Non-hormonal compositions and methods for male contraception
11583518 · 2023-02-21
Assignee
Inventors
- Guillaume El Glaoui (Luxembourg, LU)
- Mehdi El Glaoui (Luxembourg, LU)
- Philippe Perrin (Paris, FR)
- Stéphane Droupy (Nimes, FR)
- Véronique Agathon-Meriau (Luxembourg, LU)
Cpc classification
A61K9/0053
HUMAN NECESSITIES
A61K45/06
HUMAN NECESSITIES
A61K2300/00
HUMAN NECESSITIES
A61K2300/00
HUMAN NECESSITIES
A61K31/4045
HUMAN NECESSITIES
A61K31/4045
HUMAN NECESSITIES
International classification
A61K31/4045
HUMAN NECESSITIES
A61K9/50
HUMAN NECESSITIES
A61K9/16
HUMAN NECESSITIES
Abstract
The present invention relates to non-hormonal compositions and methods for inducing a condition of aspermia, azoospermia, or severe oligozoospermia in the male subject such that these compositions and methods for administering the same may be used as male contraception. Embodiments of the present invention may comprise a composition comprising an alpha-1-adrenoreceptor antagonist, such as (R)-silodosin, for daily administration to a male subject. The compositions and related methods may further include pharmaceutically acceptable carriers. The present invention further includes formulations which allow for a delay such that delayed or missed dose(s) do not nullify the contraceptive effect of the treatment regimen. Such compositions and methods may also avoid the side effects associated with typical formulations of alpha-1-adrenoreceptor antagonists.
Claims
1. A method for reversible, continuous non-hormonal contraception in a male subject, the method comprising administering once daily at about the same time, an oral dose of a composition comprising: (i) an extended release formulation of (R)-silodosin in an amount effective, when administered once daily at about the same time, to induce a reversible condition of aspermia, azoospermia or severe oligozoospermia sufficient for contraceptive effect in the male subject; and (ii) a pharmaceutically acceptable carrier, wherein once daily administration of the formulation at about the same time provides a reversible contraceptive effect, but does not affect the quality of orgasm in the male subject.
2. The method of claim 1, wherein the quality of orgasm is measured on the Numerical Rating Scale for subjective quality of orgasm.
3. The method of claim 1, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 4 to about 12 mg.
4. The method of claim 1, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 8 mg.
5. A method for reversible, continuous non-hormonal contraception in a male subject, the method comprising administering once daily at about the same time, an oral dose of a composition comprising: (i) an extended release formulation of (R)-silodosin in an amount effective, when administered once daily at about the same time, to induce a reversible condition of aspermia, azoospermia or severe oligozoospermia sufficient for contraceptive effect in the male subject; and (ii) a pharmaceutically acceptable carrier, wherein once daily administration of the formulation at about the same time provides a reversible contraceptive effect, but does not cause discomfort upon ejaculation in the male subject.
6. The method of claim 5, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 4 to about 12 mg.
7. The method of claim 5, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 8 mg.
8. A method for reversible, continuous non-hormonal contraception in a male subject, the method comprising administering once daily at about the same time, an oral dose of a composition comprising: (i) an extended release formulation of (R)-silodosin in an amount effective, when administered once daily at about the same time, to induce a reversible condition of aspermia, azoospermia or severe oligozoospermia sufficient for contraceptive effect in the male subject; and (ii) a pharmaceutically acceptable carrier, wherein a delay in administering one daily dose after an initial period of at least two consecutive days with doses administered at about the same time does not affect the contraceptive effect in the male subject, wherein the delay does not exceed 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before intake time.
9. The method of claim 8, wherein the initial period of consecutive days is at least 5 days.
10. The method of claim 8, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 4 to about 12 mg.
11. The method of claim 8, wherein the amount of (R)-silodosin in the composition administered once daily at about the same time is about 8 mg.
12. The method of claim 8, wherein the delay in administering one daily dose does not exceed 4 hours.
13. The method of claim 8, wherein the delay in administering one daily dose does not exceed 6 hours.
14. The method of claim 8, wherein the delay in administering one daily dose does not exceed 8 hours.
15. The method of claim 8, wherein the delay in administering one daily dose does not exceed 10 hours.
16. The method of claim 8, wherein the delay in administering one daily dose does not exceed 12 hours.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS
(5) It is understood that the present invention is not limited to the particular methodologies, protocols, fillers, and excipients, etc., described herein, as these may vary. It is also to be understood that the terminology used herein is used for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention. It must be noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include the plural reference unless the context clearly dictates otherwise. Thus, for example, a reference to “a vitamin” is a reference to one or more vitamins and includes equivalents thereof known to those skilled in the art and so forth.
(6) Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art to which this invention belongs. Specific methods, devices, and materials are described, although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention. All references cited herein are incorporated by reference herein in their entirety.
(7) The term “About”, as used herein, means approximately, roughly, around, or in the region of. When the term “about” is preceding a figure means plus or less 20% of the value of said figure. When the term “about” is used in conjunction with a numerical range, it modifies that range by extending the boundaries above and below the numerical values set forth by 20%.
(8) The term “subject,” as used herein, comprises any and all organisms and includes the term “patient.” “Subject” may refer to a human or any other animal. Subjects may be referred to as “male subject(s)” or “female subject(s)” depending on their respective sex. In one embodiment, the “subject” is a healthy male human subject. In a second embodiment, the subject is a male human suffering from erectile dysfunction. In a third embodiment, the subject is a male human suffering from benign prostatic hyperplasia (BPH). In a fourth embodiment, the subject is a male human suffering from both benign prostatic hyperplasia (BPH) and erectile dysfunction.
(9) The phrase “co-administration” refers to administration of two or more compositions to a subject together, which includes administration at about the same time or within a certain specific or desired time.
(10) The term “Contraceptive method” as used herein, means a method which is defined by an administration scheme and a rule of oblivion (possibility to accept a delay in the uptake, without down effect), which sustain the contraceptive effect of the drug and make it efficient and suitable for regular and wide use by a general population. In other words, in a contraceptive method in the meaning of this invention, failure to administer one daily dose during the daily dosing regimen to the male subject may not affect the continuous state of aspermia, azoospermia, or severe oligozoospermia especially if the failure occurs after a continuous administration of at least 2, preferably at least 5 preceding days.
(11) The phrase “dissolvable form” refers to any compositions that dissolve into a solution in the mouth, such as, for example, buccally or sublingually. Such compositions, in one embodiment, may dissolve within about 60 seconds or less after placement in the mouth without any chewing.
(12) The phrase “pharmaceutically acceptable,” as used herein, refers to those compounds, materials, compositions and/or dosage forms which are, within the scope of sound pharmaceutical/medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio. Thus, the phrase “pharmaceutically acceptable carriers,” as used herein, refers to such suitable compounds and materials defined above that may be added to the dosage form to assist in satisfactory processing of the dosage form or provide desirable physical characteristics to the dosage form. For example, “pharmaceutically acceptable carriers” may include, but is not limited to, binders, diluents, lubricants, glidants, colorants, emulsifiers, disintegrants, starches, water, oils, alcohols, preservatives, and sugars.
