(12) United States Patent (10) Patent N0.: US 8,975,245 B2 Goodchild Et A]
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USOO8975245B2 (12) United States Patent (10) Patent N0.: US 8,975,245 B2 Goodchild et a]. (45) Date of Patent: *hlar.10,2015 (54) ANAESTHETIC FORMULATION (56) References Cited (71) Applicant: DraWbridge Pharmaceuticals Pty Ltd, U.S. PATENT DOCUMENTS Southbank (AU) 2003/0055023 A1 3/2003 Rajewski et a1. 2003/0073665 A1 4/2003 Thompson et al. (72) Inventors: Juliet Marguerite Goodchild, Malvem (AU); Colin Stanley Goodchild, FOREIGN PATENT DOCUMENTS Malvern (AU); Benjamin James Boyd, Warrandyte (AU) EP 0399716 Bl 1/1994 W0 WO 93/17711 Al 9/1993 (73) Assignee: DraWbridge Pharmaceuticals Pty Ltd, W0 WO 01/70234 Al 9/2001 Southbank, Victoria (AU) W0 WO 2004/039426 A2 5/2004 OTHER PUBLICATIONS (*) Notice: Subject to any disclaimer, the term of this patent is extended or adjusted under 35 Brewster, M.E. et a1. 1989 “Development of a Non-Surfactant For U.S.C. 154(b) by 0 days. mulation for Alfaxalone Through the Use of Chemically-Modi?ed This patent is subject to a terminal dis Cyclodextrins” Journal ofParenteral Science & Technology 43: 262 claimer. 265. Brewster, M.E. et al. 1995 “Preparation, Characterization, and Anes (21) Appl. N0.: 14/069,751 thetic Properties of 2-hydroxypr0pyl-[5-cyclodextrin Complexes of Pregnenolone in Rat and Mouse” Journal of Pharmaceutical Sci (22) Filed: Nov. 1, 2013 ences 84: 1154-1159. Chisari, M. et al. 2009 “The In?uence of Neuroactive Steroid (65) Prior Publication Data Lipophilicity 0n GABAA Receptor Modulation: Evidence for a Low Af?nity Interaction” J Neurophysiol 102: 1254-1264. US 2014/0066417 A1 Mar. 6, 2014 Egan, T.D. et al. 2003 “The Pharmacokinetics and Pharmacodynam ics of Propofol in a Modi?ed Cyclodextrin Formulation (Captisol®) Related US. Application Data Versus Propofol in a Lipid Formulation (Diprivan®): An (63) Continuation of application No. 13/574,201, ?led as Electroencephalographic and Hemodynamic Study in a Porcine application No. PCT/AU2011/000050 on Jan. 19, Model” Anesth Analg 97:72-79. Ramsay, et al. 1974 “Controlled Sedation with Alphaxalone 2011, now Pat. No. 8,697,678. Alphadolone” British Medical Journal 2: 656-659. (60) Provisional application No. 61/297,249, ?led on Jan. Sneyd, J .R. et al. 1997 “Computer-controlled infusion of ORG 21, 2010, provisional application No. 61/385,318, 21465, a water soluble steroid i.v. anaesthetic agent, into human ?led on Sep. 22, 2010. volunteers” British J Anaethesia 79: 433-439. Supplemental European Search Report, in corresponding European (51) Int. Cl. Application No. EP 11 73 4245, dated Jan. 17,2014. A61K 31/56 (2006.01) A61K 47/40 (2006.01) Primary Examiner * Paul Zarek A61K 31/57 (2006.01) (74) Attorney, Agent, or Firm * Knobbe, Martens Olson & A61K 47/48 (2006.01) Bear, LLP B82Y5/00 (2011.01) A61K 31/5 73 (2006.01) (57) ABSTRACT (52) US. Cl. The present invention relates generally to the ?eld of drug CPC ............... .. A61K47/40 (2013.01); A61K31/56 delivery systems for neuroactive steroid anaesthetic agents. (2013.01); A61K31/57 (2013.01); A61K More particularly, anaesthetic and sedative formulations are 47/48969 (2013.01); B82Y5/00 (2013.01); provided in the form of host/guest preparations comprising A61K31/573 (2013.01) one or more neuroactive steroid anaesthetics and a cyclodex USPC ........................................................ .. 514/178 trin. Particular cyclodextrins contemplated include sulfoalkyl (58) Field of Classi?cation Search ether cyclodextrins and modi?ed forms thereof. CPC ..................... .. A61K47/48969; A61K 31/573 See application ?le for complete search history. 9 Claims, 9 Drawing Sheets US. Patent Mar. 10, 2015 Sheet 1 0f9 US 8,975,245 B2 Prepafei Habit mgresséian far 1653 rig?ting; m?'ekx and wit gith Wrightmgreiiex mean w ~ -~~ righ thigreaiiex {I} . : m mi; piimi: s'uésan '1 19 1 {50 Figure 1a Propofei: Rota we! Tes?'ime Respnnse Curves {ime after iv ink'ctisn iminuies' rotaersemndstimerun Figure 1b US. Patent Mar. 10, 2015 Sheet 2 0f9 US 8,975,245 B2 .Attha$§n® wai’t regre?sian'far iiosg righting m?ex and v’tsaii pinch respnmea. Figure 1c Aithesin: Rotamd Tes?'ime Respcmse Curves time after iv injae?an {minute‘s} 128 I ‘ 23.3‘ ‘ ' 3.5' ' ' 5% Si}>17 333 18.9 mtamdtimeseccmdsrun Figure 1d US. Patent Mar. 10, 2015 Sheet 3 0f9 US 8,975,245 B2 Phaxanw Prabit regressian far tass rifght'ing {effex and taii piimk reswrzses rm: righting reiiax “wan “55 g “ WM ~' righting {€¥¥€>¢1 1f} :5 a>22 'W tad‘ . mush._ mean. , i in W}. pimh u dng ii-QEQ- 12mg} kg iv} Wm» fierims Figure 1e iPhaxanCD: Rota red Tes?ime RESPQHSE Curves time after iv iniectizm (minute's? z? 5 2;? 3,5 51:; 8,0 13,0 3&2 S ? ° 3 {T ‘i';g ~ ~ ~ ~ ~ ~ ~ - ' - ' - ' - ' - ' - ' - ' - ' - ' - ' "1 1 a 40 .................. .: t *f ~ ‘ ‘J 2 A .ép; Q . Figure 1f US. Patent Mar. 10, 2015 Sheet 4 0f9 US 8,975,245 B2 Letihaiity Pint: yaw data dam {mgfkg iv} Figure 2 Qiithesin Fmbit 9E0? far ‘mth‘aiity 3. a, gambitvaiua v1p means dew: tiese {mgfkg iv} Figure 3 US. Patent Mar. 10, 2015 Sheet 5 0f9 US 8,975,245 B2 sieep time {minuteg mean, sem, n = 5} after repeated dases of PhaxanCE} {Ma?a} siieepingtimez-{minutes} L11w04@- 'i 3 3- 11 .5 8 7 19 Figure 4 Pravgnamimnew: Rightng Refiax Yizme Rewamse {Zwves deathai'amawhaa-ia Figure 5 US. Patent Mar. 10, 2015 Sheet 6 0f9 US 8,975,245 B2 Pregnamlanew: Ta? Pimi?ime Respnnsa Curvea deptha?sihesiasnags time ?ier iv iniesticm iminutes} Figure 6 Pregnanoianew: Rntamd Tes?ime Respanse Curves time a?er iv injectinn {minutes} 63 3.5 51'! 3,0 121% 3313 36:3 3 0 ' » -. L ~ : ~ -. 2 ~ : ~ y 2' ~ : ~ . .l - : ' a ma :6? ziegzth?ames-them $9 .. ........................................................................................................................................................................... g§ .................... “?lm ma?fka'? Figure 7 US. Patent Mar. 10, 2015 Sheet 7 0f9 US 8,975,245 B2 Alphadaianem: Rightirs'g Re?ex Yi'ma Rasgmnse Cu was deptha?si?e-siama {3.5 1.5 2.5 if» (11) iiiil‘iiiiliii} time aiter iv Mamas iminutasi Figure 8 Aiphadolsnem: Tai? Pincm'ima Respan'se {Zurvas £15 1.5 335 3L5 119 ?? 39.0 14,9 183’} time whet is? injse'atian iminuies} Figure 9 US. Patent Mar. 10, 2015 Sheet 8 0f9 US 8,975,245 B2 Aipiaadamnaw: Ratamd Tesffime Respanse turves tima a?er iv injactien Minutes; 13.51} ' W: 21-1: damho§anaasahes-ia % Changa in mean systmic hkmd pmssure time after iv in§ecti<m iminutm) i) .‘1 '18 115 10 ermmioi m5 w?