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(12) United States Patent (10) Patent No.: US 9,314.465 B2 Brew Et Al

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US009314465B2 (12) United States Patent (10) Patent No.: US 9,314.465 B2 Brew et al. (45) Date of Patent: *Apr. 19, 2016 (54) DRUG COMBINATIONS AND USES IN 2008.0003280 A1 1/2008 Levine et al. ................. 424/456 TREATING A COUGHING CONDITION 2008/O176955 A1 7/2008 Hecket al. 2008, 0220078 A1 9, 2008 Morton et al. (71) Applicant: Infirst Healthcare Limited 2009, O136427 A1 5/2009 Croft et al. 2009, O220594 A1 9, 2009 Field (72) Inventors: John Brew, London (GB); Robin Mark 2012/O128738 A1 5, 2012 Brew et al. Bannister, London (GB) 2012fO252824 A1 10/2012 Brew et al. (73) Assignee: Infirst Healthcare Limited, London FOREIGN PATENT DOCUMENTS (GB) CN 1593451 3, 2005 CN 101024.014 A 8, 2007 (*) Notice: Subject to any disclaimer, the term of this CN 101112383 B 5, 2010 patent is extended or adjusted under 35 DE 4420708 A1 12, 1995 U.S.C. 154(b) by 0 days. EP 2050435 B1 4/2009 GB 2114001 A 8, 1983 This patent is Subject to a terminal dis GB 2284761 A 6, 1995 claimer. GB 2424.185 B 9, 2006 GB 2442828 A 4/2008 JP 62-249924 A 10, 1987 (21) Appl. No.: 14/287,014 JP H1O-316568 A 12/1998 JP 2001-518928 A 10, 2001 (22) Filed: May 24, 2014 JP 200219.3839. A T 2002 JP 2003-012514 A 1, 2003 (65) Prior Publication Data JP 20030552.58 A 2, 2003 JP 2003128549 A 5, 2003 US 2014/O256750 A1 Sep. 11, 2014 JP 2003-321357 A 11, 2003 JP 2005-516917 A 6, 2005 JP 2008O31146 A 2, 2008 Related U.S. Application Data KR 2008.009994 A 1, 2008 WO 89.03213 A1 4f1989 (63) Continuation-in-part of application No. 13/446,217, WO 95,07103 A1 3, 1995 filed on Apr. 13, 2012, now abandoned, which is a WO 98.42322 A2 10, 1998 continuation-in-part of application No. WO OO/OO212 A1 1, 2000 WO OO?30715 A1 6, 2000 PCT/GB2011/051610, filed on Aug. 25, 2011, and a WO 2011/O58373 A2 5, 2003 continuation-in-part of application No. WO 2006/059152 A2 6, 2006 PCT/GB2010/052085, filed on Dec. 14, 2010, and a continuation-in-part of application No. (Continued) PCT/GB2010/052086, filed on Dec. 14, 2010, and a continuation-in-part of application No. OTHER PUBLICATIONS PCT/GB2010/051895, filed on Nov. 12, 2010, and a continuation-in-part of application No. Cough: Causes, Mechanisms and Therapy, pp. 318 (eds. Chung, et PCT/GB2010/051896, filed on Nov. 12, 2010, and a al., 2003). continuation-in-part of application No. Forsberg, et al., Selective Inhibition of Cough and Bronchoconstric tion in Conscious Guinea Pigs, Respiration 59: 72-76 (1992). PCT/GB2010/050997, filed on Jun. 15, 2010. Levine, A Novel Treatment of Chronic Unexplained Cough, Chest J. (51) Int. Cl. 134(4 Meeting Abstracts): s 17003 (2008). A6 IK3I/522 (2006.01) Murao, et al., Intoxication with Over-the-Counter Antitussive Medi A6 IK3I/485 (2006.01) cation Containing Dihydrocodeine and Chlorpheniramine Causes A6 IK 45/06 (2006.01) Generalized Convulsion and Mixed Acidosis, Inter. Med. 47: 1013 (52) U.S. Cl. 1015 (2008). CPC ............. A6 IK3I/522 (2013.01); A61 K3I/485 (Continued) (2013.01); A61K 45/06 (2013.01) (58) Field of Classification Search USPC ..................................................... 51.4/263.34 Primary Examiner — Kathrien Cruz See application file for complete search history. (74) Attorney, Agent, or Firm — One3 IP Management, P.C.; Dean G. Stathakis; Peter D. Weinstein (56) References Cited U.S. PATENT DOCUMENTS (57) ABSTRACT 6,348,470 B1 2, 2002 Korbonits et al. 6,417,206 B1 7/2002 Leflein et al. The present specification discloses compositions comprising 2002fOO52312 A1 5, 2002 Reiss et al. a plurality of therapeutic compound having antitussive activ 2003/0206942 A1 11/2003 Kulkarni et al. ity and methods and uses for treating a coughing condition 2004/0202677 A1 10/2004 Hopkins et al. 2004/0204440 A1 10, 2004 Staniforth et al. with Such compositions. 