(13) The term “dosage form,” as used herein, may be the form in which the dose is to be administered to the subject or patient. The drug or supplement is generally administered as part of a formulation that includes nonmedical agents. The dosage form has unique physical and pharmaceutical characteristics. Dosage forms, for example, may be solid, liquid or gaseous. “Dosage forms,” may include for example, a capsule, tablet, caplet, a soft shell capsule, such as a gel caplet (gel-cap), syrup, a liquid composition, a powder, a concentrated powder, a concentrated powder admixed with a liquid, a chewable form, a swallowable form, a dissolvable form, a water soluble film, an effervescent, a granulated form, a pellet form, and an oral liquid solution. Dosage forms may also include a subdermal implant, transdermal patch, injectable form, nasal spray, adhesive tablets, or transmucosally delivered solutions.
(14) As used herein, the terms “inactive,” “inert,” “excipient,” and/or “formulatory” refer to any compound that is an inactive ingredient of a described composition. The definition of “inactive ingredient” as used herein follows that of the U.S. Food and Drug Administration, as defined in 21 C.F.R. § 201.3(b)(8), which is any component of a drug product other than the active ingredient.
(15) The term “active ingredient,” then, includes any compound intended to furnish pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment and/or prevention of disease or a condition. See 21 C.F.R. § 210.3(b)(7). Further, “active ingredients” include those compounds of the composition that may undergo chemical change during the manufacture of the composition and be present in the final composition in a modified form intended to furnish an activity or effect. Id. In embodiments of the invention, this may include the alpha-1-adrenoreceptor antagonist, (R)-silodosin.
(16) The term “administrable” defines a composition that is able to be given to a subject. Likewise, “administering” refers to the act of giving a composition to a subject or otherwise making such composition available to a subject or the subject taking a composition.
(17) The term “aspermia” refers to failure to produce semen, or absence of sperm in the semen.
(18) The term “azoospermia” refers to the absence of viable sperm in the semen.
(19) The term “severe oligozoospermia” refers to a low count of sperm in ejaculate, typically about less than or equal to 1×10.sup.6 sperm per ejaculate.
(20) The term “male contraception” refers to a method used on males to prevent pregnancy of their female sexual partners. It may refer to including one of the conditions of aspermia, azoospermia, or severe oligozoospermia in such a manner that makes the male subject unable to impregnate.
(21) The term “Multiparticulate” means comprise more than one particle, term particle meaning a sphere, a microsphere, a tablet, a microtablet, a capsule or a microcapsule. The term multiparticulate may include clustered, pelletized, compressed or loose particles.
(22) The term “Once-a-day administration” means about the same time i.e. more or less 2 hours.
(23) As used herein, the term “contraceptive efficacy” or “contraceptively effective” refers to the function of a treatment as described herein for inducing reversible aspermia, azoospermia or severe oligozoospermia in which a male subject's ejaculate is incapable of inducing pregnancy through sexual contact in a female sexual partner. Accordingly, the term “sufficient for contraceptive effect,” when used, e.g., in reference to a treatment regimen or an amount of a drug or formulation, refers to a treatment that renders a male subject's ejaculate incapable of inducing pregnancy through sexual contact in a female sexual partner. “Interrupting” contraceptive efficacy refers to the return of a male subject's capacity to impregnate a female sexual partner through sexual contact.
(24) A treatment regimen using once-daily doses of an alpha-1-adrenoreceptor antagonist as described herein establishes a reversible condition or state of aspermia, azoospermia or severe oligozoospermia in a male subject that is sufficient for contraceptive effect and continuous as long as once-daily doses are administered, preferably, for example, at about the same time each day. As used herein, the term “does not affect the continuous state of aspermia, azoospermia or severe oligozoospermia sufficient for contraceptive effect,” when used in reference to failure to administer one or more daily doses of a formulation as described herein, e.g., after an initial period of regular dosing sufficient for contraceptive effect, means that the failure to administer a given dose or doses over a given span of time after contraceptive efficacy is established does not interrupt the contraceptive efficacy of the treatment over that span of time.
(25) As used herein, the term “short term” treatment refers to a treatment regimen of at least 8 days of daily doses, generally not exceeding 20 days. Short term treatment, as the term is used herein, can encompass one or more missed daily doses after an initial period of regular dosing sufficient to establish contraceptive effect. “Long term” treatment is treatment for greater than 20 days, including, for example, 30 days/one month, 45 days, 60 days/two months, three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, one year or more, e.g., two years, three years or more. Long term treatment, as the term is used herein, can encompass treatment including one or more occasional missed daily doses.
(26) As used herein, the term “orthostatic hypotension” refers to a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing.
(27) Oral contraceptives for female subjects are well known in the art such as, for example, Loestrin®, Natazia®, Ortho-Novum®, Ortho Tri-Cyclen®, Yasmin® and Yaz®. Other hormonal contraceptives may be administered to female patients through other dosage forms or methods, such as injection (e.g., Depo-Provera®), transdermal patch (e.g., Ortho Evra®), subdermal implant (e.g., Nexplanon®), vaginal ring (e.g., Nuva-Ring®) or intrauterine device (e.g., Mirena®). No comparable commercial contraceptive product (either hormonal or non-hormonal) is available to male subjects.
(28) This invention relates to the use of a composition in a non-hormonal contraception method for a male subject, the composition comprising an alpha-1-adrenoreceptor antagonist, preferably an alpha-1a-adrenoreceptor antagonist, more preferably silodosin; and a pharmaceutically acceptable carrier. The non-hormonal contraception method includes a once-a-day administration of the composition according to the present invention. In order to maintain an effective exposure to the male subject, the contraception method is carried out for at least two days.
(29) This once-a-day administration induces a contraceptive effect resulting from triggering aspermia, azoospermia, or severe oligozoospermia in the male subject for at least 24 hours.
(30) In another aspect, the invention relates to a method for male contraception. This method comprises the administration of a composition comprising an alpha-1-adrenoreceptor antagonist; and a pharmaceutically acceptable carrier, wherein the composition has a contraceptive effect by inducing aspermia, azoospermia or severe oligozoospermia making the male subject unable to conceive.
(31) In another aspect, the invention relates to a method for inducing a continuous state of aspermia, azoospermia, or severe oligozoospermia in a male subject. This method comprises the administration of a composition comprising an alpha-1-adrenoreceptor antagonist; and a pharmaceutically acceptable carrier. In such aspects, the alpha-1-adrenoreceptor antagonist, compositions and formulations thereof, as well as the frequency of the administration can be as previously described.
(32) Advantageously, the contraceptive effect obtained by the once-a-day administration of the composition of the invention is not affected by a delay of the consecutive once-a-day administration, supposed to occur 24 hours after the former administration, said delay not exceeding 6 hours after first administration, and said delay not exceeding 24 hours after further administration. Thus, the contraceptive effect obtained by the once-a-day administration of the composition of the invention is not reversed by a delay of the consecutive once-a-day administration, said delay not exceeding 6 hours after first administration, and said delay not exceeding 24 hours after further administration.