-Mfakhesin changeinpressure --- F‘i'm'x anCD Figure 11 US. Patent Mar. 10, 2015 Sheet 9 0f9 US 8,975,245 B2 % Qhange in mean diastotilc bicmd pressure time after iv inietrtiien {minut?s} £3 5 eihangeinpressure $6} Figure 12 US 8,975,245 B2 1 2 ANAESTHETIC FORMULATION Currently, a lipid formulation of di-isopropyl phenol (pro pofol) is the most highly used anaesthetic agent. Propofol, This application is a continuation of US. application Ser. however, can be contraindicated in certain at risk patients due No. 13/574,201, ?ledAug. 30, 2012, now US. Pat. No. 8,697, to its lowering effect on blood pressure, the effect it has on 678, which is the US. national phase of International Appli reducing cardiac output and it can adversely affect respiratory cation No. PCT/AU11/00050, ?led Jan. 19, 2011, which control. In particular, propofol is formulated in a lipid emul claims priority from US. Provisional Patent Application No. sion which can support microbial growth if contaminated. 61/297,249, ?led on 21 Jan. 2010, entitled “Anaesthetic for The formulation cannot, in fact, be sterilized. There have been mulation” AND U.S. Provisional Patent Application No. instances where microbially contaminated propofol formula 61/385,318 ?led on 22 Sep. 2010, entitled “Anaesthetic for tions have resulted in patients becoming infected. One other mulation,” the entire contents of which, are incorporated issue with the current propofol formulation is the pain herein by reference. induced following or during intravenous injection. Attempts to re-formulate in a water-based preparation have led to FIELD increased injection pain. Propofol also can lead to cardiovas The present invention relates generally to the ?eld of drug cular and respiratory depression and has a low therapeutic delivery systems for neuroactive steroid anaesthetic agents. index of 5, i.e. only 5 times the normal anaesthetic dose can More particularly, anaesthetic and sedative compositions are lead to death. Furthermore, the anaesthetic is incompatible provided in the form of host/ guest preparations comprising with plastic storage containers and plastic syringes which one or more neuroactive steroid anaesthetics and a cyclodex 20 complicates syringe delivery equipment which is frequently trin or a modi?ed form thereof. in standard use for intravenous anaesthesia and sedation. The drug can also cause hyperlipidaemia and can induce toxicity BACKGROUND when used in a larger dose by infusion. This is particularly problematic in the intensive care setting. Bibliographic details of references provided in the subject 25 A neuroactive steroid anaesthetic has the potential for speci?cation are listed at the end of the speci?cation. being more ef?cacious with fewer side effects than propofol. Reference to any prior art is not, and should not be taken as There is a need, therefore, to develop a suitable formulation an acknowledgment or any form of suggestion that this prior to enable the use of a neuroactive steroid anaesthetic agent in art forms part of the common general knowledge in any subjects. country. 30 Drug delivery systems aim to provide the required amount SUMMARY of drug systemically or to a targeted site for a time and under conditions suf?cient to have the desired effect.