubated at 37° C. and their dispersion behaviors were recorded by photograph at 0 hour (h), 1 h, 2 h, 3 h and 24 h. (
As illustrated in
Turbidity is a measure of the degree to which a solution loses its transparency due to the presence of dispersed particles. Here we measured the absorbance of the samples at λ=400-700 nm (within the visible light range). According to the definition of absorbance (Equation 2), the higher the absorbance of a sample, the less the transmittance of it, which indicates the greater turbidity of the solution (more incident light is scattered, Equation 1). For the sample preparation, 50 μL of the liposome-DSP compositions (sample L1) or 50 μL of the HA/liposome-DSP compositions (sample H5 and H6) was added to 2 mL of saline, where the total amounts of phospholipids in the liposome-DSP composition and the HA/liposome-DSP compositions were the same. The samples were vibrated until the liposome-DSP or HA/liposome-DSP compositions were dispersed in saline completely. The homogeneous sample solutions were transferred to a 96-well plate (200 μL/well) and the absorbance measured at λ=400 to 700 nm in a microplate reader (Synergy H1, BioTek).
An in vitro evaluation of the active agent release from the liposome-drug composition and the hydrogel/liposome-drug composition was performed in a dissolution system containing a dialysis tube (Float-A-Lyzer® G2 Dialysis Device, 20 kDa, 1 mL, Spectra/Por®) as a sample reservoir surrounded by the release medium in a glass bottle. A sample reservoir was loaded with (1) 760 μL of saline and 240 μL of liposome-DSP composition (sample L1, where the composition was slowly added into the saline) or (2) 600 μL of saline and 400 μL of 0.456% HA/liposome-DSP composition (sample H3, where the composition was slowly added into the saline), where the total amounts of phospholipids and DSP in the sample reservoirs in the two groups were the same. Saline was used as the release medium in this in vitro release evaluation. The sample reservoir was placed in 200 mL of a release medium in a glass bottle, and the system was under a slow stir at 37° C. to facilitate the dissolution of DSP from the sample reservoir to the release medium. 1 mL of the release medium was collected at indicated time points, and the released amount of DSP was measured (UV, λ=241 nm) and calculated accordingly.
The IVR result in
This application claims priority to U.S. Provisional Application No. 63/157,113, filed on Mar. 5, 2021, which is incorporated by reference in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2022/018885 | 3/4/2022 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63157113 | Mar 2021 | US |
