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Title: Process for the preparation of suspensions of
drug particles for inhalation delivery
United States Patent: 6,464,958
Issued: October 15, 2002
Inventors: Bernini; Eva (Parma, IT); Malvolti; Chiara
(Parma, IT); Garzia; Raffaella (Parma, IT); Brambilla; Gaetano (Parma, IT);
Chiesi; Paolo (Parma, IT)
Assignee: Chiesi Farmaceutici S.p.A. (Parma, IT)
Appl. No.: 830884
Filed: May 22, 2001
PCT Filed: October 28, 1999
PCT NO: PCT/EP99/08176
371 Date: May 22, 2001
102(e) Date: May 22, 2001
PCT PUB.NO.: WO00/25746
PCT PUB. Date: May 11, 2000
Abstract
The invention is directed to a process for the preparation of suspensions
of drug particles for inhalation delivery, said process providing particles
of optimized particle size and distribution homogeneously dispersed in the
carrier. The process, which is also suitable for the preparation of sterile
suspensions, includes the step of homogenizing and micronizing the
formulation in a turboemulsifier provided with a high-potency turbine,
optionally followed by a treatment in a high-pressure homogenizer. A further
aspect of the invention is directed to a process for preparing micronized
sterile beclomethasone dipropionate by gamma-irradiation.
Description of the Invention
The administration of drugs through inhalation has been used for many
years and is the mainstay of treatment of diseases which limit airflow, such
as asthma and chronic bronchitis.
Furthermore, a number of inhalatory formulations have been marketed for some
years, for the administration of steroidal antiinflammatory, decongestant
and antiallergic agents for the topical treatment of rhinitis and/or
sinusitis.
One of the advantages of the inhalatory route over the systemic one is the
possibility of delivering the drug directly at the action site, so avoiding
any systemic side-effects. Said way of administration allows to achieve a
more rapid clinical response and a higher therapeutic index.
Among the different classes of drugs which are usually administered by
inhalation for the treatment of respiratory diseases, glucocorticosteroids
such as beclomethasone dipropionate (BDP), dexamethasone, flunisolide,
budesonide, fluticasone propionate are of great importance. They can be
administered in the form of a finely divided, i.e. micronised, powder,
formulated as suspension in an aqueous phase containing any necessary
surfactants and/or cosolvents; when intended to be administered in the form
of metered doses of aerosol spray, they should also contain a low-boiling
propellant.
The effectiveness of the administration form depends on the deposition of an
adequate amount of particles at the action site. One of most critical
parameters determining the proportion of inhalable drug which will reach the
lower respiratory tract of a patient is the size of the particles emerging
from the device. In order to ensure an effective penetration into the
bronchioli and alveoli and hence ensure a high respirable fraction, the mean
aerodynamic diameter (MMAD) of the particles should be lower than 5-6
microns (.mu.m). For nasal administration, particles with higher MMAD are
required.
Other important characteristics for a correct administration and therefore
for the therapeutic efficacy, are the size distribution and the homogeneous
dispersion of the particles in the suspension.
A poor control of said parameters might favour the formation of loose
agglomerates (curds) or, if the curds become compacted and fuse, cakes of
suspended particles which, in turn, may impair the possibility of
re-suspending the product easily and providing uniform dosing either during
the filling of the containers and during the use.
The first object of the present invention is to provide a process for the
preparation of particles suspensions for use in pharmaceutical formulations
for aerosol inhalation, said particles being characterised by optimised
particle size and distribution for obtaining compositions with high
therapeutic efficacy.
In a first embodiment of the invention, the process is carried out by using
a turboemulsifier, optionally followed by a treatment with a high pressure
homogeniser.
Accordingly, said process includes a first step wherein an aqueous solution
which constitutes the carrier is dispersed in a turboemulsifier apparatus. A
typical turboemulsifier suitable for the treatment comprises a containment
vessel equipped with magnetic stirring and a high potency turbine system
which is used for homogenising the suspension. The apparatus can also be
fitted with a heating steam jacket as well as a vacuum system.
The carrier optionally contains wetting agents, surfactants,
viscosity-increasing agents, preservatives, stabilising agents, isotonicity
agents and/or buffers and can optionally be sterilised. In a second step,
one or more micronised active ingredients, obtained after conventional
milling, are added to the aqueous phase and dispersed in the same
turboemulsifier vessel by applying very high speed (2000-3000 r.p.m.,
preferably 2500-2600) for 15-20 min. In has been found that said conditions
are necessary in order to effectively disperse the micronised particles of
the active ingredient in such a way as to prevent agglomeration during
storage. Moreover, it has been more surprisingly found that the particles
during said treatment are subjected to a further mild milling which reduces
the sizes of the crystals of larger diameter so removing the fractions with
higher particle size distribution.