(33) In a particular embodiment, the daily administration of the alpha-1-adrenoreceptor antagonist is made at about the same time on each day. In this particular embodiment, about means two hours before or after the same time.
(34) A regular timetable in the administration has the benefit of assisting with patient compliance with the daily administration schedule. Further, as discussed in more detail below, for contraceptive products, it is usually recommended to take the drug at approximately the same time each day in order to maintain an effective exposure of the patient to the drug all along the dosing interval. According to one embodiment, the daily administration contraception method is a single daily administration contraception method. The non-hormonal contraceptive compositions described herein may include any alpha-1-adrenoreceptor antagonist. A person skilled in the art can adapt the composition using his general knowledge on the pharmacodynamic and pharmacokinetic properties of the said alpha-1-adrenoreceptor antagonist. In one embodiment, the alpha-1-adrenoreceptor antagonist is selected from the group comprising silodosin, terazosin, doxazosin, tamsulosin and fiduxosin.
(35) In a preferred embodiment, the composition implemented in the present invention comprises silodosin as an alpha-1-adrenoreceptor antagonist. In another embodiment, the composition comprises tamsulosine as an alpha-1-adrenoreceptor antagonist.
(36) In a preferred embodiment, the alpha-1-adrenoreceptor antagonist is (R)-Silodosin. (R)-Silodosin, formally known as (−)-(R)-1-(3-hydroxypropyl)-5-[2-[[2-[2-(2,2,2-trifluoroethoxy)phenoxy]ethyl]amino]propyl]indoline-7-carboxamide (“(R)-Silodosin”). The molecular formula is C.sub.25H.sub.32F.sub.3N.sub.3O.sub.4, and it has a molecular weight of 495.53. (R)-Silodosin has the chemical structure shown below:
(37) ##STR00016##
(38) Silodosin is powder that appears white or pale yellow/white. It melts at approximately 105 to 109° C. It is very soluble in acetic acid, freely soluble in alcohol, and very slightly soluble in water. In one embodiment, the alpha-1-adrenoreceptor antagonist is (R)-Silodosin in a polymorphic or amorphous form
(39) In embodiments of the invention, (R)-Silodosin may be particularly advantageous because it is a known antagonist of the alpha-1a-adrenoreceptors, and particularly, has high affinity and selectivity toward human alpha-1-adrenoreceptors is high (pKi=10.4±0.07) (CDER, NDA 22-206, P
(40) The ejaculatory process is mainly mediated by the autonomic nervous system and consists of two main phases: emission and expulsion. Two groups of anatomical structures are specifically involved and distinguished in each phase. The organs involved in the emission phase comprise the epididymis, vas deferens, seminal vesicles, prostate gland, prostatic urethra and bladder neck. The organs participating in the expulsion phase include the bladder neck and urethra, as well as the pelvic striated muscles.
(41) The first phase is the emission phase. During the emission phase, spermatozoa mixed with products secreted by accessory sexual glands are ejected into the posterior urethra by sequential epithelial secretion and smooth muscle cell contractions. The second phase is the expulsion phase. During the expulsion phase, sperm is ejected from the urethra through the glans meatus. According to the commonly accepted theory, expulsion is a spinal cord reflex that occurs as the ejaculatory process reaches its peak. It involves closure of bladder neck, followed by the rhythmic contractions of the urethra by pelvic-perineal and bulbospongiosus muscle, and intermittent relaxation of external urethral sphincters.
(42) Sympathetic motor neurons control the emission phase of ejaculation reflex, and expulsion phase is executed by somatic and autonomic motor neurons. These motor neurons are located in the thoracolumbar and lumbosacral spinal cord and are activated in a coordinated manner when sufficient sensory input to reach the ejaculatory threshold has entered the central nervous system. Lumbar spinothalamic (LSt) cells have been described as the spinal ejaculation generator in animals.
(43) Transportation of spermatozoa from their storage sites in the cauda epididymis via the vas deferens and in the seminal vesicles to the urethra is understood to be blocked by silodosin. This process of propulsion of sperm into the ejaculate is essential for males to produce an adequate sperm count for fertilization. Sympathetically innervated smooth muscle cells surround the vas deferens and seminal vesicles and contract in response to noradrenaline due to activation of α1A-adrenergic G protein-coupled receptors (adrenoceptors, or “AR”). Sympathetically mediated sperm transport is thereby blocked through the vas deferens during the emission phase of ejaculation, producing infertility without effects on sexual behavior or function.
(44) The ejaculatory reflex is not modified by silodosin as the sensory inputs from genital and brain areas to the spinal generator of ejaculation (lumbospinothalamic, or “LSt”) neurons) remain intact. The spinal generator role and function are not modified by silodosin as LSt cells are not known to have adrenergic receptors, only neurokinin and galanin receptors (Coolen et al P
(45) Accordingly, the non-hormonal contraceptive compositions of the present invention do not impact the production of semen in a male subject. Instead, they regulate the transport out of the semen and spermatozoa. This is advantageous over more permanent contraception methods (i.e., a vasectomy) because it is reversible upon cessation of administration of the drug.
(46) Embodiments of the invention may be, include, or resemble a variety of dosage forms that are well known in the art. For example, this may include capsules, tablets, caplets, soft shell capsules, gel caplets (gel-caps), syrups, liquid compositions, powders, concentrated powders, concentrated powders admixed with liquids, chewable forms, swallowable forms, dissolvable forms, water soluble films, effervescents, granulated forms, pellet forms, and oral liquid solutions. In a particular embodiment of the invention, the dosage form may comprise microgranules in a hard capsule containing a pharmaceutically effective amount of (R)-Silodosin to guarantee the contraceptive efficacy during a targeted duration. In such an embodiment, the microgranules may comprise (i) an inert core, (ii) a drug layer applied to the inert core, comprising (R)-Silodosin and a binder, and (iii) a controlled release coating surrounding the drug layer. Further embodiments of the invention may also comprise, optionally, a surfactant in combination with item (ii). A hard capsule may then be filled with the microgranules. Additionally or alternatively, the microgranules may be matrix microgranules of (R)-Silodosin surrounded by controlled release coating and filled in a hard capsule. Alternatively, the granules can be compressed into a tablet. The compositions described in this paragraph, including methods for preparing them, are well known in the pharmaceutical arts. W
(47) The composition can be into a single day oral dosage forms selected from the group consisting of: soft-gels, caplets, pills, tablets, microtablets, capsules, hydromatrix tablets, and osmotic tablets.
