TW202329916A - 包含生物醫藥藥物化合物之新穎醫藥組合物 - Google Patents
包含生物醫藥藥物化合物之新穎醫藥組合物 Download PDFInfo
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Abstract
根據本發明,提供一種呈非晶形單微粒粉末形式之組合物,其包含以下之混合物:
(a) 藥理學上有效劑量之至少一種生物醫藥藥物化合物;以及
(b) 醫藥學上可接受之載劑材料,該載劑材料包含雙醣與聚合材料之組合。
就此而言,較佳的醫藥學上可接受之載劑包括乳糖或海藻糖及糊精(例如麥芽糊精)。組合物可進一步包含一或多種烷基醣類。較佳烷基醣類包括蔗糖酯,諸如蔗糖單月桂酸酯。可藉由以組合方式對各種組分一起進行噴霧乾燥產生粉末組合物。
Description
本發明係關於包含適用於多種醫學病狀之生物藥劑的新穎醫藥組合物。本發明亦係關於製造此類組合物且將其調配成劑型之方法。
在本說明書中,對明顯先前出版之文獻的列舉或論述未必應視為承認該文獻係目前先進技術或公共常識之一部分。
在藥物遞送之各種熟知途徑中,經口遞送至胃腸道最為常見。其通常被視為是最受患者及醫師歡迎的。
然而,已知經口藥物投與具有缺點,包括以下實情:活性成分必須經歷肝首過代謝、胃腸道內(及胃腸道外部)之酶降解,且能夠有限接近血腦屏障(BBB)以治療中樞神經系統(CNS)之疾病。此等因素不僅可能影響某些藥物之功效,而且在一些情況下會使經口藥物遞送完全不符合投與途徑資格。
經口投與至胃腸道有額外的缺點,亦即需要經由腸道吸收活性成分作為消化過程之一部分,此耗費時間。另外,通常需要高劑量之活性成分(歸因於低生物可用性),導致副作用更多及/或安全問題增加的風險。
最後,限制其長期使用之經口調配物之其他限制為微生物不穩定性。此可能需要使用防腐劑來進行控制,可能會導致刺激且引起致敏/過敏作用。
在某些病狀(諸如急性病症)的治療中,通常高度理想的是,藥理學作用比可藉由經口藥物遞送提供的藥理學作用更快起效。
在此類情況下,藥物被立即吸收至全身循環中之投與原理更可能引起快速起效。儘管此可經由非經腸投與(諸如皮下或靜脈內注射)來完成,但此類遞送方式並不方便,且有時對於患者來說時常極難及/或不可能做到,由此需要醫師進行耗時的干預以確保順從性且避免不必要或有害的作用。
活性成分之經黏膜投與係對非經腸投與之可行的替代方案。其使藥物分子有可能經由黏膜(例如經直腸、舌下、經頰、經肺及鼻內)直接遞送至全身循環中,且可能帶來諸如以下之優點:患者順從性增加、藥物生物可用性改善且因此使劑量降低、起效更快速以及副作用減少。
然而,藥物之經黏膜投與呈現出其自身有相當明顯的問題。不同於胃腸道,胃腸道為含有相對較大量之生物流體的大型器官,諸如口腔及鼻腔之空間相對較小且所含有之體液量,諸如唾液及/或黏液少得多。此必然對可以單次劑量投與之活性成分的量帶來相當大的限制。
此外,儘管胃腸道為一種動態系統,但其在主要部分中為某種「封閉」系統。相反,在口腔及鼻腔二者中發生的快速清除機制意謂,對於已有更多限制之藥物量,通常可用於跨黏膜表面吸收之時間亦為有限的。
已提出許多調配原理來解決此問題,包括(例如)生物黏附調配原理,諸如用於口腔黏膜藥物遞送之經頰貼片(參見例如Shojaei,
J. Pharm. Pharmaceutical Sci.,
15, 19 (1998) and Gandhi,
Advanced Drug Delivery Reviews,
43, 67 (1994))以及用於鼻內藥物遞送之原位膠凝組合物(參見例如Bertan等人
Eur. J. Pharm. Sci.,
27, 62 (2006))。
呈固態形式之經黏膜藥物遞送系統可在允許調配物中之更高藥物負載方面呈現出顯著優勢。然而,儘管當向直腸、經頰、舌下及肺黏膜投與時固體藥物遞送組合物更為常見,但絕大部分鼻內藥物遞送系統仍以液體噴霧劑,通常呈水溶液形式呈遞,其中藥物溶解度扮演可用於吸收之藥物量的另一限制因素。
用於鼻內遞送之該液體噴霧劑幾乎普遍存在,係因為調配呈經鼻粉末形式之固體醫藥調配物並不容易。不同於常常用於將活性成分吸入至肺中之粉末,存在極少可商購的鼻內粉末調配物。
當調配為乾燥粉末時,經肺藥物遞送組合物通常呈「聚集」混合物之形式,其包括在較大載劑粒子上之API的微粉化粒子。此等聚集體意在吸入或致動裝置時解離/分解,從而僅在肺中沈積活性成分之細粒。
然而,此類藥物遞送系統應理解為無法在鼻內藥物遞送之情況下有效地工作。此係因為此類細粒之存在導致顯著肺部暴露風險,其不為預期投與部位。若為了避免此問題而增加藥物粒度,則將可能導致難以確保異質性『相互作用』混合物中之適當的相互作用,其取決於兩種組分之尺寸的實質性差異以確保相互作用,從而又引起潛在的製造問題,諸如在填充期間之分離(segregation)。嘗試藉由相應地增加載劑粒度來對此進行補償將未必解決該問題,但將必定增加已有有限限度之劑型的總質量中之無活性賦形劑的質量,從而有可能引起活性成分之劑量降低。
在美國專利申請案US 2005/001411 A1中解決了調配用於鼻內遞送之乾燥粉末的困難。在本文獻中,規定用於經鼻投與之粉末需要足夠細以使得其可由氣流有效地輸送且有效地沈積於鼻中,但亦需要足夠粗糙以便於將粉末引入至適當粉末裝置中,其始終為鼻內投與所需的。US 2005/001411 A1藉由製備包含活性成分之初級粒子之鬆散形成的次級粒子(聚集體)明確解決了此問題。該等聚集體之維度為幾百微米,且據稱此能夠更有效地裝載至適當鼻內投與(施用器、分配器或吹入器)裝置中。在致動此類裝置及投與該組合物時,聚集體明顯快速分解成活性成分之初級粒子。此等初級粒子之尺寸僅為幾微米,據稱有助於其溶解,及其後活性成分之鼻內吸收。
如上所陳述,意欲用於全身性吸收之藥物的經黏膜(例如鼻內)遞送避免了首過代謝,而該首過代謝不可避免地為經口投與之一部分。藥物代謝經由與能夠改變活性成分之化學結構、物理結構及/或生物活性之酶的化學反應發生。
由於大部分藥物為含有能夠經歷此類化學反應之官能基的有機分子,因此當其與能夠與體外之彼等官能基相互作用之物質形成接觸時,通常容易受某種形式之化學分解的影響。
此類化學轉化通常歸類為醫藥領域中之化學「降解」,因為其可通常導致功效損失,或在極端情況下產生毒性副產物,其中之任一者或兩者可導致藥物對患者無效及/或有害。
此類降解可能發生之速度首先取決於藥物化合物之固有化學不穩定性程度、其調配方式及其儲存條件。高溫及濕氣通常會使降解加速。
此類化學完整性之損失為可量測的,且為所有醫藥產品在其標籤上印刷及/或在其封裝上壓印有儲存期限之原因。其亦為某些處方藥物在包裝插頁中含有關於適當儲存條件之特定印刷資訊的原因。
根據經驗,活性成分愈複雜,化學或物理完整性導致生物失活成為問題之可能性愈大。就此而言,生物活性藥物/活性醫藥成分(API),諸如疫苗、酶、抗體/其部分及抗體類似物及模擬物,例如因為其較高階(例如三級)結構及呈適當構形與有效功能之間的相互作用而存在特定問題。
此外,儘管證實為愈來愈適用於治療大範圍疾病及病症,但相比於為小分子之其他API,某些生物藥劑或生物製劑(諸如抗體/其部分)可能不會特別有效且可能需要高劑量來達成顯著的生物效應。
如藉由Kou及Zhou在教科書
Amorphous Solid Dispersions之第16章,Shah等人(編), Springer (2014)中所概述,若藥物以非晶形而非以結晶物理狀態調配,則其通常以更高能態存在,且因此可能在化學上及物理上更不穩定,從而給藥物調配者帶來挑戰。
因此,通常藉由常經由鹽形成呈現呈結晶狀態之藥物(尤其小分子之藥物)來改良化學穩定性。然而,其並非簡單的問題,且實際上通常並非一種選擇,用以呈現呈此類鹽形式之大型(巨分子)生物製劑。
因此,鑒於其提供之所有前述潛在優點,仍需要經改良之固體(例如基於粉末之固體)經黏膜及尤其鼻內藥物遞送系統。
特別地,對於粉末狀藥物遞送組合物,藥物遞送領域中仍存在大量未滿足的臨床需求,該粉末狀藥物遞送組合物:
(i) 在物理上及化學上均穩定;及
(ii) 提供活性成分:
● 具有足夠的劑量;及
● 若意欲以一種形式全身性投與,其中該形式具有足夠滲透性以在(相對而言)可能的低劑量及在經黏膜背景下(諸如在鼻腔內)可用的短暫滯留時間下提供所需治療作用(諸如起效之速度及/或對藥物標靶之接近)。
除上述之外,在鼻內藥物遞送之更特定領域中,對於此類藥物遞送組合物仍存在大量未滿足的臨床需求,該藥物遞送組合物包含適當尺寸之粒子以能夠有效地:
● 填充藥物遞送裝置;及
● 沈積於相關腔室(例如鼻腔)內。
鼻內乾粉調配物係尤其自國際專利申請案WO 2010/142696及WO 2019/038756、美國專利案第10,653,690 B1號及美國專利申請案US 2018/0092839A中獲知。
生物製劑之噴霧乾燥已揭示於例如Bürki等人,
Int. J. Pharm.,
408, 248 (2011)及Lipiäinen等人,
ibid.,
543, 21 (2018))中。
吾人現已發現,有可能藉助於例如噴霧乾燥彼等活性成分以及載劑材料之特定組合的方法來以非晶形乾燥粉末組合物形式調配某些生物活性成分(亦即生物藥劑或生物製劑),如下文中所揭示。此類組合物可使彼等活性成分在投與之前的穩定性得到驚人且實質性的改良,且在相關活性成分之藥理學及/或生物活性方面無顯著損失。另外,此類組合物可使彼等活性成分在投與之後的生物可用性及/或吸收速度得以改良。
根據本發明之第一範疇,提供一種呈固體、非晶形、單微粒粉末形式的醫藥學上可接受之組合物,其包含以下之混合物:
(a) 藥理學上有效劑量之至少一種生物醫藥藥物化合物;以及
(b) 醫藥學上可接受之載劑材料,該載劑材料包含雙醣與聚合材料之組合,
該醫藥學上可接受之組合物在下文中統稱為「本發明組合物」。
本發明之組合物呈非晶形、單微粒粉末形式。『單微粒(mono-particulate)』意謂形成本發明之粉末狀組合物的複數個粒子包含均質或非均質混合物,其中生物醫藥藥物化合物(在本文中亦被稱作『活性成分』、『醫藥學上活性成分』、『藥理學上活性成分』及/或『藥物』)視情況在其他成分之存在下以非晶態囊封於如上文所定義之載劑材料內。本發明之粉末狀組合物的粒子因此呈現為活性成分、載劑材料及視情況其他成分之非晶形複合物。
由於其在性質上為非晶形的,本發明之組合物可為完全非晶形的及/或可主要為非晶形的(例如,超過約50重量%,諸如超過約75重量%,包括超過約80重量%,諸如超過約90重量%或95重量%,包括超過約99重量%非晶形)。在替代方案中,本發明之組合物可低於約50%,諸如低於約25%,更佳低於約20%,例如低於約10%,包括低於約5%或低於約1%結晶。可由熟習此項技術者使用粉末X射線繞射(PXRD)測定結晶程度(%)。亦可使用其他技術,諸如固態NMR、FT-IR、拉曼光譜法、差示掃描熱量測定(DSC)微量熱法及真實密度計算。
如在下文中所述,儘管呈非晶形物理狀態,但本發明之組合物展現出顯著且出人意料的物理及化學穩定性,且因此可以當在正常儲存條件下儲存時展現出極佳儲存期限之醫藥產品形式提供。
藉由適當技術,至少最初以多微粒形式(亦即以粉末形式)製備本發明之組合物。一般而言,適當技術屬於「基於溶劑」之方法,其包括噴霧乾燥、流體化床技術、共沈澱、超臨界流體技術、噴霧成粒、低溫技術(包括冷凍乾燥)、靜電紡絲及旋轉噴射技術,或屬於「基於融合」之方法,其包括熔融造粒、熔融擠壓、高剪切混合(例如KinetiSol®)、碾磨及使用載劑技術(例如Meltdose®)熔融材料。較佳方法包括冷凍乾燥,且更佳地,本發明之組合物係藉由噴霧乾燥方法製備。
此類粉末可適用於經由任何醫藥學上可接受之投與途徑直接遞送至患者,或可作為中間組合物呈現,該中間組合物可隨後被調配成待向一或多個患者投與之醫藥學上可接受之劑型。
就此而言,提供一種醫藥調配物及/或一種醫藥學上可接受之劑型,該調配物及/或劑型待向患者投與,且包含一或多種本發明之組合物。
適合的醫藥劑型可因此包含液體調配物,諸如溶液,其可藉由將本發明之組合物溶解於醫藥學上可接受之溶劑(諸如水)中來製備,以供例如藉由注射或藉由輸注遞送至此類患者。當活性成分為抗體或其類似物時,此類投與方式可為適用的。
替代性醫藥劑型可包含液體或半固體調配物,諸如可包含本發明之組合物(例如其粒子)之液體懸浮液及/或凝膠組合物,本發明之組合物懸浮或溶解於適當液體或半固體載劑中,該載劑可裝載至適當劑型中或藉由例如注射或輸注遞送或可在注射(例如皮下或肌肉內)之後形成,以形成植入或儲槽式調配物。
在替代方案中,本發明之組合物可呈現為基本上固體醫藥劑型之一部分。熟習此項技術者將很好地理解,術語「固體」包括在不受限制時保持其形狀及密度,及/或其中分子通常在其之間的排斥力允許之範圍內儘可能緊密地壓縮之任何形式的物質。因此,基本上固體調配物為至少約80%,諸如至少約90%,包括至少約95% (或至少約99%)呈此類形式之調配物。
就此而言,本發明之組合物可以任何多微粒形式(例如,以單純粉末、顆粒、丸粒及/或珠粒形式)提供,包含複數個可單獨地及/或可共同地基本上由一或多種本發明之組合物組成及/或包含一或多種本發明之組合物的粒子。
因此,本發明之組合物可在其製備(例如藉由噴霧乾燥)之後呈現為單個粉末混合物、粉末微球體、經塗佈粉末微球體、凍乾脂質分散液或其組合之形式。
若本發明之醫藥學上可接受之劑型『基本上由一或多種本發明之組合物的粒子組成』,則此將理解為意謂該劑型僅包含一或多種本發明之組合物,以及實質上不影響劑型之基本及新穎特徵的其他特徵及/或組分。或者,在本發明之劑型『基本上由一或多種本發明之組合物組成』之情形下,此將理解為意指該劑型總共包含至少約90重量%,諸如至少約95重量%,包括至少約97重量% (例如約99重量%)的彼等一或多種本發明之組合物。
在替代方案中,醫藥劑型包含一或多種本發明之組合物,其可以單個單位劑型形式提供,諸如子宮托、栓劑或另一形式之插入物、丸劑、膠囊、餅狀物、貼片(例如經頰貼片)、膜(例如口內膜)或錠劑(例如舌下錠劑)。
可如下製備膠囊:藉由將呈經噴霧乾燥粉末形式之本發明之組合物直接裝載至由經設計用於舌下或較佳經口遞送之適當材料製造的醫藥學上可接受之膠囊中,或藉由在裝載至此類膠囊中之前混合組合物以及賦形劑,其可涉及如下文所述的在裝載至膠囊中以供此類遞送之前的造粒步驟。當活性成分為例如酶時,可使用經口遞送。
就此而言,本發明之組合物經粒化成丸粒或丸劑,但其亦可調配(亦即,經提供以便投與)成乾燥、自由流動粉末形式。『乾燥(dry)』包括基本上不含水及其他液體溶劑,其包括低於約10%,諸如低於約6%,包括低於約5%,或低於約4%,更佳低於約3%,諸如低於約2%,例如低於約1%調配物為液體,諸如水。
本發明之粉末組合物之流動性可藉由熟習此項技術者已知之標準技術量測,包括堆密度量測,或在粉末流分析儀(例如,由Stable Micro Systems或Meritics出售之分析儀,二者均屬UK)上進行之量測,包括粉末流速依賴性測試、結塊測試、內聚力測試等。流動性之較佳量測係標準靜止角,其可使用旋轉筒、固定漏斗或擺動箱進行。
在本發明之上下文中,術語『自由流動』意欲包括粉末允許在製造期間將本發明之組合物有效填充至藥物遞送裝置中,及/或在自該裝置排出時提供足夠的注射重量(見下文)。
該術語亦可包括粉末展現出不超過約50°,諸如不超過約45°,包括不超過約40°,例如不超過約35°,且更特別地不超過約30°之靜止角;不低於約0.3 g/mL,例如不低於約0.4 g/mL,諸如不低於約0.5 g/mL,且更特別地不低於約0.6 g/mL之堆密度;及/或不低於約0.5 g/mL,諸如不低於約0.6 g/mL,例如不低於約0.7g/mL,且更特別地不低於約0.8 g/mL之振實密度。
用於製造包含乾燥粉末或顆粒之劑型的適當技術包括簡單乾燥混合、造粒(包括乾式造粒、濕式造粒、熔融造粒、熱塑性切粒(pelletising)、噴霧造粒)、擠塑/滾圓(spheronisation),或更佳地,冷凍乾燥或噴霧乾燥(見下文)。
乾式造粒技術亦為熟習此項技術者所熟知且包括任何技術,其中初級粉末粒子在高壓下聚集,包括摻雜(slugging)及輥壓,例如如下文中所述。
濕式造粒技術亦為熟習此項技術者所熟知且包括涉及任何使用造粒流體對乾燥初級粉末粒子之混合物的彙聚(massing)的技術,該流體包含揮發性、惰性溶劑,諸如單獨或呈組合形式及視情況在黏合劑或黏結劑之存在下之水、乙醇或異丙醇。該技術可涉及迫使濕物質通過篩網以產生濕顆粒,隨後使其乾燥,乾燥損失較佳低於約3重量%。
熟習此項技術者將已知,熔融造粒包括經由添加熔融黏合劑或在過程期間熔融之固體黏合劑(該黏合劑材料可包含本發明之組合物的醫藥學上可接受之載劑材料)獲得顆粒之任何技術。在造粒之後,黏合劑在室溫下固化。已知熱塑性切粒將類似於熔融造粒,但其中使用黏合劑之塑膠特性。在兩種方法中,所得之聚結物(顆粒)包含基質結構。
擠塑/滾圓將為熟習此項技術者所熟知,包括任何涉及成分之乾燥混合、與黏合劑一起濕彙聚、擠塑、將擠出物滾圓成大小均勻之球體及乾燥之方法。
熟習此項技術者將已知噴霧造粒包括任何涉及對液體(溶液、懸浮液、熔融物)進行乾燥,同時在流化床中形成顆粒之技術。因此,該術語包括其中提供外來晶種(病菌)且在其上形成顆粒之方法,以及由於磨損及/或破裂在流化床中形成固有晶種(病菌)之方法,外加任何通用噴塗造粒技術。經噴霧之液體塗佈病菌且有助於粒子之進一步集結。隨後將其乾燥以形成呈基質形式之顆粒。
術語「冷凍乾燥」包括凍乾或去溶劑(cryodesiccation)及任何低溫去溶劑(例如脫水)方法,其中產物被冷凍,壓力降低,且藉由昇華移除冷凍溶劑(例如水)。
在替代方案中,本發明之組合物可以用於經口、經頰及/或舌下使用之錠劑形式提供。此類錠劑可例如藉由視情況在將其與一或多種適當賦形劑(諸如稀釋劑、崩解劑、助滑動及/或潤滑劑)混合在一起之後直接壓縮/壓實本發明之組合物形成,且可使用諸如
Pharmaceutical Dosage Forms: Tablets. 第 1 卷,第3版,Augsburger等人(編), CRC Press (2008)及其中所引用之文獻中所描述之技術來實現。適合之壓實設備包括標準製錠機,諸如Kilian SP300或Korsch EK0、XP1、XL 100及XL 200。
可用於錠劑中之適合崩解劑(如例如Rowe等人,
Handbook of Pharmaceutical Excipients, 第6版(2009)中所定義)包括纖維素衍生物,諸如羥丙基纖維素(HPC)、低取代HPC、甲基纖維素、乙基羥乙基纖維素、羧甲基纖維素鈣、羧甲基纖維素鈉、微晶纖維素、經改質纖維素膠;澱粉衍生物,諸如適當交聯澱粉、經改質澱粉、羥丙基澱粉及預膠凝化澱粉;及其他崩解劑,諸如海藻酸鈣、海藻酸鈉、海藻酸、聚葡萄胺糖、膠態二氧化矽、多庫酯鈉、瓜爾豆膠、矽酸鎂鋁、波拉克林鉀(polacrilin potassium)及聚乙烯吡咯啶酮。可使用兩個或更多種崩解劑之組合。
較佳崩解劑包括所謂的『超崩解劑』(如例如
International Journal of Pharmaceutical Sciences Review and Research,
