Pharmaceutical compositions for treating ocular diseases or disorders
A biodegradable polymer matrix in vitreous implants addresses the challenges of frequent steroid injections by providing sustained, linear drug release for ocular diseases, enhancing treatment efficacy and reducing side effects.
Patent Information
- Application Number
- JP2024176400
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2019-03-05
- Filing Date
- 2024-10-08
- Publication Date
- 2025-01-14
- Estimated Expiration
- 2040-03-05
AI Technical Summary
Current treatments for ocular diseases such as macular edema and uveitis require frequent steroid injections, which can lead to side effects like cataract formation and increased intraocular pressure, while existing vitreous implants either provide insufficient therapeutic agent duration or prolonged exposure leading to further complications.
Development of a biodegradable polymer matrix comprising a mixture of biodegradable polyesteramide, poly(D,L-lactide), and poly(D,L-lactide-co-glycolide) polymers, uniformly dispersed with therapeutic agents, designed for intravitreal administration to release drugs in a substantially linear manner over extended periods, reducing the need for frequent injections.
The pharmaceutical compositions provide sustained release of therapeutic agents for up to several months, minimizing side effects and improving patient compliance by maintaining effective drug levels without the need for daily eye drops or multiple injections.
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Abstract
Description
[Technical field]
[0001] (Related Applications) This application claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 814,198, filed March 5, 2019, which is incorporated by reference in its entirety herein.
[0002] (Technical field) The present invention relates to pharmaceutical compositions, implants formed from the pharmaceutical compositions, methods of forming the implants, and methods of treating ocular diseases and disorders. [Background technology]
[0003] Ocular inflammatory diseases or disorders such as macular edema, retinal vein occlusion, and uveitis can cause blurred vision, double vision, floaters, eye pain, vision loss, and in severe cases, can lead to blindness.
[0004] Corticosteroids such as dexamethasone (Ozurdex®) or triamcinolone acetonide (TRIESENCE®) can be injected via intravitreal injection (IVT) for treatment. Repeated bolus injections of corticosteroids such as TRIESENCE® are associated with cataract formation, increased intraocular pressure, floaters, endophthalmitis, decreased vision, and retinal damage. Patients may receive numerous injections over the course of treatment. This regimen places a burden on patients and medical personnel.
[0005] Vitreous implants have been developed that deliver sustained concentrations of therapeutic agents over a period of time. These implants are injected or surgically implanted into the vitreous of the eye for the release of therapeutic agents to the posterior segment of the eye. For example, OZURDEX® is a vitreous implant used to slowly release dexamethasone to treat various eye diseases or disorders. However, sufficient levels of therapeutic agents are only released for approximately 30 to 60 days, after which a new implant must be injected into the patient's eye. Repeated injections can result in pain, headache, conjunctival blood spots, intraocular infections, eyeball perforation, extraocular muscle fibrosis, vitreous detachment, reactions to delivery vehicles, increased intraocular pressure, and cataract development. As an alternative, a fluocinolone acetonide-containing vitreous implant (ILUVIEN®) has also been developed that releases fluocinolone acetonide over a period of approximately 3 years. The period of corticosteroid exposure is often too long for many patients and can lead to an increased risk of corticosteroid-associated side effects, including cataract formation and elevated intraocular pressure.
[0006] Various biodegradable polymers have been used to manufacture such vitreous implants. Specific examples of such polymers include polylactic acid-co-glycolic acid (PLGA) and polylactic acid (PLA) and various analogs or derivatives. For example, US Pat. No. 5,399,633, incorporated herein by reference, discloses, inter alia, a pharmaceutical composition for treating an ocular disease or disorder comprising a biodegradable polymer matrix and at least one therapeutic agent dispersed within the polymer matrix, the polymer matrix may comprise a biodegradable poly(D,L-lactide) homopolymer, a biodegradable poly(D,L-lactide-co-glycolide), or a mixture thereof. Biodegradable polyesteramide (PEA) polymers for use in biodegradable implants have been described above. PEA is based on amino acids and contains several peptide bonds. Synthetic methods for preparing PEA are described, for example, in US Pat. No. 5,399,633, incorporated herein by reference in its entirety. The general structural formula of polyesteramides, and in particular polyesteramide copolymers, is described in US Pat. No. 5,399,633, the entirety of which is incorporated herein by reference, and is as follows: [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8 is -(CH2)4-.)
[0007] In the medical field relating to therapeutics, such as pharmaceutical compositions formulated into delivery systems, there is a great need for vitreous implants with improved safety and efficacy profiles that release therapeutic agents directly to the posterior segment of the eye in a substantially linear manner over a period of at least three months. Such pharmaceutical compositions could improve both the compliance and adverse event profiles of current vitreous implants.
[0008] Citation of any document herein should not be construed as an admission that such document is available as prior art to the present invention. [Prior art documents] [Patent documents]
[0009] [Patent Document 1] International Publication No. 2017 / 015604 [Patent Document 2] US Patent Application Publication No. 2008 / 0299174 [Patent Document 3] U.S. Pat. No. 9,789,189 Summary of the Invention [Problem to be solved by the invention]
[0010] The present invention broadly encompasses a pharmaceutical composition for treating an ocular disease or disorder, comprising a biodegradable polymer matrix comprising a mixture of a first polymer and a second polymer, where (1) the first polymer is a biodegradable polyesteramide polymer, and (2) the second polymer is (i) a biodegradable poly(D,L-lactide) polymer, (ii) a biodegradable poly(D,L-lactide-co-glycolide) polymer, or (iii) a combination of (i) and (ii). At least one therapeutic agent, or an analog or derivative thereof, a pharma- ceutical acceptable salt, zwitterion, polymorph, or solvate thereof, is homogeneously dispersed within the polymer matrix. In certain embodiments, the pharmaceutical composition of the present invention is formulated for intravitreal administration to the eye of a subject.
[0011] Current treatments for various eye diseases or disorders, such as elevated intraocular pressure or inflammation, require patients to administer daily eye drops to their eyes or receive multiple steroid injections into the eye. The pharmaceutical compositions of the present invention are designed to release a therapeutically effective amount of at least one therapeutic agent in a substantially linear manner, eliminating the need for daily eye drops and multiple steroid injections.
[0012] In certain embodiments, the pharmaceutical compositions of the present invention are formulated to provide a substantially linear release of a therapeutically effective amount of at least one therapeutic agent over a period of approximately 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, or longer.
[0013] In some embodiments, there is provided a pharmaceutical composition for treating an eye disease or disorder, comprising: (a) a biodegradable polymer matrix comprising a mixture of a first polymer and a second polymer, (1) the first polymer is a biodegradable polyesteramide polymer (PEA); (2) the second polymer is a biodegradable poly(D,L-lactide) polymer (PLA), a biodegradable polyglycolide polymer (PGA), a biodegradable poly(D,L-lactide-co-glycolide) polymer (PLGA), or a combination thereof; a biodegradable polymer matrix; (b) at least one therapeutic agent, or an analog, derivative, pharma- ceutically acceptable salt, zwitterion, polymorph, or solvate thereof, or an analog, derivative, pharma-ceutically acceptable salt, zwitterion, polymorph, or solvate thereof, homogeneously dispersed within the polymer matrix; Provided herein is a pharmaceutical composition comprising:
[0014] In some embodiments, the pharmaceutical compositions provided herein are formulated for intravitreal administration to the eye of a subject, and the pharmaceutical compositions are formulated to release at least one therapeutic agent from the pharmaceutical composition in a substantially linear manner over a period of about 1 month to about 6 months.
[0015] A number of therapeutic agents have use in the pharmaceutical compositions of the invention, including (a) those that modulate, and in particular inhibit, the activity of kinases such as Rho kinase, JAK kinase, vascular endothelial growth factor receptor (VEGF-R), or tyrosine kinase, (b) prostaglandins, (c) corticosteroids, or (d) any combination of (a)-(c).
[0016] In some embodiments, therapeutic agents include those that modulate, and in particular inhibit, the activity of kinases such as IKK kinase.
[0017] Specific therapeutic agents, as well as their analogs or derivatives, solvates, pharma- ceutically acceptable salts, polymorphs, and zwitterions, include, but are not limited to, the following: Corticosteroids, such as dexamethasone, fluocinolone acetonide, budesonide, beclomethasone, beclomethasone (e.g. as the mono- or dipropionate ester), flunisolide, fluticasone (e.g. as the propionate or furoate ester), ciclesonide, mometasone (e.g. as the furoate ester), mometasone desonide, rofleponide, hydrocortisone, prednisone, prednisolone, methylprednisone Zolone, nafrocort, deflazacort, halopredone acetate, fluocinolone acetonide, fluocinonide, clocortolone, tipredane, prednicarbate, alclometasone dipropionate, halometasone, rimexolone, deprodone propionate, triamcinolone, betamethasone, fludrocortisone, desoxycorticosterone, rofleponide, etiprednol dicloacetate, and the like, or any combination thereof; Prostaglandins, such as latanoprost, bimatoprost, travoprost, tafluprost, 3-hydroxy-2,2-bis(hydroxymethyl)propyl 7-((1r,2r,3r,5s)-2-((r)-3-(benzo[b]thiophen-2-yl)-3-hydroxypropyl)-3,5-dihydroxycyclopentyl)heptanoate, having the following structural formula: [ka] , cloprostenol isopropyl ester, 13,14-dihydrocloprostenol isopropyl ester, latanoprostene bunod, unoprostone, PGF 1α Isopropyl ester, PGF 2α Isopropyl ester, PGF 3α isopropyl ester, fluprostenol, or any combination thereof; Rho kinase (ROCK) inhibitors, such as netarsudil or ripasudil or a pharma- ceutically acceptable salt thereof; JAK kinase inhibitors, such as ruxolitinib ("JAKAFI" and "JAKAVI") against JAK1 / JAK2, tofacitinib ("XELJANZ" and "JAKVINUS") against JAK3, oclacitinib ("APOQUEL") against JAK1, and baricitinib ("OLUMIANT") against JAK1 / JAK2, and Receptor tyrosine kinase inhibitors, such as gefitinib, lapatinib, erlotinib, sunitinib, sorafenib, regorafenib, afatinib, vandetanib, semaxanib, cediranib, neratinib, axitinib, lestaurtinib, tivozanib, or any combination thereof.
[0018] In some embodiments, the therapeutic agent comprises dukeprost or tiaprost.
[0019] In some embodiments, the therapeutic ROCK inhibitor comprises 3-amino-N-(1-oxo-1,2-dihydroisoquinolin-6-yl)-2-(thiophen-3-yl)propanamide, (S)-3-amino-2-(4-(hydroxymethyl)phenyl)-N-(isoquinolin-6-yl)propanamide, (1R,2R)-N-(4-methylisoquinolin-6-yl)-2-(4-(N-(pyridin-2-yl)sulfamoyl)phenyl)cyclopropane-1-carboxamide, or a pharma- ceutical acceptable salt thereof.
[0020] In some embodiments, the therapeutic agent comprises a cyclopropylamide JAK inhibitor, including CAS#2246332-69-2 and its (R,R) isomers 2246332-34-1, CAS#2246331-96-2, CAS#2246331-95-1, CAS#2246331-94-0, CAS#2246331-82-6.
[0021] In some embodiments, the therapeutic agent comprises a prodrug of the therapeutic agent described.
[0022] In the pharmaceutical composition of the present invention, the ratio of the amount of polymer 1 to polymer 2, and the amount of components used in polymer 2 when polymer 2 is a combination of multiple polymers, is very important to design a pharmaceutical composition having the desired properties of the amount of at least one therapeutic agent delivered substantially linearly and the duration over which such delivery occurs substantially linearly. In a particular embodiment of the pharmaceutical composition of the present invention, the polymer matrix is 60% by weight of a biodegradable polyesteramide polymer; 20% by weight of a biodegradable poly(D,L-lactide) polymer, and 20% by weight of biodegradable poly(D,L-lactide-co-glycolide) polymer; Includes.
[0023] Furthermore, certain embodiments of the pharmaceutical composition of the present invention comprise About 59% by weight of a polymer matrix, about 60% by weight of the polymer matrix is a biodegradable polyesteramide polymer; About 20% by weight of the polymer matrix is a biodegradable poly(D,L-lactide) polymer; and About 20% by weight of the polymer matrix is a biodegradable poly(D,L-lactide-co-glycolide) polymer; A polymer matrix; About 41% by weight of at least one therapeutic agent; Includes.
[0024] One such particular therapeutic agent that has use in the pharmaceutical compositions of the present invention is dexamethasone.
[0025] The pharmaceutical compositions of the present invention may be formulated for intravitreal administration to the eye of a subject, where the release of the at least one therapeutic agent is substantially linear, such that about 1% of the total at least one therapeutic agent is released per day for about three months.
[0026] Numerous methods are available to one of skill in the art for forming the polymer matrix of the pharmaceutical compositions of the present invention. Certain methods involve mechanically blending the first and second polymers. Other methods are described below.
[0027] Similarly, the amount of at least one therapeutic agent loaded into the pharmaceutical compositions of the present invention can vary depending on the desired amount of therapeutic agent to be delivered substantially linearly and the duration over which the substantially linear delivery is to occur. In certain embodiments, the pharmaceutical compositions of the present invention comprise (a) about 51% by weight of a polymer matrix, and (b) about 49% by weight of at least one therapeutic agent.
