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(12) Patent Application Publication (10) Pub. No.: US 2004/0029864A1 Macmillan (43) Pub US 2004.0029864A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2004/0029864A1 MacMillan (43) Pub. Date: Feb. 12, 2004 (54) TREATMENT OF COLDS AND COUGH Related U.S. Application Data WITH A COMBINATION OF A CYCLOOXYGENASE-2 SELECTIVE (60) Provisional application No. 60/354,135, filed on Feb. INHIBITOR AND A COLDS AND COUGH 4, 2002. ACTIVE INGREDIENT AND COMPOSITIONS THEREOF Publication Classification (75) Inventor: Stephen P. MacMillan, Newtown, PA (51) Int. Cl." ....................... A61K 31/55; A61K 31/415; (US) A61K 31/495 (52) U.S. Cl. ............... 514/217.05; 514/255.04; 514/406 Correspondence Address: Charles E. Dunlap Keenan Building (57) ABSTRACT Third Floor 1330 Lady Street Columbia, SC 29201 (US) A method for the treatment, prevention and amelioration of colds and/or cough in a Subject in need of Such treatment, (73) Assignee: Pharmacia Corporation, St. Louis, MO prevention and amelioration, comprises administering to the Subject a cyclooxygenase-2 Selective inhibitor or prodrug (21) Appl. No.: 10/357,747 thereof and one or more colds and cough active ingredient. Compositions, pharmaceutical compositions and kits for (22) Filed: Feb. 4, 2003 practicing the method are also disclosed. US 2004/0029864 A1 Feb. 12, 2004 TREATMENT OF COLDS AND COUGH WITH A 0009 Recently, significant progress has also been made COMBINATION OF A CYCLOOXYGENASE-2 in the field of inflammation, and the development of drugs SELECTIVE INHIBITOR AND A COLDS AND that show promise for the treatment of the inflammation COUGH ACTIVE INGREDIENT AND related disorders of osteoarthritis and rheumatoid arthritis. It COMPOSITIONS THEREOF has been known for Some time that many of the common non-steroidal antiinflammatory drugs (NSAIDs) modulate CROSS-REFERENCE TO RELATED PATENTS prostagiandin Synthesis by inhibition of cyclooxygenases AND PATENT APPLICATIONS that catalyze the transformation of arachidonic acid-the first Step in the prostaglandin Synthesis pathway. However, 0001. The subject matter of the present invention is the use of high doses of many common NSAIDs can produce related to and claims the benefit of co-pending and com Severe side effects that limit their therapeutic potential. monly assigned U.S. Provisional Patent Application Serial 0010. In an effort to reduce the unwanted side effects of No. 60/354,135, filed on Feb. 4, 2002, which application is common NSAIDS, it was discovered that two cyclooxyge hereby incorporated herein by reference in its entirety. nases are involved in the transformation of arachidonic acid as the first Step in the prostaglandin Synthesis pathway. BACKGROUND OF THE INVENTION These enzymes have been termed cyclooxygenase-1 (Cox 0002 (1) Field of the Invention 1) and cyclooxygenase-2 (Cox-2). See, Needleman, P. et al., J. Rheumatol., 24, Suppl.49:6-8 (1997). See, Fu, J. Y., et al., 0003. The present invention relates to the treatment of J. Biol. Chem., 265(28): 16737-40 (1990). colds and coughs, and more particularly to the treatment of 0011 Cox-1 has been shown to be a constitutively pro colds and coughs by administering to a Subject a combina duced enzyme that is involved in many of the non-inflam tion of a cyclooxygenase-2 Selective inhibitor and a colds matory regulatory functions associated with prostaglandins. and cough active ingredient. Cox-2, on the other hand, is an inducible enzyme having 0004) (2) Description of the Related Art Significant involvement in the inflammatory process. Inflam mation causes the induction of Cox-2, leading to the release 0005 The common cold is an acute viral infection of the of prostanoids, which Sensitize peripheral nociceptor termi mucous membranes of the nose and throat, often involving nals and produce localized pain hyperSensitivity. See, e.g., the Sinuses. The typical Sore throat, Sneezing, and fatigue Samad, T. A. et al., Nature, 410(6827):471-5 (2001). Many can be accompanied by body aches, headache, low fever, of the common NSAIDs are now known to be inhibitors of and chills. The congested and discharging mucous mem both Cox-1 and Cox-2. Accordingly, when administered in brane may become a fertile ground for S Secondary bacterial sufficiently high levels, these NSAIDs affect not only the infection that can spread to the larynx, bronchi, lungs, or inflammatory consequences of Cox-2 activity, but also the ears. Uncomplicated infections usually last from three to ten beneficial activities of Cox-1. days. 0012 Recently, compounds that selectively inhibit Cox-2 0006 Colds are caused by any one of up to 200 viruses to a greater extent than the activity of Cox-1 have been Such as the rhinoviruses, coronaviruses, or respiratory Syn discovered. The new Cox-2-selective inhibitors are believed cytial