(48) Embodiments of the invention may further be, include, or resemble microtablets in a hard capsule, a coated tablet, a hydromatrix tablet, or an osmotic tablet containing a pharmaceutically appropriate amount of (R)-Silodosin to guarantee the contraceptive efficacy during a targeted duration. Embodiments of the invention may therefore comprise microtablets, specifically, matrix tablets of (R)-Silodosin surrounded by controlled release coating, and filled in a hard capsule. The tablets can optionally be coated by a controlled release coating prior to their formulation into a tablet. A coated tablet may be or comprise a matrix tablet of (R)-Silodosin surrounded by controlled release coating. A coated tablet may be or comprise a matrix tablet of the alpha-1-adrenoreceptor antagonist surrounded by controlled release coating. In embodiments of the invention, a hydromatrix tablet may also be used as a dosage form, particularly, e.g., a single or multiple-layer tablet comprising alpha-1-adrenoreceptor antagonist or (R)-Silodosin and an hydrophilic excipient. The compositions described in this paragraph, including methods for preparing them, are well known in the pharmaceutical arts. See e.g., Peter Timmins et al., Hydrophilic Matrix Tablets for Oral Controlled Release (2014); Rumondor et al., Minitablets: Manufacturing, Characterization Methods, and Future Opportunities. Jul. 30, 2016; Nokhodchi A., The Role of Oral Controlled Release Matrix Tablets in Drug Delivery Systems, 2(4) B
(49) In such embodiment, the compositions administrated in the use according to the present invention are formulated in forms comprising granules or tablets. The granules or tablets may optionally be coated by a controlled release coating.
(50) The granules or tablets, as previously described, can be further filled into a capsule that optionally comprises a controlled release coating.
(51) In one embodiment, the composition is in a multiparticulate form. In such embodiment, a capsule may then be filled with the previously described particles or granules. The sufficient number of these particles or granules within the capsule is determined by a person skilled in the art in view of reaching to daily dose of the alpha-1-adrenoreceptor antagonist.
(52) In one embodiment, the contraceptive effect resulting from triggering aspermia, azoospermia, or severe oligozoospermia and the absence of undesired side effects in the male subject is achieved independently from the food consumption by the male subject.
(53) In one embodiment, contraceptive effect resulting from triggering aspermia, azoospermia, or severe oligozoospermia in the male subject has the same efficacy and/or safety profile independently from the food consumption by the male subject.
(54) In one embodiment, the composition comprising the alpha-1-adrenoreceptor antagonist includes or consists of at least one particle, preferably at least one coated particle, and the average particle diameter is in the range of 0.01 to 5 mm, preferably 0.1 to 2 mm.
(55) The present invention, however, is not limited to oral administration of, e.g., capsules, tablets, and the like. Embodiments of the invention may be or comprise other dosage forms or methods, such as injection, transdermal patch, or subdermal implant. These are also well known in the arts and in embodiments of the invention may be similar to comparable female contraceptive products, such as, for example, Depo-Provera®, Ortho Evra®, and Nexplanon®, respectively.
(56) The therapeutic dose of (R)-Silodosin used in any of the dosage forms described or referred to herein may be or include, by way of example only, about 4 mg, about 8 mg, about 12 mg, about 16 mg, or about 20 mg. It is known in the art that one of the main side effects of alpha blockers is orthostatic hypotension (Roehrborn C. Alpha1-Blockers in Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: Is Silodosin Different? A
(57) In embodiments of the invention, the non-hormonal contraceptive compositions are administered to a male subject once daily. This has the benefit of assisting with patient compliance with the daily administration schedule (M. Rosenberg et al. Compliance, Counseling and Satisfaction with Oral Contraceptives: A Prospective Evaluation. P
(58) Current formulations of (R)-Silodosin for the treatment of BPH, such as the commercial product Rapaflo®, release the active ingredient immediately upon swallowing, and thus are “immediate release” (or “IR”) formulations. For a contraceptive product, however, embodiments of the invention comprising a formulation of the non-hormonal contraceptive compositions in which the therapeutic effect is capable of withstanding a delay in intake may be particularly desirable. Such formulations may be referred to as an “extended release” (or “ER”) formula. In such embodiments, a male subject's delay in intake, or failure to intake, one (or more) dose(s) would not nullify the contraceptive effect of the treatment regimen, and would also allow a day-to-day adjustment of a more convenient intake time.
(59) For an extended release formulation intended for once daily administration to a male subject, while allowing for delays and/or omissions in administration, the therapeutic dose should be adjusted in embodiments of the invention to maintain an effective control of sperm ejaculation.
(60) For instance, and by way of example only, the contraceptive effect may be designed to withstand a delay of 6 hours (e.g., contraceptive effect maintained up to 24 hours, and an additional six hour delay, for a total of 30 hours post-dose) once the steady state is reached in a male subject. In embodiments of the invention, this duration of action is longer and/or faster acting, and may be reached from one, two, three, four, five, or six initial doses. It should be noted the typical means of achieving a lengthening of the duration of action—an increase of the therapeutic dose—is not a viable option in the case of (R)-Silodosin, as it would expose the patient to a significant increase in the risk of orthostatic hypotension.
(61) According to a first embodiment, the daily administration of the alpha-1-adrenoceptor antagonist can be delayed as of the third day of two consecutive daily intakes with no impact on the contraceptive effect on the male subject, such delay not exceeding 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time, preferably not exceeding 2, 4, 6 hours from the day-before uptake time.
(62) According to second embodiment, the daily administration of the alpha-1-adrenoceptor antagonist can be delayed as of the fourth day of three consecutive daily intakes with no impact on the contraceptive effect on the male subject, such delay not exceeding 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time.
(63) According to a third embodiment, the daily administration of the alpha-1-adrenoceptor antagonist can be delayed as of the fifth day of four consecutive daily intakes with no impact on the contraceptive effect on the male subject, such delay not exceeding 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time.
(64) According to a fourth embodiment, the daily administration of the alpha-1-adrenoceptor antagonist can be delayed as of the sixth day of five consecutive daily intakes with no impact on the contraceptive effect on the male subject, such delay not exceeding 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time.
(65) According to a fifth embodiment, the daily administration of the alpha-1-adrenoceptor antagonist can be delayed as of the seventh day of six consecutive daily intakes with no impact on the contraceptive effect on the male subject, such delay not exceeding 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time.
(66) In one embodiment, the once-a-day administration contraception method is carried out for at least two days. In one embodiment, the once-a-day administration contraception method is carried out for at least three days. In one embodiment, the once-a-day administration contraception method is carried out for at least for at least four days. In one embodiment, the once-a-day administration contraception method is carried out for at least for at least five. In one embodiment, the once-a-day administration contraception method is carried out for at least six days.
(67) According to the aforementioned embodiments the delay of a subsequent daily administration does not exceed 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time. In one embodiment, the delay does not exceed 2, 4, 6, 8, 10 12, 16, 20 or 24 hours from the day-before uptake time. In one embodiment, the delay does not exceed 2 hours from the day-before uptake time. In one embodiment, the delay does not exceed 4 hours from the day-before uptake time. In one embodiment, the delay does not exceed 6 hours from the day-before uptake time. In one embodiment, the delay does not exceed 8 hours from the day-before uptake time. In one embodiment, the delay does not exceed 10 hours from the day-before uptake time. In one embodiment, the delay does not exceed 12 hours from the day-before uptake time. In one embodiment, the delay does not exceed 16 hours from the day-before uptake time. In one embodiment, the delay does not exceed 20 hours from the day-before uptake time. In one embodiment, the delay does not exceed 24 hours from the day-before uptake time.
