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Title:
Methods of administering liquid droplet aerosols of nanoparticulate drugs
United States Patent: 8,097,282
Issued: January 17, 2012
Inventors: Wood; Ray W.
(King of Prussia, PA), DeCastro; Lan (Philadelphia, PA), Bosch; H. William
(Bryn Mawr, PA)
Assignee: Alkermes Pharma
Ireland Limited (Athlone, County Westmeath, IE)
Appl. No.: 12/081,670
Filed: April 18, 2008
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Web Seminars -- Pharm/Biotech/etc.
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Abstract
There is disclosed an aerosol comprising
droplets of an aqueous dispersion of nanoparticles, said nanoparticles
comprising insoluble therapeutic or diagnostic agent particles having a
surface modifier on the surface thereof. There is also disclosed a method
for making the aerosol and methods for treatment and diagnosis using the
aerosol.
Description of the
Invention
FIELD OF THE INVENTION
The present invention is directed to the field of nanoparticles and
particularly in an aerosol form.
BACKGROUND OF THE INVENTION
Delivery of therapeutic agent to the respiratory tract is important for
both local and systemic treatment of disease. With the conventional
techniques, delivery of agents to the lung is extremely inefficient.
Attempts to develop respirable aqueous suspensions of poorly soluble
compounds have been unsuccessful. Micronized therapeutic agents suspended
in aqueous media are too large to be delivered by aerosolized aqueous
droplets. With conventional processes, it is estimated that only about 10
to 20% of the agent reaches the lung. Specifically, there is loss to the
device used to deliver the agent, loss to the mouth and throat and with
exhalation. These losses lead to variability in therapeutic agent levels
and poor therapeutic control. In addition, deposition of the agent to the
mouth and throat can lead to systemic absorption and undesirable side
effects.
The efficiency of respiratory drug delivery is largely determined by the
particle size distribution. Large particles (greater than 10 m) are
primarily deposited on the back of the throat. Greater than 60% of the
particles with sizes between 1 and 10 m pass with the air stream into the
upper bronchial region of the lung where most are deposited. With
particles less than about 1 .mu.m, essentially all of the particles enter
the lungs and pass into the peripheral alveolar region; however, about 70%
are exhaled and therefore are lost.
In addition to deposition, the relative rate of absorption and rate of
clearance of the therapeutic agent must be considered for determining the
amount of therapeutic agent that reaches the site of action. Since 99.99%
of the available area is located in the peripheral alveoli, rapid
absorption can be realized with delivery of the particles to the
periphery. For clearance, there is also differences between the central
and peripheral regions of the lung. The peripheral alveolar region
does-not have ciliated cells but relies on macrophage engulfment for
particle clearance. This much slower process can significantly extend the
time during which the particles reside in the lung thereby enhancing the
therapeutic or diagnostic effect. In contrast, particles deposited in the
upper respiratory tract are rapidly cleared by mucociliary escalator. That
is, the particles are trapped in the mucous blanket coating the lung
surface and are transported to the throat. Hence, this material is either
swallowed or removed by coughing.
While it has long been known that smaller droplets of an aerosol reach
deeper into the respiratory system (Current Concepts in the Pharmaceutical
Sciences: Dosage and Bioavailability, J. Swarbrick Ed., Lea and Febiger,
Philadelphia, Pa., 1973, pp. 97-148) these have largely been of
theoretical interest. Simply knowing that smaller droplets of aerosol can
be delivered deeper into the respiratory system does not solve the problem
of incorporating sufficient therapeutic agent into the aerosol to be
efficient, particularly where the therapeutic agent is only slightly
soluble in the liquid for the aerosol.
Nanoparticles, described in U.S. Pat. No. 5,145,684, are particles
consisting of a poorly soluble therapeutic or diagnostic agent onto which
are adsorbed a non-crosslinked surface modifier, and which have an average
particle size of less than about 400 nanometers (nm). However, no mention
is made of attempts to nebulize (aerosolize or atomize are equivalent
terms for the purpose of this disclosure) these compositions and it is not
apparent that nebulizing these composition would provide useful aerosols
or that there would be any advantage for doing so.
SUMMARY OF THE INVENTION
In accordance with the present invention, there is provided an aerosol
comprising droplets of an aqueous dispersion of nanoparticles, said
nanoparticles comprising insoluble therapeutic or diagnostic agent
particles having a surface modifier on the surface thereof.
In another aspect of the invention, there is provided a method for forming
an aerosol of a nanoparticle dispersion, said nanoparticles comprising
insoluble therapeutic or diagnostic agent particles having a surface
modifier on the surface thereof, said method comprising the steps of:
a) providing a suspension of said nanoparticles;
b) nebulizing said suspension so as to form an aerosol.
In yet another aspect of the invention, there is provided a method of
treating a mammal comprising the steps of:
a) forming an aerosol of an aqueous dispersion of nanoparticles, said
nanoparticles comprising insoluble therapeutic agent particles having a
surface modifier on the surface thereof;
b) administering said aerosol to the respiratory system of said mammal.
