|
|
Title:
Respiratory dispersion for metered dose inhalers
United States Patent: 7,790,145
Issued: September 7, 2010
Inventors: Weers; Jeffry G.
(San Diego, CA), Schutt; Ernest G. (San Diego, CA), Dellamary; Luis A.
(San Marcos, CA), Tarara; Thomas E. (San Diego, CA), Kabalnov; Alexey
(Corvallis, OR)
Assignee: Novartis AG
(Basel, CH)
Appl. No.: 12/012,827
Filed: February 5, 2008
|
|
|
Pharm Bus Intell
& Healthcare Studies
|
Abstract
A respiratory dispersion is provided for
the pulmonary delivery of at least two bioactive agents. The dispersion
comprises a propellant suspension medium having dispersed therein a
plurality of perforated microstructures, wherein the two bioactive agents
are incorporated into individual perforated microstructures.
Description of the
Invention
SUMMARY
Methods and associated compositions provide for the improved delivery of
bioactive agents using stabilized preparations. Preferably, the bioactive
agents are in a form for administration to a patient via the respiratory
tract. More particularly, the present invention provides for the formation
and use of stabilized dispersions (also referred to as stabilized
respiratory dispersions) and inhalation systems, including metered dose
inhalers comprising such dispersions and individual components thereof.
Unlike prior art formulations for targeted drug delivery, the present
invention employs novel techniques to reduce attractive forces between the
dispersed components and to reduce density differences, thereby retarding
degradation of the disclosed dispersions by flocculation, sedimentation or
creaming. As such, the disclosed stable preparations facilitate uniform
dose delivery by metered dose inhalers, and allow for more concentrated
dispersions.
The stabilized preparations of the present invention provide these and
other advantages through the use of hollow and/or porous perforated
microstructures that substantially reduce attractive molecular forces,
such as van der Waals forces, which dominate prior art dispersion
preparations. In particular, the use of perforated (or porous)
microstructures or microparticulates that are permeated or filled by the
surrounding fluid medium, or suspension medium, significantly reduces
disruptive attractive forces between the particles. Moreover, the
components of the dispersions may be selected to minimize differences in
polarizabilities (i.e. reduced Hamaker constant differentials) and further
stabilize the preparation. Unlike formulations comprising relatively
dense, solid particles or nonporous particles (typically micronized), the
dispersions of the present invention are substantially homogeneous with
only minor differences in density between particles defined by the
perforated microparticulates and the suspension medium.
In addition to the heretofore unappreciated advantages associated with the
formation of stabilized preparations, the perforated configuration and
corresponding large surface area enables the microstructures to be more
easily carried by the flow of gases during inhalation than non-perforated
particles of comparable size. This, in turn, enables the perforated
microparticles of the present invention to be carried more efficiently
into the lungs of a patient than non-perforated structures such as,
micronized particles or relatively nonporous microspheres.
In view of these advantages, the dispersions of the present invention are
particularly compatible with inhalation therapies comprising
administration of the bioactive preparation to at least a portion of the
pulmonary air passages. For the purposes of the present application, these
stabilized dispersions intended for pulmonary delivery may be termed
respiratory dispersions. In particularly preferred embodiments, such
respiratory dispersions comprise an environmentally compatible propellant
and are used in conjunction with metered dose inhalers to effectively
deliver a bioactive agent to the pulmonary air passages or nasal passages
of a patient in need thereof.
Accordingly, in preferred embodiments, the invention provides stable
respiratory dispersions for the pulmonary or nasal delivery of one or more
bioactive agents comprising a suspension medium having dispersed therein a
plurality of perforated microstructures comprising at least one bioactive
agent, wherein said suspension medium comprises at least one propellant
and substantially permeates said perforated microstructures.
For all embodiments of the invention, the perforated microstructures may
be formed of any biocompatible material that provides the physical
characteristics necessary for the formation of the stabilized dispersions.
In this regard, the microstructures comprise pores, voids, defects or
other interstitial spaces that allow the fluid suspension medium to freely
permeate or perfuse the particulate boundary, thus reducing, or minimizing
density differences between the dispersion components. Yet, given these
constraints, it will be appreciated that, any material or configuration
may be used to form the microstructure matrix. With regard to the selected
materials, it is desirable that the microstructure incorporates at least
one surfactant. Preferably, this surfactant will comprise a phospholipid
or other surfactant approved for pulmonary use. As to the configuration,
particularly preferred embodiments of the invention incorporate spray
dried hollow microspheres having a relatively thin porous wall defining a
large internal void although other void containing or perforated
structures are contemplated as well.
Along with the perforated microstructures discussed above, the stabilized
dispersions of the present invention further comprise a continuous phase
suspension medium. It is an advantage of the present invention that any
biocompatible suspension medium having adequate vapor pressure to act as a
propellant may be used. Particularly preferred suspension media are
compatible with use in a metered dose inhaler. In general, suitable
propellants for use in the suspension mediums of the present invention are
those propellant gases that can be liquefied under pressure at room
temperature and, upon inhalation or topical use are safe, toxicologically
innocuous and free of side effects. Further. it is desirable that the
selected suspension medium should be relatively non-reactive with respect
to the suspended perforated microstructures. In this regard. compatible
propellants may generally comprise hydrofluoroalkane propellants.
Particularly preferred propellants comprise 1,1,1,2-tetrafluoroethane
(CF.sub.3CH.sub.2F) (HFA-134a) and 1,1,1,2,3,3,3-heptafluoro-n-propane
(CF.sub.3CHFCF.sub.3) (HFA-227), perfluoroethane,
monochloro-difluoromethane, 1,1-difluoroethane, and combinations thereof.
It will be appreciated that, the present invention further provides
methods for forming stabilized dispersions comprising the steps of:
combining a plurality of perforated microstructures comprising at least
one bioactive agent with a predetermined volume of suspension medium
comprising at least one propellant to provide a respiratory blend wherein
said suspension medium permeates said perforated microstructures; and
mixing said respiratory blend to provide a substantially homogeneous
respiratory dispersion.
As briefly mentioned above (and discussed in more detail below) the
stability of the formed dispersions may be further increased by reducing,
or minimizing the Hamaker constant differential between the perforated
microstructures and the suspension medium. Those skilled in the art will
appreciate that, Hamaker constants tend to scale with refractive indices.
In this regard, the present invention provides preferred embodiments
directed to further stabilizing dispersions by reducing attractive van der
Waals forces comprising the steps of:
providing a plurality of perforated microstructures; and
combining the perforated microstructures with a suspension medium
comprising at least one propellant wherein the suspension medium and the
perforated microstructures are selected to provide a refractive index
differential value of less than about 0.5.
Along with the formation and stabilization of dispersions, the present
invention is further directed to the pulmonary delivery of at least one
bioactive agent using a metered dose inhaler. As used herein, the terms
"bioactive agent" refers to a substance which is used in connection with
an application that is therapeutic or diagnostic in nature such as,
methods for diagnosing the presence or absence of a disease in a patient
and/or methods for treating disease in a patient. The bioactive agent may
be incorporated, blended in, coated on or otherwise associated with the
perforated microstructure.
Accordingly, the present invention provides for the use of a propellant in
the manufacture of a stabilized dispersion for the pulmonary delivery of a
bioactive agent whereby the stabilized dispersion is aerosolized using a
metered dose inhaler to provide an aerosolized medicament that is
administered to at least a portion of the pulmonary air passages of a
patient in need thereof, said stabilized dispersion comprising a
suspension medium having dispersed therein a plurality of perforated
microstructures comprising at least one bioactive agent wherein the
suspension medium comprises at least one propellant and substantially
permeates said. perforated microstructures.
Yet another aspect of the invention provides methods for the pulmonary
delivery of one or more bioactive agents comprising the steps of:
providing a pressurized reservoir containing a stabilized respiratory
dispersion comprising a suspension medium having dispersed therein a
plurality of perforated microstructures comprising one or more bioactive
agents, wherein said suspension medium comprises a propellant and
substantially permeates said perforated microstructures;
aerosolizing said respiratory dispersion by releasing pressure on the
pressurized reservoir to provide an aerosolized medicament comprising said
perforated microstructures; and
administering a therapeutically effective amount of said aerosolized
medicament to at least a portion of the pulmonary passages of a patient in
need thereof.
It will be appreciated that, due to the aerodynamic characteristics
preferably afforded by the disclosed perforated microstructures, the
present invention is particularly efficient at delivering the selected
bioactive agent into the bronchial airways. As such, in another aspect,
the invention provides methods for increasing the effective pulmonary
deposition of a bioactive agent using a metered dose inhaler comprising
the steps of:
associating said bioactive agent with a plurality of perforated
microstructures having a mean aerodynamic diameter of less than about 5 .mu.m;
dispersing said perforated microstructures in a suspension medium
comprising a propellant to provide a respiratory dispersion; and
charging a metered dose inhaler with said respiratory dispersion wherein
said charged metered dose inhaler provides a fine particle fraction of
greater than approximately 20% w/w upon activation.
With regard to administration, another aspect of the invention is directed
to systems for the administration of one or more bioactive agents to a
patient. In preferred embodiments, the systems comprise a metered dose
inhaler. Accordingly, the present invention further provides systems for
the pulmonary administration of a bioactive agent comprising:
a fluid reservoir;
a metering valve operably associated with said fluid reservoir, and a
stabilized dispersion in said fluid reservoir wherein said stabilized
dispersion comprises a suspension medium having dispersed therein a
plurality of perforated microstructures comprising at least. one bioactive
agent wherein said suspension medium comprises at least one propellant and
substantially permeates said perforated microstructures.
As to compatible bioactive agents, those skilled in the art will
appreciate that, any therapeutic or diagnostic. agent may be incorporated
in the stabilized dispersions. of the present invention. For example, the
bioactive agent may be selected from the group consisting of antiallergics,
bronchodilators, bronchoconstrictors, pulmonary lung surfactants,
analgesics, antibiotics, leukotriene inhibitors or antagonists,
anticholinergics, mast cell inhibitors, antihistamines, antiinflammatories,
antineoplastics, anesthetics, anti-tuberculars, imaging agents,
cardiovascular agents, enzymes, steroids, genetic material, viral vectors,
antisense agents, proteins, peptides and combinations thereof. As
indicated above, the selected bioactive agent, or agents, may be used as
the sole structural component of the perforated microstructures.
Conversely, the perforated microstructures may comprise one or more
components (i.e. structural materials, surfactants, excipients, etc.) in
addition to the incorporated bioactive agents. in particularly preferred
embodiments, the perforated microstructures will comprise relatively high
concentrations of surfactant (greater than about 10% w/w) along with the
incorporated bioactive agent(s).
