Title of Invention	SOLID PHARMACEUTICAL COMPOSITIONS COMRISING A SIP RECEPTOR AGONIST AND A SUGAR ALCOHOL
Abstract	A solid pharmaceutical composition suitable for oral administration, comprising: (a) a S1P receptor agonist; and (b) a sugar alcohol.

Full Text

SOLID PHARMACEUTICAL COMPOSITIONS COMPRISING A SIP RECEPTOR AGONIST AND A SUGAR ALCOHOL Oreionio oompewae The present invention relates to pharmaceutical compositions comprising a sphingosine-1 phosphate receptor agonist. Sphingosine-1 phosphate (hereinafter MS1P") is a natural serum lipid. Presently there are 8 known S1P receptors, namely S1P1 to S1P8. S1P receptor agonists have accelerating lymphocyte homing properties. S1P receptor agonists are immunomodulating compounds which elicit a lymphopenia resulting from a re-distribution, preferably reversible, of lymphocytes from circulation to secondary lymphatic tissue, evoking a generalized immunosuppression. Naive cells are sequestered, CD4 and CD8 T-cells and B-cells from the blood are stimulated to migrate into lymph nodes (LN) and Peyer's patches (PP), and thus infiltration of cells into transplanted organs is inhibited. The various known S1P receptor agonists show structural similarities, which result in related problems in providing a suitable formulation. In particular, there is a need for an S1P receptor agonist containing formulation which is well-adapted for oral administration in a solid form, e.g. as a tablet or capsule. Accordingly, the present invention provides a solid pharmaceutical composition suitable for oral administration, comprising a S1P receptor agonist and a sugar alcohol. It has surprisingly been found that solid compositions comprising a sugar alcohol provide formulations which are particularly well suited to the oral administration of S1P receptor agonists. The compositions provide a convenient means of systemic administration of S1P receptor agonists, do not suffer from the disadvantages of liquid formulations for injection or oral use, and have good physicochemical and storage properties. In particular, the compositions of the present invention may show a high level of uniformity in the distribution of the S1P receptor agonist throughout the composition, as well as high stability. The compositions of the invention may be manufactured on high speed automated equipment, and thus do not require hand encapsulation. S1P receptor agonists are typically sphingosine analogues, such as 2-substituted 2-amino-propane-1,3-diol or 2-amino-propanol derivatives. Examples of appropriate S1P receptor agonists are, for example: wherein R, is a straight- or branched (C12.22)carbon chain - which may have in the chain a bond or a hetero atom selected from a double bond, a triple bond, 0, S, NRe, wherein R6 is H, alkyl, aralkyl, acyl or alkoxycarbonyl, and carbonyl, and/or - which may have as a substituent alkoxy, alkenyloxy, alkynyloxy, aralkyloxy, acyl, alkylamino, alkylthio, acylamino, alkoxycarbonyl, alkoxycarbonylamino, acyloxy, alkyicarbamoyl, nitro, halogen, amino, hydroxyimino, hydroxy or carboxy; or Ri is - a phenylalkyl wherein alkyl is a straight- or branched (C6-2o)carbon chain; or - a phenylalkyl wherein alkyl is a straight- or branched (Cv3o)carbon chain wherein said phenylalkyl is substituted by - a straight- or branched (Ce-2o)carbon chain optionally substituted by halogen, - a straight- or branched (Ce-2o)alkoxy chain optionally substitued by halogen, - a straight- or branched (C6.2o)alkenyloxy, - phenylalkoxy, halophenylalkoxy, phenylalkoxyalkyl, phenoxyalkoxy or phenoxyalkyl, - cycloalkylalkyl substituted by C^oalkyl, - heteroarylalkyl substituted by C6-2oaIkyl, - heterocyclic C6-2oalkyI or - heterocyclic alkyl substituted by C2-2oalkyl, and wherein the alkyl moiety may have salts with dibasic amino acids, such as lysine. The compounds and salts of the present invention encompass hydrate and solvate forms. Binding to S1P receptors can be determined according to the following assays. A. Binding affinity of S1P receptor agonists to individual human S1P receptors Transient transfection of human S1P receptors into HEK293 cells S1P receptors and Gj proteins are cloned, and equal amounts of 4 cDNAs for the EDG receptor, Gra, GrP and GrY are mixed and used to transfect monolayers of HEK293 cells using the calcium phosphate precipitate method (M. Wigler et al., Cell. 1977;11;223 and DS. Im et al., Mol. Pharmacol. 