CA1330421C - Biodegradable ocular implants - Google Patents
Biodegradable ocular implantsInfo
- Publication number
- CA1330421C CA1330421C CA000586706A CA586706A CA1330421C CA 1330421 C CA1330421 C CA 1330421C CA 000586706 A CA000586706 A CA 000586706A CA 586706 A CA586706 A CA 586706A CA 1330421 C CA1330421 C CA 1330421C
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- Canada
- Prior art keywords
- drug
- eye
- composition
- agent
- composition according
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0048—Eye, e.g. artificial tears
- A61K9/0051—Ocular inserts, ocular implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0048—Eye, e.g. artificial tears
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/10—Dispersions; Emulsions
- A61K9/127—Liposomes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
- A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
- A61K9/1605—Excipients; Inactive ingredients
- A61K9/1629—Organic macromolecular compounds
- A61K9/1641—Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, poloxamers
- A61K9/1647—Polyesters, e.g. poly(lactide-co-glycolide)
Abstract
BIODEGRADABLE OCULAR IMPLANTS
ABSTRACT OF THE DISCLOSURE
Microencapsulated drugs are employed for introduction into the chambers of the eye for 10 therapeutic purposes. The administration of drugs is controlled and maintained for long periods of time, while ensuring the substantial absence of significant levels outside the site of administration.
ABSTRACT OF THE DISCLOSURE
Microencapsulated drugs are employed for introduction into the chambers of the eye for 10 therapeutic purposes. The administration of drugs is controlled and maintained for long periods of time, while ensuring the substantial absence of significant levels outside the site of administration.
Description
27414/VIS~
~I9DEGRADaBLE OCULaR I~PLaNTS
Biocompatible microencapsulated implants are provided for treatment of ocular diseasesO
.
~he eye is fundamentally one of the most ~:
important organ.~ during life. Because of aging, di~- ~
: eases and other factors which can adversely affect ~ : vision, the ability to maintain the health of the eye~
becomes all important. The leading cause o~ blindness is the inability in the treatment of eye diseases to ~ introduce drugs or therapeutic agents into the eye.
I The exact mechani~m or reason is not known, but cer-: ~ainly the blood eye barrier (as analogous to the blood brain barrier) may be an important f~ctor. On the other hand, when a drug is injected into the eye, it quickly washe~ out or i8 depleted froQ within the eye . . into the gener~l circulation, Pro~ the therapeutic tandpoint, this may be as difficult as givi~g no drug . ~ :
at all. 8eeau~ of this inhere~t dificulty of deli-30 vering drugs into the eye, successful medical treatment ~ ~
of ocular diseases is totaily inadequate. ! -:: The need for a solutio~ i~ even more pressing ln that the cause of a nu~ber of ocular ~isea~s have now been identified a~d many are a~enable to treatment if a proper mode of therapeutic delivery is available.
It is therofore of great interest to develop modes of treatment which obviate the linitations o~ present ~ -,~
.~
modes of therapy.
There ha~ been a substantial ~esi~tance to introduce drug~ directly into one or both chambers of the eye. ~he many uncertainties a3sociated with the p 5 distribution of the drug, rate of release, binding to eye component~, concentration by cells, rapid los~
and/or inactivation, and the like, is discouraging for the efficacy of direct introduction.
10 Relevant Literature ~eller (1), Biodegradable Polymers in Con-trolled Drug Delivery, In: C~C Critical Review~ in , Therapeutic Drug Carrier Systemc, Vol. 1, CRC Press, j Boca Raton, FL, 1987, pp 39-90, describes encapsulation 15 for controlled drug delivery. See also, ~eller ~2), ~ In: ~ydrogels in Medicine and Pharmacy, N.A. Peppes ¦ ed., Vol. III, CRC Press, Boca Raton, FL, 1987, pp 137-149, describes bioerodible polymer~. ~eller, J. of Controlled Release (1985) 2:167-177; Leong et al., BioMaterials tl986) 7:364-371 describes polyanhydride microsphere~. Jackanicz et al., Contrace~tion (1973) 8:227; Yollea et al., In: Controlled Release of Biologically Active Agent~, Tanquary et al. ed~, Plenum Press, New York, NY, 1974, Chapter 3; Liu et al., OothamoloqY (1987) 94:1155-1159 and reference~ cited therein report a study for the intravitreal use of lipo~omes for therapeutic treatment of eye disease.
See al~o,-Cutright et al., Oral Surqerv, Oral Med~cinec and Oral PatholoaY (1974) 37:142 and Shindler et al., ;~ 30 Contemoorar~ Topic~ in PolYmer Science (1977) 2:251-289. Ander~on et al., Contrace~t~on (1976) 13:375 and ~iller et al., J. ~iomed~ Material~ Re~. (1977) 11:711, describe various properties of poly(dl-lactic acid).u.s.
; Patent~ af intere~t include 3,416,530; 3,626,940;
3,828,777; 3,870,791; 3,916,899; 3,944,064; 3,962,414;
4,001,388; 4,052,505; 4,05~,619; 4,164,559; 4,179,497;
~,186,184; 4,19~,642; 4,281,654; 4,303,637; 4,304,765:
~, ~:
~ ' .
., :~ :
~ ` 1 33042 1 4,304,767; 4,439,198; 4,452,776; 4,47~,751; 4,613,330;
and 4,617,186.
The following books describe the use of liposomes as drug carriers. Papahadjopoulous (197a) The Annals of the New York Academy of Science, Vol. 308, and Gregoriades and Allison (1980) Liposomes in siological Systems, John Wiley & Sons. Leserman et al., ~ature (1981) 293:226-228; Barbet et al., Supramol, Struct. Cell Bio. Chem. (1981) 16:243-258; Heath et al. Sci~nce (1980) 210:539-'41.
The preparation of liposomes is disclosed by ¦ Szoka and Papahadjopulos, Proc. Natl. Acad Sci U
(197~) 7~:145-149.
Biocompatible, particularly biodegradable, drug containing microencapsulated implants are introduced into the anterior and/or posterior chambers of the eye to provide a therapeutically effective amount of the drug for treatment of an ocular condition. The microcapsules may be polymers, particularly polyesters, ethers, or liposomes, where in each case a drug is surrounded by a barrier to immediate release upon introduction into a chamber of the eye~
~ .:
This invention provides a composition for treating an eye condition which comprises:
a pharmacologically active agent surrounded by an encapsulating agent which acts as a barrier to immediate release of the pharmacologically active agent, wherein the comp~osition is capable of introduction into a chamber of the eye and the encapsulating agent provides for an effective dosage of the pharmacologically active agent over an extended period of time.
, ~
~- This invention also provides a composition for treating an eye condition which comprises:
liposomes enclosing in their lumen an isotonic ;~ solution comprising a pharmacologically active agent, ~ ,,~
~ :`
i, ~
I! ~... .; ' ' ': ", ~
:~, ' ' ''' ' ' i ': '`'' i" ' i; ''; "
--` 1 3304 2 1 3a . wherein said composition i~ capable of introduction into a chamber of said eye and said agent is released in the eye at a rate to provide an effective dosage of said agent over an extended period of time.
Ocular condition~, diseases and disorders, are treated by introducing slow release drug-containing microcapsules directly into the anterior and/or posterior chambers of the eye. The microcapsules are formulated to include one or more drugs which may be released over an extended period of time at a therapeutically effective do~age into the vitreous humor. In this manner, drugs released from microcapsules placed into the anterior ::~
chamber will reach the cornea, aqueous humor, trabecular : 15 mesh work, iris, lens, and related structures in the ~anterior chamber. Micro- ;
,~,, , :~
.:~ .
l ~.
.
, , `~.
"~
; '~
;:.
~: :
, '~
capsules introduced into the posterior chamber are diffused throughout the vitreous in the chamber and into the entire retina (which con~i~ts of 10 different layers), into the choroid and the opposed Qclera.
S Thu~, the drug will be a~ailable at the ~itet~) where the drug i9 needed and will be maintained at an effec-t~ve dosage, rather than rapidly being washed out or as in the case of systemic ad~ini3tration, requiring greatly elevated levels of drug administration ~o the 10 host to achieve an effective level in the eye. Where ~ the drugs are encapsulated in liposome~, concentrated 3 doses of medication can be delivered into the eye for a ~ more ef~ective, less toxic treatment.
3 The primary element of the capsule will be the 15 polymeric or lipid encapsulating agent. The composi-tions will be biocompa~ible, preferably biodegradable.
~ For the most part, the polymeric compositions il will be organic esters or ethers, which when degraded result in physiologically acceptable degradation 20 products, including the monomers. Anhydrides, amides, orthoesters or the like, by themselves or in combina-tion with other monomers may al~o find use. ~he poly-mers may be addition or condensation polymers, particu-larly condensation polymer~. The polymer~ may be 25 cro~s-l~nked or non-cros~-linked, u~ually not more than lightly cross-linked, generally less tban 5%, usually le~s than 1%. For the most part, beside~ carbon and hydrogen, the 2olymers will include osygen and nitro-gen, partlcularly oxygen. The osygen may be present as 30 oYy, e.g. ~ydroxy or ether, carbonyl, e.g. non-oxo-carbonyl, such as carbo~ylic acid ester, and the like. The nitrogen may be pre~ent as amide, cyano and amino. The polymer~ set forth in ~eller ~1), supra, ~ay be used.
~ Of particular interest are polymer of ; hydroxyaliphatic carboxyllc acid~, either homo- o~
:
;~
copolymers, and polysaccharides. Included among the polyester3 of interest are polymers of D-lactic acid, L-lactic acid, racemic lactic acid, glycolic acid, polycaprolactone, and combinations thereof. By employing the L-lactate, a slowly eroding polymer is achieved, while erosion is ubstantially enhanced with the lactate racemate.
Among the polysaccharides will be calcium alginate, and functionalized celluloses, particularly carboxymethylcellulose esters characterized by being water insoluble, a molecular weight of about 5 kD to 500 kD, etc. Other polymers of intere~t include polyvinyl alcohol, esters and ethers, which are biocompatible and may be biodegradable. For the most part, characteristics of thP polymers will include biocompatibility, compatibility with the drug, ease of encapsulation, a half-life in the phy~iological environment of at least 6 hrs, preferably greater than one day, no significant enhancement of the viscosity of the vitreous, water insoluble, and the like.
For lipid encapsulating agents, the drug can be incorporated into the lumen of a vesicle which is relatively leakproof to the drug. The nature mf the liposome may be widely varied, various lipids being ;~ 25 employed for the formation of the liposcme. Proteins or other non-lipid compounds may be bound to the "b~ liposome membrane which may affect the nature of the liposome In the~ab~ence of proteinaceou~ compound~r acidic phospholipids will desirably be pre~ent in at lea~t minor amounts, while in the pre~ence of proteinaceous materials, the liposome will desirably be sub~tantially neutral.
Among lipids which may be employed ~or preparation of the liposomes are phosphatidyl ;~ 35 compound~, such a~ phosphatidyl choline IPC), phosphatidyl se~ine (PSI, and phosphatidyl ethanolamine ~:~ (PE); sphingolipids; cerebro~ides: ganglioside~
,~:
~ .
' ,~
~ 6 1 33042 1 steroids, e.g. cholesterol; etc. Desirably, the liposomes will have from about 10 to 50 mole per cent steroid, with the remainder primarily being aliphatic acids and esters of both organic and inorganic acids.