6, 105 (2011)中所定義),諸如交聯聚乙烯吡咯啶酮、乙醇酸澱粉鈉及交聯羧甲基纖維素鈉。可使用兩種或更多種超崩解劑之組合。
當崩解劑及/或超崩解劑用於錠劑時,其可以按組合物之總重量計0.5與15重量%之間的量(例如總量)使用。較佳範圍為1至8重量%,諸如約2重量%至約7重量% (例如約5重量%,諸如約4重量%)。
若存在,黏合劑較佳以按錠劑調配物之總重量計0.5重量%與20重量%之間的量使用。較佳範圍為1.0至15重量%,諸如約2.0至約12重量% (例如約10重量%)。適合之黏合劑包括纖維素膠及微晶纖維素。
如本文所描述,本發明之組合物較佳藉由噴霧乾燥方法製備。
不論呈粉末形式抑或其他形式,包含本發明之組合物的劑型可另外藉由標準技術且使用熟習此項技術者已知之標準設備來製備。就此而言,本發明之組合物可與此項技術中使用之習知醫藥添加劑及/或賦形劑組合用於相關製備,且使用標準技術併入至各種類型之醫藥製劑中,以便製備包含本發明之組合物的劑型(參見例如Lachman等人,『
The Theory and Practice of Industrial Pharmacy』,CBS,第4版(2015);『
Remington: The Science and Practice of Pharmacy』,Troy (編),Elsevier,第23版(2020);及/或『
Aulton's Pharmaceutics: The Design and Manufacture of Medicines』,Taylor及Aulton (編),Elsevier,第5版,2017)。
儘管其已被製造,但較佳的是,本發明之組合物適合於及/或經調配用於經黏膜遞送活性成分至全身循環中(且在例如疫苗之情況下,產生全身性免疫反應),或同樣在例如疫苗之情況下,在局部微環境中產生免疫反應。
熟習此項技術者將理解,術語「經黏膜」意指儘管向患者投與組合物,但該組合物以使得活性成分在其溶解之後可跨該黏膜表面吸收之形式呈現於相關黏膜表面處。相關黏膜表面因此包括口腔、鼻、眼部、陰道、子宮頸、肺及/或肛門直腸黏膜,更特別地,口腔黏膜(包括經頰及舌下黏膜)及鼻黏膜。
因此,包含本發明之組合物的劑型可直接向患者之黏膜表面(包括經肺、經直腸、經陰道、經頰、舌下或鼻內)投與以用於活性成分之經黏膜遞送。經肺及特別地鼻內投與在活性成分為疫苗時尤其適用,在鼻內投與的情況下,經黏膜吸收可能不一定會引起針對抗原之免疫反應。
若向舌下黏膜投與,則本發明之組合物可呈例如如上文所描述之舌下錠劑形式,其可包含崩解劑(disintegrant/disintegrating agent)(其可定義為能夠將此類本發明之組合物的崩解/分散加速至可量測程度的任何材料),其可例如藉由如在下文中所述當與水性介質接觸時能夠泡脹及/或膨脹之材料實現。
可替代地,本發明之組合物可以如本文所述之粉末形式舌下投與,該粉末可自適當容器(諸如膠囊或藥囊)倒入口中及舌下。
若本發明之組合物適合於及/或經調配用於舌下或更特別地鼻內投與,則其較佳以粉末組合物形式投與,其中活性成分之劑量不超過約100 mg或不超過10
9個國際單位(IU)。此類舌下及/或經鼻粉末組合物可包含與其他賦形劑摻合之本發明之組合物,或可基本上由如上文所定義之本發明之組合物組成。
適用於及/或經調配用於鼻內投與之本發明之組合物較佳藉助於適合於經鼻遞送之給藥構件提供。此類給藥構件可含有一種本發明之經噴霧乾燥之粉末組合物,或其可含有兩種或更多種此類組合物。在後一情況下,給藥構件含有兩種或更多種給藥量之本發明之該組合物,該等給藥量將各自含有藥理學上有效劑量之活性成分。
兩種或更多種本發明之組合物可藉由重複致動包含該給藥構件或與該給藥構件連通之裝置進行鼻內投與。因此,本發明之組合物可存在於適當裝置(例如經鼻施用器或分配器(吹入器),例如如下文中所述)內,及/或可存在於容器或儲集器內,該容器或儲集器作為此類施用器之一部分、附屬於此類施用器及/或適用於附屬於此類施用器。此類容器或儲集器可含有一或多種本發明之組合物,其各自含有藥理學上有效劑量之該等活性成分。
以此方式,適當的給藥構件及/或經鼻施用器可僅致動一次以在致動後遞送包含適當劑量之活性成分的單個本發明之組合物(亦即單次使用給藥單位),可多次致動以在每次此類致動時遞送各自包含適當劑量之活性成分的兩種或更多種本發明之組合物(亦即多次使用給藥單位),及/或用包含一或多種此類組合物之本發明之組合物的替代來源(例如容器或儲集器)重新填充,以提供單劑量及/或多劑量及/或給藥方案。
本發明之組合物可因此以複數個粒子之形式投與,該等粒子可單獨地及/或共同地由本發明之組合物組成及/或包含本發明之組合物。
本發明之組合物由此(最初)以固體、乾燥、自由流動、多微粒粉末形式製備,如上文所描述。
如上所陳述,本發明之組合物係以非晶形、單微粒粉末形式提供。其不由呈混合物形式之兩個或更多個離散、分離的不同成分之粒子集合的物理結合構成,諸如活性成分之較小粒子的有序或相互作用之混合物與較大但分離且化學性質不同之載劑物質粒子結合。亦即,本發明之組合物可以小粒子形式提供,該等小粒子可隨後黏附於相互作用混合物中之分離的較大載劑粒子,且若意欲用於吸入之劑型,則此類呈遞可能適用(參見例如
J. Drug Delivery, Art. ID 5635010, 1-19 (2018))。
如上文所提及,製造本發明之組合物的方法能夠形成如本文所定義的當儲存在正常儲存條件下時在物理及化學穩定性方面均展現出極佳儲存期限之醫藥產品。
本發明之組合物較佳藉由噴霧乾燥方法製備。熟習此項技術者將理解,「噴霧乾燥」方法包括自包括溶液或懸浮液(包括漿料)之液體中產生乾燥粉末之任何方法,其涉及使用熱氣體快速乾燥以將液體流轉化成蒸發溶劑及固體粒子,該等固體粒子包含先前溶解於溶液中之溶質,及/或先前懸浮於蒸發液體中之粒子。
適當噴霧乾燥設備包括某種形式之霧化構件,諸如噴嘴,其將液體分散成具有相對均勻之液滴尺寸的噴霧。此類構件可包括能夠產生乾燥、自由流動之粉末的任何構件,且可包括高壓渦流噴嘴、旋轉盤及/或霧化輪、高壓單流體噴嘴、雙流體噴嘴及/或超音波式噴嘴。
噴霧乾燥器可為單效或多效噴霧乾燥器,且可包含整合式及/或外部振動流體化床、粒子分離器及/或可為轉鼓或旋風器之收集構件。
根據本發明之另一範疇,提供一種用於製造本發明之組合物之方法,其中該方法包含以下步驟:
i) 將一或多種活性成分及醫藥學上可接受之載劑材料一起混合於適當的揮發性溶劑中,
ii) 噴霧乾燥來自步驟i)之混合物。
較佳揮發性溶劑包括水或有機溶劑,諸如低碳烷基醇(例如甲醇、異丙醇或更尤其為乙醇)、烴(例如C
5-10烷烴)、鹵代烷烴(例如二氯甲烷)、二甲基甲醯胺、二甲亞碸、乙酸乙酯、丙酮等,或其混合物。
吾人偏好將一或多種活性成分、如本文所定義之醫藥學上可接受之載劑材料及如本文所描述之其他視情況選用之成分(例如如下文中所描述之烷基醣類)與溶劑一起混合,產生可經噴霧乾燥之溶液。
可用於本發明組合物中之適當醫藥學上可接受之載劑材料包括以下之相關材料:在正常儲存條件下,在固體狀態下以適當之組合適用於(及/或經核准用於)醫藥用途及/或經黏膜(例如,舌下或特別是鼻內)遞送,且能夠維持其物理及/或化學完整性,及/或不影響任何活性成分及/或可能存在於組合物中之任何其他成分(諸如烷基醣類)的物理及/或化學完整性。
眾所周知,在嘗試獲得化學上及物理上均穩定的固體組合物(諸如粉末)時,可能會遇到很大困難。若組合物之物理形式在正常儲存條件下變化(例如從自由流動粉末變為難以排出之聚結物質),則將可能導致活性成分劑量之不可再現性。當自如本文所描述之經鼻施用器或經由該經鼻施用器分配組合物時尤其如此,其中此類集結可能導致完全不能分配活性成分。
本發明之組合物可具有藉由相對於約80%,諸如約85% (例如約90%)直至約120% (例如約115%,諸如約110%)之目標重量的個別粉末注射重量及/或相對於約85%,諸如約90% (例如約95%)直至約115% (例如約110%,諸如約105%)之目標重量的平均粉末噴射重量所量測之最小注射重量。
類似地,對於含有兩個或更多個劑量之組合物的多個劑量單元,此類穩定性對於確保活性成分之劑量隨時間的再現性至關重要。此等問題中之任一者可能對個體之健康狀況產生不利影響,及/或使個體之健康處於重大風險下。
對於本發明之某些組合物,暴露於大氣降水可能產生固態穩定性較差的粉末組合物。舉例而言,暴露於某些(例如更高)相對濕度可能影響組合物之物理形式,例如藉由潮解,及/或藉由降低組合物及/或組合物之個別組分(諸如載劑材料)之玻璃轉化溫度,或以其他方式影響。
因此,本發明之組合物及包括其之醫藥調配物及給藥構件(諸如經鼻施用器)較佳封裝於實質上防止大氣降水在本文所定義之儲存條件下進入之容器內。此類容器可包括包裝材料,諸如用於錠劑及膠囊之泡殼封裝及熱密封鋁袋及/或熱成型塑膠。此類容器亦可包含乾燥劑,諸如矽膠及/或適當分子篩,其孔徑為例如3Å或4Å。
片語『維持物理及化學完整性』基本上意謂化學穩定性及固態穩定性。
『化學穩定性』包括本發明之任何組合物可在調配成醫藥調配物或劑型時及/或當裝載至醫藥給藥構件(諸如其對應的經鼻施用器或儲集器(具有或不具有適當醫藥包裝))中時在正常儲存條件下以經分離固體形式儲存,其中組合物本身或其中所包括之活性成分的化學降解或分解程度不明顯。
術語『化學穩定性』亦可包括『立體化學(stereochemical)』及/或『組態穩定性(configurational stability)』,其意謂對生物醫藥藥物化合物之分子內之一或多個對掌性中心處的立體化學轉化(諸如外消旋)之抗性。
『物理穩定性』或『固態穩定性』包括任何本發明之組合物可在調配成醫藥調配物或劑型時及/或當裝載至醫藥給藥構件(諸如其對應的經鼻施用器或儲集器(具有或不具有適當醫藥包裝))中時或以其他方式在正常儲存條件下以經分離固體形式儲存,其中組合物本身或其中所包括之活性成分的固態轉型(例如結晶、再結晶、結晶度損失、固態相變(例如在玻璃態或橡膠態之間轉型,或轉型為聚結形式))、水合、脫水、溶劑化或去溶劑化程度不明顯。『物理穩定性』亦包括保持摺疊蛋白之正確構形及/或如下文所定義之生物活性之保持力。
不論為醫藥調配物形式抑或劑型的形式,及/或當裝載至醫藥給藥構件(該醫藥給藥構件裝載至施用器、裝置、藥物儲集器(諸如罐或容器))中時或以其他方式,本發明之組合物的「正常儲存條件」之實例包括在約-50℃與約+80℃之間(較佳在約-85℃ (諸如-25℃)與約+75℃之間,諸如約50℃)的溫度,及/或約0.1與約2巴之間(較佳大氣壓)的壓力,及/或暴露於約460勒克斯之UV/可見光,及/或約5與約95%之間(較佳約10至約40%)的相對濕度,歷時延長之時段(亦即大於或等於約十二個月,諸如約六個月)。
在此類條件下,可發現本發明之組合物(及/或其中所含之活性成分),無論是否包括於醫藥給藥構件(諸如鼻施用器或其對應的儲集器(具有或不具有適當醫藥包裝))或呈其他方式,均視需要以化學方式降解/分解,及/或經固態轉型低於約15%、更佳低於約10%且尤其低於約5%。熟習此項技術者將瞭解,溫度及壓力之上述上限及下限表示正常儲存條件之極值,且在正常儲存(例如50℃之溫度及0.1巴之壓力)期間將不會經歷此等極值之某些組合。
不管『正常儲存條件』之以上定義如何,本發明之組合物(及/或其中所含之活性成分)可在如下儲存之後以化學方式(及/或以立體化學方式)降解低於約5%,諸如低於約4% (包括低於約3%,諸如低於約2.5% (例如約2%),包括低於約1.5%且甚至低於約1%):
(a) 在約-85℃,包括-25℃,諸如0℃或室溫(例如約20℃或約25℃)或約40℃下及75%相對濕度下儲存至少約3個月,包括至少約6個月或至少約12個月;
(b) 在低於約-85℃,包括-25℃,諸如0℃或室溫(例如約20℃或約25℃)或約30℃下(在例如約65%,諸如約60%之相對濕度下)儲存至少約18個月,諸如至少約24個月,包括至少約36個月;及/或
(c) 在高於約1百萬勒克司之UV光下儲存至少約18小時。
此類化學且特別地,物理穩定性在固態組合物,諸如粉末中極為重要,以確保向患者遞送適當劑量。
本發明之組合物可因此儲存於劑型內,諸如施加器或其對應的儲集器(具有或不具有適當醫藥包裝)或另外在高達約25℃ (例如高達約30℃)之任何溫度(例如低至約-85℃,諸如-25℃,包括0℃或20℃)下儲存,較佳具有高達約40℃或甚至高達約50℃之偏移。
可用於產生本發明之組合物且具有本文所提及之所需特徵的尤其較佳的醫藥學可接受之載劑材料包括雙醣組分、麥芽糖醇、蔗糖素、蔗糖、異麥芽酮糖醇(isomalt)、麥芽糖、乳糖及尤其海藻糖。
對於聚合材料組分,可用以產生本發明之組合物且具有本文所提及之所需特徵的較佳醫藥學上可接受之載劑材料包括纖維素及其衍生物,諸如羧甲基纖維素鈉、乙基纖維素、醋酸纖維素、羥丙基甲基纖維素(羥丙甲纖維素,HPMC)、羥乙基纖維素(HEC)、羥丙基纖維素(HPC)、甲基纖維素(MC)、乙基羥乙基纖維素、羧甲基纖維素(CMC)、經改質纖維素膠、微晶纖維素及羧甲基纖維素鈉;澱粉,諸如大米澱粉、木薯澱粉、小麥澱粉及更特別地,玉米澱粉及馬鈴薯澱粉;澱粉衍生物,諸如預膠凝化澱粉、羧基甲基澱粉以及適度交聯之澱粉、經改質澱粉及乙醇酸澱粉鈉;多醣,包括聚葡萄糖、普魯蘭(pullulan)、菊糖(inulin)及糊精,諸如糊精、環糊精及線性或支化糊精,諸如麥芽糊精;粉末狀黃蓍;蠟狀賦形劑,諸如可可脂及栓劑蠟;多元醇,諸如固體聚乙二醇;丙烯酸聚合物,諸如卡波姆(carbomer)及其衍生物;聚乙烯吡咯啶酮(聚維酮,PVP);交聯聚乙烯吡咯啶酮;聚氧化乙烯(PEO);聚葡萄胺糖(聚-(D-葡糖胺));天然聚合物,諸如明膠、海藻酸鈉、果膠;硬葡聚糖;三仙膠;瓜爾膠;聚共-(甲基乙烯基醚/順丁烯二酸酐);及交聯羧甲纖維素(例如交聯羧甲基纖維素鈉)。亦可提及乙酸琥珀酸羥丙甲纖維素(HPMCAS)、共聚維酮及聚乙烯醇(PVA或PVOH)。
更佳聚合材料包括羧甲基纖維素鈉、乙醇酸澱粉鈉、聚乙烯吡咯啶酮及特別地,羥丙基甲基纖維素(諸如羥丙甲纖維素2906,較佳羥丙甲纖維素2910 (亦即『E』型),且更佳為USP/NF羥丙甲纖維素2208(亦即『K』型)及其類似物,或特別地,多醣,諸如糊精,包括環糊精(例如α-環糊精、β-環糊精及γ-環糊精及其衍生物,諸如2-羥基丙基-γ-環糊精、磺基丁醚β-環糊精鈉鹽、隨機甲基化β-環糊精、支化β-環糊精及其類似物,且特別地,2-羥基丙基-β-環糊精);及線性或支化糊精,諸如麥芽糊精。
在任何情況下,適用於本發明組合物中之聚合物應具有足夠高的分子量,使得當其以任何給定量與雙醣組合使用時,其能夠形成適用於活性成分之載劑材料。
對於任何給定聚合物,聚合物鏈長度(且因此分子量)與其黏度成正比。換言之,該聚合物之溶液的黏度與特定聚合物之分子量或鏈長成正比。
就此而言,較佳可為該聚合物在20℃下之相對黏度值不超過約1000 (更佳不超過約120,諸如不超過約60,且尤其不超過約10) mPa*s,如針對任何指定及基本上以下物質所量測:
(a) 水溶性聚合物,如2 wt%之聚合物水溶液,其藉由關於黏度之標準USP方法,亦即<911>方法I,及/或<912>方法I量測;及
(b) 不溶於水之聚合物,如5 wt%之聚合物於適合之有機溶劑中之溶液,該有機溶劑諸如丙酮、甲醇、乙醇、異丙醇、乙酸乙酯、乙腈、二氯甲烷、甲苯及其混合物,該溶劑系統可為乾燥或部分含水的,其係藉由USP方法<911>方法I量測。
熟習此項技術者將理解,哪種測試更適用於所測試之聚合物。
較佳地,載劑材料能夠產生具有如下的玻璃轉化溫度(Tg)之本發明組合物:
(a) 使得能夠產生為硬的及/或脆的、『玻璃狀』、非晶形、粉末狀物理形式,其可易於調配成醫藥調配物或劑型,及/或裝載至適合的給藥構件中,諸如經鼻施用器,或此類如本文所描述之施用器內或附屬的藥物儲集器及/或容器;及
(b) 足夠高以使得在此類醫藥調配物、劑型或給藥構件(諸如施用器或儲集器)如本文所描述被封裝且其後遭受較高外部溫度(例如高達約50℃與約80℃之間)之後,其保持在該玻璃態下,而非轉型成更黏稠或橡膠態及/或結晶狀態。
在溫暖及/或陽光充足的氣候下,媒劑內部通常經歷此類極端外部溫度,該等媒劑將常常在充足的陽光下長時間置放,其中所產生之熱量增加可為巨大的。若本發明之組合物(例如粉末)的Tg較低,則該組合物可在暴露於此類高溫之後轉型為此類黏稠/橡膠態,如此將導致本發明之該組合物的給藥低效,例如一旦致動了給藥構件或施用器,組合物即自給藥構件(諸如施用器或其對應的儲集器)低效排出(且活性成分之劑量亦如此)。此外,過低Tg可能影響呈舌下或經口使用之錠劑形式的本發明之組合物的崩解及/或溶解。
就此而言,吾人偏好當在高達約35%,諸如高達約30%,包括高達約25% (例如高達約20%,諸如低於約15%,例如低於約10%)之相對濕度下量測時,本發明之組合物的最低可量測Tg為至少約10℃,諸如至少約15℃,諸如至少約20℃,包括至少約25℃,諸如至少約35℃,包括至少約40℃,諸如至少約50℃,諸如至少約55℃,包括至少約60℃。『最低可量測Tg』包括:本發明之組合物可包含其性質上為非均質的粒子。特別地,粒子可包含載劑材料之離散區或其複合混合物,且因此可具有個別及單獨的Tg值。熟習此項技術者應清楚,最低可量測Tg之值對組合物之物理穩定性具有較強影響。
吾人尤其已發現,包含雙醣與聚合物(例如如本文所定義之HPMC)及/或尤其糊精之組合的本發明之組合物當與單獨或孤立使用之其他載劑材料相比時,能夠產生適當位準之物理及化學穩定性的組合物及活性成分。
載劑材料之尤其較佳的組合因此包括乳糖,諸如α-D-乳糖單水合物,或更佳地海藻糖,及糊精且尤其環糊精,諸如2-羥丙基-β-環糊精,或麥芽糊精,其中DE高於11,諸如麥芽糊精12DE,或DE高於15,諸如麥芽糊精19DE。吾人已發現,此類載劑材料之組合可與活性成分以及(若存在)適當比例之烷基醣類一起噴霧乾燥,以產生如本文所定義之具有在正常儲存條件下之所需物理及化學穩定性兩者的本發明之組合物。
吾人已發現,載劑材料中之雙醣及聚合物成分的相對量(且特別地,當該聚合物為糊精時)可經調節以確保活性成分之所需物理及/或化學穩定性位準,而同時不會以影響其物理穩定性之方式降低本發明之組合物的Tg。
吾人已發現,按組合物之總重量計,在約50:1至約1:50之間的雙醣:聚合物(例如糊精)按重量計之比率可視所使用之活性成分起作用。按組合物之總重量計,雙醣:聚合物(例如糊精)按重量計之較佳比率在約10:1至約1:40 (包括高達約1:30或高達約1:20)之範圍內,例如在約7:1 (包括約5:1,諸如約4:1、約3:1或約2:1)與約1:10 (諸如約1:8,包括約1:5,例如1:3或1:2)之間,更佳在約8:1 (例如約7:1、約3:1、約2:1或約1:1)至約1:8 (例如約1:3或約1:2)之間。
載劑材料之尤其較佳的組合因此包括海藻糖或乳糖(諸如α-D-乳糖單水合物),及糊精,及尤其環糊精,諸如2-羥丙基-β-環糊精,或更佳地,麥芽糊精。
藉由DE (右旋糖當量)將麥芽糊精分類,其中DE值愈高,葡萄糖鏈之平均長度就愈短。
