CN105106200A

CN105106200A - Compositions, methods and systems for respiratory delivery of two or more active agents

Info

Publication number: CN105106200A
Application number: CN201510242737.9A
Authority: CN
Inventors: R·维宁; M·S·哈特曼; D·莱丘加-巴列斯特罗; A·E·史密斯; V·B·乔希; S·K·德威维迪
Original assignee: Pearl Therapeutics Inc
Current assignee: Pearl Therapeutics Inc
Priority date: 2011-05-17
Filing date: 2011-05-17
Publication date: 2015-12-02

Abstract

Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, wherein the active agent particles and suspending particles form a co-suspension within the suspension medium.

Description

For breathing compositions, the method and system of sending two or more activating agents

Technical field

The present invention relates generally to compositions, the method and system of being sent two or more activating agents by respiratory tract.In certain embodiments, the present invention relates to compositions, the method and system of sending two kinds or many activating agents through respiratory tract, wherein at least one activating agent is selected from long-acting muscarine antagonist (" LAMA "), long-acting beta ₂3 adrenergic receptor agonists (" LABA ") and corticosteroid active agent.

Background technology

Often yearning at the targeting drug administration method of action site active agent delivery.Such as, the target administration of activating agent can reduce undesirable side effect, reduces volume requirements and treatment cost.In the situation of respiratory administration, inhaler is a kind of device to patients with respiratory tract active agent delivery known, and the present business of existing multiple different inhaler system can be purchased.Three kinds of common inhalers comprise Diskus, aerosol apparatus and metered-dose inhaler (MDI).

MDI can be used for the medicine sending dissolving or suspended form.Typically, upon being activated, MDI uses the propellant with relatively high-vapor-pressure that the aerosol droplets containing activating agent is pushed to respiratory tract.The getter action of the usual dependent patient of Diskus thus the medicine of dry powder form is sucked respiratory tract.On the other hand, aerosol apparatus forms aerosol drug for sucking by the energy acting on liquid solution or suspension.

MDI is the active delivery apparatus utilizing propellant to produce pressure.Traditionally, Chlorofluorocarbons (CFC) because of its hypotoxicity, there is required vapour pressure and suitable form stable suspension and be used as the propellant of MDI system.But traditional C FC propellant is considered to produce negative environmental effect, thus create the development that it is believed that more eco-friendly alternative propellant such as perfluorochemical (PFC) and hydrofluoroalkane (HFA).

Carry out by MDI the activating agent sent usually to be provided by the particulate form be scattered in a kind of propellant or two kinds and above propellant (that is, propellant " system ").In order to form microgranule, usually activating agent is carried out micronize.The surfactant particle be suspended in propellant or Propellant System tends to rapid aggregation or flocculation.This phenomenon of activating agent for particulate form is especially real.Gathering or the flocculation of these microgranules may cause sending of activating agent complicated then.Such as, assemble or flocculate and can cause mechanical breakdown, such as may block by the valve port of aerosol container the fault caused.The gathering of disgusting drug particles or flocculation also can cause the fast deposition of drug particles or solidifying thick, and these behaviors may cause the inconsistent of dose delivery, and it especially bothers for efficient low-dose drugs.Plant the crystal growth during another problem that suspension MDI preparation is correlated with is medicine storage therewith, this can cause the uniformity of aerosol performance and this MDI dosage delivered to decline along with the time.Recently, the solution for the MDI preparation containing anticholinergic is proposed, such as the U.S. patent No. 6,964, method disclosed in 759.

The method improving aerosol performance in Diskus introduces a subparticle carrier exactly, such as lactose.MDI was not also carried out any on a large scale for the research using this fine excipient.In nearest report, " Theinfluenceofmicronizedparticulatesontheaerosolizationp ropertiesofpressurizedmetereddoseinhalers " that Young etc. deliver; AerosolScience40, pgs.324-337 (2009) find in MDI, use this kind of subparticle carrier in fact can cause the reduction of aerosol performance.

In traditional C FC system, when the activating agent in MDI preparation is dissolved in propellant or Propellant System, surfactant is usually used to cover the surface of activating agent to reduce or prevent the appearance of rendezvous problem and maintain the substantially even of dispersion liquid.Surfactant carries out using sometimes referred to as " stablizing " suspension in like fashion.But the many CFC of being dissolved in systems also effective surfactant are invalid in HFA and PFC Propellant System, because these surfactants present different dissolubility properties in non-CFC propellant.

accompanying drawing is sketched

The figure of Fig. 1 shows the dosage delivered uniformity containing the common suspension of Glycopyrrolate and formoterol fumarate prepared by the present invention.

The figure of Fig. 2 shows the dosage delivered ratio of the common suspension formulation in Fig. 1.

The figure of Fig. 3 shows the dosage delivered uniformity containing the second common suspension preparation of formoterol fumarate and Glycopyrrolate prepared by the present invention.

The figure of Fig. 4 shows the dosage delivered ratio that second in Fig. 3 is total to suspension preparation.

When the figure of Fig. 5 shows and stores under specified different condition, the Glycopyrrolate in the common suspension preparation prepared by the present invention and the dosage delivered uniformity of formoterol fumarate.

When the figure of Fig. 6 shows and stores under specified different condition, the particle size distribution in the exemplary suspension preparation altogether prepared by the present invention.

When the figure of Fig. 7 shows and stores under specified condition, containing the exemplary particle size distribution being total to suspension and realizing that Glycopyrrolate and formoterol fumarate combine.

The contrast situation of the particle size distribution that the figure of Fig. 8 shows the exemplary suspension altogether containing Glycopyrrolate and formoterol fumarate and the particle size distribution of the preparation only containing Glycopyrrolate or formoterol fumarate.

The figure of Fig. 9 shows and gives the situation of change of the concentration level containing Glycopyrrolate and formoterol fumarate in serum after the exemplary suspension altogether of Glycopyrrolate and formoterol fumarate prepared by the present invention along with the time.The serum-concentration that Fig. 9 also show Glycopyrrolate that exemplary combination preparation realizes and formoterol fumarate is along with the situation of change of time is with the comparing result of the situation of change of the compositions only containing Glycopyrrolate or formoterol fumarate.

The figure binary shown prepared by the present invention of Figure 10 is total to the contrast situation of particle size distribution with the common suspension only containing lenticular formoterol fumarate for the formoterol that suspension realizes, and this binary altogether suspension contains formoterol fumarate and the Glycopyrrolate active agent particle of microcrystalline form.

The figure of Figure 11 shows binary prepared by the present invention Glycopyrrolate particle size distribution that realizes of suspension altogether, and this binary altogether suspension contains the Glycopyrrolate active agent particle of microcrystalline form and has the formoterol fumarate active agent particle of microcrystalline form of two kinds of different-grain diameters distribution (representing with " carefully " and " slightly ") or spray-dired formoterol fumarate.

The figure of Figure 12 shows the second binary containing the formoterol fumarate of microcrystalline form and the Glycopyrrolate active agent particle of microcrystalline form prepared by the present invention formoterol fumarate particle size distribution of realizing of suspension altogether, with the comparable situation between the formoterol fumarate particle size distribution realized containing the Glycopyrrolate active agent particle of microcrystalline form and the common suspension of spray-dired formoterol inhalation particles.

The figure of Figure 13 shows exemplary binary prepared by the present invention Glycopyrrolate altogether in suspension preparation and the dosage delivered uniformity of formoterol fumarate.

The figure of Figure 14 shows the dosage delivered uniformity of the often kind of activating agent comprised in the common suspension preparation of exemplary ternary of Glycopyrrolate, formoterol fumarate and momestasone furoate active agent particle containing microcrystalline form.

The ternary that the figure of Figure 15 shows the Glycopyrrolate containing microcrystalline form, formoterol fumarate and momestasone furoate active agent particle prepared by the present invention altogether the formoterol fumarate aerodynamic size distribution that realizes of suspension and the binary formoterol fumarate aerodynamic size that suspension realizes altogether containing Glycopyrrolate and formoterol fumarate distribute between comparable situation.

The ternary that the figure of Figure 16 shows the Glycopyrrolate containing microcrystalline form, formoterol fumarate and momestasone furoate active agent particle prepared by the present invention altogether the Glycopyrrolate aerodynamic size distribution that realizes of suspension and the binary Glycopyrrolate aerodynamic size that suspension realizes altogether containing Glycopyrrolate and formoterol fumarate distribute between comparable situation.

The figure of Figure 17 shows the Glycopyrrolate that realizes of suspension and the distribution of TB aerodynamic size altogether of ternary prepared by the present invention, the active agent particle of the microcrystalline form of this common suspension also containing formoterol fumarate and momestasone furoate except Glycopyrrolate or TB.

The figure of Figure 18 shows the aerodynamic size distribution of formoterol fumarate that realizes of suspension altogether of two kinds of binary prepared by the present invention and a kind of one-component.It illustrates the dose ratio between the common suspension of two kinds of binary and between binary and the common suspension of one-component.

The figure of Figure 19 shows the aerodynamic size distribution of formoterol fumarate that realizes of suspension altogether of two kinds of binary prepared by the present invention and two kinds of one-components.It illustrates the dose ratio between two kinds of binary and two kinds of common suspensions of one-component and between binary and the common suspension of one-component.

The dosage delivered uniformity that the common suspension of formoterol fumarate one-component that the figure of Figure 20 shows the ultra low-volume prepared by the present invention realizes.

The figure of Figure 21 shows administration two kinds and treats the accumulation response of first day over time, the single-activity agent (one is only send Glycopyrrolate-GP36, and another only sends tiotropium bromide-Si Lihua) of sending wherein using the combination (GP/FF72/9.6 and GP/FF36/9.6) of common suspension composition as described in the present invention different from two kinds compares.As a part for the clinical research described in embodiment 12, give patient by these compositionss.Especially, show in figure and obtain FEV ₁the percentage rate improving the patient of>=12% and the time reached needed for above-mentioned percentage rate.

Different seminar compound is given patient by the part that the figure of Figure 22-Figure 24 shows as the clinical research described in embodiment 12, the FEV when treatment the 7th day (the 7th day) ₁aUC _0-12mean change amount compared with basic value.(one is only send Glycopyrrolate-GP36 with the multiple different activities compositions of sending single-activity agent to use two kinds of treatments (GP/FF72/9.6 and GP/FF36/9.6) of the combination of suspension composition altogether as described in the present invention and placebo, second is only send tiotropium bromide-Si Lihua, and the 3rd is only send formoterol fumarate-FF7.2, FF9.6 and Foradil) compare.

Each activity research compositions is given patient by the part that Figure 25 shows as the clinical research described in embodiment 12, the FEV the 7th day time ₁aUC _0-12.The FEV that each activity research compositions provides compared with placebo is shown in figure ₁aUC _0-12improvement.

The treatment that Figure 26 shows GP/FF36/9.6 the 7th day time compares reached FEV with GP36, FF9.6, Si Lihua with Foradil active control ₁aUC _0-12between difference.Can easily understand by reference to Figure 26, GP/FF36/9.6 treatment significantly improves FEV better ₁aUC _0-12.

Different seminar compound is given patient by the part that Figure 27 shows as the clinical research described in embodiment 12, at treatment the 1st day (the 1st day) and the peak FEV that reaches for the 7th day ₁.The peak FEV of described display ₁representative: in specified research day, compared with placebo, each activity research compositions provides the FEV relative to basic value ₁peak change.

Figure 28 shows and compares with Si Lihua with Foradil active control, and when the 1st day and the 7th day, GP/FF36/9.6 treated the peak FEV reached ₁difference.Can easily understand by reference to Figure 28, compared with described activating agent, GP/FF36/9.6 treatment significantly improves peak FEV better ₁.

