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(12) Patent Application Publication (10) Pub. No.: US 2015/0231063 A1 Shea Et Al

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(12) Patent Application Publication (10) Pub. No.: US 2015/0231063 A1 Shea Et Al US 20150231.063A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2015/0231063 A1 Shea et al. (43) Pub. Date: Aug. 20, 2015 (54) PHARMACEUTICAL COMPOSITIONS (30) Foreign Application Priority Data COMPRISING FLURBIPROFEN Sep. 7, 2012 (GB) ................................... 1215988.5 (71) Applicant: Reckitt Benckiser Healthcare International Limited, Slough (GB) (72) Inventors: Tim Shea, Parsippany, NJ (US); Adrian Publication Classification Shephard, Slough (GB); Gary Smith, 51) int. C Hull (GB); Sue Aspley, Beverley (GB); (51) lik 9/00 (2006.01) Bernard d P Schachtel, Jupiter, FL (US)(US A63L/92 (2006.01) (21) Appl. No.: 14/424,820 (52) U.S. Cl. CPC ............... A61 K9/006 (2013.01); A61 K9/0056 (22) PCT Filed: Sep. 9, 2013 (2013.01); A61 K31/192 (2013.01) (86). PCT No.: PCT/US13A58685 S371 (c)(1), (57)57 ABSTRACT (2) Date: Feb. 27, 2015O O Th e present invention providesid an NSAID Such as 1ib buproIen f Related U.S. Application Data or flurbiprofen, or a pharmaceutically acceptable salt thereof (60) Provisional application No. 61/697,901, filed on Sep. for use in the topical treatment of coughs, especially dry 7, 2012. coughs. US 2015/023 1063 A1 Aug. 20, 2015 PHARMACEUTICAL COMPOSITIONS 0009 US 2010/022608 which discloses NSAIDs for COMPRISING FLURBIPROFEN the treatment of a non-productive cough as a symptom of viral and/or bacterial respiratory infections. TECHNICAL FIELD (0.010 Redaellietal's paper “Efficacy of flurbiprofen in influenza treatment for an open study Gazette Medica 0001. The present invention relates to a new medical use of Italiana Archivio per le Scienze Mediche, Vol 144, No. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). In par 11, 1985, pages 579-584 discusses the effect of flurbi ticular the present invention relates to an NSAID, or a phar profen on cough symptoms. maceutically acceptable salt thereof, for use in the topical 0.011 Dale et al’s paper “Chronic cough responsive to treatment of coughs, that is to provide an anti-tussive effect Ibuprofen' Pharmacotherapy, Vol 12, No. 4, 1992, pages e.g. to Sooth a dry cough. It has been found that ibuprofen and 331-333 discusses a study where ibuprofen was found to flurbiprofen are especially suitable NSAIDs for this use. be effective in treating idiophathic chronic cough. 0012 JP 2001097856 discloses an anti-tussive formu BACKGROUND AND PRIOR ART lation for treating cough symptoms, a tablet comprising ibuprofen and dimemorfan phosphate was found to Sup 0002 Coughing can be caused by a wide variety of con press Sulphurous acid gas induced cough. ditions including infection with viral respiratory pathogens. 0013 KR 20080039695 discloses a pharmaceutical The vast majority of acute cough is caused by upper respira composition for treating cough comprising gamma tory tract viral infection. Cough is a protective reflex which polyglutamic acid lycopene and an NSAID. removes inhaled foreign bodies and excessive secretions (0.014) JP 2002316927 discloses a composition for treat from the respiratory tract. Treatments for dry coughs (which ing cold and cough comprising an NSAID and pseu do not produce significant amounts of phlegm, commonly doephedrine. referred to as non-productive coughs) are well known and 0.015 Sperber et al in “Effects of naproxen on experi include cough medicines which comprise an anti-tussive mental rhinovirus colds a randomized double-blind con ingredient (to provide for cough suppression) such as Dex trol trial' Annals & Internal Medicine, Vol 117, No. 1, tromethorphan. 1992, pages 37-41 discloses a study of whether 0003. There is always a need for the product formulator naproxen alters the course of rhinovirus colds. developing cough treatments to be able to formulate Such 0016. McEwan at al in “The effects of Sulindac on the products with different, or new, ingredients. For example it is abnormal cough reflex associated with dry cough' Jour always of interest to formulate Such products which comprise nal of Pharmacology and Experimental Therapeutics, an alternative to known anti-tussives Such as Dextromethor Vol 255, No. 1, 1990, pages 161-164 discloses patients phan. with an angiotensin converting enzyme-associated 0004 Frequently a cough is associated with a sore throat, cough had a significant reduction in cough but that e.g. as the result of an upper respiratory infection. It is known patients with an idiopathic dry, unproductive cough did to treat Sore throats with an NSAID. Lozenges comprising not. flurbiprofen for the treatment of sore throats are available in 0017 U.S. Pat. No. 4,783,465 discloses a composition the UK under the trade name StrefenTM. WO97/18802 (The for treating colds and allergies comprising a propionic Boots Company) discloses the use of flurbiprofen in the treat acid NSAID and a non-sedating anti-histamine. ment of Sore throats. No disclosure or Suggestion is made in 0018. It is believed that none of the above references dis this reference to treating a cough, Such as a dry cough, with close the topical effect of NSAIDs in the treatment of cough. 