較佳麥芽糊精包括DE在6與15之間(諸如8及12)或高於15,例如高達47,諸如38、39,較佳23、24、25或26,或更佳16、17、18、20、21或22,且尤其19的麥芽糊精。熟習此項技術者應理解,DE高於20的麥芽糊精稱為『葡萄糖糖漿』。
DE高於15的麥芽糊精的平均分子量低於DE為15或低於15的麥芽糊精。所有麥芽糊精係具有不同鏈長之多醣混合物,且DE高於15的麥芽糊精具有較少較大分子量糖單元。
吾人已發現,具有較低DE之麥芽糊精(諸如DE為12或低於12之麥芽糊精)含有較長多醣鏈(例如具有大於或等於約24個葡萄糖單元),其具有形成螺旋結構之傾向,該等螺旋結構在與其他組分(諸如活性成分及/或界面活性劑,如蔗糖酯)一起存在於水性溶液中時可形成聚集體,在噴霧乾燥之前產生混濁液。此濁度可在製造期間引起穩定性及/或可加工性問題,從而需要使用管線濾波器。
儘管吾人已發現,上述濁度問題可藉由減少包括於本發明組合物內之麥芽糊精的相對量而在一定程度上緩解,該減少可藉由增加其他成分(諸如其他載劑材料(例如雙醣)、活性成分或某些添加劑(諸如蔗糖酯)之量來實現,麥芽糊精之分子量愈高,需要包括的麥芽糊精就愈少,且需要添加以緩解濁度的(例如)雙醣或蔗糖酯就愈多。
若添加更多蔗糖酯以便降低此濁度,則可能需要添加比提供適當(例如物理、化學及/或生物)效應(包括吸收增強效應)所需之效應更多的蔗糖酯,如本文所提及。相反地,增加載劑材料中雙醣相對於麥芽糊精之量可對Tg,且因此對如本文所述之組合物之固態穩定性具有負面影響。
吾人已發現,此類問題可藉由一起使用不同麥芽糊精,亦即具有較高DE之麥芽糊精,諸如DE高於15 (例如DE 18、20或更佳19)之麥芽糊精來減少且可能完全避免。
不管以上如何,適用於本文所描述之粉末組合物的包括麥芽糊精之聚合物應具有仍然足夠高的分子量,使得當以任何給定量(與雙醣組合)使用時,其能夠形成適用於活性成分之載劑材料,包括提供適當程度之物理穩定性。
可採用來自上述雙醣清單及/或聚合材料(包括麥芽糊精)中之任一者的混合物。
可用於本發明之組合物中之載劑材料的量通常在以組合物之總重量計(不論一個劑量之該組合物包括於給藥構件中或呈其他方式),約5重量%至約99.9重量%範圍內,包括至多約99重量% (例如至多約95重量%或約90重量%),諸如約10重量% (例如約25重量%,包括約35重量%)至約85重量%,包括約50重量%至約75重量%。
無論其在最終混合物中之比例如何,本發明之組合物包括包含雙醣與聚合材料(例如糊精)之組合的噴霧乾燥之載劑材料。因此,載劑材料可藉由以下來製備:對相關成分進行噴霧乾燥以形成複合載劑材料,隨後對該載劑材料與其他必需成分一起進行噴霧乾燥以形成本發明之組合物,或更佳地,載劑材料係藉由對本發明組合物之所有必要組分一起進行噴霧乾燥來原位製備。本發明之組合物可藉由在諸如L-白胺酸、異白胺酸、三白胺酸、L-酪胺酸或L-精胺酸之加工助劑存在下進行噴霧乾燥來製備。
本發明之組合物可包含至少一種生物醫藥藥物化合物。『生物醫藥藥物化合物』在此定義內亦包括生物藥劑或生物製劑,其中生物醫藥藥物化合物係由活有機體或其產物產生,或包含活有機體之組分。
生物醫藥藥物化合物包括蛋白質及/或寡肽或多肽、酶、抗體/其部分、疫苗、核苷酸及其類似物或抗體類似物、抗體模擬物、免疫球蛋白、免疫調節劑或其組合。生物醫藥藥物化合物亦可包括血液(例如血漿中懸浮之血球)、血液組分(例如人血組分)、細胞、過敏原(例如花粉、塵蟎、動物皮屑、黴菌、藥物、昆蟲毒液以及各種食物)、基因、病毒(例如動物病毒、植物病毒、細菌病毒、噬菌體、古細菌病毒、輔助病毒、真菌病毒(mycovirus)、親神經組織性病毒(neurotropic virus)、新型病毒、新現病毒(emergent virus)、腫瘤病毒(oncovirus)、孤兒病毒、過客病毒(passenger virus)、原病毒(provirus)、反轉錄病毒、慢發病毒(slow virus)、DNA病毒、dsDNA病毒、dsDNA-RT病毒、dsRNA病毒、核質巨DNA病毒(nucleocytoplasmic large DNA virus;NCLDV)、反義ssRNA病毒、RNA病毒、ssDNA病毒、ssRNA病毒、衛星病毒(包括單股RNA衛星病毒、雙股DNA衛星病毒及單股DNA衛星病毒)、病毒體(virion)、病毒粒子、類病毒粒子、類衣殼病毒粒子、病毒組分及/或元件(諸如衣殼、衣殼粒(capsomere)、內源性病毒元件(EVE)、核殼(nucleocapsid))、毒素(例如,來自細菌之毒素(諸如炭疽致死性毒素(anthrax lethal toxin)、肉毒桿菌毒素(botulinum toxin)、百日咳毒素(pertussis toxin)、金黃色葡萄球菌腸毒素B (staphylococcal enterotoxin;SEB))、真菌及藻類(諸如黃麴毒素(aflatoxin)、石房蛤毒素(saxitoxin)、新石房蛤毒素(neosaxitoxin)、瓢菌素(amanitin)、嘔吐毒(vomitoxin) (脫氧雪腐鐮刀菌烯醇(deoxynivalenol))、二醋酸熏草鐮刀菌烯醇(diacetoxyscirpenol)、T-2及HT-2毒素)、植物(諸如相思子毒素(abrin)及蓖麻毒素(ricin))、毒液(例如神經毒素(neurotoxin)、血毒素(hemotoxic)、細胞毒素(cytotoxic))或其組合。此類生物藥劑或生物製劑可以用於治療或預防選自下群中之一或多種主要適應症:腫瘤學疾病、心血管疾病、感染性疾病、自體免疫性或發炎性疾病、代謝疾病。
應瞭解,可使用之此類蛋白質及/或寡肽或多肽包括天然存在之蛋白質及/或寡肽或多肽以及其合成類似物、半合成、合成朊間質(proteose)。較佳地,此類蛋白質及/或寡肽或多肽為天然存在的,或為重組蛋白及/或肽。更佳地,此類蛋白質、寡肽及/或多肽之分子量超過5 kDa,諸如超過10 kDa,例如超過20 kDa,包括超過30 kDa。
天然存在之蛋白質、寡肽及/或多肽之類型包括細胞骨架蛋白質,諸如肌蛋白、Arp2/3、Arp2/3、冠蛋白、肌縮蛋白、成蛋白(formin)、FtsZ、葛佬素(gloverin)、角蛋白、肌凝蛋白、微管蛋白;細胞外基質蛋白,諸如膠原蛋白、彈性蛋白、底板反應蛋白(F-spondin)、皮卡丘素(pikachurin)、纖維結合蛋白(fibronectin);球狀蛋白,諸如血漿蛋白(如血清類澱粉蛋白P組分);凝血因子,諸如補體蛋白(例如C1-抑制劑、C3-轉化酶)、因子XIII、蛋白C、蛋白S、蛋白Z、蛋白Z相關蛋白酶抑制劑、凝血酶、類血友病因子(Von Willebrand Factor);急性期蛋白(例如C反應蛋白);血紅素蛋白(hemoprotein)(例如血紅蛋白(hemoglobin));細胞黏附蛋白(例如鈣黏素、室管膜蛋白(ependymin)、整合素(integrin)、NCAM、選擇素(selectin));跨膜轉運蛋白(例如CFTR、血型糖蛋白D (Glycophorin D)、混雜酶(Scramblase));離子通道(例如鉀通道、鈣通道、鈉通道、葡萄糖轉運蛋白);激素及生長因子(例如群落刺激因子(CSF)、表皮生長因子(EGF)、纖維母細胞生長因子(FGF)、血小板衍生生長因子(PDGF)、轉型生長因子(TGF)、血管內皮生長因子(VEGF)、跨膜受體(例如視紫紅質(rhodopsin));細胞內受體(例如雌激素受體);DNA結合蛋白(例如組蛋白、精蛋白(protamine));轉錄及調節蛋白(例如CI蛋白、C-myc、FOXP2、FOXP3、MyoD、P53);RNA結合蛋白(例如SRRT);免疫系統蛋白(例如免疫球蛋白、主要組織相容抗原、T細胞受體);養分儲存及/或轉運蛋白(例如鐵蛋白(ferritin));伴隨蛋白(例如GroEL);細胞介素及類似物(包括重組細胞介素),諸如IL-1受體拮抗劑、阿那白滯素(anakinra)、IL-4、IL-6、IL-10、IL-12、IL-17、IL-23、IL-27、IL-33、IL-35或更特別地,IL-2、IL-7、IL-15或IL-21、TNF-α、IFN-α、匹福那白介素(pifonakin)、莫貝白介素(mobenakin)、阿達白介素α (adargileukin alfa)、阿地白介素(aldesleukin)、西莫白介素(celmoleukin)、地尼白介素(denileukin diftitox)、培高白介素(pegaldesleukin)、替西白介素(teceleukin)、妥考妥珠單抗西莫白介素(tucotuzumab celmoleukin)、達尼司亭(daniplestim)、莫來司亭(muplestim)、人白介素(binetrakin)、阿替白介素α (atexakin alfa)、依莫白介素(emoctakin)、伊洛白介素(ilodecakin)、奧普瑞白介素(oprelvekin)、埃度白介素α (edodekin alfa)、辛曲德開貝舒托(cintredekin besudotox)、艾波白介素(iboctadekin)、開發成蛋白質治療劑之細胞介素(例如骨形態發生蛋白(bone mophogenetic protein;BMP)、顆粒球群落刺激因子(G-CSF)、干擾素α、IL-11);酶(例如氧化還原酶、轉移酶、水解酶、裂解酶、異構酶、接合酶)、酶原(例如,血管收縮素原、胰蛋白酶原、胰凝乳蛋白酶原、胃蛋白酶原、凝血酶原、纖維蛋白溶酶原、半胱天冬酶原(procaspases)、pacifastin、彈性蛋白酶原(proelastase)、前脂酶(prolipase)、羧肽脢原(procarboxypolypeptidase)),諸如α-葡糖苷酶、α-D-半乳糖苷酶、β-葡糖腦苷脂酶、艾杜糖醛-2-硫酸酯酶、n-乙醯半乳胺糖-6-硫酸酯酶、n-乙醯半乳胺糖-4-硫酸酯酶、胰臟酶產品(PEP),其含有胰脂肪酶、消化酶、脂肪酶、蛋白酶及澱粉酶之混合物;阿替普酶(alteplase)、瑞替普酶(reteplase)及替奈普酶(tenecteplase);鏈道酶α (dornase alfa)、培羅替酶(pegloticase)、拉布立酶(rasburicase)、L-天冬醯胺酶、膠原蛋白酶、培加酶(pegademase) (牛)、麩卡匹酶(glucarpidase)、奧克纖溶酶(ocriplasmin); 以及乳糖酶(來自米麴菌(asperillus oryzae)、黑麴黴(aspergillus niger)、脆壁克魯維酵母(kluyveromyces fragilis)、乳酸克魯維酵母(kluyveromyces lactis)或大腸桿菌(E coli));人類肽激素,諸如抗穆氏管激素(anti-Müllerian hormone)、脂聯素、促腎上腺皮質激素(adrenocorticotropic hormone)、血管收縮素原、血管收縮素、抗利尿激素、心房利尿鈉肽、膽囊收縮素、促皮質素釋放激素、皮質抑制素、內皮素、促卵泡激素、甘丙胺素(galanin)、胃泌素(gastrin)、類升糖素肽-1、升糖素及類升糖素肽-1類似物、達西格列酮(dasiglucagon)、促性腺素釋素(gonadotropin-releasing hormone)、生長激素釋放激素、鐵調素(hepcidin)、人類絨毛膜激性腺素(human chorionic gonadotropin)、人胎盤催乳素(human placental lactogen)、 生長激素、抑制素、瘦素、促脂素、促黃體生成激素、黑色素細胞刺激激素、腸動素(motilin)、食慾激素受體(orexin)、骨鈣化素、胰臟多肽、促乳素、促乳素釋放激素、鬆弛素、腎素、生長激素抑制激素、生長激素釋放抑制激素、促生長素釋放抑制因子、促生長素釋放抑制激素、血小板生成素、甲狀腺刺激激素、促甲狀腺素(thyrotropin)、促甲狀腺素釋放激素、鳥苷蛋白(guanylin)、尿鳥苷蛋白(uroguanylin)、人工合成促腎上腺皮質素(tetrakosaktid)、美卡舍明(mecasermin)、索馬帕西坦(somapacitan)、派格索曼(pegvisomant)、去氨加壓素(desemopressin)、特利加壓素(terlipressin)、離胺酸加壓素(lypressin)、鳥胺酸加壓素(ornipressin)、精胺酸加壓素(argipressin)、去胺縮宮素(demoxytocin)、卡貝縮宮素(carbetocin)、奧曲肽(ocreotide)、伐普肽(vapreotide)、伊卡托星(elkatonin)或其組合。
其他類型之蛋白質、寡肽及/或多肽可包括病毒或細菌蛋白。術語『病毒或細菌蛋白』包括皆為病毒或細菌之組分及產物兩者且較佳由病毒或細菌基因組編碼之蛋白質。較佳地,病毒蛋白為病毒衣殼或包膜之組分。病毒蛋白可為冠狀病毒或其一部分或變異體之(S)棘蛋白;流感病毒或其一部分或變異體之紅血球凝集素(H)或神經胺糖酸酶(N)蛋白;腺病毒或其一部分或變異體之L3蛋白;呼吸道融合病毒(RSV)白或其一部分或變異體之融合蛋白。
較佳地,蛋白質、寡肽或多肽不為人類胰島素、環孢素、胰島素、干擾素ß、干擾素γ、TPA、白蛋白、HGH、因子VIII、紅血球生成素(erythropoietin)、降鈣素、催產素、抗利尿激素(vasopressin)、伏環孢素(voclosporin)、P物質、肛褶蛙肽(kassinin)、神經激肽A、章魚唾腺精(eledoisin)、神經激肽B、VIP (血管活性腸肽 ;PHM27)、PACAP (垂體腺苷酸環化酶活化肽)、肽PHI 27 (肽組胺酸異白胺酸27)、GHRH 1-24 (生長激素釋放激素1-24)、升糖素、腸泌素、NPY (神經肽)、PYY (肽YY)、APP (鳥胰臟多肽)、PPY胰臟多肽、阿黑皮素原(proopiomelanocortin;POMC)肽、內嗎啡肽、腦啡肽五肽、強啡肽原(prodynorphin)肽、降鈣素、澱粉素、AGG01、B型利鈉肽(BNP)乳三肽、來自以下之肽組分:傳統中醫藥阿膠(Colla Corii Asini)、布舍瑞林(buserelin)、高那瑞林(gonadorelin)、戈舍瑞林(goserelin)、組胺瑞林(histrelin)、亮丙瑞林(leuprorelin)、那法瑞林(nafarelin)、曲普瑞林(triptorelin)、阿巴瑞克(abarelix)、西曲瑞克(cetrorelix)、地加瑞克(degarelix)、加尼瑞克(ganirelix)、惡拉戈利(elagolix)、瑞拉戈利(relugolix)、替維瑞克(teverelix)、去胺加壓素、利拉魯肽(liraglutide)、艾塞那肽(exenatide)、利司那肽(lixisenatide)、阿比魯肽(albiglutide)、度拉糖肽(dulaglutide)、司美魯肽(semaglutide)、生長抑素及類似物、奧曲肽、帕瑞肽(pasireotide)、蘭瑞肽(lanreotide)、特立帕肽(teriparatide),或包含以下中之一或多者的肽:布舍瑞林、高那瑞林、戈舍瑞林、組胺瑞林、亮丙瑞林、那法瑞林、曲普瑞林、阿巴瑞克、西曲瑞克(cetrorelix)、地加瑞克(degarelix)、加尼瑞克(ganirelix)、惡拉戈利、瑞拉戈利、替維瑞克、亮丙立德、利拉魯肽、奧曲肽、去胺加壓素。
可用於本發明之組合物中之生物醫藥藥物化合物亦包括抗體。術語「抗體」應理解為包括多株抗體及單株抗體。該術語亦包括抗體之所有同型,諸如:IgG、IgA、IgM、IgD及IgE。儘管抗體可為多株抗體,但其較佳為單株抗體。
在一些情況下,尤其若向人類患者重複投與抗體,則較佳的是單株抗體為人類單株抗體或人源化單株抗體。適合的單株抗體可藉由已知技術製備,例如『Monoclonal Antibodies Meeting the Challenges in Manufacturing, Formulation, Delivery and Stability of Final Drug Product』,Steven Shire, (Woodhead Publishing, 2015)、Current Trends in Monoclonal Antibody Development and Manufacturing』,Shire等人(Springer New York,2010)、『Therapeutic Monoclonal Antibodies: From Bench to Clinic』, Zhiqiang An (Wiley 2009)、『Monoclonal Antibodies; A manual of techniques』, H Zola (CRC Press, 1988)及『Monoclonal Hybridoma Antibodies: Techniques and Application』,SGR Hurrell (CRC Press, 1982)中所揭示之技術,其中文獻之相關揭示內容係以引用之方式併入本文中。可產生多特異性或單特異性多株抗體。
在一個實施例中,抗體可為鼠類、人類(包括人源化)或嵌合抗體。嵌合抗體由Neuberger等人(1998,第8屆國際生物技術研討會第2部分,792-799)論述,其中文獻之相關揭示內容以引用的方式併入本文中。可以已知方式,例如藉由將小鼠抗體之互補決定區(CDR)插入人類抗體之構架中來『人源化』適當製備之非人類抗體。在其具有對所需抗原或抗原決定基具有特異性之人類抗體之胺基酸序列的意義上,抗體可為人類抗體,但其可使用此項技術中已知不需要人類免疫之方法製備。舉例而言,可使用實質上含有人類免疫球蛋白基因之轉殖基因小鼠(參見Vaughan等人(1998) Nature Biotechnol. 16, 535-539),其中文獻中之相關揭示內容在此以引用的方式併入本文中。