Small amounts of other types of lipid material may be present, generally less than about 10 mole percent, usually less than about 5 mole percent.
The biodegradable polymers which form the microencapsulated particles will desirably be ubject to enzymatic or hydrolytic instability. Water soluble polymers may be cross-linked with hydrolytic or biodegradable unstable cross-links to provide useful water insoluble polymers. The degree of stability can be varied widely, depending upon the choice of monomer, whether a homopolymer or copolymer is employed, employing mixtures of polymers, where the polymers may be employed as varying layers or miYed.
¦ 3y employing a biodegradable polymer, particu-larly one where the biodegradation is relatively slow, `5 20 the rate of release of the drug will be primarily diffusion controlled, depending upon the surrounding membrane or monolithic polymer structure, rather than breakdown of the particle~ ~or the mo~t part, the selected particles will have lifetime~ at least equal to the aesired period of admini~tratio~, preferably at least twice the desired period of ad~inistration, and may have lifetimes of 5 to 10 time~ the desired period of admini~tration. The ~eriod o~ ad~inistration will ~u~ually be at least 3 days, re u~ually at least 7 days, generally at least about 15 days and may be 20 days or more~ -The particles may be substantially homogeneou~
as to compo~ition and physical characterstics or heterogeneous. ~hus, particle~ can be prepared where the center may be of one material a~d the -~urface have ~ ;~ one or ~ore layers of the samR or different composi- -i~ ~; tion, where the layers may be cros3-linked, of differ-!.' .
~`
,~, ' `~' 1 3~0~21 ent molecular weight, different density or poro~ity, or the llke. For example, the center could be a polylaco tate coated with a polylactate-polyglycolate copolymer, 80 as to enhance the rate of initial degradation, MoRt ratio~ of lactate to glycolate employed will be ln the range of about 1:0-1. Alternatively, the center could I be polyvinyl alcohol coated with polylactate, so that on degradation of the polylactate the center would dis-solve and be rapidly washed out of the eye.
10Any pharmacologically active agent for which sustained release is desirable may be employed. Desir-ably, the drug will be sufficiently soluble in the vi~reous to be presented at a pharmacologically effec-tive dose. Pharmacologic agents which may find use may 15be found in ~.S. Patent Nos. 4,474,451, columns 4-6 and 4,327,725, columns 7-a.
..,~
Drugs of particular interest include hydro-cortisone (5-20mcg/1 as plasma level), gentamycin l6-lOmcg/ml in serum), 5-fluorouracil (-30mg/kg body weight in serum), sorbinil, IL-2, TNF, Phakan-a ~a component o~ glutathione~, thiola-thiopronin, Bendazac, acetylsalicylic acid, trifluorothym~dine, interferon (~, B and ~), immune modulators, e.g. lymphokines, monokine~, and growth factors, etc.
. Other drugs of interest include anti-qlaucoma : drug~, such as the beta-blockers: timolol maleate, betaYolol and metipranolol; mitotics: pilocarpine, acetylcholine chloride, isoflurophate, demacarium ::
bromide, echothiophate iodide, pho~pholine iodide, carbachol, and physostigimine: epinephrine and ~alts, ~uch a~ dipivefrin hydrochloride; and dichlorphenamide, acetazolamide and methazolamidei ~nti-cataract and anti-d~abetic retinopathy drugs, ~uch as aldo~e . 35 reductase inhibitor~: tolrestat, lisinopril, enala-pr~l, and st~atil; thiol cross-linking drugs other than those considered previously; anti-cancer drug~, such as : : :
` 8 1 3304~1 .. ..
retinoic acid, methotrexate, adriamycin, bleomycin, triamcinolone, mitomycin, cis-platinum, vincristine, vinblastine, actinomycin-D, ara-c, bisantrene, CCNU, activated cytoxan, DTIC, ~MM, melphalan, mithramycin, procarbazine, VM26, VP16, and tamoxifen; immune modulatorc, other than those indicated previously;
anti-~lotting agents, such as tissue plasminogen activator, urokinase, and streptokinase; anti-tissue damage agents, such as superoxide dismutase; proteins and nucleic acids, such as mono- and polyclonal antibodies, enyzmes, protein hormones and genes, gene ~ragments and plasmids; steroids, particularly anti-in~lamma~ory or anti-fibrous drugs, such as cortisone, hydrocortisone, prednisolone, prednisone, dexametha-! 15 sone, progesterone-like compounds, medrysone (~MS) and fluorometholone; non-steroidal anti-inflammatory drugs, such as ketrolac tromethamine, diclofenac sodium and supro~en, antibiotics, such as loridine (cephalori-dine), chloramphenicol, clindamycin, amikacin, tobra-~0 mycin, methicillin, lincomycin, oxycillin, penicillin, amphotericin B, polymyxin B, cephalosporin family, ampicillin, bacitracin, carbenicillin, cepholothin, :
:~ colistin, erythromycin, ctreptomycin, neomycin, :: sulfacetamide, vancomycin, silver nitrate, sulfisox-~-i 25 azole diolamine, and tetracycline, other anti-; pathogens~ including anti-viral agent~, 3uch as .~. : -idoxuridine, trifluorouridine, vidarabine (adenine ' ~ L~ ` arabillogide) t acyclovir (acycloguanosine~ y .~ pyrimethamine, trisulfapyrimidine-2, clindamycin, 30 nystatin, flucytosine~ natamycin, miconazole and piperazine derivatives,je.g. diethylcarbamazine: ~
. cycloplegic and mydriatic agents, ~uch a~ atropine, . cyclogel, scopolamine, homatropine and mydriacyl.
Other agents include anticholinergics, 35 anticoagulants, antifibrinolytic agent~, antihista-mines, antim-alarials, antitoxins, chelating agents, ~: hormone~, immunosuppressive~, thrombolytic agent~, -9 1 3304~
vitamins, salts, desensitizing agents, prostaglandins, amino acids, metabolites and antiallergenics.
The amount of drug employed in the capqule will vary widely depending on the effective dosage required and rate of release. ~sually the drug will be from about 1 to 80, more usually 20 to 40 weight percent of the microcapsule.
Other agents may be employed in the formula-tion for a variety of purposes. In addition to the drug agent, buffering agents and preservatives may be employed. The water soluble preservatives include sodium bisulfite, sodium thiosulfate, ascorbate, ben-zalkonium chloride, chlorobutanol, thimerosal, phenyl-mercuric borate, parabens, benzyl alcohol and phenyl-ethanol. These agents may be present in amounts offrom 0.001 to 5% by weight and preferably 0.01 to 2~.
Suitable water soluble buffering agents are alkali or alkaline earth, carbonates, phosphates, bicarbonates, citrates, borates, acetates, succinates and the like, ~uch as sodium phosphate, citrate, borate, acetate, bicarbonate and carbonate. These agent~ may be present in amounts sufficient to maintain a p~ of the system of between 2 to 9 and preferably 4 to 8. As such the buffering agent may be as much as 5% on a weight to weight ba~is of the total compo~ition.
The particles may be of a narrow or broad ; range in sizer normally not exceeding 300~M, ~o as to ; ~ b~ capable of being administered with a~ ?8 gauge needle. ~3ually, the particle range will not difer by greater than about 200% of the average particle si2e, more usually not greater than about 100%. The average particle size will usually be in the ran~e of 5 ~M to mM, more usually in the range of 10 ~M to 1 mM. In ~; some instances the particles will be ~elected to have an average diameter in the range o~ 1-2 ~M to provide l~ large depots, while in other instances the particle~
g~; ~ will have average diameters in the range of about ,~
,' c, -25-500 ~M, to provide smaller depots The size of the particle can be used to control the rate of release, period of treatment and drug concentration in the I eye. In some situations mixtures of particles may be ¦ S employed employing the same or different pharmaco-I logical agent. In this way in a ~ingle administration a ¦ course of drug treatment may be achieved, where the ¦ pattern of release may be greatly varied.
! Various techniques may be employed to produce ¦ 10 the encapsulated drugs. Useful techniques include sslvent-evaporation methods, phase separation methods, interfacial methods and the like.
In preparing the polymeric encapsulated drugs, for the most part solvent-evaporation methods will be employed. Towards this end, the preformed rate controlling polymer is dissolved in a volatile substantially water-immiscible solven~, such as chloroform, methylene chloride, or benzene. Sometimes, the water immi~cible solvent will be modified with a small amount of a water-miscible organic cosolvent, particularly an oxygenated solvent, ~uch as acetone, methanol, ethanol, etc. ~sually, the water-miscible organic cosolvent will be less than about 40 vol %, usually less than about 25 vol %. The drug may then be ~,~ 25 added to the polymer-solvent ~olution~ Depending upon the nature of the drug, one may havæ the drug dispersed ; ~ n the viscous ~olymer-solvent mixture or a solid ;dispersion of d~rug particle~, where the drug will have ; been pulverized to obtain a fine p~wder, usually a microfine powder particularly of a size of less than about l m~, usually less than about 0.5 mM, and may be about O~S ~M or smaller.
The amount of polymer employed in the medium ~ will vary with the size of the particle de~ired, b~ 35 whether additional coatings will be added, the viscosity of the ~olution, the ~olubility of the ~ polymer and the like. ~sually, the concentration of `~
,~
~:
.
`` 11 1 330421 polymer will be in the range of 10 to 80 weight percent. ~he ratio of drug to polymer will vary with the desired rate of relea~e~ the amount of dru~
generally varying in the range of 1 to 80 weight S percent of the polymer.
The dispersion or solution obtained above is added to a rapidly stirred aqueous solution comprising water and a dispersing agent, which may be a protective colloid. Of particular interest as macromolecular dispersin~ agents are agents such a~ poly(vinyl alcohol) (1-5~) or non-ionic detergent~, such as Span detergents.
The volume of the organic phase will be smaller than the aqueous phase, generally being in a volume ratio of from about 1:1 to 103 of organic to aqueous phase, and an oil-in-water emulsion is produced. The rate of stirring is selected to produce the appropriate droplet size and stirring is continued throughout the next step.
In the third step, the microencapsulation vessel is closed and a mild vacuum is applied to the - system to evaporate the volatile organic Rolvent. The solvent should be evapo~ated slowly, since too rapid evaporation results in bubbles and blow holes formed in t~e microcapsule walls, The rate o evaporation may be determined empirically, usinq the eYperience reported ;~ in the literature. ~sually the vacuu~ will be in the -; range o about 3 to 10 m~ ~g. After evaporatio~ ha~ - ~ c~
been completed, the resulting microcapsules are centrifuged, washed completely with water, collected, e.g., filtration~ and drained. ~sually, the micro~
capsules will then be subdivided with 3ieves to isolate particles of a size range o the de~ired diameter~
'r;';~ The process may be carried out conveniently at room temperature, but cooling or heating may be ~! ~ employed in-specific situations to optimize the . ~ proces~. The ratio of drug to polymer is adjusted to ~ .;
~ 12 1 33042 1 produce optimized compositions, since the final product will normally result in the initial ratio. By manipu-lating the initial bulk viscosity of the drug-polymer-solvent mixture and of the aqueous dispersing medium, along with the stir rate, production of microcapsules with the desired size may be optimized. Moreover, the composition of dissolved organic solvent and the rate of solvent evaporation can be tested to produce mioro-capsules with larger or smaller crystals of drug in the microcapsules. For polymers which are hydrolytically sensitive, the microcapsules should not be exposed to the aqueous dispersing medium for excessively long periods during the solvent-evaporation step.
