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Title: Devices compositions and methods for the
pulmonary delivery of aerosolized medicaments
United States Patent: 6,509,006
Issued: January 21, 2003
Inventors: Platz; Robert M. (Half Moon Bay, CA); Patton;
John S. (San Carlos, CA); Foster; Linda (Sunnyvale, CA); Eljamal; Mohammed
(San Jose, CA)
Assignee: Inhale Therapeutic Systems, Inc. (San Carlos, CA)
Appl. No.: 427075
Filed: October 26, 1999
Abstract
According to the subject invention, dispersible dry powder
pharmaceutical-based compositions are provided, including methods for their
manufacture and dry powder dispersion devices. A dispersible dry powder
pharmaceutical-based composition is one having a moisture content of less
than about 10% by weight (% w) water, usually below about 5% w and
preferably less than about 3% w; a particle size of about 1.0-5.0 .mu.m mass
median diameter (MMD), usually 1.0-4.0 .mu.m MMD, and preferably 1.0-3.0 .mu.m
MMD; a delivered dose of about >30%, usually >40%, preferably >50%, and most
preferred >60%; and an aerosol particle size distribution of about 1.0-5.0 .mu.m
mass median aerodynamic diameter (MMAD), usually 1.5-4.5 .mu.m MMAD, and
preferably 1.5-4.0 MMAD. Such composition are of pharmaceutical grade
purity.
DESCRIPTION OF SPECIFIC EMBODIMENTS
The present invention is based at least in part on the dispersibility
characteristics of the pharmaceutical-based dry powder compositions produced
according to the present invention. The dispersibility characteristics of
the subject pharmaceutical-based compositions means that they are more
suitable for use in pulmonary delivery devices than compositions prepared by
other methods. The compositions of the invention are readily aerosolized and
rapidly absorbed through the lungs of a host when delivered by a dry powder
inhaler.
DEFINITIONS
In interpreting the claims to the various aspects of this invention, there
are several important definitons that should be considered.
The term "dispersibility" or "dispersible" means a dry powder having a
moisture content of less than about 10% by weight (% w) water, usually below
about 5% w and preferably less than about 3% w; a particle size of about
1.0-5.0 .mu.m mass median diameter (MMD), usually 1.0-4.0 .mu.m MMD, and
preferably 1.0-3.0 .mu.m MMD; a delivered dose of about >30%, usually >40%,
preferably >50%, and most preferred >60%; and an aerosol particle size
distribution of about 1.0-5.0 .mu.m mass median aerodynamic diameter (MMAD),
usually 1.5-4.5 .mu.m MMAD, and preferably 1.5-4.0 MMAD. Methods and
compositions for improving dispersibility are disclosed in U.S. application
Ser. No.: 08/423,568, filed Apr. 14, 1995, now abandoned, the disclosures of
which are hereby incorporated by reference.
The term "powder" means a composition that consists of finely dispersed
solid particles that are free flowing and capable of being readily dispersed
in an inhalation device and subsequently inhaled by a subject so that the
particles reach the lungs to permit penetration into the alveoli. Thus, the
powder is said to be "respirable." Preferably the average particle size is
less than about 10 microns (.mu.m) in diameter with a relatively uniform
spheroidal shape distribution. More preferably the diameter is less than
about 7.5 .mu.m and most preferably less than about 5.0 .mu.m. Usually the
particle size distribution is between about 0.1 .mu.m and about 5 .mu.m in
diameter, particularly about 0.3 .mu.m to about 5 .mu.m.
The term "dry" means that the composition has a moisture content such that
the particles are readily dispersible in an inhalation device to form an
aerosol. This moisture content is generally below about 10% by weight (% w)
water, usually below about 5% w and preferably less than about 3% w.
The term "therapeutically effective amount" is the amount present in the
composition that is needed to provide the desired level of drug in the
subject to be treated to give the anticipated physiological response. This
amount is determined for each drug on a case-by-case basis. Guidelines are
given hereafter.
The term "physiologically effective amount" is that amount delivered to a
subject to give the desired palliative or curative effect. This amount is
specific for each drug and its ultimate approved dosage level. Guidelines
are given hereafter.
The term "pharmaceutically acceptable carrier" means that the carrier can be
taken into the lungs with no significant adverse toxicological effects on
the lungs.