As such, another aspect of the invention provides for respiratory
dispersions for the pulmonary delivery of one or more bioactive-agents
comprising a suspension medium having dispersed therein a plurality of
microparticles comprising greater than about 20% w/w surfactant and at
least one bioactive agent wherein said suspension medium comprises at
least one propellant. Those skilled in the art will appreciate that, due
to their other physiochemical characteristics, the morphology of the
incorporated high surfactant particulates may vary without substantially
destabilizing the dispersion. As such, stabilized dispersions may be
formed with such particulates even if they exhibit relatively low porosity
or are substantially solid. That is, while preferred embodiments of the
present invention will comprise perforated microstructures or microspheres
associated with high levels of surfactant, acceptable dispersions may be
formed using relatively low porosity particulates of the same surfactant
concentration. In this respect, such embodiments are specifically
contemplated as being within the scope of the present invention.
In addition to the components mentioned above, the stabilized dispersions
may optionally comprise one or more additives to further enhance stability
or increase biocompatibility. For example, various surfactants,
co-solvents, osmotic agents, stabilizers, chelators, buffers, viscosity
modulators, solubility modifiers and salts can be associated with the
perforated microstructure, suspension medium or both. The use of such
additives will be understood to those of ordinary skill in the art and the
specific quantities, ratios, and types of agents can be determined
empirically without undue experimentation.
DESCRIPTION
While the present invention may be embodied in many different forms,
disclosed herein are specific illustrative embodiments thereof that
exemplify the principles of the invention. It should be emphasized that
the present invention is not limited to the specific embodiments
illustrated.
As set forth above, the present invention provides methods and
compositions that allow for the formation of stabilized suspensions that
may advantageously be used for the delivery of bioactive agents. The
enhanced stability of the suspensions is primarily achieved by lowering
the van der Waals attractive forces between the suspended particles, and
by reducing the differences in density between the suspension medium and
the particles. In accordance with the teachings herein, the increases in
suspension stability may be imparted by engineering perforated
microstructures which are then dispersed in a compatible suspension
medium. In this regard, the perforated microstructures preferably comprise
pores, voids, hollows, defects or other interstitial spaces that allow the
fluid suspension medium to freely permeate or perfuse the particulate
boundary. Particularly preferred embodiments comprise perforated
microstructures that are both hollow and porous, almost honeycombed or
foam-like in appearance. In especially preferred embodiments the
perforated microstructures comprise hollow, porous spray dried
microspheres.
With respect to the instant specification, the terms "perforated
microstructures" and "perforated microparticles" are used to describe
porous products, preferably comprising a bioactive agent, distributed
throughout the suspension medium in accordance with the teachings herein.
Accordingly, the subject terms may be used interchangeably throughout the
instant specification unless the contextual setting indicates otherwise.
When the perforated microstructures are placed in the suspension medium
(i.e. propellant), the suspension medium is able to permeate the
particles, thereby creating a "homodispersion", wherein both the
continuous and dispersed phases are substantially indistinguishable. Since
the defined or "virtual" particles (i.e. those comprising the volume
circumscribed by the microparticulate matrix) are made up almost entirely
of the medium in which they are suspended. the forces driving particle
aggregation (flocculation) are minimized. Additionally, the differences in
density between the defined particles and the continuous phase are
minimized by having the microstructures filled with the medium, thereby
effectively slowing particle creaming or sedimentation. As such, the
stabilized suspensions of the present invention are particularly
compatible with inhalation therapies and may be used in conjunction with
metered dose inhalers (MDIs), to improve dose reproducibility, reduce
clogging of the MDI valve, increase fine particle fraction, and reduce
throat deposition and the resulting side-effects.
Typical prior art suspensions for inhalation therapy comprise solid
micronized particles and small amounts (<1% w/w) of surfactant (e.g.
lecithin, Span-85, oleic acid) to increase electrostatic repulsion between
particles. In sharp contrast, the suspensions of the present invention are
designed not to increase repulsion between particles, but rather to
decrease the attractive forces between particles. The principal forces
driving flocculation in nonaqueous media are van der Waals attractive
forces. Van der Waals forces are quantum mechanical in origin, and can be
visualized as attractions between fluctuating dipoles (i.e. induced
dipole-induced dipole interactions). Dispersion forces are extremely
short-range and scale as the sixth power of the distance between atoms.
When two macroscopic bodies approach one another the dispersion
attractions between the atoms sums up. The resulting force is of
considerably longer range, and depends on the geometry of the interacting
bodies.
More specifically, for two spherical particles, the magnitude of the van
der Waals potential, V.sub.A, can be approximated by
-- see Original Patent.
One way to minimize the differences in the Hamaker constants is to create
a "homodispersion", that is make both the continuous and dispersed phases
essentially indistinguishable as discussed above. In addition to
exploiting the morphology of the particles to reduce the effective Hamaker
constant, the components of the structural matrix (defining the perforated
microstructures) will preferably be chosen so as to exhibit a Hamaker
constant relatively close to that of the selected suspension medium. In
this respect, one may use the actual values of the Hamaker constants of
the suspension medium and the particulate components to determine the
compatibility of the dispersion ingredients and provide a good indication
as to the stability of the preparation. Alternatively, one could select
relatively compatible perforated microstructure components and suspension
mediums using readily discernible characteristic physical values that
coincide with measurable Hamaker constants.
In this respect, it has been found that the refractive index values of
many compounds tend to scale with the corresponding Hamaker constant.
Accordingly, easily measurable refractive index values may be used to
provide a fairly good indication as to which combination of suspension
medium and particle excipients will provide a dispersion having a
relatively low effective Hamaker constant and associated stability. It
will be appreciated that, since refractive indices of compounds are widely
available or easily derived, the use of such values allows for the
formation of stabilized dispersions in accordance with the present
invention without undue experimentation. For the purpose of illustration
only, the refractive indices of several compounds compatible with the
disclosed dispersions are provided in Table I immediately below
-- see Original Patent.
Consistent with the compatible dispersion components set forth above,
those skilled in the art will appreciate that, the formation of
dispersions wherein the components have a refractive index differential of
less than about 0.5 is preferred. That is, the refractive index of the
suspension medium will preferably be within about 0.5 of the refractive
index associated-with the perforated particles or microstructures. It will
further be appreciated that, the refractive index of the suspension medium
and the particles may be measured directly or approximated using the
refractive indices of the major component in each respective phase. For
the perforated microstructures, the major component may be determined on a
weight percent basis. For the suspension medium, the major component will
typically be derived on a volume percentage basis. In selected embodiments
of the present invention the refractive index differential value will
preferably be less than about 0.45, about 0.4, about 0.35 or even less
than about 0.3. Given that lower refractive index differentials imply
greater dispersion stability, particularly preferred embodiments comprise
index differentials of less than about 0.28, about 0.25, about 0.2, about
0.15 or even less than about 0.1. It is submitted that a skilled artisan
will be able to determine which excipients are particularly compatible
without undue experimentation given the instant disclosure. The ultimate
choice of preferred excipients will also be influenced by other factors,
including biocompatibility, regulatory status, ease of manufacture, cost.
In contrast to prior art attempts to provide stabilized suspensions which
require excipients (i.e. surfactants) that are soluble in the suspension
medium, the present invention provides for stabilized dispersions, at
least in part, by immobilizing the bioactive agent(s) and excipients
within the structural matrix of the hollow, porous microstructures.
Accordingly, preferred excipients useful in the present invention are
substantially insoluble in the suspension medium. Under such conditions,
even surfactants like, for example, lecithin cannot be considered to have
surfactant properties in the present invention since surfactant
performance requires the amphiphile to be reasonably soluble in the
suspension medium. The use of insoluble excipients also reduces the
potential for particle growth by Ostwald ripening.
As discussed above, the minimization of density differences between the
particles and the continuous phase is largely dependent on the perforated
and/or hollow nature of the microstructures, such that the suspension
medium constitutes most of the particle volume. As used herein, the term
"particle volume" corresponds to the volume of suspension medium that
would be displaced by the incorporated hollow/porous particles if they
were solid, i.e. the volume defined by the particle boundary. For the
purposes of explanation, and as discussed above, these fluid filled
particulate volumes may be referred to as "virtual particles." Preferably,
the average volume of the bioactive agent/excipient shell or matrix (i.e.
the volume of medium actually displaced by the perforated microstructure)
comprises less than 70% of the average particle volume (or less than 70%
of the virtual particle). More preferably, the volume of the
microparticulate matrix comprises less than about 50%, 40%, 30% or even
20% of the average particle volume. Even more preferably, the average
volume of the shell/matrix comprises less than about 10%, 5% or 3% of the
average particle volume. Those skilled in the art will appreciate that,
such a matrix or shell volumes typically contributes little to the virtual
particle density which is overwhelmingly dictated by the suspension medium
found therein. Of course, in selected embodiments the excipients used to
form the perforated microstructure may be chosen so the density of the
resulting matrix or shell approximates the density of the surrounding
suspension medium.
It will further be appreciated that, the use of such microstructures will
allow the apparent density of the virtual particles to approach that of
the suspension medium substantially eliminating the attractive van der
Waals forces. Moreover, as previously discussed, the components of the
microparticulate matrix are preferably selected, as much as possible given
other considerations, to approximate the density of suspension medium.
Accordingly, in preferred embodiments of the present invention, the
virtual particles and the suspension medium will have a density
differential of less than about 0.6 g/cm.sup.3. That is, the mean density
of the virtual particles (as defined by the matrix boundary) will be
within approximately 0.6 g/cm.sup.3 of the suspension medium. More
preferably, the mean density of the virtual particles will be within 0.5,
0.4, 0.3 or 0.2 g/cm.sup.3 of the selected suspension medium. In even more
preferable embodiments the density differential will be less than about
0.1, 0.05, 0.01, or even less than 0.005 g/cm.sup.3.
In addition to the aforementioned advantages, the use of hollow, porous
particles allows for the formation of free-flowing dispersions comprising
much higher volume fractions of particles in suspension. It should be
appreciated that, the formulation of prior art dispersions at volume
fractions approaching close-packing generally results in dramatic
increases in dispersion viscoelastic behavior. Rheological behavior of
this type is not appropriate for MDI applications. Those skilled in the
art will appreciate that, the volume fraction of the particles may be
defined as the ratio of the apparent volume of the particles (i.e. the
particle volume) to the total volume of the system. Each system has a
maximum volume fraction or packing fraction. For example, particles in a
simple cubic arrangement reach a maximum packing fraction of 0.52 while
those in a face centered cubic/hexagonal close packed configuration reach
a maximum packing fraction of approximately 0.74. For non-spherical
particles or polydisperse systems, the derived values are different.