可根據本發明使用之(單株)抗體之非限制性實例為依決洛單抗(edrecolomab) (L01XC01)、托西莫單抗(tositumomab) (V10XA53)、利妥昔單抗(rituximab) (L01XC02)、巴利昔單抗(basiliximab) (LO4AC02)、英利昔單抗(infliximab) (L04AB02)、阿達木單抗(adalimumab) (L04AB04)、替伊莫單抗(ibritumomab) (V10XX02)、維多珠單抗(vedolizumab) (L04AA33)、曲妥珠單抗(trastuzumab) (L01XC03)、吉妥單抗奧佐米星(gemtuzumab ozogamicin) (L01XC05)、西妥昔單抗(cetuximab) (L01XC06)、貝伐珠單抗(bevacizumab) (L01XC07)、帕尼單抗(panitumumab) (L01XC08)、地舒單抗(denosumab) (M05BX04)、依洛尤單抗(evolocumab) (C10AX13)、布羅達單抗(brodalumab) (L04AC12)、厄瑞努單抗(erenumab) (N02CD01)、卡托莫西單抗(catumaxomab) (L01XC09)、奧法木單抗(ofatumumab) (L01XC10)、伊匹木單抗(ipilimumab) (L01XC11)、厄瑞努單抗-aooe、本妥昔單抗維多汀(brentuximab vedotin) (L01XC12)、帕妥株單抗(pertuzumab) (L01XC13)、曲妥珠單抗恩他新(trastuzumab emtansine) (L01XC14)、阿托珠單抗(obinutuzumab) (L01XC15)、迪奴圖單抗β (dinutuximab beta) (L01XC16)、納武利尤單抗(nivolumab) (L01XC17)、那他珠單抗(natalizumab) (L04AA23)、依奇珠單抗(ixekizumab) (L04AC13)、瑞利珠單抗((reslizumab) (R03DX08)、杜匹魯單抗(dupilumab) (D11AH05)、帕博利珠單抗(pembrolizumab) (L01XC18)、博納吐單抗(blinatumomab) (L01XC19)、雷莫蘆單抗(ramucirumab) (L01XC21)、耐昔妥珠單抗(necitumumab) (L01XC22)、埃羅妥珠單抗(elotuzumab) (L01XC23)、達雷木單抗(daratumumab) (L01XC24)、莫格利珠單抗(mogamulizumab) (L01XC25)、奧英妥珠單抗奧加米星(inotuzumab ozogamicin) (L01XC26)、奧拉單抗(olaratumab) (L01XC27)、度伐利尤單抗(durvalumab) (L01XC28)、貝邁奇單抗(bermekimab) (L01XC29)、阿維魯單抗(avelumab) (L01XC31)、阿特珠單抗(atezolizumab) (L01XC32)、西米普利單抗(cemiplimab) (L01XC33)、 帕西妥莫單抗(moxetumomab pasudotox) (L01XC34)、達法思單抗(tafasitamab) (L01XC35)、恩諾單抗維多汀(enfortumab vedotin) (L01XC36)、泊洛妥珠單抗維多汀(polatuzumab vedotin) (L01XC37)、艾薩妥昔單抗(isatuximab) (L01XC38)、貝蘭妥單抗馬佛多坦(belantamab mafodotin) (L01XC39)、多塔利單抗(dostarlimab) (L01XC40)、曲妥珠單抗德魯特坎(trastuzumab deruxtecan) (L01XC41)、雙特異性T細胞接合分子(BiTE;諸如博納吐單抗、索利托單抗(Solitomab)、AMG 330、MT112、MT111、BAY2010112、MEDI-565、瑞瑪奈珠單抗(fremanezumab)、伽奈珠單抗-gnlm (galcanezumab-gnlm)、依普奈珠單抗-jjmr (eptinezumab jjmr)、烏司奴單抗(ustekinumab)、依庫珠單抗(eculizumab)、奧馬珠單抗(omalizumab)或其組合。
可根據本發明使用之抗體之其他非限制性實例包括依那西普(etanercept)、托西珠單抗(tocilizumab)、司妥昔單抗(siltuximab)、賽瑞單抗(sarilumab)、奧洛組單抗(olokizumab)、西魯庫單抗(sirukumab)、替拉珠單抗(tildrakizumab)、古塞庫單抗(guselkumab)、BI-655066、LY3074828、蘇金單抗(secukinumab)、CNTO6785、比美吉珠單抗(bimekizumab)、SCH-900117、MLDL1278A、伯考賽珠單抗(bococizumab)、布雷奴單抗(briakinumab)、莫羅單抗(muromonab)、阿昔單抗(abciximab)、阿侖單抗(alemtuzumab)、賽妥珠單抗(certolizumab)、卡那單抗(canakinumab)、貝利單抗(belimumab)、艾達賽珠單抗(idarucizumab)、美泊珠單抗(mepolizumab)、阿利庫單抗(alirocumab)、奧瑞組單抗(ocrelizumab)、艾美賽珠單抗(emicizumab)、貝那利珠單抗(benralizumab)、布洛舒單抗(burosumab)、拉那利尤單抗(lanadelumab)、依瑪魯單抗(emapalumab)、伊巴珠單抗(ibalizumab)、雷武珠單抗(ravulizumab)、洛莫索珠單抗(romosozumab)、瑞莎珠單抗(risankizumab)、布洛賽珠單抗(brolucizumab)、克利珠單抗(crizanlizumab)、戈沙妥珠單抗(sacituzumab)、艾法珠單抗(efalizumab)、奈巴庫單抗(nebacumab)、達利珠單抗(daclizumab)、奧馬珠單抗(omalizumab)、烏司奴單抗(ustekinumab)、曲妥珠單抗-美坦新偶聯物(ado-trastuzumab emtansine)、曲妥珠單抗德魯特坎(fam-trastuzumab deruxtecan)、薩特利珠單抗(satralizumab)、英比利珠單抗(inebilizumab)、替妥木單抗(teprotumumab)、依凡納單抗(evinacumab)、埃萬妥單抗(amivantamab)、曲羅蘆單抗(tralokinumab)、阿尼富路單抗(anifrolumab)、朗妥昔單抗特林(loncastuximab tesirine)、阿替韋單抗(atoltivimab)、瑪替韋單抗(maftivimab)、奧西韋單抗-ebgn (odesivimab-ebgn)、瑪格妥昔單抗-cmkb(margetuximab-cmkb)、阿蘇維單抗-zykl(ansuvimab-zykl)、阿杜卡努單抗(aducanumab)、阿杜卡努單抗-avwa、瑞達韋單抗(regdanvimab)、索曲韋單抗(sotrovimab)、 替索妥單抗維多汀(tisotumab vedotin)、替索妥單抗維多汀-tftv、特澤佩魯單抗(tezepelumab)、特澤佩魯單抗-ekko、特本他舒(tebentafusp)、特本他舒-tebn、法瑞慈單抗(faricimab)、法瑞慈單抗-svoa、舒敏單抗(sutimlimab)、舒敏單抗-jome、瑞拉利單抗(relatlimab)、替沙格韋單抗(tixagevimab)、西加韋單抗(cilgavimab)、卡瑞單抗casirivimab)、依米得韋單抗(imdevimab)、替雷利珠單抗(tislelizumab)、奧伯單抗(omburtamab)、司柏索利單抗(spesolimab)、尼塞韋單抗(nirsevimab)、特立妥單抗(teclistamab)、烏妥昔單抗(ublituximab)、莫遜圖單抗(mosunetuzumab)、曲美木單抗(tremelimumab)、派安普利單抗(penpulimab)、侖卡奈單抗(lecanemab)、伊諾莫單抗(inolimomb)、替利組單抗(teplizumab)、多奈單抗(donanemab)、米妥昔單抗索拉夫坦辛(mirvetuximab soravtansine)、特瑞普利單抗(toripalimab)、信迪利單抗(sintilimab)、瑞弗利單抗(retifanlimab)、奧普珠單抗莫納托克斯(oportuzumab monatox)、納索利單抗(narsoplimab)或其組合。
可用於本發明之組合物中之生物醫藥藥物化合物亦包括抗體模擬物。可使用之抗體模擬物的非限制性實例包括親和抗體分子(諸如ABY-025)、阿非林(affilin) (諸如SPVF 2801)、阿非莫(affimer)、阿非汀(affitin)、阿爾法體(諸如CMPX-1023)、抗運載蛋白、高親合性多聚體、設計型錨蛋白重複蛋白(DARPins,諸如MP0112)、非諾莫(fynomer)、庫尼茲域肽(kunitz domain peptide)(諸如艾卡拉肽(Ecallantide) (Kalbitor))、阿德奈汀(adnectin)及單功能抗體(諸如培地他尼(Pegdinetanib)(Angiocept))、nanoCLAMP、單域抗體(諸如駱駝抗體)及獲自軟骨魚的IgNAR (免疫球蛋白新抗原受體)之V
NAR片段、二價單域抗體(諸如卡普賽珠單抗(caplacizumab) (Cablivi));及犰狳重複蛋白,其在下文稱為設計型犰狳重複播蛋白、肽適體及打結素或其組合。
在替代方案中,本發明之組合物包含抗體衍生分子,諸如抗體片段(F(ab);例如蘭尼單抗(ranibizumab)(S01LA04))、二價抗體片段(F(ab')
2)以及相關分子,諸如其保留抗原結合位點之可變片段(Fv)及其他片段、單鏈可變片段(scFv) (其可為二價的(例如雙功能抗體)或三價的)、單域抗體或其組合。『二價』表示抗體、抗體模擬物、抗體衍生分子及相關分子具有兩個抗原結合位點。相比之下,單價分子將具有僅一個抗原組合位點。有待於在Winter & Milstein (1991) Nature 349, 293-299中找到合成保留其特異性結合位點之抗體衍生分子中所涉及之技術的一般綜述。
『ScFv分子』包括其中V
H及V
L搭配物域經由可撓性寡肽連接的分子。使用抗體衍生分子而非全抗體之優點係多重的。片段之較小尺寸可得到改良的藥理特性,諸如更好地穿透至目標位點。移除全抗體之效應功能,諸如補體結合。Fab、Fv、ScFv及dAb抗體衍生分子均可表現於抗體衍生分子中且自抗體衍生分子分泌,因此使得可輕鬆生產大量分子。
應瞭解,此類抗體、抗體模擬物、抗體衍生分子及相關分子可為單特異性、雙特異性或多特異性或其組合。雙特異性或多特異性包括意謂其結合兩個或更多個不同目標。
術語『抗體』亦可包括抗體樣分子,其可使用基於活體內及活體外之選擇方法進行篩選及選擇。此類選擇方法包括酵母表面呈現、原核或細菌表面呈現、哺乳動物表面呈現、核糖體呈現、mRNA呈現、cDNA呈現、
CIS呈現、共價抗體呈現(CAD)、活體外區室形成(IVC)及噬菌體呈現技術或用於分子之其他隨機選擇技術。
可用於本發明組合物中之生物醫藥藥物化合物亦包括以下抗體/免疫球蛋白:用於血管外投與之普通人類免疫球蛋白(J06BA01);用於血管內投與之普通人類免疫球蛋白(J06BA02);抗D (rh)免疫球蛋白(J06BB01);破傷風免疫球蛋白(J06BB02);水痘/帶狀疱疹免疫球蛋白(J06BB03);B型肝炎免疫球蛋白(J06BB04);狂犬病免疫球蛋白(J06BB05);風疹免疫球蛋白(J06BB06);痘瘡免疫球蛋白(J06BB07);葡萄球菌免疫球蛋白(J06BB08);巨細胞病毒免疫球蛋白(J06BB09);白喉免疫球蛋白(J06BB10);A型肝炎免疫球蛋白(J06BB11);腦炎;蟲媒免疫球蛋白(J06BB12);百日咳免疫球蛋白J06BB13);麻疹免疫球蛋白(J06BB14);腮腺炎免疫球蛋白(J06BB15);帕利珠單抗(palivizumab) (J06BB16);莫維組單抗(motavizumab) (J06BB17);蘭希班單抗(raxibacumab) (J06BB18)、貝茨羅特斯單抗(bezlotoxumab) (J06BB21);奧托薩昔單抗(obiltoxaximab) (J06BB22);炭疽免疫球蛋白(J06BB19);組合(J06BB30);或其組合。
當生物醫藥藥物化合物包含一或多種疫苗時,本發明之組合物尤其適用。
成本為考慮改善發展中國家中之疫苗接種計劃的顯著因素。降低疫苗成本之一種方式為產生更穩定的疫苗組合物,其中此類組合物不需要冷鏈,例如使其更便宜且更易於運送及儲存。此外,認為疫苗在次最佳儲存條件下之活性損失明顯導致不太有效的疫苗接種計劃(Brandau等人,2003)。世界衛生組織(WHO)要求疫苗調配物在37℃下儲存一週之後的效價最低。然而,當在室溫下儲存僅1小時時許多疫苗可能失去超過50%之其效力(Plotkin & Orenstein,2004)。
在一個實施例中,疫苗可為活的或活性疫苗、減毒疫苗、活減毒疫苗(例如麻疹、流行性腮腺炎及風疹(MMR)疫苗、水痘(variella/chickenpox)疫苗)、滅活(inactivated/killed)疫苗(例如脊髓灰質炎疫苗、流感疫苗)。
在一個實施例中,疫苗可為全病原體疫苗、次單位疫苗或核酸疫苗,諸如活減毒疫苗、滅活疫苗、次單位疫苗、重組疫苗、多醣疫苗、結合疫苗、類毒素疫苗、病毒載體疫苗及/或信使RNA (mRNA)疫苗。
在另一實施例中,疫苗可為次單位疫苗(諸如蛋白次單位疫苗,例如重組疫苗或類病毒粒子(VLP)疫苗(包括類衣殼病毒粒子、病毒衣殼衍生之類病毒粒子),其抵抗例如B型肝炎、非細胞性百日咳疫苗流感、HIV、HPV、瘧疾、淋病、脊髓灰質炎、茲卡病毒、天花病毒、猴痘病毒、各種類型之癌症(諸如,表現及/或過度表現HER2 (人類表皮生長因子受體2)、EGFR (表皮生長因子受體)、CD-20、VEGF (血管內皮生長因子)、VEGFR (血管內皮生長因子受體)、CEA (癌胚抗原)、CA-125 (癌症生抗原125)、MUC-1 (黏蛋白1)或MAGE (黑色素瘤相關抗原)之癌症),更具體而言,由病毒(包括呼吸道融合病毒(RSV)或冠狀病毒(包括任一病毒之變異體))引起的急性呼吸道疾病,諸如急性呼吸窘迫症候群(ARDS)及/或嚴重急性呼吸道症候群(SARS),且尤其是COVID-19,或例如,其中蛋白質為(S)棘蛋白或其部分;多醣疫苗,例如肺炎鏈球菌多醣疫苗、腦膜炎球菌疫苗;或結合疫苗,例如肺炎鏈球菌結合疫苗、流感嗜血桿菌B型結合疫苗、腦膜炎球菌結合疫苗、MenACWY)。次單位疫苗可在不同系統,諸如大腸桿菌系統、酵母細胞系統、昆蟲細胞系統、植物系統或哺乳動物細胞系統中製造。
在另一實施例中,疫苗可為核酸疫苗(諸如DNA疫苗或RNA疫苗,較佳其中RNA為信使RNA (mRNA))。此類疫苗之實例可包括抗癌DNA疫苗、抗肺結核之DNA疫苗、抗遲緩愛德華氏菌(
Edwardsiella tarda)之DNA疫苗、抗HIV之DNA疫苗、抗炭疽之DNA疫苗、抗流感之DNA疫苗、抗登革熱之DNA疫苗、抗傷寒之DNA疫苗、抗不同抗原之DNA疫苗(例如p
CE6、p
CE18、呈質體pSia10、pIDSia10、pIDOmpU、pSiVa1等形式之海豚鏈球菌(
S iniae) DNA疫苗)、預防性DNA疫苗、非複製mRNA疫苗、活體內自複製mRNA疫苗、活體外樹突狀細胞非複製mRNA疫苗、樹突狀細胞疫苗、個人化癌症疫苗(例如其中疫苗中之RNA序列經設計為編碼癌症特異性抗原)、抵抗SARS疾病(諸如由冠狀病毒SARS-CoV-2,亦即冠狀病毒2019或COVID-19引起之疾病)的RNA疫苗。
在又另一個實施例中,疫苗可為類毒素疫苗(例如破傷風類毒素(TT)疫苗;白喉疫苗;白喉、百日咳及破傷風(DPT)疫苗;或肉毒桿菌類毒素疫苗)。為避免疑問,類毒素疫苗包括使用由例如導致疾病之病菌製得之毒素的類毒素疫苗。
在又另一個實施例中,疫苗可為病毒載體疫苗。病毒載體可為痘病毒(例如牛痘病毒、改良型安卡拉疫苗病毒(MVA)、鳥類痘病毒(avipox)、雞痘病毒(fowlpox))、反轉錄病毒(例如慢病毒)、水泡性口炎病毒(VSV)、麻疹病毒、腺病毒、腺相關病毒、巨細胞病毒、仙台病毒(Sendai virus)、單純疱疹病毒或其組合。病毒載體可為活的或活性病毒疫苗、減毒病毒疫苗、活減毒病毒疫苗、滅活疫苗或滅活病毒疫苗。
在又另一個實施例中,疫苗可為細菌載體疫苗。細菌載體可為乳酸菌牛分枝桿菌BCG (lactic acid bacterium
Mycobacterium bovisBCG)、乳酸乳球菌(
Lactococcus lactis)、沙門氏菌屬(
Salmonella/Salmonella spp)、、枯草芽孢桿菌(
Bacillus subtilis)、銅綠假單胞菌(
Pseudomonas aeruginosa)、志賀氏桿菌屬(
Shigella/Shigella spp)、霍亂弧菌
(Vibrio Cholera)、鰻弧菌(
Vibrio anguillarum)、假結核棒狀桿菌(
Corynebacterium pseudotuberculosis)、百日咳博德特氏菌(
Bordetella pertussis)、鏈球菌(
Streptococcus)、產單核細胞李斯特氏菌(
Listeria Monocytogenes)、大腸桿菌(
Escherichia coli)、小腸大腸炎耶氏桿菌(
Yersinia enterocolitica)、恥垢分支桿菌(
Mycobacterium smegmatis)、乳桿菌屬(
Lactobacillus)或其組合。
在又一實施例中,疫苗可為抗例如肺炎球菌細菌感染之結合疫苗。
在又一實施例中,疫苗可為重組載體疫苗。
在另一實施例中,疫苗可為基於奈米粒子之疫苗(諸如,基於介孔矽奈米粒子(MSN)之疫苗或基於固體脂質奈米粒子(sLNP)之疫苗)、或類病毒粒子(VLP)疫苗(例如,衣殼VLP疫苗或病毒衣殼衍生之VLP疫苗),該等疫苗中之各者可有效抵抗包括以下之疾病:流感、HIV、HPV、瘧疾、淋病、脊髓灰質炎、茲卡病毒、天花病毒、猴痘病毒、細菌感染(諸如沙眼披衣菌(
Chlamydia trachomatis)、淋病奈瑟氏菌(
Neisseria gonorrhoeae)、奈瑟氏腦膜炎菌(
Neisseria meningitidis)、百日咳博德特氏菌(
Bordetella pertussis)或結核分支桿菌(
Mycobacterium tuberculosis))或各種類型之癌症(諸如,表現及/或過度表現HER2 (人類表皮生長因子受體2)、EGFR (表皮生長因子受體)、CD-20、VEGF (血管內皮生長因子)、VEGFR (血管內皮生長因子受體)、CEA (癌胚抗原)、CA-125 (癌症抗原125)、MUC-1 (黏蛋白1)或MAGE (黑色素瘤相關抗原)、大腸直腸癌、乳癌、前列腺癌、肺癌、子宮頸癌及卵巢癌),更具體而言,由病毒(包括呼吸道融合病毒(RSV)或冠狀病毒(包括任一病毒之變異體))引起的急性呼吸道疾病,諸如急性呼吸窘迫症候群(ARDS)及/或嚴重急性呼吸道症候群(SARS),且尤其是COVID-19。基於奈米粒子或基於VLP之疫苗亦可攜帶及/或遞送蛋白質或其部分(諸如病毒、細菌、哺乳動物、真菌或寄生蛋白,該等蛋白質或其部分可為膜蛋白、表面蛋白、融合蛋白、包膜蛋白、結構蛋白、棘蛋白、核殼或衣殼蛋白或其組合)、DNA、脂質、多醣、毒素(諸如細菌性毒素)、mRNA、RNA或病毒疫苗(諸如活病毒疫苗、減毒病毒疫苗、活減毒病毒疫苗、滅活病毒疫苗)。基於奈米粒子或基於VLP之疫苗亦可進一步攜帶及/或遞送佐劑及免疫刺激分子,諸如TLR促效劑及細胞介素。
