Indian Patents. 214103:PHARMACEUTICAL COMPOSITION FOR THE TREATMENT OF DISEASES CAUSED BY THROMBUS OR EMBOLUS.

Title of Invention	PHARMACEUTICAL COMPOSITION FOR THE TREATMENT OF DISEASES CAUSED BY THROMBUS OR EMBOLUS.
Abstract	Medicinal compositions containing as the active ingredients 2-acetoxy-5- .-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or its pharmacologically acceptable salt and aspirin. Because of having excellent inhibitory effects on platelet aggregation and thrombosis, these compositions are useful as preventives or remedies for diseases induced by thrombus or embolization.

Full Text	SPECIFICATION PHARMACEUTICAL COMPOSITION COMPRISING ASPIRIN [TECHNICAL FIELD] This invention relates to pharmaceutical compositions containing 2- acetoxy- 5- (a-cyclopropylcarbonyl-2 fluorobenzyl) - 4,5,6,7-tetrahydrothieno[3,2 - clpyridine or a pharmaceutically acceptable salt thereof, and aspirin, as active ingredients [particularly pharmaceutical compositions for prevention or treatment (particularly for treatment) of diseases caused by thrombus or embolus]; to the use of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)- 4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof and aspirin for the manufacture of pharmaceutical compositions for prevention or treatment (particularly for treatment) of diseases caused by thrombus or embolus; and to methods for the prevention or treatment (particularly to methods for the treatment) of diseases caused by thrombus or embolus by administration of an effective amount of 2-acetoxy-5-(a- cyclopropylcarbonyl-2-fluoroben2yl)-4,5,6,7-tetxahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof and aspirin to warm-blooded animals (particularly humans). [BACKGROUND ART] 2-Acetoxy-5- (a-cyclopropylcarbonyl-2 -fluorobenzyl) -4,5,6,7- tetrahydrothieno[3,2-c]pyridine has been described in the Japanese Patent Application Publication No. Hei 6-41139, and possesses potent inhibitory activity against platelet aggregation. Furthermore, aspirin is well known to have an inhibiting activity against platelet aggregation, although the activity is low. However, pharmaceutical compositions containing both compounds have not been known. [DISCLOSURE OF THE INVENTION] The present inventors have studied therapeutic agents with low toxicity that exert inhibitory activity against platelet aggregation and have found that the problems described above are solved by using pharmaceutical compositions comprising 2- acetoxy- 5- (a- cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7- tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof and aspirin. The present invention provides pharmaceutical compositions containing 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2- c]pyridine or a pharmaceutically acceptable salt thereof and aspirin as active ingredients [particularly pharmaceutical compositions for prevention or treatment (particularly for treatment) of diseases caused by thrombus or embolus]; the use of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7- tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, and aspirin, for the manufacture of pharmaceutical compositions [particularly pharmaceutical compositions for prevention or treatment (particularly for treatment) of diseases caused by thrombus or embolus]; and methods for the prevention or treatment (particularly methods for treatment) of diseases caused by thrombus or embolus by administration of an effective amount of 2-acetoxy- 5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, and aspirin, to warm-blooded animals (particularly humans), simultaneously or sequentially. 2-Acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7- tetrahydrothieno[3,2-c]pyridine, and pharmaceutically acceptable salts thereof, which is one of the active ingredients of the present invention, is a known compound. For instance, the compound has already been described in Japanese Patent Application Publication No. Hei 6-41139 and Japanese Patent Application Publication No. 2002-145883 (priority: Japanese Patent Application No. 2000-205396 and Japanese Patent Application No. 2000-266780). The chemical structure is described below. The pharmaceutically acceptable salts of 2-acetoxy-5-(a- cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine may be, for example, hydrohalogenic acid salts such as hydrofluoride, hydrochloride, hydrobromide or hydroiodide; nitrate; perchlorate; sulfate; phosphate; C1-C4 alkanesulfonates optionally substituted by halogens such as methanesulfonate, trifluoromethanesulfonate, ethanesulfonate; C6-C10 arylsulfonates optionally substituted by C1-C4 alkyl groups such as benzenesulfonate or p- toluenesulfonate; C1-C6 aliphatic acid salts such as acetate, malate, fumarate, succinate, citrate, tartarate, oxalate or maleate; amino acid salts such as glycine salt, lysine salt, arginine salt, ornitine salt, glutamic acid salt or aspartic acid salt; and the preferred compounds are hydrohalogenates or C1-C6 aliphatic acid salts; and more preferred compounds are the hydrochloride or the maleate. When one of the active ingredients of the present invention, 2-acetoxy-5- (a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, is allowed to stand so that it is open to the atmosphere, it may become hydrated by absorption of water or adsorption of water. Such hydrated compounds are included in the present invention. Further, one of the active ingredients of the present invention, 2-acetoxy- 5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, may absorb some kinds of organic solvents and may form solvates in some cases, and these solvates are also included in the present invention. Furthermore, since 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)- 