Optionally the process can be carried out under vacuum in order to skim off
the suspension.
In a more preferred embodiment of the invention, the drug, dispersed in the
aqueous phase, is subjected to an additional homogenisation treatment under
high-pressure to further reduce the mean size of the suspended particles. A
typical apparatus used for this treatment, such as the Microfluidizer.RTM.,
includes a high pressure pump which can supply pressures up to 1500 bar and
one or more interaction chambers. During the process, the sample is
introduced as a stream, then forced at the operating pressure through the
interaction chambers where the stream is accelerated to extremely high
velocities and subjected to three main forces: i) shear (sliding of
particles across one another, tearing); ii) impaction (collisions;
crushing); iii) cavitation (collapsing of cavities or bubbles of the
surrounding liquid phase; an increased change in velocity with a decreased
change in pressure).
The degree of reduction of the solid particles size and the resulting
distribution particle curve can be optimised by controlling the following
variables i) the type and size of the interaction chamber; ii) the operating
pressure; iii) the time of processing and the number of cycle the material
is going through.
The effect of the process is also dependent on physico-chemical
characteristics of the ingredient subjected to the treatment. According to
the hardness of its crystalline lattice, different pressure and processing
times can be requested to achieve the desired results.
It has now been found that, in case of steroids, it is possible to tighten
the distribution particle curve in such a way as that the mean diameter of
at least 90% of the particles is lower than or equal to 5 .mu.m by keeping
the operating pressures between 500 and 1000 bar. In particular, particles
optimised for pulmonary delivery are obtained using an interaction chamber
with sharp edges and maintaining the operating pressure between 600 and 800
bar. Overprocessing at higher pressure should be avoided as it may result in
particle-size growth and curds formation. Said surprising results were
achieved by submitting the suspension to only one cycle of treatment and
therefore for a very short period, making the process very convenient and
attractive from an industrial point of view.
The process of the invention is efficiently carried out at room temperature
which constitutes a considerable advantage in case of potentially
thermolabile molecules such as steroids. On the other hand, the temperature
does not significantly increase during the treatment. Furthermore, said
specific range of pressures turned out to be suitable for reducing the
particle size of the suspended active ingredient without requiring a
significant increment in the amount of surfactants. It is general knowledge
indeed that the total surface area of the active ingredient increases upon
micronisation making sometimes necessary to change the formula of the
suspension. Therefore, the breaking of the particles has to be controlled to
the degree allowed by the chosen composition.
At the end of the treatment of the invention, particles of particle size
distribution within well-defined parameters as well as a good dispersion of
the suspended particles are obtained. The resulting formulation is
physically stable and it can be easily re-suspended after at least one year
of storage.
In order to prevent an increment in the viscosity of the suspension and the
formation of even loose aggregates during storage which may puzzle the
patient before the use, the process can be preferably carried out by
operating at 600-700 bar and by employing an additional interaction chamber
arranged in series with respect to the former.
The most widely experienced applications of high-pressure homogenisation
regard solid-in-liquid dispersion of paint, pigments, ink-jet printing ink
and ceramic powders.
WO 96/14925 deals with dispersion of hard, non-compliant particles used in
magnetic recording media such as audio tapes, video tapes or computer
diskettes.
Examples of applications to pharmaceutical compositions can be yet found in
the prior art but none of them envisages treatment of steroids.
EP 768114 claims the use of said apparatus for treating aerosol formulation
containing low-boiling components such as hydrofluoro-carbon alkanes (HFA's)
at ambient temperatures. Homogenisation is achieved at 550-620 bar but after
repeated cycles of treatment. Micronisation of the active ingredients
exemplified i.e. ipratropium bromide and salbuterol sulfate is achieved only
at very high pressures (about 1400 bar).
Also EP 726088 claims a process, consisting of re-circulation under
high-pressure through multiple tiny openings in order to obtain
homogeneously dispersed formulation containing liquefied propellants to be
used in pressurised aerosol inhalers.
Illig et al. (Pharm Tech October 1996) in a study aiming at describing the
advantages of Microfluidizer.RTM. processing over conventional milling
treatments, applied such technology to produce suspensions of iodinated
radiopaque materials with reduced particle size.
Calvor et al. (Pharm Dev Technol 3, 297-305, 1998) discloses the use of
high-pressure homogenisation to produce nanoparticle formulation of polymers
(less than 1 .mu.m and preferably 5-7 nm).
The suspensions prepared according to the process of the invention can be
partitioned in suitable containers such as multi-dose or, preferably,
single-dose systems for nebulisation, preformed or prepared with the "blow,
fill and seal" technology, or pumps or systems for the rhinologic
administration.