2000;57;753). Briefly, a DNA mixture containing 25 pg of DNA and 0.25 M CaCI2 is added to HEPES-buffered 2 mM Na2HP04. Subconfluent monolayers of HEK293 cells are poisoned with 25 mM chloroquine, and the DNA precipitate is then applied to the cells. After 4 h, the monolayers are washed with phosphate-buffered saline and refed media (90% 1:1 Dulbecco's modified essential media (DMEM):F-12 + 10% fetal bovine serum). The cells are harvested 48-72 h after addition of the DNA by scraping in HME buffer (in mM: 20 HEPES, 5 MgCI2, 1 EDTA, pH 7.4) containing 10% sucrose on ice, and disrupted using a Dounce homogenizes After centrifugation at 800*g, the supernatant is diluted with HME without sucrose and centrifuged at 100,000*g for 1h. The resulting pellet is rehomogenized and centrifuged a second hour at 100,000*g. This crude membrane pellet is resuspended in HME with sucrose, aliquoted, and snap-frozen by immersion in liquid nitrogen. The membranes are stored at 70°C. Protein concentration is determined spectroscopically by Bradford protein assay. GTPvS binding assay using S1P receptor/HEK293 membrane preparations GTPyS binding experiments are performed as described by DS. Im et al., Mol. Pharmacol. 2000; 57:753. Ligand-rnediated GTPyS binding to G-proteins is measured in GTP binding buffer (in mM: 50 HEPES, 100 NaCI, 10 MgCI2, pH 7.5) using 25 pg of a membrane preparation from transiently transfected HEK293 cells. Ligand is added to membranes in the presence of 10 pM GDP and 0.1 nM [35S]GTPyS (1200 Ci/mmol) and incubated at 30°C for 30 min. Bound GTPyS is separated from unbound using the Brandel harvester (Gaithersburg, MD) and counted with a liquid scintillation counter. The composition of the invention preferably contains 0.01 to 20% by weight of S1 P receptor agonists, more preferably 0.1 to 10%, e.g. 0.5 to 5% by weight, based on the total weight of the composition. The sugar alcohol may act as a diluent, carrier, filler or bulking agent, and may suitably be mannitol, maltitol, inositol, xyiitol or lactitol, preferably a substantially non-hygroscopic sugar alcohol, e.g. mannitol (D-mannitol). A single sugar alcohol may be used, or a mixture of two or more sugar alcohols, e.g a mixture of mannitol and xyiitol, e.g. in a ratio of 1:1 to 4:1. In a particularly preferred embodiment, the sugar alcohol is prepared from a spray-dried composition, e.g. mannitol composition, having a high specific surface area. The use of this type of mannitol composition may assist in promoting uniform distribution of the S1P receptor agonist throughout the mannitol in the compositon. A higher surface area may be achieved by providing a sugar alcohol, e.g. mannitol, preparation consisting of particles having a smaller mean size and/or a rougher surface on each particle. The use of a spray-dried sugar alcohol, e.g. mannitol, e.g. with a mean particle size of 300 pm or less, has also been found to improve compressibility and hardness of tablets formed from the composition. Preferably the single point surface area of the sugar alcohol preparation, e.g. mannitol, is 1 to 7 m2/g, e.g. 2 to 6 m2/g or 3 to 5 m2/g. The mannitol preparation may suitably have a mean particle size of 100 to 300 pm, e.g. 150 to 250 pm and a bulk density of 0.4 to 0.6 g/mL, e.g. 0.45 to 0.55 g/mL A suitable high surface area mannitol is Parteck M200, available commercially from E. Merck. The composition preferably contains 75 to 99.99% by weight of the sugar alcohol, more preferably 85 to 99.9%, e.g 90 to 99.5% by weight, based on the total weight of the composition. The composition preferably further comprises a lubricant. Suitable lubricants include stearic acid, magnesium stearate, calcium stearate, zinc stearate, glyceryl palmitostearate, sodium stearyl fumarate, canola oil, hydrogenated vegetable oil such as hydrogenated castor oil (e.g. Cutina® or Lubriwax® 101), mineral oil, sodium iauryl sulfate, magnesium oxide, colloidal silicon dioxide, silicone fluid, polyethylene glycol, polyvinyl alcohol, sodium benzoate, talc, poloxamer, or a mixture of any of the above. Preferably the lubricant comprises magnesium stearate, hydrogenated castor oil or mineral oil. Colloidal silicon dioxide and polyethylene glycol are less preferred as the lubricant. The composition preferably contains 0.01 to 5% by weight of the lubricant, more preferably 1 to 3% by weight, e.g. about 2% by weight, based on the total weight of the composition. The composition may comprise one or more further excipients such as carriers, binders or diluents. In particular, the composition may comprise microcrystalline cellulose (e.g. Avicel®), methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, starch (e.g. corn starch) or dicalcium phosphate, preferably in an amount of from 0.1 to 90 % by weight, e.g. 1 to 30%'by weight, based on the total weight of the composition. Where a binder, e.g. microcrystalline cellulose, methylcellulose, hydroxypropyl cellulose, hydroxypropylmethyl cellulose is used, it is preferably included in an amount of 1 to 8 %, e.g. 