0019. The present invention seeks to provide an alternative NSAIDS. way of treating coughs, in particular dry coughs, to the meth 0005 NSAIDs are known for a range of pharmaceutical ods already known in the art. It would be especially beneficial uses, for example analgesic formulations of ibuprofen are if the cough treatment could be provided together with a commercially available. However, the applicant is not aware reduction of the pain of a sore throat. that NSAIDs have been reported to be effective for the topical treatment of coughs, in particular dry coughs. Statement of Invention 0006 NSAIDs have been proposed for treating medical 0020. The present invention thus provides according to a conditions of the gums and the mouth. EP-A-0-137-668 (Up first aspect an NSAID or a pharmaceutically acceptable salt john) describes the use of ibuprofen and flurbiprofen for thereof for use in the topical treatment of coughs on the preventing or inhibiting alveolar bone resorption. EP-A-0- mucous membrane of the throat of a person in need of treat 486-561 (Sepracor) describes the use of S(+)-flurbiprofen or ment for a cough. It has been found that treatments of dry Ketoprofen to treat periodontal disease (including periodon coughs for which an anti-tussive (cough Suppression) effect is titis, gingivitis and periodontosis) and to promote bone required are especially effective according to the present regrowth associated with the disease. Both these documents invention. specifically describe the treatment of the gums with these 0021. The term “topical treatment” as used herein, and the NSAIDs and do not relate to the treatment of any other part of references to “topical refer to application to internal surfaces the oral cavity, including the throat. of the throat of a patient, that is to the mucous membranes. 0007. There are references disclosing NSAIDs for the 0022. The words “patient” and “person' are used inter treatment of coughs. Examples include: changeably herein. 0008 JP 2003081821 which discloses a composition 0023. It has been found that beneficial effects in the treat comprising ibuprofen, stramonium extract and potas ment of coughs (symptoms) in a person requiring such treat sium guaiacosulfonate to suppress capsaicin induced ment can be obtained by the topical treatment of said person cough. with an NSAID or a pharmaceutically acceptable salt thereof US 2015/023 1063 A1 Aug. 20, 2015 by providing the NSAID so that it is topically applied in the aprofen, flurbiprofen, fenoprofen, fenbufen, ketoprofen, throat of the person receiving the treatment. In trials con indoprofen, pirprofen, carprofen, oxaprozin, prapoprofen, ducted by the Applicant, coughs (symptoms) in people Suf miroprofen, tioxaprofen, Suprofen, alminoprofen, tiaprofenic fering from an upper respiratory tract infection (URI) have acid, fluprofen, and bucloxic acid. Preferred members of the been reported to be less troublesome/reduced following treat propionic acid group include ibuprofen, naproxen, flurbipro ment with a therapeutically effective amount of an NSAID fen, diclofenac, fenoprofen, ketoprofen and fenbufen. applied topically to the mucous membrane of the throat com 0037 Suitable acetic acid derivatives for use herein pared to when no NSAID is administered. include, but are not limited to, indomethacin, Sulindac, tol 0024. Furthermore the treatment of coughs (symptoms) metin, Zomepirac, diclofenac, fehchlofenac, alchlofenac, by administering an NSAID as above allows the amelioration ibufenac, isoxepac, furofenac, tiopinac, Zidometacin, acem of the cough and its symptoms to be achieved in a safe, etacin, fentiazac, clidanac and OXipinac. Preferred members effective and straightforward manner. The administration of of the acetic acid group include tolmetin Sodium, Zomepinac NSAIDs is well known and does not require complicated Sodium, Sulindac and indomethacin. dosage regimes. The present invention also provides the fur 0038. The fenamic acid derivatives for use herein include, ther advantage that the amelioration of the cough and its but are not limited to, mefenamic acid, meclofenamic acid, symptoms can be achieved simultaneously with other ben flufenamic acid, niflumic acid and tolfenamic acid. Preferred efits such as the reduction of the pain/soreness in the throat members of the fenamic acid group include mefenamic acid which may be present at the same time as a cough, Such as a and meclofenamic acid. dry cough. 0039. The biphenylcarboxylic acid derivatives for use 0025. According to a second aspect of the present inven herein include, but are not limited to, diflunisal and flufenisal. tion, there is also provided a method of the topical treatment 0040. The oxicams for use herein include, but are not of coughs comprising the administration of a therapeutically limited to, piroxicam, Sudoxican, isoxicam. A preferred effective amount of an NSAID to the internal surface the member of this group is piroXicam. throat of a person in need of treatment for a cough.
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