The particle size distribution of each batch of microcapsules will be relatively narrow. ~owever, when desired, the size-fractions may be further refined by a physical separation process such as dry or wet sieving.
In order to define the potential drug-release behavior of the micro~apsules in vivo, a weighed sample of microcapsules may be added to a measured volume of a solution containing four parts by weight of ethanol and six parts by weight of deionized water. The mixture is maintained at 37C and stirred slowly to maintain the ~: 25 microcapsules suspended. The appearance of the dis-sol~ed drug a~ a function of time may be followed spectrophotometrically until the absorbance becomes ;~Constant or until greater than 90% of the drug ha~ been ~-relea~ed~ The drug concent~ation after 1 h in the medium is indicative of the amount of free unencap-sulated drug in the dose, while the time required for 90% drug to be released i~ related to the expected duration of action of the dose in vivo. As a general rule, one day of drug release in vitro is approYimately ;~ 35 equaI to 35 days of release in vivo. While release ~ay ~not be uniform, normally the relea~e will be free of : .
, .
:~ ~
~:`
` 13 1 330421 ,.
larger fluctuations from some average value which allows for a relatively uniform release.
When employing a liposome encapsulated drug the encapsulating lipid bilayer membrane may be prepared in a variety of ways. In general, the literature provides a variety of methods for liposome formation and for linking compounds to a lipid group any of which may be utilized. For the preparation of liposomes, see, in particular, Szoka and Papahadjopulos, Proc. Natl. Acad. Sci. ~SA ~1978) 75:
145-149.
The liposome solution will normally be isotonic with the physiological fluid in which it is to act. The p~ of the solution will generally be greater than about 6 and not greater than about 9, more usually from about 6 to 8, preferably from about 6.5 to 7.5.
Variou~ buffers may be u~ed which are phy~iologically acceptable, particularly phosphate, carbonate and acetate.
The concentration of the drug will vary, depending upon its physiologically effective concen-tration, the ability to maintain the concentration in the lumen of the liposome, the effect of the compound on th~ stability and impermeability of the liposome, as well a~ the size and number of liposomes. The drug ;~ concentration may range from about O.O}m~ to about IOOmM. The concentration of buffer will generally be f ~ fro~ about 20 to about lOOmMr while the concentration of salt per milliliter of ~olution will generally range ~0 ~rom about 0.25 to 0.90 percent.
The microcapsules may be administ~red into the ey~ in a variety of ways, including injection, infu- -- ~ sion, trocar, etc. Various techniques ~or introducing materials into the anterior and/or posterior chambers are well known, ~ee, for example, Liu et al., 1987, su~ra, and references cited therein.
The following examples are offered by way of '~
.
:,~
:~
, ~
~ 14 1 330421 illustration and not by way of limitation.
EXPERIMENTA~
S PolYmeric EncaPsulated Druqs The appropriate weight of polymer is 301ubilized with a water immi~cible organic volatile solvent, e.g. benzene, methylene chloride or chloro-form. The proper amount of drug is added to the polymeric mixture to form a slurry which is mixed to substantial homogeneity. The slurry i~ then added dropwise to a vessel containins rapidly ~tirred deionized distilled water in a volume ratio of 1:0.5-1 x 103 (organic slurry:water). The water is 2-5 wt %
polyvinyl alcohol. The vessel is sealed and a mild vacuum applied slowly to prevent bubbles and blow holes in the microcapsules over a period of about 8-10 hr~.
After evaporation of the solvent, the microcapsules are centrifuged, washed repeatedly with ~terile distilled water, filtered a~d drained. The microcapsule4 are sized with sieves, dried in vacuo and may then be used ~-;
directly by trocar injection for introduction into the vitreous humor of the eye. Por sulfadiazine, the drug ;~ wa~ 10 wt %, for hydrocortisone 40 wt %, and for methotrexate 25 wt ~ of the polymer weight. The drugs were used as microfine powers, s 20 ~M. The trocar injection was with a 20-gauge needle, the particle3 belng o~ an average size of about 0~2 m~
The monomer D~-lactic acid wa~ recry~tallized twice from acetone and twice from methyl ethyl ketone.i The lactic,acid was added to a polymeriza~ion tube, air and residual solvent removed in vacuo and the tube heated until the lactic acid melted. Catalyst (tetraphenyl tin, 0.02 wt %) was added and the tube 35 3ealed in vacuo and heated at 170-175C for seven hour~. After cooling, the tube was opened and the ;;~ ~ polymeric product di solved in acetone, pre~ipita~ed ;~
with water at room temperature and then dried in vacuo. The polymer should not be expo~ed to water ~or long periods of time, particularly during the ~olvent-, evaporation step during microcap~ule formation.
The following table~ indicate the results:
Table 1 Drug Time RE LE
# uq/ml Analv~is wks moc AC PC AC PC
1* sulfa- fluores- 0 0.0 -- 0 --diazine cence 1 2.0 -- 0 --2 . 1.5 -- 0 --3 1.3 -- 0 --4 1.5 -- 0 --1.6 -- 0 --6 1~8 -- 0 --7 1.4 -- 0 --: 8 1.5 ~ 0 --'~ 9 1.5 --- O ,~, 10 1~4 - 0 ~: 11 1.6 -- 0 IZ 1.3 -- 0 ..
Animal - Rabbit ..
* ~ Microcapn~le~ i~ hC tanterior chamb¢r) icrocap~ules ~n PC tEosterior cha~ber) ,.'~ r . ,~ ... , .
The sul~adiazLne containing polylactic microcap~ules placed in the anterior chamber of the . `~ ri~ht eye released the drug for 12 months~ There was ,~ no detection of any arug in the control left eye.
. ~ -. ~
~' ~-~ 16 1 330421 . ~
Table 2 Drug ~ime RE LE
# uq/ml Analy~is wks mos AC PC AC PC
2* ~ulfa- fluoreq- 0 0.0 -- 0 --diazine cence 1 0 -- 0.0 --2 0 -- 2.5 --3 0 -- 2.6 --4 0 -- 2.4 --0 -- 2.9 --6 0 -- 3.0 ~
7 0 -- 2.8 --8 0 -- 2.6 --9 0 -- 2.6 --0 -- 2.7 --~: 11 0 -- 2.4 -~
12 0 -- 2.3 -# = Animal = Rabbit * = Microcapsules in AC (anterior chamber) + - ~icrocap~ules in PC (posterior chamber) ~.
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The experiment of ~able 1 was repeated, employing a higher dose level.
--Table 3 Drug Time RE LE
# ua/ml ~ y~ wks mos AC PC AC PC
10 3* sulfa- fluores- O 0.0 diazine cence 2 3.1 4 2.9 -- __ __ 6 3.2 -- ~
8 3.0 0.0 -- ~~
# ~ Animal = Rabbit * = Microcapsules in AC (anterior chamber) + 5 Microcapsules in PC (posterior chamber) , . - .
A shorter time period was used to monitor the :~ cour~e o~ the release. The data demonstrate that the ~ drug level had equilibrated within 2 weeks (the 2 week :~ level wa~ the same a~ the 8 week levsl). At a week~ -; ~ 25 when the anim~l was ~acrificed, the level in the :
~ ~o~terior cha~ber wa~ found to be 0, The data demon- :
;~ trate that m~dication placed in ~he anterior chamber -~ d~d not ~ig~ate into the posterior cha~ber~
:~ 30 .'~
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1 3304~1 Table 4 Drug Time RE L~
# ug/ml AnalY~is wks mos AC PC AC PC
4* ~ulfa- fluores- 0 0.0 diazine cence 2 4.2 4 4.3 0 ~;
# = Animal = Rabbit * = Microcap~ule~ in AC (anterior chamber) I = Microcapsules in PC (posterior chamber~
This experiment repeats the experiment above, ~ but employs a higher do~age level.
I ~
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# ug/ml AnalYsis wks mo3 AC _ PC AC PC
l+ hydrocortisone 2LC 1 <.02 1.5 0 0 ~uccinate 2+ hyd~ocortisone ~PLC 2 <.02 2.0 o 0 10 succinate 3+ hydroco~tisone ~PLC 3 <.02 2.3 O O
succinate 4+ hydrocortisone EPLC 4 ~.02 1.0 0 0 succinate 5+ hydrocortisone EPLC 5 <.02 1.5 0 0 succinate 6+ hydrocortisone HPLC 6 <.02 1.25 0 0 ~ succinate .,~ 7+ hydrocortiaone 3PLC 7 <.02 4.1 0 0 succinate 8+ hydrocortisone 3P~C 8 <.02 Z.5 0 0 :~ succinate ,~ 9+ hydrocortisone EPLC 9 ~.02 1.5 0 0 ~ ~uccinate ;;: 25~0+ hydrocortisone EP~C 10 ~.02 2_4 0 0 uccinate ~ "' ~ ` Animal - Rabbit -~ -r crocapsules in ~C ~anterior chamber) ;~ ~icrocap~ules in PC tposterior chamber) ~ 0 ~ "
~,i"- ~: Ten different animals ~er~ employed with ~ydrocortisone succinate as a drug incorparated into ..;: ~ 35 polylactic acid~ ~he same amount of drug/polymer was .3:, ~ ~ placed into th- right eye~ of each of the animals~ One a~imal was sacrficed at the end of each of the month~ - :
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indicated to generate the data. The results demonstrate the following: 1) drug placed in the posterior chamber of the eye did nGt migrate into the anterior chamber in detectable amounts; 2) drug was still being released at 10 months at roughly the equilibration level; 3) the left ayes which were not medicated showed no drug.
_ __ Table 6 ~ :
Drug Time RE LE
# ua/ml Analysis wks mos AC PC AC PC
1~ MTX EMIT 1 -- -- <.01 1.0 2+ MTX EWIT 2 -- -- <.01 0.9 3+ MTX EMIT 3 -- -- <.01 1.1 4+ MTX EMIT 4 -- -- <.01 1.0 S+ MTX EMIT 5 -- -- <.01 1.2 ~: 20 6+ MTX EMIT 6 -- -- <~01 0~8 7+ MTX EMIT 7 -- -- <,01 0.7 # - Animal ~ Rabbit ~ * = Microcapsules in AC (anterior chamber) .: ~ - Microcapsule~ in PC (posterior chamber) .
. 25 . . ~
ethotrexate wa~ incorporated into polylactic acid and th~ microcapsules placed in the po~terior chamb~r of the left eye.. Drug did not appear to .migrate to the anterior chamber. Drug was ~till being , released at 7 months.
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Lipid EncaPsulated D~u~s PreParation of li~osomes:
Doxorubicin wa incorporated into liRosomes by S using 39.35 ~M of the drug in methanol with 19.65 ~Mi cardiolipin. The mixture was dried through evaporation under nitrogen. ~dded to the dried mixture were 100 ~M
phosphatidyl choline, 68.4 ~M cholesterol, and 38.9 ~M
steraylamine. The latter was mixed and dried under nitrogen. The mixture was hydrated with 10 ml 0.01 M
phosphate buffer with 0.85% NaCl, pH 7.4,. After a swelling time of 30 minutes the liposome3 ~ere stirred for 15 mintues, followed by sonication under nitrogen in a fixed-tem~erature bath at 37C for 90 minutes.