[0028] The biodegradable (D,L-lactide) polymer used in the pharmaceutical composition of the present invention can be an acid end-capped biodegradable poly(D,L-lactide) homopolymer or an ester end-capped poly(D,L-lactide) homopolymer.
[0029] Similarly, the poly(D,L-lactide-co-glycolide) polymer used in the pharmaceutical composition of the present invention can be an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer or an acid-capped biodegradable poly(D,L-lactide-co-glycolide).
[0030] A wide variety of polyesteramides (PEAs) have utility in the pharmaceutical compositions of the present invention. Generally, such PEAs comprise the following chemical structure (I): [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4 are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8 is -(CH2)4-.)
[0031] A particular PEA having use in the pharmaceutical compositions of the present invention has the following chemical structure (III): [ka] (III)
[0032] Other examples of PEA's that have use in the present invention are disclosed in US Pat. No. 9,873,765 and US Pat. No. 9,789,189, which are hereby incorporated by reference in their entireties.
[0033] Also provided is a vitreous implant for treating an ocular disease or disorder comprising the pharmaceutical composition of the present invention. Numerous methods are available for manufacturing the vitreous implant of the present invention. One particular method that has application in the present invention is PRINT® technology particle manufacturing. Using PRINT® technology, vitreous implants can be mass produced with a consistent and predictable customized therapeutic release profile with high reproducibility from implant to implant that is not possible with other technologies such as extrusion. PRINT® technology, which is used to manufacture the vitreous implant of the present invention and the particles used in the particle suspension of the present invention, is disclosed in WO 2007 / 021762, WO 2007 / 024323, and WO 2007 / 030698, which are incorporated herein by reference in their entirety. Mold cavities used to manufacture the intravitreal implants of the present invention may vary from the stated dimensions by ±50 μm, or ±40 μm, or ±30 μm, or ±20 μm, or ±10 μm, or ±5 μm, in various embodiments.
[0034] PRINT® technology allows for the creation of vitreous implants with therapeutic agent release profiles that are free of statistically significant variations. As a result, at least one therapeutic agent release profile exemplified in an embodiment of the implant exhibits a coefficient of variation that is within a confidence interval and does not affect the substantially linear manner in which the therapeutic agent is released. The ability to manufacture vitreous implants of the present invention that exhibit a high degree of consistency in therapeutic agent loading and release is an advantage over the state of the art.
[0035] In certain embodiments of the present invention, 1. A pharmaceutical composition comprising: (a) about 59% by weight of a polymer matrix, (i) about 60% by weight of a biodegradable polyesteramide polymer having the structure: [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4 are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8is -(CH2)4-.) (ii) about 20% by weight of a biodegradable poly(D,L-lactide) homopolymer, and (iii) about 20% by weight of a biodegradable poly(D,L-lactide-co-glycolide) copolymer; Including, (i), (ii), and (iii) are blended together to form the polymer matrix. A polymer matrix; (b) about 41% by weight of dexamethasone uniformly dispersed within said polymer matrix; Including, The pharmaceutical composition is formulated for intravitreal administration to an eye of a subject; and the dexamethasone is released in a substantially linear manner such that about 1% of the total amount of the at least one therapeutic agent contained therein is released per day for about three months; Pharmaceutical compositions include An intravitreal implant is provided.
[0036] Also provided is a method for treating an ocular disease or disorder in a human in need thereof, comprising administering at least one vitreous implant of the present invention to the vitreous humor of the human's eye.
[0037] Ocular diseases or disorders that can be treated with the intravitreal implants of the present invention include, but are not limited to, elevated intraocular pressure, ocular inflammatory diseases or disorders, glaucoma, neurodegenerative diseases or disorders, or combinations thereof.
[0038] Examples of ocular inflammatory diseases or disorders that can be treated by the pharmaceutical compositions and vitreous implants of the present invention include, but are not limited to, uveitis, corneal ulcers, endophthalmitis, autoimmune diseases of the cornea or ocular surface, ocular symptoms of HIV disease, or combinations thereof. In some embodiments, the ocular inflammatory disease or disorder is ocular herpes. Non-limiting examples of specific neurodegenerative diseases or disorders that can be treated by the present invention include diabetic eye disease, macular degeneration (wet or dry), inflammation, or dry eye. [Brief description of the drawings]
[0039] For a better understanding of the above and other aspects of the present invention, please refer to the following drawings and detailed description.
[0040] [Figure 1] Graph plotting the average daily release of dexamethasone from various pharmaceutical compositions of the invention (Samples 8-15). [Diagram 2] Graph of the cumulative percentage of dexamethasone released from intravitreal implant 7. [Diagram 3] Graph of the average daily release rate of dexamethasone from intravitreal implant 7. [Figure 4] Graph of the cumulative percentage of therapeutic agent released over time from Sample 16. [Diagram 5] Graph of the cumulative percentage of therapeutic agent released over time from Sample 17. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0041] The present invention provides novel pharmaceutical compositions and therapeutic agent delivery systems, specifically vitreous implants, and methods of making and using the same for sustained release of at least one therapeutic agent in a substantially linear manner into the eye. A novel family of degradable polymer matrices was prepared by blending biodegradable poly(D,L-lactide) polymers, biodegradable poly(D,L-lactide-co-glycolide) polymers, and polyesteramides. The pharmaceutical compositions of the present invention extend to biodegradable therapeutic agent delivery systems comprising a polymer matrix and a therapeutic agent contained within the polymer matrix. Using PRINT® technology, a vitreous implant was developed from the pharmaceutical compositions of the present invention that delivers high sustained concentrations of at least one therapeutic agent in a substantially linear manner for a period of up to 5 months in vitro. The present invention extends to biodegradable vitreous implants with highly uniform, tunable and reproducible size, shape, loading, composition, and loading distribution, and desired sustained release profiles of therapeutic agents, making them useful for treating various ocular diseases or disorders.
[0042] The present invention is based on the unexpected and surprising discovery that by creating a polymer matrix comprising a PEA polymer, a PLGA polymer and / or a PLA polymer, or a combination thereof, and at least one therapeutic agent contained within the polymer matrix, at least one therapeutic agent is released in a substantially linear manner for at least 3 months, 4 months, 5 months, 6 months, or longer. Although not obligated and certainly not wishing to be bound by any description of the amount of therapeutic agent released or the substantially linear manner in which the therapeutic agent is released from the pharmaceutical composition of the present invention over the time period described herein, it is presumed that unique and novel polymer matrices can be produced by blending two or more different types of polymers, and different degrees of phase separation blends can be obtained depending on the thermodynamic properties and miscibility of the polymers selected to form the polymer matrix. By varying the ratio of the polymers used in the polymer matrix, i.e., the ratio between the first polymer and the second polymer (and adjusting the amount of the second polymer component), the hydrophobicity of the polymer matrix can be adjusted. Furthermore, the pharmaceutical composition having the claimed polymer matrix released at least one therapeutic agent in a substantially linear manner. Controlling this hydrophobicity and the amount of therapeutic agent contained within the polymer matrix allows for control of the amount of therapeutic agent that is released in a substantially linear manner and the period over which such substantially linear release occurs. Thus, the present invention allows for the design of pharmaceutical compositions to release therapeutic agent in a substantially linear manner over a particular period of time.
[0043] Broadly, the present invention extends to pharmaceutical compositions for treating ocular diseases or disorders. Such pharmaceutical compositions of the present invention include a biodegradable polymer matrix comprising a mixture of a first polymer and a second polymer, the first polymer being a biodegradable polyesteramide, and the second polymer being selected from (a) a biodegradable poly(D,L-lactide) polymer, (b) a biodegradable poly(D,L-lactide-co-glycolide) copolymer, and (c) a combination of (a) and (b). The pharmaceutical compositions of the present invention further include at least one therapeutic agent homogeneously dispersed within the polymer matrix, the pharmaceutical composition being formulated to release the at least one therapeutic agent from the pharmaceutical composition in a substantially linear manner over at least about 1 month, about 2 months, about 3 months, about 4 months, about 5 months, about 6 months, or longer. Optionally, the pharmaceutical composition may be formulated as an intravitreal implant for intravitreal administration to the eye of a subject. The PRINT® technology described and illustrated below can be used to manufacture such intravitreal implants of the present invention.
[0044] A number of terms and phrases are used throughout this specification and claims and are defined below.
[0045] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention.
[0046] It is also noted that the reagents described herein are merely exemplary and that equivalents thereof are known in the art.
[0047] As used herein, unless otherwise stated, the term “alkyl,” by itself or as part of another substituent, refers to an alkyl group having the designated number of carbon atoms (e.g., C 1-6means a straight or branched chain hydrocarbon having from 1 to 6 carbon atoms, including straight, branched, or cyclic substituents. Examples include, but are not limited to, methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, pentyl, neopentyl, hexyl, and cyclopropylmethyl. Most preferred are (C 1-6 ) Alkyl, in particular ethyl, methyl, isopropyl, isobutyl, n-pentyl, n-hexyl, and cyclopropylmethyl.
[0048] As used herein, "alkenyl" refers to unsaturated aliphatic hydrocarbon moieties, including straight-chain and branched-chain groups. An alkenyl moiety necessarily contains at least one alkene. "Alkenyl" may be exemplified by groups such as ethenyl, n-propenyl, isopropenyl, n-butenyl, and the like. Alkenyl groups may be substituted or unsubstituted. Two or more substituents may be present. When substituted, the substituent is preferably alkyl, halogen, or alkoxy. The substituents themselves may also be substituted. The substituents may be located on the alkene itself as well as on adjacent member atoms or on the alkynyl moiety.
[0049] As used herein, "alkynyl" refers to unsaturated aliphatic hydrocarbon moieties, including straight-chain and branched-chain groups. An alkynyl moiety necessarily contains at least one alkyne. "Alkynyl" may be exemplified by groups such as ethynyl, propynyl, n-butynyl, and the like. An alkynyl group may be substituted or unsubstituted. Two or more substituents may be present. When substituted, the substituent is preferably alkyl, amino, cyano, halogen, alkoxyl, or hydroxyl. The substituent may itself be substituted. The substituents may be located on the alkyne itself, as well as on adjacent member atoms or on the alkynyl moiety.
[0050] As used herein, unless otherwise specified, "aryl", alone or in combination with other terms, refers to a carbocyclic aromatic system containing one or more rings (typically one, two or three rings), which may be pendant together, such as biphenyl, or fused together, such as naphthalene. Examples of aryl groups include phenyl, anthracyl, and naphthyl. Preferred examples are phenyl and naphthyl, and most preferred is phenyl.
[0051] In this specification, the number of carbon atoms in a substituent is defined as "C x-y " or "C x -C y " where x is the minimum and y is the maximum number of carbon atoms in the substituent.
[0052] As used herein, a "protecting group" refers to a protecting group moiety, e.g., as described in "Protective Groups in Organic Synthesis" by T. Green and P. Wuts, 3rd ed., John Wiley and Sons, 1999. For example, a carboxylic acid group can be protected as an ester, e.g., an alkyl ester (e.g., methyl ester, t-butyl ester), a haloalkyl ester (e.g., haloalkyl ester), a trisalkylsilylalkyl ester, or an arylalkyl ester (e.g., benzyl ester, nitrobenzyl ester), or as an amide, e.g., a methylamide.
[0053] The term "treatment" refers to the application of one or more specific treatments used to improve a disease. In some embodiments, the specific treatment is the administration of one or more therapeutic agents. "Treatment" of an individual (e.g., a mammal, such as a human) or cell is any type of intervention used to attempt to change the natural course of an individual or cell. Treatment includes, but is not limited to, the administration of a pharmaceutical composition and may be performed prophylactically or following the onset of a pathological event or contact with a pathogen. Treatment includes any desired effect on the symptoms and pathology of a disease or condition, and may include, for example, a minimal change or improvement in one or more measurable markers of the disease or condition during treatment. Also included is "prophylactic" treatment, which may be directed to reducing the rate of progression of the disease or condition during treatment, delaying the onset of the disease or condition, or reducing its severity upon onset. An "effective amount" or "therapeutically effective amount" refers to an amount of a therapeutic agent administered to a mammalian subject, either as a single dose or as part of a series, effective to produce the desired therapeutic effect.
[0054] As used herein, "pharmaceutical acceptable salts" refers to derivatives of the compounds disclosed herein, where the parent compound is modified by converting an existing acid or base moiety into its salt form. Lists of suitable salts are found in "Remington's Pharmaceutical Sciences, 17th ed." (Mack Publishing Company, Easton, Pennsylvania, 1985, p. 1418) and Journal of Pharmaceutical Science, Vol. 66, No. 2 (1977), which are incorporated herein by reference in their entireties.
[0055] As used herein, singular references also include plural references unless the context clearly dictates otherwise.
[0056] As used herein, the term "comprising" means that the compositions and methods include the recited elements and do not exclude other elements.
[0057] "About" and "approximately" are interchangeable and refer to the number, parameter, or property qualified thereby plus or minus a certain percentage (e.g., ±5%), which will be understood by those of skill in the art as appropriate to the scientific context in which the term is used. Furthermore, all numbers, values, and expressions referring to quantities used herein are subject to various measurement uncertainties encountered in the art. Thus, unless otherwise specified, all values given may be understood as modified by the term "about".