Accordingly, the maximum packing fraction is often considered to be an
empirical parameter for a given system.
Here, it was surprisingly found that the porous structures of the present
invention do not exhibit undesirable viscoelastic behavior even at high
volume fractions, approaching close packing. To the contrary, they remain
as free flowing, low viscosity suspensions having little or no yield
stress when compared with analogous suspensions comprising solid
particulates. The low viscosity of the disclosed suspensions is thought to
be due, at least in large part, to the relatively low van der Waals
attraction between the fluid-filled hollow, porous particles. As such, in
selected embodiments the volume fraction of the disclosed dispersions is
greater than approximately 0.3. Other embodiments may have packing values
on the order of 0.3 to about 0.5 or on the order of 0.5 to about 0.8, with
the higher values approaching a close packing condition. Moreover, as
particle sedimentation tends to naturally decrease when the volume
fraction approaches close packing, the formation of relatively
concentrated dispersions may further increase formulation stability.
Although the methods and compositions of the present invention may be used
to form relatively concentrated suspensions, the stabilizing factors work
equally well at much lower packing volumes and such dispersions are
contemplated as being within the scope of the instant disclosure. In this
regard, it will be appreciated that, dispersions comprising low volume
fractions are extremely difficult to stabilize using prior art techniques.
Conversely, dispersions incorporating perforated microstructures
comprising a bioactive agent as described herein are particularly stable
even at low volume fractions. Accordingly, the present invention allows
for stabilized dispersions, and particularly respiratory dispersions, to
be formed and used at volume fractions less than. 0.3. In some preferred
embodiments, the volume fraction is approximately 0.0001-0.3, more
preferably 0.001-0.01. Yet other preferred embodiments comprise stabilized
suspensions having volume fractions from approximately 0.01 to
approximately 0.1.
The perforated microstructures of the present invention may also be used
to stabilize dilute suspensions of micronized bioactive agents. In such
embodiments the perforated microstructures may be added to increase the
volume fraction of particles in the suspension, thereby increasing
suspension stability to creaming or sedimentation. Further, in these
embodiments the incorporated microstructures may also act in preventing
close approach (aggregation) of the micronized drug particles. It should
be appreciated that, the perforated microstructures incorporated in such
embodiments do not necessarily comprise a bioactive agent. Rather, they
may be formed exclusively of various excipients, including surfactants.
As indicated throughout the instant specification, the dispersions of the
present invention are preferably stabilized. In a broad sense, the term
"stabilized dispersion" will be held to mean any dispersion that resists
aggregation, flocculation or creaming to the extent required to provide
for the effective delivery of a bioactive agent. While those skilled in
the art will appreciate that there are several methods that may be used to
assess the stability of a given dispersion, a preferred method for the
purposes of the present invention comprises determination of creaming or
sedimentation time. In this regard, the creaming time shall be defined as
the time for the suspended drug particulates to cream to 1/2 the volume of
the suspension medium. Similarly, the sedimentation time may be defined as
the time it takes for the particulates to sediment in 1/2 the volume of
the liquid medium. One relatively simple way to determine the creaming
time of a preparation is to provide the particulate suspension in a sealed
glass vial. The vials are agitated or shaken to provide relatively
homogeneous dispersions which are then set aside and observed using
appropriate instrumentation or by visual inspection. The time necessary
for the suspended particulates to cream to 1/2 the volume of the
suspension medium (i.e., to rise to the top half of the suspension
medium), or to sediment within 1/2 the volume (i.e., to settle in the
bottom 1/2 of the medium), is then noted. Suspension formulations having a
creaming time greater than 1 minute are preferred and indicate suitable
stability. More preferably, the stabilized dispersions comprise creaming
times of greater than 1, 2, 5, 10, 15, 20 or 30 minutes. In particularly
preferred embodiments, the stabilized dispersions exhibit creaming times
of greater than about 1, 1.5, 2, 2.5, or 3 hours. Substantially equivalent
periods for sedimentation times are indicative of compatible dispersions.
Regardless of the ultimate composition or precise creaming time, the
stabilized respiratory dispersions of the present invention preferably
comprise a plurality of perforated microstructures, or microparticulates
that are dispersed or suspended in the suspension medium. In such cases,
the perforated microstructures comprise a structural matrix that exhibits,
defines or comprises voids, pores, defects, hollows, spaces, interstitial
spaces, apertures, perforations or holes that allows the surrounding
suspension medium to freely permeate, fill or pervade the microstructure.
The absolute shape (as opposed to the morphology) of the perforated
microstructure is generally not critical and any overall configuration
that provides the desired stabilization characteristics is contemplated as
being within the scope of the invention. Accordingly, preferred
embodiments can comprise approximately microspherical shapes. However,
collapsed, deformed or fractured particulates are also compatible. With
this caveat, it will be appreciated that, particularly preferred
embodiments of the invention comprise spray dried hollow, porous
microspheres.
In order to maximize dispersion stability and optimize distribution upon
administration, the mean geometric particle size of the perforated
microstructures is preferably about 0.5-50 .mu.m, more preferably 1-30 .mu.m.
It will be appreciated that, large particles (i.e. greater than 50 .mu.m)
should not be used as large particles may tend to aggregate, separate from
the suspension and clog the valve or orifice of the container. In
especially preferred embodiments, the mean geometric particle size (or
diameter) of the perforated microstructures is less than 20 .mu.m or less
than 10 .mu.m. More preferably, the mean geometric diameter is less than
about 5 .mu.m, and even more preferably, less than about 2.5 .mu.m. In
especially preferred embodiments, the perforated microstructures will
comprise a powder of dry, hollow, porous microspherical shells of
approximately 1 to 10 .mu.m in diameter, with shell thicknesses of
approximately 0.1 .mu.m to approximately 0.5 .mu.m. It is a particular
advantage of the present invention that the particulate concentration of
the dispersions and structural matrix components can be adjusted to
optimize the delivery characteristics of the selected particle size.
As discussed throughout the instant specification, the porosity of the
microstructures may play a significant part in establishing dispersion
stability. In this respect, the mean porosity of the perforated
microstructures may be determined through electron microscopy coupled with
modern imaging techniques. More specifically, electron micrographs of
representative samples of the perforated microstructures may be obtained
and digitally analyzed to quantify the porosity of the preparation. Such
methodology is well known in the art and may be undertaken without undue
experimentation.
For the purposes of the present invention, the mean porosity (i.e. the
percentage of the particle surface area that is open to the interior
and/or a central void) of the perforated microstructures may range from
approximately 0.5% to approximately 80%. In more preferred embodiments,
the mean porosity will range from approximately 2% to approximately 40%.
Based on selected production parameters, the mean porosity may be greater
than approximately, 2%, 5%, 10%, 15%, 20%, 25% or 30% of the
microstructure surface area. In other embodiments, the mean porosity of
the microstructures may be greater than about 40%, 50%, 60%, 70% or even
80%. As to the pores themselves, they typically range in size from about 5
nm to about 400 nm, with mean pore sizes preferably in the range of from
about 20 nm, to about 200 nm. In particularly preferred embodiments, the
mean pore size will be in the range of from about 50 nm to about 100 nm.
As may be seen in FIGS. 1A1 to 1F2 (see Original Patent), and discussed in
more detail below, it is a significant advantage of the present invention
that the pore size and porosity may be closely controlled by careful
selection of the incorporated components and production parameters.
Along with the geometric configuration, the perforated or porous and/or
hollow design of the microstructures also plays an important role in the
resulting aerosol properties upon activation of the MDI. In this respect,
the perforated structure and relatively high surface area of the dispersed
microparticles enables them to be carried along in the flow of gases
during inhalation with greater ease for longer distances than
non-perforated particles of comparable size. Because of their high
porosity, the density of the particles is significantly less than 1.0
g/cm.sup.3, typically less than 0.5 g/cm.sup.3, more often on the order of
0.1 g/cm.sup.3 and as low as 0.01 g/cm.sup.3. Unlike the geometric
particle size, the aerodynamic particle size, d.sub.aer, of the perforated
microstructures depends substantially on the particle density, .rho.:
d.sub.aer=d.sub.geo .rho., where d.sub.geo is the geometric diameter. For
a particle density of 0.1 g/cm.sup.3, d.sub.aer will be roughly three
times smaller than d.sub.geo, leading to increased particle deposition
into the peripheral regions of the lung and correspondingly less
deposition in the throat. In this regard, the mean aerodynamic diameter of
the perforated microstructures is preferably less than about 5 .mu.m, more
preferably less than about 3 .mu.m, and, in particularly preferred
embodiments, less than about 2 .mu.m. Such particle distributions will act
to increase the deep lung deposition of the administered agent.
As will be shown subsequently in the Examples, the particle size
distribution of the aerosol formulations of the present invention are
measurable by conventional techniques such as, for example, cascade
impaction or by time of flight analytical methods. Determination of the
emitted dose in pressurized inhalations was done according to the proposed
U.S. Pharmacopeia method (Pharmacopeial Previews, 22 (1996) 3065) which is
incorporated herein by reference. These and related techniques enable the
"fine particle fraction" of the aerosol, which corresponds to those
particulates that are likely to effectively deposited in the lung, to be
calculated. As used herein the phrase "fine particle fraction" refers to
the percentage of the total amount of active medicament delivered per
actuation from the mouthpiece onto plates 2-7 of an 8 stage Andersen
cascade impactor. Based on such measurements, the formulations of the
present invention will preferably have a fine particle fraction of
approximately 20% or more by weight of the perforated microstructures
(w/w). More preferably, they will exhibit a fine particle fraction of from
about 25% to 80% w/w, and even more preferably from about 30 to 70% w/w.
In selected embodiments the present invention will preferably comprise a
fine particle fraction of greater than about 30%, 40%. 50%, 60%, 70% or
80% by weight.
Further, it has also been found that the formulations of the present
invention exhibit relatively low deposition rates, when compared with
prior art preparations, on the induction port and onto plates 0 and 1 of
the impactor. Deposition on these components is linked with deposition in
the throat in humans. More specifically, commercially available CFC
inhalers have simulated throat depositions of approximately 40-70% (w/w)
of the total dose, while the formulations of the present invention
typically deposit less than about 20% w/w. Accordingly, preferred
embodiments of the present invention have simulated throat depositions of
less than about 40%, 35%, 30%, 25%, 20%, 15% or even 10% w/w. Those
skilled in the art will appreciate that, significant decrease in throat
deposition provided by the present invention will result in a
corresponding decrease in associated local side-effects such as, throat
irritation and candidiasis.