The untrapped doxorubicin was separated from liposomal-encapsulated drug by extensive dialysis against 0.01 M
phosphate buffer with 0.85% NaCl, pH 7.4, at 4C over 24 hours with several changes of buffer solution. The entrapment o~ doxorubicin in cardiolipin liposomes was determined by fluorescence. The ~ize of the liposomes used ranged from 900 to 1100 angstrom units.
: :
I. Injection of doxorubicin into the anterior chamber (AC):
1. 50 ~9/0.1 ml doxorubicin was injected into the AC of 10 New Zealand white rabbits. The AC was ; tapped for doxorubicin a~say.
, 2. 50 ~g/0.10 ml doYorubicin was injected ~nto the right and left AC in each of two rabbits. The contralateral eye was given 0.10 ml of nornal saline.
The two animals were observed for two week~ for ocular toxicity.
The results are given in Table 7.
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~ ~ 22 1 33042 1 ~:3 _ _ _ Table 7 Residual aqeous humor dosorubicin after AC injection of 3 50 ug of the unencapsulated drug into the right eye.
5 The left eye served as control.
Time Doxorubicin (hours) Sample ~uq/ml) Mean ~ SD Control 0 1 23.5 22.5 ' 1.41 0 2 21.5 2 3 0.125 ~.135 + 0.01 0 4 0.1~5 4 5 0.075 0.0925 ~ 0.02 0 6 0.11 8 7 0.025 0.030 + 0.01 0 8 0.035 ~ 16 9 <0.005 <0.005 0 `~ 10 <0.005 ~ 20 ~he mean half-life of doxorubicin in the AC is - approYimately 1 hour. Unencapsulated doxorubicin causes ocular inflammation and corneal edema within 2-3 days after AC injection. The control aaline in~ected eyes were found to be normal on gross examination and ~lit-lamp biomicroscopy.
.'~
~ 25 1, .",, ii ~ - - II. Iniection of lipo ome-encapsulated - dosorubici~ into AC.
1. 50 ~g/O.10 ml of lipo~ome-encapsulated doxorubicin was ~njected into the AC of one eye of 28 rabbit~ The contralateral uninjected eye served as x~ control, 2. 50 ~g of doxorubicin in liposome waa '~ injected into one eye of each of two rabbits and observed for 3 week~ The contralateral eye received 0~10 ml normal saline.
., 'i ~
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~ 23 1 330~2i Table 8 gives the results of these experiments.
_ ___ .
Table 8 Re~idual aqueous humor doxorubicin after AC injection o 50 ug of the encapsulated drug into the left eye.
The right eye served as control.
Time Doxorubicin 10 tdays) SamPle luq/ml) Mean + SD Control 0 140.14 39.40 + 2.78 0 242.35 335.67 439.46 1 58.10 5.90 + 2.14 0 64.35 77.35 83.79 2 92.25 2.40 ~ 0.56 0 _ .
:~ 102.90 111.67 122.77 3 131.53 1.22 + 0.22 0 141.15 150.87 ,~,,~,;, ~ ,. r ~ . ,, 16 1.32 - ' 4 17 0.96 0~77 + 0.18 0 ~:.
~: 30 180.67 lg,0.57 200.8~
8 210.19 0.19 ~ 0.06 0 ~; 220.12 230.26 ~ ~40.19 '`~:
. - -..
` - 1 330421 , 24 i Table 8 continued Time Doxorubicin ! ( days) Sample (u~/ml) Mean + SD Control 16 25 <00.005 <0.0~5 0 26 <0.005 27 0.01 28 <0.005 Detectable encapsulated doxorubicin could be found up to 2 weeks in the anterior chamber (AC). Significant amounts were present up to 8 days post AC injection.
Clinically the eye tolerated the encapsulated form very well with little to no signs of inflammation and no corneal edema.
-:
In one of the two animals injected for clinical observation, small amounts of lipsomes could be seen in the interior anterior chamber. The eye wa~
clinically quiet.
III~ Injection of doxorubicin into the osterior chamber (PC):
1. 50 ~g/0.1 ml doxorubicin was injected into the posterior chamber (PC) of each of 10 rabbits~ The contralatera1 eye served as control.
. ~"
;~ ~ 2. S0 ~g/0.1~ ml of doYorubioin was injec~ed into one ey~ of two animals for clinical ob~ervation for one week. Saline control was injected into the cont~alateral aye.
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, 25 1 330421 ¦ The results of doxorubicin injection into the ~ PC are shown in Table 9.
, Table 9 Residual vitreou3 doxorubicin after injection of 50~g -of the drug into the PC of the right eye. The left eye served as control.
Time Doxorubicin ~ :
10 (hours? Sam~le (ug/ml) Mean ~ SD Control 0 1 8.4Q 8.55 + 0.24 0 2 8.74 2 3 6.54 5.59 + 1.34 0 4 4.65 4 5 4.3 3.85 + 0.64 0 6 3-g :~
8 7 0.98 0.86 + 0.16 0 . ; 0.75 16 9 0.26 0.24 + 0.04 0 0.21 The half-life of free doYorubicin is approximately 3 hours~ Clinically the PC injection of doxorubicin was well tolerated. No ~vidence of tosicity wa~ noted.
.~, _ . '' ;:'-rv~ Iniection of enca~sulated doxorubicin into : th~ PC. :
~0 1. 50 ~g/0.1 ml of encap~ulated-liposome : ~ doYorubicin wa~ injected into the ri~ht PC of 28 , ~
. ~ rabbits. Th~ left eye of the rabbit~ ~erved as controls.
i,,, ~ ,~
~-: '' 2. Empty lipsame~ (saline encapsulated and :- prepared in the ~ame proportions aq with doxorubicin ~ ~ ~ .
; ;,.
.~
incorporation) were injected into the vitreoui~ of 4 eyes in the following volume: 0.0125 ml, 0.025ml, 0.05ml and O.lOml. The animal were obs~rved, a~
controls, up to four months.
S
I Table 10 i Residual vitreous doxorubicin after injection of encapsulate doxorubicin in the PC of the ri~ht eye.
The left eye served as control.
Time Do~orubicin (daYs) Sam~le (uq/ml) Mean ~ SD Control 0 1 8.S6 7.09 + 1.41 0 2 7.5~
3 7.05 4 5.19 1 5 4.10 3.51 + 0.48 0 : ~ 3.55 7 2.94 8 3.45 2 9 1.92 1.82 ~ 0.43 0 ;.
1.62 11 1.38 12 2.38 3 13 1.98 2.13 + 0.27 0 ~: 14 2.25 1.85 16 2,45 .~ .
,~ 4 17 2 173 2.33 + 0.20 0 ,~ I9 1~69 -: :
~ 20 1.98 - ~
`. 30 8 21 0.98 1.72 + 0.8S 0 ~ :
22 1.30 : z3 2.94 24 1.65 . , 14 25 2.91 2~02 + 1.01 0 26 2.89 27 l.OS
28 1.25 .
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r The liposome-encapsulated do~orubicin was . observed in the vitreous (PC) as a localized, de~se opacity immiediately following injection. What appear~
I 5 as an inflammatory proceqs was seen during the irst 7-i~ 10 days. The margin of the vitreou~ opacity gradually ! blurred and the localized dense opacity began to Aj decrease and fade. Opacity of much of the vitreous ,A~ occurred in all cases and clouded the visualization of 1 10 the fundus up to 14 days of the experiment. This clouding of the vitreous did not correlate with the clearance of the doxorubicin which cleared wi~hin the first two days of the experiment. Residual levels of doxorubicin became constant and was maintained at a significant level for up to two weeks. Perhaps, the residual vitreous doxorubicin is bonded with liposomes resulting in minimal clearance from the vitreous.
- The vitreou~ opacity was seen in all the eyes receiving empty liposomes up to the entire four month~
! ~ 20 of observation. The opacity iq not drug related but was most likely due to interaction of the phospholipid~
of the liposomes and the vitreous gel. The vitreous induced cloudins by liposomes did not diminish after ; th~ first week and appear~ to be permanent, at least to ~` 25 the extent of our observations~
It is evident from the above reQults that microcapsules can find ~f~ective use internal to the ;~ ye chamber for treatment of a wide variety of conditions. The microcap~ules provide for continuous admlni-qtration of a drug over long periods of tLme, avoiding the nee~ of a paitient to administer drugs in much less effective ways, such as topically. In addition, treatments can be achieved by maintaining ~.
appropriately therapeutic level~ of drug~ in the eye, minimizing high concentrations throughout the host syste~ which may have deleterious effects. The drug iq retained in the appropriate site, since migration is '~
: :
, ~ 28 1 330421 not observed to other chamber3 or eyes. Equilibration level~ are rapidly achieved and ~aintained for long period~ of time. Furthermore, one or only a few drug administrations may be requ$red for treatments over e~tended periods of time, reducing the burden on the patient for self-administration, ensuring continued controlled medication, and minimizing the interference with the activities of the patient.
Both polymeric and lipid encapsulation protect lQ doses of pharmacological agents from being diluted or degraded in the general circulation. The agents can be entrapped in various concentration~ without any modifications. Encapsulation provides concentrated doses of medication which are more effective and les~
toxic than free drugs. Further, the drugs in liposomes can be protected from enzymatic attack or immune recognition because liposomes are biocompatible and nontoxic, being similar to cell membranes.
Although the foregoing invention has been de-acribe~ in some detail by way of illustration and eY-ample for purposes of clarity of understanding, it will be obvious that certain changes and difications may be practiced within the 3cope of the appended claim~.
:~ :
~ 35
~I9DEGRADaBLE OCULaR I~PLaNTS
Biocompatible microencapsulated implants are provided for treatment of ocular diseasesO
.
~he eye is fundamentally one of the most ~:
important organ.~ during life. Because of aging, di~- ~
: eases and other factors which can adversely affect ~ : vision, the ability to maintain the health of the eye~
becomes all important. The leading cause o~ blindness is the inability in the treatment of eye diseases to ~ introduce drugs or therapeutic agents into the eye.
I The exact mechani~m or reason is not known, but cer-: ~ainly the blood eye barrier (as analogous to the blood brain barrier) may be an important f~ctor. On the other hand, when a drug is injected into the eye, it quickly washe~ out or i8 depleted froQ within the eye . . into the gener~l circulation, Pro~ the therapeutic tandpoint, this may be as difficult as givi~g no drug . ~ :
at all. 8eeau~ of this inhere~t dificulty of deli-30 vering drugs into the eye, successful medical treatment ~ ~
of ocular diseases is totaily inadequate. ! -:: The need for a solutio~ i~ even more pressing ln that the cause of a nu~ber of ocular ~isea~s have now been identified a~d many are a~enable to treatment if a proper mode of therapeutic delivery is available.
It is therofore of great interest to develop modes of treatment which obviate the linitations o~ present ~ -,~
.~
modes of therapy.
There ha~ been a substantial ~esi~tance to introduce drug~ directly into one or both chambers of the eye. ~he many uncertainties a3sociated with the p 5 distribution of the drug, rate of release, binding to eye component~, concentration by cells, rapid los~
and/or inactivation, and the like, is discouraging for the efficacy of direct introduction.
