This Invention addresses technical and functional enhancements introduced to an inhaler developed particularly for use with inhalable powdered medications prepared in capsules containing a single dose. This device is widely used for delivering inhale medications for the treatment of respiratory diseases, where each capsule holds a single dose.
More particularly, the present invention consists in an improvement that can be introduced in different inhalers which work based on inhalable powdered medications prepared in capsules containing a single dose, such as the one disclosed in the document WO2013/016787 A1 published on Jul. 2, 2013. The changes are concentrated in the suction means of the airflow, including means for aeration, or false air inlet, concurrently with the air inlet during inhalation, with objective of setting pre-measured mixtures of air and inhaled powdered medication at certain inhalation resistances, affecting de-agglomeration of the formulation and its fine particle fraction FPF, or inhalable fraction, which wouldn't de possible with state-of-the art capsule based dry powder inhalers.
As described in WO2013/016787, a variety of inhalers available for delivering powdered medications prepared in type of single capsules, multidose-reservoir or in form of trip-blisters with independent recesses containing doses, such as those disclosed in the following documents:
BRPI0501263, BRPI0415711, BRPI0710078, CA2391466, DE19637125, EPO406893, EP0666085, EP0911047, EP1270034, EP1350532, EP2010258, BRPI0710078, U.S. Pat. No. 3,906,950, U.S. Pat. No. 3,991,761, U.S. Pat. No. 5,048,514,U.S. Pat. No. 5,372,128, U.S. Pat. No. 7,284,552, U.S. Pat. No. 7,870,856, W09727892, W02004035121, W02004052435, W02005044353, W02005113042, W02006051300, W02007116002 and GB2151491A.
Capsule based inhalers are small, easy to handle and economic to be manufactured since they require fewer components and allow reutilization; therefore they are candidates for delivering generic formulations. Such devices generally present their respective innovative characteristics, although in most cases these characteristics are incorporated in basic parts, such as the compartment for inserting a single dose capsule containing powdered medication; means for perforating the capsule at two opposite points at least for creating small openings in form of outlets for releasing the powdered medication; structure for inflow of air created by breath activate aspiration; channeling of this air flow through a de-agglomeration chamber; connected to a capsule compartment for releasing the formulation mixture with air; and a mouthpiece structure for inhalation the air flow with medication.
As appears, single dose capsule inhalers has practically resulted in the establishment of a standard device which allows the powdered medication to be inhaled efficiently from a capsule, for different types of treatments related to respiratory diseases, many of them chronic and widespread, including asthma, bronchitis and Chronic Obstructive Pulmonary Disease (COPD). Rigid gelatin or HPMC capsules containing excipients and micronized active substances, either individually or in combinations, are used in such inhalers.
Thus, known devices for inhaling powdered medications prepared in capsules work with the capsules held in a receptacle as taught for example in documents EP1350532A2 and U.S. Pat. No. 3,906,950 A; or loose in a de-agglomeration chamber which dimensions are only large enough to allow subjecting the capsule to specific movements, as taught for example in documents BRPI0415711A, BRPI0501263A, BRPI0710078, EP0911047A1, U.S. Pat. No. 5,048,514 A, WO2004052435A1, WO2005044353A1, WO2006051300A1 WO2007116002A1, CA2391466C, EP1270034A2, U.S. Pat. No. 3,991,761 A, U.S. Pat. No. 7,284,552 B2 and WO2005113042A1. These movements may occur with the capsule in a vertical or in the horizontal position.
In vertical position, the capsule longitudinal axis is in vertical position and, consequently its chamber is defined by a cylindrical area with a diameter sized to hold the capsule in the vertical position, as taught in documents: BRP10415711A, EP0911047A1, EPO491426A1, U.S. Pat. No. 5,048,514 A, U.S. Pat. No. 3,906,950 A, WO2004052435A1, WO 2005044353A1, WO 2006051300A1 and WO 2007116002A1.
In the horizontal position, the capsule longitudinal axis is positioned horizontally in a chamber also defined by a cylindrical area with a diameter larger than the length of the capsule in order to hold it in a horizontal position, such as taught for example, in documents: BRPI0501263A, BRPI0710078, CA2391466C, EP1270034A2, U.S. Pat. No. 3,991,761 A, U.S. Pat. No. 7,284,552 B2 and WO2005113042A1.
In both constructive cases, meaning with the capsule working in vertical or horizontal position, the capsule holding the dose it is subject to circular movements around its longitudinal axis, and rectilinear movements in random directions, knocking against the walls of its de-agglomeration chamber.
On the other hand, devices with the capsule in a horizontal position, such capsule is subject to rotation movements like a propeller. It is noted that the movements of the capsule are an important and decisive factor for encouraging air circulation and breaking down the powder for releasing the dose during inhalation. These inhalers use different ways for opening the capsule, or breaking through the capsule membrane, or piercing the capsule at opposite ends, in order to allow the air to flow into such capsule and release the formulation.