With respect to the advantageous deposition profile provided by the
instant invention, it is well known that MDI propellants typically force
suspended particles out of the device at a high velocity towards the back
of the throat. Since prior art formulations typically contain a
significant percentage of large particles and/or aggregates, as much as
two-thirds or more of the emitted dose may impact the throat. Yet, as
discussed above, the stabilized dispersions of the present invention
result in surprisingly low throat deposition upon administration. While
not wishing to be bound by any particular theory, it appears that the
reduced throat deposition provided by the instant invention results from
decreases in particle aggregation and from the hollow and/or porous
morphology of the incorporated microstructures. That is, the hollow and
porous nature of the dispersed microstructures slows the velocity of
particles in the propellant stream, just as a hollow/porous whiffle ball
travels slower than a baseball. Thus, rather than impacting and sticking
to the back of the throat, the relatively slow traveling particles are
subject to inhalation by the patient. Accordingly, a substantially higher
percentage of the administered bioactive agent is deposited in the
pulmonary air passages where it may be efficiently absorbed.
Whatever configuration and/or size distribution is ultimately selected for
the perforated microstructure, the composition of the defining structural
matrix may comprise any one of a number of biocompatible materials. It
will be appreciated that, as used herein, the terms "structural matrix" or
"microstructure matrix" are equivalent and shall be held to mean any solid
material forming the perforated microstructures which define a plurality
of voids, apertures, hollows, defects, pores, holes, fissures, etc. that
promote the formation of stabilized dispersions as explained above. The
structural matrix may be soluble or insoluble in an aqueous environment.
In preferred embodiments, the perforated microstructure defined by the
structural matrix comprises a spray dried hollow porous microsphere
incorporating at least one surfactant. For other selected embodiments the
particulate material may be coated one or more times with polymers,
surfactants or other compounds which aid suspension.
More generally, the perforated microstructures may be formed of any
biocompatible material that is relatively stable and preferably insoluble
with respect to the selected suspension medium and can provide the
necessary perforated configuration. While a wide variety of materials may
be used to form the particles, in particularly preferred embodiments, the
structural matrix is associated with, or comprises, a surfactant such as,
a phospholipid or fluorinated surfactant. Although not required, the
incorporation of a compatible surfactant can improve the stability of the
respiratory dispersions, increase pulmonary deposition and facilitate the
preparation of the suspension. Moreover, by altering the components, the
density of the structural matrix may be adjusted to approximate the
density of the surrounding medium and further stabilize the dispersion.
Finally, as will be discussed in further detail below, the perforated
microstructures preferably comprise at least one bioactive agent.
As set forth above, the perforated microstructures of the present
invention may optionally be associated with, or comprise, one or more
surfactants. Moreover, miscible surfactants may optionally be combined
with the suspension medium liquid phase. It will be appreciated by those
skilled in the art that the use of surfactants, while not necessary to
practice the instant invention, may further increase dispersion stability,
simplify formulation procedures or increase bioavailability upon
administration. With respect to MDIs, surfactants further serve to
lubricate the metering valve, thereby ensuring consistent reproducibility
of valve actuation and accuracy of dose dispersed. Of course combinations
of surfactants, including the use of one or more in the liquid phase and
one or more associated with the perforated microstructures are
contemplated as being within the scope of the invention. By "associated
with or comprise" it is meant that the structural matrix or perforated
microstructure may incorporate, adsorb, absorb, be coated with or be
formed by the surfactant.
In a broad sense, surfactants suitable for use in the present invention
include any compound or composition that aids in the formation and
maintenance of the stabilized respiratory dispersions by forming a layer
at the interface between the structural matrix and the suspension medium.
The surfactant may comprise a single compound or any combination of
compounds, such as in the case of co-surfactants. Particularly preferred
surfactants are substantially insoluble in the propellant, nonfluorinated,
and selected from the group consisting of saturated and unsaturated
lipids, nonionic detergents, nonionic block copolymers, ionic surfactants,
and combinations of such agents. It should be emphasized that, in addition
to the aforementioned surfactants, suitable (i.e. biocompatible)
fluorinated surfactants are compatible with the teachings herein and may
be used to provide the desired stabilized preparations.
Lipids, including phospholipids, from both natural, and synthetic sources
are particularly compatible with the present invention and may be used in
varying concentrations to form the structural matrix. Generally,
compatible lipids comprise those that have a gel to liquid crystal phase
transition greater than about 40.degree. C. Preferably, the incorporated
lipids are relatively long chain (i.e. C.sub.16-C.sub.22) saturated lipids
and more preferably comprise phospholipids. Exemplary phospholipids useful
in the disclosed stabilized preparations comprise egg phosphatidylcholine,
dilauroylphosphatidylcholine, dioleoylphosphatidylcholine,
dipalmitoylphosphatidylcholine, disteroylphosphatidylcholine, short-chain
phosphatidylcholines, phosphatidylethanolamine,
dioleoylphosphatidylethanolamine, phosphatidylserine, phosphatidylglycerol,
phosphatidylinositol, glycolipids, ganglioside GM1, sphingomyelin,
phosphatidic acid, cardiolipin; lipids bearing polymer chains such as,
polyethylene glycol, chitin, hyaluronic acid, or polyvinylpyrrolidone;
lipids bearing sulfonated mono-, di-, and polysaccharides; fatty acids
such as palmitic acid, stearic acid, and oleic acid; cholesterol,
cholesterol esters, and cholesterol hemisuccinate. Due to their excellent
biocompatibility characteristics, phospholipids and combinations of
phospholipids and poloxamers are particularly suitable for use in the
stabilized dispersions disclosed herein.
Compatible nonionic detergents comprise: sorbitan esters including
sorbitan trioleate (SPAN.RTM. 85
[2-(4-hydroxy-3-octadec-9-enoyloxy-oxolan-2-yl)-2-octadec-9
enoyloxy-ethyl)octadec-9-enoate-C.sub.60H.sub.108O.sub.8]), sorbitan
sesquioleate, sorbitan monooleate, sorbitan monolaurate, polyoxyethylene
(20) sorbitan monolaurate, and polyoxyethylene (20) sorbitan monooleate,
oleyl polyoxyethylene (2) ether, stearyl polyoxyethylene (2) ether, lauryl
polyoxyethylene (4) ether, glycerol esters, and sucrose esters. Other
suitable nonionic detergents can be easily identified using McCutcheon's
Emulsifiers and Detergents (McPublishing Co., Glen Rock, N.J.) which is
incorporated herein in its entirety. Preferred block copolymers include
diblock and triblock copolymers of polyoxyethylene and polyoxypropylene,
including poloxamer 188 (PLURONIC.RTM.
[methyloxirane-C.sub.5H.sub.10O.sub.2] F-68 (a mixture of polyoxyethylene
and polyoxypropylene)), poloxamer 407 (PLURONIC.RTM. F-127), and poloxamer
338. Ionic surfactants such as sodium sulfosuccinate, and fatty acid soaps
may also be utilized. In preferred embodiments, the microstructures may
comprise oleic acid or its alkali salt.
In addition to the aforementioned surfactants, cationic surfactants or
lipids are preferred especially in the case of delivery or RNA or DNA.
Examples of suitable cationic lipids include: DOTMA,
N-[1-(2,3-dioleyloxy)propyl]-N,N,N-trimethylammonium-chloride; DOTAP,
1,2-dioleyloxy-3-(trimethylammonio)propane; and DOTB,
1,2-dioleyl-3-(4'-trimethylammonio)butanoyl-sn-glycerol. Polycationic
amino acids such as polylysine, and polyarginine are also contemplated.
Those skilled in the art will further appreciate that, a wide range of
surfactants may optionally be used in conjunction with the present
invention. Moreover, the optimum surfactant or combination thereof for a
given application can readily be determined by empirical studies that do
not require undue experimentation. It will further be appreciated that,
the preferred insolubility of any incorporated surfactant in the
suspension medium will dramatically decrease the associated surface
activity. As such, it is arguable as to whether these. materials have
surfactant-like character prior to contracting an aqueous bioactive
surface (e.g. the aqueous hypophase in the lung). Finally, as discussed in
more detail below, surfactants comprising the porous particles may also be
useful in the formation of precursor oil-in-water emulsions (i.e. spray
drying feed stock) used during processing to form the structural matrix.
Unlike prior art formulations, it has surprisingly been found that the
incorporation of relatively high levels of surfactants (i.e.
phospholipids) may be used to increase the stability of the disclosed
dispersions. That is, on a weight to weight basis, the structural matrix
of the perforated microstructures may comprise relatively high levels of
surfactant. In this regard, the perforated microstructures will preferably
comprise greater than about 1%, 5%, 10%, 15%, 18%, or even 20% w/w
surfactant. More preferably, the perforated microstructures will comprise
greater than about 25%, 30%, 35%, 40%, 45%, or 50% w/w surfactant. Still
other exemplary embodiments will comprise perforated microstructures
wherein the surfactant or surfactants are present at greater than about
55%, 60%, 65%, 70%, 75%, 80%, 85%, 90% or even 95% w/w. In selected
embodiments the perforated microstructures will comprise essentially 100%
w/w of a surfactant such as a phospholipid. Those skilled in the art will
appreciate that, in such cases, the balance of the structural matrix
(where applicable) will preferably comprise a bioactive agent or non
surface active excipients or additives.
While such surfactant levels are preferably employed in perforated
microstructures, they may be used to provide stabilized systems comprising
relatively nonporous, or substantially solid, particulates. That is, while
preferred embodiments will comprise perforated microstructures or
microspheres associated with high levels of surfactant, acceptable
dispersions may be formed using relatively low porosity particulates of
the same surfactant concentration (i.e. greater than about 10% or 20%
w/w). In this respect, such embodiments are specifically contemplated as
being within the scope of the present invention.
In other preferred embodiments of the invention, the structural matrix
defining the perforated microstructure optionally comprises synthetic or
natural polymers or combinations thereof. In this respect, useful polymers
comprise polylactides, polylactide-glycolides, cyclodextrins,
polyacrylates, methylcellulose, carboxymethylcellulose, polyvinyl
alcohols, polyanhydrides, polylactams, polyvinyl pyrrolidones,
polysaccharides (dextrans, starches, chitin, chitosan, etc.), hyaluronic
acid, proteins, (albumin, collagen, gelatin, etc.). Those skilled in the
art will appreciate that, by selecting the appropriate polymers, the
delivery profile of the respiratory dispersion may be tailored to optimize
the effectiveness of the bioactive agent.