COMPOSITIONS OF THE INVENTION
One aspect of this invention is a dispersible pharmaceutical-based dry
powder composition for pulmonary delivery, the composition comprising a
therapeutically effective amount of a pharmaceutical in combination with a
pharmaceutically acceptable carrier.
In general, the compositions of this invention have a suitable for pulmonary
delivery because of their dispersibility characteristics. Such compositions
were not previously known in the art. In the dry state, the pharmaceutical
may be in crystalline or amorphous form. Some examples of pharmaceutical
compositions suitable for formulation into dispersible dry powders are
listed in Table 1. These include macromolecule and non-macromolecule-based
pharmaceuticals, usually macromolecules, with insulin, interleukin-1
receptor, parathyroid hormone (PTH-34), alpha-1 antitrypsin, calcitonin, low
molecular weight heparin, heparin, interferon, and nucleic acids being
preferred.
A therapeutically effective amount of active pharmaceutical will vary in the
composition depending on the biological activity of the drug employed and
the amount needed in a unit dosage form. Because the subject compounds are
dispersible, it is highly preferred that they be manufactured in a unit
dosage form in a manner that allows for ready manipulation by the formulator
and by the consumer. This generally means that a unit dosage will be between
about 0.5 mg and 15 mg of total material in the dry powder composition,
preferably between about 2 mg and 10 mg. Generally, the amount of drug in
the composition will vary from about 0.05% w to about 99.0% w. Most
preferably the composition will be about 0.2% to about 97.0% w drug.
The amount of the pharmaceutically acceptable carrier is that amount needed
to provide the necessary stability, dispersibility, consistency and bulking
characteristics to ensure a uniform pulmonary delivery of the composition to
a subject in need thereof. Numerically the amount may be from about 0.05% w
to about 99.95% w, depending on the activity of the drug being employed.
Preferably about 5% w to about 95% w will be used.
The carrier may be one or a combination of two or more pharmaceutical
excipients, but will generally be substantially free of any "penetration
enhancers." Penetration enhancers are surface active compounds which promote
penetration of a drug through a mucosal membrane or lining and are proposed
for use in intranasal, intrarectal, and intravaginal drug formulations.
Exemplary penetration enhancers include bile salts, e.g., taurocholate,
glycocholate, and deoxycholate; fusidates, e.g., taurodehydrofusidate; and
biocompatible detergents, e.g., Tweens, Laureth-9, and the like. The use of
penetration enhancers in formulations for the lungs, however, is generally
undesirable because the epithelial blood barrier in the lung can be
adversely affected by such surface active compounds. The dry powder
compositions of the present invention are readily absorbed in the lungs
without the need to employ penetration enhancers.
The types of pharmaceutical excipients that are useful as carriers in this
invention include stabilizers such as human serum albumin (HSA), bulking
agents such as carbohydrates, amino acids and polypeptides; pH adjusters or
buffers; salts such as sodium chloride; and the like. These carriers may be
in a crystalline or amorphous form or may be a mixture of the two.
It has been found that HSA is particularly valuable as a carrier in that it
provides improved dispersibility.
Bulking agents that are particularly valuable include compatible
carbohydrates, polypeptides, amino acids or combinations thereof. Suitable
carbohydrates include monosaccharides such as galactose, D-mannose, sorbose,
and the like; disaccharides, such as lactose, trehalose, and the like;
cyclodextrins, such as 2-hydroxypropyl-.beta.-cyclodextrin; and
polysaccharides, such as raffinose, maltodextrins, dextrans, and the like;
alditols, such as mannitol, xylitol, and the like. A preferred group of
carbohydrates includes lactose, threhalose, raffinose maltodextrins, and
mannitol. Suitable polypeptides include aspartame. Amino acids include
alanine and glycine, with glycine being preferred.
Additives, which are minor components of the composition of this invention,
may be included for conformational stability during spray drying and for
improving dispersibility of the powder. These additives include hydrophobic
amino acids such as tryptophan, tyrosine, lucine, phenylalanine, and the
like.
Suitable pH adjusters or buffers include organic salts prepared from organic
acids and bases, such as sodium citrate, sodium ascorbate, and the like;
sodium citrate is preferred.
The unit dosage form, method of treatment, and process of preparation of
this invention are described hereafter.
Unit Dosage Form.