Each inhaler is embodied with intrinsic physical constructive characteristics that together with the formulation shape the pulmonary deposition and dose releasing profile. Dry powdered formulations prepared in capsules consists mainly of a blend of lactose and micronized active substances that must be broken-down during inhalation in order to allow the release of the dose with an adequate percentage of fine particle fraction, or breathable fraction (considered particles smaller than 4.6 μ micra). Within lung deposition, the breathable fraction is the percentage of the formulation reaching the lower portion of lungs, a relevant parameter for determination of the product therapeutic efficacy. For capsule based dry powder inhalers, this breathable percentage may vary from 15% to 50% of the emitted dose, however, independent on the inhaler type, such percentage values may differ based formulation and substance, and can de considered adequate based of the parameters found in registered products, acknowledged as Reference Leading Drugs (RLD).
One of the parameters for analyzing the performance of a dry powder inhaler is through its inhalation resistance, which determines the volume of air which enters the inhaler at a given inhalation capacity, which can be measured in L/min. (liters per minute). This volumetric flow may be calculated by using the flow resistance at a specific inhalation pressure, measured in Kilopascal-kPa (or pressure drop). A 4 kPa parameter is normally addressed as it is given by the European pharmacopeia and the USP as the inhalation pressure parameter (pressure drop) for adjusting analytical equipments for dry powder inhalers in-vitro formulation assays.
In order to ensure adequate release of certain formulations, it is preferable to use inhalers which allow constructive means for influencing lung deposition profile, breathable fraction, and the inhalation resistance.
Usually, to adjust the breathable fraction, a carrier can be used, as for example, inhalable lactose with different levels of micronization to thereby reduce or increase the breathable fraction percentage, in order to achieve a certain adequate parameter in-vitro result. However, adjustment of fine breathable fraction via carrier micronization has limitations which may restrict the use of capsule based inhalers (single dose capsule) for administration of certain drug medications in view of the limitation to obtain a satisfactory lung deposition profile only via formulation.
The lung stages can be simulated by using equipments that identify the dimension of the particles, sucking the inhalable powder in determined air flow, through various filter patterns to establish the percentage of particle retention in different stages each identified by deposition of determined size of particles in form of a cascade. Such equipments, also known as “cascade impactor”, can be operated in distinct inhalation flows to simulate the lung deposition profile for different lung capacities (L/min). These apparatus enable to collect the exact amount of lactose and active substance in each stage, simulating the human inhalation in stages, such as mouth, throat, trachea and lungs; represented in various stages of distribution; the early stages representing the deposition in the upper parts of the lung, and the final stages representing the deposition in the lower part of the lung.
Although there are available various grades of micronized lactose, it is not always technically possible to achieve the adequate deposition result in all lung stages, especially in lower stages where percentages of active substances are quantitatively smaller, but not less relevant to determine product efficacy. Another limiting aspect relates to certain quantitative standards for carriers and active substance in each stage of lung deposition. If the construction of a determined inhaler does not present aerodynamic means to enable achievement of a desired lung deposition profile, the quantity of micronized lactose and drug substance can be eventually above or below the desired pattern preventing the release of formulations qualitatively and quantitatively desirable.
Inhalers such as those disclosed in BRPI0501263, BRPI0415711, BRPI0710078, CA2391466, DE19637125, EPO406893, EP0666085, EP0911047, EP1270034, EP1350532, EP2010258, BRPI0710078, U.S. Pat. No. 3,906,950, U.S. Pat. No. 3,991,761, U.S. Pat. No. 5,048,514, U.S. Pat. No. 5,372,128, U.S. Pat. No. 7,284,552, U.S. Pat. No. 7,870,856, W09727892, W02004035121, W02004052435, W02005044353, W02005113042, W02006051300, W02007116002 and GB2151491A describes individual constructive characteristics, not elaborating on specific means to influence or regulate the releasing of the formulation and its deposition profile, limiting their effectiveness for the releasing of formulations with certain parameters.
The pressure or inhalation resistance is other relevant aspect but not decisive for obtaining a determined lung deposition profile.
Therefore, the objective to solve the problem should take into consideration a constructive feature in a powder inhaler which capsule spins in its horizontal axis, which can influence different aerodynamic aspects contributing to enable preparation of formulations to achieve adequate deposition of active substance in lung stages with the aimed inhalation resistance.
The formulation release profile can also influenced by the manner and site where the capsule is opened. Normally, dry powder inhalers use needles or pins to pierce the capsule at its ends. This is designed to ensure that the air flow also penetrates the capsule through a vortex, encouraging the creation of the spray in the de-agglomeration chamber housing the capsule, resulting in a mixture of the air with the inhalant substance that flows through the mouthpiece, and from there to the lungs. The breakdown chamber, which houses the capsule, is therefore decisive for the drug release profile, and part of the set responsible for inhalation resistance.