In addition to the aforementioned polymer materials and surfactants, it
may be desirable to add other excipients to an aerosol formulation to
improve microsphere rigidity, drug delivery and deposition, shelf-life and
patient acceptance. Such optional excipients include, but are not limited
to: coloring agents, taste masking agents, buffers, hygroscopic agents.
antioxidants, and chemical stabilizers. Further, various excipients may be
incorporated in, or added to, the particulate matrix to provide structure
and form to the perforated microstructures (i.e. microspheres). These
excipients may include, but are not limited to, carbohydrates including
monosaccharides, disaccharides and polysaccharides. For example,
monosaccharides such as, dextrose (anhydrous and monohydrate), galactose,
mannitol, D-mannose, sorbitol, sorbose and the like; disaccharides such
as, lactose, maltose, sucrose, trehalose, and the like; trisaccharides
such as, raffinose and the like; and other carbohydrates such as, starches
(hydroxyethylstarch), cyclodextrils and maltodextrins. Amino acids are
also suitable excipients with glycine preferred. Mixtures of carbohydrates
and amino acids are further held to be within the scope of the present
invention. The inclusion of both inorganic (e.g. sodium chloride, calcium
chloride), organic salts (e.g. sodium citrate, sodium ascorbate, magnesium
gluconate, sodium gluconate, tromethamine hydrochloride) and buffers is
also contemplated.
Yet other preferred embodiments include perforated microstructures that
may comprise, or may be coated with, charged species that prolong
residence time at the point of contact or enhance penetration through
mucosae. For example, anionic charges are known to favor mucoadhesion
while cationic charges may be used to associate the formed
microparticulate with negatively charged bioactive agents, such as genetic
material. The charges may be imparted through the association or
incorporation of polyanionic or polycationic materials such as polyacrylic
acids, polylysine, polylactic acid and chitosan.
In addition to, or instead of, the components discussed above, the
perforated microstructures will preferably comprise at least one bioactive
agent. As used herein, "bioactive agent" refers to a substance which is
used in connection with an application that is therapeutic or diagnostic
in nature, such as, methods for diagnosing the presence or absence of a
disease in a patient and/or in methods for treating a disease in a
patient. Particularly preferred bioactive agents for use in accordance
with the invention include anti-allergics, peptides and proteins,
bronchodilators and anti-inflammatory steroids for use in the treatment of
respiratory disorders such as asthma by inhalation therapy.
It will be appreciated that, the perforated microstructures of the present
invention may exclusively comprise one or more bioactive agents (i.e. 100%
w/w). However, in selected embodiments the perforated microstructures may
incorporate much less bioactive agent depending on the activity thereof.
Accordingly, for highly active materials the perforated microstructures
may incorporate as little as 0.001% by weight although a concentration of
greater than about 0.1% w/w is preferred. Other embodiments of the
invention may comprise greater than about 5%, 10%, 15%, 20%, 25%, 30% or
even 40% w/w bioactive agent. Still more preferably, the perforated
microstructures may comprise greater than about 50%, 60%, 70%, 75%, 80% or
even 90% w/w bioactive agent. In particularly preferred embodiments, the
final stabilized respiratory dispersion desirably contains from about
40%-60% w/w more preferably 50%-70% w/w, and even more preferably 60%-90%
w/w of bioactive agent relative to the weight of the microparticulate
matrix. The precise amount of bioactive agent incorporated in the
stabilized dispersions of the present invention is dependent upon the
agent of choice, the required dose, and the form of the drug actually used
for incorporation. Those skilled in the art will appreciate that, such
determinations may be made by using well-known pharmacological techniques
in combination with the teachings of the present invention.
Accordingly, bioactive agents that may be administered in the form of
aerosolized medicaments in conjunction with the teachings herein include
any drug that may be presented in a form which is relatively insoluble in
the selected propellant and subject to pulmonary uptake in physiologically
effective amounts. Compatible bioactive agents comprise hydrophilic and
lipophilic respiratory agents, bronchodilators, antibiotics, antivirals,
pulmonary lung surfactants, anti-inflammatories, steroids, antihistaminics,
leukotriene inhibitors or antagonists, anticholinergics, antineoplastics,
anesthetics, enzymes, cardiovascular agents, genetic material including.
DNA and RNA, viral vectors, immunoactive agents, imaging agents, vaccines,
immunosuppressive agents, peptides, proteins and combinations thereof.
Particularly preferred bioactive agents for administration using
aerosolized medicaments in accordance with the present invention include
mast cell inhibitors (anti-allergics), bronchodilators, and
anti-inflammatory steroids for use in the treatment of respiratory
disorders such as asthma by inhalation therapy, for example cromoglycate
(e.g. the sodium salt), and albuterol (e.g. the sulfate salt). For
systemic delivery (e.g. delivery of the bioactive agent to the systemic
circulation for the treatment of autoimmune diseases such as diabetes or
multiple sclerosis), peptides and proteins are particularly preferred.
Exemplary medicaments or bioactive agents may be selected from, for
example, analgesics, e.g. codeine, dihydromorphine, ergotamine, fentanyl,
or morphine; anginal preparations, e.g. diltiazem; mast cell inhibitors,
e.g. cromolyn sodium; antiinfectives, e.g. cephalosporins, macrolides,
quinolines, penicillins, streptomycin, sulphonamides, tetracyclines and
pentamidine; antihistamines, e.g. methapyrilene; anti-inflammatories, e.g.
fluticasone propionate, beclomethasone dipropionate, flunisolide,
budesonide, tripedane, cortisone, prednisone, prednisolone, dexamethasone,
betamethasone, or triamcinolone acetonide; antitussives, e.g. noscapine;
bronchodilators, e.g. ephedrine, adrenaline, fenoterol, formoterol,
isoprenaline, metaproterenol, salbutamol, albuterol, salmeterol,
terbutaline; diuretics, e.g. amiloride; anticholinergics, e.g. ipatropium,
atropine, or oxitropium; lung surfactants e.g. Surfaxin, Exosurf, Survanta;
xanthines, e.g. aminophylline, theophylline, caffeine; therapeutic
proteins and peptides, e.g. DNAse, insulin, glucagon, LHRH, nafarelin,
goserelin, leuprolide, interferon, rhu IL-1 receptor, macrophage
activation factors such as lymphokines and muramyl dipeptides, opioid
peptides and neuropeptides such as enkaphalins, endorphins, renin
inhibitors, cholecystokinins, DNAse, growth hormones, leukotriene
inhibitors and the like. In addition, bioactive agents that comprise an
RNA or DNA sequence, particularly those useful for gene therapy, genetic
vaccination, genetic tolerization, or antisense applications, may be
incorporated in the disclosed dispersions as described herein.
Representative DNA plasmids include pCMVp (available from Genzyme Corp,
Framington, Mass.) and PCMV-.beta.-gal (a CMV promotor linked to the E.
coli Lac-Z gene, which codes for the enzyme .beta.-galactosidase).
The selected bioactive agent(s) may comprise, be associated with, or
incorporated in, the perforated microstructures in any form that provides
the desired efficacy and is compatible with the chosen production
techniques. As used herein, the terms "associate" or "associating" mean
that the structural matrix or perforated microstructure may comprise,
incorporate, adsorb, absorb, be coated with or be formed by the bioactive
agent. Where appropriate, the medicaments may be used in the form of salts
(e.g. alkali metal or amine salts or as acid addition salts) or as esters
or as solvates (hydrates). In this regard, the form of the bioactive
agents may be selected to optimize the activity and/or stability of the
medicament and/or to minimize the solubility of the medicament in the
suspension medium. It will further be appreciated that, the aerosolized
formulations according to the invention may, if desired, contain a
combination of two or more active ingredients. The agents may be provided
in combination in a single species of perforated microstructure or
individually in separate species of perforated microstructures that are
combined in the suspension medium. For example, two or more bioactive
agents may be incorporated in a single feed stock preparation and spray
dried to provide a single microstructure species comprising a plurality of
medicaments. Conversely, the individual medicaments could be added to
separate stocks and spray dried separately to provide a plurality of
microstructure species with different compositions. These individual
species could be added to the propellant medium in any desired proportion
and placed in the aerosol delivery system as described below. Further, as
briefly mentioned above, the perforated microstructures (with or without
an associated medicament) may be combined with one or more conventionally
micronized bioactive agents to provide the desired dispersion stability.
Based on the foregoing, it will be appreciated by those skilled in the art
that a wide variety of bioactive agents may be incorporated in the
disclosed stabilized dispersions. Accordingly, the list of preferred
bioactive agents above is exemplary only and not intended to be limiting.
It will also be appreciated by those skilled in the art that the proper
amount of bioactive agent and the timing of the dosages may be determined
for the formulations in accordance with already-existing information and
without undue experimentation.
As seen from the passages above, various components may be associated
with, or incorporated in the perforated microstructures of the present
invention. Similarly, several techniques may be used to provide
particulates having the appropriate morphology (i.e. a perforated
configuration) and density. Among other methods, perforated
microstructures compatible with the instant invention may be formed by
techniques including lyophilization, spray drying, multiple emulsion,
micronization, or crystallization. It will further be appreciated that,
the basic concepts of many of these techniques are well known in the prior
art and would not, in view of the teachings herein, require undue
experimentation to adapt them so as to provide the desired perforated
microstructures.
While several procedures are generally compatible with the present
invention, particularly preferred embodiments typically comprise
perforated microstructures formed by spray drying. As is well known, spray
drying is a one-step process that converts a liquid feed to a dried
particulate form. With respect to pharmaceutical applications, it will be
appreciated that, spray drying has been used to provide powdered material
for various administrative routes including inhalation. See, for example,
M. Sacchetti and M. M. Van Oort in: Inhalation Aerosols: Physical and
Biological Basis for Therapy, A. J. Hickey, ed. Marcel Dekkar, New York,
1996, which is incorporated herein by reference.