(68) In one embodiment, the dosage form is self-administered.
(69) Therefore, embodiments of the invention comprise modification of the pharmacokinetic profile of (R)-Silodosin in such a way that, at the steady state, Its C.sub.max is lowered compared to the pharmacokinetic profile obtained with the IR and/or other traditional formulations of (R)-Silodosin. In embodiments of the invention, the C.sub.max of an ER formulation of (R)-Silodosin is lower than the C.sub.max reached with the same dose administered in the IR and/or other traditional formulation, leading to a lower risk of orthostatic hypotension. In further embodiments of the invention, this also means that the C.sub.max of IR/traditional (R)-Silodosin and the C.sub.max reached with a higher dose administered in the ER formulation may be comparable, allowing an additional therapeutic effect without an increased risk of orthostatic hypotension.
(70) In embodiments of the extended release formulation described herein, the non-hormonal compositions may also allow for consumption with or without food. Typically, as discussed herein, alpha-1 blockers are administered with food in order to decrease the peak of their plasma concentration and consequently limit the occurrence of the cardiovascular side effects. A so-called “food effect” is known to impact the pharmacokinetic profile of traditional formulations of (R)-Silodosin, leading to a delayed T.sub.max and lower C.sub.max. (EMA/793234/2009. CHMP assessment report for Urorec. Procedure No. EMEA/H/C/001092. 10 Jan. 2010.) It is assumed that these effects are due to the delayed voiding of the stomach in the presence of food.
(71) As described above, embodiments of the invention may comprise unitary dosage forms such as microgranules or microtablets in hard capsule that are released in the stomach. With sufficiently small size (for instance, e.g., with a diameter ≤5 mm, preferably ≤2 mm) to progress to the intestine in the flow of the digestive fluids, microgranules or microtablets will not be retained in the stomach with the food. Thus, the food effect—which relies upon a delayed voiding of the stomach in the presence of food—would not impact such formulations. Notably, additional mechanisms may be responsible for avoidance of the food effect.
(72) In embodiments of the invention, the microgranules or microtablets may also be designed with a specific density in order to avoid the food effect. If the density of the microgranules or microtablets is too low, they will float at the top of the gastric fluids contained in the stomach during a fasting state, delaying transit to the intestine. Accordingly, in embodiments of the invention, the target density of the microgranules or microtablets may be designed to avoid the floating phenomenon. In embodiments of the invention, a density ≥1 may be desirable. In embodiments of the invention, a density ranging from about 1 to about 1.6 may be desirable. However, those skilled in the art will appreciate that other densities may be appropriate or ideal.
(73) As previously discussed, male orgasm is controlled by the involuntary, or autonomic, limbic nervous system and occurs in the pleasure centers in the brain. During orgasm, the anterior lobe of the cerebellar vermis and deep cerebellar nuclei are activated; the left ventromedial and orbitofrontal cortex are de-activated.
(74) Although no effect of silodosin has been described on central nervous pathways, and it is possible for patients on silodosin administration to still experience orgasms, as reported by Shimizu et al. However, some studies have reported a decrease in orgasmic quality for male subjects who are administered silodosin daily, including Shimizu et al and Capogrosso et al., while others, including Kobayashi et al. and Bozkurt et al., have reported discomfort upon ejaculation.
(75) Embodiments of the invention therefore include methods and compositions of administering silodosin which do not significantly impair the quality of orgasm for the male subject (often measured by the Numerical Rating Scale, NRS, for the quality of orgasm). Other potential side effects which the claimed invention would avoid (or, at minimum, maintain) are decreased sexual desire, feelings of reduced virility, ejaculation distress, decreased satisfaction, undesirable decrease or increase in intravaginal ejaculation latency time, and/or premature ejaculation.
(76) In embodiments of the invention, silodosin is either present alone, or in association with another active agent, or in combination with another active agent. The non-hormonal contraceptive compositions of the present invention.
(77) In an embodiment of the invention, alpha-1-adrenoreceptor antagonist, preferably silodosin may be included or used in the non-hormonal contraceptive compositions in any specific form just described. In another embodiment, the non-hormonal contraceptive compositions may include or use a combination of alpha-1-adrenoreceptor antagonist or other components in the ranges or amounts just described.
(78) In a specific embodiment, various active ingredients may be incorporated into multiple compositions as a kit. In some embodiments, the non-hormonal contraceptive compositions disclosed herein may be packaged as kits using materials known to those of ordinary skill in the art.
(79) In one embodiment, the use of the composition in the daily administration contraception method further comprises a simultaneous or sequential administration of an additional composition. In one embodiment, the additional composition is related or not related to the sexual health of the male subject. In one embodiment, the additional composition does not affect the cardiovascular system of the male subject. In one other embodiment, the additional composition affects the cardiovascular system of the male subject. More in particular, the additional composition may induce the lowering of the male subject arterial pressure.
(80) Advantageously, the safety profile of the present inventions male contraceptive method allows the simultaneous or sequential administration of an additional composition that may lower the patient's arterial pressure, with no risk of a hypotensive crisis.
(81) Phosphodiesterase type 5 (PDE5) inhibitors, for example, are a class of drugs used in the treatment of erectile dysfunction. Because the prevalence of erectile dysfunction and of BPH increases in aging men, embodiments of the invention may comprise the co-administration of PDE5 inhibitors and (R)-Silodosin in male patients suffering from both pathologies.
(82) In one embodiment, use of the composition in the daily administration contraception method further comprises a simultaneous or sequential administration of an additional composition suitable for treating erectile dysfunction; preferably the additional composition comprises a phosphodiesterase-5 inhibitor.
(83) PDE5 inhibitors are mild vasodilators associated with small decreases in blood pressure. (Huang S; and Lie J. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. PT (2013) 38(7): 407, 414-419.) Alpha-blockers are also well known vasoactive compounds. Thus, the co-administration of PDE5 inhibitors and alpha-blockers may, under some circumstances, result in additive vasodilatory effect, particularly within patient populations likely to be prescribed PDE5 inhibitors in clinical practice. (Schwartz B, Kloner R. Drug Interactions With Phosphodiesterase-5 Inhibitors Used for the Treatment of Erectile Dysfunction or Pulmonary Hypertension. C
(84) Another typical way to limit the risk of side effects of co-administration of an alpha blocker and PDE5 inhibitor is to separate the intake of each drug by several hours, as reported by Schwartz et al. The median T.sub.max (time when the peak of plasma concentrations are reached) of the 4 currently marketed PDE-5 inhibitors (sildenafil, vardenafil, tadalafil, avanafil) ranges from 0.5 to 2 hours (Sharon A. Huang; and Janette D. Lie. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P&T (2013) 38 (7):407-419). The median T.sub.max of (R)-Silodosin is about 2 hours. Center for Drug Evaluation and Research, NDA 22-206, CLINICAL PHARMACOLOGY AND BIOPHARMACEUTICS REVIEWS (July 2008). When the alpha blocker and the PDE-5 inhibitor are taken several hours apart, the C.sub.max of each compound is not reached in the same time so that the cumulative effect is lower. However, as described herein, in embodiments of the present invention, such as an ER formulation of (R)-Silodosin, the C.sub.max is lower than in traditional/IR formulations of (R)-Silodosin and the T.sub.max is delayed further apart from the T.sub.max of its associated PDE5 inhibitor. Thus, it is possible to co-administer an alpha blocker composition as described herein as well as the PDE-5 inhibitor in the same time.