WO2013/016787 aims specific solutions to achieve above objectives, and therefore, the inhaler has been improved in its air/powder mixture chamber and adjacencies, more specifically at the air flow outlet and route. A passage was introduced in the roof of this de-agglomeration chamber with specific geometry, carefully dimensioned, normally rectangular or circular, which constitutes an outlet for the inhalant, with the length of this outlet also being preferably equal to the length of the cylindrical part of the capsule (except rims) and its width is approximately ⅓ or less than its diameter. Logically, this opening is fitted with a sieve-like structure at an appropriate mesh, in order to retain possible particles whose dimensions are not appropriate for inhalation.
Thus, during inhalation process, the capsule is subject to a variety of rotating and rectilinear movements in the vertical or horizontal positions, consequently leading to the affirmation that, as the air flow enters the inhaler, the capsule rotates horizontally like a propeller and is concomitantly moved outwards and downwards, hitting the bottom and roof of its chamber. When it is up against the roof, a specific effect occurs, because at a given movement, the capsule and the outlet are aligned, thus producing a valve-like effect, meaning that the capsule is practically sucked into the rectangular outlet and at this moment the airflow is reduced for a fraction of a second, due to the rotation of the capsule, thus defining a new standard of functioning through which the air outlet from the capsule chamber is blocked intermittently during inhalation. These sudden blockages in fact generate additional forces with micro-collisions of the capsules against the inner walls of the chamber, producing other effects that cause the powder in the capsule to be subject to bursts that move the clumped powder in directions opposite to the centrifugal and gravitational forces at its ends, fostering breakdown and release with greater efficiency normally achieved merely through the vortex effects in the chamber. In this case, the brief intermittent blockages of air occur when the displacement of the capsule in the air flow forces it up against the air outlet from the chamber, with both longitudinal axes aligned.
Thus, WO2013/016787 presents an alternative form for the release of inhalable powdered formulations with a more efficient pulmonary deposition profile for an inhaler that functions with the capsule in a horizontal position.
On the other hand, WO2013/016787 describes an improvement in construction for a version of a powder inhaler that functions with a capsule subject to a horizontal rotating movement, which offers means for achieving an adequate powder release profile at high inhalation resistance, in contrast to the state-of-the-art model for dry powder inhalers that work with the capsule in a horizontal position and with lower inhalatory pressure.
There is no doubt that WO2013/016787 discloses a more flexible operation, particularly with regard to the desired percentage of formulation that reaches the lower part of the lung, region with the greatest importance for the effectiveness of the medication. However, after further tests of in-vitro characterization with newly invented test model, it was verified that would be possible to expand the flexibility of the inhaler adding means to influence the release profile and inhalation resistance, concomitantly with a significant improvement enabling development of powder formulations that can reach certain percentages of active substances in the respective lung stages.
Provide constructive means to influence air flow distribution and inhalation pressure to allow rebalancing air route through aerodynamic construction of a dry powder inhaler, type which capsule containing dose works in horizontal position, with objective to achieve desirable results in the lung deposition stages, mainly lower lung stages where percentages of active substances are quantitatively smaller but decisive for clinic effectiveness of the formulation.
Proposed means by the present invention consists to provide false openings or entries that allow establishing additional air flow concurrently with the main air flow, which conducts the medication and, through a de-agglomeration chamber and mouthpiece portion, such additional flow is mixed with the main inhalation flow, providing a new parameter for influencing the internal aerodynamic balance on the device and pattern of effectiveness for formulation de-agglomeration given by said “aeration effect on the formulation” which allows considerably to influence the medication release profile, contributing to achieve adequate percentages of active substance deposition within the different lung stages, which could not be achieved only via carrier micronization.
For a better understanding of this invention, a detailed description thereof is presented below, referenced to the appended drawings:
In compliance with these illustrations and their details, more specifically the
The above-mentioned mouthpiece (4) also has means to establish an inward air flow from outside and is hollow in order to do so, forming that vertical passage (16) for the inhalant, whose lower end is connected to the capsule receptacle (2A) which, above the slot-in cradle (3), has a wider portion that constitutes the de-agglomeration chamber (15), cylindrical, with a diameter slightly larger than the length of the capsule (C), and also has a tangential secondary air intake point (17) positioned between the walls of the capsule receptacle (2A) and the base housing (1) which in turn has one or two primary air intake points (18), with a pocket (19) formed between them which improves the stability of the air flow created when the patient breathes in during the inhalation process, being this operation illustrated in
Laboratory tests for in-vitro characterization of lung stages deposition with new constructive features has proven that would be possible to expand the flexibility of such kind of inhalers by adding means to influence the release profile and inhalation resistance, concurrently with significant improvement in the final result to certain deposition profiles, aiming elaboration of powder formulations with adequate percentages of active substance reaching respective lung stages.
Changes along the passage (16) can significantly influence aerodynamic flow and inhalation pressure, concurrently, such influence also collaborate to assist to reach the aimed results in the lung deposition stages, specially in lower stages where percentages of active substances are quantitatively smaller.
Thus, as also illustrated in
Filing Document | Filing Date | Country | Kind |
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PCT/BR2013/000254 | 7/16/2013 | WO | 00 |