In yet another embodiment, there is provided a method of diagnosing a
mammal, said method comprising
a) forming an aerosol of an aqueous dispersion of nanoparticles, said
nanoparticles comprising insoluble diagnostic imaging agent 10 particles
having a surface modifier on the surface thereof;
b) administering said aerosol to the respiratory system of said mammal;
and
c) imaging said imaging agent in said respiratory system.
DETAILED DESCRIPTION OF THE INVENTION
The compositions of the invention are aerosols. Aerosols can be defined
for the present purpose as colloidal systems consisting of-very finely
divided liquid droplets dispersed in and surrounded by a gas. The droplets
in the aerosols typically have a size less than about 50 microns in
diameter although droplets of a much smaller size are possible.
The aerosols of the present invention are particularly useful in the
treatment of respiratory related illnesses such as asthma, emphysema,
respiratory distress syndrome, chronic bronchitus, cystic fibrosis and
acquired immune deficiency syndrome including AIDS related pneumonia.
The aerosols of the invention are made by nebulizing the nanoparticle
containing solution using a variety of known nebulizing techniques.
Perhaps the simplest of systems is the "two-phase" system which consists
of a solution or a suspension of active ingredient, in the present case, a
nanoparticle containing a therapeutic or diagnostic agent, in a liquid
propellent. Both liquid and vapor phases are present in a pressurized
container and when a valve on the container is opened, liquid propellent
containing the nanoparticle dispersion is released. Depending on the
nature of the ingredients and the nature of the valve mechanism, a fine
aerosol mist or aerosol wet spray is produced.
There are a variety of nebulisers that are available to produce the
aerosols of the invention including small volume nebulizers. Compressor
driven nebulizers incorporate jet technology and use compressed air to
generate the aerosol. Commercially available devices are available from
Healthdyne Technologies Inc; Invacare Inc.; Mountain Medical Equipment
Inc.; Pari Respiratory Inc.; Mada Medical Inc.; Puritan-Bennet; Schuco
Inc.; Omron Healthcare Inc.; DeVilbiss Health Care Inc; and Hospitak Inc.
Ultrasonic nebulizers deliver high medication output and are used by
patients-suffering from severe asthma, or other severe respiratory related
illnesses.
The particles comprise a therapeutic or diagnostic agent. (therapeutic
agents are sometimes referred to as drugs or pharmaceuticals. The
diagnostic agent referred to is typically a contrast agent such as an
x-ray contrast agent but can also be other diagnostic materials.) The
therapeutic or diagnostic agent exists as a discrete, crystalline phase.
The crystalline phase differs from a non-crystalline or amorphous phase
which results from precipitation techniques, such as described in EPO
275,796.
The invention can be practiced with a wide variety of therapeutic or
diagnostic agents. The therapeutic or diagnostic agent preferably is
present in an essentially pure form. The therapeutic or diagnostic agent
must be poorly soluble and dispersible in at least one liquid medium. By
"poorly soluble" it is meant that the therapeutic or diagnostic agent has
a solubility in the liquid dispersion medium of less than about 10 mg/mL,
and preferably of less than about 1 mg/mL. A preferred liquid dispersion
medium is water. However, the invention can be practiced with other liquid
media in which a therapeutic or diagnostic agent is poorly soluble and
dispersible including, for example, aqueous salt solutions, safflower oil
and solvents such as ethanol, t-butanol, hexane and glycol. The pH of the
aqueous dispersion media can be adjusted by techniques known in the art.
Suitable therapeutic or diagnostic agents can be selected from a variety
of known classes of therapeutic or diagnostic agents including, for
example, analgesics, anti-inflammatory agents, anthelmintics,
anti-arrhythmic agents, antibiotics (including penicillins),
anticoagulants, antidepressants, antidiabetic agents, antiepileptics,
antihistamines, antihypertensive agents, antimuscarinic agents,
antimycobacterial agents, antineoplastic agents, immunosuppressants,
antithyroid agents, antiviral agents, anxiolytic sedatives (hypnotics and
neuroleptics), astringents, beta-adrenoceptor blocking agents, blood
products and substitutes, cardiac inotropic agents, contrast media,
corticosteroids, cough suppressants (expectorants and mucolytics),
diagnostic agents, diagnostic imaging agents, diuretics, dopaminergics (antiparkinsonian
agents), haemostatics, immuriological agents, lipid regulating agents,
muscle relaxants, parasympathomimetics, parathyroid calcitonin and
biphosphonates, prostaglandins, radio-pharmaceuticals, sex hormones
(including steroids), antiallergic agents, stimulants and anoretics,
sympathomimetics, thyroid agents, vasodilators and xanthines. Preferred
therapeutic or diagnostic agents include those intended for oral
administration and intravenous administration. A description of these
classes of therapeutic agents and diagnostic agents and a listing of
species within each class can be found in Martindale, The Extra
Pharmacopoeia, Twenty-ninth Edition, The Pharmaceutical Press, London,
1989. The therapeutic or diagnostic agents are commercially available
and/or can be prepared by techniques known in the art.