(85) Advantageously, alpha-adrenoreceptor antagonist extended release formulations allow the simultaneous or sequential administration of an additional composition that may lower the patient's arterial pressure, with no risk of a hypotensive crisis. In one embodiment, the alpha-adrenoreceptor antagonist is an alpha-1-adrenoreceptor antagonist, preferably (R)-Silodosin. In one embodiment, the extended release formulations are adapted according to the general knowledge of the skilled artisan. In one embodiment the extended release formulations are the extended release formulations according to the present invention
(86) The kits of the present invention may comprise or use a combination of compositions, including but not limited to PDE5 inhibitors. Additionally or alternatively, kits may further include, by way of example, one or more back-up methods of birth control provided in the event that it is needed. For instance, embodiments of the invention may comprise a composition formulated to maintain a contraceptive effect in a male subject for about 30 hours. If the male subject engages in sexual intercourse after about 30 hours, it may be necessary or optimal to utilize a back-up method of birth control, such as a condom or an emergency contraceptive such as, e.g., Plan B One-Step® or EllaOne.
(87) In embodiments of the invention, the kit may be packaged in a sachet or package. In such embodiments, a kit may comprise one or more individual dosage forms. In some embodiments, each kit may comprise two individual dosage forms. In some embodiments, each kit may comprise three individual dosage forms. In some embodiments, a kit may comprise a total dosage form.
(88) Additionally or alternatively, in embodiments of the invention, an individual dosage form, unit dosage form, or total dosage form may be individually wrapped, packaged as multiple units on paper strips or in vials of any size, without limitation. The orally dissolvable compositions of the invention may be packaged in unit dose, rolls, bulk bottles, blister packs, and combinations thereof, without limitation.
(89) Therefore, the invention also relates to a packaging of unitary doses of the composition of the invention. The composition, as previously described, includes alpha-1-adrenoreceptor antagonist in an amount ranging from about 0.1 to about 30 mg, preferably from about 0.2 to about 20 mg, preferably the alpha-1-adrenoreceptor antagonist is (R)-silodosin in an amount of 8 to 12 mg.
(90) In one embodiment the male contraceptive packaging comprises at least one packaging unit; wherein said packaging unit comprises from about 7 to about 30 separately packaged unitary doses of the composition as described in the present invention.
(91) In one embodiment, the male contraceptive packaging comprises from about 7 to about 28 unitary doses. The male contraceptive packaging may comprise 7, 14, 28, 56 or 84 unitary doses. The male contraceptive packaging may be suitable for longer periods of the non-hormonal male contraception method of the present invention. In such embodiments, the male contraceptive packaging comprises 7, 14, 28, 56, 84 or 168 to 365 unitary doses of the composition as described in the present invention.
(92) According to another embodiment the male contraceptive packaging comprises from about 10 to about 30 unitary doses. The male contraceptive packaging may comprise 10, 20, 30, 60 or 90 unitary doses. The male contraceptive packaging may be suitable for longer periods of the non-hormonal male contraception method of the present invention. In such embodiments, the male contraceptive packaging comprises 10, 20, 30, 60, 90 or 180 to 360 unitary doses of the composition as described in the present invention.
(93) In one embodiment the unitary doses are placed in at least one blister. The male contraceptive packaging is adequately labeled and may further comprise instructions for the male contraception method according to the present invention.
(94) All pharmaceutical preparations described herein are well known to those of ordinary skill in the art, and determination of workable methods for preparing orally dissolvable compositions in any particular instance will generally be within the capability of the person skilled in the art.
(95) Details concerning any of excipients may be found in WADE & WELLER, HANDBOOK OF PHARMACEUTICAL EXCIPIENTS (2nd ed. 1994). AU active ingredients, fillers and excipients are commercially available from companies such as Aldrich Chemical Co., FMC Corp, Bayer, BASF, Alexi Fres, Witco, Mallinckrodt, Rhodia, ISP, and others. The excipients used in the orally dissolvable compositions fall into several functional categories and may include, by way of example, plasticizers, emulsifiers, taste enhancers, sweeteners, and flavoring agents. Additionally or alternatively, excipients may be of the type used in other FDA-approved oral contraceptive products.
(96) In one embodiment, the non-hormonal contraceptive compositions comprise one or more inactive ingredients. The inactive ingredients may comprise one or more of the following: sugar, corn syrup, water, gelatin, citric acid, lactic acid, one or more glazing agents (e.g., vegetable oil, beeswax, carnauba wax), one or more natural flavors (e.g., plum, apple, mixed berry, cherry), one or more natural colors (e.g., black carrot), and one or more masking flavors (e.g., tartaric acid, menthol).