In general, spray drying consists of bringing together a highly dispersed
liquid, and a sufficient volume of hot air to produce evaporation and
drying of the liquid droplets. The preparation to be spray dried or feed
(or feed stock) can be any solution, course suspension, slurry, colloidal
dispersion, or paste that may be atomized using the selected spray drying
apparatus. Typically, the feed is sprayed into a current of warm filtered
air that evaporates the solvent and conveys the dried product to a
collector. The spent air is then exhausted with the solvent. Those skilled
in the art will appreciate that, several different types of apparatus may
be used to provide the desired product. For example, commercial spray
dryers manufactured by Buchi Ltd. or Niro Corp. will effectively produce
particles of desired size. It will further be appreciated that, these
spray dryers, and specifically their atomizers, may be modified or
customized for specialized applications, i.e. the simultaneous spraying of
two solutions using a double nozzle technique. More specifically, a
water-in-oil emulsion can be atomized from one nozzle and a solution
containing an anti-adherent such as mannitol can be co-atomized from a
second nozzle. In other cases, it may be desirable to push the feed
solution though a custom designed nozzle using a high pressure liquid
chromatography (HPLC) pump. Provided that microstructures comprising the
correct morphology and/or composition are produced the choice of apparatus
is not critical and would be apparent to the skilled artisan in view of
the teachings herein.
While the resulting spray-dried powdered particles typically are
approximately spherical in shape, nearly uniform in size and frequently
are hollow, there may be some degree of irregularity in shape depending
upon the incorporated medicament and the spray drying conditions. In many
instances the dispersion stability of spray-dried microspheres appears to
be more effective if an inflating agent (or blowing agent) is used in
their production. Particularly preferred embodiments may comprise an
emulsion with the inflating agent as the disperse or continuous phase (the
other phase being aqueous in nature). The inflating agent is preferably
dispersed with a surfactant solution, using, for instance, a commercially
available microfluidizer at a pressure of about 5000 to 15,000 psi. This
process forms an emulsion, preferably stabilized by an incorporated
surfactant, typically comprising submicron droplets of water immiscible
blowing agent dispersed in an aqueous continuous phase. The formation of
such dispersions using this and other techniques are common and well known
to those in the art. The blowing agent is preferably a fluorinated
compound (e.g. perfluorohexane, perfluorooctyl bromide, perfluorodecalin,
perfluorobutyl ethane) which vaporizes during the spray-drying process,
leaving behind generally hollow, porous aerodynamically light
microspheres. As will be discussed in more detail below, other suitable
blowing agents include chloroform, Freons, and hydrocarbons. Nitrogen gas
and carbon dioxide are also contemplated as a suitable blowing agent.
Although the perforated microstructures are preferably formed using a
blowing agent as described above, it will be appreciated that, in some
instances, no blowing agent is required and an aqueous dispersion of the
medicament and surfactant(s) are spray dried directly. In such cases, the
formulation may be amenable to process conditions (e.g., elevated
temperatures) that generally lead to the formation of hollow, relatively
porous microparticles. Moreover, the medicament may possess special
physicochemical properties (e.g., high crystallinity, elevated melting
temperature, surface activity, etc.) that make it particularly suitable
for use in such techniques.
When a blowing agent is employed, the degree of porosity of the perforated
microstructure appears to depend, at least in part, on the nature of the
blowing agent, its concentration in the feed stock (i.e. as an emulsion),
and the spray drying conditions. With respect to controlling porosity, it
has surprisingly been found that the use of compounds, heretofore
unappreciated as blowing agents, may provide perforated microstructures
having particularly desirable characteristics. More particularly, in this
novel and unexpected aspect of the present invention it has been found
that the use of fluorinated compounds having relatively high boiling
points (i.e. greater than about 60.degree. C.) may be used to produce
particulates that are especially suitable for inhalation therapies. In
this regard, it is possible to use fluorinated blowing agents having
boiling points of greater than about 70.degree. C., 80.degree. C.,
90.degree. C. or even 95.degree. C. Particularly preferred blowing agents
have boiling points greater than the boiling point of water, i.e. greater
than 100.degree. C. (e.g. perflubron, perfluorodecalin). In addition,
blowing agents with relatively low water solubility (<10.sup.-6 M) are
preferred since they enable the production of stable emulsion dispersions
with mean weighted particle diameters less than 0.3 .mu.m. As indicated
above, these blowing agents will preferably be incorporated in an
emulsified feed stock prior to spray drying. For the purposes of the
present invention this feed stock will also preferably comprise one or
more bioactive agents, one or more surfactants, or one or more excipients.
Of course, combinations of the aforementioned components are also within
the scope of the invention.
While not limiting the invention in any way it is hypothesized that, as
the aqueous feed component evaporates during spray drying it leaves a thin
crust at the surface of the particle. The resulting particle wall or crust
formed during the initial moments of spray drying appears to trap any high
boiling blowing agents as hundreds of emulsion drop lets (ca. 200-300 nm).
As the drying process continues, the pressure inside the particulate
increases thereby vaporizing at least part of the incorporated blowing
agent and forcing it through the relatively thin crust. This venting or
outgassing apparently leads to the formation of pores or other defects in
the crust. At the same time, remaining particulate components (possibly
including some blowing agent) migrate from the interior to the surface as
the particle solidifies. This migration apparently slows during the drying
process as a result of increased resistance to mass transfer caused by an
increased internal viscosity. Once the migration ceases, the particle
solidifies, leaving vesicles, vacuoles or voids where the emulsifying
agent resided. The number of pores, their size, and the resulting wall
thickness is largely dependent on the nature of the selected blowing agent
(i.e. boiling point), its concentration in the emulsion, total solids
concentration, and the spray-drying conditions.
It has been surprisingly found that substantial amounts of these
relatively high boiling blowing agents may be retained in the resulting
spray dried product. That is, the spray dried perforated microstructures
may comprise as much as 5%, 10%, 20%, 30% or even 40% w/w of the blowing
agent. In such cases, higher production yields were obtained as a result
an increased particle density caused by residual blowing agent. It will be
appreciated by those skilled in the art that this retained fluorinated
blowing agent may alter the surface characteristics of the perforated
microstructures and further increase the stability of the respiratory
dispersions. Conversely, the residual blowing agent can easily be removed
with a post-production evaporation step in a vacuum oven. Optionally,
pores may be formed by spray drying a bioactive agent and an excipient
that can be removed from the formed microspheres under a vacuum.
In any event, typical concentrations of blowing agent in the feed stock
are between 5% and 100% w/v, and more preferably, between about 20% to 90%
w/v. In other embodiments, blowing agent concentrations will preferably be
greater than about 10%, 20%, 30%, 40% 50% or even 60% w/v. Yet other feed
stock emulsions may comprise 70%, 80%, 90% or even 95% w/v of the selected
high boiling point compound.
In preferred embodiments, another method of identifying the concentration
of blowing agent used in the feed is to provide it as a ratio of the
concentration of the blowing agent to that of the stabilizing surfactant
(i.e. phospholipid) in the precursor emulsion. For fluorocarbon blowing
agents such as perfluorooctyl bromide and phosphatidylcholine, the ratio
may be termed a perfluorocarbon/phosphatid-ylcholine ratio (or PFC/PC
ratio). While phosphatidylcholine is used as an example, it will be
appreciated that the appropriate surfactants may be substituted therefor.
In any event, the PFC/PC ratio will range from about 1 to about 60 and
more preferably, from about 10 to about 50. For preferred embodiments, the
ratio will generally be greater than about 5, 10, 20, 25, 30, 40 or even
50. In this respect, FIG. 1 (see Original Patent) shows a series of
pictures taken of perforated microstructures formed of phosphatidylcholine
(PC) using various amounts of perfluorooctyl bromide (PFC), a relatively
high boiling point fluorocarbon as the blowing agent. The PFC/PC ratios
are provided under each subset of pictures, i.e. from IA to IF. Formation
and imaging conditions are discussed in greater detail in Examples I and
II below. With regard to the micrographs, the column on the left shows the
intact microstructures while the column on the right illustrates
cross-sections of fractured microstructures from the same preparations.
As may easily be seen in the FIG. 1, the use of higher PFC/PC ratios
provides structures of a more hollow and porous nature. More particularly,
those methods employing a PFC/PC ratio of greater than about 4.8 tended to
provide structures that are particularly compatible with the dispersions
disclosed herein. Similarly, FIG. 2 (see Original Patent), a micrograph
which will be discussed in more detail in Example IV below, illustrates a
preferably porous morphology obtained by using higher boiling point
blowing agents (in this case perfluorodecalin).
While relatively high boiling point blowing agents comprise one preferred
aspect of the instant invention, it will be appreciated that more
conventional blowing or inflating agents may also be used to provide
compatible perforated microstructures. Generally, the inflating agent can
be any material that will turn to a gas at some point during the spray
drying or post-production process. Suitable agents include:
1. Dissolved low-boiling (below 100.degree. C.) solvents with limited
miscibility with aqueous solutions, such as methylene chloride, acetone
and carbon disulfide used to saturate the solution at room temperature.
2. A gas, e.g. CO.sub.2 or N.sub.2, used to saturate the solution at room
temperature and elevated pressure (e.g. 3 bar). The droplets are then
supersaturated with the gas at 1 atmosphere and 100.degree. C.
3. Emulsions of immiscible low-boiling (below 100.degree. C.) liquids such
as Freon 113, perfluoropentane, perfluorohexane, perfluorobutane, pentane,
butane, FC-11, FC-11B1, FC-11B2, FC-12B2, FC-21, FC-21B1, FC-21B2,
FC-31B1, FC-113A, FC-122, FC-123, FC-132, FC-133, FC-141, FC-141B. FC-142.
FC-151, FC-152, FC-1112, FC-1121 and FC-1131.
With respect to these lower boiling point inflating agents, they are
typically added to the feed stock in quantities of about 1% to 80% w/v of
the surfactant solution. Approximately 30% w/v inflating agent has been
found to produce a spray dried powder that may be used to form the
stabilized dispersions of the present invention.
Regardless of which blowing agent is ultimately selected, it has been
found that compatible perforated microstructures may be produced
particularly efficiently using a Buchi mini spray drier (model B-191,
Switzerland). As will be appreciated by those skilled in the art, the
inlet temperature and the outlet temperature of the spray drier are not
critical but will be of such a level to provide the desired particle size
and to result in a product that has the desired activity of the
medicament. In this regard, the inlet and outlet temperatures are adjusted
depending on the melting characteristics of the formulation components and
the composition of the feed stock. The inlet temperature may thus be
between 60.degree. C. and 170.degree. C., with the outlet temperatures of
about 40.degree. C. to 120.degree. C. depending on the composition of the
feed and the desired particulate characteristics. Preferably, these
temperatures will be from 90.degree. C. to 120.degree. C. for the inlet
and from 60.degree. C. to 90.degree. C. for the outlet. The flow rate
which is used in the spray drying equipment will generally be about 3 ml
per minute to about 15 ml per minute. The atomizer air flow rate will vary
between values of 1,200 liters per hour to about 3,900 liters per hour.