4,5,6,7-tetrahydrothieno[3,2-c]pyridine has an asymmetric carbon atom, optical isomers exist based on the asymmetric carbon atom. These optical isomers are also included in the present invention. The other active ingredient, aspirin, is a well-known compound, as an analgesic antipyretic. [INDUSTRIAL APPLICABILITY] The pharmaceutical compositions of the present invention (particularly pharmaceutical compositions for the prevention or treatment of diseases caused by thrombus or embolus) which contain 2-acetoxy-5-(a-cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, and aspirin, as active ingredients, possess excellent inhibitory activity against platelet aggregation and thrombogenesis with short onset latency and low toxicity. Thus the pharmaceutical compositions of the present invention are useful as preventative or therapeutic agents (particularly as therapeutic agents) against diseases caused by thrombus or embolus, for example, diseases induced by platelet aggregation, including stable or unstable angina pectoris and so forth; cardiovascular or cerebrovascular disorders, e.g., thromboembolism, associated with atherosclerosis or diabetes mellitus, such as unstable angina pectoris, cerebral ischemic insult or restenosis due to angioplasty, endarterectomy or stent therapy; or thromboembolism caused by thromboembolization such as recurrent embolism after degradation of the original thrombus, embolism, ischemia-induced dementia, peripheral arteriopathy, thromboembolization associated with hemodialysis or atrial fibrillation, or thromboembolization in the vascular prosthesis, or in the bypass between the aorta and the coronary artery. Furthermore, the therapeutic agent of the present invention is administered to warm-blooded animals (particularly humans). According, to the present invention, the use in combination of 2-acetoxy- 5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, and aspirin, results in more potent effectiveness than the use of each component alone. Furthermore, plasma levels of these agents do not have to be maintained at a certain level and higher during the same period, in order to produce their effects. It is believed that these 2 agents reach the receptors, at which they act in vivo, and turn on switches at the receptors to induce the effects. Even though the plasma level of one component of the pharmaceutical composition is too low to induce the effects with increasing time after the agent was administered, the switches at the receptors have already been turned on. Thus the preventative or therapeutic efficacy of the agent is expected by inhibiting thrombogenesis or embolization. Therefore, when the other component of the pharmaceutical composition is administered later, the therapeutic effect of the compound administered later is expected to add to the therapeutic effects of the previously administered component. However, it is convenient clinically that both components are administered at the same time. Thus 2-acetoxy-5-(a-cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof and aspirin are simultaneously administered as a combination drug. In the case that both agents cannot be mixed technically, each component can be administered separately. Moreover, as described previously, since each component produces significant effects as a single form, each component can be sequentially administered at appropriate intervals. The maximum intervals between administration of each of the two components that can be accepted to elicit significant effects could be confirmed by clinical trials or animal studies. The route for administration of 2-acetoxy-5-(a-cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt, thereof, and aspirin, which is employed in the present invention, is generally the oral route. However, other routes, for example, intravenous administration, can be used. Thus, the 2 components can be prepared respectively as separate formulations, or can be mixed physically to form a single formulation for administration. The single formulations of the mixed components are, for example, powders, granules, tablets, capsules and so forth, and can be prepared by regular formulation techniques, as described below. These formulations are prepared by conventional methods by using excipients (organic excipients, for example, sugar derivatives such as lactose, sucrose, glucose, mannitol or sorbitol; starch derivatives such as corn starch, potato starch, a-starch or dextrin; cellulose derivatives such as crystalline cellulose; gum arabic; dextran; or pullulan; and inorganic excipients, for example, silicate derivatives such as light silicic acid anhydride, synthetic aluminum silicate, calcium silicate or magnesium aluminate metasilicate; phosphate derivatives such as calcium hydrogenphosphate; carbonates such as calcium carbonate; or sulfates such as calcium sulfate), lubricants (for example, stearic acid; metal stearate derivatives such as calcium stearate or magnesium stearate; talc; waxes such as beeswax or spermaceti; boric acid; adipic acid; sulfate derivatives such as sodium sulfate; glycol; fumaric acid; sodium benzoate; DL-leucine; lauryl sulfate derivatives such as sodium lauryl sulfate or magnesium lauryl sulfate; silicic acid derivatives such as silicic acid anhydride or silicic acid hydrate; and starch derivatives described above), binders (for example, hydroxypropyl cellulose, hydroxypropylmethylcellulose, poly(vinylpyrrolidone), polyethylene glycol and similar compounds described in the above excipients), disintegrators (for example, cellulose derivatives such as low substituted hydroxypropylcellulose, carboxymethylcellulose, calcium carboxymethylcellulose, internally cross-linked sodium carboxymethylcellulose; chemically modified starch/cellulose