[0058] Wherever numerical ranges are disclosed herein, such ranges are continuous and include both the minimum and maximum values of the range, as well as every number between such minimum and maximum values. Furthermore, where a range refers to an integer, every integer between such minimum and maximum values is included. Also, where multiple ranges are provided to describe a feature or characteristic, these ranges may be combined. That is, unless otherwise indicated, all ranges disclosed herein should be understood to include all subranges subsumed therein. For example, a range described as "1 to 10" should be understood to include every subrange between the minimum value of 1 and the maximum value of 10.
[0059] As used herein, a "therapeutic agent" refers to a compound or substance within a pharmaceutical composition that is biologically active and produces the effect of the pharmaceutical composition.
[0060] As used herein, the term "pharmaceutical composition" refers to a composition that includes a therapeutic agent, excipients, carriers, etc. Generally, a pharmaceutical composition is administered to a patient, rather than a therapeutic agent alone.
[0061] As used herein, "eye disease or disorder" or "ocular disease or disorder" may be used interchangeably and include, but are not limited to, glaucoma, allergies, inflammatory eye diseases or disorders, ocular hypertension, eye cancer, neurodegenerative eye diseases or disorders (such as diabetic macular edema (DME) and wet or dry age-related macular degeneration (AMD)), uveitis, diabetic retinopathy, and dry eye.
[0062] As used herein, a "kinase" is a type of enzyme that transfers a phosphate group from a high-energy donor, such as ATP, to a specific target molecule (substrate), a process called phosphorylation.
[0063] As used herein, "Receptor Tyrosine Kinase (RTK)" refers to a receptor protein with intracellular kinase activity selected from the RTK family of proteins described in Schlessinger (Cell, vol. 103, pp. 211-225, 2000). "Receptor tyrosine kinase dimer" refers to a complex in the cell surface membrane that contains two receptor tyrosine kinase proteins. In some embodiments, a receptor tyrosine kinase dimer may contain two covalently linked receptor tyrosine kinase proteins. Particularly noteworthy RTK dimers are Her receptor dimers and VEGFR dimers. Receptor tyrosine kinases are an important class of receptors involved in many fundamental cellular processes, including cell proliferation, survival, metabolism, and migration (e.g., Schlessinger, Cell, vol. 103, pp. 211-225, 2000). Well-known families of this class include epidermal growth factor receptor (EGFR or Her1), platelet-derived growth factor receptor (PDGFR), fibroblast growth factor receptor (FGFR), and vascular endothelial growth factor receptor (VEGFR). The class of receptor tyrosine kinases is so named because, when activated by dimerization, the intracellular domain of the RTK acquires tyrosine kinase activity, which in turn can activate various signaling pathways. As a result, RTKs are important components of signaling pathways that mediate cell-cell communication and their functions as relays in signaling pathways. They have important roles in numerous processes, controlling cell proliferation and differentiation, controlling cell growth and cell metabolism, and promoting cell survival and apoptosis. Because of this property, many receptor tyrosine kinases have been used as targets for drug development, as well as several promising clinical phase therapeutic agents, such as IRESSA® (gefitinib) and TARCEVA® (erlotinib), which are designed to inhibit RTK activity (e.g., Taxler, Expert Opin. Ther. Targets, vol. 7, pp. 215-234, 2003).The availability of convenient methods to measure pathway activation could lead to a better understanding of therapeutic mechanisms and improved therapeutic agent selection and disease management (Mirshafiey et al., Innov. Clin. Neursci. 11, 7-8, 23-26, 2014).
[0064] As used herein, Janus Kinase (JAK) refers to a cytoplasmic tyrosine kinase that transmits cytokine signals from membrane receptors to STAT transcription factors. Four JAK family members are known: JAK1, JAK2, JAK3, and TYK2. Upon cytokine binding to its receptor, JAK family members transphosphorylate and / or autophosphorylate each other, after which STATs are phosphorylated and translocate to the nucleus to regulate transcription. JAK-STAT intracellular signaling is suitable for interferons, most interleukins, and various cytokines and endocrine factors such as EPO, TPO, GH, OSM, LIF, CNTF, GM-CSF, and PRL (Vainchenker W. et al., 2008).
[0065] The JAK family is involved in intracellular signal transduction from over 70 different cytokines. Cytokines bind to their cell surface receptors, triggering receptor dimerization and subsequent activation / phosphorylation of JAK tyrosine kinases. JAKs are either constitutively associated with receptors or are recruited upon cytokine binding. Specific tyrosine residues on the receptor are then phosphorylated by activated JAKs and serve as docking sites for STAT proteins. STATs are phosphorylated by JAKs, dimerize, and translocate to the nucleus where they bind to specific DNA factors and activate gene transcription. JAK1 signals with all JAK isoforms in a cytokine-dependent manner.
[0066] JAKs are essential for multiple physiological functions, and these essential JAK functions have been demonstrated using genetically engineered mouse models lacking specific JAKs. - / -Mice died perinatally, whereas Jak2 - / - Mice suffer from erythropoiesis and die around E12. - / - Mice are viable but have a SCID phenotype with T cell, B cell, and NK cell deficiencies. - / - Mice exhibit features of the hyper-IgE syndrome, a phenotype that indicates an essential and non-redundant role for JAK activity in vivo (K. Ghoreschi, A. Laurence, J. J. O'Shea, Immunol. Rev. 228, 273, 2009).
[0067] Furthermore, mutations in JAK enzymes have been linked to human disease. Inactivating mutations in JAK3 (or the cognate common gamma chain cytokine receptor) cause a severe SCID phenotype (JJ O'Shea, M. Pesu, DC Borie, PS Changelian, Nat. Rev. Drug Discov. 3, 555, 2004). Deletion of TYK2 leads to hyper-IgG syndrome and increased risk of infection (Y. Minegishi et al., Immunity 25, 745, 2006). Consistent with mouse data showing that mice lacking JAK1 and JAK2 are nonviable, no inactivating mutations have been reported for JAK1 and JAK2. However, several mutations leading to constitutively active JAK2 have been identified, which lead to myeloproliferative disorders, confirming the central role of JAK2 in hematopoiesis (O. bdel-Wahab, Curr. Opin. Hematol. 18, 117, 2011). JAK2 is the only JAK family member involved in signaling of the crucial hematopoietic cytokines IL-3, GMCSF, EPO, and TPO.
[0068] Furthermore, JAKs play multiple roles in cytokine signaling granules in both immune and non-immune cells. Autoimmunity is caused by an abnormal adaptive immune response to self-antigens, and JAK-STAT (signal transducer and activator of transcription) signaling is known to play a key role in this process. Therefore, JAK inhibitors may have considerable potential for the development of therapeutic agents to treat autoimmunity. JAK3 is a particularly attractive target because its expression is restricted to the immune system, unlike other JAKs.
[0069] A large body of literature has been accumulated linking the JAK / STAT pathway to a variety of diseases and disorders, including hyperproliferative disorders, cancers (such as leukemia and lymphoma), immune and inflammatory disorders (such as transplant rejection), asthma, chronic obstructive pulmonary disease, allergies, rheumatoid arthritis, type 1 diabetes, amyotrophic lateral sclerosis, eye diseases or disorders, and multiple sclerosis, making them targets for the development of a number of therapeutic agents to modulate, and particularly inhibit, their activity.
[0070] As used herein, "Rho-associated protein kinase" or "Rho kinase" (ROCK) is a key intracellular regulator of cytoskeletal dynamics and cell motility. Rho kinase regulates multiple downstream targets of Rho A, including, for example, myosin light chain, binding subunit of myosin light chain phosphatase, and LIM kinase 2, via phosphorylation. These substrates control actin fiber organization and contractility. In smooth muscle cells, Rho kinase regulates calcium sensitization and smooth muscle contraction. Inhibition of Rho kinase blocks 5-HT and phenylephrine agonist-induced muscle contraction. When introduced into non-smooth muscle cells, Rho kinase induces stress fiber formation and is required for Rho A-regulated cell transformation. Rho kinase is involved in a variety of cellular processes, including, but not limited to, cell adhesion, cell motility and migration, growth control, cell contraction, and cytokines. Rho kinase is also involved in activation of the Na / H exchange system, stress fiber formation, adducin activation, and physiological processes (vasoconstriction, bronchial smooth muscle contraction, proliferation of vascular smooth muscle and endothelial cells, platelet aggregation, etc.).
[0071] Inhibition of Rho kinase activity in animal models has been shown to provide numerous benefits for the treatment of human diseases. These include models of cardiovascular disease (hypertension, atherosclerosis, restenosis, cardiac hypertrophy, high intraocular pressure, cerebral ischemia, cerebral vasospasm, penile erectile dysfunction, etc.), models of central nervous system disorders (neurodegeneration and spinal cord injury, etc.), and models of neoplasia. Inhibition of Rho kinase activity has been shown to inhibit tumor cell growth and metastasis, angiogenesis, arterial thrombotic disorders (platelet aggregation and leukocyte aggregation, etc.), asthma, intraocular pressure control, and bone resorption. Inhibition of Rho kinase activity in patients has benefits for controlling cerebral vasospasm and ischemia after subarachnoid hemorrhage, reducing intraocular pressure, increasing aqueous humor outflow by relaxing the trabecular meshwork tissue, improving blood flow to the optic nerve, treating glaucoma, reducing intraocular pressure (IOP), and protecting healthy ganglion cells.
[0072] In mammals, Rho kinase consists of two isoforms, ROCK1 (ROCKβ, p160-ROCK) and ROCK2 (ROCKα). ROCK1 and ROCK2 are differentially expressed and regulated in specific tissues. For example, ROCK1 is ubiquitously expressed at relatively high levels, whereas ROCK2 is preferentially expressed in heart, blood vessels, and skeletal muscle. These isoforms are also expressed in a developmental stage-specific manner in several tissues. ROCK1 is a substrate for cleavage by caspase-3 during apoptosis, whereas ROCK2 is not. Smooth muscle-specific basic calponin is phosphorylated only by ROCK2.
[0073] In view of the range of cellular processes and diseases involved, compounds that selectively inhibit one Rho kinase or inhibit ROCK1 and ROCK2 are desirable. Examples of Rho kinase inhibitor therapeutic agents include netarsudil or a pharma- ceutical acceptable salt thereof (e.g., RHOPRESSA®), which is used to lower IOP and treat glaucoma, and ripasudil or a pharma-ceutical acceptable salt thereof (e.g., GLANATEC®), which is used to treat glaucoma and ocular hypertension. In certain embodiments, biologically active metabolites of such Rho kinase inhibitors are desirable.
[0074] As used herein, "prostaglandin" refers to any compound having a prostanoic acid skeleton: [ka] (Prostanoic acid skeleton)
[0075] Such compounds and their analogs or derivatives have ocular hypotensive activity and thus have use in the treatment or amelioration of ocular diseases or disorders.
[0076] Another type of therapeutic agent that has utility in the pharmaceutical compositions (e.g., vitreous implants) of the present invention is corticosteroids and analogs or derivatives thereof, or salts or prodrugs thereof. As used herein, "corticosteroids" refers to a class of steroid hormones produced in the adrenal cortex of vertebrates, and also encompasses synthetic analogs and derivatives of these hormones. Two types of corticosteroids, e.g., glucocorticoids and mineralocorticoids, are involved in a wide range of physiological processes. Corticosteroids have been reported to have utility in the treatment of ocular diseases or disorders, particularly ocular inflammatory diseases or disorders.
[0077] As used herein, a "therapeutically effective amount" refers to the level or amount of a therapeutic agent required to treat a disease or disorder, i.e., the level or amount of a therapeutic agent that produces a therapeutic response or desired effect in a subject to which the therapeutic agent is administered. In certain embodiments of the invention, a therapeutically effective amount refers to the level or amount of a therapeutic agent required to treat an ophthalmic disease or disorder.
[0078] The invention further extends to intravitreal implants prepared from the pharmaceutical compositions of the invention for placement at or within the posterior portion of a human eye, in these embodiments, the substantially linear release of therapeutic agent from the implant provides a concentration of therapeutic agent in the vitreous of a patient's eye treating an ocular disease or disorder over a period of time for which the implant is designed to substantially linearly release therapeutic agent.
[0079] In some embodiments, the implants described herein are designed with a size, shape, and composition that provides maximum approximation of the implant to the iridocorneal angle of the human eye, hi some embodiments, the implants are manufactured with pharmaceutical compositions of the invention, which include a polymer matrix as described herein.
[0080] As used herein, the term "polymer" is intended to include homopolymers (polymers having only one type of repeating unit) and copolymers (polymers having two or more types of repeating units).
[0081] "Biodegradable polymer" or "biodegradable polymer" may be used interchangeably and refer to a polymer that degrades in vivo under physiological conditions. Release of at least one therapeutic agent occurs simultaneously with or following degradation of the biodegradable polymer over time. The biodegradable polymer may be a homopolymer or a copolymer.