Preferred diagnostic agents include the x-ray imaging agent WIN-8883
(ethyl 3,5-diacetamido-2,4,6-triiodobenzoate) also known as the ethyl
ester of diatrazoic acid (EEDA), WIN 67722, i.e.,
(6-ethoxy-6-oxohexyl-3,5-bis(acetamido)-2,4,6-triiodobenzoate;
ethyl-2-(3,5-bis(acetamido)-2,4,6-triiodobenzoyloxy)butyrate (WIN 16318);
ethyl diatrizoxyacetate (WIN 12901); ethyl
2-(3,5bis(acetamido)-2,4,6-triiodobenzoyloxy)propionate (WIN 16923);
N-ethyl 2-(3,5-bis(acetamido)-2,4,6-triiodobenzoyloxy acetamide (WIN
65312); isopropyl 2(3,5-bis(acetamido)-2,4,6-triiodobenzoyloxy)acetamide
(WIN 12855); diethyl 2-(3,5-bis(acetamido)-2,4,6-triiodobenzoyloxy
malonate (WIN 67721); ethyl
2-(3,5bis(acetamido)-2,4,6-triiodobenzoyloxy)phenylacetate (WIN 67585);
propanedioic acid, [[3,5-bis(acetylamino)2,4,5-triodobenzoyl]oxy]-,
bis(1-methyl)ester (WIN 68165); and benzoic acid,
3,5-bis(acetylamino)-2,4,6triodo-, 4(ethyl-3-ethoxy-2-butenoate) ester
(WIN 68209). Suitable diagnostic agents are also disclosed in U.S. Pat.
No. 5,260,478; U.S. Pat. No. 5,264,610; U.S. Pat. No. 5,322,679 and U.S.
Pat. No. 5,300,739.
Preferred contrast agents include those which are expected to disintegrate
relatively rapidly under physiological conditions, thus minimizing any
particle-associated inflammatory response. Disintegration may result from
enzymatic hydrolysis, solubilization of carboxylic acids at physiological
pH, or other mechanisms. Thus, poorly soluble iodinated carboxylic acids
such as iodipamide, diatrizoic acid, and metrizoic acid, along with
hydrolytically labile iodinated species such as WIN 67721, WIN 12901, WIN
68165, and WIN 68209 or others may be preferred.
Surface Modifiers
Suitable surface modifiers can preferably be selected from known organic
and inorganic pharmaceutical excipients. Such excipients include various
polymers, low molecular weight oligomers, natural products and
surfactants. Preferred surface modifiers include nonionic and ionic
surfactants.
Representative examples of surface modifiers include gelatin, casein,
lecithin (phosphatides), gum acacia, cholesterol, tragacanth, stearic
acid, benzalkonium chloride, calcium stearate, glycerol monostearate,
cetostearyl alcohol, cetomacrogol emulsifying wax, sorbitan esters,
polyoxyethylene alkyl ethers, e.g., macrogol ethers such as cetomacrogol
1000, polyoxyethylene castor oil derivatives, polyoxyethylene sorbitan
fatty acid esters, e.g., the commercially available Tweens.TM.,
polyethylene glycols, polyoxyethylene stearates, colloidal silicon
dioxide, phosphates, sodium dodecylsulfate, carboxymethylcellulose
calcium, carboxymethylcellulose sodium, methylcellulose,
hydroxyethylcellulose, hydroxy propylcellulose,
hydroxypropylmethylcellulose phthalate, noncrystalline cellulose,
magnesium aluminum silicate, triethanolamine, polyvinyl alcohol, and
polyvinylpyrrolidone (PVP). Most of these surface modifiers are known
pharmaceutical excipients and are described in detail in the Handbook of
Pharmaceutical Excipients, published jointly by the American
Pharmaceutical Association and The Pharmaceutical Society of Great
Britain, the Pharmaceutical Press, 1986.
Particularly preferred surface modifiers include polyvinylpyrrolidone,
tyloxapol, poloxamers such as Pluronics.TM. F68 and F108, which are block
copolymers of ethylene oxide and propylene oxide, and polyxamines such as
Tetronics.TM. 908 (also known as Poloxamine.TM. 908), which is a
tetrafunctional block copolymer derived from sequential addition of
propylene oxide and ethylene oxide to ethylenediamine, available from
BASF, dextran, lecithin, dialkylesters of sodium sulfosuccinic acid, such
as Aerosol OTs.TM., which is a dioctyl ester of sodium sulfosuccinic acid,
available from American Cyanimid, Duponols.TM. P, which is a sodium lauryl
sulfate, available from DuPont, Tritons.TM. X-200, which is an alkyl aryl
polyether sulfonate, available from Rohn and Haas, Tween.TM. and Tweens.TM.