10 Relevant Literature ~eller (1), Biodegradable Polymers in Con-trolled Drug Delivery, In: C~C Critical Review~ in , Therapeutic Drug Carrier Systemc, Vol. 1, CRC Press, j Boca Raton, FL, 1987, pp 39-90, describes encapsulation 15 for controlled drug delivery. See also, ~eller ~2), ~ In: ~ydrogels in Medicine and Pharmacy, N.A. Peppes ¦ ed., Vol. III, CRC Press, Boca Raton, FL, 1987, pp 137-149, describes bioerodible polymer~. ~eller, J. of Controlled Release (1985) 2:167-177; Leong et al., BioMaterials tl986) 7:364-371 describes polyanhydride microsphere~. Jackanicz et al., Contrace~tion (1973) 8:227; Yollea et al., In: Controlled Release of Biologically Active Agent~, Tanquary et al. ed~, Plenum Press, New York, NY, 1974, Chapter 3; Liu et al., OothamoloqY (1987) 94:1155-1159 and reference~ cited therein report a study for the intravitreal use of lipo~omes for therapeutic treatment of eye disease.
See al~o,-Cutright et al., Oral Surqerv, Oral Med~cinec and Oral PatholoaY (1974) 37:142 and Shindler et al., ;~ 30 Contemoorar~ Topic~ in PolYmer Science (1977) 2:251-289. Ander~on et al., Contrace~t~on (1976) 13:375 and ~iller et al., J. ~iomed~ Material~ Re~. (1977) 11:711, describe various properties of poly(dl-lactic acid).u.s.
; Patent~ af intere~t include 3,416,530; 3,626,940;
3,828,777; 3,870,791; 3,916,899; 3,944,064; 3,962,414;
4,001,388; 4,052,505; 4,05~,619; 4,164,559; 4,179,497;
~,186,184; 4,19~,642; 4,281,654; 4,303,637; 4,304,765:
~, ~:
~ ' .
., :~ :
~ ` 1 33042 1 4,304,767; 4,439,198; 4,452,776; 4,47~,751; 4,613,330;
and 4,617,186.
The following books describe the use of liposomes as drug carriers. Papahadjopoulous (197a) The Annals of the New York Academy of Science, Vol. 308, and Gregoriades and Allison (1980) Liposomes in siological Systems, John Wiley & Sons. Leserman et al., ~ature (1981) 293:226-228; Barbet et al., Supramol, Struct. Cell Bio. Chem. (1981) 16:243-258; Heath et al. Sci~nce (1980) 210:539-'41.
The preparation of liposomes is disclosed by ¦ Szoka and Papahadjopulos, Proc. Natl. Acad Sci U
(197~) 7~:145-149.
Biocompatible, particularly biodegradable, drug containing microencapsulated implants are introduced into the anterior and/or posterior chambers of the eye to provide a therapeutically effective amount of the drug for treatment of an ocular condition. The microcapsules may be polymers, particularly polyesters, ethers, or liposomes, where in each case a drug is surrounded by a barrier to immediate release upon introduction into a chamber of the eye~
~ .:
This invention provides a composition for treating an eye condition which comprises:
a pharmacologically active agent surrounded by an encapsulating agent which acts as a barrier to immediate release of the pharmacologically active agent, wherein the comp~osition is capable of introduction into a chamber of the eye and the encapsulating agent provides for an effective dosage of the pharmacologically active agent over an extended period of time.
, ~
~- This invention also provides a composition for treating an eye condition which comprises:
liposomes enclosing in their lumen an isotonic ;~ solution comprising a pharmacologically active agent, ~ ,,~
~ :`
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--` 1 3304 2 1 3a . wherein said composition i~ capable of introduction into a chamber of said eye and said agent is released in the eye at a rate to provide an effective dosage of said agent over an extended period of time.
Ocular condition~, diseases and disorders, are treated by introducing slow release drug-containing microcapsules directly into the anterior and/or posterior chambers of the eye. The microcapsules are formulated to include one or more drugs which may be released over an extended period of time at a therapeutically effective do~age into the vitreous humor. In this manner, drugs released from microcapsules placed into the anterior ::~
chamber will reach the cornea, aqueous humor, trabecular : 15 mesh work, iris, lens, and related structures in the ~anterior chamber. Micro- ;
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.
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capsules introduced into the posterior chamber are diffused throughout the vitreous in the chamber and into the entire retina (which con~i~ts of 10 different layers), into the choroid and the opposed Qclera.
S Thu~, the drug will be a~ailable at the ~itet~) where the drug i9 needed and will be maintained at an effec-t~ve dosage, rather than rapidly being washed out or as in the case of systemic ad~ini3tration, requiring greatly elevated levels of drug administration ~o the 10 host to achieve an effective level in the eye. Where ~ the drugs are encapsulated in liposome~, concentrated 3 doses of medication can be delivered into the eye for a ~ more ef~ective, less toxic treatment.
3 The primary element of the capsule will be the 15 polymeric or lipid encapsulating agent. The composi-tions will be biocompa~ible, preferably biodegradable.
~ For the most part, the polymeric compositions il will be organic esters or ethers, which when degraded result in physiologically acceptable degradation 20 products, including the monomers. Anhydrides, amides, orthoesters or the like, by themselves or in combina-tion with other monomers may al~o find use. ~he poly-mers may be addition or condensation polymers, particu-larly condensation polymer~. The polymer~ may be 25 cro~s-l~nked or non-cros~-linked, u~ually not more than lightly cross-linked, generally less tban 5%, usually le~s than 1%. For the most part, beside~ carbon and hydrogen, the 2olymers will include osygen and nitro-gen, partlcularly oxygen. The osygen may be present as 30 oYy, e.g. ~ydroxy or ether, carbonyl, e.g. non-oxo-carbonyl, such as carbo~ylic acid ester, and the like. The nitrogen may be pre~ent as amide, cyano and amino. The polymer~ set forth in ~eller ~1), supra, ~ay be used.
~ Of particular interest are polymer of ; hydroxyaliphatic carboxyllc acid~, either homo- o~
:
;~
copolymers, and polysaccharides. Included among the polyester3 of interest are polymers of D-lactic acid, L-lactic acid, racemic lactic acid, glycolic acid, polycaprolactone, and combinations thereof. By employing the L-lactate, a slowly eroding polymer is achieved, while erosion is ubstantially enhanced with the lactate racemate.
Among the polysaccharides will be calcium alginate, and functionalized celluloses, particularly carboxymethylcellulose esters characterized by being water insoluble, a molecular weight of about 5 kD to 500 kD, etc. Other polymers of intere~t include polyvinyl alcohol, esters and ethers, which are biocompatible and may be biodegradable. For the most part, characteristics of thP polymers will include biocompatibility, compatibility with the drug, ease of encapsulation, a half-life in the phy~iological environment of at least 6 hrs, preferably greater than one day, no significant enhancement of the viscosity of the vitreous, water insoluble, and the like.
For lipid encapsulating agents, the drug can be incorporated into the lumen of a vesicle which is relatively leakproof to the drug. The nature mf the liposome may be widely varied, various lipids being ;~ 25 employed for the formation of the liposcme. Proteins or other non-lipid compounds may be bound to the "b~ liposome membrane which may affect the nature of the liposome In the~ab~ence of proteinaceou~ compound~r acidic phospholipids will desirably be pre~ent in at lea~t minor amounts, while in the pre~ence of proteinaceous materials, the liposome will desirably be sub~tantially neutral.
Among lipids which may be employed ~or preparation of the liposomes are phosphatidyl ;~ 35 compound~, such a~ phosphatidyl choline IPC), phosphatidyl se~ine (PSI, and phosphatidyl ethanolamine ~:~ (PE); sphingolipids; cerebro~ides: ganglioside~
,~:
~ .
' ,~
~ 6 1 33042 1 steroids, e.g. cholesterol; etc. Desirably, the liposomes will have from about 10 to 50 mole per cent steroid, with the remainder primarily being aliphatic acids and esters of both organic and inorganic acids.
Small amounts of other types of lipid material may be present, generally less than about 10 mole percent, usually less than about 5 mole percent.
The biodegradable polymers which form the microencapsulated particles will desirably be ubject to enzymatic or hydrolytic instability. Water soluble polymers may be cross-linked with hydrolytic or biodegradable unstable cross-links to provide useful water insoluble polymers. The degree of stability can be varied widely, depending upon the choice of monomer, whether a homopolymer or copolymer is employed, employing mixtures of polymers, where the polymers may be employed as varying layers or miYed.
¦ 3y employing a biodegradable polymer, particu-larly one where the biodegradation is relatively slow, `5 20 the rate of release of the drug will be primarily diffusion controlled, depending upon the surrounding membrane or monolithic polymer structure, rather than breakdown of the particle~ ~or the mo~t part, the selected particles will have lifetime~ at least equal to the aesired period of admini~tratio~, preferably at least twice the desired period of ad~inistration, and may have lifetimes of 5 to 10 time~ the desired period of admini~tration. The ~eriod o~ ad~inistration will ~u~ually be at least 3 days, re u~ually at least 7 days, generally at least about 15 days and may be 20 days or more~ -The particles may be substantially homogeneou~
as to compo~ition and physical characterstics or heterogeneous. ~hus, particle~ can be prepared where the center may be of one material a~d the -~urface have ~ ;~ one or ~ore layers of the samR or different composi- -i~ ~; tion, where the layers may be cros3-linked, of differ-!.' .
~`
,~, ' `~' 1 3~0~21 ent molecular weight, different density or poro~ity, or the llke. For example, the center could be a polylaco tate coated with a polylactate-polyglycolate copolymer, 80 as to enhance the rate of initial degradation, MoRt ratio~ of lactate to glycolate employed will be ln the range of about 1:0-1. Alternatively, the center could I be polyvinyl alcohol coated with polylactate, so that on degradation of the polylactate the center would dis-solve and be rapidly washed out of the eye.
10Any pharmacologically active agent for which sustained release is desirable may be employed. Desir-ably, the drug will be sufficiently soluble in the vi~reous to be presented at a pharmacologically effec-tive dose. Pharmacologic agents which may find use may 15be found in ~.S. Patent Nos. 4,474,451, columns 4-6 and 4,327,725, columns 7-a.
..,~
Drugs of particular interest include hydro-cortisone (5-20mcg/1 as plasma level), gentamycin l6-lOmcg/ml in serum), 5-fluorouracil (-30mg/kg body weight in serum), sorbinil, IL-2, TNF, Phakan-a ~a component o~ glutathione~, thiola-thiopronin, Bendazac, acetylsalicylic acid, trifluorothym~dine, interferon (~, B and ~), immune modulators, e.g. lymphokines, monokine~, and growth factors, etc.