(97) In some embodiments, the non-hormonal contraceptive compositions may comprise one or more inactive ingredients that include but are not limited to water, buffers (including, by way of example and without limitation, phosphate buffers, citrate buffers, lactic acid, and others known to those of ordinary skill in the art), stabilizing agents (including, by way of example and without limitation, antioxidants (e.g., ascorbic acid, propionic acid, sodium bisulfite, sodium sulfite, and the like), chelating agents (e.g., fumaric acid, sodium edetate, and the like), and others known to those of ordinary skill in the art), surfactants (including, by way of example and without limitation, wetting agents (e.g., sorbitan monolaurate, etc.), antifoaming agents (e.g., sorbitan trioleate, etc.), detergents (e.g., sucrose stearate, etc.), solubilizing agents (e.g., polyethylene glycol 400 monostearate, etc.), and others known to those of ordinary skill in the art), processing aids (e.g., substances used to assist processing, including, by way of example and without limitation, lubricating agents, antioxidants, and others known to those of ordinary skill in the art), lubricating agents (including, by way of example and without limitation, stearic acid, calcium stearate, magnesium stearate, zinc stearate, talc, mineral and vegetable oils, benzoic acid, poly (ethylene glycol), glyceryl behenate, stearyl fumarate, and others known to those of ordinary skill in the art), emulsifiers (including, by way of example and without limitation, synthetic (e.g., sodium lauryl sulfate, potassium laurate, etc.), natural (e.g., gelatin, lecithin, etc.), and finely divided solid emulsifiers (e.g., bentonite, magnesium hydroxide, etc.), and others known to those of ordinary skill in the art), suspending agents (including, by way of example and without limitation, cellulose derivatives (e.g., carboxymethylcellulose, methylcellulose, ethyl cellulose, etc.), natural polymers (e.g., alginates, xanthan gum, guar gum, etc.), synthetic polymers (e.g., carbomers, polyvinyl pyrrolidone, etc.), clays (e.g., magnesium aluminum silicate, hectorite, etc.), and others known to those of ordinary skill in the art), preservatives (including, by way of example and without limitation, benzalkonium chloride, benzethonium chloride, benzyl alcohol, cetrimide, glycerin, propylene glycol, benzoic acid and sodium benzoate, potassium sorbate and sorbic acid, and others known to those of ordinary skill in the art), opaquing agents (including, by way of example and without limitation, titanium dioxide, and others known to those of ordinary skill in the art), glidants (including, by way of example and without limitation, silicon dioxide, colloidal or fumed silica, magnesium stearate, calcium stearate, stearic acid, cornstarch, talc and others known to those of ordinary skill in the art), diluents (including, by way of example and without limitation, corn syrup, lactose, sodium chloride, sucrose (sugar), and others known to those of ordinary skill in the art), colorants or coloring agents (including, by way of example and without limitation, FD&C Red No. 3, FD&C Red No. 20, FD&C Yellow No. 6, FD&C Blue No. 2, D&C Green No. 5, FD&C Orange No. 5, FD&C Red No. 8, caramel, ferric oxide, pigments, dyes, tints, titanium dioxide, natural coloring agents, such as grape skin extract, red beet powder, beta carotene, annatto, carmine, turmeric, paprika, black carrot juice, and others known to those of ordinary skill in the art), sweeteners or sweetening agents (including, by way of example and without limitation, sucrose, fructose, high fructose corn syrup, dextrose, saccharin sodium, maltodextrin, aspartame, potassium acesulfame, neohesperidin dihydrochalcone, sucralose, monoammonium glycyrrhizinate, and others known to those of ordinary skill in the art), perfuming agents (including, by way of example and without limitation, natural flavor oil, a synthetic flavor oil, and others known to those of ordinary skill in the art), glazing agents (including, by way of example and without limitation, vegetable oil, beeswax, carnauba wax, and others known to those of ordinary skill in the art), flavoring agents or flavorants (including, by way of example and without limitation, natural flavor oil, synthetic flavor oil, and other masking flavors known to those of ordinary skill in the art), and cooling agents (including, by way of example, N-substituted p-menthane-3-carboxamides, such as N-ethyl p-menthane-3-carboxamide (“WS-3”) (Millennium Specialty Chemicals, Jacksonville, Fla.). Additional examples of other inactive ingredients are well known in the art. See, e.g., R
(98) Other objectives, features and advantages of the present invention will become apparent from the following specific examples. The specific examples, while indicating specific embodiments of the invention, are provided by way of illustration only. Accordingly, the present invention also includes those various changes and modifications within the spirit and scope of the invention that may become apparent to those skilled in the art from this detailed description. The invention will be further illustrated by the following non-limiting examples.
EXAMPLES
Example 1
(R)-Silodosin Extended Release Formulation
(99) This example relates to extended release formulations of (R)-Silodosin.
(100) Controlled release granules of (R)-Silodosin are prepared in accordance with the present invention as follows. (R)-Silodosin is suspended in an aqueous solution of hydroxypropylmethyl cellulose (Opadry©) and potassium phosphate monobasic (KH.sub.2PO.sub.4). The composition of the (R)-Silodosin suspension is detailed in table 1.
(101) TABLE-US-00001 TABLE 1 (R)-Silodosin suspension composition % w/w Silodosin 9.60 HPMC (Opadry ©) 10.00 KH.sub.2PO.sub.4 0.68 Purified water 79.72
(102) Then, the suspension, under continuous stirring, is sprayed onto inert cores of cellulose spheres and the obtained granules are dried. The composition of the obtained granules is presented in table 2.
(103) TABLE-US-00002 TABLE 2 (R)-Silodosin granules composition % w/w Silodosin 4.36 HPMC (Opadry ©) 4.54 KH.sub.2PO.sub.4 0.31 Cellulose microspheres 90.79
(104) An aqueous coating solution containing ethylcellulose (ECD Aquacoat®, 26.67% w/w) and dibutylsebaccate (DBS, 2.0% w/w) is then sprayed onto the (R)-Silodosin granules and dried. The composition of the protected granules is presented in table 3.
(105) TABLE-US-00003 TABLE 3 (R)-Silodosin protected granules composition % w/w Silodosin 4.15 HPMC (Opadry ©) 4.32 KH.sub.2PO.sub.4 0.30 Cellulose microspheres 86.47 Aquacoat ECD/DBS 4.76
(106) The coated granules are further coated by spraying with an aqueous extended release coating solution of ethylcellulose (ECD Aquacoat®, 25.25% w/w), dibutylsebaccate (DBS, 1.89% w/w) and guar gum (0.53% w/w). The extended release granules are dried and their final composition is presented in table 4, hereafter named formulation A.
(107) TABLE-US-00004 TABLE 4 (R)-Silodosin formulation A extended release granules composition % w/w Silodosin 3.32 HPMC (Opadry ©) 3.46 KH.sub.2PO.sub.4 0.23 Cellulose microspheres 69.18 Aquacoat ECD/DBS 3.81 Aquacoat ECD/guar gum/DBS 20
(108) The average particle size was less than 2 mm and the average density thereof was greater than 1
(109) Hard capsules were filled with the adequate quantity of formulation A to a final content of 8 and 12 mg per capsule.
Example 2
(R)-Silodosin Extended Release Dissolution Rate
(110) The dissolution test for comparison of the dissolution rate of (R)-Silodosin from the reference immediate release (Urorec®) formulation and from the experimental extended release formulation A according to example 1 was carried out at 50 rpm in 900 mL of 0.1N HCl solution in a USP type 2 apparatus at 25° C. The results of this comparative dissolution rate are presented in
(111) The dissolution rate of the extended release formulation is slowed down compared to that of the reference immediate release formulation.
Example 3
Single Administration Contraceptive Effect
(112) A study is undertaken to evaluate the effectiveness of the compositions of the present invention in the treatment of male subjects. The objective of the study is to determine whether oral intake of (R)-Silodosin formulation results in a contraceptive effect.
(113) A total of 7 subjects, aged 18 to 40 years were enrolled in an open-label study. An initial analysis of each subject's semen, collected via masturbation after 3 days of abstinence, is performed by microscopic examination of the fresh semen. Each subject receives one single dose of 12 mg immediate release (R)-Silodosin.
(114) A semen analysis of each subject is conducted 24 hours after the dosing. The analysis shows the results in Table 5 below.