80, which are polyoxyethylene sorbitan fatty acid esters, available from
ICI Specialty Chemicals; Carbowaxs.TM. 3550 and 934, which are
polyethylene glycols available from Union Carbide; Crodestas.TM. F-110,
which is a mixture of sucrose stearate and sucrose distearate, available
from Croda Inc., Crodestasmi SL-40, which is available from Croda, Inc.,
and SA9OHCO, which is
C.sub.18H.sub.37CH.sub.2(CON(CH.sub.3)CH.sub.2(CHOH).sub.4(CH.sub.2OH).su-
b.2. Surface modifiers which have been found to be particularly useful
include Tetronics.TM. 908, the Tweenss.TM., Pluronics.TM. F-68 and
polyvinylpyrrolidone. Other useful surface modifiers 15 include:
decanoyl-N-methylglucamide; n-decyl .beta.-D-glucopyranoside; n-decyl
.beta.-D-maltopyranoside; n-dodecyl .beta.-D-glucopyranoside; n-dodecyl
.beta.-D-maltoside; heptanoyl-N-methylglucamide; n-heptyl-.beta.-D-glucopyranoside;
n-heptyl .beta.-D-thioglucoside; n-hexyl .beta.-D-glucopyranoside;
nonanoyl-N-methylglucamide; n-noyl .beta.-D-glucopyranoside;
octanoyl-N-methylglucamide; n-octyl-.beta.-D-glucopyranoside; octyl
.beta.-D-thioglucopyranoside; and the like.
Another useful surface modifier is tyloxapol (a nonionic liquid polymer of
the alkyl aryl polyether alcohol type; also known as superinone or
triton). This surface modifier is commercially available and/or can be
prepared by techniques known in the art.
Another preferred surface modifier is p-isononylphenoxypoly(glycidol) also
known as Olin-1OG.TM. or Surfactant 10-G, is commercially available as
1OG.TM. from Olin Chemicals, Stamford, Conn.
Non-Ionic Surface Modifiers
Preferred surface modifiers can be selected from known non-ionic
surfactants, including the poloxamines such as Tetronic.TM. 908 (also
known as Poloxamine.TM. 908), which is a tetrafunctional block copolymer
derived from sequential addition of propylene oxide and ethylene oxide to
ethylenediamine, available from BASF, or Tetronic.TM. 1508 (T-1508), or a
polymer of the alkyl aryl polyether alcohol type, such as tyloxapol.
The surface modifiers are commercially available and/or can be prepared by
techniques known in the art. Two- or more surface modifiers can be used in
combination.
Tyloxapol
Tyloxapol (4-(1,1,3,3-tetramethylbutyl)-phenol polymer with ethylene oxide
and formaldehyde) is a preferred surface modifier and is a nonionic liquid
polymer of the alkyl aryl polyether alcohol type. Tyloxapol, also known as
"Superinone", is disclosed as useful as a nonionic surface active agent in
a lung surfactant composition in U.S. Pat. No. 4,826,821 and as a
stabilizing agent for 2-dimethylaminoethyl 4-n-butylaminobenzoate in U.S.
Pat. No. 3,272,700.
Tyloxapol may be associated with the nanoparticles and may function as a
surface modifier, as a stabilizer, and/or as a dispersant. Alternatively,
the tyloxapol may serve other purposes. Tyloxapol may serve all three
functions. The tyloxapol may serve as a stabilizer and/or a dispersant,
whereas another compound acts as a surface modifier.
Auxiliary Surface Modifiers
Particularly preferred auxiliary surface modifiers are those which impart
resistance to particle aggregation during sterilization and include
dioctylsulfosuccinate (DOSS), polyethylene glycol, glycerol, sodium
dodecyl sulfate, dodecyl trimethyl ammonium bromide and a charged
phospholipid such as dimyristoyl phophatidyl glycerol. The surface
modifiers are commercially available and/or can be prepared by techniques
known in the art. Two or more surface modifiers can be used in
combination.
Block Copolymer Surface Modifiers
One preferred surface modifier is a block copolymer linked to at least one
anionic group. The polymers contain at least one, and preferably two,
three, four or more anionic groups per molecule.
Preferred anionic groups include sulfate, sulfonate, phosphonate,
phosphate and carboxylate groups. The anionic groups are covalently
attached to the nonionic block copolymer. The nonionic sulfated polymeric
surfactant has a molecular weight of 1,000-50,000, preferably 2,000-40,000
and more preferably 3,000-30,000. In preferred embodiments, the polymer
comprises at least about 50%, and more preferably, at least about 60% by
weight of hydrophilic units, e.g., alkylene oxide units. The reason for
this is that the presence of a major weight proportion of hydrophilic
units confers aqueous solubility to the polymer.
A preferred class of block copolymers useful as surface modifiers herein
includes sulfated block copolymers of ethylene oxide and propylene oxide.
These block copolymers in an unsulfated form are commercially available as
Pluronics.TM.. Specific examples of the unsulfated block copolymers
include F68, F108 and F127.
Another preferred class of block copolymers useful herein include
tetrafunctional block copolymers derived from sequential addition of
ethylene oxide and propylene oxide to ethylene diamine. These polymers, in
an unsulfated form, are commercially available as Tetronics.TM..