. Other drugs of interest include anti-qlaucoma : drug~, such as the beta-blockers: timolol maleate, betaYolol and metipranolol; mitotics: pilocarpine, acetylcholine chloride, isoflurophate, demacarium ::
bromide, echothiophate iodide, pho~pholine iodide, carbachol, and physostigimine: epinephrine and ~alts, ~uch a~ dipivefrin hydrochloride; and dichlorphenamide, acetazolamide and methazolamidei ~nti-cataract and anti-d~abetic retinopathy drugs, ~uch as aldo~e . 35 reductase inhibitor~: tolrestat, lisinopril, enala-pr~l, and st~atil; thiol cross-linking drugs other than those considered previously; anti-cancer drug~, such as : : :
` 8 1 3304~1 .. ..
retinoic acid, methotrexate, adriamycin, bleomycin, triamcinolone, mitomycin, cis-platinum, vincristine, vinblastine, actinomycin-D, ara-c, bisantrene, CCNU, activated cytoxan, DTIC, ~MM, melphalan, mithramycin, procarbazine, VM26, VP16, and tamoxifen; immune modulatorc, other than those indicated previously;
anti-~lotting agents, such as tissue plasminogen activator, urokinase, and streptokinase; anti-tissue damage agents, such as superoxide dismutase; proteins and nucleic acids, such as mono- and polyclonal antibodies, enyzmes, protein hormones and genes, gene ~ragments and plasmids; steroids, particularly anti-in~lamma~ory or anti-fibrous drugs, such as cortisone, hydrocortisone, prednisolone, prednisone, dexametha-! 15 sone, progesterone-like compounds, medrysone (~MS) and fluorometholone; non-steroidal anti-inflammatory drugs, such as ketrolac tromethamine, diclofenac sodium and supro~en, antibiotics, such as loridine (cephalori-dine), chloramphenicol, clindamycin, amikacin, tobra-~0 mycin, methicillin, lincomycin, oxycillin, penicillin, amphotericin B, polymyxin B, cephalosporin family, ampicillin, bacitracin, carbenicillin, cepholothin, :
:~ colistin, erythromycin, ctreptomycin, neomycin, :: sulfacetamide, vancomycin, silver nitrate, sulfisox-~-i 25 azole diolamine, and tetracycline, other anti-; pathogens~ including anti-viral agent~, 3uch as .~. : -idoxuridine, trifluorouridine, vidarabine (adenine ' ~ L~ ` arabillogide) t acyclovir (acycloguanosine~ y .~ pyrimethamine, trisulfapyrimidine-2, clindamycin, 30 nystatin, flucytosine~ natamycin, miconazole and piperazine derivatives,je.g. diethylcarbamazine: ~
. cycloplegic and mydriatic agents, ~uch a~ atropine, . cyclogel, scopolamine, homatropine and mydriacyl.
Other agents include anticholinergics, 35 anticoagulants, antifibrinolytic agent~, antihista-mines, antim-alarials, antitoxins, chelating agents, ~: hormone~, immunosuppressive~, thrombolytic agent~, -9 1 3304~
vitamins, salts, desensitizing agents, prostaglandins, amino acids, metabolites and antiallergenics.
The amount of drug employed in the capqule will vary widely depending on the effective dosage required and rate of release. ~sually the drug will be from about 1 to 80, more usually 20 to 40 weight percent of the microcapsule.
Other agents may be employed in the formula-tion for a variety of purposes. In addition to the drug agent, buffering agents and preservatives may be employed. The water soluble preservatives include sodium bisulfite, sodium thiosulfate, ascorbate, ben-zalkonium chloride, chlorobutanol, thimerosal, phenyl-mercuric borate, parabens, benzyl alcohol and phenyl-ethanol. These agents may be present in amounts offrom 0.001 to 5% by weight and preferably 0.01 to 2~.
Suitable water soluble buffering agents are alkali or alkaline earth, carbonates, phosphates, bicarbonates, citrates, borates, acetates, succinates and the like, ~uch as sodium phosphate, citrate, borate, acetate, bicarbonate and carbonate. These agent~ may be present in amounts sufficient to maintain a p~ of the system of between 2 to 9 and preferably 4 to 8. As such the buffering agent may be as much as 5% on a weight to weight ba~is of the total compo~ition.
The particles may be of a narrow or broad ; range in sizer normally not exceeding 300~M, ~o as to ; ~ b~ capable of being administered with a~ ?8 gauge needle. ~3ually, the particle range will not difer by greater than about 200% of the average particle si2e, more usually not greater than about 100%. The average particle size will usually be in the ran~e of 5 ~M to mM, more usually in the range of 10 ~M to 1 mM. In ~; some instances the particles will be ~elected to have an average diameter in the range o~ 1-2 ~M to provide l~ large depots, while in other instances the particle~
g~; ~ will have average diameters in the range of about ,~
,' c, -25-500 ~M, to provide smaller depots The size of the particle can be used to control the rate of release, period of treatment and drug concentration in the I eye. In some situations mixtures of particles may be ¦ S employed employing the same or different pharmaco-I logical agent. In this way in a ~ingle administration a ¦ course of drug treatment may be achieved, where the ¦ pattern of release may be greatly varied.
! Various techniques may be employed to produce ¦ 10 the encapsulated drugs. Useful techniques include sslvent-evaporation methods, phase separation methods, interfacial methods and the like.
In preparing the polymeric encapsulated drugs, for the most part solvent-evaporation methods will be employed. Towards this end, the preformed rate controlling polymer is dissolved in a volatile substantially water-immiscible solven~, such as chloroform, methylene chloride, or benzene. Sometimes, the water immi~cible solvent will be modified with a small amount of a water-miscible organic cosolvent, particularly an oxygenated solvent, ~uch as acetone, methanol, ethanol, etc. ~sually, the water-miscible organic cosolvent will be less than about 40 vol %, usually less than about 25 vol %. The drug may then be ~,~ 25 added to the polymer-solvent ~olution~ Depending upon the nature of the drug, one may havæ the drug dispersed ; ~ n the viscous ~olymer-solvent mixture or a solid ;dispersion of d~rug particle~, where the drug will have ; been pulverized to obtain a fine p~wder, usually a microfine powder particularly of a size of less than about l m~, usually less than about 0.5 mM, and may be about O~S ~M or smaller.
The amount of polymer employed in the medium ~ will vary with the size of the particle de~ired, b~ 35 whether additional coatings will be added, the viscosity of the ~olution, the ~olubility of the ~ polymer and the like. ~sually, the concentration of `~
,~
~:
.
`` 11 1 330421 polymer will be in the range of 10 to 80 weight percent. ~he ratio of drug to polymer will vary with the desired rate of relea~e~ the amount of dru~
generally varying in the range of 1 to 80 weight S percent of the polymer.
The dispersion or solution obtained above is added to a rapidly stirred aqueous solution comprising water and a dispersing agent, which may be a protective colloid. Of particular interest as macromolecular dispersin~ agents are agents such a~ poly(vinyl alcohol) (1-5~) or non-ionic detergent~, such as Span detergents.
The volume of the organic phase will be smaller than the aqueous phase, generally being in a volume ratio of from about 1:1 to 103 of organic to aqueous phase, and an oil-in-water emulsion is produced. The rate of stirring is selected to produce the appropriate droplet size and stirring is continued throughout the next step.
In the third step, the microencapsulation vessel is closed and a mild vacuum is applied to the - system to evaporate the volatile organic Rolvent. The solvent should be evapo~ated slowly, since too rapid evaporation results in bubbles and blow holes formed in t~e microcapsule walls, The rate o evaporation may be determined empirically, usinq the eYperience reported ;~ in the literature. ~sually the vacuu~ will be in the -; range o about 3 to 10 m~ ~g. After evaporatio~ ha~ - ~ c~
been completed, the resulting microcapsules are centrifuged, washed completely with water, collected, e.g., filtration~ and drained. ~sually, the micro~
capsules will then be subdivided with 3ieves to isolate particles of a size range o the de~ired diameter~
'r;';~ The process may be carried out conveniently at room temperature, but cooling or heating may be ~! ~ employed in-specific situations to optimize the . ~ proces~. The ratio of drug to polymer is adjusted to ~ .;
~ 12 1 33042 1 produce optimized compositions, since the final product will normally result in the initial ratio. By manipu-lating the initial bulk viscosity of the drug-polymer-solvent mixture and of the aqueous dispersing medium, along with the stir rate, production of microcapsules with the desired size may be optimized. Moreover, the composition of dissolved organic solvent and the rate of solvent evaporation can be tested to produce mioro-capsules with larger or smaller crystals of drug in the microcapsules. For polymers which are hydrolytically sensitive, the microcapsules should not be exposed to the aqueous dispersing medium for excessively long periods during the solvent-evaporation step.
The particle size distribution of each batch of microcapsules will be relatively narrow. ~owever, when desired, the size-fractions may be further refined by a physical separation process such as dry or wet sieving.
In order to define the potential drug-release behavior of the micro~apsules in vivo, a weighed sample of microcapsules may be added to a measured volume of a solution containing four parts by weight of ethanol and six parts by weight of deionized water. The mixture is maintained at 37C and stirred slowly to maintain the ~: 25 microcapsules suspended. The appearance of the dis-sol~ed drug a~ a function of time may be followed spectrophotometrically until the absorbance becomes ;~Constant or until greater than 90% of the drug ha~ been ~-relea~ed~ The drug concent~ation after 1 h in the medium is indicative of the amount of free unencap-sulated drug in the dose, while the time required for 90% drug to be released i~ related to the expected duration of action of the dose in vivo. As a general rule, one day of drug release in vitro is approYimately ;~ 35 equaI to 35 days of release in vivo. While release ~ay ~not be uniform, normally the relea~e will be free of : .
, .
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` 13 1 330421 ,.
larger fluctuations from some average value which allows for a relatively uniform release.
When employing a liposome encapsulated drug the encapsulating lipid bilayer membrane may be prepared in a variety of ways. In general, the literature provides a variety of methods for liposome formation and for linking compounds to a lipid group any of which may be utilized. For the preparation of liposomes, see, in particular, Szoka and Papahadjopulos, Proc. Natl. Acad. Sci. ~SA ~1978) 75:
145-149.
The liposome solution will normally be isotonic with the physiological fluid in which it is to act. The p~ of the solution will generally be greater than about 6 and not greater than about 9, more usually from about 6 to 8, preferably from about 6.5 to 7.5.
Variou~ buffers may be u~ed which are phy~iologically acceptable, particularly phosphate, carbonate and acetate.
The concentration of the drug will vary, depending upon its physiologically effective concen-tration, the ability to maintain the concentration in the lumen of the liposome, the effect of the compound on th~ stability and impermeability of the liposome, as well a~ the size and number of liposomes. The drug ;~ concentration may range from about O.O}m~ to about IOOmM. The concentration of buffer will generally be f ~ fro~ about 20 to about lOOmMr while the concentration of salt per milliliter of ~olution will generally range ~0 ~rom about 0.25 to 0.90 percent.
The microcapsules may be administ~red into the ey~ in a variety of ways, including injection, infu- -- ~ sion, trocar, etc. Various techniques ~or introducing materials into the anterior and/or posterior chambers are well known, ~ee, for example, Liu et al., 1987, su~ra, and references cited therein.
The following examples are offered by way of '~
.
:,~
:~
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~ 14 1 330421 illustration and not by way of limitation.
EXPERIMENTA~
S PolYmeric EncaPsulated Druqs The appropriate weight of polymer is 301ubilized with a water immi~cible organic volatile solvent, e.g. benzene, methylene chloride or chloro-form. The proper amount of drug is added to the polymeric mixture to form a slurry which is mixed to substantial homogeneity. The slurry i~ then added dropwise to a vessel containins rapidly ~tirred deionized distilled water in a volume ratio of 1:0.5-1 x 103 (organic slurry:water). The water is 2-5 wt %
polyvinyl alcohol. The vessel is sealed and a mild vacuum applied slowly to prevent bubbles and blow holes in the microcapsules over a period of about 8-10 hr~.