(115) TABLE-US-00005 TABLE 5 efficacy of a single dose of 12 mg of (R)-silodosin given in an immediate release (IR) formulation. 24 h Effect (N = 7) Aspermia 6/7 Azoospermia 1/7 Total 7/7
(116) As shown in Table 5, administration of the immediate release (R)-Silodosin formulation led to aspermia or azoospermia in 100% of the male subjects.
(117) The study also showed that administration of the composition did not impair the erectile function nor the quality of orgasm in any of the male subjects.
Example 4
Clinical Studies (Extended Release Formulation)
(118) A study is undertaken to evaluate the effectiveness of the compositions of the present invention in the treatment of male subjects. The objective of the study is to demonstrate that oral intake of an extended release (R)-Silodosin formulation results in aspermia or azoospermia up to 30 hours after administration.
(119) An open-labeled study is conducted in 6 subjects aged 18-45 years. An initial analysis of each subject's semen collected via masturbation after 3 days of abstinence by microscopic examination of the fresh semen. A single dose of 12 mg extended release (R)-Silodosin is administered.
(120) A semen analysis of each subject is conducted utilizing the methods described above at thirty hours after the administration.
(121) Administration of the extended release (R)-Silodosin formulation lead to aspermia or azoospermia in 100% of the male subjects up to thirty hours after administration
(122) The study also showed that administration of the composition did not impair the erectile function nor the quality of orgasm in any of the male subjects.
Example 5
Clinical Studies (Extended Release Formulation)
(123) A study is undertaken to evaluate the effectiveness of the compositions of the present invention in the treatment of male subjects. The objective of the study is to determine whether oral intake of an extended release (R)-Silodosin formulation results in aspermia or azoospermia.
(124) A double-blind, placebo controlled study is conducted over a two week period. A total of 20 subjects, aged 20-45 years, are chosen for the study. An initial analysis of each subject's semen collected via masturbation after 3 days of abstinence using by microscopic examination of the fresh semen. A single dose of 12 mg extended release (R)-Silodosin is administered daily to each subject for five days.
(125) A semen analysis of each subject is conducted utilizing the methods described above at twelve, twenty-four, thirty-six, and forty-eight hours after the administration of the final dose.
(126) Administration of the extended release (R)-Silodosin formulation lead to aspermia or azoospermia in 100% of the male subjects for twenty-four hours after the fifth and final dose. Further, 100% of the male subjects experienced aspermia or azoospermia for at least forty-eight hours after the fifth and final dose, showing that a missed dose on the sixth day did not impact the efficacy achieved by administration of the composition.
(127) The study also showed that administration of the composition did not impair the erectile function nor the quality of orgasm in any of the male subjects.
Example 6
Clinical Studies (Extended Release Formulation and the Food Effect)
(128) A study is undertaken to evaluate the effectiveness of the compositions of the present invention in the treatment of male subjects when administered in the presence of food. The objective of the study is to determine whether oral intake of an extended release (R)-Silodosin formulation, when administered with food, results in a reduced effect on aspermia or azoospermia.
(129) A double-blind, placebo controlled study is conducted over a two week period. A total of 12 subjects, aged 20-45 years, are chosen for the study. An initial analysis of each subject's semen collected via masturbation after 3 days of abstinence by microscopic examination of the fresh semen. Each subject receives two successive single doses of 12 mg extended release (R)-Silodosin, one in fed condition, the other in fasted condition.
(130) A semen analysis of each subject is conducted utilizing the methods described above at thirty or forty-eight hours after the administration of each dose.
(131) Administration of the extended release (R)-Silodosin formulation led to aspermia or azoospermia in 100% of the twelve male subjects in both fed and fasted conditions.
(132) Without further elaboration, it is believed that one skilled in the art, using the preceding description, can utilize the present invention to the fullest extent. The following examples are illustrative only, and not limiting of the remainder of the disclosure in any way whatsoever.
(133) While specific embodiments of the present invention have been described, other and further modifications and changes may be made without departing from the spirit of the invention. All further and other modifications and changes are included that come within the scope of the invention as set forth in the claims. The disclosure of each publication cited above is expressly incorporated by reference in its entirety to the same extent as if each were incorporated by reference individually.
Example 7
(R)-Silodosin Pharmacokinetic Properties
(134) The pharmacokinetic properties of (R)-Silodosin (SIL) is modeled based on plasma concentration-versus-time profiles obtained after a single administration of 8 mg of (R)-Silodosin to healthy volunteers. (R)-Silodosin data are described by a bi-compartment model with a first-order input rate constant. The pharmacokinetic properties of (R)-Silodosin were measured on the basis of observed plasma concentrations. The observed plasma concentrations validate the plasma concentration simulation methods for (R)-Silodosin.
(135) Since the pharmacokinetic properties of (R)-Silodosin are linear over the dose-range 1-24 mg and are time-independent, the models are suitable for predicting the pharmacokinetic profiles of the compounds given at different doses under multiple dosing regimens.
(136) A contraception is maintained up to 24 h after the administration of a 12-mg single dose of (R)-Silodosin. The C24 is the (R)-Silodosin plasma concentration 24 hours post-dose. Thus, a dosing regimen maintaining (R)-Silodosin plasma concentrations significantly above C24 results in a continuous contraception.
(137) Maintaining the (R)-Silodosin concentration at a level at least equal to C24 should be sufficient; however, due to the variability of the pharmacokinetic properties of (R)-Silodosin and the individual metabolism variability, it is important to provide a significant security margin (ie., minimum (R)-Silodosin concentration significantly higher than C24).
Example 8
Effective Exposure after Repeated Administrations of (R)-Silodosin
(138) The model is used to simulate the pharmacokinetic properties of (R)-Silodosin after at least two to at least five daily administrations of 8 mg of (R)-Silodosin. After the administration of the (R)-Silodosin formulation A, the (R)-Silodosin plasma concentrations are constantly above C24, as presented in
(139) The effective exposure of (R)-Silodosin concentration is significantly superior to the C24 concentration as for the second administration, showing that the contraceptive efficiency is maintained.
(140) Furthermore, the maximal plasma concentration (C.sub.max) is inferior to the C.sub.max measured past the administration of immediate release 8 mg (R)-Silodosin formulations where the risk of orthostatic hypotension is considered acceptable by health authorities.
(141) Thus, the administration of (R)-Silodosin formulation A reduces the risk of unacceptable orthostatic hypotension.
Example 9
Delayed or Omitted Intake does not Affect Contraceptive Effect
(142) The administration of 8 and 12 mg (R)-Silodosin extended release formulations according to formulation A allows maintaining the contraception all along the once daily treatment, including in case of delayed intake and in case of a single omission.
(143) A 6-hour delay in the 6th intake (intake at 126 hours instead of 120 hours) does not allow the (R)-Silodosin concentration to drop below the C24 concentration, as illustrated in
(144) Furthermore, the (R)-Silodosin plasma concentration is maintained above C24 even if the 6th day administration is omitted, as illustrated in
(145) Thus, as confirmed by the results presented in