Another preferred class of surface modifiers contain at least one
polyethylene oxide (PEO) block as the hydrophilic portion of the molecule
and at least one polybutylene oxide (PBO) block as the hydrophobic
portion. Particularly preferred surface modifiers of this class are
diblock, triblock, and higher block copolymers of ethylene oxide and
butylene oxide, such as are represented, for example, by the following
structural formula: PEOPBO; PEOPBOPEO; and PEOPBOPEOPBO. The block
copolymers useful herein are known compounds and/or can be readily
prepared by techniques well known in the art.
Highly preferred surface modifiers include triblock copolymers of the PEO
PBO PEO having molecular weights of 3800 and 5000 which are commercially
available from Dow Chemical, Midland, Mich., and are referred to as
B20-3800 and B20-5000. These surface modifiers contain about 80% by weight
PEO. In a preferred embodiment, the surface modifier is a triblock polymer
having the structure
-- see Original Patent.
The described particles can be prepared in a method comprising the steps
of dispersing a therapeutic or diagnostic agent in a liquid dispersion
medium and applying mechanical means in the presence of grinding media to
reduce the particle size of the therapeutic or diagnostic agent to an
effective average particle size of less than about 400 nm. The particles
can be reduced in size in the presence of a surface modifier.
Alternatively, the particles can be contacted with a surface modifier
after attrition.
The therapeutic or diagnostic agent selected is obtained commercially
and/or prepared by techniques known in the art in a conventional coarse
form. It is preferred, but not essential, that the particle size of the
coarse therapeutic or diagnostic agent selected be less than about 10 mm
as determined by sieve analysis. If the coarse particle size of the
therapeutic or diagnostic agent is greater than about 100 mm, then it is
preferred that the particles of the therapeutic or diagnostic agent be
reduced in size to less than 100 mm using a conventional milling method
such as airjet or fragmentation milling.
The coarse therapeutic or diagnostic agent selected can then be added to a
liquid medium in which it is essentially insoluble to form a premix. The
concentration of the therapeutic or diagnostic agent in the liquid medium
can vary from about 0.1-60%, and preferably is from 5-30% (w/w). It is
preferred, but not essential, that the surface modifier be present in the
premix. The concentration of the surface modifier can vary from about 0.1
to about 90%, and preferably is 1-75%, more preferably 20-60%, by weight
based on the total combined weight of the therapeutic or diagnostic agent
and surface modifier. The apparent viscosity of the premix suspension is
preferably less than about 1000 centipoise.
The premix can be used directly by subjecting it to mechanical means to
reduce the average particle size in the dispersion to less than 1000 nm.
It is preferred that the premix be used directly when a ball mill is used
for attrition. Alternatively, the therapeutic or diagnostic agent and,
optionally, the surface modifier, can be dispersed in the liquid medium
using suitable agitation, e.g., a roller mill or a Cowles type mixer,
until a homogeneous dispersion is observed in which there are no large
agglomerates-visible to the naked eye. It is preferred that the premix be
subjected to such a premilling dispersion step when a recirculating media
mill is used for attrition. Alternatively, the therapeutic or diagnostic
agnet and, optionally, the surface modifier, can be dispersed in the
liquid medium using suitable agitiation, e.g., a roller mill or a Cowles
type mixer, until a homogeneous dispersion is observed in which there are
no large agglomerates visible to the naked eye. It is preferred that the
premix be subjected to such a premilling dispersion step when a
recirculating media mill is used for attrition.
The mechanical means applied to reduce the particle size of the
therapeutic or diagnostic agent conveniently can take the form of a
dispersion mill. Suitable dispersion mills include a ball mill, an
attritor mill, a vibratory mill, and media mills such as a sand mill and a
bead mill. A media mill is preferred due to the relatively shorter milling
time required to provide the intended result, desired reduction in
particle size. For media milling, the apparent viscosity of the premix
preferably is from about 100 to about 1000 centipoise. For ball milling,
the apparent viscosity of the premix preferably is from about 1 up to
about 100 centipoise. Such ranges tend to afford an optimal balance
between efficient particle fragmentation and media erosion.
Preparation Conditions
The attrition time can vary widely and depends primarily upon the
particular mechanical means and processing conditions selected. For ball
mills, processing times of up to five days or longer may be required. On
the other hand, processing times of less than 1 day (residence times of
one minute up to several hours) have provided the desired results using a
high shear media mill.
The particles must be reduced in size at a temperature which does not
significantly degrade the therapeutic or diagnostic agent. Processing
temperatures of less than about 30-40 C are ordinarily preferred. If
desired, the processing equipment can be cooled with conventional cooling
equipment. The method is conveniently carried out under conditions of
ambient temperature and at processing pressures which are safe and
effective for the milling process. For example, ambient processing
pressures are typical of ball mills, attritor mills and vibratory mills.