The part that Figure 29 shows as the clinical research described in embodiment 12 gives patient the paddy FEV in early morning that different seminar's compounds reaches ₁improvement situation.Each activity research compositions is shown compared with placebo to paddy FEV in early morning in figure ₁the improvement situation of value.

Figure 30 shows in the clinical research shown in embodiment 12, to use use described herein two kinds of treatments (GP/FF72/9.6 and GP/FF36/9.6) and the different single-activity agent positive controls of the combination of suspension composition and FEV before administration in the 7th day each other altogether ₁the difference of recruitment.Can easily understand by reference to Figure 30, compared with described single-activity agent positive control, GP/FF72/9.6 and GP/FF36/9.6 treatment significantly improves FEV before administration better ₁but there is not significant difference each other in it.

Figure 31 shows the part as the clinical research described in embodiment 12, compared with placebo, use two of the combination of common suspension composition kinds to treat gulp capacity (IC) that the active positive control composition of (GP/FF72/9.6 and GP/FF36/9.6) and Si Lihua the provides improvement situation before the peak value and administration in the 7th day of the 1st day and the 7th day.

Figure 32 shows the order of severity of the chronic obstructive pulmonary disease regardless of patients, all achieves consistent patient's response in the clinical research described in embodiment 12.

detailed Description Of The Invention

The invention provides compositions, the method and system for sending two or more activating agents through breathing.In a particular embodiment, the invention discloses pharmaceutical composition, the system and method for being sent two or more activating agents by MDI through respiratory tract, at least one activating agent is selected from long-acting muscarine antagonist (" LAMA "), long-acting beta in certain embodiments ₂3 adrenergic receptor agonists (" LABA ") and corticosteroid active agent.Compositions of the present invention can be formulated into by MDI through lung or nasal delivery there.The method of the invention comprises to be stablized for through breathing the method comprising the preparation of two or more activating agents of sending, and sends through lung the method that two or more activating agents are used for the treatment of pulmonary disease or symptom by MDI.Invention further describes the MDI system for sending two or more activating agents, and prepare the method for this system.

The pharmaceutical composition institute facing challenges of preparation containing two or more activating agents usually can be owing to, occur being difficult between activating agent expecting or do not wish the interaction that occurs, or after adding multiple actives, cause the change of preparation.This interaction is commonly referred to " share effect ", when sending suspension formulation by MDI, share preparation that effect can show as the preparation that such as comprises single-activity agent and comprise the combination of two or more activating agents following one or more in similarity there occurs and depart from: the aerosol performance that preparation provides and particle size distribution feature; The dosage delivered uniformity of one or more activating agents; Sending or absorbability of one or more activating agents; Or the dose ratio of one or more activating agents viewed.

In a particular embodiment, altogether mixed suspension composition of the present invention avoids and relevant to combination preparation share effect.For purposes of the present invention, compositions avoids share effect, activating agent selected in combination preparation in aerosol performance, Size Distribution and dosage delivered uniformity all with only containing this selected activating agent as activating agent Comparative formulation compared with not there is deviation.In certain embodiments, selected activating agent does not have and share effect this point and can be proven in the following manner: the plasma concentration of the targeted delivery dosage of activating agent selected in combination preparation does not have to depart from along with the situation of change of time is compared with the plasma concentration of this selected activating agent in the Comparative formulation of the activating agent only selected as activating agent and with identical dose delivery containing this selected activating agent along with the situation of change of time.

For given parameter, the term in the application " do not occur departing from " represent the performance that realizes of combination preparation can reach the Comparative formulation only containing a kind of activating agent in combination preparation ± 20%.In certain embodiments, the performance that combination preparation realizes does not change compared with the Comparative formulation only containing a kind of activating agent in combination preparation.Such as, when meet in following condition one or more time can think that the common suspension comprising two or more activating agents described in the application does not occur share effect: for often kind of this type of activating agent of given dose, its institute in combination altogether suspension show the respective value that Comparative formulation that aerosol performance, particle size distribution profiles, dosage delivered uniformity and plasma concentration only contain single kind of activating agent along with the change of time is in reaches ± 20% scope in.In certain embodiments, combination of the present invention aerosol performance, particle size distribution profiles, dosage delivered uniformity and plasma concentration that altogether the activating agent of each given dose realizes in suspension composition along with one or more in the situation of change of time be in the respective value that the Comparative formulation only containing single-activity agent reaches ± 15% scope in.In other embodiments, combination of the present invention aerosol performance, particle size distribution profiles, dosage delivered uniformity and plasma concentration that altogether the activating agent of each given dose realizes in suspension composition along with one or more in the situation of change of time be in the respective value that the Comparative formulation only containing single-activity agent reaches ± 10% scope in.In certain embodiments, for the activating agent of each given dose, combination of the present invention altogether compared with suspension composition and the Comparative formulation only containing a kind of activating agent following one or more in not there are differences: the aerosol performance of preparation; Particle size distribution profiles; Dosage delivered uniformity; And plasma concentration is along with the situation of change of time.

In certain embodiments, the benefit that the combination being included in two or more activating agents in compositions of the present invention can provide exceedes the pharmaceutical preparation only containing single-activity agent.Such as, when the combination of two or more activating agents is sent simultaneously, compare when it is sent separately with any one in the activating agent combinationally used, the treatment effective dose of these two kinds of activating agents all can correspondingly reduce, thus avoids or reduce contingent side effect.In addition, compared with when being sent separately with any one in the activating agent share, the treatment benefit that onset is more rapid or the persistent period is longer can when two or more activating agents share, be realized.

In a particular embodiment, method of the present invention comprises and can send by breathing the Therapeutic Method that common suspension composition of the present invention treats pulmonary disease or symptom.Such as, compositions of the present invention, method and system can be used for treatment inflammatory or obstructive disease of lung or symptom.In a particular embodiment, compositions of the present invention, method and system can be used for treatment and suffer to be selected from asthma, chronic obstructive pulmonary disease (COPD), the airway hyperreactivity of other drug treatment secondary worsens, allergic rhinitis, sinusitis, Pulmonary Vascular shrinks, inflammation, irritated, respiratory disorder, respiratory distress syndrome, pulmonary hypertension, Pulmonary Vascular shrinks, and those can to independent such as LAMA, LABA, the treatment of corticosteroid or other activating agents of the present invention produces response or produces any other respiratory system disease of replying to the combination of these activating agents and other therapies, symptom, character, genotype or phenotype.In a particular embodiment, compositions of the present invention, method and system can be used for the treatment pneumonia relevant to cystic fibrosis and obstruction.As used in the present invention, term " COPD " and " chronic obstructive pulmonary disease " comprise chronic obstructive disease of lung (COLD), chronic obstructive airway disease (COAD), chronic airflow limited (CAL) and chronic obstructive airway disease (CORD), and comprise chronic bronchitis, bronchiectasis and emphysema.Term used in the present invention " asthma " no matter refer to the asthma of which kind of type or origin, the asthma of bringing out after comprising endogenous (nonallergic) asthma and exogenous (anaphylaxis) asthma, mild asthma, moderate asthma, severe asthma, bronchial asthma, exercise-induced asthma, occupational asthma and bacteriological infection.Asthma also can be understood to comprise wheezy-infant syndrome (wheezy-infantsyndrome).

Compared with only sending the compositions of single-activity agent, when suffering from the patient of pulmonary disease, the embodiment of suspension composition altogether of the present invention makes the testing result of one or more pulmonary function or capacity significantly increase.In the embodiment that some is such, compared with only containing the compositions of single-activity agent, send the common suspension composition comprising two or more activating agents as described in the present invention and make FEV ₁significantly increase with the one in respiratory capacity (IC) or both.

Be to be understood that embodiment of the present invention is exemplary.Various embodiments during later application describes in detail are not intended to limit the scope of the invention, and it is only as the example of various example.Therefore, the content that the present invention records can comprise those themes independently can granted patent.In addition, when not departing from scope, those skilled in the art can change the step of correlation technique in embodiment disclosed by the invention or order of action.In other words, unless the certain order of step or effect is for suitably implementing to be necessary for embodiment, otherwise the order of particular step or effect can be revised.

i. define

Unless there are other clear and definite explanation, otherwise technical term used in the present invention has the implication that residing field is understood usually.For clear object, following term is defined.

Term used in the present invention " activating agent " comprises any reagent, medicine, compound, compositions or other materials that can be used for being used in or giving human or animal because of the needs of any object, comprise treatment, pharmaceutical purpose, pharmacologically active, diagnosis, cosmetic and prevention reagent and immunomodulator.Term " activating agent " can be replaced and use with term " medicine ", " medicine ", " medicament ", " crude drug " or " therapeutic agent "." activating agent " used in the present invention also comprises those and it has been generally acknowledged that the natural or hahnemannian product (homeopathicproduct) without therapeutic activity.

Term " association ", " with ... associate " or " association " refer to chemical individual, compositions or structure when neighbouring surface during such as contiguous another chemical entities, compositions or structure surperficial, interaction occurred between which or mutual relation.Association comprise such as adsorb, stick, covalently bound, hydrogen bond, ionic bond and electrostatic attraction, your (Lifshitz-vanderWaals) effect and the polarity effect of Li Fuxizi-Van der Waals.It is a kind of associated forms that term " sticks ", and it is used as all general designations that granule or agglomerate can be made to have attracted to the power of the tendency on surface." stick " and also refer to that those impel and keep contacting with each other between granule thus make substantially there is not the segregation phenomenon that can observe between granule, this segregation phenomenon is because under normal operation caused by the different buoyancy of granule in propellant.In one embodiment, those attachments or the granule that is connected to surface are included in the scope that term " sticks ".Normal condition can comprise the storage under room temperature or the storage under acceleration of gravity.As described herein; active agent particle can associate to form common suspension with particle mutually, the segregation phenomenon that wherein substantially there are not those that can observe between particle and active agent particle or its flocculate and cause because of their buoyancy difference in propellant.

" particle " refers to that those are applicable to breathe and to send and can as the material of the carrier of active agent particle or combination of materials.Particle and active agent particle interact thus repeatedly can give activating agent, be delivered to or be transported to target site i.e. respiratory tract.Particle of the present invention is dispersed in the suspension media comprising propellant or Propellant System, and has any shape, size or the surface characteristic that can be mixed with and be suitable for reaching required suspension stability or activating agent delivery performance.Exemplary particle comprises those and has the granule being conducive to the particle diameter breathing active agent delivery, and those have the granule being suitable for the physical arrangement of preparing and sending stable suspension of the present invention.

Term " altogether suspension " refers to the suspension of the granule of two or more types in suspension media with different composition, wherein the granule of a type and one or more other grain types at least generating portion associate.Association can cause at least one grain type be suspended in suspension media to occur one or more specific visual changes.Specific change caused by association can comprise such as one or more following changes: assemble or the speed of flocculation, the rate of departure and character i.e. sedimentation or solidifying thick, paste or precipitum density, with the adhesion of chamber wall, with the adhesion of valve module and the dispersion rate when stirring and degree.

For judging whether that the illustrative methods that there is common suspension comprises as follows: if a kind of weight density of grain type is greater than propellant and the weight density of another kind of grain type is less than propellant, then visible observation can be adopted to coagulate thick or this method of settling behavior to determine whether common suspension exists.Term " weight density " refers to the density of the material of those composition granules, wherein gets rid of the space in granule.In one embodiment, material can be mixed with the form being suitable for visualization, or also can by normally vial thus be suitable for visualization in substance transfer to transparent vials.After initial stirring, bottle is left standstill the sufficiently long time to form sedimentation or solidifying thick layer, be generally 24 hours.If the sedimentation observed or solidifying thick layer are completely evenly or substantially uniform simple layers, then show to there is common suspension.Term " altogether suspension " comprises part suspension altogether, and wherein at least most two kinds of grain types there occurs association each other, but, also can observe a little separation (being namely less than majority) of at least two kinds of grain types.