3 to 6% by weight, based on the total weight of the composition. The use of a binder increases the granule strength of the formulation, which is particularly important for fine granulations. Microcrystalline cellulose and methylcellulose are particularly preferred where a high tablet hardness and/or longer disintegration time is required. Hydroxypropyl cellulose is preferred where faster disintegration is required. Where appropriate, xylitol may also be added as an additional binder, for example in addition to microcrystalline cellulose, e.g. in an amount up to 20% by weight of the sugar alcohol, e.g. xylitol. In one embodiment, the composition further comprises a stabiliser, preferably glycine HCI or sodium bicarbonate. The stabiliser may be present in an amount of e.g. 0.1 to 30%, preferably 1 to 20% by weight. The composition may be in the form of a powder, granule or pellets or a unit dosage form, for example as a tablet or capsule. The compositions of the present invention are well-adapted for encapsulation into an orally administrable capsule shell, particularly a hard gelatin shell. Alternatively the compositions may be compacted into tablets. The tablets may optionally be coated, for instance with talc or a polysaccharide (e.g. cellulose) or hydroxypropylmethylcellulose coating. Where the pharmaceutical capsule is in unit dosage form, each unit dosage will suitably contain 0.5 to 10 mg of the S1P receptor agonist. The compositions of the invention may show good stability characteristics as indicated by standard stability trials, for example having a shelf life stability of up to one, two or three years, and even longer. Stability characteristics may be determined, e.g. by measuring decomposition products by HPLC analysis after storage for particular times, at particular temperatures, e.g. 20°, 40° or 60°C. The pharmaceutical compositions of the present invention may be produced by standard processes, for instance by conventional mixing, granulating, sugar-coating, dissolving or lyophiiizing processes. Procedures which may be used are known in the art, e.g. those described in L. Lachman et al. The Theory and Practice of Industrial Pharmacy, 3rd Ed, 1986, H. Sucker et al, Pharmazeutische Technologie, Thieme, 1991, Hagers Handbuch der pharmazeutischen Praxis, 4th Ed. (Springer Verlag, 1971) and Remington's Pharmaceutical Sciences, 13th Ed., (Mack Publ., Co., 1970) or later editions. In one aspect, the present invention relates to a process for producing a pharmaceutical composition, comprising: (a) mixing an S1P receptor agonist with a sugar alcohol; (b) milling and/or granulating the mixture obtained in (a); and (c) mixing the milled and/or granulated mixture obtained in.(b) with a lubricant. By using this process, a preparation having a good level of content and blend uniformity (i.e. a substantially uniform distribution of the S1P receptor agonist throughout the composition), dissolution time and stability is obtained. The S1P receptor agonist, e.g. 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol, hydrochloride, may optionally be micronized, and/or pre-screened, e.g. with a 400 to 500 pm mesh screen, before step (a) in order to remove lumps. The mixing step (a) may suitably comprise blending the S1P receptor agonist and the sugar alcohol, e.g. mannitol in any suitable blender or mixer for e.g. 100 to 400 revolutions. The process may be carried out by dry mixing the components. In this embodiment the milling step (b) may suitably comprise passing the mixture obtained in (a) through a screen, which preferably has a mesh size of 400 to 500 pm. Process step (a) may comprise the step of mixing the total amount of S1P receptor agonist at first with a low amount of sugar alcohol, e.g. from 5 to 25% by weight of the total weight of sugar alcohol, in order to form a pre-mix. Subsequently the remaining amount of sugar alcohol is added to the pre-mix. Step (a) may also comprise the step of adding a binder solution, e.g. methylcellulose and/or xylitol, e.g. an aqueous solution, to the mixture. Alternatively the binder is added to the mix dry and water is added in the granulation step. The milled mixture obtained in (b) may optionally be blended once more before mixing with the lubricant. The lubricant, e.g. magnesium stearate, is preferably pre-screened, e.g. with a 800 to 900 pm screen, before mixing. Alternatively, a wet granulation process is employed. In this embodiment, the S1P receptor agonist is preferably first dry-mixed with the desired sugar alcohol, e.g. mannitol, and the obtained sugar alcohoI/S1P receptor agonist mixture is then dry-mixed with a binder such as hydroxypropyl cellulose or hydroxypropylmethyl cellulose. Water is then