derivatives such as carboxymethylstarch, sodium carboxymethylstarch; cross-linked polyvinylpyrrolidone; or starch derivatives described above), emulsifiers (for example, colloidal clays such as bentonite or veegum; metal hydroxides such as magnesium hydroxide or aluminum hydroxide; anionic surfactants such as sodium lauryl sulfate or calcium stearate; cationic surfactants such as benzalkonium chloride; or nonionic surfactants such as polyoxyethylene alkyl ether, polyoxyethylenesorbitan ester of fatty acids or sucrose ester of fatty acids), stabilizers (for example, parahydroxybenzoates such as methylparaben or propylparaben; alcohols such as chlorobutanol, benzyl alcohol or phenylethyl alcohol; benzalkonium chlorides; phenol derivatives such as phenol or cresol; thimerosal; dehydroacetic acid; or sorbic acid), aorrigents (for example, sweetening, souring and flavoring agents all of which are conventionally used), and diluents. The dose and the dose ratio of 2-acetoxy-5-(a-cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or pharmaceutically acceptable salt thereof, and aspirin, can be widely altered based on several factors such as activity of each compound, and the symptoms, age and body weight of the patients. Generally, the lower limit of the oral dose (mg drug dose/time) is 0.1 mg (preferably, 1 mg) per time, while the upper limit is 1,000 mg (preferably, 500 mg) per time. The lower and upper limits of intravenous injection are 0.01 mg (preferably, 0.1 mg) and 500 mg (preferably, 250 mg), respectively. They are administered to the adult from 1 to 7 times a day based on the symptoms of the patient, simultaneously or sequentially. Generally, the dose ratio of 2-acetdxy-5-(a-cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or pharmaceutically acceptable salt thereof, and aspirin, is from 1:500 to 500:1 as their weight ratio. [Best Mode for Carrying Out the Invention] The present invention is described in detail with examples and formulations in the following. However, the claim of the present invention is not restricted to the following description. (Example 1) Inhibitory Activity against Thrombogenesis As the test animals, male Sprague Dawley rats of 7 weeks old were purchased from SLC Japan and 6 rats per group were used. 2-Acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7- tetrahydrothieno[3,2-c]pyridine was synthesized according to the method described in the Specification of Japanese Patent Application Publication No. Hei 6-41139 and was used, while aspirin was purchased from Sigma Chemical Co. and was used. Both compounds were suspended in 5% (w/v) gum arabic solution, and were diluted so as to be 1 ml/kg of administration volume and were orally administered. The inhibitory activities of the compounds against thrombogenesis or thrombus formation were evaluated in the modified arterio-venous shunt thrombosis model in rats, which was described by Umetsu et al. [Thromb. Haemost.. 39, 74-83 (1978)]. The shunt tube was prepared as follows; i.e., both sides of a medical silicon tube of 12 cm length [inner diameter: 1.5 mm, outer diameter: 2.5 mm, purchased from KANEKA Medix Co., Ltd] were connected each to a polyethylene tube of 7 cm length [inner diameter: 0.5 mm, outer diameter: 1.0 mm, purchased from Natsume Seisakusho Co., Ltd.] covered with silicon via a medical silicon tube of 0.7 cm length [inner diameter: 1.0 mm, outer diameter: 1.5 mm, KANEKA Medix Co., Ltd] as connector. A surgical suture of 10 cm length was placed in the silicon tube of 12 cm length. The animal was anesthetized with an intraperitoneal injection of 40 mg/kg of pentobarbital sodium (purchased from Abbott Laboratories Inc.), and the jugular of one side and the carotid of the other side were exposed. The arteriovenous shunt was made by cannulation of a shunt tube filled with heparin solution [30 units/kg, purchased from Fuso Pharmaceutical Co., Ltd] into the carotid and the jugular which had been previously exposed. The test compounds were orally administered and the blood was started to circulate into the shunt area two hours after the administration. Thirty minutes after the circulation was started, the shunt tube was removed, and the thrombus adsorbed on the surgical suture was weighed. The results are shown in Table 1. The results in the table are expressed as the average weight ± SE (n=6). The powders in the formula described in the above table are mixed, compressed with a tableting machine and formulated as a tablet containing 250 mg in total. The tablet can be coated with film or sugar, when necessary. WE CLAIM: 1. A pharmaceutical composition comprising 2-acetoxy-6-(a- cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceuticaily acceptable salt thereof, and aspirin, as active ingrodients. 2. A pharmaceutical composition as claimed in claim 1, in which the pharmaceuticaily acceptable salt is the hydrochloride or mateate. 3. A idt comprising 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)- 4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically a acceptable salt thereof, and aspirin, for simultaneous or sequential administration. 4. A kit as claimed in claim 3, for simultaneous administration. 5. A ldt as claimed In claim 3, for sequential administration. 6. A kit according to any of claims 3 to 5, in which the pharmaceuticaily acceptable salt is the hydrochloride or maleate. Pharmaceutical compositions comprising 2-acetoxy-5-(a- cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof, and aspirin, as active ingredients. The pharmaceutical compositions of the present invention possess excellent inhibitory activity against platelet aggregation and thrombogenesis, and are useful for preventing or treating diseases caused by thrombus or embolus.