Exemplary common suspension detection experiment can carry out under different propellant temperature, has sedimentation with the close grain type of the propellant density under room temperature or solidifying thick behavior to highlight those.If different grain types has identical separating property and whole sedimentation or all solidifying thick, then can determine whether there is common suspension by other characteristics measuring suspension, such as measure assemble or flocculation rate, the rate of departure, paste or precipitum density, with the adhesion of chamber wall, with the adhesion of valve module and the dispersion rate when stirring and degree, and the individual features of the single grain type of above-mentioned feature and similar suspension to be contrasted.Those skilled in the art can adopt the various analytical method known to measure these characteristics.

When being used in those and containing or provide the compositions such as compositions of the present invention of the aggregation, granule, drop etc. that can suck, term " minuteness particle dosage " or " FPD " refer to that be in can dosage within the scope of suction, and it can represent by gross mass or represent by nominal standard dose or the ratio that indicates dosage.Be in and can determine by measuring the dosage be deposited on outside cascade impactor throat level in vitro by the dosage within the scope of suction, namely under the flow velocity of 30l/min the 3rd level of ram of new generation (NextGenerationImpactor) to the summation of the dosage delivered of filter.

When in the compositions such as compositions of the present invention be used in containing or provide the aggregation, granule, drop etc. that can suck, term " minuteness particle mark " or " FPD " refer to be in can delivered substance within the scope of suction relative to the ratio of dosage delivered (namely the trigger of delivery apparatus such as MDI discharge amount).Being in the amount of delivered substance within the scope of suction to be the amount be deposited on outside cascade impactor venturi level recorded in vitro, such as under the flow velocity of 30l/min in ram of new generation from level 3 to the summation of the delivered substance of filter.

Term used herein " suppression " refers to that measurable minimizing trend or minimizing degree have appearred in phenomenon, symptom or situation.Term " suppression " or its arbitrary form have the implication of most broad sense, and comprise and minimize, prevent, alleviate, suppress, prevent, retrain, force, limit, slow down development and similar meaning.

Term used in the present invention " mass median dynamic diameter " or " MMAD " refer to aerocolloidal special air kinetic diameter, the granule that the aerosol of 50% quality is less than MMAD by aerodynamic diameter under this numerical value formed, and MMAD can calculate according to the method in American Pharmacopeia (" USP ") monograph 601.

Term used herein " optical diameter " refers to by adopting Fraunhofer diffraction pattern and using Laser diffraction particle size analyser (the such as SympatecGmbH with dry powder dispenser, Clausthal-Zellerfeld, Germany) measured by particle diameter.

The transformation of term solution mediation refers to a specific phenomenon, in this phenomenon, the better solid matter form of a kind of solubility property (namely have the granule (its can as the driving force of Ostwald (Ostwald) ripening) of small curvature radius, or amorphous substance) can occur to dissolve and recrystallize thus formed can the more stable crystal form that coexists of propellant solution equilibria saturated with it.

" patient " refers to that activating agent of the present invention combination has the animal of response to treatment to it.In one embodiment, patient is the mankind.

" porous microstructure " refers to the particle with structural matrix, this structural matrix presents, limits or comprise those can make the suspension media of surrounding permeate, load or spread to the space of microstructure, pore, defect, hollow, space, gap space, hole, perforation or hole, the people such as such as Weers are in U.S. patent the 6th, the material recorded in 309, No. 623 and preparation.The original form of porous microstructure is usually unimportant, and any structure of the formulation properties desired by the present invention that can provide all contains within the scope of the invention.Therefore, in one embodiment, porous microstructure can comprise intimate spherical structure, such as hollow, that suspend, spray-dired microsphere.But those are at original form or to there is depression, wavy, distortion or the microgranule of fragmentation in length-width ratio be also suitable.

As particle of the present invention, porous microstructure can be by any substantially can not occur to degrade or dissolve in selected suspension media and the material with biocompatibility formed.Although various material can be used to form granule, structural matrix and surfactant carry out associating or it comprises surfactant such as phospholipid or fluorinated surfactant in certain embodiments.Although optional, the stability of breathing dispersion can be improved in porous microstructure or more general compatible surfactant of introducing in particle and increase pulmonary deposition and be conducive to the preparation of suspension.

Term used in the present invention " suspension media " refers to the material providing continuous phase, and active agent particle and particle can be dispersed in this continuous phase thus to form suspension preparation altogether.The suspension media that suspension preparation uses of the present invention altogether comprises propellant.Term used in the present invention " propellant " refers to the material of one or more pharmacology's inertia, and when starting MDI metering valve, it can produce sufficiently high vapour pressure thus the medicament in MDI tank is pushed to patient under common room temperature condition.Therefore, term " propellant " refers to a kind of propellant or two or more different propellants combine " Propellant System " that formed simultaneously.

Term " can suck " and typically refer to its size and it can be made to be inhaled into arrive the granule, aggregation, drop etc. of lung airway.

When being used to refer to suspension composition altogether of the present invention, term " physical stability " and " physically stable " refer to a kind of compositions, said composition can resist the gathering, flocculation and the particle diameter that cause due to the effect of solution mediated transformation change in one or more phenomenons and substantially can maintain MMAD and the minuteness particle dosage of particle.In one embodiment, physical stability can by allowing compositions bear accelerated degradation condition to measure, such as temperature cycling process of the present invention.

When for activating agent, term " effectively " refers at 0.01mg/kg in about 1mg/kg dosage range or treating effective activating agent lower than during this dosage range.The usual dosage of effective active agent is generally in the scope of about 100 μ g to about 100mg.

When for activating agent, term " efficiently " refers at 10 μ g/kg dosage or treating effective activating agent lower than during this dosage.The usual dosage range of high-efficiency activated dose is generally up to about 100 μ g.

Term " stability of suspension " and " stable suspension " refer to the suspension preparation of the common suspension character that can maintain active agent particle and particle within a certain period of time.In one embodiment, stability of suspension can be assessed by the dosage delivered uniformity of suspension composition altogether of the present invention.

Term " substantially insoluble " refers to that compositions is insoluble to specific solvent completely or compositions is insoluble in this specific solvent.Term " substantially insoluble " refers to that the dissolubility of specific solute in every 100 parts of solvents is lower than 1 part of solute.Term " substantially insoluble " also comprises defined " sl. sol. " (every 1 part of solute 100 to 1000 parts of solvents), " very slightly soluble " (every 1 part of solute 1000 to 10,000 part of solvent) and " insoluble,practically " (every 1 part of solute is more than 10,000 part of solvent), with reference to TheScienceandPracticeofPharmacy, 21sted.Lippincott, Williams & Wilkins, the 2006,212nd page table 16-1.

Term used in the present invention " surfactant " refers to the reagent at the interface be preferentially adsorbed between two immiscible phases, the interface between such as, interface between water and organic polymer soln, water/air or the interface between organic solvent/air.Surfactant has hydrophilic module and hydrophobicity module usually, and therefore when being adsorbed onto microgranule, they tend to module to be presented to those and can not adsorb by the continuous phase of similar coated granule, thus reduces particle aggregation.In certain embodiments, surfactant can also promote drug absorption and increase the bioavailability of medicine.

" treatment effective dose " refers to the disease or symptom that can realize suppressing patient, or the amount of the compound that can prophylactically suppress or prevent disease or symptom from occurring.Treatment effective dose can be the amount by one or more diseases of patient or remission compound to a certain extent; One or more physiology that can disease or the symptom origin cause of formation followed to be correlated with those or biochemical parameters partially or completely return to the amount of normal compound; And/or the amount of compound of the probability that disease or symptom occur can be reduced.

Term " chemically stable " and " chemical stability " refer to a kind of suspension formulation altogether, the various catabolites of the activating agent in said preparation maintain lower than the bottom line (1% total chromatographic peak area required in such as ICH guide Q3B (R2)) specified by regulatory requirements within the effect duration for people's product, and be between activating agent analysis thing wherein and total degradation product acceptable mass balance level (as in ICH guide Q1E the level that defines).

iI. compositions

Compositions of the present invention is a kind of suspension altogether, and it comprises two or more activating agents and comprises suspension media, one or more active agent particles and one or more particles.Certainly, if necessary, compositions of the present invention also can comprise one or more other component.In addition, version and the combination of the component of compositions of the present invention can also be used.

Suspension composition altogether of the present invention can be made into multiple different preparation.In certain embodiments, compositions of the present invention comprises the first activating agent provided with active agent particle form, and the particle that this active agent particle and at least one contain the second activating agent suspends altogether.In other embodiments, compositions of the present invention comprises two or more activating agents provided with two or more multi-form active agent particles, these active agent particles suspend altogether with at least one particle, and this particle contains activating agent and this activating agent is different from the activating agent that active agent particle comprises.In some other embodiments, compositions of the present invention comprises two or more activating agents provided with two or more multi-form active agent particles, these active agent particles suspend altogether with at least one particle, and this particle contains activating agent and this activating agent activating agent that can comprise with active agent particle is identical or different.In other embodiment, compositions of the present invention comprises two or more activating agents provided with two or more multi-form active agent particles, and the particle that these active agent particles do not contain activating agent with one or more suspends altogether.When compositions of the present invention comprises two or more active agent particles, this kind of compositions can be called " polynary " suspension altogether.Such as, the compositions comprising the two kinds of active agent particles suspended altogether with one or more particles can be called binary suspension altogether, and the compositions comprising the three kinds of active agent particles suspended altogether with one or more particles can be called ternary suspension etc. altogether.

In the present compositions, even if active agent particle and particle also present association when multiple different active agent particle is present in compositions, thus active agent particle and particle can be coexisted in suspension media.Usually, owing to there is density variation between dissimilar granule and the suspension media residing for it (as propellant or propulsion system), so buoyancy can cause those than the low density granule of propellant, granule generation sedimentation that is solidifying thick and that cause those higher than propellant density to occur.Therefore; in the suspension be made up of the dissimilar granulate mixture with different densities or different tendency of flocculation, estimate that often kind of dissimilar granule has special sedimentation or solidifying thick behavior and then can estimate that sedimentation or solidifying thick behavior can cause dissimilar granule to be separated in suspension media.

But; the combination of propellant of the present invention, active agent particle and particle provides a kind of common suspension containing the combination of two or more activating agents; wherein active agent particle and particle to be co-located in propellant (namely; active agent particle and particle mutually associate thus make particle and active agent particle substantially there will not be being separated each other; such as by differential sedimentation or the solidifying thick separation do not detected each other, even also all do not detect after experienced by the time being enough to be formed solidifying thick or settled layer).In a particular embodiment, such as, compositions of the present invention forms common suspension, and wherein particle subjected to temperature fluctuation and/or under acceleration ranges up to and beyond such as 1g, 10g, 35g, 50g and 100g, carrying out association that is centrifugal and that still can maintain under the strong buoyancy caused between active agent particle.But, should be appreciated that suspension altogether of the present invention is not by the restriction of specific critical association power.Such as; successfully can obtain a kind of common suspension wanted required for the present invention, wherein active agent particle and particle mutually associate thus active agent particle and particle in the continuous phase that formed by suspension media under patient's service condition of routine can not be separated from each other substantially.