added and the mixture granulated, e.g. using an automated granulator. The granulation is then dried and milled. If desirable, an additional amount of binder may be added in step (c) to the mixture obtained in (b). The process may comprise a further step of tabletting or encapsulating the mixture obtained in (c), e.g. into a hard gelatin capsule using an automated encapsulation device. The capsules may be coloured or marked so as to impart an individual appearance and to make them instantly recognizable. The use of dyes can serve to enhance the appearance as well as to identify the capsules. Dyes suitable for use in pharmacy typically include carotinoids, iron oxides, and chlorophyll. Preferably, the capsules of the invention are marked using a code. The pharmaceutical compositions of the present invention are useful, either alone or in combination with other active agents, for the treatment and prevention of conditions e.g. as disclosed in US 5,604,229, WO 97/24112, WO 01/01978, US 6,004,565, US 6,274,629 and JP-14316985, the contents of which are incorporated herein by reference. In particular, the pharmaceutical compositions are useful for: a) treatment and prevention of organ or tissue transplant rejection, for example for the treatment of the recipients of heart, lung, combined heart-lung, liver, kidney, pancreatic, skin or corneal.transplants, and the prevention of graft-versus-host disease, such as sometimes occurs following bone marrow transplantation; particularly in the treatment of acute or chronic alio- and xenograft rejection or in the transplantation of insulin producing cells, e.g. pancreatic islet cells; b) treatment and prevention of autoimmune disease or of inflammatory conditions, e.g. multiple sclerosis, arthritis (for example rheumatoid arthritis), inflammatory bowel disease, hepatitis, etc.; c) treatment and prevention of viral myocarditis and viral diseases caused by viral mycocarditis, including hepatitis and AIDS. Accordingly, in further aspects the present invention provides: 1. A composition as defined above, for use in treating or preventing a disease or condition as defined above. 2. A method of treating a subject in need of immunomodulation, comprising administering to the subject an effective amount of a composition as defined above. 3. A method of treating or preventing a disease or condition as defined above, comprising administering to the subject a composition as defined above. 4. Use of a pharmaceutical composition as defined above for the preparation of a medicament for the prevention or treatment of a disease or condition as defined above. The invention will now be described with reference to the following specific embodiments. Example 1 Micronized Compound A, e.g. 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-dioll hydrochloride salt (FTY720), is screened and 116.7 g of the screened compound is mixed with 9683.3 g mannitol (Parteck M200 from E. Merck). The mixture is then milled in a Frewitt MGI device (Key International Inc. USA) using a 30 mesh screen. Magnesium stearate is screened using a 20 mesh screen and 200 g of the screened compound blended with the FTY720/mannitol mixture to produce a product composition. The product composition is then compacted on a tablet press using a 7 mm die to form 120 mg tablets, each containing: Compound A, e.g. FTY720 * 1.4 mg Mannitol M200 116.2mg Magnesium stearate 2.4 mg Total 120 mg * 1 mg of Compound A in free form is equivalent to 1.12 mg of FTY720. Example 2 In a further example, the process of example 1 is repeated except that the magnesium stearate is replaced by Cutina® (hydrogenated castor oil). Example 3 Compound A, e.g. FTY720, and mannitol (Parteck M200 from E. Merck) are each screened separately using an 18 mesh screen. 1.9 g screened FTY720 is mixed with 40 g screened mannitol for 120 revolutions in a blender at 32 rpm. The FTY720/mannitol mixture is then screened through a 35 mesh screen. The screened FTY720/mannitol mixture is added to a granulator along with a further 340.1 g mannitol and 12 g hydroxypropylcellulose. The mixture is mixed for 3 minutes. Water is then added at a rate of 100 ml/minute and the mixture granulated for 2 minutes. The granulation is transferred into a tray dryer and dried at 50°C for 150 minutes. The mixture is then milled in a Frewitt MGI device using a 35 mesh screen. Magnesium stearate is screened and 6 g of the screened compound is blended for 90 revolutions at 32 rpm with the FTY720/mannitol mixture to produce a product composition showing a substantially uniform distribution of the S1P receptor agonist throughout the mannitol in the blend. The product composition is then filled into size 3 hard gelatin shells on an Hoflinger & Karg 400 encapsulation device. 