視情況,呈疫苗組合物形式之本發明組合物可包含佐劑。術語「佐劑」欲意謂添加至調配物中以增加調配物內之一或多種本發明之產物的生物學作用的任何化合物。佐劑可為具有不同陰離子之鋅、銅或銀鹽中之一或多者,該等陰離子為例如但不限於不同醯基組合物之氟離子、氯離子、溴離子、碘離子、氰酸根、亞硫酸根、氫氧根、磷酸根、碳酸根、乳酸根、乙醇酸根、檸檬酸根、硼酸根、酒石酸根及乙酸根。佐劑亦可為有機多聚陽離子(例如聚乙烯亞胺(PEI))、陽離子型聚合物(諸如陽離子型纖維素醚、陽離子型纖維素酯、去乙醯化玻尿酸、聚葡萄胺糖)、陽離子型樹枝狀聚合物、陽離子型合成聚合物(諸如聚(乙烯基咪唑))及陽離子型多肽(諸如聚組胺酸、聚離胺酸、聚精胺酸及含有此等胺基酸之肽)、陽離子型(N3)或陰離子型(L3)脂質佐劑。視宿主物種而定,可使用多種佐劑來增加免疫反應。此類佐劑包括(但不限於)類毒素佐劑、細胞介素、自然殺手T細胞(NKT)配體(例如α-半乳糖腦苷脂(α GalCer)及類似物)、C型凝集素受體(CLR)配體、鐸樣受體(TLR)促效劑(例如CpG、CpG ODN、Poly I:C、葡糖哌喃糖基脂質A (GLA)、單磷醯基脂質A (MPL)、雷西莫特(resiquimod) (R848)、鞭毛蛋白(flagellin)、咪唑喹啉(例如咪喹莫特(imiquimod))、STING配體(例如STING促效劑:雙-(3',5')-環狀二聚鳥苷單磷酸(c-di-GMP或cdGMP))、胞壁醯二肽、EP 109 942、EP 180 564及EP 231 039之『免疫刺激複合(Iscom)』、 表面活性物質,諸如溶血卵磷脂、聚陰離子、肽、螺血氰蛋白(KLH)、鋁鹽、礬、鋁膠、氫氧化鋁、磷酸鋁、基於皂素之佐劑(例如基質M1)、δ菊糖微粒佐劑(例如Advax)、DEAE-聚葡萄糖、中性油(例如miglyol)、植物油(諸如花生油)、角鯊烯(例如,鯊魚角鯊烯)乳液(例如,MF59、AS03、弗氏完全或不完全佐劑(Freund's complete or incomplete adjuvant)、Montanide ISA51、Montanide ISA720)、脂質體(例如DOPE (1,2-二-(9Z-十八烷醯基)-sn-甘油-3-磷酸乙醇胺):DDA( 溴化二甲基二(十八烷基)銨鹽)多層脂質體、氯化N-[1-(2,3-二油醯氧基)丙基]-N,N,N-三甲銨(DOTAP)、脂質奈米粒子、聚(乳酸-共-乙醇酸) (PLGA)奈米粒子、Pluronic多元醇或Ribi佐劑系統、核酸(例如單股RNA)、Hiltonol或其組合。『Pluronic』、『Alhydrogel』、『Hiltonol』、『Montanide』為註冊商標。
此類疫苗將適用於針對疾病、病症及/或病狀進行疫苗接種、降低其風險、預防或對抗疾病、病症及/或病狀。該疾病、病症及/或病狀可例如由病毒、細菌及/或寄生蟲感染引起。或者,該疾病、病症及/或病狀可具有內源性及/或基因環境病因,包括自體免疫性疾病、心血管疾病、發炎性疾病、代謝疾病及/或癌症。
在一較佳實施例中,引起疾病、病症及/或病狀之病毒可為正黏液病毒(例如流感病毒,諸如流感病毒A(H1N1)、A(H3N2)、A(H7N7)、A(H3N8);傳染性鮭魚貧血症病毒(isavirus)或托高土病毒(thogotovirus))、小病毒(parvovirus) (例如腺相關病毒、犬小病毒(CPV)、貓泛白血球減少症(FPV)、貂腸炎病毒(MEV))、腺病毒、肺病毒(例如呼吸道融合病毒(RSV))、疱疹病毒(例如單純疱疹病毒(HSV)、貓疱疹病毒1型(FHV-1)、馬疱疹病毒(EHV)、水痘帶狀疱疹病毒)、馬頓病毒(matonavirus) (例如風疹病毒(rubella virus))、棒狀病毒(狂犬病病毒)、反轉錄病毒(例如慢病毒、人類免疫缺乏病毒(HIV)、人類T-嗜淋巴細胞病毒(HTLV))、痘病毒(例如痘瘡病毒、天花病毒、猴痘病毒)、副黏病毒(例如麻疹病毒、新城病病毒(Newcastle sisease virus)、腮腺炎病毒、犬瘟熱病毒(CDV)、犬副流感病毒(CPi))、乳突狀瘤病毒(例如人乳突狀瘤病毒(HPV))、呼腸孤病毒(例如輪狀病毒)、小RNA病毒(例如脊髓灰白質炎病毒、肝病毒A病毒、肝病毒B病毒)、杯狀病毒(例如諾沃克病毒(Norwalk virus)、沙波病毒(sapovirus)、水泡疹病毒(vesivirus),諸如貓杯狀病毒(FCV))、諾羅病毒(norovirus)、黃病毒(flavivirus)(例如西尼羅河病毒(West Nile virus)、登革熱病毒、蜱傳腦炎病毒(tick-borne encephalitis virus)、黃熱病病毒、茲卡病毒、日本腦炎病毒(Japanese encephalitis virus))、披衣病毒(togavirus)(例如α病毒)或冠狀病毒(例如嚴重急性呼吸道症候群冠狀病毒,諸如SARS-CoV-1或SARS-CoV-2)。
在一較佳實施例中,細菌可為球菌細菌(例如沙眼披衣菌、淋病奈瑟氏菌、奈瑟氏腦膜炎菌、金黃色葡萄球菌、溶血性葡萄球菌(
Staphylococcus haemolyticus)、無乳鏈球菌(
Streptococcus agalactiae)、牛鏈球菌(
Streptococcus bovis)、馬鏈球菌(
Streptococcus equi)、化膿性鏈球菌(
Streptococcus pyogenes))、芽孢桿菌細菌(例如炭疽芽孢桿菌(
Bacillus anthracis)、百日咳博德特氏菌、支氣管敗血博德特氏菌(
Bordetella bronchiseptica)、肺炎嗜衣原體(
Chlamydophila pneumoniae)、破傷風梭菌(
Clostridium tetani)、白喉棒狀桿菌(
Corynebacterium diphtheriae)、嗜肺性退伍軍人桿菌(
Legionella pneumophila)、麻風分支桿菌(
Mycobacterium leprae)、結核分支桿菌(
Mycobacterium tuberculosis)、霍亂弧菌(
Vibrio cholerae)、立克次體(
Rickettsia))、螺旋形(螺旋菌(
spirochete)或螺菌屬(
spirilla))細菌(例如伯氏疏螺旋體(
Borrelia burgdorferi)、鉤端螺旋體屬(
Leptospira)、腎臟鉤端螺旋體(
Leptospira interrogan)、梅毒螺旋體(
Treponema pallidum)、齒垢密螺旋體(
Treponema denticola)、立氏新立克次氏體(
Neorickettsia risticii)或黴漿菌(例如雞敗血性黴漿菌(
Mycoplasma gallisepticum),豬肺炎支原體(
Mycoplasma hyopneumoniae))。
在一較佳實施例中,寄生蟲可為原蟲(例如梨形鞭毛蟲屬,瘧原蟲屬)、蠕蟲(例如扁蟲、線蟲)或皮外寄生物(例如壁虱、跳蚤、虱、蟎)。
在一較佳實施例中,自體免疫性疾病可為葡萄膜炎、異位性皮膚炎、化膿性汗腺炎、全身性紅斑性狼瘡症、類風濕性關節炎、牛皮癬性關節炎、多發性硬化症、1型糖尿病、重症肌無力、格-巴二氏症候群(Guillain-Barré syndrome)、骨關節炎、僵直性脊椎炎、克羅恩氏病(Crohn's disease)、潰瘍性結腸炎、牛皮癬、陣發性夜間血紅素尿症(paroxysmal nocturnal hemoglobinuria)、視神經脊髓炎(neuromyelitis optica)、慢性特發性風疹、偏頭痛或囊腫性纖維化。
在一個實施例中,癌症可為癌瘤、肉瘤、淋巴瘤、白血病、生殖細胞癌或母細胞瘤。較佳地,癌症可為骨骼及肌肉癌症、大腦及神經系統之癌症(例如神經膠母細胞瘤、神經膠質瘤、神經母細胞瘤、脊索瘤)、乳癌(例如乳癌、髓性癌、葉狀腫瘤)、內分泌系統癌症(例如甲狀腺癌、多發性內分泌瘤症候群、腎上腺皮質癌)、眼癌(例如葡萄膜黑色素瘤、視網膜母細胞瘤、視神經神經膠質瘤)、胃腸癌(例如胃(gastric/stomach)癌、大腸癌、直腸癌、大腸直腸癌、胰臟癌、肝癌膽囊癌)、泌尿生殖癌及婦科癌(例如膀胱癌、子宮頸癌、卵巢癌、腎細胞癌、前列腺癌、腎母細胞瘤、尿道上皮膀胱癌)、頭頸癌(例如頭頸癌、食道癌、咽癌、口腔癌)、 造血癌症(霍奇金氏淋巴瘤(Hodgkin's lymphoma)、AIDS相關淋巴瘤、急性骨髓白血病、急性淋巴母細胞白血病、非霍奇金氏淋巴瘤(non-Hodgkin's lymphoma))、皮膚癌(例如黑色素瘤、基底細胞癌、鱗狀細胞皮膚癌、角化棘皮瘤)、胸部及呼吸道癌症(例如小細胞肺癌、非小細胞肺癌、胸膜肺母細胞瘤)、抗血管相關癌症(例如HIV/AIDS相關癌症)。
在另一實施例中,癌症可表現及/或過度表現一或多種腫瘤相關抗原,諸如HER2 (人類表皮生長因子受體2)、EGFR (表皮生長因子受體)、CD-20、VEGF (血管內皮生長因子)、VEGFR (血管內皮生長因子受體)、CEA (癌胚抗原)、CA-125 (癌症抗原125)、MUC-1 (黏蛋白1)、MAGE (黑色素瘤相關抗原)。
因此,疫苗之實例可包括注射式脊髓灰質炎疫苗(沙克疫苗(Salk vaccine))、A型肝炎疫苗、狂犬病疫苗(例如犬、貓或人類狂犬病疫苗)、流感疫苗(例如馬流感疫苗)、蜱傳腦炎疫苗(tick-borne encephalitis vaccine)、東西方馬腦脊髓炎疫苗(EEE/WEE)、冠狀病毒(例如SARS-冠狀病毒)疫苗(包括BBIBP-CorV、CoronaVac、Covaxin、QazVac、TURKOVAC、CoviVac)、注射式傷寒疫苗、霍亂疫苗、鼠疫疫苗、百日咳疫苗、炭疽疫苗、霍亂疫苗、鼠疫疫苗、沙門氏菌疫苗、肺結核疫苗、傷寒疫苗、腸毒性大腸桿菌疫苗、減毒流感疫苗(LAIV),例如FLUMIST、日本腦炎疫苗、麻疹疫苗、流行性腮腺炎疫苗、麻疹及風疹(MR)疫苗、麻疹、流行性腮腺炎及風疹(MMR)疫苗、麻疹、流行性腮腺炎、風疹及水痘(MMRV)疫苗、脊髓灰質炎疫苗、輪狀病毒疫苗、風疹疫苗、天花疫苗、水痘疫苗、黃熱病疫苗、帶狀疱疹疫苗、蜱傳腦炎疫苗、COVID-19)、mRNA疫苗、類毒素疫苗(例如破傷風類毒素、白喉類毒素、肉毒桿菌類毒素)、病毒載體疫苗、DNA疫苗、重組載體疫苗、次單位疫苗(包含蛋白質次單位,例如B型肝炎、非細胞性百日咳疫苗、多醣(例如肺炎鏈球菌多醣疫苗、腦膜炎球菌疫苗或結合,例如肺炎鏈球菌結合疫苗、流感嗜血桿菌b型結合疫苗、腦膜炎球菌結合疫苗)、重組疫苗、結合疫苗,以及疫苗佐劑或其組合。
疫苗之其他實例包括埃博拉病毒疫苗、茲卡病毒疫苗、痘病毒疫苗(例如猴痘病毒疫苗)、RSV疫苗、HIV疫苗、貓鼻氣管炎(FVR)疫苗、馬西尼羅河病毒疫苗、波托馬克馬熱病(Potomac Horse Fever;PHF)疫苗、馬疱疹病毒疫苗、瘧疾疫苗(例如RTS,S/A S01或Mosquirix®)或抗癌疫苗(例如,HEPLISAV-B®、Gardasil®、Cervarix®、T-VEC (Imlygic®)、Sipuleucel-T、PROSTVAC®、CVAC-301 (PANVAC®)、CV9104、 MVA.5T4、MVA-BN(R)-HER2、TroVax®、DCVax-L、TAEK-VAC-HerBy、ChAdOx1-MAGEA3-NYESO、瑞多匹特(Rindopepimut)及抗HER2及短尾畸型表現癌之疫苗)。
在一些實施例中,疫苗可僅向個體投與一次。在其他實施例中,疫苗可向個體投與兩次或多次。舉例而言,在疫苗為失活、次單位、重組、多醣、結合或類毒素疫苗之實施例中,向個體分別投與初級劑量及一或多個後續加強劑量可為合適的。
在一些實施例中,疫苗可與另一類型之生物醫藥藥物化合物(例如抗體)組合投與至個體。因此,免疫可包含主動及/或被動免疫之組分。主動免疫在暴露於抗原之後引起主動免疫,而被動免疫被動地(例如經由外源性(例如自另一宿主)產生之預形成抗體)提供免疫性。
免疫療法,視情況其中免疫療法為溶瘤病毒療法。溶瘤病毒療法(OV)包括意謂使用勝任型複製病毒感染及破壞癌細胞之免疫療法形式。較佳地,勝任型病毒特異性攻擊腫瘤細胞而非健康細胞。
本發明之組合物亦可包含:
● 包括外源性、內源性及自體抗原或其組合之抗原;及/或
● 病毒載體包括反轉錄病毒(例如慢病毒)、痘病毒、腺病毒及腺相關病毒(AAV))或其組合。
可用於本發明組合物中之生物醫藥藥物化合物亦包括寡核苷酸,包括適體(包括DNA、RNA、XNA或肽適體)、啉核酸(morpholinos)、CpG寡去氧核苷酸、多嘌呤反向-胡斯坦髮夾或其組合;以及核苷酸(例如腺苷單磷酸(AMP)、鳥苷單磷酸(GMP)、胞嘧啶核苷單磷酸(CMP)、尿苷單磷酸(UMP)、環腺苷單磷酸(cAMP)、環鳥苷單磷酸(cGMP)、環胞嘧啶核苷單磷酸(cCMP)、環尿苷單磷酸(cUMP)、去氧腺苷單磷酸(dAMP)、去氧鳥苷單磷酸(dGMP)、去氧胞苷單磷酸(dCMP)、(去氧)胸苷單磷酸(dTMP)、腺苷二磷酸(ADP)、鳥苷二磷酸(GDP)、胞嘧啶核苷二磷酸(CDP)、尿苷二磷酸(UDP)、 去氧腺苷二磷酸(dADP)、去氧鳥苷二磷酸(dGDP)、去氧胞苷二磷酸(dCDP)、(去氧)胸苷二磷酸(dTDP)、腺苷三磷酸(ATP)、鳥苷三磷酸(GTP)、胞嘧啶核苷三磷酸(CTP)、尿苷三磷酸(UTP)、去氧腺苷三磷酸(dATP)、去氧鳥苷三磷酸(dGTP)、去氧胞苷三磷酸(dCTP)、(去氧)胸苷三磷酸(dTTP))、核苷及相對應的核鹼基(例如腺嘌呤、腺苷、去氧腺苷、鳥嘌呤、鳥苷、去氧鳥苷、胸腺嘧啶、5-甲基尿苷、胸苷、尿嘧啶、尿苷、去氧尿苷、胞嘧啶、胞嘧啶核苷、去氧胞苷)、反義元件(例如反義寡核苷酸、反義RNA)、siRNA治療劑(例如ONPATTRO® (帕替斯喃(patisiran))及GIVLAARI™ (吉沃西蘭(givosiran))、mRNA治療劑、DNA治療劑或其組合。
可用於本發明組合物中之生物醫藥藥物化合物亦包括免疫調節劑,諸如介白素(例如IL-2、IL-7、IL-12、IL-27、IL-4、IL-10、IL-35、IL-33)、細胞介素(例如干擾素、G-CSF)、趨化激素(例如CCL3、CCL26、CXCL7)、胞嘧啶磷酸-鳥苷、寡去氧核苷酸、葡聚糖或其組合。
另外,及/或在替代方案中,可用於本發明組合物中之較佳生物醫藥藥物化合物包括在室溫及大氣壓下水溶性為至少約10 mg/mL,諸如至少約1 mg/mL,包括至少約100 µg/mL,諸如至少約10 µg/mL,例如至少約1 µg/mL且尤其至少約0.5 µg/mL,例如至少約0.1 µg/mL,諸如至少約0.05 µg/mL且尤其至少約0.01 µg/mL的化合物(上文或以其他方式列出)。『水溶性』應理解為不僅包括在純水中之溶解性,而且包括在相關生理流體中之溶解性,且尤其在鼻中發現之溶解性(其亦可根據等滲性及pH進行模擬)。
可用於本發明組合物中之較佳活性成分包括融合蛋白阿拉西普(abatacept)及以下抗體:帕博利珠單抗、阿達木單抗、烏司奴單抗、曲妥珠單抗、貝伐珠單抗、利妥昔單抗、納武利尤單抗、英利昔單抗、依庫珠單抗、奧馬珠單抗、西妥昔單抗及帕尼單抗、瑞瑪奈珠單抗、伽奈珠單抗-gnlm及依普奈珠單抗-jjmr;以下酶:阿替普酶、瑞替普酶、替奈普酶、鏈道酶α、培羅替酶、拉布立酶及L-天冬醯胺酶;及以下疫苗:傷寒疫苗、百日病疫苗、霍亂疫苗、肺結核疫苗、傷寒疫苗、麻疹、流行性腮腺炎及/或風疹(包括MMR)疫苗、脊髓灰質炎疫苗、黃熱病疫苗、帶狀疱疹(zoster)/帶狀疱疹(shingles)疫苗、破傷風類毒素、白喉類毒素及肉毒桿菌類毒素疫苗,且尤其是流感疫苗及SARS-冠狀病毒(例如SARS-CoV-2)疫苗。
可用於本發明組合物中之其他活性成分包括癌胚抗原(CEA)、癌症相關腫瘤標記物(諸如癌症抗原125 (CA125))、黏蛋白1 (MUC-1)、黑色素瘤相關抗原(MAGE)。
可採用相同或不同類別中之前述活性成分中之一或多者的組合。
當本發明之組合物係藉由如上文所述之基於溶劑之方法(包括藉助於噴霧乾燥之方法)製造時,此可能引起活性成分之存在形式不再為結晶鹽形式,係因為其以非晶形式自由分散於載劑材料內且由載劑材料囊封。本發明之組合物可在本文所提及之正常儲存條件下使該活性成分之化學穩定性損失極小至無損失。
此外,當以此方式製備時,在製造相關組合物之前,當與呈分離形式之生物醫藥藥物化合物相比時,存在於本發明組合物中的生物醫藥藥物化合物可具有基本上相同的生物活性。『基本上相同生物活性』包括生物活性損失低於約95%,諸如低於約90%,包括低於約85%、低於約80%、低於約75%、低於約70%、低於約65%、低於約60%、低於約55%、低於約50%、低於約45%、低於約40%、低於約35%、低於約20%、低於約25%、低於約20%或約15%,且尤其低於約10% (取決於所用生物醫藥藥物化合物,該生物活性可包括效力、結合活性及/或藥理學效應,諸如免疫反應),其可藉由對討論中的生物醫藥藥物化合物之適當分析來量測,例如,如下文所描述。
此外,當在如前文所定義之普通儲存條件下調配成醫藥調配物或劑型時,及/或當裝載至醫藥學給藥構件(諸如經鼻施用器或其對應的儲集層(具有或不具有適當的醫藥學包裝))或呈其他方式時,本發明組合物可以經分離固體形式儲存,其中生物醫藥藥物化合物之生物活性的損失程度不顯著(例如,生物醫藥藥物化合物之生物活性的損失低於約95%,諸如低於約90%,包括低於約85%、低於約80%、低於約75%、低於約70%、低於約65%、低於約60%、低於約55%、低於約50%、低於約45%、低於約40%、低於約35%、低於約20%、低於約25%、低於約20%或約15%,且尤其低於約10%),其可藉由對討論中的生物醫藥藥物化合物之適當分析來量測,例如,如下文所描述。
可用於本發明之組合物之單次劑量中的活性成分之量必須足以發揮其藥理學作用。對於經黏膜(例如舌下、經頰且尤其鼻內)投與之本發明之組合物,該量在單次劑量中不得超過約100 mg。上文所提及之相關生物醫藥藥物化合物之實際劑量包括此項技術中已知且可針對諸如
Martindale - The Complete Drug Reference, 第40版,Pharmaceutical Press, London (2020)之醫學文獻及其中所提及之文獻(所有文獻中之相關揭示內容以引用的方式併入本文中)中所討論之活性成分描述的彼等劑量。然而,與包含相同活性成分之先前技術組合物相比,可發現本發明之組合物展現出良好生物可用性及/或快速吸收,從而引起更快速起效及/或更高血漿濃度。
就此而言,本發明組合物中的藥理學上適當量之活性成分可低於文獻中所提及之量(參見上文)。儘管如此,此類量可藉由熟習此項技術者確定且可隨待治療之病狀的類型及嚴重程度及最適用於個別患者之程度而變化。此亦可能隨調配物之性質以及待治療之病況的類型及嚴重程度,以及待治療之特定患者的年齡、體重、性別、腎功能、肝功能及反應而變化。
視生物醫藥藥物化合物之效能而定,且根據待使用之最終劑型,可用於本發明之組合物中之活性成分之總量可在以組合物之總重量計,約0.0001重量%或約0.0002重量%,例如約0.001重量%,諸如約0.01重量%,包括約0.1重量% (例如約1重量%、約2重量%或約5重量%),諸如約10重量% (例如約20重量%)至多約95重量%,諸如約75重量%,例如約50重量%,例如約40重量%之範圍內。此與最初存在於本發明之給藥構件中之組合物的各別劑量(其應為相同的)之數目無關。