The common suspension of active agent particle of the present invention and particle has the chemical stability of expectation, suspension stability and activating agent delivery characteristics.Such as, in a particular embodiment, when being present in MDI tank, suspension altogether of the present invention can suppress or reduce one or more following situations: the flocculation of active agent materials; The differential sedimentation or solidifying thick of active agent particle and particle; The solution mediated transformation effect of active agent materials; Chemical degradation containing the component in the preparation of active agent materials or surfactant; And the loss of the loss of activating agent on container sealing system surface especially on metering valve surface.Still can realize above-mentioned performance characteristics when being sent common suspension preparation by MDI and maintain the performance of suspended particulates, thus making can reach in the overall process of the common suspension preparation in emptying MDI tank and minuteness particle mark, minuteness particle dosage and these characteristics of dosage delivered uniformity desired by maintaining.In addition, when use a kind of relatively simple and its also not by adding cosolvent, anti-solvent, solubilizing agent or adjuvant and improving the HFA suspension media of its performance time, suspension altogether of the present invention also can provide preparation stable on a kind of physics and chemistry and make two or more activating agents contained by it have consistent delivery properties, even if when the obvious difference of dosage delivered of these activating agents also can realize.Further, compositions prepared in accordance with the present invention, the pharmacy effect that it can be eliminated or substantially avoid the preparation containing multiple actives common when utilizing MDI to send.Such as, as described in detail in the embodiment of the present application, when the delivery characteristics of each activating agent in the activating agent that combination preparation of the present invention comprises is prepared with identical activating agent separately and is sent respectively the delivery characteristics that reaches suitable.

Altogether suspension provided by the present invention also can simplify activating agent preparation, send and administration process.Not by the constraint of any particular theory, it is conceivable that, by this form of common suspension of active agent particle and particle, the sending of activating agent contained by this dispersion liquid, physical stability and delivery properties just can control by controlling the size of particle, composition, form and relative quantity substantially, thus the degree of dependence of the size that can reduce active agent particle and morphological character.In addition, in a particular embodiment, pharmaceutical composition of the present invention can be prepared by being substantially devoid of anti-solvent, solubilizing agent, the non-CFC propellant of cosolvent or adjuvant or Propellant System.

Physics and the chemical degradation of wherein contained activating agent can be suppressed according to the common suspension composition of training centre preparation of the present invention.Such as, in a particular embodiment, compositions of the present invention can suppress the chemical degradation of the activating agent comprised in the composition, flocculation, gathering and solution mediated transformation active one or more.The chemistry that altogether suspension preparation of the present invention provides and suspension stability can make the multiple actives in compositions all carry out sending (" DDU in a kind of mode that can reach required dosage delivered uniformity in the whole process of emptying MDI tank "), though work as sent at least one activating agent be the difference of efficient and various activating agent in dosage delivered very large time still can reach.

The DDU of the often kind of activating agent contained by common suspension composition containing two or more activating agents of the present invention can reach ± and 30% or higher.In this kind of embodiment, the DDU of often kind of activating agent altogether contained by suspension composition of the present invention can reach ± and 25% or higher.In another this kind of embodiment, the DDU of often kind of activating agent altogether contained by suspension composition of the present invention can reach ± and 20% or higher.In addition, suspension composition altogether of the present invention can substantially maintain FPF and FPD performance, even under the condition being in accelerated degradation in the overall process of emptying MDI tank.Such as, even if compositions of the present invention also can by FPF or FPD performance maintain its initial value 80%, 90%, 95% or more under the condition of accelerated degradation.

When using non-CFC propellant to prepare, suspension composition altogether of the present invention can provide the additional benefit realizing this kind of performance.In a particular embodiment, when using the suspension media only comprising the non-CFC propellant that one or more are modified without performance to prepare, compositions of the present invention can one or more in realize target DDU, FPF or FPD, and the method that wherein said performance is modified can be such as add one or more cosolvents, anti-solvent, solubilizing agent, adjuvant or other propellant decorative material.

(i) suspension media

The suspension media that compositions of the present invention comprises contains one or more propellants.Generally speaking, the suitable propellant used as suspension media can liquefy under room temperature pressure and for sucking or being propellant gas harmless in safe those toxicology for the use of local.In addition, wish selected by propellant relatively with between particle and active agent particle not react.Exemplary suitable propellants comprises, hydrofluoroalkane (HFA), perfluorochemical (PFC) and Chlorofluorocarbons (CFC).

The particular instance that can be used for the propellant of the suspension media forming the common suspension of the present invention comprises, HFA 134a (CF ₃cH ₂f) (HFA-134a), 1,1,1,2,3,3,3-seven fluorine n-propane (CF ₃cHFCF ₃) (HFA-227), hexafluoroethane, a chloro fluoromethane, 1,1 Difluoroethane and their combination.Further, suitable propellant comprises such as: short hydrocarbon; C _1-4containing hydrochlorofluorocarazeotropic such as CH ₂clF, CCl ₂fCHClF, CF ₃cHClF, CHF ₂cClF ₂, CHClFCHF ₂, CF ₃cH ₂cl and CClF ₂cH ₃; C _1-4containing HFC (as HFA) such as CHF ₂cHF ₂, CF ₃cH ₂f, CHF ₂cH ₃and CF ₃cHFCF ₃; Also has perfluorocarbon such as CF ₃cF ₃and CF ₃cF ₂cF ₃.

The classification of the specific fluorine carbon or fluorinated compound that can be used as suspension media includes but not limited to, fluorine heptane, fluorine cycloheptane, methyl fluoride cycloheptane, fluorine hexane, fluorine cyclohexane extraction, amyl fluoride, fluorine Pentamethylene., methyl fluoride Pentamethylene., fluorine dimethylcyclopentane, methyl fluoride Tetramethylene., fluorine dimethylcyclobutane, fluorine trimethyl Tetramethylene., fluorine butane, fluorine Tetramethylene., fluoro-propane, fluorine ether, perfluoroalkyl polyether and fluorine triethylamine.These compounds can be used alone or have more volatile propellant with those and combinationally use.

Except above mentioned fluorine carbon and hydrofluoroalkane, various typical Chlorofluorocarbons and the fluorinated compound that is substituted can also be used as suspension media.In this respect, when notice may to environmental effects, following material can also be used: FC-11 (CCl ₃f), FC-11B1 (CBrCl ₂f), FC-11B2 (CBr ₂clF), FC12B2 (CF ₂br ₂), FC21 (CHCl ₂f), FC21B1 (CHBrClF), FC-21B2 (CHBr ₂f), FC-31B1 (CH ₂brF), FC113A (CCl ₃cF ₃), FC-122 (CClF ₂cHCl ₂), FC-123 (CF ₃cHCl ₂), FC-132 (CHClFCHClF), FC-133 (CHClFCHF ₂), FC-141 (CH ₂clCHClF), FC-141B (CCl ₂fCH ₃), FC-142 (CHF ₂cH ₂cl), FC-151 (CH ₂fCH ₂cl), FC-152 (CH ₂fCH ₂f), FC-1112 (CClF=CClF), FC-1121 (CHCl=CFCl) and FC-1131 (CHCl=CHF).Similarly, each in these compounds can be used alone or combinationally use to form stable suspension of the present invention with other compounds (that is, the fluorocarbons of low volatility).

In certain embodiments, suspension media can be formed by single propellant.In other embodiments, suspension media can being combined to form by propellant.In certain embodiments, the compound of relative volatility can mix that suspension media is had can improve its stability with low-vapor pressure component or strengthen this specific physical characteristic of bioavailability of the activating agent wherein disperseed mutually.In certain embodiments, comprise compared with the compound of low-vapor pressure the fluorinated compound (as fluorocarbon) that those boiling points are greater than 25 DEG C.In certain embodiments, can comprise for the fluorinated compound compared with low-vapor pressure in suspension media, perfluoro bromide octane C ₈f ₁₇br (PFOB or perflubron), dichloro fluoro-octane C ₈f ₁₆cl ₂, perfluorooctyl ethane C ₈f ₁₇c ₂h ₅(PFOE), perfluoro decyl bromide C ₁₀f ₂₁br (PFDB) or perfluorobutyl ethane C ₄f ₉c ₂h ₅.In certain embodiments, these compounds compared with low-vapor pressure to there is level relatively low.These compounds directly can be added in suspension media or with particle and associate mutually.

The suspension media that the present composition comprises can be formed by the propellant or Propellant System being substantially free of other material, and other wherein said material comprises such as anti-solvent, solubilizing agent, cosolvent or adjuvant.Such as, in certain embodiments, suspension media can be formed by non-CFC propellant or Propellant System, is such as substantially free of HFA propellant or the Propellant System of other material.These embodiments simplify those and contain the preparation and production process that are suitable for the common suspension composition breathing active agent delivery.

But in other embodiments, the character depending on selected propellant, particle or the character of activating agent of sending, suspension media used can also comprise other material except propellant or Propellant System.These other materials can comprise such as, and one or more suitable anti-solvent, solubilizing agent, cosolvent or adjuvant are to be used for regulating the dissolubility of the vapour pressure of such as preparation, stability or particle.Such as, propane, ethanol, isopropyl alcohol, butane, iso-butane, pentane, isopentane or dialkyl ethers such as dimethyl ether can be added in the propellant in suspension media.Similarly, suspension media can contain volatile fluorine carbon.In other embodiments, can add in polyvinylpyrrolidone (" PVP ") or Polyethylene Glycol (" PEG ") in suspension media one or both.In suspension media, add the functional characteristic that PVP or PEG can realize needed for one or more, in one embodiment, PVP or PEG can join in suspension media as the inhibitor of crystal growth.Usually, use volatile co-solvent or adjuvant time, these volatile cosolvent or adjuvants can be selected from known Hydrocarbon or fluorocarbon, and the ratio shared by it be propellant up to about 1%w/w.Such as, when suspension media contains cosolvent or adjuvant, suspension media contains the cosolvent or adjuvant that are less than about 0.01%, 0.1% or 0.5%w/w.When suspension media contains PVP or PEG, this component can account at the most suspension media up to about 1%w/w, or be less than about 0.01%, 0.1% or 0.5%w/w.

(ii) active agent particle

The active agent particle of the present invention altogether contained by suspension can be dispersed in or to be suspended in suspension media by those and those materials that its size formed is conducive to inhalable particles to deliver from common suspension are formed.Therefore, in one embodiment, active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 90% volume ratio is about 7 μm or less.In other embodiments, active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 90% volume ratio is about 7 μm to about 1 μm, about 5 μm to about 2 μm, about 3 μm to about 2 μm.In a further embodiment, active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 90% volume ratio is about 6 μm or less, about 5 μm or less, about 4 μm or less, about 3 μm or less.In other embodiments, active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 50% volume ratio is about 4 μm or less.In a further embodiment, active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 50% volume ratio is about 3 μm or less, about 2 μm or less, about 1.5 μm or less, about 1 μm or less.In a still further embodiment; active agent particle provides with the form of micronize materials, and wherein the optical diameter of the active agent particle of at least 50% volume ratio be about 4 μm to about 1 μm scopes, about 3 μm to about 1 μm scopes, about 2 μm to about 1 μm scopes, about 1.3 μm and about 1.9 μm.

Active agent particle can be obtained by activating agent completely or also can be obtained by the combination comprising one or more activating agents and one or more excipient or adjuvant.In a particular embodiment, the activating agent be present in active agent particle can be lenticular completely or substantially, and that is most of active agent molecule arranges along the long-range of crystrallographic plane with the repetition form of rule.In another embodiment, active agent particle can comprise the activating agent existed with lenticular or amorphous form.In another embodiment, active agent particle can comprise substantially with the activating agent that amorphous form exists, and namely active agent molecule itself is not completely in noncrystal shape and along the repeated arrangement of long-range maintenance rule.In another embodiment, in active agent particle, there are two or more activating agents, these all activating agents can with lenticular or substantially lenticular form exist.Exist in the embodiment of two or more activating agents at other, at least one this kind of activating agent can with lenticular or substantially crystallike form exist and at least another kind of activating agent can exist with unbodied form.

When active agent particle of the present invention comprises the combination of one or more activating agents and one or more excipient or adjuvant, this excipient or adjuvant can be selected according to the chemistry of used activating agent and physical property.In addition, the excipient be applicable to for preparing active agent particle comprises the excipient that association can occur with particle described in those the present invention.In a particular embodiment, such as, active agent particle can be prepared with one or more materials being selected from following group: the surface active material that lipid, carbohydrate, aminoacid, organic salt, peptide, protein, alditol, synthesis or natural polymer or surface active material of the present invention such as can associate with particle.