Commercially available spray dryers are well known to those in the art,
and suitable settings for any particular dispersion can be readily
determined through standard empirical testing, with due reference to the
examples that follow. Of course, the conditions may be adjusted so as to
preserve biological activity in larger molecules such as proteins or
peptides.
Particularly preferred embodiments of the present invention comprise spray
drying preparations comprising a surfactant such as a phospholipid and at
least one bioactive agent. In other embodiments, the spray drying
preparation may further comprise an excipient comprising a hydrophilic
moiety such as, for example, a carbohydrate (i.e. glucose, lactose, or
starch) in addition to any selected surfactant. In this regard, various
starches and derivatized starches suitable for use in the present
invention. Other optional components may include conventional viscosity
modifiers, buffers such as phosphate buffers or other conventional
biocompatible buffers or pH adjusting agents such as acids or bases, and
osmotic agents (to provide isotonicity, hyperosmolarity, or hyposmolarity).
Examples of suitable salts include sodium phosphate (both monobasic and
dibasic), sodium chloride, calcium phosphate, calcium chloride and other
physiologically acceptable salts.
Whatever components are selected, the first step in particulate production
typically comprises feed stock preparation. Preferably, the selected drug
is dissolved in water to produce a concentrated solution. The drug may
also be dispersed directly in the emulsion, particularly in the case of
water insoluble agents. Alternatively, the drug may be incorporated-in the
form of a solid particulate dispersion. The concentration of the drug used
is dependent on the dose of drug required in the final powder and the
performance of the MDI drug suspension (e.g., fine particle dose). As
needed, co-surfactants such as poloxamer 188 or span 80 may be added to
this annex solution. Additionally, excipients such as sugars and starches
can also be added.
In selected embodiments an oil-in-water emulsion is then formed in a
separate vessel. The oil employed is preferably a fluorocarbon (e.g.,
perfluorooctyl bromide, perfluorodecalin) which is emulsified using a
surfactant such as a long chain saturated phospholipid. For example, one
gram of phospholipid may be homogenized in 150 g hot distilled water
(e.g., 60.degree. C.) using a suitable high shear mechanical mixer (e.g.,
ULTRA-TURRAX.TM., [a shear mixing instrument], model T-25 mixer) at 8000
rpm for 2 to 5 minutes. Typically 5 to 25 g of fluorocarbon is added
dropwise to the dispersed surfactant solution while mixing. The resulting
perfluorocarbon in water emulsion is then processed using a high pressure
homogenizer to reduce the particle size. Typically the emulsion is
processed at 12,000 to 18,000 psi, 5 discrete passes and kept at 50 to
80.degree. C.
The drug solution and perfluorocarbon emulsion are then combined and fed
into the spray dryer. Typically the two preparations will be miscible as
the emulsion will preferably comprise an aqueous continuous phase. While
the bioactive agent is solubilized separately for the purposes of the
instant discussion it will be appreciated that, in other embodiments, the
bioactive agent may be solubilized (or dispersed) directly in the
emulsion. In such cases, the bioactive emulsion is simply spray dried
without combining a separate drug preparation.
In any event, operating conditions such as inlet and outlet temperature,
feed rate, atomization pressure, flow rate of the drying air, and nozzle
configuration can be adjusted in accordance with the manufacturer's
guidelines in order to produce the required particle size, and production
yield of the resulting dry microstructures. Exemplary settings are as
follows: an air inlet temperature between 60.degree. C. and 170.degree.
C.; an air outlet between 40.degree. C. to 120.degree. C.; a feed rate
between 3 ml to about 15 ml per minute; and an aspiration setting of 100%
and an atomization, air flow rate between 1,200 to 2,800 L/hr. The
selection of appropriate apparatus and processing conditions are well
within the purview of a skilled artisan in view of the teachings herein
and may be accomplished without undue experimentation. It will be
appreciated that, the use of these and substantially equivalent methods
provide for the formation of hollow porous aerodynamically light
microspheres with particle diameters appropriate for aerosol deposition
into the lung.
Along with spray drying the perforated microstructures of the present
invention may be formed by lyophilization. Those skilled in the art will
appreciate that, lyophilization is a freeze-drying process in which water
is sublimed from the composition after it is frozen. The particular
advantage associated with the lyophilization process is that biologicals
and pharmaceuticals that are relatively unstable in an aqueous solution
can be dried without elevated temperatures (thereby eliminating the
adverse thermal effects), and then stored in a dry state where there are
few stability problems. With respect to the instant invention such
techniques are particularly compatible with the incorporation of peptides,
proteins, genetic material and other natural and synthetic macromolecules
in the perforated microstructures without compromising physiological
activity. Methods for providing lyophilized particulates are known to
those of skill in the art and it would clearly not require undue
experimentation to provide dispersion compatible microstructures in
accordance with the teachings herein. Accordingly, to the extent that
lyophilization processes may be used to provide microstructures having the
desired porosity and size they are conformance with the teachings herein
and are expressly contemplated as being within the scope of the instant
invention.
In addition to the aforementioned techniques, the perforated
microstructures of the present invention may also be formed using a double
emulsion method. In the double emulsion method the medicament is first
dispersed in a polymer dissolved in an organic solvent (e.g. methylene
chloride) by sonication or homogenization. This primary emulsion is then
stabilized by forming a multiple emulsion in a continuous aqueous phase
containing an emulsifier such as polyvinylalcohol. The organic solvent is
then removed by evaporation or extraction using conventional techniques
and apparatus. The resulting microspheres are washed, filtered and dried
prior to combining them with an appropriate suspension medium in
accordance with the present invention.
As extensively discussed above, the stabilized dispersions of the present
invention further comprise a continuous phase suspension medium. It is an
advantage of the present invention that any biocompatible suspension
medium having adequate vapor pressure to act as a propellant may be used.
Particularly preferred suspension media are compatible with use in a
metered dose inhaler. That is, they will be able to form aerosols upon the
activation of the metering valve and associated release of pressure. In
general, the selected suspension medium should be biocompatible (i.e.
relatively non-toxic) and non-reactive with respect to the suspended
perforated microstructures comprising the bioactive agent. Preferably, the
suspension medium will not act as a substantial solvent for any components
incorporated in the perforated microspheres. Selected embodiments of the
invention comprise suspension media selected from the group consisting of
fluorocarbons (including those substituted with other halogens),
hydrofluoroalkanes, perfluorocarbons, hydrocarbons, alcohols, ethers or
combinations thereof. It will be appreciated that, the suspension medium
may comprise a mixture of various compounds selected to impart specific
characteristics.
Particularly suitable propellants for use in the suspension mediums of the
present invention are those propellant gases that can be liquefied under
pressure at room temperature and, upon inhalation or topical use, are
safe, toxicologically innocuous and free of side effects. In this regard,
compatible propellants may comprise any hydrocarbon, fluorocarbon,
hydrogen-containing fluorocarbon or mixtures thereof having a sufficient
vapor pressure to efficiently form aerosols upon activation of a metered
dose inhaler. Those propellants typically termed hydrofluoroalkanes or
HFAs are especially compatible. Suitable, propellants include, for
example, short chain hydrocarbons, C.sub.1-4 hydrogen-containing
chlorofluorocarbons such as CH.sub.2ClF, CCl.sub.2F.sub.2CHClF,
CF.sub.3CHClF, CHF.sub.2CClF.sub.2, CHClFCHF.sub.2, CF.sub.3CH.sub.2Cl,
and CClF.sub.2CH.sub.3; C.sub.1-4 hydrogen-containing fluorocarbons (e.g.
HFAs) such as CHF.sub.2CHF.sub.2, CF.sub.3CH.sub.2F, CHF.sub.2CH.sub.3,
and CF.sub.3CHFCF.sub.3; and perfluorocarbons such as CF.sub.3CF.sub.3 and
CF.sub.3CF.sub.2CF.sub.3. Preferably, a single perfluorocarbon or
hydrogen-containing fluorocarbon is employed as the propellant.
Particularly preferred as propellants are 1,1,1,2-tetrafluoroethane
(CF.sub.3CH.sub.2F) (HFA-134a) and 1,1,1,2,3,3,3-heptafluoro-n-propane
(CF.sub.3CHFCF.sub.3) (HFA-227), perfluoroethane;
monochlorodifluoromethane, 1,1-difluoroethane, and combinations thereof.
It is desirable that the formulations contain no components that deplete
stratospheric ozone. In particular it is desirable that the formulations
are substantially free of chlorofluorocarbons such as CCl.sub.3F,
CCl.sub.2F.sub.2, and CF.sub.3CCl.sub.3.
Specific fluorocarbons, or classes of fluorinated compounds, that are
useful in the suspension media include, but are not limited to,
fluoroheptane, fluorocycloheptane, fluoromethylcycloheptane, fluorohexane,
fluorocyclohexane, fluoropentane, fluorocyclopentane,
fluoromethylcyclopentane, fluorodimethylcyclopentanes,
fluoromethylcyclobutane, fluorodimethylcyclobutane,
fluorotrimethylcyclobutane, fluorobutane, fluorocyclobutane, fluoropropane,
fluoroethers, fluoropolyethers and fluorotriethylamines. It will be
appreciated that, these compounds may be used alone or in combination with
more volatile propellants. It is a distinct advantage that such compounds
are generally environmentally sound and biologically non-reactive.
In addition to the aforementioned fluorocarbons and hydrofluoroalkanes,
various chlorofluorocarbons and substituted fluorinated compounds may also
be used as suspension mediums in accordance with the teachings herein. In
this respect, FC-11 (CCL3F), FC-11 B (CBrCl2F), FC-11B2 (CBr2ClF), FC 12B2
(CF2Br2), FC21 (CHCl.sub.2F), FC21 B1 (CHBrClF), FC-21B2 (CHBr2F), FC-31B1
(CH2BrF), FC-113A (CC13CF.sub.3), FC-122 (CClF2CHCl.sub.2), FC-123
(CF3CHCl.sub.2), FC-132 (CHClFCHClF), FC-133 (CHClFCHF2), FC-141
(CH2ClCHClF), FC-141B (CC12FCH3), FC-142 (CHF2CH.sub.2Cl), FC-151
(CH2FCH.sub.2Cl), FC-152 (CH2FCH2F), FC-1112 (CClF.dbd.CClF), FC-1121 (CHCl.dbd.CFCl)
and FC-1131 (CHCl.dbd.CHF) are all compatible with the teachings herein
despite possible attendant environmental concerns. As such, each of these
compounds may be used, alone or in combination with other compounds (i.e.
less volatile fluorocarbons) to form the stabilized respiratory
dispersions of the present invention.