Full Text

SPECIFICATION
PHARMACEUTICAL COMPOSITION COMPRISING ASPIRIN
[TECHNICAL FIELD]
This invention relates to pharmaceutical compositions containing 2-
acetoxy- 5- (a-cyclopropylcarbonyl-2 fluorobenzyl) - 4,5,6,7-tetrahydrothieno[3,2 -
clpyridine or a pharmaceutically acceptable salt thereof, and aspirin, as active
ingredients [particularly pharmaceutical compositions for prevention or
treatment (particularly for treatment) of diseases caused by thrombus or
embolus]; to the use of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-
4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt
thereof and aspirin for the manufacture of pharmaceutical compositions for
prevention or treatment (particularly for treatment) of diseases caused by
thrombus or embolus; and to methods for the prevention or treatment
(particularly to methods for the treatment) of diseases caused by thrombus or
embolus by administration of an effective amount of 2-acetoxy-5-(a-
cyclopropylcarbonyl-2-fluoroben2yl)-4,5,6,7-tetxahydrothieno[3,2-c]pyridine or a
pharmaceutically acceptable salt thereof and aspirin to warm-blooded animals
(particularly humans).
[BACKGROUND ART]
2-Acetoxy-5- (a-cyclopropylcarbonyl-2 -fluorobenzyl) -4,5,6,7-
tetrahydrothieno[3,2-c]pyridine has been described in the Japanese Patent
Application Publication No. Hei 6-41139, and possesses potent inhibitory
activity against platelet aggregation. Furthermore, aspirin is well known to have
an inhibiting activity against platelet aggregation, although the activity is low.
However, pharmaceutical compositions containing both compounds have not
been known.
[DISCLOSURE OF THE INVENTION]
The present inventors have studied therapeutic agents with low toxicity
that exert inhibitory activity against platelet aggregation and have found that the
problems described above are solved by using pharmaceutical compositions
comprising 2- acetoxy- 5- (a- cyclopropylcarbonyl-2- fluorobenzyl)-4,5,6,7-
tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof
and aspirin.
The present invention provides pharmaceutical compositions containing
2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-
c]pyridine or a pharmaceutically acceptable salt thereof and aspirin as active
ingredients [particularly pharmaceutical compositions for prevention or
treatment (particularly for treatment) of diseases caused by thrombus or
embolus]; the use of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-
tetrahydrothieno[3,2-c]pyridine or a pharmaceutically acceptable salt thereof,
and aspirin, for the manufacture of pharmaceutical compositions [particularly
pharmaceutical compositions for prevention or treatment (particularly for
treatment) of diseases caused by thrombus or embolus]; and methods for the
prevention or treatment (particularly methods for treatment) of diseases caused
by thrombus or embolus by administration of an effective amount of 2-acetoxy-
5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
or a pharmaceutically acceptable salt thereof, and aspirin, to warm-blooded
animals (particularly humans), simultaneously or sequentially.
2-Acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-
tetrahydrothieno[3,2-c]pyridine, and pharmaceutically acceptable salts thereof,
which is one of the active ingredients of the present invention, is a known
compound. For instance, the compound has already been described in
Japanese Patent Application Publication No. Hei 6-41139 and Japanese Patent
Application Publication No. 2002-145883 (priority: Japanese Patent Application
No. 2000-205396 and Japanese Patent Application No. 2000-266780). The
chemical structure is described below.
The pharmaceutically acceptable salts of 2-acetoxy-5-(a-
cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine may
be, for example, hydrohalogenic acid salts such as hydrofluoride, hydrochloride,
hydrobromide or hydroiodide; nitrate; perchlorate; sulfate; phosphate; C1-C4
alkanesulfonates optionally substituted by halogens such as methanesulfonate,
trifluoromethanesulfonate, ethanesulfonate; C6-C10 arylsulfonates optionally
substituted by C1-C4 alkyl groups such as benzenesulfonate or p-
toluenesulfonate; C1-C6 aliphatic acid salts such as acetate, malate, fumarate,
succinate, citrate, tartarate, oxalate or maleate; amino acid salts such as glycine