Both steps, involving respectively the turboemulsifier and the high-pressure
homogeniser, can be carried out without any contact with atmosphere and are
therefore compatible with working in sterile environment.
All the steps of the process can be carried out on an industrial scale.
The types of dispersion which can preferably benefit of such treatment are:
i) sterile suspensions obtained as from a micronised sterile active
ingredient; ii) suspensions obtained as from a micronised non-sterile active
ingredient.
The process of the invention could also be advantageously utilised for: iii)
suspensions obtained from a non-sterile ingredient in the form of non-micronised
powder; iv) sterile formulations as a result of wet steam treatment of the
bulk suspensions.
In fact, it has been more surprisingly found that particles of the desired
particle size distribution can also be obtained by submitting the suspension
containing the non-micronised active ingredient to the high-pressure
homogenisation treatment. In particular, by applying operating pressures
lower than those previously claimed, particles suitable for nasal delivery
could be obtained. Said treatment might also be effective in restoring the
desired particle size distribution after that unfavourable changes in their
profile have occurred as a result of heat-sterilising processes. The latter
methods may indeed lead to the formation of aggregates which will hardly
de-aggregate into fine particles upon administration.
Drugs which can advantageously be used for preparing the suspensions
according to the process of the invention include those steroids which are
usually administered by inhalation for the treatment of respiratory
diseases, such as beclometasone dipropionate, flunisolide, momethasone
furoate, triamcinolone acetonide, dexamethasone, fluticasone propionate,
budesonide and its epimers. The corresponding formulations can be prepared
by dispersing the active ingredient(s) in an aqueous solution or in
high-boiling organic solvents, such as alcohols. According to the particle
size and particle distribution obtained, they can be used either for
pulmonary or nasal delivery.
Moreover, the particles obtained with the process of the invention, suitably
dried, can optionally be conditioned in pressurised dosed areosol inhalers.
Suspensions in organic solvents can be directly distributed in containers
for pressurised aerosols.
As reported above, the process of the invention is compatible with working
under sterile conditions. Since sterility is a requirement more and more
demanded for pharmaceutical formulations intended for nebulisation, it would
be highly advantageous to provide aqueous suspensions of steroids to be
delivered as sterile single-dose preparations. Said formulations allow to
avoid the use of antimicrobials or preservatives which are extensively
reported to be responsible of allergies and irritations of airways which, in
turn, manifest by cough or bronchospasm.
It is therefore a second object of the invention to provide a process for
the preparation of particles to be used as aqueous suspensions intended for
aerosol inhalation, said particles being constituted of a sterile micronised
active ingredient and characterised by an optimal size distribution for
obtaining high therapeutic efficacy starting from.
Said process comprises the following steps: i) to prepare an aqueous
solution, which constitutes the carrier and optionally containing wetting
agents, surfactants, viscosity-increasing agents, stabilising agents,
isotonicity agents and/or buffers, in a suitable turboemulsifier vessel; ii)
to sterilise the aqueous base inside the same container; iii) to add, in a
sterile environment, one or more active sterile micronised ingredients; iv)
to disperse all the ingredients by using the same turboemulsifier.
The resulting suspension can be directly partitioned under sterile
conditions, in plastic single-dose containers, pre-formed and sterilised by
suitable treatments or produced in sterile by employing the "blow, fill and
seal" technology.
Before packaging, the suspension can optionally be submitted to a further
high-pressure homogenisation treatment, still carried out under sterile
conditions.
A third object of the invention is a process for making therapeutically
acceptable micronised BDP sterile as a result of gamma-ray irradiation.
The use of gamma irradiation for sterilising steroids has been already
reported in the literature. However, data always refer to drugs in the form
of powders, solutions, suspensions, creams or ointments; furthermore, even
in the most favourable cases, a decrease of the content is often observed
which do not conform with the current ICH (International Conference
Harmonisation) requirements for pharmaceutical formulations or products
intended for.
Hayes R et al. in J Pharm Pharmacol 32 (Suppl), 48P, 1980 compare the
stability of powder BDP with respect to that of its solution in methanol or
propylene glycol, solvents currently used for the preparation of creams.
Cobalt (60 Co), at doses of 1 to 4 Mrad is used as gamma-irradiating
source. The conclusions are that BDP in the form of powder is stable
immediately after irradiation while its solutions undergo quick degradation.