In other embodiments, such as, activating agent can be joined in the solution that one or more materials of being selected from following group are formed, then spraying dry forms particle, activating agent contained by this particle is among those materials forming particle, and this group comprises lipid, phospholipid, carbohydrate, aminoacid, slaine, organic salt, peptide, protein, alditol, synthesis or natural polymer or surfactant material.

The micronised active agent that any suitable method can be used as to obtain those or be included in active agent particle or particle can be used.Various diverse ways can be used to generate and to be suitable for use in the active agent particle be total in suspension preparation of the present invention; these methods include but not limited to, by pulverize or method for grinding, crystallization or recrystallization method, utilize the method for supercritical or nearly supercritical solvent precipitation, spraying dry, the method for atomizing freeze drying or lyophilizing carries out micronize process.The referenced patent that instruction obtains the proper method of micronised active agent comprises, the such as U.S. patent No. 6,063; 138, U.S, the patent No. 5; 858,410, the U.S. patent No. 5,851; 453, the U.S. patent No. 5; 833,891, U.S, the patent No. 5,707; 634, and international patent application no WO2007/009164.Active agent particle wherein comprises the active agent materials prepared together with one or more excipient or adjuvant; micronized activating agent can be formed by one or more said methods, uses said method to obtain and has the particle size distribution of expectation and the active agent particle of grain structure.

Active agent particle can exist in suspension media with any suitable concentration.Such as, in certain embodiments.The concentration of active agent particle can at about 0.01mg/mL to about between 20mg/mL.At some in this kind of embodiment, the concentration of active agent particle can about 0.05mg/ml to about between 20mg/ml, about 0.05mg to about between 10mg/ml and at about 0.05mg to about between 5mg/ml.

Various treatment reagent or prevention reagent can be used in suspension altogether of the present invention.Exemplary activating agent comprises those can with the activating agent of the form administration of aerosol drug, the activating agent be suitable for use in compositions of the present invention comprises those can be existed in a specified pattern or can be formulated into specific form thus be dispersed in selected suspension media (such as, substantially insoluble or in suspension media, present the dissolubility substantially maintaining suspension preparation form altogether), and common suspension can be formed with particle, and can by breathing the activating agent of its physiology effective dose of picked-up.Activating agent for the formation of active agent particle of the present invention can have various physiologically active.

The example of the particular active agent that the present composition comprises can be such as short acting beta-agonists, as bitolterol, carbuterol, fenoterol, hexoprenaline, isoproterenol (isopropyl (nor-) epinephrine), levosalbutamol, orciprenaline (orciprenaline), pirbuterol, procaterol, rimiterol, salbutamol (albuterol), terbutaline, tulobuterol, reproterol, ipratropium and epinephrine; Long-acting beta ₂3 adrenergic receptor agonists (" LABA "), as bambuterol, clenbuterol, formoterol and salmaterol; Super long effective β ₂3 adrenergic receptor agonists, as carmoxirole, rice water sieve, QAB-149 and containing the derivative β of the adamantyl of saligenin or indole ₂agonist; Cortical steroid, as beclometasone, budesonide, ciclesonide, flunisolide, fluticasone, methylprednisolone, mometasone, prednisone and omcilon; Antiinflammatory, as FLUTICASONE PROPIONATE, beclomethasone dipropionate, flunisolide, budesonide, three Pai Dinuo (tripedane), cortisone, prednisone, prednisolone, dexamethasone, betamethasone or triamcinolone acetonide; Antitussive, as narcotine; Bronchodilator, as ephedrine, epinephrine, fenoterol, formoterol, isoproterenol, orciprenaline, salbutamol, albuterol, salmaterol, terbutaline; And muscarine antagonist, comprise long-acting muscarine antagonist (" LAMA ") as Glycopyrrolate, enlightening Xipi sieve Nimes (dexipirronium), scopolamine, tropicamide, pirenzepine, dimenhydrinate, tiotropium, Da Tuoping, aclidinium bromide, hold in the palm these product, ipratropium, atropine, benzatropine or oxitropine.

When needing, the activating agent that the present composition comprises can also include but not limited to, those activating agents herein recorded especially use with the form of its salt (such as, alkali metal salts or ammonium salt or acid-addition salts), ester, solvate (hydrate) or free alkali.In addition, activating agent can be the mixture of various crystal form or isomeric form or isomeric form, such as, can be pure isomer, the mixture of isomer, racemic modification or its mixture.In this respect, the activating agent form that is suitable for can be selected thus the activity of activating agent and/or stability optimization and/or the dissolubility of activating agent in suspension media are minimized.

Because compositions disclosed in this invention can send the activating agent of very low dosage repeatedly, in certain embodiments, the activating agent that compositions of the present invention comprises can be selected from one or more effective or efficient activating agents.Such as, in certain embodiments, compositions of the present invention can comprise one or more by with the effective active agent of the dose delivery being selected from following group: each dosage about 100 μ g to about between 100mg, about 100 μ g to about between 10mg, about 100 μ g are to about between 10mg.In other embodiments, compositions of the present invention can comprise two or more by with the combination of effective or high-efficiency activated dose of the dose delivery being selected from following group: each dosage is up to about 80 μ g, up to about 40 μ g, up to about 20 μ g, up between about 10 μ g or about 10 μ g to about 100 μ g.In addition, in certain embodiments, compositions of the present invention can comprise two or more by with the combination of high-efficiency activated dose of the dose delivery being selected from following group: between each dosage about 0.1 to about 2 μ g, between about 0.1 to about 1 μ g, between about 0.1 to about 0.5 μ g.

In certain embodiments, the activating agent that compositions of the present invention comprises is LABA activating agent.In this kind of embodiment, compositions comprises the combination of a kind of LABA activating agent and a kind of LAMA activating agent or corticosteroid active agent.In another this kind of embodiment, compositions comprises the combination of a kind of LAMA activating agent and a kind of LABA activating agent and corticosteroid.In this kind of embodiment, LABA activating agent can be selected from such as bambuterol, clenbuterol, formoterol, salmaterol, carmoxirole, rice water sieve, QAB-149 and containing the derivative β of the adamantyl of saligenin or indyl ₂agonist and its pharmaceutically acceptable salt any, ester, isomer or solvate.At some in this kind of embodiment, activating agent is selected from formoterol and pharmaceutically acceptable salt, ester, isomer or solvate.

Formoterol can be used for treatment than as described in the present invention those inflammatories or obstructive disease of lung or symptom.Chemistry (±)-2-hydroxyl-5-[(1RS)-1-hydroxyl-2-[[(1RS)-2-(4-the methoxyphenyl)-1-Methylethyl]-ammonia] ethyl] formailide by name of formoterol, it is used in pharmaceutical composition with the form of racemic fumarate dihydrate usually.In appropriate circumstances, formoterol can use the form of its salt (such as alkali metal salts or ammonium salt or acid-addition salts) or ester or solvate (hydrate).In addition, formoterol can be the mixture of any crystal form or isomeric form or isomeric form, such as, and pure isomer, the mixture of isomer, racemic modification or its mixture.In this respect, the formoterol form that is suitable for can be selected thus the activity of formoterol and/or stability optimization and/or the dissolubility that makes formoterol in suspension media are minimized.Formoterol pharmaceutically acceptable salt comprises such as inorganic acid salt than example hydrochloric acid, hydrobromic acid, sulfonic acid and phosphoric acid; And acylate such as fumaric acid, maleic acid, acetic acid, lactic acid, citric acid, tartaric acid, ascorbic acid, succinic acid, 1,3-propanedicarboxylic acid, gluconic acid, tricarballylic acid, oleic acid, benzoic acid, p-Methoxybenzoic acid, salicylic acid, neighbour or P-hydroxybenzoic acid, parachlorobenzoic-acid, Loprazolam, p-methyl benzenesulfonic acid and 3-hydroxyl-2-naphthalene-carboxylic acid.The hydrate of formoterol has been documented in such as the U.S. patent No. 3,994,974 and the U.S. patent No. 5,684, in 199.Specific crystal form has been documented in such as WO95/05805, and the specific isomer of formoterol has also been documented in the U.S. patent No. 6,040, in 344.

In a particular embodiment, the formoterol material for the formation of formoterol granule is formoterol fumarate, and in this kind of embodiment, formoterol fumarate exists with the form of dihydrate.When compositions of the present invention comprises formoterol, in certain embodiments, the Fonnoterol concentration that compositions of the present invention comprises can realize the dosage delivered being selected from following group: MDI at every turn startup effect can produce about 0.5 μ g between about 30 μ g, 0.5 μ g to about 1 μ g, about 1 μ g to about 10 μ g between, between about 2 μ g to about 5 μ g, between about 2 μ g to about 10 μ g, between about 5 μ g to about 10 μ g, between about 3 μ g to about 30 μ g.In other embodiments, compositions of the present invention comprises the formoterol of q.s thus can provide the dosage delivered being selected from following group: MDI at every turn startup effect can produce up to about 30 μ g, up to about 10 μ g, up to about 5 μ g, up to about 2.5 μ g, up to about 2 μ g or up to about 1.5 μ g.In order to realize dosage delivered of the present invention, when compositions of the present invention comprises formoterol as activating agent, in a particular embodiment, the amount of the formoterol that compositions comprises can be selected from such as about 0.01mg/ml to about between 1mg/ml, about 0.01mg/ml to about between 0.5mg/ml, and about 0.03mg/ml is to about between 0.4mg/ml.

When common liquid suspension pharmaceutical compositions of the present invention comprises LABA activating agent, activity can be salmaterol in certain embodiments, comprises its any pharmaceutically acceptable salt, ester, isomer or solvate.Salmaterol can be used for treatment such as those inflammatories of the present invention or obstructive disease of lung or symptom.In addition, using salmaterol as LABA activating agent time, at some, in this kind of embodiment, compositions can also comprise LAMA or corticosteroid active agent.In other this kind of embodiment, compositions comprises the combination of salmaterol and LAMA activating agent and corticosteroid.Salmaterol and pharmaceutically acceptable salt thereof and their preparation method have been documented in such as the U.S. patent No. 4,992,474, the U.S. patent No. 5,126,375 and U.S. patent 5,225, in 445.

When comprising the salmaterol as LABA activating agent, in certain embodiments, the concentration of salmaterol that compositions of the present invention comprises can realize being selected from the targeted delivery dosage of following group: MDI at every turn startup effect can produce between about 2 μ g to about 120 μ g, between about 4 μ g to about 40 μ g, between about 8 μ g to about 20 μ g, between about 8 μ g to about 40 μ g, between about 20 μ g to about 40 μ g, between about 12 μ g to about 120 μ g.In other embodiments, compositions of the present invention can comprise the salmaterol of q.s thus can provide the targeted delivery dosage being selected from following group: MDI at every turn startup effect can produce up to about 120 μ g, up to about 40 μ g, up to about 20 μ g, up to about 10 μ g, up to about 8 μ g or up to about 6 μ g.For realizing targeted delivery dosage of the present invention, when compositions of the present invention comprises salmaterol as activating agent, the amount of salmaterol that compositions comprises in a particular embodiment can be selected from such as about 0.04mg/ml to about between 4mg/ml, about 0.04mg/ml to about between 2.0mg/ml and about 0.12mg/ml to about between 0.8mg/ml.Such as, compositions of the present invention can comprise enough salmaterol with the targeted delivery dosage realizing being selected from following group: between about 4 μ g to about 120 μ g, between about 20 μ g to about 100 μ g and between about 40 μ g to about 120 μ g.In other embodiments, compositions of the present invention can comprise the salmaterol of q.s thus provide the targeted delivery dosage being selected from following group: MDI at every turn startup effect can produce up to about 100 μ g, up to about 40 μ g or up to about 15 μ g.