[0082] As used herein, the term "polymer matrix" refers to a homogenous mixture of polymers. In other words, the matrix does not include mixtures in which some parts differ from others in terms of material, density, etc. Thus, the polymer matrix does not include compositions that include a core and one or more outer layers, nor does it include compositions that include a therapeutic agent reservoir and one or more portions surrounding the therapeutic agent reservoir. In the pharmaceutical compositions of the present invention, the polymer matrix includes a first polymer and a second polymer, the first polymer includes a polyesteramide polymer (PEA) and the second polymer includes a PLA polymer, a PLGA polymer, or a combination of a PLA polymer and a PLGA polymer, e.g., (i) biodegradable poly(D,L-lactide) polymers; (ii) a biodegradable poly(D,L-lactide-co-glycolide) polymer, or (iii) a combination of (i) and (ii); Includes.
[0083] The polymers used in the polymer matrix of the pharmaceutical compositions of the present invention have independent properties associated with them which, when combined, provide the properties necessary to provide release of a therapeutically effective amount of a therapeutic agent in a substantially linear manner over a desired period of time.
[0084] Such polymers are often subject to enzymatic or hydrolytic instability. Water-soluble polymers may be crosslinked with hydrolytically or biodegradably unstable crosslinks to obtain useful water-insoluble polymers. The degree of stability can vary widely depending on the choice of monomer, whether a homopolymer or copolymer is employed, whether a mixture of polymers is employed, and whether the polymer contains terminal acid groups.
[0085] Equally important to controlling the biodegradability of the polymer and therefore the sustained release profile of the pharmaceutical compositions of the present invention is the relative average molecular weight of the polymer matrix employed in the intravitreal implants of the present invention. Different molecular weights of the same or different polymer compositions can be included to modulate the release profile of at least one therapeutic agent.
[0086] Numerous methods of polymer matrix formation are known to those skilled in the art, including, but not limited to, melt mixing, solution mixing, partial block or graft copolymerization, and preparation of Interpenetrating Polymer Networks (IPNs). "Melt mixing" involves mixing a first polymer and a second polymer together while they are in a molten state. It involves the use of shear force, extensional force, compression force, ultrasonic energy, electromagnetic energy, thermal energy, or a combination comprising at least one of the above forces or forms of energy, and it is carried out in a processing device where the above forces or forms of energy are exerted by a single screw, multiple screws, intermeshing co-rotating or counter-rotating screws, non-intermeshing co-rotating or counter-rotating screws, reciprocating screws, screws with pins, screws with screens, barrels with pins, rolls, rams, helical rotors, or a combination comprising at least one of the above.
[0087] The melt mixing with said forces may be carried out in machines such as single or multi-screw extruders, Buss kneaders, Henschel, Helicone, Ross mixers, Banbury, roll mills, molding machines such as injection molding machines, vacuum molding machines, blow molding machines, or combinations comprising at least one of the foregoing machines.
[0088] Solution mixing may also be used to produce the polymer matrix, where the polymer is placed in a solution and mixed. Additional energy such as shear, compression, ultrasonic vibration, etc. may also be used in solution mixing to promote homogenization of the quantum dots with the hydrogel. In one embodiment, the hydrogel is suspended in a fluid (e.g., water, alcohol, etc.) and introduced into an ultrasonic processor with the quantum dots. The mixture may be solution mixed by ultrasonication for a time effective to disperse the quantum dots in the hydrogel. The hydrogel with the quantum dots may then be dried, extruded, and molded as required. The temperature of the hydrogel may be increased during extrusion to promote the occurrence of crosslinking. The fluid used to swell the hydrogel may be removed by using a vacuum on the extruder during the extrusion process.
[0089] In certain embodiments, the polymer matrices of the present invention are prepared by mechanical mixing of the polymers.
[0090] In embodiments, the polymer matrix may be formed from polylactic acid, glycolic acid, and any combination of these copolymers and polyesteramides, which provide a substantially linear release of at least one therapeutic agent to the eye over time. More importantly, one of skill in the art can design the polymer matrix used in the pharmaceutical compositions of the present invention to deliver at least one therapeutic agent in a substantially linear manner over at least about 1 month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, or more.
[0091] As used herein, "substantially linear" means that the first 90% of the therapeutic agent released from the pharmaceutical compositions of the invention is released at a rate greater than or equal to 0.9. 2 In one embodiment, the first 80% of the therapeutic agent released from the pharmaceutical compositions of the invention should have an R value of 0.9 or greater. 2 It should have a value.
[0092] Polymeric materials or compositions suitable for use in the implant include those that are miscible and biocompatible with the eye such that they do not substantially interfere with the function and physiology of the eye. Such polymeric materials may be biodegradable or biodegradable. Examples of useful polymeric materials include, but are not limited to, those materials derived from and / or including organic esters and organic ethers that yield physiologically acceptable degradation products upon degradation. Polymeric materials derived from and / or including anhydrides, amides, orthoesters, and the like, alone or in combination with other monomers, may also be utilized in the present invention. The polymeric materials may be addition or condensation polymers. The polymeric materials may be crosslinked or uncrosslinked. For certain embodiments, in addition to carbon and hydrogen, the polymer may include at least one of oxygen and nitrogen. The oxygen may be present as an oxy (e.g., hydroxy or ether), carbonyl (e.g., non-oxocarbonyl such as carboxylate ester), and the like. The nitrogen may be present as an amide, cyano, or any combination thereof.
[0093] In one embodiment, polymers (either homopolymers or copolymers) of hydroxyaliphatic carboxylic acids and polysaccharides are useful for the implant. Polyesters can include D-lactic acid, L-lactic acid, racemic lactic acid, glycolic acid, polycaprolactone, copolymers thereof, and combinations thereof.
[0094] Some properties of polymers or polymeric materials for use in embodiments of the present invention may include biocompatibility, miscibility with at least one selected therapeutic agent, ease of use of the polymer in creating the therapeutic agent delivery systems described herein, a desired half-life in physiological environments, and hydrophilicity.
[0095] Specific examples of polymers that have application in the polymer matrices used in the preparation of pharmaceutical compositions (e.g., intravitreal implants) of the invention are synthetic aliphatic polyesters, such as polymers of lactic acid and / or glycolic acid, including poly-(D,L-lactide) (PLA), poly-(D-lactide), poly-(L-lactide), polyglycolic acid (PGA), and / or poly(D,L-lactide-co-glycolide) copolymers (PLGA).
[0096] PLGA is synthesized by random ring-opening copolymerization of cyclic dimers of glycolic acid and lactic acid, where successive monomer units of glycolic acid or lactic acid are linked by ester bonds.
[0097] PLGA and PLA polymers are known to degrade via backbone hydrolysis (bulk erosion), with the end degradation products being lactic acid and glycolic acid, which are non-toxic and well-established natural metabolic compounds. Lactic acid and glycolic acid are safely eliminated by conversion to carbon dioxide and water via the Krebs cycle. Furthermore, the biocompatibility of PLA, PGA, and PLGA polymers has been investigated in both non-ocular and ocular tissues in animals and humans. Findings indicate that the polymers are well tolerated. Additionally, PLA, PGA, and PLGA may contain terminal esters or acids.
[0098] Examples of PLA polymers that may be utilized in embodiments of the present invention include the RESOMER® product line available from Evonik Industries, including, but not limited to, those designated R207S, R202S, R202H, R203S, R203H, R205S, R208, R206, and R104. Examples of suitable PLA polymers include both acid-terminated and ester-terminated polymers having inherent viscosities ranging from about 0.15 to about 2.2 dL / g as measured by an Ubbelohde (size 0c) glass capillary viscometer at 0.1% (w / v) in CHCl3 and 25°C.
[0099] PLA can be synthesized with various molecular weights and various inherent viscosities. For example, but not limited to, in one embodiment, PLA such as RESOMER® R208S can be used, which has an inherent viscosity of about 1.8 to about 2.2 dL / g. In another embodiment, PLA such as RESOMER® R203S can be used, which has an inherent viscosity of about 0.25 to about 0.35 dL / g. In yet another embodiment, PLA such as RESOMER® R205S can be used, which has an inherent viscosity of about 0.55 to about 0.75 dL / g.
[0100] Examples of PGA polymers that may be utilized in embodiments of the present invention include the RESOMER® product line available from Evonik Industries, including, but not limited to, those designated G205S. Other examples of suitable PGA polymers include both acid-terminated and ester-terminated polymers. In some embodiments, the inherent viscosity of the PGA polymer ranges from about 1.05 to about 1.25 dL / g as measured by an Ubbelohde (size 0c) glass capillary viscometer at 0.1% (w / v) in CHCl3 and 25°C.
[0101] Examples of PLGA polymers that may be utilized in embodiments of the present invention include the RESOMER® product line available from Evonik Industries, including, but not limited to, those designated RG502, RG502S, RG502H, RG503, RG503H, RG504, RG504H, RG505, RG506, RG653H, RG752H, RG752S, RG753H, RG753S, RG755, RG755S, RG756, RG756S, RG757S, RG750S, RG858, and RG858S. These PLGA polymers include both acid-terminated and ester-terminated polymers with inherent viscosities ranging from about 0.14 to about 1.7 dL / g as measured by an Ubbelohde (size 0c) glass capillary viscometer at 0.1% (w / v) in CHCl3 and 25°C. Exemplary polymers used in various embodiments of the present invention may contain molar ratios of D,L-lactide to glycolide ranging from about 50:50 to about 85:15, including but not limited to 50:50, 65:35, 75:25, and 85:15.
[0102] Other examples of PLGA polymers that may be utilized in embodiments of the present invention include those manufactured by Lakeshore Biomaterials, including, but not limited to, DLG 1A, DLG 3A, or DLG 4A. Such DLG polymers include both acid (A)-terminated and ester (E)-terminated polymers with inherent viscosities ranging from about 0.0.5 to about 1.0 dL / g as measured by an Ubbelohde (size 0c) glass capillary viscometer at 0.1% (w / v) in CHCI3 and 25° C. Exemplary polymers used in various embodiments of the present invention may include a range of molar ratios of D,L-lactide to glycolide from about 1:99 to about 99:1, including, but not limited to, 50:50, 65:35, 75:25, and 85:15.
[0103] RESOMERS®, designated with “RG” or “DLG” in the product name (e.g., RG752S), is poly(D,L-lactide-co-glycolide) or PLGA having the following general structural formula (V): [ka] (V)
[0104] DLG of various molecular weights with various D,L-lactide-glycolide ratios can be synthesized. In one embodiment, DLG, such as 1A, having an inherent viscosity of about 0.05 to about 0.15 dL / g can be used. In another embodiment, DLG, such as 2A, having an inherent viscosity of about 0.15 to about 0.25 dL / g can be used.
[0105] Poly(D,L-lactide-co-glycolide) or PLGA copolymers can be synthesized with different ratios of lactide to glycolide, such as a 75:25 lactide:glycolide ratio. These copolymers can be ester-terminated PLGA copolymers, designated with an "S" at the end of the product name, or acid-terminated PLGA copolymers, designated with an "H" at the end of the product name.
[0106] Another biodegradable polymer that has application in the vitreous implant of the present invention is polyesteramide (PEA).PEA is disclosed in U.S. Patent No. 9,896,544 and U.S. Patent No. 9,789,189, which are incorporated herein by reference in their entirety.An example of the general structure of PEA is the following chemical structure (I): [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4 are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8 is -(CH2)4-.)
[0107] A specific example of a PEA having use in the present invention has the following chemical structure: [ka] (III)
[0108] PEA polymers having use in the pharmaceutical compositions (e.g., intravitreal implants) of the invention degrade hydrolytically, rather than enzymatically, via bulk erosion, and are fully biocompatible, such that their degradation should not cause any substantial interference with the function or physiology of the eye.
[0109] The ratio between the amount of lactide and glycolide present in the implants of the present invention as well as the ratio of PEA to lactide and glycolide can be varied, thereby altering the biodegradation characteristics of the product and allowing one of skill in the art to tailor the polymer degradation time and the duration and amount of therapeutic agent that is sustainedly released. Thus, modifying and customizing the biodegradable polymer matrix will alter the therapeutic agent delivery profile according to the presumed theory discussed above, which discussion the inventors are not obligated to provide and are not bound in any way by.
[0110] Additionally, the present invention extends to compositions including liquid formulations and delivery systems, and as such, the compositions may be construed to include solutions, suspensions, or other liquid-containing compositions used in ophthalmic therapy.
[0111] Particle Suspension As explained above, the pharmaceutical compositions of the present invention can be formulated into particle suspensions. As used herein, a particle suspension is a micronized pharmaceutical composition formulated as a suspension in a liquid phase containing necessary excipients, such as a delivery vehicle.
[0112] Additionally, the liquid formulation can be a particle suspension. The particles are typically smaller than the intravitreal implants disclosed herein and can vary in shape. For example, some embodiments of the present invention use substantially cylindrical particles. The therapeutic agent delivery system of the present invention can include a population of the aforementioned particles having a predetermined particle size distribution. In some embodiments, the suspension can include a population of particles having a desired diameter measurement.
[0113] As discussed above, the polymer blends described herein can be used with particle suspensions. Thus, in some embodiments, the PLA, PGA, PLGA, and PEA polymers discussed above can be formulated into polymer matrices described herein, which can be combined with at least one therapeutic agent and formulated as particle suspensions for ocular administration. Additional agents can be used in the particle suspensions described herein, including, but not limited to, tocopherols (e.g., α-tocopherol, β-tocopherol, γ-tocopherol, and δ-tocopherol).