virus. Infection with a viral Strain conferS only a to offer advantages that include the capacity to prevent or temporary immunity to that Strain. Colds in infants and reduce inflammation while avoiding harmful Side effects young children caused by the respiratory Syncytial virus can associated with the inhibition of Cox-1. progreSS to pneumonia and other complications, and can 0013 Interestingly, for purposes of the present invention, result in death. it has been reported that isolated alkali metal and alkali-earth metal Salts of acetaminophen could be used for treatment of 0007. It is believed that there is no treatment for the mammals in need of an analgesic or antipyretic agent. U.S. common cold other than that aimed at relieving Symptoms Pat. No. 6,160,020 to Ohannesian et al. However, the and keeping the body well rested, fed, and hydrated. How purpose of the invention was to provide metal Salts of ever, many compounds have been found that are effective in acetaminophen with improved acqueous Solubility and taste. the relief of aches and pain (analgesics-usually non-Ste The acetaminophen salts could be combined with other roidal anti-inflammatory drugs, or NSAIDs), in reducing active ingredients Such as analgesics, decongestants, expec Sneezing and runny nose (antihistamines), for the Suppres torants, antituSSives, antihistamines, diuretics, gastrointesti Sion of coughs (antituSSives), for the breakup of nasal and nal agents, bronchodilators, and Sleep-inducing agents. The Sinus congestion (decongestants), and for helping clear the analgesic could be Supplied by acetylsalicylic acid (aspirin), lungs of excess mucus (expectorants). Many of these medi indomethacin, and CoX-2 inhibitorS Such as floSulide, nime cations are available commercially, and more are now being Sulide, celecoxib, 5-(4-aminosu lfonyl-3-fluorophenyl)-4- developed. cyclohexyl-2-methyloxazole, meloxicam, nambumethone, 0008 One promising area for colds medications is the and etodolac, among other compounds. However, no indi development of new antiviral agents. Older antiviral com cation was provided that the analgesic should be a Cox-2 pounds Such as aciclovir have proven to be effective against Selective inhibitor. Furthermore, the additional chemical herpesviruses, and new materials. Such as dipyridamole, reactions and Separations necessary to provide isolated metal impulsin, and pleconaril have shown promise for the pre Salts of acetaminophen, rather than the acid form of acetami vention and/or amelioration of colds. See, e.g., Jefferson, T. nophen, result in additional expense and require more com O. et al., Cochrane Database Syst. Rev., 1:3 CD002743 pleX production techniques. (2001); and Romero, J. R., Expert. Opin. Investig. Drugs, 0014 U.S. Pat. Nos. 6,271,253; 6,034.256; 6,077,850; 10(2):369-379 (2001). and 6,271,253 to Carter et al. describe the use of certain US 2004/0029864 A1 Feb. 12, 2004 substituted benzopyran Cox-2 inhibitors for the treatment of and amelioration of colds and/or cough in a Subject in need inflammation. It is also Stated that the Substituted benzopy of Such treatment, prevention and amelioration, the compo ran Cox-2 inhibitors can be used in addition to other Sition comprising a cyclooxygenase-2 Selective inhibitor, a anti-inflammatories, and in combination with opioids and colds and cough active ingredient, and a pharmaceutically other analgesics, codeine, hydrocodone, antihistamines, acceptable excipient. decongestants, diuretics and antituSSive agents. 0022. The present invention is also directed to a novel kit 0015 U.S. Pat. No. 6,303,628 to Nakao et al. describes that is Suitable for use in the treatment, prevention or certain bicycliccarbonyl indole compounds as having Cox-2 amelioration of colds and/or cough, the kit comprises a first Selective inhibitory activity, and States that these compounds dosage form comprising a colds and cough active ingredient are useful for treating Cox-2 mediated diseases-including and a Second dosage form comprising a cyclooxygenase-2 co-administration with Such other ingredients as another Selective inhibitor or prodrug thereof, in quantities which pain reliever, a potentiator, a decongestant, an antituSSive, a comprise a therapeutically effective amount of the combi prostaglandin, a diuretic, an antihistamine, anticancer nation of the compounds for the treatment, prevention, or agents, and the like. amelioration of colds and/or cough. 0016. From the foregoing, it can be seen that a need exists 0023. Among the several advantages found to be for improved treatment methods and compositions for colds achieved by the present invention, therefore, may be noted and coughs. It would also be useful if Such improved the provision of improved treatment methods and composi methods and compositions could be provided
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