對於經黏膜(包括經肺、經頰、舌下或較佳鼻內)投與,視所用活性成分而定,每單位劑量活性成分之適當劑量(以游離酸/鹼計算)在約0.01 µg範圍內,諸如約0.1 µg,包括約1 µg (例如約10 µg,諸如約250 µg)直至約100 mg(例如約80 mg),諸如約1 mg與約60 mg之間(例如約3 mg,諸如約10 mg至約50 mg)。
對於其他投與形式(例如藉由注射或經口投與),視所用活性成分而定,每單位劑量之活性成分的適當劑量(以游離酸/鹼計算)在約1 μg至約1,000 mg,諸如約500 mg (例如約400 mg)之範圍內,諸如在約1 mg與約300 mg之間(例如約3 mg,諸如約10 mg至約200 mg)。
或者,活性成分之適當劑量可基於不同生物藥劑(亦即蛋白質、寡肽、多肽、酶、抗體及其部分、疫苗、核苷酸及其類似物、抗體類似物、抗體模擬物、免疫球蛋白、免疫調節劑、血液、血液組分、細胞、過敏原、基因、病毒、毒素、毒液或其組合)之生物活性或作用(而非生物醫藥化合物之質量)。適當劑量可在約10
-9個國際單位(IU)至約1×10
9個IU之範圍內。國際單位(IU)包括意謂在根據國際公認標準化生物程序(參見世界衛生組織(WHO)國際標準)測試時產生指定效應的活性成分的數量。用於視不同生物醫藥化合物而定計算適當IU的方法將為熟習此項技術者所知。
根據本發明之三個其他範疇,提供:
● 本發明之組合物,其用於治療其中包括之至少一種生物醫藥藥物化合物適用於(例如藉由經黏膜,諸如鼻內投與該組合物)之病狀;
● 本發明組合物之用途,其用於製造用以治療其中包括之至少一種生物醫藥藥物化合物所適用之病狀的(例如經黏膜,諸如鼻內)藥劑;及
● 治療本發明組合物內所包括之至少一種生物醫藥藥物化合物適用於之病狀的方法,該方法包含向患有該病狀或易患該病狀之患者(例如經黏膜,諸如鼻內)投與本發明組合物。
視此類組合物中所包括之活性成分之性質而定,本發明組合物適用於治療廣泛範圍之臨床病狀,包括類風濕性關節炎、牛皮癬、僵直性脊椎炎、克羅恩氏病、多發性硬化症、糖尿病性視網膜病變、年齡相關之黃斑部變性、糖尿病、尿崩症、癌症,以及牛皮癬性關節炎及慢性阻塞性肺病(COPD)。
包含例如阿拉西普及阿達木單抗(抗TNF(α)藥劑)之本發明組合物可用於治療類風濕性關節炎、牛皮癬性關節炎、僵直性脊椎炎、克羅恩氏病、潰瘍性結腸炎、牛皮癬、化膿性汗腺炎、葡萄膜炎及青少年特發性關節炎;包含例如蘭尼單抗及阿柏西普之本發明組合物可用於治療糖尿病性視網膜病變及年齡相關之黃斑部變性; 包含例如阿達木單抗之本發明組合物可用於治療牛皮癬及僵直性脊椎炎;包含例如西妥昔單抗及帕尼單抗之本發明組合物可用於治療表現EGFR之轉移性大腸直腸癌;包含帕博利珠單抗(抗PD-1藥劑)的本發明組合物可用於治療黑色素瘤、非小細胞肺癌、頭頸癌、霍奇金氏淋巴瘤、胃癌、子宮頸癌、尿道上皮癌、大腸直腸癌、腎細胞癌及乳癌; 包含烏司奴單抗(抗介白素(IL)-12/23藥劑)之本發明組合物可用於治療牛皮癬; 包含曲妥珠單抗(抗HER2藥劑之本發明組合物可用於治療乳癌;包含貝伐珠單抗(抗VEGF藥劑)之本發明組合物可用於治療大腸癌;包含利妥昔單抗(抗CD20藥劑)之本發明組合物可用於治療非霍奇金氏淋巴瘤;包含納武利尤單抗(抗PD1藥劑)之本發明組合物可用於治療黑色素瘤、非小細胞肺癌、腎細胞癌及頭頸癌;包含英利昔單抗(抗TNF(α)藥劑)之本發明組合物可用於治療類風濕性關節炎、牛皮癬性關節炎、僵直性脊椎炎、克羅恩氏病、潰瘍性結腸炎及牛皮癬;包含依庫珠單抗(抗補體組分C5藥劑)之本發明組合物可用於治療陣發性夜間血紅素尿症(PNH)、非典型性溶血性尿毒性症候群(aHUS)及視神經脊髓炎;包含奧馬珠單抗(抗IgE藥劑)之本發明組合物可用於治療哮喘及慢性特發性風疹;包含西妥昔單抗及帕尼單抗(抗EGFR藥劑)之本發明組合物可用於治療大腸直腸癌; 包含瑞瑪奈珠單抗(例如瑞瑪奈珠單抗-vfrm)、伽奈珠單抗(例如伽奈珠單抗-gnlm)及依普奈珠單抗(例如依普奈珠單抗-jjmr) (例如降鈣素基因相關肽(CGRP)抑制劑)之本發明組合物可用於治療偏頭痛。
包含相關酶之本發明組合物可用於多種病狀,諸如肝糖儲積症(glycogen storage disorder) (α-葡糖苷酶)、脂質儲積症(α-D-半乳糖A及β-葡糖腦苷脂酶)、黏多醣儲積症(mucopolysaccharidoses) (α-L-艾杜糖苷及艾杜糖醛-2-硫酸酯酶)、黏多醣儲積症(N-乙醯半乳胺糖-6-硫酸酯酶及N-乙醯半乳胺糖-4-硫酸酯酶)、各種胰臟病症,包括囊腫性纖維化、舒戴二氏症候群(Shwachman-Diamond syndrome)、慢性胰臟炎、胰臟腫瘤或除去全部或部分胰臟(PEP)、急性心肌梗塞(阿替普酶、瑞替普酶及替奈普酶)、囊腫性纖維化(鏈道酶α)、慢性痛風(培羅替酶)、腫瘤裂解症候群(拉布立酶)、白血病(L-天冬醯胺酶)、基於膠原蛋白之病症,諸如杜普伊特倫氏攣縮(Dupuytren's contracture) (膠原蛋白酶)、嚴重合併性免疫缺失病(severe combined immunodeficiency disease) (培加酶,牛)、甲胺喋呤解毒(麩卡匹酶)、玻璃體黃斑黏附(奧克纖溶酶(ocriplasmin))、急性心肌梗塞(阿替普酶、瑞替普酶及替奈普酶)、囊腫性纖維化(鏈道酶α)、慢性痛風(培羅替酶)、腫瘤裂解症候群(拉布立酶)及L-白血病(天冬醯胺酶)。
包含疫苗之本發明組合物可用於治療相關病狀,在相關病狀內意欲引起免疫反應,包括上文所述之免疫反應中之任一者。
如上文所提及,本發明之組合物亦可包括一或多種烷基醣類,或亦可與一或多種烷基醣類一起投與。與不包括例如烷基醣類及/或包括已知充當界面活性劑之不同賦形劑的相應組合物相比,發現包含烷基醣類之本發明之組合物可展現出出人意料地良好生物可用性及吸收速度。
可用烷基醣類包括烷基糖苷,其可定義為藉由與烷基之鍵連接的任何糖,諸如C
7-18烷基糖苷。因此,烷基糖苷可包括烷基麥芽糖苷(諸如十二烷基麥芽糖苷)、烷基葡糖苷、烷基蔗糖苷(alkyl sucroside)、烷基硫代麥牙糖苷(alkyl thiomaltoside)、烷基硫代糖苷(alkyl thioglucoside)、烷基硫代蔗糖(alkyl thiosucrose)及烷基麥芽三糖(alkyl maltotrioside)。然而,吾人偏好烷基醣為糖酯。
可用於本發明之組合物中之糖酯包括三糖酯,諸如棉子糖酯;單醣酯,諸如葡糖酯、半乳糖酯及果糖酯;及/或較佳地雙醣酯,諸如麥芽糖酯、乳糖酯、海藻糖酯,及尤其一或多種蔗糖酯。
可用於本發明之組合物中之蔗糖酯具有在6與20之間的親水性親脂性平衡值。術語『親水性親脂性平衡(hydrophilic-lipophilic balance,HLB)』為熟習此項技術者將很好地理解之技術術語(參見例如由ICI Americas Inc, 1976 (1980修訂)公開之『
The HLB System: A Time-Saving Guide to Emulsifier Selection』,在該文獻第7章(第20-21頁)中提供如何確定HLB值之方法)。蔗糖酯中之脂肪酸鏈愈長及酯化程度愈高,HLB值就愈低。較佳HLB值在10與20之間,更佳在12與20之間。
蔗糖酯因此包括C
8-22飽和或不飽和脂肪酸酯,較佳飽和脂肪酸酯,且較佳C
10-18脂肪酸酯,且最佳C
12脂肪酸酯。可自其形成此類蔗糖酯之尤其適合之脂肪酸包括芥子酸、二十二烷酸、油酸、硬脂酸、棕櫚酸、肉豆蔻酸及月桂酸。尤其較佳之此類脂肪酸為月桂酸。可商購的蔗糖酯包括以Surfhope®及Ryoto® (Mitsubishi-Kagaku Foods Corporation, Japan)商標出售之彼等蔗糖酯。
蔗糖酯可為脂肪酸之二酯或單酯,較佳單酯,諸如蔗糖單月桂酸酯。熟習此項技術者將瞭解,術語『單月桂酸酯』係指月桂酸之單酯,且術語『月桂酸酯(lauric acid ester)』及『月桂酸酯(laurate)』具有相同含義且可因此可互換地使用。可商購的蔗糖單月桂酸酯產物亦有時被稱作『蔗糖月桂酸酯』。可含有少量二酯及/或較高蔗糖酯及微量其他蔗糖酯及游離蔗糖之可商購的蔗糖單月桂酸酯(或蔗糖月桂酸酯)產品,諸如Surfhope ® D-1216 (Mitsubishi-Kagaku Foods Corporation, Japan),適合用於本發明。熟習此項技術者將理解,本文中對特定蔗糖酯之任何提及包括包含該蔗糖酯作為主要組分之可商購的產品。
較佳蔗糖酯含有僅一種蔗糖酯,此意謂單一蔗糖酯(例如可商購的蔗糖酯產品)含有單一蔗糖酯作為主要組分(可商購的產品可能含有雜質,例如單酯產品可能含有少量二酯及/或較高酯,此類產品可被視為在本發明之情形下『含有僅一種蔗糖酯』)。如本文中所用,術語『主要組分』應理解為係指蔗糖酯(諸如通常可商購的界面活性劑產品,其通常以某一範圍之酯組合物出售)之混合物中之主要組分(例如大於約50%,諸如約70%重量/重量或體積/體積)。
尤其較佳蔗糖酯為蔗糖單月桂酸酯。
不論包括於本發明之組合物內抑或包括於包括一或多種本發明組合物的最終劑型中,以該組合物之總重量計,可使用之烷基醣類的量可在約0.1重量%至約10重量%,諸如約0.5重量%至約5重量%,較佳約0.75重量%至約3重量% (例如至約2重量%,諸如約1重量%)之範圍內。
此外,視情況,其他賦形劑可用於包括一或多中(另外的)界面活性劑的本發明之組合物內或與本發明之組合物一起投與。可提及之界面活性劑包括聚氧化乙烯酯(例如Myrj
TM),包括聚乙二醇8硬脂酸酯(Myrj
TMS8)、聚乙二醇32硬脂酸酯(Gelucire® 48/16)、聚乙二醇40硬脂酸酯(Myrj
TMS40)、聚乙二醇100硬脂酸酯(Myrj
TMS100)及聚乙二醇15羥基硬脂酸酯(Kolliphor® HS 15)、聚氧化乙烯烷基醚(例如Brij
TM),包括聚乙二醇十六基十八基醚(例如Brij
TMCS12、CS20及CS25)、聚乙二醇月桂基醚(例如Brij
TML9及L23)及聚乙二醇十八烷基醚(例如Brij
TMS10及S20)及聚氧甘油酯(例如Gelucire®),包括月桂醯基聚氧甘油酯(Gelucire® 44/14)及十八醯基聚氧甘油酯(Gelucire® 50/13)、脫水山梨糖醇酯(例如Span™),包括脫水山梨糖醇單棕櫚酸酯(Span™ 40)及脫水山梨糖醇單硬脂酸酯(Span™ 60)、聚山梨醇酯(Tweens
TM),包括聚山梨醇酯40 (聚氧乙烯(20)脫水山梨糖醇單棕櫚酸酯)、聚山梨醇酯60 (聚氧乙烯(20)脫水山梨糖醇單硬脂酸酯)及聚山梨醇酯20 (聚氧乙烯(20)脫水山梨糖醇單月桂酸酯)及月桂基硫酸鈉;及單醯基甘油(單甘油酸酯),諸如2-油酸甘油酯、2-花生四烯酸甘油酯、單月桂酸甘油酯、丙三醇單肉豆蔻酸酯、丙三醇單棕櫚酸酯、甘油基羥基硬脂酸酯,及較佳地丙三醇單硬脂酸酯、丙三醇單油酸酯(例如Cithrol®)及丙三醇單辛酸酯(例如Capmul®)。其他界面活性劑可包括乳酸月桂酯、二棕櫚醯基磷脂醯膽鹼(DPPC)及泊洛沙姆。
可包括於本發明之組合物內,或與本發明之組合物一起投與之其他視情況額外成分(賦形劑)包括等滲劑及/或滲透劑(例如氯化鈉)、固醇(或類固醇),諸如膽固醇及植物固醇(例如菜油固醇、穀固醇及豆固醇);抗氧化劑(例如偏亞硫酸氫鈉,或另外,α-生育酚、抗壞血酸、抗壞血酸鉀、抗壞血酸鈉、抗壞血酸棕櫚酸酯、丁基化羥基甲苯、丁基化羥基大茴香醚、鎵酸十二烷基酯、鎵酸辛基酯、沒食子酸丙酯、油酸乙酯、單硫代甘油、維生素E聚乙二醇丁二酸鹽或瑞香草酚);螯合(錯合)劑(例如依地酸(EDTA)、檸檬酸、酒石酸、蘋果酸、麥芽糖醇及半乳糖,包括此等藥劑中之任一者的鹽形式);防腐劑(例如苯紮氯銨,或另外,苯甲醇、硼酸、對羥苯甲酸酯、丙酸、苯酚、甲酚或木糖醇);黏度調節劑或膠凝劑(諸如纖維素衍生物,包括羥基丙基纖維素、甲基纖維素、羥丙基甲基纖維素、羧基甲基纖維素等,澱粉及經改質澱粉、膠態二氧化矽、偏矽酸鋁、聚卡波非(polycarbophil)(例如Noveon®)、卡波姆(例如Carbopol®)及聚乙烯吡咯啶酮);黏膜黏附聚合物,諸如羧甲基纖維素、經改質纖維素膠及羧甲基纖維素鈉(NaCMC);澱粉衍生物,諸如適度交聯之澱粉、經改質澱粉及乙醇酸澱粉鈉;交聯聚乙烯吡咯酮、丙烯酸聚合物,諸如卡波姆及其衍生物(聚卡波非(Polycarbophyl)、Carbopol®等);聚氧化乙烯(PEO);聚葡萄胺糖(聚-(D-葡糖胺));天然聚合物,諸如明膠、海藻酸鈉、果膠;硬葡聚糖;三仙膠;瓜爾膠;聚共-(甲基乙烯基醚/順丁烯二酸酐);及交聯羧甲纖維素(例如交聯羧甲基纖維素鈉);pH緩衝劑(例如檸檬酸、順丁烯二酸、蘋果酸或甘胺酸或其相應鹽,諸如檸檬酸鈉);著色劑;穿透增強劑(例如十四烷酸異丙酯、棕櫚酸異丙酯、吡咯啶酮或三辛酸甘油酯);其他脂質(中性及極性);芳族羧酸,諸如視情況經一或多個選自以下之基團取代的苯甲酸:甲基、羥基、胺基及/或硝基,例如甲苯甲酸或柳酸;及(若適宜)調味劑(例如檸檬、胡椒薄荷粉末,或較佳地薄荷醇)、甜味劑(例如新橙皮苷(neohesperidin)、乙醯磺胺酸K,或較佳地,蔗糖素)及染料。其他賦形劑可包括三醣(例如棉子糖)及甘露糖醇,以及pH調節劑(例如鹽酸及氫氧化鈉)。
以組合物之總重量計,本身可與本發明之組合物(無論其包括於何種劑型中)包括在一起之此類『額外』賦形劑(包括存在於本發明之組合物中之不為烷基醣類的界面活性劑)的總量亦可為至多約15重量% (例如約10重量%),諸如至多約5重量%。
例如,若一或多種額外賦形劑為錠劑、膜或其類似物中之填充劑或載劑,則可包括於包括一或多種本發明組合物的最終劑型內之此類『額外』賦形劑之總量可為至多約99.99%,諸如至多約99.9%,包括至多約99%,例如至多約90%。
熟習此項技術者將瞭解,若任何額外視情況選用之成分包括於本發明之組合物內,則出於上文所描述之原因,彼等成分之性質及/或所包括之彼等成分的量不應對該組合物之Tg具有不利影響。就此而言,此類視情況選用之成分可併入噴霧乾燥方法中(亦即,與活性成分及載劑材料一起混合於適當揮發性溶劑中且隨後噴霧乾燥),或可單獨地包括於噴霧乾燥之複數個粒子中。
根據本發明之另一態樣,提供適用於醫學(人類及獸醫學)且因此適用於治療需要已知相關活性成分可用以治療之病狀的醫學治療之患者的本發明之組合物。
對此類病狀之『治療』包括此類病狀之預防或診斷,外加治療性、對症性及緩解性治療。
本發明之組合物可藉由熟習此項技術者已知之任何適合的給藥構件投與。本發明之組合物可經黏膜,且尤其經鼻內,藉助於適合之經鼻施用器或分配器構件投與,該構件能夠向鼻腔投與適合劑量之呈一或多個本發明之組合物形式的活性成分。
因此,適合之經鼻給藥構件及/或施用器應能夠容納及儲存一或多個劑量之本發明之組合物本身,或能夠連接至容納及儲存一或多個劑量之本發明之組合物的儲集器/容器,且如此不會造成組合物之物理及化學完整性之顯著損失,包括例如進水。以此方式,一旦施用器裝置由最終使用者致動(不論此為單次劑量或多次劑量使用),組合物將為可用的,此時施用器將向個體之鼻黏膜遞送具有適當劑量之如本文所定義之活性成分的組合物(例如粉末)。
先前技術中已描述適當施用構件。當與本發明的組合物一起使用時,此類組合物可裝入連接至此類施用構件或形成此類施用構件之一部分的儲集器中,在該處容納該組合物,直至致動施用構件或分配器。在下文中,術語『施用器』、『分配器』、『裝置』、『施用構件』、『分配構件』、『施用器裝置』、『分配裝置』及『吹入器』可互換使用且表示相同事物。
含有本發明之固體、多微粒粉末組合物的儲集器可為不透明的。因為本發明之組合物的穩定性,所以不需要在投與或使用之前檢查儲集器之內容物(亦即,粉末組合物)。
熟習此項技術者應理解術語『不透明』包括『不透明或半透明、不透光及/或不允許光穿過』。
因此,包含本發明之組合物的施用器不包括(不需要包括)可透過其觀測施用器之儲集器的內容物的檢查窗,且就此而言,該儲集器就其性質而言可為完全不透明的,亦即至少約98%,諸如至少約99%,且尤其約99.9%不透明,及/或不超過約2%,諸如不超過約1%,且尤其約0.1%透明、半透明及/或不透光,以便檢查儲集器之內容物。
此類施用構件因此亦可包括用於經由出口構件自儲集器排出如本文所描述之粉末組合物的機構,該出口構件包括尺寸經設定為置放於人類體腔(諸如鼻孔內之各類物體,諸如形狀適宜之噴嘴。
因此,用於排出粉末之機構可包括用於致動裝置之構件,其可包括呼吸致動件,或用於在使用者致動裝置之後即刻產生力的致動構件。
因此,施用器應能夠在單次投與步驟中(且以該裝置不需要「灌滿(priming)」方式)提供可再現且足夠量之粉末組合物,從而將提供治療劑量之活性成分。
可用於投與呈粉末形式之本發明組合物的經鼻施用/吸入裝置可包括可基於在將活性成分遞送至肺之領域中已知的技術調節之多劑量施用,諸如定量劑量吸入裝置(MDI)、乾粉吸入裝置(DPI;包括較低、中等及較高抗性DPI)及軟霧吸入裝置(SMI)。
在MDI中,本發明組合物應能夠當懸浮於其中通常所用之溶劑(諸如推進劑)中時形成穩定的懸浮液,該推進劑在遞送裝置致動時具有足夠的蒸汽壓,以形成氣溶膠(例如烴、碳氟化合物、含氫碳氟化合物或其混合物)。
然而,若經鼻施用器為在致動之後自其中分配組合物且隨後在使用之後丟棄的單次劑量施用器,則用於遞送單次劑量之活性成分的適合之施用構件或裝置包括呼吸輔助及吹氣輔助設計(Optinose®),以及US 6,398,074、US 6,938,798或US 9,724,713中所描述之施用器,所有文獻之相關揭示內容均以引用之方式併入本文中。本申請案之圖1及圖2係分別基於US 6,398,074之圖1及圖2,且圖3至7係分別基於US 9,724,713之圖19至圖23。其均為可用於經鼻內投與本發明組合物的施用器之圖式。
在圖1中,該裝置包含上部主體/分配器頭1,其併入有出口通道40 (亦即,如上文所描述之『出口構件』之一部分)及允許使用者致動該裝置之抓持構件60。在上部主體/分配器頭1內安裝一元件,在其總成中用參考數字2表示,該元件併入有儲集器10及用於噴氣器20之空氣腔22。此元件2有可能與主體1一體式產生。亦提供下部主體3以便能夠相對於上部主體1且相對於元件2滑動,使用者對下部主體施加推動力以致動該裝置。
儲集器10含有單次劑量之本發明組合物。儲集器10具有進氣口11及產物出口15。包含透氣的網格之產物保持裝置12安置於進氣口11中以將產物保持於儲集器10中,直至該組合物被分配。較佳以密封方式,藉由封擋球16阻擋產物出口15,封擋球16係在施用器被致動且產物被分配時藉由空氣流自其阻擋位置移開。
當使用者致動該裝置時,以使得活塞21壓縮腔室22中所含之空氣20的方式對柱塞25施加壓力。由於網格12為可透氣的,因此腔室22中之空氣的壓縮產生噴氣,其被傳輸到儲集器10,且由此施加至用於阻擋產物出口15之封擋球16。