2005/022O897 A1 10/2005 Hacket al. 2006, O148837 A1 7/2006 Giordano et al. 2007, 0160689 A1 7/2007 Giordano et al. 10 Claims, No Drawings US 9,314.465 B2 Page 2 (56) References Cited Database WPI, Week 200343, Thomson Scientific, London, GB, AN 2003-451953 & JP 2003-055258 (Rohto) Feb. 26, 2003. Dicpinigaitis, et al., Currently Available Antitussives. Pulmonary FOREIGN PATENT DOCUMENTS Pharmacology & Therapeutics 22(2): 148-151 (2009). WO 2006064780 A1 6, 2006 Gallico, et al., “Moguisteine: a novel peripheral non-narcotic antitus WO 2008.002514 A2 1, 2008 sive drug Br. J. Phamacol. (1994), 112, 795-800. WO 2008O89260 A2 T 2008 Grattan, et al., “The effect of inhaled and oral dextromethorphan on WO 2009019598 A2 2, 2009 citric acid induced cough in man' Br. J. Clin. Pharmacol., 1995, vol. WO 2010, 146394 A1 12/2010 39, No. 3, p. 261-263. WO 2011/0583.74 A1 5, 2011 WO 2011/073646 A1 6, 2011 Levine, A Novel Treatment of Chronic Unexplained Cough, Abstract WO 2011/073647 A1 6, 2011 P331, Annals of Allergy, Asthma & Immunology 102(1): A113 WO 2012/O25761 A1 3, 2012 (2009). WO 2013,004999 A1 1, 2013 Minamizawa, et al., Effect ofd-Psuedophedrine on Cough Reflex and its Mode of Action in Guinea Pigs, Journal of Pharmacological Sci OTHER PUBLICATIONS ences 102(1): 136-142 (2006). Nickitas-Etienne, PCT International Preliminary Report on Patent Nickitas-Etienne, PCT International Preliminary Report on Patent ability, PCT/GB2012/050816, pp. 9, Jan. 7, 2014. ability, PCT/GB2010/050997, pp. 9, Dec. 16, 2011. Packman, et al., Antitussive Effects of Diphenhydramine on the Cit Nickitas-Etienne, PCT International Preliminary Report on Patent ric Acid Aerosol-Induced Cough Response in Humans, Int. J. Clin. ability, PCT/GB2010/051895, pp. 10, May 15, 2012. Pharmacol. Ther. Toxicol. 29(6): 218-222 (1991). Nickitas-Etienne, PCT International Preliminary Report on Patent Small, et al., The Releaxant and Spasmogenic Effects of Some ability, PCT/GB2010/051896, pp. 10, May 15, 2012. Xanthine Derivatives Acting on Guinea-Pig Isolated Trachealis Nickitas-Etienne, PCT International Preliminary Report on Patent Muscle, Br. J. Pharmacol.94: 1091-1 100 (1988). ability, PCT/GB2010/052085, pp. 9, Jun. 19, 2012. Balsamo, et al. Mucoactive drugs, European Respiratory Review, Nickitas-Etienne, PCT International Preliminary Report on Patent 2010, vol. 19, No. 116, p. 127-133. ability, PCT/GB2010/052086, pp. 6, Jun. 19, 2012. Rogers, Mucoactive Agents for Airway Mucus Hypersecretory Dis Nickitas-Etienne, PCT International Preliminary Report on Patent eases, Respiratory Care, Sep. 2007, vol. 52, No. 9, p. 1176-1197. ability, PCT/GB2011/051610, pp. 13, Mar. 5, 2013. Wangemann, Notes from Practice Clinical Experiences with the Usmani, et al., “Theobromine inhibits sensory nerve activation and Asthma Drug Dyspnoced, from the 2nd Internal Division of the cough” FASEB J., 2005, vol. 19, No. 2, p. 231-233. Westend Hospital, Berlin-Charlottenburg (Head physician: Dr. A. Usmani, et al., “Theobromine inhibits sensory nerve activation and Tietze). cough” FASEB J., Nov. 17, 2004 p. 1-16. Abstracts: Presented At Poster Sessions, Annals of Allergy, Asthma Usmani, et al., Theobromine Inhibits Sensory Nerve Activation and & Immunology, USA, Jan. 1, 2009, V102 N1, p. A23, A25-A128. Cough, FASEB Journal, pp. 1-16, online publication Nov. 2004. Brown, et al., “Antitussive activity of sigma-1 receptor agonists in the Wangemann G. Klinische Erfahrungen über das Asthmamittel guinea-pig Br. J. Pharmacol., 2004, vol. 141, No. 2, p. 233-240. Dyspnoced, Arztliche Wochenschrift, 1950, vol. 5(17), p. 272-273. Database WPI, Week 200343, Thomson Scientific, London, GB, AN Wangemann, Clinical Experience with Dyspnocedy an Anti-Athma 2005-704785 & CN 1593 451 (Yang X) Mar 16, 2005. Drug, Arztliche Wochenschrift 5(17): 272-273 (1950). Database WPI, Week 200308, Thomson Scientific, London, GB, AN 2003-078587 & JP 2002-193839 (Meiji) Jul 10, 2002. * cited by examiner US 9,314,465 B2 1. 