120 mg of the product composition is added to each capsule. Therefore each capsule contains: FTY720 * 0.56 mg Mannitol M200 114.04mg Hydroxypropylcellulose 3.6 mg Magnesium stearate 1.8 mg Total 120 mg Example 4 In a further example, the process of example 3 is repeated except that the magnesium stearate is replaced by Cutina® (hydrogenated castor oil). Example 5 In a further example, the process of example 3 is repeated except that the hydroxypropyl cellulose is replaced by hydroxypropyimethyl cellulose. Example 6a Micronized Compound A, e.g. FTY720, is screened using a 400 pm (40 mesh) screen. 58.35 g of the screened compound is mixed with 4841.65 g mannitol (Parteck M200 from E. Merck) in a 25L Bohle bin blender for 240 blending revolutions. The mixture is then milled in a Frewitt MGI device using a 400 ym mesh screen, and the milled mixture is blended once more. Magnesium stearate is screened and 100 g of the screened compound is blended with the FTY720/mannitol mixture to produce a product composition showing a substantially uniform distribution of the S1P receptor agonist throughout the mannitol in the blend. The product composition is then filled into size 3 hard gelatin shells on an Hofiinger & Karg 400 encapsulation device. 120 mg of the product composition is added to each capsule. Therefore each capsule contains: FTY720 * 1.4 mg MannitolM200 116.2 mg Magnesium stearate 2.4 mg Total 120 mg Example 6b In an alternative embodiment, capsules are manufactured using the components and in the amounts as described in Example 6a, but the FTY720 is first mixed with 14 mg mannitol (before screening). This mixture is then screened as described above. The screened mixture is then blended with the remaining mannitol and the magnesium stearate is. added, followed by additional blending and filling into capsules. Examples 7 and 8 In further examples, capsules are prepared as described in example 6, except that each capsule contains each component in the following amounts: Example 7 Example 8 FTY720 * 2.8 mg 5.6 mg Mannitol M200 114.8 mg 112 mg Magnesium stearate 2.4 mg 2.4 mg Total 120 mg 120 mg Examples 9 to 11 In further examples, capsules are prepared as described in examples 6 to 8, except that the magnesium stearate is replaced in each case by Cutina® (hydrogenated castor oil). Examples 12 to 22 using an extruder RG-5 type. The extruded material is dried at 65°C by a fluidized-bed granuiator STREA I Type (Patheon, Canada) and then sieved through a 24 mesh sieve. Fine particles which pass through a 60 mesh sieve are removed. The obtained fine granules are filled into capsules by a Zuma capsule-filling machine (100 mg per capsule). Examples 28 to 31 Tablets containing the following ingredients (in mg) are produced: * The amount of xylitol indicated in brackets was used as a binder. FTY720, D-mannitol and xylitol are placed in a fluid-bed granuiator (MP-01 model, Powrex), mixed for five minutes, and granulated under spray of binder solution, followed by drying till the exhaust temperature reaches 40°C. The granulation conditions are as shown below. Dried powder is passed through a 24-mesh sieve, added to the specified amount of filler and lubricant, and mixed in a mixer (Tubular Mixer, WAB) for three minutes to make the powder for compression. The resulting powder is compressed by a tabletting machine (Cleanpress correct 12 HUK, Kikushui Seisakusho) with a punch of 7 mm i.d. x 7.5 mm R at a compression force of 9800 N. Granulation conditions: Claims 1. A solid pharmaceutical composition suitable for oral administration, comprising: (a) a S1P receptor agonist; and (b) a sugar alcohol. 2. A composition according to claim 1, wherein the S1P receptor agonist comprises 2-amino-2-[2-(4-octylphenyl)ethyi]propane-1,3-diol or 2-amino-2-{2-[4-(1-oxo-5-phenylpentyl)-phenyt]ethyl}propane-1,3-diol or a pharmaceutical^ acceptable salt thereof. 3. A composition according to claim 1 or claim 2; wherein the sugar alcohol comprises mannitol. 4. A composition according to any preceding claim, further comprising a lubricant. 5. A composition according to claim 4, wherein the lubricant comprises magnesium stearate. 6. A composition according to any preceding claim, comprising 0.5 to 5% by weight of the S1P receptor agonist. 7. A composition according to any preceding claim, comprising 90 to 99.5% by weight of the sugar alcohol. 8. A composition according to any of claims 4 to 7, comprising 1.5 to 2.5% by weight of the lubricant. 9. A composition according to any preceding claim, in the form of a tablet. 10. A composition according to any of claims 1 to 9 in the form of a capsule. j I 3

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