salt, lysine salt, arginine salt, ornitine salt, glutamic acid salt or aspartic acid
salt; and the preferred compounds are hydrohalogenates or C1-C6 aliphatic acid
salts; and more preferred compounds are the hydrochloride or the maleate.
When one of the active ingredients of the present invention, 2-acetoxy-5-
(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or
a pharmaceutically acceptable salt thereof, is allowed to stand so that it is open
to the atmosphere, it may become hydrated by absorption of water or adsorption
of water. Such hydrated compounds are included in the present invention.
Further, one of the active ingredients of the present invention, 2-acetoxy-
5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
or a pharmaceutically acceptable salt thereof, may absorb some kinds of organic
solvents and may form solvates in some cases, and these solvates are also
included in the present invention.
Furthermore, since 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-
4,5,6,7-tetrahydrothieno[3,2-c]pyridine has an asymmetric carbon atom, optical
isomers exist based on the asymmetric carbon atom. These optical isomers are
also included in the present invention.
The other active ingredient, aspirin, is a well-known compound, as an
analgesic antipyretic.
[INDUSTRIAL APPLICABILITY]
The pharmaceutical compositions of the present invention (particularly
pharmaceutical compositions for the prevention or treatment of diseases caused
by thrombus or embolus) which contain 2-acetoxy-5-(a-cyclopropylcarbonyl-2-
fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically
acceptable salt thereof, and aspirin, as active ingredients, possess excellent
inhibitory activity against platelet aggregation and thrombogenesis with short
onset latency and low toxicity. Thus the pharmaceutical compositions of the
present invention are useful as preventative or therapeutic agents (particularly
as therapeutic agents) against diseases caused by thrombus or embolus, for
example, diseases induced by platelet aggregation, including stable or unstable
angina pectoris and so forth; cardiovascular or cerebrovascular disorders, e.g.,
thromboembolism, associated with atherosclerosis or diabetes mellitus, such as
unstable angina pectoris, cerebral ischemic insult or restenosis due to
angioplasty, endarterectomy or stent therapy; or thromboembolism caused by
thromboembolization such as recurrent embolism after degradation of the
original thrombus, embolism, ischemia-induced dementia, peripheral
arteriopathy, thromboembolization associated with hemodialysis or atrial
fibrillation, or thromboembolization in the vascular prosthesis, or in the bypass
between the aorta and the coronary artery. Furthermore, the therapeutic agent
of the present invention is administered to warm-blooded animals (particularly
humans).
According, to the present invention, the use in combination of 2-acetoxy-
5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
or a pharmaceutically acceptable salt thereof, and aspirin, results in more
potent effectiveness than the use of each component alone. Furthermore,
plasma levels of these agents do not have to be maintained at a certain level and
higher during the same period, in order to produce their effects. It is believed
that these 2 agents reach the receptors, at which they act in vivo, and turn on
switches at the receptors to induce the effects. Even though the plasma level of
one component of the pharmaceutical composition is too low to induce the
effects with increasing time after the agent was administered, the switches at
the receptors have already been turned on. Thus the preventative or therapeutic
efficacy of the agent is expected by inhibiting thrombogenesis or embolization.
Therefore, when the other component of the pharmaceutical composition
is administered later, the therapeutic effect of the compound administered later
is expected to add to the therapeutic effects of the previously administered
component. However, it is convenient clinically that both components are
administered at the same time. Thus 2-acetoxy-5-(a-cyclopropylcarbonyl-2-
fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically
acceptable salt thereof and aspirin are simultaneously administered as a