In certain embodiments, compositions of the present invention comprises long-acting muscarine antagonist (LAMA) activating agent.In compositions of the present invention, the example of operable LAMA activating agent comprises Glycopyrrolate, enlightening Xipi sieve Nimes, tiotropium bromide, song department chloramines, aclidinium bromide and Da Tuoping, comprises its any pharmaceutically acceptable salt, ester, isomer or solvate.In certain embodiments, compositions of the present invention comprises the combination of LAMA activating agent and LABA activating agent or corticosteroid.In other this kind of embodiment, compositions of the present invention comprises the combination of LAMA activating agent and LABA and corticosteroid active agent.When compositions comprises LAMA activating agent, in a particular embodiment, can Glycopyrrolate be selected, comprise its any pharmaceutically acceptable salt, ester, isomer or solvate.

Glycopyrrolate can be used for treatment inflammatory or obstructive disease of lung or symptom, such as those those diseases of the present invention or symptoms.Glycopyrrolate as anticholinergic agents can serve as bronchodilator and provide secretion depression effect, thus increases to the pulmonary disease of feature for those with mucosal secretions or symptom plays useful treatment use.Glycopyrrolate is a kind of tetravalence ammonium salt.In appropriate circumstances, Glycopyrrolate can use the form of its salt (as alkali metal salts or ammonium salt or as acid-addition salts) or ester or solvate (hydrate).In addition, Glycopyrrolate can be the mixture of various crystal form or isomeric form or isomeric form, such as, can be pure isomer, the mixture of isomer, racemic modification or its mixture.In this respect, the suitable form of Glycopyrrolate can be selected thus the activity of Glycopyrrolate and/or stability optimization and/or the dissolubility that makes Glycopyrrolate in suspension media are minimized.Suitable equilibrium ion is pharmaceutically acceptable equilibrium ion, comprise such as: fluoride, chloride, bromide, iodide, nitrate, sulfate, phosphate, formates, acetate, trifluoroacetate, propionate, butyrate, lactate, citrate, tartrate, malate, maleate, succinate, benzoate, parachlorobenzoic-acid salt, diphenyl acetic acid salt or triphenylacetic acid salt, oxybenzoic acid salt, p-hydroxybenzoate, 1-hydroxynaphenyl-2-carboxylate, 3-hydroxynaphenyl-2-carboxylate, mesylate and benzene sulfonate.In the specific embodiment of compositions of the present invention; use hydrobromate and bromination 3-[(cyclopenta-oxybenzene acetyl group) oxygen]-1, the 1-dimethyl pyrrolidine of Glycopyrrolate, it can adopt the U.S. patent No. 2; 956, method disclosed in 062 is prepared.

When compositions of the present invention comprises Glycopyrrolate, in certain embodiments, said composition can comprise enough Glycopyrrolates thus can provide the dosage delivered being selected from following group: each MDI startup effect can produce between about 10 μ g to about 100 μ g, between about 15 μ g to about 100 μ g, between about 15 μ g to about 80 μ g and between about 10 μ g to about 80 μ g.In other this kind of embodiment, said preparation comprises enough Glycopyrrolates thus can provide the dosage delivered being selected from following group: each MDI startup effect can produce up to about 100 μ g, up to about 80 μ g, up to about 40 μ g, up to about 20 μ g or up to about 10 μ g.In a further embodiment, said preparation can comprise enough Glycopyrrolates thus can provide the dosage delivered being selected from following group: each MDI startup effect can produce about 9 μ g, about 18 μ g, about 36 μ g and about 72 μ g.For realizing the dosage delivered that the present invention expects, when compositions of the present invention comprises Glycopyrrolate as activating agent, the amount of the Glycopyrrolate in a particular embodiment contained by compositions can be selected from such as, and about 0.04mg/mL is to about between 2.25mg/mL.

In other embodiments, tiotropium bromide comprises its any pharmaceutically acceptable salt, ester, isomer or solvate, can be included in compositions of the present invention as LAMA activating agent.Tiotropium bromide be a kind of known be suitable for treatment as described in the present invention to pneumonia or the long-acting anticholinergic thing blocking relevant disease or symptom.The form that tiotropium bromide comprises its crystal form and pharmaceutically acceptable salt has been documented in such as the U.S. patent No. 5,610,163, U.S. patent No. RE39820, the U.S. patent No. 6,777,423 and the U.S. patent No. 6.908, in 928.When compositions of the present invention comprises tiotropium bromide, said composition can comprise enough tiotropium bromides thus can provide the dosage delivered being selected from following group in certain embodiments: each MDI startup effect can produce between about 2.5 μ g to about 25 μ g, between about 4 μ g to about 25 μ g and between about 2.5 μ g to about 20 μ g and between about 10 μ g to about 20 μ g.In other this kind of embodiment, said preparation can comprise enough tiotropium bromides thus can provide the dosage delivered being selected from following group: each MDI startup effect can produce up to about 25 μ g, up to about 20 μ g, up to about 10 μ g, up to about 5 μ g or up to about 2.5 μ g.In a further embodiment, said preparation can comprise enough tiotropium bromides thus can provide the dosage delivered being selected from following group: each MDI startup effect can produce about 3 μ g, 6 μ g, 9 μ g, 18 μ g and 36 μ g.For realizing dosage delivered of the present invention, when compositions of the present invention comprises tiotropium bromide as activating agent, the amount of the tiotropium bromide in a particular embodiment contained by compositions can be selected from such as about 0.01mg/mL to about between 0.5mg/mL.

In other embodiments, compositions of the present invention comprises corticosteroid.This kind of activating agent can be selected from such as beclometasone, budesonide, ciclesonide, flunisolide, fluticasone, methylprednisolone, mometasone, prednisone and triamcinolone, comprises its any pharmaceutically acceptable salt, ester, isomer or solvate.In certain embodiments, this kind of compositions comprises the combination of corticosteroid active agent and LAMA or LABA activating agent.In other this kind of embodiment, compositions comprises the compositions of corticosteroid active agent and LAMA and LABA activating agent.When compositions comprises corticosteroid active agent, mometasone can be selected in a particular embodiment.

The preparation method of mometasone and pharmaceutically acceptable salt thereof such as momestasone furoate and these materials is known and has been documented in such as the U.S. patent No. 4,472,393, the U.S. patent No. 5,886,200 and the U.S. patent No. 6,177, in 560.Mometasone be suitable for treatment as described in the present invention those to pneumonia or block relevant disease or symptom (see, for example the U.S. patent No. 5,889,015, the U.S. patent No. 6,057,307, the U.S. patent No. 6,057,581, the U.S. patent No. 6,677,322, the U.S. patent No. 6,677,323 and the U.S. patent No. 6,365,581).

When compositions of the present invention comprises mometasone, compositions comprises the mometasone (comprising its pharmaceutically acceptable salt any, ester, isomer or solvate) of q.s thus can realize being selected from the targeted delivery dosage of following group in a particular embodiment: each MDI startup effect can produce between about 20 μ g to about 400 μ g, between about 20 μ g to about 200 μ g, between about 50 μ g to about 200 μ g, between about 100 μ g to about 200 μ g, between about 20 μ g to about 100 μ g and between about 50 μ g to about 100 μ g.In other embodiments, compositions of the present invention can comprise the mometasone (comprising its pharmaceutically acceptable salt any, ester, isomer or solvate) of q.s thus can provide the targeted delivery dosage being selected from following group: each MDI startup effect can produce up to about 400 μ g, up to about 200 μ g or up to about 100 μ g.

In other embodiments, compositions of the present invention comprises the corticosteroid being selected from fluticasone and budesonide.Fluticasone and budesonide be all applicable to treatment of the present invention those to pneumonia or block relevant disease.The preparation method of fluticasone, its pharmaceutically acceptable salt such as FLUTICASONE PROPIONATE and these materials is all known and is documented in the such as U.S. patent No. 4,335,121, the U.S. patent No. 4,187,301 and U.S. patent publication No. US2008125407 in.Budesonide is also known and is documented in the such as U.S. patent No. 3,929, in 768.In certain embodiments, the fluticasone that compositions of the present invention can comprise q.s comprises its pharmaceutically acceptable salt any, ester, isomer or solvate, thus can realize the targeted delivery dosage being selected from following group: MDI at every turn startup effect can produce between about 20 μ g to about 200 μ g, between about 50 μ g to about 175 μ g and between about 80 μ g to about 160 μ g.In other embodiments, the fluticasone that compositions of the present invention can comprise q.s comprises its pharmaceutically acceptable salt any, ester, isomer or solvate, thus can provide the targeted delivery dosage being selected from following group: MDI at every turn startup effect can produce up to about 175 μ g, up to about 160 μ g, up to about 100 μ g or up to about 80 μ g.In a particular embodiment, the budesonide that compositions of the present invention can comprise q.s comprises its pharmaceutically acceptable salt any, ester, isomer or solvate, thus can provide the targeted delivery dosage being selected from following group: MDI at every turn startup effect can produce between about 30 μ g to about 240 μ g, between about 30 μ g to about 120 μ g and between about 30 μ g to about 50 μ g.In other embodiments, compositions of the present invention can comprise the budesonide of q.s, comprise its pharmaceutically acceptable salt any, ester, isomer or solvate, thus the targeted delivery dosage being selected from following group can be provided: MDI at every turn startup effect can produce up to about 240 μ g, up to about 120 μ g or up to about 50 μ g.

In each example, compositions of the present invention comprises two or more activating agents.In certain embodiments, compositions comprises the combination of two or more active agent particles that can suspend altogether with single particle.Alternatively, can comprise can two or more active agent particles of suspending altogether of the particle different from two or more for compositions.Alternatively, compositions of the present invention can comprise single-activity agent granule and single particle suspends, and wherein single-activity agent granule comprises one or more activating agents, and single particle comprises one or more active agent particles.Further, compositions of the present invention can comprise two or more activating agents, and these active groups are combined in single active agent particle.Such as, when using one or more adjuvants or adjuvant and active agent materials to prepare active agent particle, this active agent particle can comprise the granule containing two or more different activities agent.

(iii) particle

The particle that suspension composition comprises of the present invention altogether can promote those stability comprising activating agent in the composition and delivery performance.Although can use multi-form particle, particle is formed by the material of pharmacology's inertia usually, and this material can be inhaled into and it is insoluble in selected propellant.Usually, most of particle has can size within the scope of incoming call.Therefore, in a particular embodiment, the MMAD of particle is no more than about 10 μm, but is not less than again about 500nm.In another embodiment, the MMAD of particle is in about 5 μm to about between 750nm.In another embodiment, the MMAD of particle is between about 1 μm to about 3 μm.When being used in the MDI embodiment of nasal delivery there, the MMAD of particle is between 10 μm to 50 μm.

For making the suspension particle diameter that can suck be within the scope of described MMAD, particle has the volume-median optical diameter between about 0.2 μm to about 50 μm usually.In one embodiment, particle has the volume-median optical diameter being no more than about 25 μm.In another embodiment, particle has the volume-median optical diameter being selected from following group: between about 0.5 μm to about 15 μm, between about 1.5 μm to about 10 μm and between about 2 μm to about 5 μm.

The concentration of the particle that compositions of the present invention comprises can adjust according to the amount of such as used active agent particle and suspension media.In one embodiment, the concentration of particle that suspension media comprises is selected from following group: about 1mg/ml is to about 15mg/ml, about 3mg/ml to about 10mg/ml, about 5mg/ml to about 8mg/ml and about 6mg/ml.In another embodiment, the concentration of particle that comprises of suspension media is up to about 30mg/ml.In another embodiment, the concentration of particle that comprises of suspension media is up to about 25mg/ml.