Control of the temperature, e.g., by jacketing or immersion of the milling
chamber in ice water are contemplated. Processing pressures from about 1
psi (0.07 kg/cm2) up to about 50 psi (3.5 kg/cm2) are contemplated.
Processing pressures from about 10 psi (0.7 kg/cm2) to about 20 psi 1.4
kg/cm2)
The surface modifier, if it was not present in the premix, must be added
to the dispersion after attrition in an amount as described for the premix
above. Thereafter, the dispersion can be mixed, e.g., by shaking
vigorously. Optionally, the dispersion can be subjected to a sonication
step, e.g., using an ultrasonic power supply. For example, the dispersion
can be subjected to ultrasonic energy having a frequency of 20-80 kHz for
a time of about 1 to 120 seconds.
After attrition is completed, the grinding media is separated from the
milled particulate product (in either a dry or liquid dispersion form)
using conventional separation techniques, such as by filtration, sieving
through a mesh screen, and the like.
Grinding Media
The grinding media for the particle size reduction step can be selected
from rigid media preferably spherical or particulate in form having an
average size less than about 3 mm and, more preferably, less than about 1
mm. Such media desirably can provide the particles with shorter processing
times and impart less wear to the milling equipment. The selection of
material for the grinding media is not believed to be critical. We have
found that zirconium oxide, such as 95% ZrO2 stabilized with magnesia,
zirconium silicate, and glass grinding media provide particles having
levels of contamination which are believed to be acceptable for the
preparation of pharmaceutical compositions. However, other media, such as
stainless steel, titania, alumina, and 95% ZrO2 stabilized with yttrium,
are expected to be useful. Preferred media have a density greater than
about 3 g/cm3.
Polymeric Grinding Media
The grinding media can comprise particles, preferably substantially
spherical in shape, e.g., beads, consisting essentially of polymeric
resin. Alternatively, the grinding media can comprise particles comprising
a core having a coating of the polymeric resin adhered thereon.
In general, polymeric resins suitable for use herein are chemically and
physically inert, substantially free of metals, solvent and monomers, and
of sufficient hardness and friability to enable them to avoid being
chipped or crushed during grinding. Suitable polymeric resins include
crosslinked polystyrenes, such as polystyrene crosslinked with
divinylbenzene, styrene copolymers, polycarbonates, polyacetals, such as
Delrin.TM., vinyl chloride polymers and copolymers, polyurethanes,
polyamides, poly(tetrafluoroethylenes), e.g., Teflon.TM., and other
fluoropolymers, high density polyethylenes, polypropylenes, cellulose
ethers and esters such as cellulose acetate, polyhydroxymethacrylate,
polyhydroxyethyl acrylate, silicone containing polymers such as
polysiloxanes and the like. The polymer can be biodegradable. Exemplary
biodegradable polymers include poly(lactides), poly(glycolide) copolymers
of lactides and glycolide, polyanhydrides, poly(hydroxyethyl methacylate),
poly(imino carbonates), poly(N-acylhydroxyproline)esters, poly(N-palmitoyl
hydroxyproline) esters, ethylene-vinyl acetate copolymers,
poly(orthoesters), poly(caprolactones), and poly(phosphazenes). In the
case of biodegradable polymers, contamination from the media itself
advantageously can metabolize in vivo into biologically acceptable
products which can be eliminated from the body.
The polymeric resin can have a density from 0.8 to 3.0 g/cm3. Higher
density resins are preferred inasmuch as it is believed that these provide
more efficient particle size reduction.
The media can range in size from about 0.1 to 3 mm. For fine grinding, the
particles preferably are from 0.2 to 2 mm, more preferably, 0.25 to 1 mm
in size.
In a particularly preferred method, a therapeutic or diagnostic agent is
prepared in the form of submicron particles by grinding the agent in the
presence of a grinding media having a mean particle size of less than
about 75 microns.
The core material of the grinding media preferably can be selected from
materials known to be useful as grinding media when fabricated as spheres
or particles. Suitable core materials include zirconium oxides (such as
95% zirconium oxide stabilized with magnesia or yttrium), zirconium
silicate, glass, stainless steel, titania, alumina, ferrite and the like.
Preferred core materials have a density greater than about 2.5 g/cm3. The
selection of high density core materials is believed to facilitate
efficient particle size reduction.
Useful thicknesses of the polymer coating on the core are believed to
range from about 1 to about 500 microns, although other thicknesses
outside this range may be useful in some applications. The thickness of
the polymer coating preferably is less than the diameter of the core.
The cores can be coated with the polymeric resin by techniques known in
the art. Suitable techniques include spray coating, fluidized bed coating,
and melt coating. Adhesion promoting or tie layers can optionally be
provided to improve the adhesion between the core material and the resin
coating. The adhesion of the polymer coating to the core material can be
enhanced by treating the core material to adhesion promoting procedures,
such as roughening of the core surface, corona discharge treatment, and
the like.