combination drug. In the case that both agents cannot be mixed technically,
each component can be administered separately. Moreover, as described
previously, since each component produces significant effects as a single form,
each component can be sequentially administered at appropriate intervals. The
maximum intervals between administration of each of the two components that
can be accepted to elicit significant effects could be confirmed by clinical trials
or animal studies.
The route for administration of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-
fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically
acceptable salt, thereof, and aspirin, which is employed in the present invention,
is generally the oral route. However, other routes, for example, intravenous
administration, can be used. Thus, the 2 components can be prepared
respectively as separate formulations, or can be mixed physically to form a
single formulation for administration. The single formulations of the mixed
components are, for example, powders, granules, tablets, capsules and so forth,
and can be prepared by regular formulation techniques, as described below.
These formulations are prepared by conventional methods by using
excipients (organic excipients, for example, sugar derivatives such as lactose,
sucrose, glucose, mannitol or sorbitol; starch derivatives such as corn starch,
potato starch, a-starch or dextrin; cellulose derivatives such as crystalline
cellulose; gum arabic; dextran; or pullulan; and inorganic excipients, for
example, silicate derivatives such as light silicic acid anhydride, synthetic
aluminum silicate, calcium silicate or magnesium aluminate metasilicate;
phosphate derivatives such as calcium hydrogenphosphate; carbonates such as
calcium carbonate; or sulfates such as calcium sulfate), lubricants (for example,
stearic acid; metal stearate derivatives such as calcium stearate or magnesium
stearate; talc; waxes such as beeswax or spermaceti; boric acid; adipic acid;
sulfate derivatives such as sodium sulfate; glycol; fumaric acid; sodium
benzoate; DL-leucine; lauryl sulfate derivatives such as sodium lauryl sulfate or
magnesium lauryl sulfate; silicic acid derivatives such as silicic acid anhydride
or silicic acid hydrate; and starch derivatives described above), binders (for
example, hydroxypropyl cellulose, hydroxypropylmethylcellulose,
poly(vinylpyrrolidone), polyethylene glycol and similar compounds described in
the above excipients), disintegrators (for example, cellulose derivatives such as
low substituted hydroxypropylcellulose, carboxymethylcellulose, calcium
carboxymethylcellulose, internally cross-linked sodium carboxymethylcellulose;
chemically modified starch/cellulose derivatives such as carboxymethylstarch,
sodium carboxymethylstarch; cross-linked polyvinylpyrrolidone; or starch
derivatives described above), emulsifiers (for example, colloidal clays such as
bentonite or veegum; metal hydroxides such as magnesium hydroxide or
aluminum hydroxide; anionic surfactants such as sodium lauryl sulfate or
calcium stearate; cationic surfactants such as benzalkonium chloride; or
nonionic surfactants such as polyoxyethylene alkyl ether,
polyoxyethylenesorbitan ester of fatty acids or sucrose ester of fatty acids),
stabilizers (for example, parahydroxybenzoates such as methylparaben or
propylparaben; alcohols such as chlorobutanol, benzyl alcohol or phenylethyl
alcohol; benzalkonium chlorides; phenol derivatives such as phenol or cresol;
thimerosal; dehydroacetic acid; or sorbic acid), aorrigents (for example,
sweetening, souring and flavoring agents all of which are conventionally used),
and diluents.
The dose and the dose ratio of 2-acetoxy-5-(a-cyclopropylcarbonyl-2-
fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or pharmaceutically
acceptable salt thereof, and aspirin, can be widely altered based on several
factors such as activity of each compound, and the symptoms, age and body
weight of the patients.
Generally, the lower limit of the oral dose (mg drug dose/time) is 0.1 mg
(preferably, 1 mg) per time, while the upper limit is 1,000 mg (preferably, 500
mg) per time. The lower and upper limits of intravenous injection are 0.01 mg
(preferably, 0.1 mg) and 500 mg (preferably, 250 mg), respectively. They are