The common suspension that can realize desired by the present invention by selecting the relative quantity of particle and activating agent.Common suspension composition can be realized when the amount of particle exceedes the amount of active agent particle in mass.Such as, in a particular embodiment, the ratio of particle gross mass and active agent particle gross mass can between about 3:1 to about 15:1 or alternatively, between about between 2:1 to 8:1.Alternatively, depend on used particle and the character of active agent particle, the ratio of particle gross mass and active agent particle gross mass can be greater than 1, such as up to about 1.5, up to about 5, up to about 10, up to about 15, up to about 17, up to about 20, up to about 30, up to about 40, up to about 50, up to about 60, up to about 75, up to about 100, up to about 150 and up to about 200.In a still further embodiment, the ratio of particle gross mass and active agent particle gross mass can be selected between about 10 to about between 200, about 60 to about between 200, about 15 to about between 60, about 15 to about between 170, about 15 to about between 60, about 16, about 60 and about 170.

In other embodiments, the amount of particle is less than the quality of active agent particle in mass.Such as, in a particular embodiment, the gross mass of particle can be low to moderate 20% of active agent particle gross mass.But in certain embodiments, the gross mass of particle also can approximate or equal the gross mass of active agent particle.

The particle being applicable to compositions of the present invention can be formed by one or more pharmaceutically acceptable materials or excipient, and it is suitable for by inhalation delivery and substantially non-degradable or be dissolved in suspension media.In one embodiment, the porous microstructure that the present invention defines can be used as particle.The Exemplary excipients that can be used for being formed particle of the present invention includes but not limited to: (a) carbohydrate, as monosaccharide, and such as fructose, galactose, glucose, D-MANNOSE, sorbose etc.; As disaccharidase, such as sucrose, lactose, trehalose, cellobiose etc.; Cyclodextrin, such as 2-HP-BETA-CD; And polysaccharide, such as Raffinose, maltodextrin, dextran, starch, chitin, chitosan, inulin etc.; (b) aminoacid, such as alanine, glycine, arginine, aspartic acid, glutamic acid, cysteine, lysine, leucine, isoleucine, valine etc.; C metal that () is obtained by organic bronsted lowry acids and bases bronsted lowry and organic salt, such as sodium citrate, sodium ascorbate, magnesium gluconate, gluconic acid sodium salt, trometamol hydrochlorate etc.; (d) peptide and protein, such as aspartame, three leucines, human serum albumin, collagen protein, gelatin etc.; (e) alditol, such as mannitol, xylitol etc.; (f) synthesis natural polymer or its combination, such as polylactic acid, polylactic acid be lactide, cyclodextrin, polyacrylate, methylcellulose, carboxymethyl cellulose, polyvinyl alcohol, polyanhydride, poly-lactam, polrvinyl chloride ketopyrrolidine, hyaluronic acid, Polyethylene Glycol; And (g) comprises and fluoridizes or the surfactant of Non-fluorinated compound, such as saturated and undersaturated lipid, nonionic detergent, non-ionic block copolymer, ionic surface active agent and combination thereof.In a particular embodiment, particle can comprise calcium salt, as calcium chloride, see the such as U.S. patent No. 7,442,388.

In addition, phospholipid preparation that is natural and synthesis source can be used to be applicable to the particle of compositions of the present invention.In a particular embodiment, selected phospholipid has the phase in version from gel to liquid crystal when being greater than 40 DEG C.Exemplary phospholipid is relative long-chain (that is, C ₁₆-C ₂₂) saturated phospholipid and can saturated phospholipid be comprised, such as there is the phosphatidylcholine of 16C or 18C (palmityl and stearoyl) acyl chain length.Exemplary phospholipid comprises, and phosphoglyceride is Dioctonoyl pnosphotidyl choline, distearyl acid phosphatidyl choline, two Semen arachidis hypogaeae ester phosphatidyl choline, two mountain Yu phosphatidyl choline, diphosphatidylglycerol, short-chain phosphatidylcho, long-chain saturated phospholipid acyl ethanolamine, long-chain saturated phospholipid acyl serine and long-chain saturated phospholipid acyl inositol such as.More excipient has been disclosed in International Patent Publication No. WO96/32149 and the U.S. patent No. 6,358,530,6,372,258 and 6,518, in 239.

In a particular embodiment, particle can be formed by using one or more lipid of the present invention, phospholipid or saccharides.In certain embodiments, particle comprises one or more surfactants.The use of particle formed by one or more surfactants or comprise this surfactant can promote the absorption of selected activating agent, thus increases its bioavailability.Particle of the present invention, particle such as by using one or more lipids to be formed can present the surface roughness (rugosity) of expectation, thus reduces intergranular interaction further and promote aerosolized effect by the surf zone reducing pellet-pellet interphase interaction.In a still further embodiment, in suitable situation, those can be used naturally to be present in lipid in lung to form particle, because this particle has the potentiality that minimizing helps the effect of biting (therefore can reduce the phagocytosis of pulmonary alveolar macrophage), more long-life controlled release granule can be provided in lung.

On the other hand, be similar to disclosed in international patent application no WO2005/000267, compositions of the present invention can the particle that is suitable for of choice for use thus increase the bin stability of selected activating agent.Such as, in one embodiment, particle can comprise pharmaceutically acceptable and have the excipient of the stabilization of at least 55 DEG C, at least 75 DEG C or at least 100 DEG C Tg.The glass formers being applicable to compositions of the present invention includes but not limited to, one or more three leucines, sodium citrate, sodium phosphate, ascorbic acid, inulin, cyclodextrin, polyvinylpyrrolidone, mannitol, sucrose, lactose, trehalose, proline.The more examples forming the excipient of glass have been disclosed in U.S. patent No. RE37,872,5,928,469,6,258,341 and 6,309, in 671.

Can come as required to design particle, sizing and be shaped thus stability and the activating agent delivery characteristics of expectation can be provided.In an exemplary embodiment, particle contains porous microstructure of the present invention.When using porous microstructure as particle in compositions of the present invention, it can be formed by using one or more excipient of the present invention.Such as, in a particular embodiment, porous microstructure can comprise at least one in following material: the fluorinated surfactant of lipid, phospholipid, nonionic detergent, non-ionic block copolymer, ionic surface active agent, biocompatibility and their combination, especially those have been approved for the material of pulmonary.The specific surfactant that can be used for preparing porous microstructure comprises, PLURONICS F87, poloxamer188 and Pluronic/Lutrol F 108.Other specific surfactants comprise oleic acid or its alkali metal salt.In one embodiment, porous microstructure comprises the surfactant being greater than about 10%w/w.

In certain embodiments, particle can be prepared by the mode using fluorocarbon oil (as perfluoro bromide octane, perfluorodecalin) to form emulsion oil-in-water, and this fluorocarbon oil carries out emulsifying by using the surfactant as long-chain saturated phospholipid.Can high-pressure homogenizer be used to carry out homogenizing to reduce droplet size the perfluorocarbon in the aqueous emulsion of gained subsequently.Perfluorocarbon emulsion can be fed in spray dryer, comprises activating agent if wish in porous microstructure, can charging together with activator solution alternatively.As everyone knows, spraying dry is a kind of technique that liquid feedstock conversion can be become dry particles form.Spraying dry has been used to be provided for the powder medicaments that various different way of administration comprises inhalation.Required particle size can be prepared by the operating condition (such as entrance and outlet temperature, feed rate, atomizing pressure, dry gas flow velocity and nozzle arrangements) of adjustment spray dryer, and then obtained dry microstructure.These methods preparing exemplary porous microstructure have been disclosed in the U.S. patent 6,309 of the people such as Weers, in 623.

Porous microstructure of the present invention also can be pulverized by first lyophilizing and then carry out or prepared by micronized method.Lyophilizing is freeze-dried technique, and the water in freezing rear compositions can be sublimated removing.This technique can carry out drying under the condition not needing high temperature.In a still further embodiment, particle is prepared by using drying process with atomizing, such as U.S. patent 5, and 727, described such in 333.

In addition, particle of the present invention can contain filling agent, such as aggregated particles.Polymerizable polymer can be formed by biocompatibility and/or Biodegradable polymeric, copolymer or its mixture.In one embodiment, the polymer that can form the light fine particles of aerodynamic can be used, such as functionalized polyester graft copolymer and biodegradable polyanhydride.Such as, can use based on the filling eroding polymer containing poly-(hydroxy acid) polyester.Polyglycolic acid (PGA), polylactic acid (PLA) or its copolymer can be used to form particle.Polyester can comprise charged group or can be functionalized group, such as aminoacid.Such as, particle can be formed by poly-(D, L lactic acid) and/or poly-(D, Pfansteihl-altogether-glycolic) (PLGA), and it comprises surfactant such as DPPC.

Other possible Candidate polymers for particle can comprise, polyamide, Merlon, polyene is as polyethylene, polypropylene, Polyethylene Glycol, poly-(oxirane), poly-(PETP), polyvinyl compounds is as polyvinyl alcohol, polyvinylether and polyvinyl ester, the polymer of acrylic acid and methacrylic acid, cellulose and other polysaccharide, and peptide or protein, or their copolymer or mixture.Can needing to come choice for use those have suitable stability and the polymer of degradation speed in vivo for the application of different controlled drug release delivery, or make these polymer have this suitable stability and degradation speed by modifying.

Compositions of the present invention can comprise the particle of two or more types.Further, compositions of the present invention can comprise the particle wherein containing one or more activating agents.When activating agent is included in particle, this particle should have the size that can suck and can be undertaken preparing and producing by example method as described in the present invention and material.

The compositions prepared of training centre according to the present invention can the degraded of activating agent in composite inhibiting.Such as, in a particular embodiment, compositions of the present invention can suppress the flocculation of the activating agent comprised in the composition, gathering and solution mediated transformation one or more phenomenons active.Pharmaceutical composition of the present invention is applicable to carrying out respiratory drugs by MDI in the specific mode of one and sends, often kind of activating agent which can make the combination of two or more activating agents comprise all reaches the dosage delivered uniformity (" DDU ") of expectation, or even also can reach when this combination contains effective and efficient activating agent.As described in detail in the embodiment that the present invention includes, even when sending two or more activating agents of very low dosage, compositions of the present invention also can make in the whole process of emptying MDI tank the DDU of often kind of activating agent reach ± 30% or higher.In this kind of embodiment, compositions of the present invention can make in the whole process of emptying MDI tank the DDU of often kind of activating agent reach ± 25% or higher.In another this kind of embodiment, compositions of the present invention can make in the whole process of emptying MDI tank the DDU of often kind of activating agent reach ± 20% or higher.

FPF and FPD performance substantially can also remain unchanged by compositions of the present invention in the whole process of emptying MDI tank, even if under accelerated degradation condition.Such as, compositions of the present invention can by FPF and FPD performance maintain its initial value 80%, 90%, 95% or more in the whole process of emptying MDI tank, even if under the condition of accelerated degradation.When carrying out preparing when using non-CFC propellant and eliminate or substantially avoid the drug influence that those compositionss comprising multiple actives exist usually, compositions of the present invention still can provide the additional benefit realizing this kind of performance.In a particular embodiment, when adopt only containing one or more not by add such as cosolvent, anti-solvent, solubilizing agent, adjuvant or other propellants modify one or more in material to carry out the non-CFC propellant improved suspension media to its performance prepare time, compositions of the present invention still can one in realize target DDU, FPF and FPD performance or all.