Bussey DM et al. in J Parent Sci Technol 37, 51-54, 1983 and Kane MP et al.
in J Pharm Sci 72, 30-35, 1983 report data on the degradation of powder
corticosteroids sterilised by using 60 Co as irradiating source. The
percentage of degradation varies from a minimum of 0.2%/Mrad for prednisone
to a maximum of 1.4%/Mrad for hydrocortisone sodium succinate, The
degradation following irradiation causes the loss of the C17 side chain and
the oxidation of the alcohol group at the C11 position. Sterilisation of
micronised steroids was reported in Illum L et al. in Arch Pharm Chemi Sci
Ed. 2, 167-74, 1974. The active ingredients submitted to two different
radiation doses (4.5 and 15 Mrad) showed different degradation degrees,
namely below 1% for hydrocortisone acetate and prednisone and about 2.4% for
hydrocortisone, prednisolone and prednisolone hydrate.
WO 99/25359 claims a process for sterilisation of a powdered form of a
glucocorticosteroid, preferably budesonide, by employing temperatures (from
100 to 130oC.) significantly lower than those considered necessary
for the heat sterilisation of other substances.
PT-A-69652 disclosed cold sterilisation of micronized glucocorticosteroids
using mixture of ethylene oxide and carbon dioxide. Specific examples are
prednacinolone, dexamethasone, prednisolone and salts, esters and fluoro
derivatives thereof. Sterile BDP is not reported. Furthermore, the technique
requires the elimination of residual ethylene oxide which is time consuming
and difficult. In the light of the present strict regulatory requirement the
method would be not suitable for producing therapeutically acceptable
glucocorticosteroids.
In summary, methods of sterilisation, in particular gamma-ray irradiation,
has never been previously applied to micronised beclomethasone dipropionate
(BDP). Moreover, the stability upon storage of the corresponding suspensions
of the micronised irradiated product has never been verified. Degradation
processes may indeed start after a significant lag-time due to the energy
stored up by the drug after irradiation.
It has now surprisingly been found that BDP micronised substance when
subjected to gamma-irradiation at 2 to 9 KGy under particular conditions,
remains chemically stable. Contrary to what has been reported in WO 99/25359
for budesonide, no significant chemical degradation was observed with
respect to the non-irradiated product. Sterile BDP micronised substance
according to the process of the invention experiences any change neither in
its crystalline characteristics, as demonstrated by DSC (Differential
Scanning Calorimetry), TGA (Thermal Gravimetric Analysis), XRD (X-ray
diffractometry), IR (infrared spectrum), nor in its particle size as proved
by Malvern analysis. Also the corresponding suspensions turned out to be
physically and chemically stable after long-term and accelerated storage
conditions.
The process is carried out on the product packed in containers made of
suitable materials, preferably polythene, after having replaced air by
nitrogen, or optionally under vacuum; the containers are, in turn, sealed in
bags made of oxygen-proof materials such as Polikem.RTM. or Co-pack.RTM..
It has indeed been found that the presence of oxygen during irradiation
dramatically affects the stability of the product as the latter becomes more
sensitive to oxidative processes. The ratio between the volume of the
container and the amount of micronised powder should also be kept as low as
possible and necessarily equal or less than 7:1 w/v.
The present process was validated according to the International Standard
Organization Procedure ISO-11137-2B in order to ensure a Sterility Assurance
Level (SAL) of at least 10-6 (preferably 10-7) and it yields a
material sterile according the criteria of the European Pharmacopoeia (Ph.Eur).
The method of the invention allows to solve the technical problem of
preparing micronised BDP sterile suspensions to be used for nebulisation.
Sterilisation methods of the prior art carried out directly on the final
formulation are indeed not suitable; aseptic filtration cannot be utilised
due to non-filterability of suspended particles, while wet steam
(autoclaving) involves a degree of heat which can be only tolerated by
thermostable steroids. For instance, BDP suspensions subjected to a wet
steam process under conditions similar to those reported in U.S. Pat. No.
3,962,430 (121oC. for 15 minutes) undergo a remarkable decrease in
the content in active ingredient (about 8-9%), with a corresponding
significant increase in degradation products (about 10-11%).
The BDP starting material for the process has a bioburden of less than 100
CFU (colony forming units) per gram, preferably less tan 10 CFU per gram and
is used in the form of micronised powder, particularly in the form of
particles having a MMAD of less than 10 .mu.m, more preferably less than 5 .mu.m.
The corresponding formulation for inhalation can be advantageously used in
the treatment of any allergic condition and/or inflammatory condition of the
nose or lungs, such as asthma as well as of bronchopulmonary dysplasia
either in hospital and domicilary setting.
Claim 1 of 20 Claims
What is claimed is:
1. A process for the preparation of an aerosol inhalable suspension of
particles, comprising:
a) preparing a suspension of a steroid active ingredient, in a
turboemulsifier provided with a turbine adapted for homogenising the
suspension;
b) optionally subjecting the resulting suspension to a further treatment in
a high pressure homogeniser,
thereby forming said aerosol inhalable suspension.
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