administered to the adult from 1 to 7 times a day based on the symptoms of the
patient, simultaneously or sequentially.
Generally, the dose ratio of 2-acetdxy-5-(a-cyclopropylcarbonyl-2-
fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or pharmaceutically
acceptable salt thereof, and aspirin, is from 1:500 to 500:1 as their weight ratio.
[Best Mode for Carrying Out the Invention]
The present invention is described in detail with examples and
formulations in the following. However, the claim of the present invention is not
restricted to the following description.
(Example 1)
Inhibitory Activity against Thrombogenesis
As the test animals, male Sprague Dawley rats of 7 weeks old were
purchased from SLC Japan and 6 rats per group were used.
2-Acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-
tetrahydrothieno[3,2-c]pyridine was synthesized according to the method
described in the Specification of Japanese Patent Application Publication No. Hei
6-41139 and was used, while aspirin was purchased from Sigma Chemical Co.
and was used. Both compounds were suspended in 5% (w/v) gum arabic
solution, and were diluted so as to be 1 ml/kg of administration volume and
were orally administered.
The inhibitory activities of the compounds against thrombogenesis or
thrombus formation were evaluated in the modified arterio-venous shunt
thrombosis model in rats, which was described by Umetsu et al. [Thromb.
Haemost.. 39, 74-83 (1978)].
The shunt tube was prepared as follows; i.e., both sides of a medical
silicon tube of 12 cm length [inner diameter: 1.5 mm, outer diameter: 2.5 mm,
purchased from KANEKA Medix Co., Ltd] were connected each to a polyethylene
tube of 7 cm length [inner diameter: 0.5 mm, outer diameter: 1.0 mm,
purchased from Natsume Seisakusho Co., Ltd.] covered with silicon via a
medical silicon tube of 0.7 cm length [inner diameter: 1.0 mm, outer diameter:
1.5 mm, KANEKA Medix Co., Ltd] as connector. A surgical suture of 10 cm
length was placed in the silicon tube of 12 cm length.
The animal was anesthetized with an intraperitoneal injection of 40
mg/kg of pentobarbital sodium (purchased from Abbott Laboratories Inc.), and
the jugular of one side and the carotid of the other side were exposed. The
arteriovenous shunt was made by cannulation of a shunt tube filled with
heparin solution [30 units/kg, purchased from Fuso Pharmaceutical Co., Ltd]
into the carotid and the jugular which had been previously exposed.
The test compounds were orally administered and the blood was started
to circulate into the shunt area two hours after the administration. Thirty
minutes after the circulation was started, the shunt tube was removed, and the
thrombus adsorbed on the surgical suture was weighed. The results are shown
in Table 1. The results in the table are expressed as the average weight ± SE
(n=6).
The powders in the formula described in the above table are mixed,
compressed with a tableting machine and formulated as a tablet containing 250
mg in total. The tablet can be coated with film or sugar, when necessary.
WE CLAIM:
1. A pharmaceutical composition comprising 2-acetoxy-6-(a-
cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
or a pharmaceuticaily acceptable salt thereof, and aspirin, as active
ingrodients.
2. A pharmaceutical composition as claimed in claim 1, in which the
pharmaceuticaily acceptable salt is the hydrochloride or mateate.
3. A idt comprising 2-acetoxy-5-(a-cyclopropylcarbonyl-2-fluorobenzyl)-
4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a pharmaceutically a acceptable
salt thereof, and aspirin, for simultaneous or sequential administration.
4. A kit as claimed in claim 3, for simultaneous administration.
5. A ldt as claimed In claim 3, for sequential administration.
6. A kit according to any of claims 3 to 5, in which the pharmaceuticaily
acceptable salt is the hydrochloride or maleate.
Pharmaceutical compositions comprising 2-acetoxy-5-(a-
cyclopropylcarbonyl-2-fluorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine or a
pharmaceutically acceptable salt thereof, and aspirin, as active ingredients.
The pharmaceutical compositions of the present invention possess
excellent inhibitory activity against platelet aggregation and thrombogenesis,
and are useful for preventing or treating diseases caused by thrombus or
embolus.