封擋球16之尺寸及其固定在儲集器產物出口15處,以使得球16當藉助於噴出空氣20經由儲集器10產生最小預定壓力時自其阻擋位置處移開。
由封擋球16產生之預壓縮確保當封擋球自其阻擋位置處移開時,使用手中積聚的能量使得與柱塞25成一體之活塞21在該腔室22內被推動,藉此產生強大的噴出空氣20,亦即適合精細噴霧出本發明組合物之劑量的氣流。
當達到此最小壓力時,球朝向該裝置之出口通道40快速移動,且由噴氣產生之空氣流20實質上排出在儲集器10內所容納之本發明之組合物的全部劑量。
較佳地,出口通道40之直徑大於封擋球16之直徑,以便允許該劑量之產物藉由圍繞球16流動而經由該出口通道40排出。如圖2中所示,該圖表示在致動之後之相同裝置,通道40包含阻止或固定球16以防止在排出產物時該球自該裝置中排出之構件41。
可用於鼻內投與本發明之組合物的另一實施例係提供於US 9,724,713中之第7欄第50行至第8欄第61行及圖19至23,其再現為本申請案之圖3至7。
在此實施例中,儲集器10緊固於包括分配器出口通道40 (亦即如上文所描述之『出口構件』之一部分)之上部主體/分配器頭1中,該上部主體/分配器頭具有抓持構件或指托60,其允許使用者致動該裝置。上部主體/分配器頭1之徑向肩部37 (參見圖5)有利地限定該上部主體/分配器頭1中之儲集器10的經組裝位置。
機械開放系統包括一組桿61、62,其中當該裝置被致動時,第二桿部分62被該第一桿部分61推動。在其致動衝程結束時,亦即在分配位置中,該組桿61、62與封擋元件16協作,該封擋元件為球狀,尤其是如上文所述之第一實施例中之球,以便以機械方式自其封閉位置中排出。
在此實施例中,該活塞21與第一桿部分61分離,且相對於空氣腔22及相對於緊固至第一桿部分61之圓柱形表面614兩者滑動。圖7為圖3至6中之裝置之空氣排出器在其靜止位置處之圖解透視圖。
空氣腔22可因此為圓柱形的,且在其靜止位置處在溝槽或凹槽615處與周圍空氣連通,該等溝槽或凹槽形成於該圓柱形表面614中且與該活塞21協作,尤其在其靜止位置處如此。該活塞21因此包括內唇215,其在致動期間以氣密方式在圓柱形壁614上滑動,且在其靜止位置處與溝槽615協作。該活塞21亦包括與推動元件25 (在第一實施例中稱為『柱塞』)之頂部邊緣251協作之軸向延伸部216,該推動元件在致動期間在空氣腔22中移動該活塞21。
保持器部件42藉由軸向延伸部43向下延伸,該軸向延伸部在致動期間與第一桿部分61之頂部軸向端610接觸。
另外,在此實施例中,不存在外部主體,而僅存在組裝於空氣腔22之底部軸向邊緣上之蓋罩27。
彈簧80設置於空氣腔22之徑向凸緣225與形成第一桿部分61及圓柱形表面614之部件之間,以便在致動之後使空氣排出器自動返回至其靜止位置。
操作原理如下。在圖3中之靜止位置中,儲集器10藉由保持器部件42及藉由封擋元件/球16以密封方式封閉。空氣排出器藉由在該活塞21之內唇215與圓柱形表面614之溝槽615之間協作而與大氣接觸。
當需要致動該裝置時,使用者按下推動元件25。在此初始衝程期間,該活塞之內唇215離開溝槽615以便以氣密方式與圓柱形表面614協作,藉此封閉空氣腔22。在相同時間,推動元件25之頂部邊緣251與活塞21之軸向延伸部216接觸,且第一桿部分61之頂部軸向端610與保持器部件42之軸向延伸部43接觸。
然而,第二桿部分62之頂部軸向端621仍不與封擋元件/球16之圓形表面55接觸,如圖4中可見。
連續致動因此同時移動空氣腔中之活塞21,藉此壓縮其中所含之空氣,且移動保持器部件42使其遠離封閉儲集器10之位置。當第二桿部分62接觸封擋元件/球16之圓形表面55時,該封擋元件/球以機械方式自其封閉位置處排出,以便使組合物能夠在藉由空氣排出器壓縮之空氣的作用下被排出。
分配位置顯示於圖5中。如圖5中可見,當組合物在由空氣排出器提供之經壓縮空氣的作用下被排出時,保持器部件42可能與第一桿部分61分離。在此位置中,該封閉元件/球自儲集器10中排出,以便使該流體或粉末能夠在經壓縮空氣之作用下被分配。因此,封閉元件
/ 球16在上部主體/分配器頭1之花鍵(spline) 3中卡住,該等花鍵尤其防止該封閉元件/球16自該上部主體分配器頭1中排出之任何風險。
當使用者鬆開該裝置時,如圖6中所示,在制動期間被壓縮之彈簧80使第一桿部分61返回至其靜止位置。此產生吸力,從而將封閉元件16及保持器部件42吸回至其封閉位置,或接近其封閉位置。此因此阻擋新吸力之路徑,以避免在空氣排出器自動返回至其靜止位置中時污染空氣排出器,而空的儲集器仍組裝在空氣排出器上。然而,活塞21由於與空氣腔22之摩擦及在儲集器30中產生之吸力而保持於其分配位置中,使得圓柱形表面614在該活塞之內唇215上滑動,直至該內唇再次與溝槽615協作。此時,空氣腔22再次與周圍空氣連通,且不再因返回該靜止位置中而產生吸力。因此,活塞21亦被帶向其靜止位置。如此使得有可能在使用之後封閉儲集器。
視情況,由上部主體/分配器頭1及空儲集器10形成之單元可自空氣排出器中移除且由包括全儲集器之新單元替換。
可使用之適當施用器裝置包括可購自Aptar Pharma,France (UDS Monopowder)的施用器裝置。參見例如國際專利申請案WO 2022/208014及WO 2021/005311。可與本發明之組合物(尤其呈粉末形式之彼等組合物)結合使用之施用器裝置的其他實例包括美國專利申請案US 2011/0045088、美國專利第US 7,722,566號(參見例如圖1及7)及US 5,702,362及國際專利申請案WO 2014/004400中所描述之彼等施用器裝置,該等文獻之相關揭示內容以引用的方式併入本文中。
根據本發明之另一範疇,提供一種用於製造包含本發明之組合物的施用器裝置之方法,其中該方法包含以下步驟:將該組合物裝載至在該施用器裝置內或附加於該施用器裝置的儲集器中。
根據本發明之另一範疇,提供一種無針施用器,其適用於向人類患者之體腔中投與本發明之固態非晶形單微粒粉末組合物,該空腔包括黏膜表面,其中該施用器包含:
(i) 在包含本發明之組合物之該施用器內部或附加於該施用器的(視情況不透明的)儲集器;
(ii) 用於在使用者致動該裝置時產生一力的視情況選用的致動構件;及
(iii) 在該致動之後可經其分配該粉末組合物的分配構件。
根據本發明之另一範疇,提供一種包含一或多種呈粉末形式之本發明組合物的施用器及/或分配器裝置,該施用器或裝置可被致動一次或多次,以在每次此類制動時遞送一或多種各自包含適當劑量之活性成分的本發明之組合物,該施用器/分配器裝置包含:
經其分配至少一種組合物的出口;
在使用者制動該裝置時自外部產生力(例如氣流)之構件;
含有該一或多種本發明之組合物的至少一個(視情況可替換的)儲集器,該儲集器以直接或間接與該分配器出口連通之方式置放或能夠以此被置放;
該裝置及/或儲集器中之可位移,視情況可倒轉的密封構件,其用於將該一或多種組合物保留於儲集器內,直至組合物被分配;
與該密封構件協作之機械開放系統,使得當該裝置被致動時,單個本發明組合物被加力構件以機械方式排出;及
視情況,用於重新密封該裝置及/或儲集器以將其他組合物保留於儲集器內直至另一組合物被分配之機構。
根據本發明之又另一範疇,提供一種包含單次劑量之本發明之組合物的施用器及/或分配器裝置,其適用於分配該組合物,該施用器/分配器裝置包含:
分配器出口;
空氣排出器,其用於在該裝置被致動時產生空氣流,該空氣排出器包括在靜止位置與分配位置之間在空氣腔中滑動之活塞;
該活塞在該空氣腔內以氣密方式滑動;
至少一個含有本發明之組合物之劑量的儲集器,該儲集器包括連接至該空氣排出器之進氣口;
連接至該分配器出口之組合物出口;
該進氣口包括用於將組合物保留於儲集器中,直至組合物被分配之可位移密封構件(例如保持器部件);
該組合物出口由安裝於該儲集器之組合物出口中的封閉元件封閉;
該裝置進一步包括機械開放系統,該機械開放系統與該封閉元件協作以便在該裝置被致動時將該封閉元件自其封閉位置以機械方式排出;及
該空氣排出器之該活塞當在靜止位置時以非氣密方式與該空氣腔協作。
在本發明之後一範疇中,較佳的是:
(i) 在其內該活塞以氣密方式滑動之空氣腔實質上為圓柱形的;
(ii) 封閉元件被強制安裝於儲集器之組合物出口中;
(iii) 該空氣腔在該靜止位置處與大氣連通;及/或
(iv) 該活塞包括適用於與圓柱形表面協作之內唇,該圓柱形表面包括與處於靜止位置之該活塞之該內唇以非氣密方式協作之溝槽。
此類經鼻施用器或分配裝置能夠提供適當且可再現之粉末噴霧圖案及/或羽流幾何形狀,從而能夠將該粉末有效遞送至鼻腔(例如鼻孔)。
在本發明之組合物中,平均粒度可表示為基於體重、數量或體積之平均直徑。如本文中所用,熟習此項技術者將理解,術語「基於體重之平均直徑」包括平均粒度係由按重量計之粒度分佈,亦即其中各尺寸級別中之現有分率(相對量)經定義為如藉由例如篩分(例如濕篩分)獲得之重量分率的分佈表徵及定義。術語「基於體積之平均直徑」在其含義上類似於基於重量之平均直徑,但熟習此項技術者將理解,包括平均粒度係由按體積計之粒度分佈,亦即其中各尺寸級別中之現有分率(相對量)經定義為如藉由例如雷射繞射所量測之體積分率的分佈表徵及定義。如本文中所用,熟習此項技術者將理解,術語「基於數量之平均直徑」包括平均粒度係由按數量計之粒度分佈,亦即其中各尺寸級別中之現有分率(相對量)經定義為如藉由例如顯微術量測之數量分率的分佈表徵及定義。本領域中熟知之其他儀器可用以量測粒度,諸如藉由例如Malvern Instruments, Ltd (Worcestershire, UK)、Sympatec GmbH (Clausthal-Zellerfeld, Germany)及Shimadzu (Kyoto, Japan)出售之設備。
儘管當本發明之組合物經調配用於投與,例如向口腔、眼部或其他黏膜經口、局部投與,或藉由注射或輸注投與時,粒度不為(或更確切地說可能不為)關鍵的,但本發明之粉末組合物的基於體積之平均直徑(VMD)通常將在約0.2 μm,諸如約0.5 μm (例如,約1 μm)至多約1,000 μm (例如,至多約500 μm,諸如約400 nm或約500 nm)之範圍內,且適當粒度範圍可基於意欲包括此類組合物之劑型加以選擇。
然而,熟習此項技術者將理解,為了允許有效鼻內投與,粉末之基於體積之平均直徑(VMD)通常將在約5 μm至多約300 μm之範圍內(例如,至多約200 μm)。視所使用之施用器裝置而定,VMD可在約10 μm至約100 μm,諸如約20 μm至約60 μm之範圍內。
用於鼻內藥物遞送之較佳粒度分佈亦可包括其中D10為高於約3 μm且低於約75 μm 例如,至多約50 μm),諸如大於約10 μm,且D90在約80 μm與約1,000 μm (例如,約500 μm)之間,諸如低於約100 μm之彼等粒度分佈。熟習此項技術者將理解,參數『D10』(或『Dv(10)』)意謂包含低於樣本中之材料總體積的10%之粒度分佈中之尺寸(或直徑)。類似地,『D90』(或『Dv(90)』)意謂包含低於材料之90%的尺寸。
熟習此項技術者應理解,為了允許有效經肺投與,粉末將通常具有約0.2 µm至多約10 µm範圍內的VMD。
具有在以上範圍內之粒度分佈及VMD之粉末包括整體VMD及/或發出之VMD,亦即當最初裝載至該裝置中時及/或當分別自其中排出時之粒度分佈。
粒度可藉由標準設備來量測,諸如乾(或濕)粒度量測技術,包括可購自諸如Sympatec及Malvern之製造商的乾燥分散技術。
較佳粒子形狀包括球狀或實質上球狀,意謂該等粒子具有小於約20,更佳低於約10,諸如低於約4,及尤其低於約2之縱橫比,及/或可在該等粒子之至少約90%中具有不超過約50%之平均值,諸如不超過約30%之該值,例如不超過約20%之該值的半徑變化(自重心至粒子表面所量測)。
然而,粒子可為任何形狀,包括不規則形狀(例如,『葡萄乾(raisin)』形狀)、針形、圓盤形或骰型粒子。對於非球形粒子,尺寸可指示為具有例如相同重量、體積或表面積之相應球形粒子的大小。
自經鼻施用器及/或分配器裝置發射(分配)之本發明之粉末組合物的噴霧角應較佳低於約90°。
當在本文中在量,例如絕對量,諸如劑量、重量、體積、尺寸、直徑、縱橫比、角度等,或在組合物或組合物之組分中之個別成分的相對量(例如,百分比)(包括濃度及比率),時間範圍及諸如溫度、壓力、相對濕度等之參數之情形下使用詞語『約』時,應瞭解,此類變量為近似的,且因此可與本文所指定之實際數值相差±10%,例如±5%,且較佳±2% (例如,±1%)。即使此類數值首先以百分比表示,情況亦如此(例如,『約10%』可意謂約數值10±10%,即在9%與11%之間的任何值)。
本發明之組合物具有以下優勢:其能夠在廣泛範圍之溫度及相對濕度下製備且此後儲存而無生物活性之顯著損失。因此,本發明之組合物可在不影響向個體投與之活性成分之量的情況下經受低溫(例如,冰點以下)。此外,本發明之組合物可具有其比相關先前技術組合物在更高溫度下在物理及化學上更穩定之優點。
本發明之組合物進一步亦可具有其提供與先前技術組合物相比之更高生物可用性的活性成分之優點。本發明之組合物可提供此比此類先前技術及/或可商購的組合物更高的生物可用性以及更快速的吸收,其將可能引起更快速的起效,且因此滿足顯著的醫療需求。
本文所描述之組合物、醫藥調配物、用途及方法亦可具有如下優點:在治療其中相關活性成分已知的病狀中,對於第一有反應者、醫師及/或患者而言,其可能比先前技術中已知之類似調配物或方法(治療)更方便、更有效、毒性更低、活性範圍更廣、效力更強、產生的副作用更小、患者間差異性更低,或與先前技術中已知之類似調配物或方法(治療)相比其可能具有其他有用的藥理學特性,不論藉由經黏膜(諸如鼻內投與)抑或以其他方式用於治療前述病狀。
參考附圖,藉由以下實例說明本發明,但絕不限制本發明,其中圖1至圖7表示可以用於分配粉末組合物之致動器裝置的圖式,且圖8及圖9顯示在形成經噴霧乾燥之粉末之後的SARS-CoV-2 RBD棘蛋白之不同條件下的保留活性與相同蛋白質針對噴霧乾燥之前的初始溶液的活性的比較。
實例 1 本發明之組合物 I
藉由向30 mL玻璃小瓶中添加所需量之凍乾β-半乳糖苷酶(乳糖酶;5000單位/毫克;Merck/Sigma Aldrich Germany)及以下賦形劑來製備六種各自具有大約2 g粉末之調配物:海藻糖((Merck/Sigma Aldrich,Germany)、麥芽糊精(MD) IT12及IT19 (Roquette,France)、蔗糖月桂酸酯D1216 (SL;Mitsubishi Chemicals,Japan)及HPMC K3 (Dupont,USA)。組合物顯示於下表1中(其中個別組分以wt%為單位)。
表 1
調配物 | 乳糖酶 | 海藻糖 | MD IT12 | MD IT19 | SL | HPMC |
1 | 0.61 | 40.0 | 52.3 | 0 | 3.05 | 0 |
2 | 1.22 | 40.0 | 51.7 | 0 | 3.05 | 0 |
3 | 1.22 | 40.0 | 0 | 53.3 | 1.49 | 0 |
4 | 0.61 | 40.0 | 47.4 | 0 | 3.05 | 4.80 |
5 | 0.61 | 40.0 | 52.3 | 0 | 3.05 | 0 |
6 | 0.61 | 40.0 | 0 | 53.9 | 1.49 | 0 |
隨後將小瓶置於於在-20℃之冷凍器中。在裝運之前,將小瓶置放於具有乾燥劑(分子篩)之鋁袋中且置放於具有濕冰之隔熱箱中。
使用具有伸長管柱之ProCepT噴霧乾燥器在Xedev (Belgium)進行噴霧乾燥。藉由改變噴嘴類型及方法條件自所製備之六種調配物產生總計12個樣本。噴霧乾燥方法之概述顯示於下表2中。
在噴霧乾燥之前,將六種製備之調配物溶解於水中,所得固體負荷(w/w%,水:固體)在5%與10%之間的範圍內。自此等溶液,將0.5 mL自各小瓶萃取至單獨LC小瓶中且放入冷凍機中,隨後裝運。此等為用於在噴霧乾燥前測定酶活性之參考溶液。
溶液之進料速率設定成4 g/min,使得對於表2中所示之樣本的處理時間為1至5 min之間。為了在處理期間減少可能的熱保留,在一些操作期間使用冰浴冷卻收集容器。
表 2
註釋
1. 『開放式』表示暴露於空氣;『封閉式』表示處於氮氣下。
2. 在噴射嘴處的入口溫度
3. 在旋風器之出口處的出口溫度
ID | 所用調配物 | 噴嘴類型 | 迴路類型 1 | 是否冷凍? | 產率(%) | T in(℃) 2 | T out(℃) 3 | 固體L (%) |
001 | 1 | 超音波 | 開放式 | 否 | ~100 | 160 | 58 | 10 |
002 | 1 | 雙流體 | 開放式 | 否 | 68 | 120 | 47 | 10 |
003 | 5 | 超音波 | 開放式 | 否 | 81 | 160 | 60 | 10 |
004 | 5 | 超音波 | 開放式 | 是 | 82 | 160 | 59 | 10 |
005 | 3 | 超音波 | 開放式 | 否 | 81 | 160 | 60 | 7.5 |
006 | 3 | 超音波 | 開放式 | 是 | 83 | 160 | 58 | 7.5 |
007 | 2 | 超音波 | 封閉式 | 否 | 81 | 160 | 65 | 7.5 |
008 | 2 | 超音波 | 封閉式 | 是 | 85 | 160 | 66 | 7.5 |
009 | 4 | 超音波 | 封閉式 | 否 | 76 | 160 | 66 | 10 |
010 | 4 | 超音波 | 封閉式 | 是 | 75 | 160 | 68 | 10 |
011 | 6 | 雙流體 | 封閉式 | 否 | 81 | 120 | 50 | 5 |
012 | 6 | 雙流體 | 封閉式 | 是 | 81 | 120 | 50 | 5 |
在噴霧乾燥之後,將樣本置放於冷凍機中直至裝運。在與上文所描述相同之條件下,亦即使用除濕劑及濕冰裝運樣本。
使用2-硝基苯基β-D-半哌喃半乳糖苷(ONPG;Merck/Sigma Aldrich,Germany)作為酶受質進行酶活性分析。
在分析之前,將100 mg之各經噴霧乾燥之材料轉移至獨立LC小瓶中且稀釋至與參考溶液相同的濃度(參見上文)。
用PBS (pH 7.4)稀釋酶溶液、參考物及經噴霧乾燥之粉末,且其後添加過量5 mM ONPG。在0.5、1、2、3、4及5分鐘在420 nm下量測混合物之UV/可見光吸光度。一式兩份地執行此操作。
使用線性回歸將經噴霧乾燥之溶液之吸光度與對應參考溶液相比較。將參考溶液指定為具有100%活性,而斜率之商係用於測定經噴霧乾燥之溶液之保留活性。結果呈現於下表3中。(注意,因為存在關於參考樣本完整性之一些不確定性,所以排除關於樣本001及002之結果)。
表 3
註釋
1. 活性 = 經噴霧乾燥樣本之斜率/參考樣本之斜率×100
樣本 | |||||
003 | 004 | 005 | 006 | 007 | |
時間(min) | 420 nm處之吸光度 | ||||
0.5 | 0.0585 | 0.0620 | 0.1280 | 0.1220 | 0.1165 |