[0114] In some embodiments, the particles have a size of less than about 100 μm in any dimension. In some embodiments, the maximum dimension may be from about 10 μm to about 100 μm, or from about 12.5 μm to about 25 μm to about 50 μm. In other embodiments, the minimum dimension may be from about 10 μm to about 100 μm, or from about 12.5 μm to about 25 μm. PRINT® technology is readily available for producing the particles used in the particle suspensions herein. The pharmaceutical compositions (e.g., intravitreal implants and particle suspensions) of the present invention comprise a therapeutic agent content of from about 1% to about 90%, or from about 1% to about 80%, or from about 1% to about 70%, or from about 1% to about 60%, or from about 1% to about 50%, or from about 1% to about 40%, or from about 1% to about 30%, or from about 1% to about 20%, or from about 1% to about 10%, or from about 10% to about 50%, or from about 10% to about 40%, or from about 10% to about 30%, or from about 10% to about 25%, or from about 10% to about 23%, or from about 10% to about 20%, or from about 15% to about 35%, or from about 15% to about 30%, or from about 15% to about 25%.
[0115] Delivery vehicles can be used to administer the particle suspensions described herein via intravitreal injection. For example, hyaluronic acid (HA) delivery vehicles can be used to formulate injectable vehicles to deliver the particle suspensions, such as those described in U.S. Patent No. 7,582,311 and U.S. Patent No. 7,651,703, which are incorporated herein by reference in their entirety. Hyaluronic acid (HA) is a polyanionic polysaccharide composed of N-acetyl-D-glucosamine and β-glucuronic acid. The unique viscoelastic properties of HA, together with its biocompatibility and non-immunogenicity, have led to its use in numerous clinical applications, including for replenishing synovial fluid in arthritis, as a surgical aid in eye surgery, and for promoting healing and regeneration of surgical wounds. Recently, HA has been explored as a therapeutic agent delivery agent for various routes of administration, including ocular, nasal, pulmonary, parenteral, and topical.
[0116] In some embodiments, the particle suspension is delivered in an aqueous solution. In certain embodiments, the particle suspension of the present invention is delivered in an aqueous solution containing a sorbitol and hyaluronic acid (HA / sorbitol) vehicle. The aqueous solution comprises about 0.1-99% HA and about 1-99% sorbitol, or about 0.1-50% HA and about 20-90% sorbitol, or about 0.1-10% HA and about 40-60% sorbitol. In some embodiments, the aqueous solution comprises about 1% HA and about 50% sorbitol.
[0117] Manipulation of therapeutic release profiles The rate of therapeutic agent release from a vitreous implant or particle suspension (e.g., pharmaceutical composition of the present invention) depends on several factors, including but not limited to the surface area of the implant, the therapeutic agent content, the water solubility of the therapeutic agent, and the rate of polymer degradation.As explained above, a very important factor that determines the rate of therapeutic agent release, in addition to its duration, is the ratio of the amount of the first polymer used, e.g., PEA, to the amount of the second polymer used, e.g., (a) PLA, (b) PLGA, or a combination of (a) and (b), and also the PGLA:PLA ratio when the second polymer is a combination of PLA and PLGA.Other relevant factors include lactide stereoisomer composition (i.e., the amount of L-lactide to DL-lactide) and molecular weight.
[0118] The versatility of PGA, PLA, PLGA, and PEA allows for the construction of delivery systems to tailor therapeutic release to treat a variety of ocular diseases or disorders.
[0119] The versatility of PGA, PLA, PLGA, and PEA polymers, when combined with the manufacturing techniques of the present invention, i.e., PRINT® Technology particle manufacturing, can produce a multitude of custom tailored, consistent, and predictable therapeutic release profiles that were not possible with prior art techniques such as extrusion. PRINT® Technology, used to manufacture the intravitreal implants of the present invention and to manufacture the particles used in the particle suspensions of the present invention, is described in WO 2007 / 021762, WO 2007 / 024323, and WO 2007 / 030698, which are incorporated herein by reference in their entireties.
[0120] Mold cavities used to manufacture the intravitreal implants of the present invention may vary from the stated dimensions by ± about 50 μm, or ± about 40 μm, or ± about 30 μm, or ± about 20 μm, or ± about 10 μm, or ± about 5 μm, in various embodiments.
[0121] PRINT® technology allows the manufacture of intravitreal implants of the invention that exhibit highly reproducible therapeutic agent release profiles from implant to implant. The therapeutic agent release profiles exhibited by various implants of the invention are consistent from implant to implant and exhibit statistically insignificant variability. As a result, the therapeutic agent release profiles exhibited by embodiments of the intravitreal implants of the invention exhibit coefficients of variation that are within the confidence intervals and do not affect therapeutic delivery. The ability to manufacture implants that exhibit a high degree of consistency in therapeutic agent loading and release is an advantage over the state of the art.
[0122] Suitable therapeutic agents, and their analogs, derivatives, pharma- ceutically acceptable salts, zwitterions, polymorphs, or solvates, homogeneously dispersed within the polymeric matrices described herein for use in various embodiments of the present invention may be those found in the Orange Book, a publication of the U.S. Food and Drug Administration, which, among other things, lists therapeutic agents approved for the treatment of ocular diseases or disorders.
[0123] Examples of therapeutic agents having use in the pharmaceutical compositions of the invention or in vitreous implants or particle suspensions made from the pharmaceutical compositions of the invention include inhibitors of the receptor tyrosine kinases (RTKs) discussed above. Specific examples of RTK inhibitors having use herein include, but are not limited to, gefitinib (IRESSA®), lapatinib (TYKERB® and TYVERB®), erlotinib (TARCEVA®), sunitinib malate (SUTENT®), sorafenib (NEXAVAR), regorafenib (STIVARGA®), vandetanib, afatinib (GILOTRIF®), axitinib (INLYTA®), semaxanib, cediranib (RECENTIN), neratinib (NERLYNX®), lestaurtinib, and tivozanib (FOTIVDA®).
[0124] Rho kinase inhibitors also have applications herein. Specific examples of such Rho kinase inhibitors that have applications in the pharmaceutical compositions of the present invention (e.g., the vitreous implants of the present invention) include, but are in no way limited to, netarsudil or its pharma- ceutical acceptable salts (e.g., RHOPRESSA®), which are used to reduce IOP and treat glaucoma, and ripasudil or its pharma-ceutical acceptable salts (e.g., GLANATEC®), which are used to treat glaucoma and high intraocular pressure.
[0125] Particular JAK inhibitors that have use in the pharmaceutical compositions of the invention (e.g., the vitreous implants of the invention) for use in treating an ocular disease or disorder include, but are not limited to, ruxolitinib (JAKAFI® and JAKAVI®) against JAK1 / JAK2, tofacitinib (XELJANZ® and JAKVINUS) against JAK3, oclacitinib (APOQUEL®) against JKA1, and baricitinib (OLUMIANT®) against JAK1 / JAK2.
[0126] Further examples of therapeutic agents having use herein include corticosteroids and their analogs and derivatives. Examples include, but are not limited to, dexamethasone, budesonide, beclomethasone, beclomethasone (e.g., as the mono- or dipropionate ester), flunisolide, fluticasone (e.g., as the propionate or furoate ester), ciclesonide, mometasone (e.g., as the furoate ester), mometasone desonide, rofleponide, hydrocortisone, prednisone, prednisolone, methylprednisolone, nafrocort, deflazacort, halopredone acetate, fluocinolone acetonide, fluocinonide, clocortolone, tipredane, prednicarbate, alclometasone dipropionate, halometasone, rimexolone, deprodone propionate, triamcinolone, betamethasone, fludrocortisone, desoxycorticosterone, rofleponide, etiprednol dicloacetate, and the like.
[0127] Specific examples of corticosteroids or analogues or derivatives thereof that have use herein include the following: (a) Dexamethasone (having the chemical structural formula (V) shown immediately below) [ka] (V) IUPAC Name: (8S,9R,10S,llS,13S,14S,16R,17R)-9-Fluoro-n,17-dihydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl-6,7,8,9,10,ll,12,13,14,15,16,17-dodecahydro-3H-cyclopenta[a]phenanthren-3-one. (b) Fluocinolone acetonide (having the chemical structural formula (VI) shown immediately below) [ka] (VI) IUPAC Name: (1S,2S,4R,8S,9S,1lS,12R,13S,19S)-12,19-difluoro-ll-hydroxy-8-(2-hydroxyacetyl)-6,6,9,13-tetramethyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one.
[0128] Prostaglandins and analogs or derivatives thereof having utility as therapeutic agents in the pharmaceutical compositions (e.g., vitreous implants and particle suspensions) of the present invention include, but are not limited to, latanoprost, bimatoprost, travoprost, tafluprost, 3-hydroxy-2,2-bis(hydroxymethyl)propyl 7-((1r,2r,3r,5s)-2-((r)-3-(benzo[b]thiophen-2-yl)-3-hydroxypropyl)-3,5-dihydroxycyclopentyl)heptanoate (chemical structural formula (II)), cloprostenol isopropyl ester, 13,14-dihydrocloprostenol isopropyl ester, latanoprost, unoprostone, PGF 1α Isopropyl ester, PGF 2α Isopropyl ester, PGF 3α In some embodiments, the prostaglandins and analogs or derivatives thereof that have therapeutic uses include dukeprost, tiaprost, or both. In some embodiments, the prostaglandins and analogs or derivatives thereof that have therapeutic uses include the free acids and pharma- ceutical acceptable salts of the prostaglandins and analogs or derivatives thereof.
[0129] Other therapeutic agents that have use in the pharmaceutical compositions of the invention for treating ocular diseases or disorders, such as glaucoma, include, but are not limited to, beta blockers, miotics, alpha adrenergic receptor agonists, or carbonic anhydrase inhibitors, and antimetabolites such as 5-fluorouracil or mitomycin C.
[0130] Of course, the pharmaceutical compositions of the present invention can include one therapeutic agent or a combination of two or more therapeutic agents, examples of which are discussed above. Additionally, analogs or derivatives, pharma- ceutical acceptable salts, zwitterions, solvates, esters, and polymorphs of the therapeutic agents as discussed herein have use in the pharmaceutical compositions of the present invention. As used herein, an "analog" is a compound that has a similar structure to that of another compound (its "parent" compound), but differs from the other compound in certain moieties. An analog may differ from its parent compound in that one or more atoms, functional groups, or substituents are replaced by another atom, group, or substituent. Similarly, an analog of a parent compound may also be formed by replacing a particular atom of the parent compound with a radioisotope of that particular atom. A "derivative" is a compound that is believed to result from, or is actually synthesized from, a parent compound by replacing an atom with another atom or group of atoms.
[0131] As used herein, a "pharmaceutical acceptable salt" refers to an ionizable therapeutic agent that is in combination with a counterion to form a neutral complex.
[0132] The term "zwitterion" refers to a molecule or ion that has separately positive and negative charged groups within it.
[0133] As used herein, "polymorphism" or "polymorphism" refers to the ability of a solid material to exist as more than one form or crystal. Crystal forms may be referred to herein as being characterized by graphic data. Such data may include, for example, powder X-ray diffraction and solid-state NMR spectra. As is well known in the art, graphic data potentially provides additional technical information (so-called "fingerprints") that further define each solid form, but which cannot necessarily be described by reference to numerical values or peak positions alone.
[0134] In the pharmaceutical compositions of the present invention (e.g., intravitreal implants and particle suspensions), a therapeutic agent is mixed with a biodegradable polymer matrix to form a pharmaceutical composition. The amount of therapeutic agent used in the pharmaceutical composition depends on several factors, including the selection of the biodegradable polymer matrix, the selection of the therapeutic agent, the desired rate of substantially linear release, the duration of the desired rate of release, the composition of the pharmaceutical composition, and ocular PK, to name a few.
[0135] For example, the total therapeutic agent content of a pharmaceutical composition (eg, an intravitreal implant) of the present invention may comprise from about 0.1 to about 60.0% by weight of the total pharmaceutical composition. In certain embodiments, the therapeutic agent comprises from about 1% to about 90%, or from about 1% to about 80%, or from about 1% to about 70%, or from about 1% to about 60%, or from about 1% to about 50%, or from about 1% to about 40%, or from about 1% to about 30%, or from about 1% to about 20%, or from about 1% to about 10%, or from about 10% to about 50%, or from about 10% to about 40%, or from about 10% to about 30%, or from about 10% to about 25%, or from about 10% to about 23%, or from about 10% to about 20%, or from about 15% to about 35%, or from about 15% to about 30%, or from about 15% to about 25%. These percentages are by weight. In certain embodiments, dexamethasone comprises approximately 20.0% by weight of the pharmaceutical composition.
[0136] The pharmaceutical compositions of the present invention are prepared by dissolving the polymer matrix and the therapeutic agent in a suitable solvent to produce a homogeneous solution. For example, the solvent may be acetone, alcohol (e.g., methyl or ethyl alcohol), acetonitrile, tetrahydrofuran, chloroform, and ethyl acetate. Other solvents known in the art are also contemplated. The solvent is then allowed to evaporate, leaving behind a homogeneous film. The solution may be sterile filtered prior to evaporation of the solvent.