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Patent Number

214103

Indian Patent Application Number

777/KOLNP/2003

PG Journal Number

05/2008

Publication Date

01-Feb-2008

Grant Date

30-Jan-2008

Date of Filing

13-Jun-2003

Name of Patentee

SANKYO COMPANY LIMITED

Applicant Address

5-1, NIHONBASHI HONCHO 3-CHOME, CHUO-KU, TOKYO 103-8426

Inventors:

#	Inventor's Name	Inventor's Address
1	ASAI FUMITOSHI	C/O. SANKYO CO. LTD., 2-58 HIROMACHI 1-CHOME, SHINAGAWA-KU, TOKYO 140-8710,
2	SUGIDACHI, ATSUHIRO	C/O. SANKYO CO. LTD., 2-58, HIROMACHI 1-CHOME, SHINAGAWA-KU, TOKYO 140-8710
3	OGAWA, TAKETOSHI	C/O. SANKYO CO. LTD., 2-58, HIROMACHI 1-CHOME, SHINAGAWA-KU, TOKYO 140-8710
4	INOUE TERUHIKO	C/O. UBE RESEARCH LABORATORY, 1978-5, O-AZA KOGUSHI, YAMAGUCHI 755-0067

PCT International Classification Number

A61K 31/4365

PCT International Application Number

PCT/JP01/11201

PCT International Filing date

2001-12-20

PCT Conventions:

#	PCT Application Number	Date of Convention	Priority Country
1	2000-392983	2000-12-25	Japan