2 DRUG COMBINATIONS AND USES IN complications are common and include abdominal or pelvic TREATING ACOUGHING CONDITION hernias, fatigue fractures of lower ribs and costochondritis. Even though cough medicines are a common an over-the This continuation-in-part application claims priority pur counter remedy for individuals seeking outpatient medical suant to 35 U.S.C. S 120 to U.S. patent application Ser. No. attention, their effectiveness as a treatment for a cough is 13/446.217, filed Apr. 13, 2012, a continuation-in-part appli doubtful. In 2006, the American College of Chest Physicians cation of International patent Application PCT/GB2011/ issued guidelines stating that “most over the counter cough 051610, filed Aug. 25, 2011, which claims priority to GB medications are ineffective’, and several research reports Provisional 1014391.5, filed Aug. 27, 2010; International seem to confirm this conclusion. For example, the non-opiate patent Application PCT/GB2010/052085, filed Dec. 14, 10 antitussive drug Dextromethorphan is marketed as a cough 2010, which claims priority to GB Provisional 092.1805.8. filed Dec. 14, 2009; International patent Application PCT/ therapy. However, its efficacy and suitability as a treatment GB2010/052086, filed Dec. 14, 2010, which claims priority for cough is questionable, since its apparent Success as a to GB Provisional 092.1803.3, filed Dec. 14, 2009: Interna clinical treatment was attributed to a placebo effect: Dex tional patent Application PCT/GB2010/051895, filed Nov. 15 tromethorphan itself had no efficacy in treating cough. (Ram 12, 2010, which claims priority to GB Provisional 09 19889.6 sey et al., Br. J. Clin. Pharmacol.) Similarly, the decongestant filed Nov. 13, 2009; International patent Application PCT/ pseudoephedrine has been to shown to have very limited GB2010/051896, filed Nov.
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  • Pharmacotherapy of Impaired Mucociliary Clearance in Non-CF Pediatric Lung Disease

    Pharmacotherapy of Impaired Mucociliary Clearance in Non-CF Pediatric Lung Disease

    Pediatric Pulmonology 42:989–1001 (2007) State of the Art Pharmacotherapy of Impaired Mucociliary Clearance in Non-CF Pediatric Lung Disease. A Review of the Literature 1 1 1,2 Ruben Boogaard, MD, * Johan C. de Jongste, MD, PhD, and Peter J.F.M. Merkus, MD, PhD Summary. Mucoactive agents are used to treat a variety of lung diseases involving impaired mucociliary clearance or mucus hypersecretion. The mucoactive agents studied most frequently are N-acetylcysteine (NAC), recombinant human DNase (rhDNase), and hypertonic saline. Studies on the efficacy of these have been mainly conducted in adults, and in patients with cystic fibrosis (CF). The exact role of mucoactive agents in children with non-CF lung disease is not well established. We present an overview of the current literature reporting clinical outcome measures of treatment with NAC, rhDNase, and hypertonic saline in children. Pediatr Pulmonol. 2007; 42:989–1001. ß 2007 Wiley-Liss, Inc. Key words: mucolytic; sulfhydryl compounds; N-acetylcysteine; dornase alfa; hyper- tonic saline; respiratory tract disease. INTRODUCTION One possible means to evaluate a mucoactive agent is to assess its effect on mucociliary clearance (MCC) or cough Mucus clearance is an important primary innate airway clearance with the use of radiolabeled aerosol. Discussing defense mechanism, and our understanding of the key this subject is outside the scope of this review. Moreover, parameters underlying its function has grown rapidly in the studies on mucoactive agents in CF patients, and studies last decade.1,2 Impaired mucus clearance or mucus hyper- on physiotherapy or secretion clearance techniques in secretion are important clinical features in diseases such as (pediatric) lung disease patients have been reviewed by cystic fibrosis (CF), recurrent bronchitis, asthma, and others, and will therefore not be discussed in this review.