After evaporation of the solvent, the microcapsules are centrifuged, washed repeatedly with ~terile distilled water, filtered a~d drained. The microcapsule4 are sized with sieves, dried in vacuo and may then be used ~-;
directly by trocar injection for introduction into the vitreous humor of the eye. Por sulfadiazine, the drug ;~ wa~ 10 wt %, for hydrocortisone 40 wt %, and for methotrexate 25 wt ~ of the polymer weight. The drugs were used as microfine powers, s 20 ~M. The trocar injection was with a 20-gauge needle, the particle3 belng o~ an average size of about 0~2 m~
The monomer D~-lactic acid wa~ recry~tallized twice from acetone and twice from methyl ethyl ketone.i The lactic,acid was added to a polymeriza~ion tube, air and residual solvent removed in vacuo and the tube heated until the lactic acid melted. Catalyst (tetraphenyl tin, 0.02 wt %) was added and the tube 35 3ealed in vacuo and heated at 170-175C for seven hour~. After cooling, the tube was opened and the ;;~ ~ polymeric product di solved in acetone, pre~ipita~ed ;~
with water at room temperature and then dried in vacuo. The polymer should not be expo~ed to water ~or long periods of time, particularly during the ~olvent-, evaporation step during microcap~ule formation.
The following table~ indicate the results:
Table 1 Drug Time RE LE
# uq/ml Analv~is wks moc AC PC AC PC
1* sulfa- fluores- 0 0.0 -- 0 --diazine cence 1 2.0 -- 0 --2 . 1.5 -- 0 --3 1.3 -- 0 --4 1.5 -- 0 --1.6 -- 0 --6 1~8 -- 0 --7 1.4 -- 0 --: 8 1.5 ~ 0 --'~ 9 1.5 --- O ,~, 10 1~4 - 0 ~: 11 1.6 -- 0 IZ 1.3 -- 0 ..
Animal - Rabbit ..
* ~ Microcapn~le~ i~ hC tanterior chamb¢r) icrocap~ules ~n PC tEosterior cha~ber) ,.'~ r . ,~ ... , .
The sul~adiazLne containing polylactic microcap~ules placed in the anterior chamber of the . `~ ri~ht eye released the drug for 12 months~ There was ,~ no detection of any arug in the control left eye.
. ~ -. ~
~' ~-~ 16 1 330421 . ~
Table 2 Drug ~ime RE LE
# uq/ml Analy~is wks mos AC PC AC PC
2* ~ulfa- fluoreq- 0 0.0 -- 0 --diazine cence 1 0 -- 0.0 --2 0 -- 2.5 --3 0 -- 2.6 --4 0 -- 2.4 --0 -- 2.9 --6 0 -- 3.0 ~
7 0 -- 2.8 --8 0 -- 2.6 --9 0 -- 2.6 --0 -- 2.7 --~: 11 0 -- 2.4 -~
12 0 -- 2.3 -# = Animal = Rabbit * = Microcapsules in AC (anterior chamber) + - ~icrocap~ules in PC (posterior chamber) ~.
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The experiment of ~able 1 was repeated, employing a higher dose level.
--Table 3 Drug Time RE LE
# ua/ml ~ y~ wks mos AC PC AC PC
10 3* sulfa- fluores- O 0.0 diazine cence 2 3.1 4 2.9 -- __ __ 6 3.2 -- ~
8 3.0 0.0 -- ~~
# ~ Animal = Rabbit * = Microcapsules in AC (anterior chamber) + 5 Microcapsules in PC (posterior chamber) , . - .
A shorter time period was used to monitor the :~ cour~e o~ the release. The data demonstrate that the ~ drug level had equilibrated within 2 weeks (the 2 week :~ level wa~ the same a~ the 8 week levsl). At a week~ -; ~ 25 when the anim~l was ~acrificed, the level in the :
~ ~o~terior cha~ber wa~ found to be 0, The data demon- :
;~ trate that m~dication placed in ~he anterior chamber -~ d~d not ~ig~ate into the posterior cha~ber~
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1 3304~1 Table 4 Drug Time RE L~
# ug/ml AnalY~is wks mos AC PC AC PC
4* ~ulfa- fluores- 0 0.0 diazine cence 2 4.2 4 4.3 0 ~;
# = Animal = Rabbit * = Microcap~ule~ in AC (anterior chamber) I = Microcapsules in PC (posterior chamber~
This experiment repeats the experiment above, ~ but employs a higher do~age level.
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'.3 ~ ' 19 1 33042 1 . _ _ Table 5 Drug Time RE LE
# ug/ml AnalYsis wks mo3 AC _ PC AC PC
l+ hydrocortisone 2LC 1 <.02 1.5 0 0 ~uccinate 2+ hyd~ocortisone ~PLC 2 <.02 2.0 o 0 10 succinate 3+ hydroco~tisone ~PLC 3 <.02 2.3 O O
succinate 4+ hydrocortisone EPLC 4 ~.02 1.0 0 0 succinate 5+ hydrocortisone EPLC 5 <.02 1.5 0 0 succinate 6+ hydrocortisone HPLC 6 <.02 1.25 0 0 ~ succinate .,~ 7+ hydrocortiaone 3PLC 7 <.02 4.1 0 0 succinate 8+ hydrocortisone 3P~C 8 <.02 Z.5 0 0 :~ succinate ,~ 9+ hydrocortisone EPLC 9 ~.02 1.5 0 0 ~ ~uccinate ;;: 25~0+ hydrocortisone EP~C 10 ~.02 2_4 0 0 uccinate ~ "' ~ ` Animal - Rabbit -~ -r crocapsules in ~C ~anterior chamber) ;~ ~icrocap~ules in PC tposterior chamber) ~ 0 ~ "
~,i"- ~: Ten different animals ~er~ employed with ~ydrocortisone succinate as a drug incorparated into ..;: ~ 35 polylactic acid~ ~he same amount of drug/polymer was .3:, ~ ~ placed into th- right eye~ of each of the animals~ One a~imal was sacrficed at the end of each of the month~ - :
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indicated to generate the data. The results demonstrate the following: 1) drug placed in the posterior chamber of the eye did nGt migrate into the anterior chamber in detectable amounts; 2) drug was still being released at 10 months at roughly the equilibration level; 3) the left ayes which were not medicated showed no drug.
_ __ Table 6 ~ :
Drug Time RE LE
# ua/ml Analysis wks mos AC PC AC PC
1~ MTX EMIT 1 -- -- <.01 1.0 2+ MTX EWIT 2 -- -- <.01 0.9 3+ MTX EMIT 3 -- -- <.01 1.1 4+ MTX EMIT 4 -- -- <.01 1.0 S+ MTX EMIT 5 -- -- <.01 1.2 ~: 20 6+ MTX EMIT 6 -- -- <~01 0~8 7+ MTX EMIT 7 -- -- <,01 0.7 # - Animal ~ Rabbit ~ * = Microcapsules in AC (anterior chamber) .: ~ - Microcapsule~ in PC (posterior chamber) .
. 25 . . ~
ethotrexate wa~ incorporated into polylactic acid and th~ microcapsules placed in the po~terior chamb~r of the left eye.. Drug did not appear to .migrate to the anterior chamber. Drug was ~till being , released at 7 months.
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Lipid EncaPsulated D~u~s PreParation of li~osomes:
Doxorubicin wa incorporated into liRosomes by S using 39.35 ~M of the drug in methanol with 19.65 ~Mi cardiolipin. The mixture was dried through evaporation under nitrogen. ~dded to the dried mixture were 100 ~M
phosphatidyl choline, 68.4 ~M cholesterol, and 38.9 ~M
steraylamine. The latter was mixed and dried under nitrogen. The mixture was hydrated with 10 ml 0.01 M
phosphate buffer with 0.85% NaCl, pH 7.4,. After a swelling time of 30 minutes the liposome3 ~ere stirred for 15 mintues, followed by sonication under nitrogen in a fixed-tem~erature bath at 37C for 90 minutes.
The untrapped doxorubicin was separated from liposomal-encapsulated drug by extensive dialysis against 0.01 M
phosphate buffer with 0.85% NaCl, pH 7.4, at 4C over 24 hours with several changes of buffer solution. The entrapment o~ doxorubicin in cardiolipin liposomes was determined by fluorescence. The ~ize of the liposomes used ranged from 900 to 1100 angstrom units.
: :
I. Injection of doxorubicin into the anterior chamber (AC):
1. 50 ~9/0.1 ml doxorubicin was injected into the AC of 10 New Zealand white rabbits. The AC was ; tapped for doxorubicin a~say.
, 2. 50 ~g/0.10 ml doYorubicin was injected ~nto the right and left AC in each of two rabbits. The contralateral eye was given 0.10 ml of nornal saline.
The two animals were observed for two week~ for ocular toxicity.
The results are given in Table 7.
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~ ~ 22 1 33042 1 ~:3 _ _ _ Table 7 Residual aqeous humor dosorubicin after AC injection of 3 50 ug of the unencapsulated drug into the right eye.
5 The left eye served as control.
Time Doxorubicin (hours) Sample ~uq/ml) Mean ~ SD Control 0 1 23.5 22.5 ' 1.41 0 2 21.5 2 3 0.125 ~.135 + 0.01 0 4 0.1~5 4 5 0.075 0.0925 ~ 0.02 0 6 0.11 8 7 0.025 0.030 + 0.01 0 8 0.035 ~ 16 9 <0.005 <0.005 0 `~ 10 <0.005 ~ 20 ~he mean half-life of doxorubicin in the AC is - approYimately 1 hour. Unencapsulated doxorubicin causes ocular inflammation and corneal edema within 2-3 days after AC injection. The control aaline in~ected eyes were found to be normal on gross examination and ~lit-lamp biomicroscopy.
.'~
~ 25 1, .",, ii ~ - - II. Iniection of lipo ome-encapsulated - dosorubici~ into AC.
1. 50 ~g/O.10 ml of lipo~ome-encapsulated doxorubicin was ~njected into the AC of one eye of 28 rabbit~ The contralateral uninjected eye served as x~ control, 2. 50 ~g of doxorubicin in liposome waa '~ injected into one eye of each of two rabbits and observed for 3 week~ The contralateral eye received 0~10 ml normal saline.
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~ 23 1 330~2i Table 8 gives the results of these experiments.
_ ___ .
Table 8 Re~idual aqueous humor doxorubicin after AC injection o 50 ug of the encapsulated drug into the left eye.
The right eye served as control.
Time Doxorubicin 10 tdays) SamPle luq/ml) Mean + SD Control 0 140.14 39.40 + 2.78 0 242.35 335.67 439.46 1 58.10 5.90 + 2.14 0 64.35 77.35 83.79 2 92.25 2.40 ~ 0.56 0 _ .
:~ 102.90 111.67 122.77 3 131.53 1.22 + 0.22 0 141.15 150.87 ,~,,~,;, ~ ,. r ~ . ,, 16 1.32 - ' 4 17 0.96 0~77 + 0.18 0 ~:.
~: 30 180.67 lg,0.57 200.8~
8 210.19 0.19 ~ 0.06 0 ~; 220.12 230.26 ~ ~40.19 '`~:
. - -..