1 | 0.1160 | 0.1175 | 0.2455 | 0.2335 | 0.2160 |
2 | 0.2260 | 0.2270 | 0.4740 | 0.4540 | 0.4125 |
3 | 0.3355 | 0.3370 | 0.7030 | 0.6685 | 0.6110 |
4 | 0.4445 | 0.4480 | 0.9245 | 0.8810 | 0.8050 |
5 | 0.5540 | 0.5580 | 1.1345 | 1.0850 | 0.9915 |
斜率 | 0.111 | 0.112 | 0.231 | 0.220 | 0.201 |
斜率參考 | 0.128 | 0.128 | 0.252 | 0.252 | 0.239 |
活性 1 | 87% | 87% | 92% | 88% | 84% |
樣本 | |||||
008 | 009 | 010 | 011 | 012 | |
時間(min) | 420 nm處之吸光度 | ||||
0.5 | 0.1165 | 0.0650 | 0.0695 | 0.0680 | 0.0625 |
1 | 0.2195 | 0.1230 | 0.1320 | 0.1360 | 0.1210 |
2 | 0.4240 | 0.2365 | 0.2530 | 0.2620 | 0.2380 |
3 | 0.6310 | 0.3490 | 0.3745 | 0.3890 | 0.3550 |
4 | 0.8320 | 0.4625 | 0.4965 | 0.5175 | 0.4730 |
5 | 1.0305 | 0.5750 | 0.6160 | 0.6425 | 0.5880 |
斜率 | 0.208 | 0.116 | 0.124 | 0.129 | 0.118 |
斜率參考 | 0.239 | 0.148 | 0.148 | 0.133 | 0.133 |
活性 1 | 87% | 78% | 84% | 97% | 88% |
結果顯示,根據本發明之噴霧乾燥方法之後的酶活性損失係最小的。
實例 2 本發明之組合物 II
各自包含約2.5至2.6 g粉末之十二種調配物係藉由向100 mL玻璃燒瓶中添加所需量之凍乾SARS-CoV-2 RBD棘蛋白(L452R)、His標籤(『S蛋白』;SPD-C52He,ACRO Biosystems,US)以及以下賦形劑來製備:海藻糖二水合物(Pfanstiel,US)、麥芽糊精(MD) IT19 (Roquette,France)、蔗糖月桂酸酯D1216 (SL;Mitsubishi Chemicals,Japan)、磷酸鹽緩衝鹽水(PBS)及純去離子水(5%固體含量)。調配物具有下表4中所示之組合物(其中個別組分以wt%為單位)。
表 4
最終粉末中之 4% 標稱水含量。
調配物 | S蛋白 | 海藻糖 | MD IT19 | SL | PBS |
7 | 0.0009 | 20.0 | 73.0 | 3.0 | - |
8 | 0.0009 | 40.0 | 53.0 | 3.0 | - |
9 | 0.0009 | 60.0 | 33.0 | 3.0 | - |
10 | 0.0009 | 80.0 | 13.0 | 3.0 | - |
11 | 0.0009 | 20.0 | 76.0 | - | - |
12 | 0.0009 | 80.0 | 16.0 | - | - |
13 | 0.0009 | 20.0 | 57.0 | - | 19 |
14 | 0.0009 | 61.0 | 16 | - | 19 |
15 | 0.0009 | 20.0 | 76.0 | 3.0 | - |
16 | 0.0009 | 40.0 | 53.0 | 3.0 | - |
17 | 0.0009 | 60.0 | 33.0 | 3.0 | - |
18 | 0.0009 | 80.0 | 53.0 | 3.0 | - |
使用具有伸長管柱之ProCepT噴霧乾燥器,使用超音波及雙流體噴嘴進行噴霧乾燥。噴霧乾燥方法之概述顯示於下表5中。
在噴霧乾燥之前,將0.8 mL溶液自各小瓶提取至獨立的LC小瓶中且置於冷凍機(-20℃)中。此等溶液為用於測定蛋白質在噴霧乾燥前之初始活性的參考溶液。
溶液之進料速率設定成4 g/min,使得對於表5中所示之樣本的處理時間為約13 min。
表 5
調配物 | 噴嘴類型 | 回收(%) | T in(℃) | 固體L (%) |
7 | 超音波 | 68 | 160 | 5 |
8 | 超音波 | 87 | 160 | 5 |
9 | 超音波 | 82 | 160 | 5 |
10 | 超音波 | 79 | 160 | 5 |
11 | 超音波 | 77 | 160 | 5 |
12 | 超音波 | 88 | 160 | 5 |
13 | 超音波 | 101 | 160 | 5 |
14 | 超音波 | 88 | 160 | 5 |
15 | 雙流體 | 72 | 120 | 5 |
16 | 雙流體 | 74 | 120 | 5 |
17 | 雙流體 | 71 | 120 | 5 |
18 | 雙流體 | 71 | 120 | 5 |
在噴霧乾燥之後,將樣本置放於具有乾燥劑之密封鋁袋中且儲存在-20℃下直至分析。其他粉末以相同方式封裝且在四種不同溫度(-20℃、-5℃、20℃及40℃)下儲存4週。
使用SARS-CoV-2棘蛋白效價分析套組ELISA (RAS-A020-96TEST,ACRO Biosystems,US)分析蛋白質活性。在分析之前,將經噴霧乾燥之材料及初始溶液稀釋至約0.2 ng/mL之目標濃度且一式兩份地分析所有樣本。
噴霧乾燥之後所量測之粉末相對於初始溶液的保留活性在30% (可接受損失)至100% (最小損失)之範圍內,如圖8中所示。
在儲存4週之後進行第二次分析。應注意分析之間及之內的一些變化(包括儲存時之較高活性及重複之間的變化),顯而易見的是,在所有溫度下儲存之所有樣本中的活性得以保留,如圖9中所示。
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Claims (27)
- 一種醫藥學上可接受之組合物,該組合物呈固體非晶形單微粒粉末組合物形式,其包含以下之混合物: (a) 藥理學上有效劑量之至少一種生物醫藥藥物化合物;以及 (b) 醫藥學上可接受之載劑材料,該載劑材料包含雙醣與聚合材料之組合。
- 如請求項1之組合物,其中該聚合材料包含麥芽糊精。
- 如請求項1或請求項2之組合物,其中該雙醣係選自由以下組成之群:麥芽糖醇、海藻糖、蔗糖素、蔗糖、異麥芽酮糖醇(isomalt)、麥芽糖及乳糖。
- 如請求項3之組合物,其中該雙醣包含乳糖或海藻糖。
- 如前述請求項中任一項之組合物,其中該載劑材料包含海藻糖與麥芽糊精19DE之組合。
- 如前述請求項中任一項之組合物,其中按該組合物之總重量計,雙醣:聚合物之重量比在約10:1與約1:10之範圍內。
- 如請求項6之組合物,其中雙醣:聚合物之比率在約2:1至約1:8之範圍內。
- 如前述請求項中任一項之組合物,其中當在至多約35%之相對濕度下量測時,該組合物之最低可量測玻璃轉化溫度為至少約10℃。
- 如前述請求項中任一項之組合物,其中該組合物進一步包含蔗糖酯。
- 如請求項9之組合物,其中該蔗糖酯包含蔗糖單月桂酸酯。
- 如前述請求項中任一項之組合物,其中該至少一種生物醫藥藥物化合物之該藥理學上有效劑量不超過約100 mg。
- 如前述請求項中任一項之組合物,其中至少一種生物醫藥藥物化合物係選自以下之群:蛋白質、作為寡肽、多肽、酶、抗體、疫苗及核苷酸。
- 如前述請求項中任一項之組合物,其適合及/或適用於經鼻遞送。
- 如請求項13之組合物,其中該粉末之粒度分佈包括高於約3 µm的D10。
- 如請求項13或請求項14之組合物,其中該粉末具有包括在約10 μm與約100 μm範圍內之基於體積之平均直徑的粒度分佈。
- 如請求項13至15中任一項之組合物,其中該生物醫藥藥物化合物為疫苗。
- 如請求項1至12中任一項之組合物,其適合及/或適用於經口遞送。
- 如請求項17之組合物,其中該生物醫藥藥物化合物為酶。
- 如請求項1至12中任一項之組合物,其溶解於醫藥學上可接受之溶劑中以藉由注射或藉由輸注遞送。
- 如請求項19之組合物,其中該生物醫藥藥物化合物為抗體。
- 一種用於製造如前述請求項中任一項中所定義之組合物的方法,其中該方法包含以下步驟: (i) 將一或多種生物醫藥藥物化合物與醫藥學上可接受之載劑材料一起混合於適當的揮發性溶劑中, (ii) 噴霧乾燥來自步驟i)之混合物。
- 一種組合物,其可藉由如請求項21中所定義之方法獲得。
- 一種經鼻施用裝置,其適合及/或適用於將如請求項1至16中任一項或請求項22中所定義之組合物遞送至鼻,該經鼻施用裝置包含儲集器(reservoir),或附屬於及/或連接至儲集器,該儲集器內容納有該組合物。
- 一種用於製造如請求項23之施用裝置的方法,其包含如請求項21之方法,接著將由此形成之該組合物裝載至該施用裝置內、或附屬於或連接至該施用裝置之儲集器中。
- 一種用於治療病狀的如請求項1至20中任一項或如請求項22之組合物,所述病狀為該組合物中所包括之至少一種生物醫藥藥物化合物所適用的病狀。
- 一種如請求項1至20中任一項或如請求項22之組合物之用途,其用於製造用以治療其中包括之至少一種生物醫藥藥物化合物所適用之病狀的藥劑。
- 一種治療如請求項1至20中任一項或如請求項22之組合物內所包括的至少一種生物醫藥藥物化合物所適用的病狀之方法,該方法包含向患有或易患該病狀之患者投與本發明之組合物。
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GB2117005.5 | 2021-11-25 | ||
GBGB2117005.5A GB202117005D0 (en) | 2021-11-25 | 2021-11-25 | New pharmaceutical composition |
GB2208144.2 | 2022-06-01 | ||
GBGB2208144.2A GB202208144D0 (en) | 2022-06-01 | 2022-06-01 | New pharmaceutical composition |
GB2213306.0 | 2022-09-12 | ||
GBGB2213306.0A GB202213306D0 (en) | 2022-09-12 | 2022-09-12 | New pharmaceutical composition |
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TW202329916A true TW202329916A (zh) | 2023-08-01 |
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TW111145223A TW202329916A (zh) | 2021-11-25 | 2022-11-25 | 包含生物醫藥藥物化合物之新穎醫藥組合物 |
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EP (1) | EP4436551A1 (zh) |
KR (1) | KR20240111761A (zh) |
AR (1) | AR127783A1 (zh) |
AU (1) | AU2022398370A1 (zh) |
CA (1) | CA3239053A1 (zh) |
IL (1) | IL313015A (zh) |
MX (1) | MX2024006130A (zh) |
TW (1) | TW202329916A (zh) |
WO (1) | WO2023094818A1 (zh) |
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DE19518810A1 (de) | 1995-05-26 | 1996-11-28 | Bayer Ag | Nasal-Applikator |
JP4462761B2 (ja) | 1998-03-10 | 2010-05-12 | バルワー エス.アー. | 格納容器に格納された液体製品を投与する装置、及び格納容器の充填方法 |
FR2817847B1 (fr) | 2000-12-08 | 2003-03-28 | Tebro | Dispositif de distribution de produit fluide ou pulverulent |
LU90825B1 (en) | 2001-09-06 | 2003-03-07 | Iee Sarl | Method for the determination of one or more parameters of a seat passenger |
US7722566B2 (en) | 2003-10-09 | 2010-05-25 | Shin Nippon Biomedical Laboratories, Ltd. | Device to deliver a powdery medicine into nasal cavity |
KR20100120289A (ko) * | 2008-01-15 | 2010-11-15 | 애보트 게엠베하 운트 콤파니 카게 | 분말상 단백질 조성물 및 이의 제조 방법 |
EP2266563A1 (en) | 2009-06-11 | 2010-12-29 | Charité-Universitätsmedizin Berlin (Charité) | Use of opioid receptor antagonists for acute treatment of paraphilic arousal states |
WO2011013003A2 (en) | 2009-07-31 | 2011-02-03 | Shin Nippon Biomedical Laboratories, Ltd. | Intranasal granisetron and nasal applicator |
JP5623355B2 (ja) | 2010-07-30 | 2014-11-12 | オートリブ ディベロップメント エービー | カーテンエアバッグ |
CN104470569B (zh) | 2012-06-28 | 2018-04-27 | 美国政府(由卫生和人类服务部的部长所代表) | 用于疫苗和其它治疗试剂的鼻干粉递送系统 |
FR3007992B1 (fr) | 2013-07-05 | 2018-01-26 | Aptar France Sas | Dispositif de distribution de produit fluide ou pulverulent. |
CN104489669A (zh) * | 2014-12-12 | 2015-04-08 | 深圳先进技术研究院 | 一种植物酵素益生菌粉及其制备方法 |
CA3071552A1 (en) | 2017-08-20 | 2019-02-28 | Formulex Pharma Innovations Ltd. | Dry powder compositions for intranasal delivery |
EP3698773A1 (en) * | 2019-02-21 | 2020-08-26 | Università degli Studi di Parma | Composition and manufacturing of powders containing nanoadjuvants for mucosal vaccination |
US10653690B1 (en) | 2019-07-09 | 2020-05-19 | Orexo Ab | Pharmaceutical composition for nasal delivery |
FR3098420B1 (fr) | 2019-07-10 | 2021-07-09 | Aptar France Sas | Dispositif de distribution nasale de poudre |
EP4154866A1 (en) * | 2020-05-18 | 2023-03-29 | Orexo AB | New pharmaceutical composition for drug delivery |
FR3121047B1 (fr) | 2021-03-29 | 2023-07-14 | Aptar France Sas | Dispositif de distribution nasale de poudre |
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- 2022-11-25 TW TW111145223A patent/TW202329916A/zh unknown
- 2022-11-25 IL IL313015A patent/IL313015A/en unknown
- 2022-11-25 AU AU2022398370A patent/AU2022398370A1/en active Pending
- 2022-11-25 KR KR1020247018845A patent/KR20240111761A/ko unknown
- 2022-11-25 EP EP22814493.7A patent/EP4436551A1/en active Pending
- 2022-11-25 MX MX2024006130A patent/MX2024006130A/es unknown
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- 2022-11-25 CA CA3239053A patent/CA3239053A1/en active Pending
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MX2024006130A (es) | 2024-06-04 |
AR127783A1 (es) | 2024-02-28 |
AU2022398370A1 (en) | 2024-05-30 |
IL313015A (en) | 2024-07-01 |
EP4436551A1 (en) | 2024-10-02 |
WO2023094818A1 (en) | 2023-06-01 |
KR20240111761A (ko) | 2024-07-17 |
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