Another aspect of this invention is a unit dosage form for pulmonary
delivery of dispersible dry powder pharmaceutical-based compositions, which
dosage form comprises a unit dosage receptacle containing a
pharmaceutical-based dry powder composition, which composition comprises a
therapeutically effective amount of a pharmaceutical in combination with a
pharmaceutically acceptable carrier.
In this aspect of the invention, the composition of this invention (as
discussed hereinbefore) is placed within a suitable dosage receptacle in an
amount sufficient to provide a subject with drug for a unit dosage
treatment. The dosage receptacle is one that fits within a suitable
inhalation device to allow for the aerosolization of the interferon-based
dry powder composition by dispersion into a gas stream to form an aerosol
and then capturing the aerosol so produced in a chamber having a mouthpiece
attached for subsequent inhalation by a subject in need of treatment. Such a
dosage receptacle includes any container enclosing the composition known in
the art such as gelatin or plastic capsules with a removable portion that
allows a stream of gas (e.g., air) to be directed into the container to
disperse the dry powder composition. Such containers are exemplified by
those shown in U.S. Pat. No. 4,227,522 issued Oct. 14, 1980; U.S. Pat. No.
4,192,309 issued Mar. 11, 1980; and U.S. Pat. No. 4,105,027 issued Aug. 8,
1978. Suitable containers also include those used in conjunction with
Glaxo's Ventolin Rotohaler brand powder inhaler or Fison's Spinhaler brand
powder inhaler. Another suitable unit-dose container which provides a
superior moisture barrier is formed from an aluminum foil plastic laminate.
The pharmaceutical-based powder is filled by weight or by volume into the
depression in the formable foil and hermetically sealed with a covering
foil-plastic laminate. Such a container for use with a powder inhalation
device is described in U.S. Pat. No. 4,778,054 and is used with Glaxo's
Diskhaler.RTM. (U.S. Pat. Nos. 4,627,432; 4,811,731; and 5,035,237). All of
these references are incorporated herein by reference.
Method of Treating a Disease State.
Another aspect of this invention is a method of treating a condition
responsive to treatment by a pharmaceutical of interest, which method
comprises pulmonarily administering to a subject in need thereof a
physiologically effective amount of a dispersible pharmaceutical-based dry
powder composition that comprises a therapeutically effective amount of drug
in combination with a pharmaceutically acceptable carrier.
Conditions that may be treated by the compositions of this are described in
Table 1.
The physiologically effective amount needed to treat a particular condition
or disease state will depend on the individual, the condition, length of
treatment, the regularity of treatment, the type of drug, and other factors,
but can be determined by one of ordinary skill in the medicinal arts.
It is presently believed that the effective absorption by a host of dry
powder composition according to the present invention results from a rapid
dissolution in the ultra-thin (<0.1 .mu.m) fluid layer of the alveolar
lining of the lung. The particles of the present invention thus have a mean
size which is from 10 to 50 times larger than the lung fluid layer, making
it unexpected that the particles are dissolved and the interferon
systemically absorbed in a rapid manner for either local lung or systemic
treatment An understanding of the precise mechanism, however, is not
necessary for practicing the present invention as described herein.
The aerosolized pharmaceutical-based dry powders of this invention are
particularly useful in place of parenteral delivery. Thus, the methods and
compositions of the present invention will be particularly valuable in
chronic treatment protocols where a patient can self-medicate. The patient
can achieve a desired dosage by inhaling an appropriate amount of drug, as
just described. The efficiency of systemic delivery via the method as just
described will typically be in the range from about 15% to 50%.
Method for Aerosolizing the Powder.
Still another aspect of this invention is a device and method for
aerosolizing a pharmaceutical-based dry powder composition that comprises a
therapeutically effective amount of drug in combination with a
pharmaceutically acceptable carrier, which method comprises dispersing an
amount of the dry powder composition in a gas stream to form an aerosol and
capturing the aerosol in a chamber having a mouthpiece for subsequent
inhalation by a patient.
A further detailed description of this method is found in pending U.S.
patent application Ser. Nos.: 07/910,048 and 08/207,472, both of which are
incorporated herein by reference.
Preparing the Compositions.
Still another aspect of this invention is a method for preparing a
dispersible pharmaceutical-based dry powder composition of this invention
that comprises spray drying an aqueous mixture of the drug and a
pharmaceutically acceptable carrier under conditions to provide a respirable
dry powder composition.