Continuous Grinding
In a preferred grinding process, the particles are made continuously
rather than in a batch mode. The continuous method comprises the steps of
continuously introducing the therapeutic or diagnostic agent and rigid
grinding media into a milling chamber, contacting the agent with the
grinding media while in the chamber to reduce the particle size of the
agent, continuously removing the agent and the grinding media from the
milling chamber, and thereafter separating the agent from the grinding
media.
The therapeutic or diagnostic agent and the grinding media are
continuously removed from the milling chamber. Thereafter, the grinding
media is separated from the milled particulate agent (in either a dry or
liquid dispersion form) using conventional separation techniques, in a
secondary process such as by simple filtration, sieving through a mesh
filter or screen, and the like. Other separation techniques such as
centrifugation may also be employed.
In a preferred embodiment, the agent and grinding media are recirculated
through the milling chamber. Examples of suitable means to effect such
recirculation include conventional pumps such as peristaltic pumps,
diaphragm pumps, piston pumps, centrifugal pumps and other positive
displacement pumps which do not use sufficiently close tolerances to
damage the grinding media. Peristaltic pumps are generally preferred.
Another variation of the continuous process includes the use of mixed
media sizes. For example, larger media may be employed in a conventional
manner where such media is restricted to the milling chamber. Smaller
grinding media may be continuously recirculated through the system and
permitted to pass through the agitated bed of larger grinding media. In
this embodiment, the smaller media is preferably between about 1 and 300
mm in mean particle size and the larger grinding media is between about
300 and 1000 mm in mean particle size.
Precipitation Method
Another method of forming the desired nanoparticle dispersion is by
microprecipitation. This is a method of preparing stable dispersions of
therapeutic and diagnostic agents in the presence of a surface modifying
and colloid stability enhancing surface active agent free of trace of any
toxic solvents or solubilized heavy metal inpurities by the following
procedural steps: 1. Dissolving the therapeutic or diagnostic agent in
aqueous base with stirring, 2. Adding above #1 formulation with stirring
to a surface active surfactant (or surface modifiers) solution to form a
clear solution, and 3. Neutralizing above formulation #2 with stirring
with an appropriate acid solution. The procedure can be followed by: 4.
Removal of formed salt by dialysis or diafiltration and 5. Concentration
of dispersion by conventional means.
This microprecipitation process produces dispersion of therapeutic or
diagnostic agents with Z-average particle diameter less than 400 nm (as
measured by photon correlation spectroscopy) that are stable in particle
size upon keeping under room temperature or refrigerated conditions. Such
dispersions also demonstrate limited particle size growth upon
autoclave-decontamination conditions used for standard blood-pool
pharmaceutical agents.
Step 3 can be carried out in semicontinuous, continuous batch, or
continuous methods at constant flow rates of the reacting components in
computer controlled reactors or in tubular reactors where reaction pH can
be kept constant using pH-stat systems. Advantages of such modifications
are that they provide cheaper manufacturing procedures for large-scale
production of nanoparticulate dispersion systems.
Additional surface modifier may be added to the dispersion after
precipitation. Thereafter, the dispersion can be mixed, e.g., by shaking
vigorously Optionally, the dispersion can be subjected to a sonication
step, e.g., using an ultrasonic power supply. For example, the dispersion
can be subjected to ultrasonic energy having a frequency of 20-80 kHz for
a time of about 1 to 120 seconds.
In a preferred embodiment, the above procedure is followed with step 4
which comprises removing the formed salts by diafiltration or dialysis.
This is done in the case of dialysis by standard dialysis equipment and by
diafiltration using standard diafiltration equipment known in the art.
Preferably, the final step is concentration to a desired concentration of
the agent dispersion. This is done either by diafiltration or evaporation
using standard equipment known in this art.
An advantage of microprecipitation is that unlike milled dispersion, the
final product is free of heavy metal contaminants arising from the milling
media that must be removed due to their toxicity before product is
formulated.
A further advantage of the microprecipitation method is that unlike
solvent precipitation, the final product is free of any trace of trace
solvents that may be toxic and must be removed by expensive treatments
prior to final product formulation.
In another preferred embodiment of the microprecipitation process, a
crystal growth modifier is used. A crystal growth modifier is defined as a
compound that in the co-precipitation process incorporates into the
crystal structure of the microprecipitated crystals of the pharmaceutical
agent, thereby hindering growth or enlargement of the microcrystalline
precipitate, by the so called Ostwald ripening process. A crystal growth
modifier (or a CGM) is a chemical that is at least 75% identical in
chemical structure to the pharmaceutic) agent. By "identical" is meant
that the structures are identical atom for atom and their connectivity.
Structural identity is characterized as having 75% of the chemical
structure, on a molecular weight basis, identical to the therapeutic or
diagnostic agent. The remaining 25% of the structure may be absent or
replaced by different chemical structure in the CGM. The crystal growth
modifier is dissolved in step #1 with the therapeutic or diagnostic agent.