[0137] Manufacturing of vitreous implants As explained above, the present invention extends to the pharmaceutical composition of the present invention formulated as an intravitreal implant or particle suspension.Various methods may be used to prepare the implant or particle suspension of the present invention.These methods include, but are in no way limited to, solution casting, phase separation, interfacial methods, molding, compression molding, injection molding, extrusion, coextrusion, thermal extrusion, die-cutting, heat compression, and combinations thereof.In some embodiments, the implant is preferably molded into a polymeric mold.
[0138] In a particular embodiment, the implants of the present invention are manufactured by PRINT® technology (Liquidia Technologies, Inc.) particle manufacturing. In particular, the implants are manufactured by casting the material intended to make up the implant into a mold cavity.
[0139] The mold can be a polymeric mold, and the mold cavity can be formed in any desired shape and size. Characteristically, when the implants and particles are formed in the mold cavity, the implants are highly uniform in shape, size, and composition. Due to the consistency between the physical and compositional makeup of each implant of the pharmaceutical composition, the pharmaceutical composition of the present invention provides a highly uniform release rate and dosage range. Furthermore, methods and materials for manufacturing the implants of the present invention are disclosed in U.S. Pat. Nos. 9,545,737, 9,214,590, 9,205,594, 8,992,992, 8,662,878, 8,518,316, 8,444,907, 8,439,666, 8,420,124, 8,268,446, 8,263,129, 8,152,129, 8,271,129, 8,301,129, 8,271,129, 8,271,129, 8,30 ... Nos. 8,728, 8,128,393, and 7,976,759, U.S. Patent Application Publication No. 2013-0228950, U.S. Patent Application Publication No. 2013-0011618, U.S. Patent Application Publication No. 2013-0256354, U.S. Patent Application Publication No. 2010-0003291, U.S. Patent Application Publication No. 2009-0165320, and U.S. Patent Application Publication No. 2008-0299174, which are incorporated by reference in their entireties.
[0140] The mold cavities can be formed in a variety of shapes and sizes. For example, the mold cavities can be in the shape of a prism, a square prism, a triangular prism, a pyramid, a square pyramid, a triangular pyramid, a cone, a cylinder, a torus, or a rod. The mold cavities in the mold can be the same or different shapes. In some aspects of the invention, the implant is in the shape of a cylinder, a square prism, or a rod. In certain embodiments, the implant is a rod. The rod can only have 90° angles, can be bulging along its long axis, or can be tapered so that one end is smaller than the other end.
[0141] The mold cavities can be from nanometers to micrometers to millimeters and larger. For some embodiments of the invention, the mold cavities are in the micrometer and millimeter range. For example, the mold cavities may have a minimum dimension between about 50 nanometers and about 750 μm. In some embodiments, the minimum mold cavities dimensions may be between about 100 μm and about 300 μm. In other embodiments, the minimum mold cavities dimensions may be between about 125 μm and about 250 μm. In yet other embodiments, the minimum mold cavities dimensions may be between about 10 μm and about 100 μm. In some embodiments, the minimum mold cavities dimensions may be between about 12.5 μm and about 50 μm, e.g., between 25 μm and 30 μm. Also, the mold cavities may have a maximum dimension between about 750 μm and about 10,000 μm. In other embodiments, the maximum mold cavities dimensions may be between about 1,000 μm and about 5,000 μm. In another embodiment, the maximum mold cavity size can be between about 1000 μm and about 3500 μm. In yet another embodiment, the maximum mold cavity size can be between about 25 μm and about 100 μm. In some embodiments, the minimum mold cavity size can be between about 25 μm and about 50 μm, e.g., between 25 μm and 30 μm.
[0142] In one embodiment, a mold cavity with dimensions of about 12.5 μm×about 12.5 μm×about 25 μm (W×H×L) is utilized to produce particles of the particle suspension of the present invention.
[0143] In one embodiment, a mold cavity with dimensions of about 25 μm×about 25 μm×about 25 μm (W×H×L) is utilized to produce particles of the particle suspension of the present invention.
[0144] In one embodiment, a mold cavity with dimensions of about 25 μm×about 25 μm×about 50 μm (W×H×L) is utilized to produce particles of the particle suspension of the present invention.
[0145] In one embodiment, a mold cavity with dimensions of about 50 μm×about 50 μm×about 30 μm (W×H×L) is utilized to produce particles of the particle suspension of the present invention.
[0146] In one embodiment, a mold cavity with dimensions of about 50 μm×about 50 μm×about 50 μm (W×H×L) is utilized to produce particles of the particle suspension of the present invention.
[0147] In one embodiment, a mold cavity generally having a rod shape with dimensions of about 140 μm×about 140 μm×about 1325 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0148] In a further embodiment, a rod-shaped mold cavity with dimensions of about 225 μm×about 225 μm×about 2965 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0149] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 395 μm×about 311 μm×about 6045 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0150] In one embodiment, a mold cavity generally having a rod shape with dimensions of about 100 μm×about 100 μm×about 1500 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0151] In a further embodiment, a rod-shaped mold cavity with dimensions of about 150 μm×about 150 μm×about 3150 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0152] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 180 μm×about 180 μm×about 3000 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0153] In one embodiment, a mold cavity generally having a rod shape with dimensions of about 200 μm×about 200 μm×about 2000 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0154] In a further embodiment, a rod-shaped mold cavity with dimensions of about 200 μm×about 200 μm×about 1000 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0155] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 225 μm×about 225 μm×about 2700 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0156] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 250 μm×about 250 μm×about 1500 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0157] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 200 μm×about 200 μm×about 4500 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0158] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 265 μm×about 265 μm×about 4500 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0159] In another embodiment, a mold cavity generally having a rod shape with dimensions of about 255 μm×about 255 μm×about 4500 μm (W×H×L) is utilized to manufacture the intravitreal implants of the present invention.
[0160] Once manufactured, the implants and particles may be left on the storage array or may be immediately removed for storage and / or use. The implants and particles described herein may be manufactured using aseptic processes or may be sterilized after manufacture. Additionally, the present invention contemplates kits that include storage arrays with the manufactured implants and particles attached thereto. Such storage array / implant kits provide a convenient method for mass transportation and distribution of the manufactured implants.
[0161] In another embodiment, the implants and particles can be manufactured using additive manufacturing techniques, such as those described in U.S. Patent No. 9,120,270, to create a master template for use in the PRINT® process or to create a mold for use in the PRINT® process, or to directly manufacture the implants.
[0162] In certain embodiments, the implants and particles are manufactured via a process of (i) dissolving a polymer and a therapeutic agent in a solvent (e.g., acetone), (ii) casting the solution into a thin film, (iii) drying the film, (iv) folding the thin film onto itself, (v) heating the folded thin film on the substrate to form a substrate, (vi) placing the thin film on the substrate onto a mold having a mold cavity, (vii) applying pressure, and in some embodiments, heat, to the mold-thin film-substrate combination such that the thin film enters the mold cavity, (viii) cooling, and (ix) removing the substrate from the mold to provide an implant that substantially mimics the size and shape of the mold cavity.
[0163] delivery device In some embodiments, a delivery device may be used to insert the vitreous implant or particle suspension of the present invention into one or both eyes for the treatment of an ocular disease or disorder. Suitable devices may include needles or needle-like applicators, such as those disclosed in International Publication No. WO 2018 / 045386, the entirety of which is incorporated herein by reference. In some embodiments, the minimum dimension of the implant may range from about 50 μm to about 750 μm, and thus a needle or needle-like applicator ranging from about 15 gauge to about 30 gauge may be utilized. In some embodiments, the needle gauge is about 15, about 16, about 17, about 18, about 19, about 20, about 21, about 22, about 23, about 24, about 25, about 26, about 27, about 28, about 29, or about 30. In one embodiment, the device uses a 25 gauge needle for an implant with a minimum dimension of 265 μm. In another embodiment, the device uses a 21 or 22 gauge needle for implants with a minimum dimension of 395 μm. In yet another embodiment, the device uses a 27 gauge needle for implants with a minimum dimension of 200 μm or for particle suspensions. The delivery implant may be a syringe with an appropriately sized needle or a syringe-like implant with a needle applicator. In one embodiment, the device uses a 27 gauge ultra-thin wall needle with an internal diameter of 300±10 micrometers.
[0164] Delivery routes include paracentesis, intravitreal, subconjunctival, intralental, intrascleral, fornix, anterior sub-Tenon, suprachoroidal, posterior sub-Tenon, subretinal, anterior chamber, and posterior chamber, among others.
[0165] In some embodiments, one or more implants are delivered to the anterior chamber of a patient's eye to treat glaucoma and / or elevated intraocular pressure.
[0166] In some embodiments, one or more implants are delivered to the anterior chamber of a patient's eye to treat uveitis.
[0167] kit The vitreous implant and the delivery device may be provided in combination as a kit for use. The implant may be packaged separately from the delivery device and loaded into the delivery device immediately prior to use. Alternatively, the implant may be loaded into the delivery device prior to packaging. In this case, the delivery implant is ready for use when the kit is opened. The components may be sterilized separately and combined into the kit, or may be sterilized after being combined into the kit. Additionally, as described above, the kit may include an array onto which the implant is bonded.
[0168] Use of the Vitreous Implant of the Present Invention for the Treatment of Ocular Diseases or Disorders In one aspect of the invention, there is provided a method of treating an ocular disease or disorder, comprising placing an intravitreal implant of the invention in the eye of a patient suffering from the disease or disorder, allowing the implant to degrade, and releasing a therapeutic agent in a substantially linear fashion over a period of at least about three months. The patient can be a human or an animal, such as a dog, cat, horse, cow (or any farm animal).
[0169] treatment process Over the course of treatment, the biodegradable polymer matrix of the pharmaceutical composition of the present invention degrades to release the therapeutic agent in a substantially linear manner over a period of at least about three months. When the therapeutic agent has been completely released, the polymer matrix has disintegrated. Complete degradation of the polymer matrix may take longer than complete release of the therapeutic agent from the polymer matrix. Polymer matrix degradation may occur at the same rate as the release of the therapeutic agent.
[0170] Optionally, the pharmaceutical composition is administered repeatedly. This administration regimen results in a second administration of the pharmaceutical composition of the present invention following the release of the therapeutic agent of the first administration. This administration regimen can be repeated 3, 4, 5, 6, 7, 8, 9, 10 or more times. In one embodiment, the intravitreal implant of the present invention should be completely degraded before re-administration is performed.
[0171] The present invention may be better understood by reference to the following non-limiting examples, which are given as illustrative of the present invention, and are presented in order to more fully illustrate certain embodiments of the present invention, and they should in no way be construed as limiting the broad scope of the present invention.
[0172] (Example) Example 1: Implant Manufacturing A series of polymer matrix / therapeutic agent blends were prepared prior to implant fabrication. Solution blending was used to produce a uniformly dispersed therapeutic agent throughout the implant body. Each of the blends prepared contained different ratios of PEA (polymer 1) and polymer 2 (including a PLA polymer, a PLGA polymer, or a combination of PLA and PLGA polymers). The PLA polymer used to prepare the pharmaceutical composition was RESOMER® R203S PLA polymer (available from Evonik Industries). The PLGA polymer used to prepare the pharmaceutical composition of the invention for this example was RESOMER® RG653H PLGA polymer (also available from Evonik Industries). The PEA used in the pharmaceutical composition had the chemical structure III.
[0173] In preparing the pharmaceutical composition, the polymers were mixed together in a specific ratio, then chloroform was added directly and the polymer was allowed to dissolve. The polymer / chloroform solution was then added directly to the micronized dexamethasone. The chloroform was then allowed to evaporate over a polyethylene terephthalate (PET) sheet placed on a hot plate at 60° C. After removal of the chloroform, a thin film of homogenous material remained.
[0174] Example 2: Manufacturing of a mold Templated molds of the desired dimensions in the shape of a rod with dimensions 265 x 265 x 4500 μm were produced using the PRINT® process. The different pharmaceutical compositions of the invention that were produced are shown in column 2 of Table 1. If no polymer is listed in column 2 for a particular vitreous implant of the invention, it means that the polymer was not used in the production of the pharmaceutical composition used in that particular vitreous implant.
[0175] Example 3: Preparation of dexamethasone implants A series of implants were produced using the polymer matrix / therapeutic agent blend of Example 1 and the mold of Example 2. The polymer matrix / therapeutic agent blend was spread onto a PET sheet and heated. Once heated, the solvent was completely dried. A mold of the desired dimensions was used to cover the blend. A roller was used to apply light pressure to spread the blend across the molding surface of the mold. The mold / blend laminate was then passed through a commercially available thermal laminator using the parameters in the table below. The blend flowed into the mold cavity and took the shape of the mold cavity. The blend was allowed to cool at room temperature and formed into individual implants within the mold cavities. The mold was then removed leaving a two-dimensional array of implants arranged on a film. The individual implants were removed from the PET film using forceps.