` - 1 330421 , 24 i Table 8 continued Time Doxorubicin ! ( days) Sample (u~/ml) Mean + SD Control 16 25 <00.005 <0.0~5 0 26 <0.005 27 0.01 28 <0.005 Detectable encapsulated doxorubicin could be found up to 2 weeks in the anterior chamber (AC). Significant amounts were present up to 8 days post AC injection.
Clinically the eye tolerated the encapsulated form very well with little to no signs of inflammation and no corneal edema.
-:
In one of the two animals injected for clinical observation, small amounts of lipsomes could be seen in the interior anterior chamber. The eye wa~
clinically quiet.
III~ Injection of doxorubicin into the osterior chamber (PC):
1. 50 ~g/0.1 ml doxorubicin was injected into the posterior chamber (PC) of each of 10 rabbits~ The contralatera1 eye served as control.
. ~"
;~ ~ 2. S0 ~g/0.1~ ml of doYorubioin was injec~ed into one ey~ of two animals for clinical ob~ervation for one week. Saline control was injected into the cont~alateral aye.
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, 25 1 330421 ¦ The results of doxorubicin injection into the ~ PC are shown in Table 9.
, Table 9 Residual vitreou3 doxorubicin after injection of 50~g -of the drug into the PC of the right eye. The left eye served as control.
Time Doxorubicin ~ :
10 (hours? Sam~le (ug/ml) Mean ~ SD Control 0 1 8.4Q 8.55 + 0.24 0 2 8.74 2 3 6.54 5.59 + 1.34 0 4 4.65 4 5 4.3 3.85 + 0.64 0 6 3-g :~
8 7 0.98 0.86 + 0.16 0 . ; 0.75 16 9 0.26 0.24 + 0.04 0 0.21 The half-life of free doYorubicin is approximately 3 hours~ Clinically the PC injection of doxorubicin was well tolerated. No ~vidence of tosicity wa~ noted.
.~, _ . '' ;:'-rv~ Iniection of enca~sulated doxorubicin into : th~ PC. :
~0 1. 50 ~g/0.1 ml of encap~ulated-liposome : ~ doYorubicin wa~ injected into the ri~ht PC of 28 , ~
. ~ rabbits. Th~ left eye of the rabbit~ ~erved as controls.
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~-: '' 2. Empty lipsame~ (saline encapsulated and :- prepared in the ~ame proportions aq with doxorubicin ~ ~ ~ .
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incorporation) were injected into the vitreoui~ of 4 eyes in the following volume: 0.0125 ml, 0.025ml, 0.05ml and O.lOml. The animal were obs~rved, a~
controls, up to four months.
S
I Table 10 i Residual vitreous doxorubicin after injection of encapsulate doxorubicin in the PC of the ri~ht eye.
The left eye served as control.
Time Do~orubicin (daYs) Sam~le (uq/ml) Mean ~ SD Control 0 1 8.S6 7.09 + 1.41 0 2 7.5~
3 7.05 4 5.19 1 5 4.10 3.51 + 0.48 0 : ~ 3.55 7 2.94 8 3.45 2 9 1.92 1.82 ~ 0.43 0 ;.
1.62 11 1.38 12 2.38 3 13 1.98 2.13 + 0.27 0 ~: 14 2.25 1.85 16 2,45 .~ .
,~ 4 17 2 173 2.33 + 0.20 0 ,~ I9 1~69 -: :
~ 20 1.98 - ~
`. 30 8 21 0.98 1.72 + 0.8S 0 ~ :
22 1.30 : z3 2.94 24 1.65 . , 14 25 2.91 2~02 + 1.01 0 26 2.89 27 l.OS
28 1.25 .
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r The liposome-encapsulated do~orubicin was . observed in the vitreous (PC) as a localized, de~se opacity immiediately following injection. What appear~
I 5 as an inflammatory proceqs was seen during the irst 7-i~ 10 days. The margin of the vitreou~ opacity gradually ! blurred and the localized dense opacity began to Aj decrease and fade. Opacity of much of the vitreous ,A~ occurred in all cases and clouded the visualization of 1 10 the fundus up to 14 days of the experiment. This clouding of the vitreous did not correlate with the clearance of the doxorubicin which cleared wi~hin the first two days of the experiment. Residual levels of doxorubicin became constant and was maintained at a significant level for up to two weeks. Perhaps, the residual vitreous doxorubicin is bonded with liposomes resulting in minimal clearance from the vitreous.
- The vitreou~ opacity was seen in all the eyes receiving empty liposomes up to the entire four month~
! ~ 20 of observation. The opacity iq not drug related but was most likely due to interaction of the phospholipid~
of the liposomes and the vitreous gel. The vitreous induced cloudins by liposomes did not diminish after ; th~ first week and appear~ to be permanent, at least to ~` 25 the extent of our observations~
It is evident from the above reQults that microcapsules can find ~f~ective use internal to the ;~ ye chamber for treatment of a wide variety of conditions. The microcap~ules provide for continuous admlni-qtration of a drug over long periods of tLme, avoiding the nee~ of a paitient to administer drugs in much less effective ways, such as topically. In addition, treatments can be achieved by maintaining ~.
appropriately therapeutic level~ of drug~ in the eye, minimizing high concentrations throughout the host syste~ which may have deleterious effects. The drug iq retained in the appropriate site, since migration is '~
: :
, ~ 28 1 330421 not observed to other chamber3 or eyes. Equilibration level~ are rapidly achieved and ~aintained for long period~ of time. Furthermore, one or only a few drug administrations may be requ$red for treatments over e~tended periods of time, reducing the burden on the patient for self-administration, ensuring continued controlled medication, and minimizing the interference with the activities of the patient.
Both polymeric and lipid encapsulation protect lQ doses of pharmacological agents from being diluted or degraded in the general circulation. The agents can be entrapped in various concentration~ without any modifications. Encapsulation provides concentrated doses of medication which are more effective and les~
toxic than free drugs. Further, the drugs in liposomes can be protected from enzymatic attack or immune recognition because liposomes are biocompatible and nontoxic, being similar to cell membranes.
Although the foregoing invention has been de-acribe~ in some detail by way of illustration and eY-ample for purposes of clarity of understanding, it will be obvious that certain changes and difications may be practiced within the 3cope of the appended claim~.
:~ :
~ 35
Claims (10)
1. A composition for treating an eye condition which comprises:
a pharmacologically active agent encapsulated by an encapsulating agent, wherein said composition is capable of introduction into a chamber of said eye and said encapsulating agent provides for an effective dosage of said pharmacologically active agent over an extended period of time.
a pharmacologically active agent encapsulated by an encapsulating agent, wherein said composition is capable of introduction into a chamber of said eye and said encapsulating agent provides for an effective dosage of said pharmacologically active agent over an extended period of time.
2. A composition according to claim 1, wherein said encapsulating agent is selected from pharmacologically acceptable biodegradable polymers and liposomes.
3. A composition for treating an eye condition which comprises:
microencapsulated drug particles of not greater than about 300 micrometers, said particles comprising said drug and a pharmacologically acceptable biodegradable polymer wherein said composition is capable of introduction into a chamber of said eye and is degradable at a rate to provide an effective dosage of said drug over an extended period of time.
microencapsulated drug particles of not greater than about 300 micrometers, said particles comprising said drug and a pharmacologically acceptable biodegradable polymer wherein said composition is capable of introduction into a chamber of said eye and is degradable at a rate to provide an effective dosage of said drug over an extended period of time.
4. A composition according to claims 2 or 3, wherein said polymer is a condensation polymer.
5. A composition according to claim 3, wherein said particle comprises a pharmacologically acceptable buffering agent.
6. A composition according to claim 3, wherein said drug is at least one of a cytotoxic agent or a growth factor.
7. A composition according to claim 3, wherein said composition contains an effective dosage for treatment of said eye condition wherein said dosage is sufficient to be maintained in said chamber for at least one month.
8. A composition according to Claim 7, wherein said particle is of an average size in the range of 10 to 250 micrometers.
9. A composition for treating an eye condition which comprises:
liposomes enclosing in their lumen an isotonic solution comprising a pharmacologically active agent, wherein said composition is capable of introduction into a chamber of said eye and said agent is released in the eye at a rate to provide an effective dosage of said agent over an extended period of time.
liposomes enclosing in their lumen an isotonic solution comprising a pharmacologically active agent, wherein said composition is capable of introduction into a chamber of said eye and said agent is released in the eye at a rate to provide an effective dosage of said agent over an extended period of time.
10. A composition according to Claim 9, wherein said liposome as from about 10 to 50 mole percent cholesterol in the lipid bilayer.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US136,402 | 1987-12-22 | ||
| US07/136,402 US4853224A (en) | 1987-12-22 | 1987-12-22 | Biodegradable ocular implants |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1330421C true CA1330421C (en) | 1994-06-28 |
Family
ID=22472699
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000586706A Expired - Lifetime CA1330421C (en) | 1987-12-22 | 1988-12-21 | Biodegradable ocular implants |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US4853224A (en) |
| EP (1) | EP0322319B1 (en) |
| JP (3) | JPH0822814B2 (en) |
| AT (1) | ATE79252T1 (en) |
| CA (1) | CA1330421C (en) |
| DE (1) | DE3873712T2 (en) |
| ES (1) | ES2051882T3 (en) |
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| BE788575A (en) * | 1971-09-09 | 1973-01-02 | Alza Corp | OCULAR DEVICE FOR THE ADMINISTRATION OF A |
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| CA1311686C (en) * | 1986-06-25 | 1992-12-22 | John Weldon Shell | Controlled release bioerodible drug delivery system |
-
1987
- 1987-12-22 US US07/136,402 patent/US4853224A/en not_active Expired - Lifetime
-
1988
- 1988-12-21 CA CA000586706A patent/CA1330421C/en not_active Expired - Lifetime
- 1988-12-22 ES ES88403285T patent/ES2051882T3/en not_active Expired - Lifetime
- 1988-12-22 JP JP63322223A patent/JPH0822814B2/en not_active Expired - Lifetime
- 1988-12-22 AT AT88403285T patent/ATE79252T1/en not_active IP Right Cessation
- 1988-12-22 DE DE8888403285T patent/DE3873712T2/en not_active Expired - Lifetime
- 1988-12-22 EP EP88403285A patent/EP0322319B1/en not_active Expired
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1997
- 1997-08-25 JP JP9228591A patent/JP2975332B2/en not_active Expired - Fee Related
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1998
- 1998-10-07 JP JP10285091A patent/JPH11189527A/en active Pending
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| JP2975332B2 (en) | 1999-11-10 |
| DE3873712T2 (en) | 1993-02-11 |
| EP0322319A2 (en) | 1989-06-28 |
| JPH1067650A (en) | 1998-03-10 |
| EP0322319A3 (en) | 1989-08-02 |
| DE3873712D1 (en) | 1992-09-17 |
| JPH0822814B2 (en) | 1996-03-06 |
| US4853224A (en) | 1989-08-01 |
| ATE79252T1 (en) | 1992-08-15 |
| JPH11189527A (en) | 1999-07-13 |
| ES2051882T3 (en) | 1994-07-01 |
| EP0322319B1 (en) | 1992-08-12 |
| JPH02702A (en) | 1990-01-05 |
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