Spray drying is a process in which a homogeneous aqueous mixture of drug and
the carrier is introduced via a nozzle (e.g., a two fluid nozzle), spinning
disc or an equivalent device into a hot gas stream to atomize the solution
to form fine droplets. The aqueous mixture may be a solution, suspension,
slurry, or the like, but needs to be homogeneous to ensure uniform
distribution of the components in the mixture and ultimately the powdered
composition. Preferably the aqueous mixture is a solution. The solvent,
generally water, rapidly evaporates from the droplets producing a fine dry
powder having particles 1 to 5 .mu.m in diameter. Surprisingly, the drug is
not degraded when it is exposed to the hot drying gas, and the interferon
powders can be prepared having sufficient purity for pharmaceutical use. An
acceptable purity is defined as less than 5% degradation products and
contaminates, preferably less than 3% and most preferably less than 1%.
The spray drying is done under conditions that result in substantially
amorphous powder of homogeneous constitution having a particle size that is
respirable, a low moisture content and flow characteristics that allow for
ready aerosolization. Preferably the particle size of the resulting powder
is such that more than about 98% of the mass is in particles having a
diameter of about 10 .mu.m or less with about 90% of the mass being in
particles having a diameter less than 5 .mu.m. Alternatively, about 95% of
the mass will have particles with a diameter of less than 10 .mu.m with
about 80% of the mass of the particles having a diameter of less than 5 .mu.m.
The solutions may then be sprayed dried in conventional spray drying
equipment from commercial suppliers, such as Buchi, Niro, Yamato Chemical
Co., Okawara Kakoki Co., and the like, resulting in a substantially
amorphous particulate product.
For the spraying process, such spraying methods as rotary atomization,
pressure atomization and two-fluid atomization can be used. Examples of the
devices used in these processes include "Parubisu [phonetic rendering]
Mini-Spray GA-32" and "Parubisu Spray Drier DL41", manufactured by Yamato
Chemical Co., or "Spray Drier CL-8," "Spray Drier L-8," "Spray Drier FL-12,"
"Spray Drier FL-16" or "Spray Drier FL-20," manufactured by Okawara Kakoki
Co., can be used for the method of spraying using rotary-disk atomizer.
While no special restrictions are placed on the nozzle of the atomizer used
in the process of spraying, it is recommended to use a nozzle which can
produce a spray-dry composition with a grain diameter suitable for nasal,
pharyngeal or pulmonary administration. For example, nozzle types "1A," "1,"
"2A," "2," "3" and the like, manufactured by Yamato Chemical Co., can be
used for the above-mentioned spray-drier, manufactured by the same company.
In addition, disks type "MC-50," "MC-65" or "MC-85," manufactured by Okawara
Kakoki Co., can be used as rotary disks of the spray-drier atomizer,
manufactured by the same company.
While no particular restrictions are placed on the gas used to dry the
sprayed material, it is recommended to use air, nitrogen gas or an inert
gas. The temperature of the inlet of the gas used to dry the sprayed
materials such that it does not cause heat deactivation of the sprayed
material. The range of temperatures may vary between about 50oC. to
about 200oC., preferably between about 50oC. and 100o
C. The temperature of the outlet gas used to dry the sprayed material, may
vary between about 0oC. and about 150o, preferably between
0oC. and 90oC., and even more preferably between 0o
C. and 60oC. The fact that inlet and outlet temperatures above about
55oC. can be used is surprising in view of the fact that most
macromolecule-based drugs deactivate at that temperature, with nearly
complete deactivation occurring at about 70oC.
The dispersible pharmaceutical-based dry powders of the present invention
may optionally be combined with pharmaceutical carriers or excipients which
are suitable for respiratory and pulmonary administration. Such carriers may
serve simply as bulking agents when it is desired to reduce the interferon
concentration in the powder which is being delivered to a patient, but may
also serve to enhance the stability of the interferon compositions and to
improve the dispersibility of the powder within a powder dispersion device
in order to provide more efficient and reproducible delivery of the
interferon and to improve handling characteristics of the interferon such as
flowability and consistency to facilitate manufacturing and powder filling.