[0176] Table 1: Blend and mold designs [Table 1]
[0177] Example 4: Analysis of dexamethasone content The implants prepared as described above were dissolved in acetonitrile, methanol, and water. The dexamethasone content of each implant was measured by RP-HPLC using a Phenomenex Luna® Phenyl-Hexyl HPLC, 3 μm particle size, 4.6×100 mm analytical column. The mobile phase consisted of a gradient of 0.1% trifluoroacetic acid (TFA) purified in water and acetonitrile over 4 min at 1.0 mL / min. The UV absorbance of dexamethasone was measured at 245 nm. Table 2 shows the dexamethasone content measured for each implant.
[0178] Table 2: Dexamethasone content [Table 2]
[0179] Example 5: In vitro release analysis of selected implants A single implant as described above was placed in a 4 mL glass screw cap vial and incubated in 3 mL of 1×PBS at 37°. At each time point of interest, the media was removed for analysis. The media was then replaced with 3 mL of fresh media. The removed media was analyzed for dexamethasone released by HPLC method. FIG. 1 shows the in vitro release of dexamethasone measured for each implant evaluated. FIG. 2 shows the cumulative % of dexamethasone released from implant sample 7. The graph shows that the slope of the graph is substantially constant from day 0 to approximately day 90. Thus, these data show that the pharmaceutical composition (e.g., intravitreal implant) of the present invention releases therapeutic agent in a substantially linear manner for at least 3 months.
[0180] Sample 7 is an intravitreal implant of the present invention made from a pharmaceutical composition of the present invention comprising: (a) about 59% by weight of a polymer matrix comprising: (i) about 60% by weight of a biodegradable polyesteramide homopolymer having chemical structural formula (III), (ii) about 20% by weight of a biodegradable poly(D,L-lactide) homopolymer, and (iii) about 20% by weight of a biodegradable poly(D,L-lactide-co-glycolide) copolymer, where (i), (ii), and (iii) are mixed together to form the polymer matrix; and (b) about 41% by weight of dexamethasone uniformly dispersed within the polymer matrix.
[0181] 3 is a graph of the average daily release rate of dexamethasone from Sample 7 of the intravitreal implant of the present invention. In FIG. 3, the daily release of dexamethasone from day 0 to about day 90 is substantially constant, again indicating that the pharmaceutical composition (e.g., intravitreal implant) of the present invention releases therapeutic agent in a substantially linear fashion over at least three months.
[0182] The PEA-only polymer matrix exhibits a very slow and non-linear release profile. The PLGA / PLA-only polymer matrix exhibits a non-linear release profile after an initial onset.
[0183] Surprisingly, it has been observed that dexamethasone eluting from the combined PEA / PLGA matrix exhibits a high daily release and a substantially linear release profile (eg, over 90 days from initial administration).
[0184] The present invention is not to be limited in scope by the specific embodiments described herein. Various modifications of the present invention in addition to those described herein will be apparent to those skilled in the art from the foregoing description and the associated drawings. Such modifications are intended to be encompassed by the scope of the appended claims.
[0185] Example 6: Storage and Stability of Compounds and Compositions The compounds or compositions provided herein are prepared and placed in containers for storage at ambient or elevated temperatures. When the compounds or compositions are stored in polyolefin plastic containers, whether dissolved or suspended in a liquid composition (e.g., aqueous or organic liquid) or as a solid, discoloration of the compounds or compositions is reduced compared to polyvinyl chloride plastic containers. Without wishing to be bound by theory, the containers reduce exposure of the contents of the container to electromagnetic radiation, whether visible light (e.g., having a wavelength of about 380-780 nm) or ultraviolet (UV) light (e.g., about 190-320 nm (UV-B light) or about 320-380 nm (UV-A light)). Some containers also have or include a second component capable of reducing exposure of the contents of the container to infrared light. Containers that may be used include those made from polyolefins, such as polyethylene, polypropylene, polyethylene terephthalate, polycarbonate, polymethylpentene, polybutene, or combinations thereof, particularly polyethylene, polypropylene, or combinations thereof. Additionally, to further reduce exposure of the contents of the container to UV, visible, or infrared light, the container may be placed within a second container, such as a container of paper, cardboard, paperboard, metal film, or foil, or a combination thereof. Compounds and compositions that benefit from reduced fading, spoilage, or both during storage include eye drops or implants that include the compounds or compositions provided herein. The eye drops or implants may require storage for up to or more than three months, and in some cases, up to or more than one year. The container described herein may be an eye drop or implant container. The container may be in any form suitable for containing the contents, such as a bag, bottle, or box.
[0186] Other suitable containers and packaging are described, for example, in WO 2018 / 159700, WO 2018 / 159701, and WO 2018 / 159702, and Japanese Patent No. 6236167, the contents of which are incorporated herein by reference.
[0187] The composition disposed within the described container may include boric acid, D-mannitol, benzalkonium chloride, polyoxyl 40 stearate, polyethylene glycol 400, ethylenediaminetetraacetic acid, or combinations thereof, and water or other suitable solvent medium or additives. In some cases, the medium is an aqueous medium. In other cases, the medium is a non-aqueous medium.
[0188] Example 7: Polymer matrix / therapeutic agent mixture A series of polymer matrix / therapeutic agent blends were prepared prior to implant fabrication. High temperature melt mixing was used to produce a uniformly dispersed therapeutic agent throughout the implant body. The polymer and small molecule JKA inhibitor were freeze-milled to produce a fine powder. This powder was then high temperature melt mixed using a hot plate at 130°C to produce a uniform paste.
[0189] Example 8: Manufacturing of a mold Templated molds with rod-shaped dimensions of 200 x 200 x 4500 μm were fabricated using the PRINT® process. Implants were fabricated with the JAK inhibitor (1R,2R)-N-(4-methylisoquinolin-6-yl)-2-(4-(N-(pyridin-2-yl)sulfamoyl)phenyl)cyclopropane-1-carboxamide.
[0190] Example 9: Manufacture of implants A series of implants were made using the polymer matrix and JAK inhibitor blend of Example 7 and the mold of Example 8 (see Table 3). The polymer matrix / therapeutic agent blend was spread onto a PET sheet and heated. Once heated, the blend was covered with a mold of the desired dimensions. A roller was used to apply light pressure to spread the blend across the molding surface of the mold. The mold / blend laminate was then passed through a commercially available thermal laminator using the parameters in Table 4 below. The blend flowed into the mold cavity and took the shape of the mold cavity. The blend was allowed to cool at room temperature and formed into individual implants within the mold cavities. The mold was then removed leaving a two-dimensional array of implants arranged on a film. The individual implants were removed from the PET film using forceps.
[0191] Table 3: Blend composition and mold design [Table 3]
[0192] Table 4: Processing parameters [Table 4]
[0193] To analyze the implant contents, the implants were first dissolved in 1 mL of DMSO. Once dissolved, 3 mL of methanol was added to each sample and mixed. Small molecule JAK inhibitor content was measured by RP-HPLC using a Waters Atlantis T3, 3 μm particle size, 4.6 x 75 mm analytical column. The mobile phase consisted of a gradient of 0.1% TFA purified water and acetonitrile over 5 min at 1.0 mL / min. UV absorbance of the therapeutic agent was measured at 262 nm.
[0194] The in vitro release of the implant formulations was analyzed. Single implants were placed in 4 mL glass screw cap vials and incubated at 37° in 3 mL of 1×PBS containing 0.5% Tween 20. At each time point of interest, the media was removed for analysis. The media was then replaced with 3 mL of fresh media. The removed media was analyzed for the released therapeutic agent (i.e., (1R,2R)-N-(4-methylisoquinolin-6-yl)-2-(4-(N-(pyridin-2-yl)sulfamoyl)phenyl)cyclopropane-1-carboxamide) by HPLC method. As can be seen from Figures 4 and 5, at least the initial 80% of the therapeutic agent released from the implants had an R of 0.9 or greater. 2 had value.
[0195] [Note] [Appendix 1] A pharmaceutical composition for treating an eye disease or disorder, comprising: (a) a biodegradable polymer matrix comprising a mixture of a first polymer and a second polymer, (1) the first polymer is a biodegradable polyesteramide polymer; (2) the second polymer is a biodegradable poly(D,L-lactide) polymer, a biodegradable poly(D,L-lactide-co-glycolide) polymer, or a combination thereof; a biodegradable polymer matrix; (b) at least one therapeutic agent, or an analog, derivative, pharma- ceutically acceptable salt, zwitterion, polymorph, or solvate thereof, homogeneously dispersed within the polymer matrix; and Including, the pharmaceutical composition is formulated for intravitreal administration to an eye of a subject; the pharmaceutical composition is formulated to release the at least one therapeutic agent from the pharmaceutical composition in a substantially linear manner over a period of about 1 month to about 6 months; Pharmaceutical compositions.
[0196] [Appendix 2] The pharmaceutical composition of claim 1, wherein the at least one therapeutic agent inhibits the activity of a kinase.
[0197] [Appendix 3] The pharmaceutical composition of claim 2, wherein the kinase comprises Rho kinase, Janus kinase (JAK), vascular endothelial growth factor receptor (VEGF-R) kinase, or receptor tyrosine kinase.
[0198] [Appendix 4] the kinase is Rho kinase, and The at least one therapeutic agent is Netarsudil or a pharma- ceutically acceptable salt thereof, Ripasudil or a pharma- ceutically acceptable salt thereof, or Combinations of these Including, 4. The pharmaceutical composition of claim 3.
[0199] [Appendix 5] the kinase is a JAK inhibitor, and The at least one therapeutic agent is Ruxolitinib, Tofacitinib, Oclacitinib, Baricitinib, or Combinations of these Including, 4. The pharmaceutical composition of claim 3.
[0200] [Appendix 6] the kinase is a receptor tyrosine kinase, and The at least one therapeutic agent is Gefitinib, Lapatinib, Erlotinib, Sunitinib, Sorafenib, Regorafenib, Afatinib, Vandetanib, Semaxanib, Cediranib, Neratinib, Axitinib, Lestaurtinib, Tivozanib, or Combinations of these Including, 4. The pharmaceutical composition of claim 3.
[0201] [Appendix 7] The at least one therapeutic agent is Prostaglandins, Corticosteroids, or Combinations of these That is, 2. The pharmaceutical composition of claim 1.
[0202] [Appendix 8] The corticosteroids include dexamethasone, budesonide, beclomethasone, beclomethasone (e.g., as the mono- or dipropionate ester), flunisolide, fluticasone (e.g., as the propionate or furoate ester), ciclesonide, mometasone (e.g., as the furoate ester), mometasone desonide, rofleponide, hydrocortisone, prednisone, prednisolone, methylprednisolone, nafrocort, def 8. The pharmaceutical composition of claim 7, which is lazacort, halopredone acetate, fluocinolone acetonide, fluocinonide, clocortolone, tipredane, prednicarbate, alclometasone dipropionate, halometasone, rimexolone, deprodone propionate, triamcinolone, betamethasone, fludrocortisone, desoxycorticosterone, rofleponide, etiprednol dicloacetate, or a combination thereof.
[0203] [Appendix 9] The at least one therapeutic agent is Latanoprost, bimatoprost, travoprost, tafluprost, 3-hydroxy-2,2-bis(hydroxymethyl)propyl 7-((1r,2r,3r,5s)-2-((r)-3-(benzo[b]thiophen-2-yl)-3-hydroxypropyl)-3,5-dihydroxycyclopentyl)heptanoate (chemical structure (II)), cloprostenol isopropyl ester, 13,14-dihydrocloprostenol isopropyl ester, latanoprost, unoprostone, PGF 1α Isopropyl ester, PGF 2α Isopropyl ester, PGF 3α isopropyl ester, fluprostenol, or a combination thereof; Corticosteroids, or Combinations of these That is, 2. The pharmaceutical composition of claim 1.
[0204] [Appendix 10] The at least one therapeutic agent is Latanoprost, Corticosteroids, or a combination thereof, That is, 2. The pharmaceutical composition of claim 1.
[0205] [Appendix 11] The corticosteroid is dexamethasone, 9. The pharmaceutical composition of claim 8.
[0206] [Appendix 12] The at least one therapeutic agent is netarsudil or a pharma- ceutical acceptable salt thereof; 5. The pharmaceutical composition according to claim 4.
[0207] [Appendix 13] The polymer matrix is 60% by weight of a biodegradable polyesteramide polymer; 20% by weight of a biodegradable poly(D,L-lactide) polymer, and 20% by weight of biodegradable poly(D,L-lactide-co-glycolide) polymer; Including, 13. A pharmaceutical composition according to any one of claims 1 to 12.
[0208] [Appendix 14] the polymer matrix is a mechanical blend of the first polymer and the second polymer; 14. A pharmaceutical composition according to any one of claims 1 to 13.
[0209] [Appendix 15] about 51% by weight of a polymer matrix; and about 49% by weight of at least one therapeutic agent; Including, 15. A pharmaceutical composition according to any one of claims 1 to 14.
[0210] [Appendix 16] The biodegradable (D,L-lactide) polymer is an acid end-capped biodegradable poly(D,L-lactide) homopolymer or an ester end-capped poly(D,L-lactide) homopolymer; 16. A pharmaceutical composition according to any one of claims 1 to 15.
[0211] [Appendix 17] The poly(D,L-lactide-co-glycolide) polymer is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer or an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; 17. A pharmaceutical composition according to any one of claims 1 to 16.