With respect to possible media combinations, relatively volatile compounds
may be mixed with lower vapor pressure components to provide suspension
media having specified physical characteristics selected to further
improve stability or enhance the bioavailability of the dispersed
bioactive agent. In preferred embodiments, the lower vapor pressure
compounds will comprise fluorinated compounds (e.g. fluorocarbons) having
a boiling point greater than about 25.degree. C. Particularly preferred
lower vapor pressure fluorinated compounds for use in the suspension
medium may comprise of perfluorooctylbromide C.sub.8F.sub.17Br (PFOB or
perflubron), dichlorofluorooctane C.sub.8F.sub.16Cl.sub.2,
perfluorooctylethane C.sub.8F.sub.17C.sub.2H.sub.5 (PFOE),
perfluorodecylbromide C.sub.10F.sub.21Br (PFDB) or perfluorobutylethane
C.sub.4F.sub.9C.sub.2H.sub.5. Preferably, these lower vapor pressure
compounds are present in a relatively low level. Such compounds may be
added directly to the suspension medium or may be associated with the
perforated microstructures.
Similarly, as indicated above, it is an advantage of the present invention
that stabilized dispersions may be formed in HFA or PFC propellants
without the use of additional cosolvents or adjuvants. Accordingly, in
selected embodiments the formulations are substantially free of
potentially reactive liquid components of higher polarity than the
propellant employed. This is largely because the presence of cosolvents or
adjuvants could potentially increase the solubility of the perforated
particles in the suspension medium, thereby altering particle morphology,
and particle size (growth by Ostwald ripening) over time. However,
depending on the perforated microstructure composition, or the selection
of propellant, it may be desirable to include an appropriate cosolvent or
adjuvant to adjust vapor pressure or increase administration efficiency.
As such, it is expressly contemplated that an HFA propellant containing
suspension medium may additionally contain an adjuvant or cosolvent as
long as it does not adversely impact the stability of the particles. For
example propane, ethanol, isopropyl alcohol, butane, isobutane, pentane,
isopentane or a dialkyl ether such as dimethyl ether may be incorporated
in the suspension media. Similarly, the suspension medium may contain a
volatile fluorocarbon. In general, up to 50% w/w of the propellant may
comprise a volatile adjuvant such as a hydrocarbon or fluorocarbon. More
preferably, the suspension medium will comprise less than about 40%, 30%,
20% or 10% w/w of cosolvent or adjuvant.
It will further be appreciated that, one of ordinary skill in the art can
readily determine other compounds that would perform suitably in the
present invention which apparently do not exhibit a desirable vapor
pressure and/or viscosity. Rather, it will be understood that, certain
compounds outside the preferred ranges of vapor pressure or viscosity can
be used if they provide the desired aerosolized medicament upon activation
of a MDI.
The stabilized suspensions or dispersions of the present invention may be
prepared by dispersal of the microstructures in the selected suspension
medium which may then be placed in a container or reservoir. In this
regard, the stabilized preparations of the present invention can be made
by simply combining the components in sufficient quantity to produce the
final desired dispersion concentration. Although the microstructures
readily disperse without mechanical energy, the application of energy
(e.g., sonication or stirring) to aid in dispersion is expressly
contemplated as being within the scope of the invention. Alternatively,
the components may be mixed by simple shaking or other type of agitation.
The process is preferably carried out under anhydrous conditions to
obviate any adverse effects of moisture on suspension stability. Once
formed, the dispersion has a reduced susceptibility to flocculation and
sedimentation.
The remarkable stability provided by the preparations of the instant
invention is graphically illustrated in FIGS. 3A to 3D (see Original Patent)
where a MDI formulation prepared in accordance with the present invention
(as will be discussed more fully in Example XVIII below) is compared with
a commercially available MDI formulation. In each of the pictures, taken
at 0 seconds, 30 seconds, 60 seconds and 2 hours after shaking, the
commercial formulation is on the left, and the perforated microstructure
dispersion formed accordance with the present invention is on the right.
Whereas the commercial cromolyn sodium formulation shows creaming within
30 seconds of mixing, almost no creaming is noted in the spray-dried
particles after as long as 2 hours. Moreover, there was little creaming in
perforated microstructure formulation after 4 hours (not shown). This
example clearly illustrates the stability that can be achieved when the
hollow porous particles of compatible materials are filled with the
suspension medium (i.e. in the form of a homodispersion).
It will also be understood that, other components can be included in the
pharmaceutical compositions of the present invention. For example, osmotic
agents, stabilizers, chelators, buffers, hygroscopic agents, viscosity
modulators, salts, and sugars can be added to fine tune the stabilized
dispersions for maximum life and ease of administration. Such components
may be added directly to the suspension medium or associated with, or
incorporated in, the dispersed perforated microstructures. Considerations
such as sterility, isotonicity, and biocompatibility may govern the use of
conventional additives to the disclosed compositions. The use of such
agents will be understood to those of ordinary skill in the art and the
specific quantities, ratios, and types of agents can be determined
empirically without undue experimentation.
Conventional bulk manufacturing methods and machinery well known to those
skilled in the art of pharmaceutical manufacture may be employed for the
preparation of large scale batches for commercial production of filled
canisters, or reservoirs for MDIs. With MDIs for example, in one bulk
manufacturing method, a metering valve is crimped onto an aluminum can to
provide an empty canister or reservoir. The perforated microparticles are
added to a charge vessel, and a liquefied propellant (suspension medium)
is pressure-filled through the charge vessel into a manufacturing vessel.
The respiratory blend or drug suspension is mixed before recirculation to
a filling machine and an aliquot of the stabilized dispersion is then
filled through the metering valve into the reservoir. Typically, in
batches prepared for pharmaceutical use, each filled canister is
check-weighed, coded with a batch number and packed into a tray for
storage before release testing.
In other embodiments, the perforated microparticles are introduced into an
empty reservoir which is then crimp-sealed to the metering valve. The
reservoir or canister is then charged with HFA propellant by over pressure
through the valve stem. In yet another embodiment, the stabilized
dispersion may be prepared outside the canister or reservoir and then
introduced cold filling techniques. The canister is then crimped sealed.
Those skilled in the art will appreciated that the filling procedure
selected will, at least to some extent, depend on the type of valve
chosen.
The canisters generally comprise a container or reservoir capable of
withstanding the vapor pressure of the propellant used such as, a plastic
or plastic-coated glass bottle, or preferably, a metal can or, for
example, an aluminum can which may optionally be anodized, lacquer-coated
and/or plastic-coated, wherein the container is closed with a metering
valve. The metering valves are designed to deliver a metered amount of the
formulation per actuation. The valves incorporate a gasket to prevent
leakage of propellant through the valve. The gasket may comprise any
suitable elastomeric material such as, for example, low density
polyethylene, chlorobutyl, black and white butadiene-acrylonitrile
rubbers, butyl rubber and neoprene. Suitable valves are commercially
available from manufacturers well known in the aerosol industry, for
example, from Valois, France (e.g. DFIO, DF30, DF 31/50 ACT, DF60), Bespak
pic, LTK (e.g. BK300, BK356) and 3M-Neotechnic Ltd., LIK (e.g.
SPRAYMISER.TM., a heribicide applicator).
Each filled canister is conveniently fitted into a suitable channeling
device prior to use to form a metered dose inhaler for administration of
the medicament into the lungs or nasal cavity of a patient. Suitable
channeling devices comprise for example a valve actuator and a cylindrical
or cone-like passage through which medicament may be delivered from the
filled canister via the metering valve, to the nose or mouth of a patient
e.g., a mouthpiece actuator. Metered dose inhalers are designed to deliver
a fixed unit dosage of medicament per actuation such as, for example, in
the range of 10 to 5000 micrograms of bioactive agent per actuation.
Typically, a single charged canister will provide for tens or even
hundreds of shots or doses.
It will be appreciated that, the stabilized preparations for use in
metered dose inhalers of the present invention may be advantageously
supplied to the physician or other health care professional, in a sterile,
prepackaged or kit form. More particularly, the formulations may be
supplied as charged MDI reservoirs or canisters, ready for administration.
Such kits may contain a number of charged canisters, preferably along with
a disposable actuator. In this regard, the patient may then change or
substitute canisters during a particular course of treatment. It will also
be appreciated that, such kits may include a single charged canister
associated or affixed to an actuator, or that the preparation may be
supplied in a disposable MDI device.
Administration of bioactive agent may be indicated for the treatment of
mild, moderate or severe, acute or chronic symptoms or for prophylactic
treatment. Moreover, the bioactive agent may be administered to treat
local or systemic conditions or disorders. It will be appreciated that,
the precise dose administered will depend on the age and condition of the
patient, the particular medicament used and the frequency of
administration and will ultimately be at the discretion of the attendant
physician. When combinations of bioactive agents are employed, the dose of
each component of the combination will generally be the same as that
employed for each component when used alone.
As discussed throughout the specification, the stabilized dispersions
disclosed herein are preferably administered to the lung or pulmonary air
passages of a patient via aerosolization, such as with a metered dose
inhaler. MDIs are well known in the art and could easily be employed for
administration of the claimed dispersions without undue experimentation.
Breath activated MDIs, as well as those comprising other types of
improvements which have been, or will be, developed are also compatible
with the stabilized dispersions and present invention and, as such, are
contemplated as being with in the scope thereof. However, it should be
emphasized that, in preferred embodiments, the stabilized dispersions may
be administered using a number of different routes including, but not
limited to, topical, nasal, pulmonary or oral. Those skilled in the art
will appreciate that, such routes are well known and that the dosing and
administration procedures may be easily derived for the stabilized
dispersions of the present invention.
More efficient delivery of the aerosolized medicament to the bronchial
airways has several important clinical implications. Among such advantages
are: reduced cost of diagnosis and therapy due to reduction in the amount
of aerosolized material required to generate a clinical result; smaller,
more effective and more efficient patient dosing at the desired site
(i.e., the lung or bronchus); and reduced side effects due to less
deposition in the throat. Such advantages may in turn help to increase
overall patient compliance.
Claim 1 of 26 Claims
1. A respiratory dispersion for the
pulmonary delivery of at least two bioactive agents, the dispersion
comprising a propellant suspension medium having dispersed therein a
plurality of perforated microstructures, wherein the two bioactive agents
are incorporated into individual perforated microstructures.
____________________________________________
If you want to learn more
about this patent, please go directly to the U.S.
Patent and Trademark Office Web site to access the full
patent.
|