Such carrier materials may be combined with the drug prior to spray drying,
i.e., by adding the carrier material to the purified bulk solution. In that
way, the carrier particles will be formed simultaneously with the drug
particles to produce a homogeneous powder. Alternatively, the carriers may
be separately prepared in a dry powder form and combined with the dry powder
drug by blending. The powder carriers will usually be crystalline (to avoid
water absorption), but might in some cases be amorphous or mixtures of
crystalline and amorphous. The size of the carrier particles may be selected
to improve the flowability of the drug powder, typically being in the range
from 25 .mu.m to 100 .mu.m. A preferred carrier material is crystalline
lactose having a size in the above-stated range.
Alternatively, dry powder compositions may be prepared by other processes
such as lyophilization and jet milling as disclosed in WO 91/16038, the
disclosures of which are hereby incorporated by reference.
TABLE 1
DRUG INDICATIONS
SELECTED MACROMOLECULE DRUGS
FOR SYSTEMIC APPLICATIONS
Calcitonin Osteoporosis Prophylaxis
Paget's Disease
Hypercalcemia
Erythropoietin (EPO) Anemia
Factor IX Hemophilia B
Granulocyte Colony Stimulating Neutropenia
Factor (G-CSF)
Granulocyte Macrophage Colony Bone Marrow Engraftment/
Transplant Failure
Stimulating Factor (GM-CSF)
Growth Hormone Short Stature
Renal Failure
Heparin Blood Clotting
Heparin (Low Molecular Weight) Blood Clotting
Insulin Type I and Type II Diabetes
Interferon Alpha Hepatitis B and C
Hairy Cell Leukemia
Kaposi's Sarcoma
Interferon Beta Multiple Sclerosis
Interferon Gamma Chronic Granulomatous
Disease
Interleukin-2 Renal Cancer
Luteinizing Hormone Releasing Prostate Cancer
Hormone (LHRH) Endometriosis
Somatostatin Analog Gastrointestinal Cancers
Vasopressin Analog Diabetes Insipidus
Bed Wetting
FSH Fertility
Amylin Type I Diabetes
Ciliary Neurotrophic Factor Lou Gehrig's Disease
Growth Hormone Releasing Factor (GRF) Short Stature
Insulin-Like Growth Factor Osteoporosis
Nutritional Support
Insulinotropin Type II Diabetes
Interferon Beta Hepatitis B and C
Interferon Gamma Rheumatoid Arthritis
Interleukin-1 Receptor Antagonist Rheumatoid Arthritis
Interleukin-3 Adjuvant to Chemotherapy
Interleukin-4 Immunodeficiency Disease
Interleukin-6 Thrombocytopenia
Macrophage Colony Stimulating Fungal Disease
Factor (M-CSF)
Cancer
Hypercholesterolemia
Nerve Growth Factor Peripheral Neuropathies
Parathyroid Hormone Osteoporosis
Somatostatin Analog Refractory Diarrheas
Thymosin Alpha 1 Hepatitis B and C
IIb/IIIa Inhibitor Unstable Angina
Alpha-1 Antitrypsin Cystic Fibrosis
Anti-RSV Antibody Respiratory Syncytial Virus
Cystic Fibrosis Transmembrane Cystic Fibrosis
Regulator (CFTR) Gene
Deoxyribonuclase (DNase) Chronic Bronchitis
Heparin Asthma
Bactericidal/Permeability Adult Respiratory Distress
Syndrome (ARDS)
Increasing Protein (BPI)
Anti-CMV Antibody Cytomegalovirus
Interleukin-1 Receptor Asthma
SELECTED NON-MACROMOLECULE DRUGS FOR SYSTEMIC
AND LOCAL LUNG APPLICATIONS
Pentamidine isethiouate Pneumocystis carini
peneumonia
Albuterol sulfate Broncospasm
Metaproterenol sulfate Bronchial asthma
Beclomethasone diprepionate
Trimcinoline acetomide
Budesonide acetonide
Ipratropium bromide
Flunisolide
Cromolyn sodium
Ergotamine Tartrate Migranes
Claim 1 of 2 Claims
What is claimed is:
1. Biocompatible particles for delivery of a therapeutic, prophylactic or
diagnostic agent to the pulmonary system comprising a therapeutic,
prophylactic or diagnostic agent wherein the particles have a tap density of
0.34 g/cm3 and the particles have an MMAD of 1 .mu.m with 90% of the
particles <5.0 .mu.m in diameter wherein said agent is alpha-1-antitrypsin.
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