[0212] [Appendix 18] The biodegradable polyesteramide homopolymer has the following structure (I): 18. A pharmaceutical composition according to any one of claims 1 to 17. [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4 are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8 is -(CH2)4-.)
[0213] [Appendix 19] The biodegradable polyesteramide homopolymer has the following structure (II): 19. A pharmaceutical composition according to any one of claims 1 to 18. [ka] (II)
[0214] [Appendix 20] The pharmaceutical composition comprises about 59% by weight of a polymer matrix and about 41% by weight of at least one therapeutic agent. 20. A pharmaceutical composition according to any one of claims 1 to 19.
[0215] [Appendix 21] The pharmaceutical composition comprises: (a) about 59% by weight of a polymer matrix, (i) about 60% by weight of the polymer matrix is a biodegradable polyesteramide homopolymer; (ii) about 20% by weight of the polymer matrix is a biodegradable poly(D,L-lactide) homopolymer; and (iii) about 20% by weight of the polymer matrix is a biodegradable poly(D,L-lactide-co-glycolide) copolymer; A polymer matrix; (b) about 41% by weight of at least one therapeutic agent, the at least one therapeutic agent is dexamethasone; at least one therapeutic agent; Including, The pharmaceutical composition is formulated for intravitreal administration to an eye of a subject; and the pharmaceutical composition is formulated to provide a substantially linear release of the at least one therapeutic agent such that about 1% of the total amount of the at least one therapeutic agent contained therein is released per day for about three months; 21. The pharmaceutical composition of claim 20.
[0216] [Appendix 22] 1. A pharmaceutical composition comprising: (a) about 59% by weight of a polymer matrix, (i) about 60% by weight of a biodegradable polyesteramide homopolymer having the following structure (I): [ka] (I) (where m+p is in the range of 0.9 to 0.1, a+b is in the range of 0.1 to 0.9, m+p+a+b=1 (where either m or p may be zero), n is in the range of 5 to 300, a is at least 0.01, b is at least 0.015, the ratio of a to b (a:b) is from 0.1:9 to 0.85:0.15, and the m and / or p units and the a and b units are randomly distributed; R 1 is independent (C2-C 20 ) alkyl; R at m or p, which is a single backbone unit 3 and R 4 are each independently hydrogen, (C1-C6) alkyl, (C2-C6) alkenyl, (C2-C6) alkynyl, (C6-C 10 ) aryl, (C1-C6 alkyl, -(CH2)SH, -(CH2)2S(CH)3, (CH3)2-CH-CH2-, -CH(CH3)2, -CH(CH3)-CH2-CH3, -CH2-C6H5, -(CH2)4-NH2, and mixtures thereof; R 5 are independently 20 )Alkyl, (C2-C 20 ) alkenylene; R 6 is a bicyclic fragment of a 1,4:3,6-dianhydrohexitol of the following structural formula (II): [ka] R 7 are independently (C6-C 10 ) aryl, (C1-C6) alkyl, or a protecting group; and R 8 is -(CH2)4-.) (ii) about 20% by weight of a biodegradable poly(D,L-lactide) homopolymer, and (iii) about 20% by weight of a biodegradable poly(D,L-lactide-co-glycolide) copolymer; Including, (i), (ii), and (iii) are blended together to form the polymer matrix. A polymer matrix; (b) about 41% by weight of dexamethasone uniformly dispersed within said polymer matrix; Including, The pharmaceutical composition is formulated for intravitreal administration to an eye of a subject; and the pharmaceutical composition is formulated to provide a substantially linear release of the dexamethasone such that about 1% of the total amount of the dexamethasone contained in the pharmaceutical composition is released from the pharmaceutical composition per day for about three months; Pharmaceutical compositions.
[0217] [Appendix 23] The biodegradable polyesteramide homopolymer has the following structure (III): 23. The pharmaceutical composition of claim 22. [ka] (III)
[0218] [Appendix 24] 24. A vitreous implant comprising a pharmaceutical composition according to any one of claims 1 to 23.
[0219] [Appendix 25] 25. An intravitreal implant for treating an ocular disease or disorder comprising the pharmaceutical composition of any one of claims 1 to 24.
[0220] [Appendix 26] The ocular inflammatory disease or disorder includes uveitis, corneal ulcer, endophthalmitis, autoimmune diseases of the cornea or ocular surface, ocular symptoms of HIV disease, or a combination thereof; A pharmaceutical composition according to any one of claims 1 to 23, or a vitreous implant according to claim 24 or 25.
[0221] [Appendix 27] The ocular inflammatory disease or disorder includes diabetic eye disease, wet age-related macular degeneration, dry age-related macular degeneration, inflammation, dry eye, or a combination thereof; A pharmaceutical composition according to any one of claims 1 to 23, or a vitreous implant according to claim 24 or 25.
[0222] [Appendix 28] The disease or disorder of the eye includes glaucoma, a neurodegenerative disease or disorder, high intraocular pressure, an ocular inflammatory disease or disorder, or a combination thereof; A pharmaceutical composition according to any one of claims 1 to 23, or a vitreous implant according to claim 24 or 25.
[0223] [Appendix 29] The neurodegenerative disease or disorder includes diabetic eye disease, wet age-related macular degeneration, dry age-related macular degeneration, inflammation, dry eye, or a combination thereof; 29. The pharmaceutical composition of claim 28.
[0224] [Appendix 30] A method for treating an ocular disease or disorder in a subject in need of such treatment, comprising administering to the subject a therapeutically effective amount of a pharmaceutical composition of any one of appendices 1 to 23 or a vitreous implant of appendices 24 or 25.
[0225] [Appendix 31] The subject is a human. 31. The method according to claim 30.
[0226] [Appendix 32] said administering to said subject comprises administering to the vitreous humor of an eye of said subject; 32. The method according to claim 30 or 31.
[0227] [Appendix 33] The ocular inflammatory disease or disorder includes uveitis, corneal ulcer, endophthalmitis, autoimmune diseases of the cornea or ocular surface, ocular symptoms of HIV disease, or a combination thereof; 33. The method of any one of claims 30 to 32.
[0228] [Appendix 34] The ocular inflammatory disease or disorder includes diabetic eye disease, wet age-related macular degeneration, dry age-related macular degeneration, inflammation, dry eye, or a combination thereof; 33. The method of any one of claims 30 to 32.
[0229] [Appendix 35] The disease or disorder of the eye includes glaucoma, a neurodegenerative disease or disorder, high intraocular pressure, an ocular inflammatory disease or disorder, or a combination thereof; 33. The method of any one of claims 30 to 32.
[0230] [Appendix 36] The neurodegenerative disease or disorder includes diabetic eye disease, wet age-related macular degeneration, dry age-related macular degeneration, inflammation, dry eye, or a combination thereof; 36. The method according to claim 35.
[0231] [Appendix 37] A method for eluting a therapeutic agent from a depot in a subject in need of treatment, comprising administering to the subject once a depot comprising a pharmaceutical composition of any one of Appendixes 1 to 23 or a vitreous implant of Appendix 24 or 25, wherein an amount of the therapeutic agent elutes from the depot at a rate of about 1% of the therapeutic agent in the initial depot per day for about one week to about three months after administration of the depot.
[0232] [Appendix 38] A method for eluting a therapeutic agent from a depot in a subject in need of treatment, comprising administering a depot comprising the pharmaceutical composition of any one of appendices 1 to 23 or the vitreous implant of appendices 24 or 25 to the subject once, wherein from about day 7 to about day 90 after administration of the depot, an amount of about 10 to about 500 ng, about 500 to about 1500 ng, or about 1000 to about 2000 ng of the therapeutic agent is eluted from the depot per day.
[0233] [Appendix 39] A method of administering a therapeutic agent to a subject in need of treatment, comprising administering a depot comprising a pharmaceutical composition of any one of claims 1 to 23 once to the subject, wherein a quantity of said therapeutic agent elutes from said depot at a rate of about 1% of said therapeutic agent in the initial depot per day for about one week to about three months after administration of the depot.
[0234] [Appendix 40] A method of administering a therapeutic agent to a subject in need of treatment, comprising administering to the subject once a depot comprising a vitreous implant described in Appendix 24 or 25, wherein an amount of the therapeutic agent elutes from the depot at a rate of about 1% of the therapeutic agent in the initial depot per day for about one week to about three months after administration of the depot.
[0235] [Appendix 41] 24. A method of administering a therapeutic agent to a subject in need of treatment, comprising administering a depot comprising the pharmaceutical composition of any one of appendices 1 to 23 once to the subject, wherein an amount of about 10 to about 500 ng, about 500 to about 1500 ng, or about 1000 to about 2000 ng of the therapeutic agent is eluted from the depot daily from about day 7 to about day 90 after administration of the depot.
[0236] [Appendix 42] 26. A method of administering a therapeutic agent to a subject in need of treatment, comprising administering to the subject once a depot comprising the vitreous implant of appendix 24 or 25, wherein an amount of about 10 to about 500 ng, about 500 to about 1500 ng, or about 1000 to about 2000 ng of the therapeutic agent is eluted from the depot daily from about day 7 to about day 90 after administration of the depot.
[0237] [Appendix 43] The therapeutic agent is eluted from the depot in an amount of about 750 to about 1250 ng per day from about day 7 to about day 90 after administration of the depot. 43. The method of claim 38, 41, or 42.
[0238] [Appendix 44] About 1000 ng of the therapeutic agent is eluted from the depot every day from about day 7 to about day 90 after administration of the depot. 43. The method of claim 38, 41, or 42.
[0239] [Appendix 45] the amount of therapeutic agent elutes from the depot at a rate of about 1% of the therapeutic agent in the initial depot per day for about one week to about two months after administration of the depot; 41. The method of claim 37, 39, or 40.
[0240] [Appendix 46] The amount of the therapeutic agent is eluted from the depot daily from about day 7 to about day 60 after administration of the depot. 38. The method of claim 38, 41, 42, 43, or 44.
[0241] [Appendix 47] The administering is by injection into the eye of the subject. 45. The method of any one of claims 37 to 44.
Claims
1. A biodegradable polymer matrix comprising a mixture of a first polymer and a second polymer, (1) the first polymer is a biodegradable polyesteramide polymer, the first polymer comprising the structure: 【Chemistry 1】 (III) (2) the second polymer is a biodegradable poly(D,L-lactide-co-glycolide) polymer or a combination of the biodegradable poly(D,L-lactide-co-glycolide) polymers, the biodegradable poly(D,L-lactide-co-glycolide) polymers including ester end-capped biodegradable poly(D,L-lactide-co-glycolide) polymers, acid end-capped biodegradable poly(D,L-lactide-co-glycolide) polymers, or a combination thereof; Biodegradable polymer matrix.
2. the biodegradable polymer matrix is a mechanical blend of the first polymer and the second polymer; The biodegradable polymer matrix of claim 1 .
3. The biodegradable poly(D,L-lactide-co-glycolide) polymer is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer or an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; 3. The biodegradable polymer matrix according to claim 1 or 2.
4. the second polymer is a combination of the biodegradable poly(D,L-lactide-co-glycolide) polymers, the combination of the biodegradable poly(D,L-lactide-co-glycolide) polymers being an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer and an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; 3. The biodegradable polymer matrix according to claim 1 or 2.
5. the second polymer is a combination of the biodegradable poly(D,L-lactide-co-glycolide) polymers, the combination of biodegradable poly(D,L-lactide-co-glycolide) polymers including 20±5% by weight of the biodegradable polymer matrix of ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymers and 20±5% by weight of the biodegradable polymer matrix of acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymers; 3. The biodegradable polymer matrix according to claim 1 or 2.
6. (1) about 60% by weight of the biodegradable polymer matrix is a biodegradable polyesteramide homopolymer, about 20% by weight of the biodegradable polymer matrix is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer, and about 20% by weight of the biodegradable polymer matrix is an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; (2) about 60% by weight of the biodegradable polymer matrix is a biodegradable polyesteramide homopolymer, about 30% by weight of the biodegradable polymer matrix is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer, and about 10% by weight of the biodegradable polymer matrix is an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; (3) about 60% by weight of the biodegradable polymer matrix is a biodegradable polyesteramide homopolymer, about 10% by weight of the biodegradable polymer matrix is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer, and about 30% by weight of the biodegradable polymer matrix is an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer; or (4) about 40% by weight of the biodegradable polymer matrix is a biodegradable polyesteramide homopolymer, about 30% by weight of the biodegradable polymer matrix is an ester end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer, and about 30% by weight of the biodegradable polymer matrix is an acid end-capped biodegradable poly(D,L-lactide-co-glycolide) copolymer.
3. The biodegradable polymer matrix according to claim 1 or 2.
7. 7. A vitreous implant comprising a biodegradable polymer matrix according to any one of claims 1 to 6.
8. 10. Use of the vitreous implant of claim 7 in the preparation of an injectable medicament for a method of eluting a therapeutic agent from a depot in a subject in need of treatment.
9. The injectable medicament is an injectable ophthalmic drug; 9. The use according to claim 8.
10. The injectable medicament releases the therapeutic agent substantially linearly over a period of at least three months.
10. Use according to claim 8 or 9.
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