Particle Size
As used herein, particle size refers to a number average particle size as
measured by conventional particle size measuring techniques well known to
those skilled in the art, such as sedimentation field flow fractionation,
photon correlation spectroscopy, or disk centrifugation. When photon
correlation spectroscopy (PCS) is used as the method of particle sizing
the average particle diameter is the Z-average particle diameter known to
those skilled in the art. By "an effective average particle size of less
than about 1000 nm" it is meant that at least 90% of the particles have a
weight average particle size of less than about 1000 nm when measured by
the above-noted techniques. In preferred embodiments, the effective
average particle size is less than about 400 nm and more preferrably less
than about 300 nm. In some embodiments, an effective average particle size
of less than about 100 nm has been achieved. With reference to the
effective average particle size, it is preferred that at least 95% and,
more preferably, at least 99% of the particles have a particle size less
than the effective average, e.g., 1000 nm. In particularly preferred
embodiments essentially all of the particles have a size less than 1000
nm. In some embodiments, essentially all of the particles have a size less
than 400 nm.
Ratios
The relative amount of therapeutic or diagnostic agent and surface
modifier can vary widely and the optimal amount of the surface modifier
can depend, for example, upon the particular therapeutic or diagnostic
agent and surface modifier selected, the critical micelle concentration of
the surface modifier if it forms micelles, the hydrophilic lipophilic
balance (HLB) of the stabilizer, the melting point of the stabilizer, its
water solubility, the surface tension of water solutions of the
stabilizer, etc. The surface modifier preferably is present in an amount
of about 0.1-10 mg per square meter surface area of the therapeutic or
diagnostic agent. The surface modifier can be present in an amount of
0.1-90%, preferably 20-60% by weight based on the total weight of the dry
particle.
Diagnosis
A method for diagnostic imaging for use in medical procedures in
accordance with this invention comprises administering to the body of a
test subject in need of a diagnostic image an effective contrast producing
amount of the diagnostic image contrast composition. In addition to human
patients, the test subject can include mammalian species such as rabbits,
dogs, cats, monkeys, sheep, pigs, horses, bovine animals and the like.
Thereafter, at least a portion of the body containing the administered
contrast agent is exposed to x-rays or a magnetic field to produce an
x-ray or magnetic resonance image pattern corresponding to the presence of
the contrast agent. The image pattern can then be visualized.
Any x-ray visualization technique, preferably, a high contrast technique
such as computed tomography, can be applied in a conventional manner.
Alternatively, the image pattern can be observed directly on an x-ray
sensitive phosphor screen-silver halide photographic film combination or
by use of a storage phosphor screen.
Visualization with a magnetic resonance imaging system can be accomplished
with commercially available magnetic imaging systems such as a General
Electric 1.5 T Sigma imaging system [1H resonant frequency 63.9 megahertz
(MHz)]. Commercially available magnetic resonance imaging systems are
typically characterized by the magnetic field strength used, with a field
strength of 2.0 Tesla as the current maximum and 0.2 Tesla as the current
minimum. For a given field strength, each detected nucleus has a
characteristic frequency. For example, at a field strength of 1.0 Tesla,
the resonance frequency for hydrogen is 42.57 10 MHz; for phosphorus-31 it
is 17.24 MHz; and for sodium 23 it is 11.26 Mhz.
A contrast effective amount of the diagnostic agent containing composition
is that amount necessary to provide tissue visualization with, for
example, magnetic resonance imaging or x-ray imaging. Means for
determining a contrast effective amount in a particular subject will
depend, as is well known in the art, on the nature of the magnetically
reactive material used, the mass of the subject being imaged, the
sensitivity of the magnetic resonance or x-ray imaging system and the
like.
After administration of the compositions, the subject mammal is maintained
for a time period sufficient for the administered compositions to be
distributed throughout the subject and enter the tissues of the mammal.
Typically, a sufficient time period is from about 20 minutes to about 90
minutes and, preferably from about 20 minutes to about 60 minutes.
Claim 1 of 11 Claims
1. A method of treating a respiratory
illness in a mammal comprising the steps of: (a) providing a nebulized
aerosol composition, wherein the composition comprises aqueous droplets
having a particle size of less than ten microns in diameter, wherein the
aqueous droplets comprise: (i) water; (ii) crystalline particles of a
therapeutic agent which is poorly soluble in water, wherein the
crystalline particles have an effective average particle size of less than
400 nm, and wherein the therapeutic agent is present in the aqueous medium
at an amount of from about 0.1% to about 60% (w/w) based on the total
weight of the therapeutic agent and surface modifier; and (iii) at least
one surface modifier adsorbed on the surface of the crystalline
therapeutic agent particles, wherein the surface modifier is present at an
amount of from about 0.1% to about 90% (w/w) based upon the total weight
of the combined therapeutic agent and surface modifier, and wherein the at
least one surface stabilizer is selected from the group consisting of a
polyoxyethylene sorbitan fatty acid ester, lecithin, and a combination of
a polyoxyethylene sorbitan fatty acid ester and lecithin; and (b)
administering the aerosol composition to the lungs of the mammal, wherein
the therapeutic agent is not beclomethasone, wherein the therapeutic agent
is budesonide. ____________________________________________
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