In one embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, between the first and second wherein said active agent particles and described multiple particle, association occurs thus forms suspension altogether.In this kind of embodiment, the ratio between the gross mass of particle and the gross mass of the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, between the first and second wherein said active agent particles and described multiple particle, association occurs thus forms suspension altogether.In this kind of embodiment, the ratio between the gross mass of particle and the gross mass of the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the multiple actives granule of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; And comprise its any pharmaceutically acceptable salt, ester, isomer or the multiple of solvate suck particle containing formoterol, wherein said multiple particle has volume-median optical diameter between about 1.5 μm to about 10 μm and its concentration in suspension media is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g, and these particles can form suspension altogether with described multiple actives granule generation association.In this kind of embodiment, the ratio between the gross mass of particle and the gross mass of the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the multiple actives granule of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; And comprise its any pharmaceutically acceptable salt, ester, isomer or the multiple of solvate suck particle containing formoterol, the wherein said multiple particle that sucks has volume-median optical diameter between about 1.5 μm to about 10 μm and its concentration in suspension media is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g, and these can suck particle can form suspension with described multiple actives granule generation association.In this kind of embodiment, the ratio between the gross mass of particle and the gross mass of the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; 3rd activating agent, it contains the corticosteroid being selected from beclometasone, budesonide, ciclesonide, flunisolide, fluticasone, methylprednisolone, mometasone, prednisone and triamcinolone and comprising their pharmaceutically acceptable salts any, ester, isomer or solvate; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, first, second, and third wherein said active agent particle and described multiple particle generation association thus form suspension altogether.In this kind of embodiment, first, second, and third active agent particle of at least 90% has the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of first, second, and third active agent particle is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Comprise the 3rd active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing budesonide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce budesonide dosage delivered between about 30 μ g to about 50 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, first, second, and third wherein said active agent particle and described particle generation association thus form suspension altogether.In this kind of embodiment, first, second, and third active agent particle of at least 90% has the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of first, second, and third active agent particle is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Comprise the 3rd active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing budesonide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce budesonide dosage delivered between about 30 μ g to about 50 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, first, second, and third wherein said active agent particle and described multiple particle generation association thus form suspension altogether.In this kind of embodiment, first, second, and third active agent particle of at least 90% has the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of first, second, and third active agent particle is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Comprise the 3rd active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing mometasone, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce mometasone dosage delivered between about 20 μ g to about 100 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, first, second, and third wherein said active agent particle and described multiple particle generation association thus form suspension altogether.In this kind of embodiment, first, second, and third active agent particle of at least 90% has the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of first, second, and third active agent particle is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Comprise the 3rd active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing mometasone, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce mometasone dosage delivered between about 20 μ g to about 100 μ g; And multiple the sucked particle containing porous microstructure, this particle has the volume-median optical diameter between 1.5 μm to about 10 μm, first, second, and third wherein said active agent particle and described multiple particle generation association thus form suspension altogether.In this kind of embodiment, first, second, and third active agent particle of at least 90% has the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of first, second, and third active agent particle is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Multiple the sucked particle comprising porous microstructure, wherein said porous microstructure contains the corticosteroid being selected from beclometasone, budesonide, ciclesonide, flunisolide, fluticasone, methylprednisolone, mometasone, prednisone and triamcinolone and comprising their pharmaceutically acceptable salts any, ester, isomer or solvate, wherein said particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second described active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of particle and the gross mass of the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle containing porous microstructure, this porous microstructure contains budesonide and comprises its any pharmaceutically acceptable salt, ester, isomer or solvate, this particle contains enough budesonides thus each startup effect of metered-dose inhaler can be made can to produce the budesonide dosage delivered of about 30 μ g extremely between about 50 μ g, this particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second described active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio of the gross mass of the gross mass of particle and the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing Glycopyrrolate, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce Glycopyrrolate dosage delivered between about 15 μ g to about 80 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle containing porous microstructure, this porous microstructure contains mometasone and comprises its any pharmaceutically acceptable salt, ester, isomer or solvate, wherein this particle contains enough mometasones thus each startup effect of metered-dose inhaler can be made can to produce the mometasone dosage delivered of about 20 μ g extremely between about 100 μ g, this particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second described active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of the gross mass of particle and the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; Sucked particle containing porous microstructure, this porous microstructure contains the corticosteroid being selected from beclometasone, budesonide, ciclesonide, flunisolide, fluticasone, methylprednisolone, mometasone, prednisone and triamcinolone and comprising their pharmaceutically acceptable salts any, ester, isomer or solvate, wherein particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of the gross mass of particle and the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle containing porous microstructure, this porous microstructure contains budesonide and comprises its any pharmaceutically acceptable salt, ester, isomer or solvate, this particle contains enough budesonides thus makes each startup effect of metered-dose inhaler can produce the budesonide dosage delivered of about 30 μ g extremely between about 50 μ g, this particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of the gross mass of particle and the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

In another embodiment, the common suspension composition sent by metered-dose inhaler of the present invention is comprised: the suspension media containing pharmaceutically acceptable HFA propellant; Comprise the first active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing tiotropium bromide, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce tiotropium bromide dosage delivered between about 5 μ g to about 20 μ g; Comprise the second active agent particle of its any pharmaceutically acceptable salt, ester, isomer or solvate containing formoterol, this active agent particle is suspended in suspension media and its concentration existed is enough to make each startup effect of metered-dose inhaler can produce formoterol dosage delivered between about 2 μ g to about 10 μ g; And multiple the sucked particle comprising porous microstructure, this porous microstructure contains mometasone and comprises its any pharmaceutically acceptable salt, ester, isomer or solvate, this particle contains enough mometasones thus makes each startup effect of metered-dose inhaler can produce the mometasone dosage delivered of about 20 μ g extremely between about 100 μ g, this particle has the volume-median optical diameter between about 1.5 μm to about 10 μm, and forms altogether suspension with the first and second active agent particle generation associations.In this kind of embodiment, first and second active agent particles of at least 90% have the optical diameter being less than 7 μm by volume, and the ratio between the gross mass of the gross mass of particle and the first and second active agent particles is selected from about 3:1 to about between 15:1 and about between 2:1 to 8:1.

quantitative intake system

As in the inventive method mention, compositions disclosed in this invention can be used in MDI system.MDI can be configured to the medicine of the aerosol form of sending specified quantitative.In one embodiment, MDI system comprises the container tank for store compressed liquid phase preparation, and it is arranged in the trigger with nozzle.MDI system can comprise preparation of the present invention, and said preparation comprises suspension media, the active agent particle of at least one type and the particle of at least one type.Container tank for MDI can be any suitable structure, and in an exemplary embodiment, container tank can have the volume range of about 5mL to about 25mL, such as has the volume of 19mL.After jolting device, between lips and teeth nozzle being inserted patient mouth Palestine and China.Usually, patient exhales to empty lungs deeply, then while startup MDI cartridge case, carries out deep and slow respiration.

Metering valve in the inside of exemplary medicinal cupping, the preparation of this volume, with the measuring room of preparation (as 63 μ l or any volume that other can be held by the metering valve that commercial channel can obtain) that can hold designated volume, is released in the expansion chambers of valve stem end by upon start up.Trigger controls container tank, and can comprise the port with trigger nozzle, and this trigger nozzle can be used for holding the valve rod of metering valve.Upon start up, the preparation of designated volume can enter into expansion chambers, discharges and form high velocity fog thus enter the pulmonary of patient from starting nozzle.

iV. method

The invention provides through breathing the compound method of sending the pharmaceutical composition comprising at least two kinds of activating agents of the present invention.In one embodiment, the method comprising the steps of: provide a kind of suspension media, one or more active agent particles and one or more particles, these components carried out combining forming active agent particle of the present invention and particle associates and the common suspension preparation of common point in suspension media mutually.In this kind of embodiment, active agent particle and the association of particle make them can not be separated because of its different buoyancy in propellant.Should be appreciated that the method preparing drug combination preparation of the present invention can comprise, the active agent particle of two or more types and the combination of one or more particles are provided.In a further embodiment, the method can comprise, and provides the combination of two or more particles and two or more active agent particles according to certain mode, and described mode can make this be combined to form common suspension.In yet another embodiment, one or more active agent particles of the present invention can combine with one or more particles.In a particular embodiment, the active agent materials comprised at active agent particle be selected from LABA, LAMA or corticosteroid active agent one or more.In certain embodiments, active agent particle is made up of active agent materials and other adjuvants, adjuvant and stabilizing agent etc. substantially.

Provide two or more activating agents stable composition method specific embodiment in, the invention provides the method for the solution mediated transformation effect of the activating agent in the pharmaceutical composition that a kind of suppression sends through lung.In one embodiment, the suspension media that suspension media of the present invention is such as formed by HFA propellant can be obtained.Also can obtain active agent particle, and suspension media, particle and active agent particle can be carried out combining thus form altogether suspension, wherein active agent particle and particle mutually associate also common point in the continuous phase formed by suspension media.Compare when not containing contained active agent particle in the identical suspension media of particle with those, can find that suspension altogether of the present invention causes the solution of irreversible crystal aggregation phenomenon to mediate inversion of phases effect for those and has higher toleration, thus it can improve stability and dose uniformity.

In a further embodiment, the method forming the stable composition sent through lung containing two or more activating agents comprises, and keeps FPF and/or FDP of compositions in the whole process of emptying MDI tank.Keep in the specific embodiment of the method for FPF and/or FPD of lung delivering drugs preparation at those, can provide a kind of and of the present inventionly suck common suspension, this common suspension FPD and/or FPF can be maintained respectively in the whole process of emptying MDI tank its initial FPD and/or FPF ± 20%, ± 10% or even ± 5% in.Namely, under the common suspension of box lunch is in the condition of accelerated degradation, still this performance can be realized.In one embodiment, the suspension media that suspension media of the present invention is such as formed by HFA propellant can be obtained.Also can obtain or obtained particle of the present invention.Also the active agent particle of the present invention of one or more types can be obtained, and suspension media, particle and active agent particle are carried out combining thus form altogether suspension, wherein active agent particle and particle mutually associate also common point in suspension media.Even if after this kind of compositions being exposed to the process of one or many temperature cycling, altogether suspension also FPD or FPF can be maintained compositions be exposed to one or many temperature cycling before treatment ± 20%, ± 10% or even ± 5% in.

This application discloses preparation can send the MDI of two or more activating agents method through lung.In certain embodiments, this method can comprise and loads container tank of the present invention with active agent particle and particle.Trigger valve can be arranged on one end of container tank and sealed container tank.Trigger valve can be adjusted thus make MDI at every turn startup effect can send the quantitative activating agent be included in common suspension composition.Can use pharmaceutically acceptable suspension media than propellant as described in the present invention to load container tank, thus active agent particle and particle can form stable common suspension in suspension media.

Send in the method for two or more activating agents in use compositions of the present invention through breathing, said composition is sent by MDI.Therefore, in the specific embodiment of this kind of method, the MDI being filled with compositions of the present invention can be obtained, and by the startup effect of MDI, two or more activating agents are delivered to patient through lung.Such as, in one embodiment, the method comprises sends two or more activating agents through lung, by between the spigot joint lips and teeth being inserted into patient's face after jolting MDI device.Usually, then patient's first dark expiration once deeply breathes to empty lungs while startup MDI medicinal cupping.Upon start up, the preparation of designated volume can be introduced into expansion chambers, from starting nozzle, then discharges formation high velocity fog enter into patient lungs.In one embodiment, in the whole process of emptying MDI tank, the dosage delivered of often kind of activating agent can not exceed higher than mean delivered dose 30%, also can not be less than 30% lower than mean delivered dose.Therefore, the DDU of the application's two or more activating agents that a kind of MDI of making can be provided to send reaches the method for desirable value.In this kind of embodiment, the method can in the overall process of the emptying MDI tank sending common suspension, and the DDU of often kind of activating agent in two or more activating agents that MDI tank is sent reaches the DDU, ± DDU of 25% or the higher and DDU of ± 20% or higher of such as ± 30% or higher.

The invention provides and treat the method that those suffer the patient of inflammatory or obstructive disease of lung or symptom.In certain embodiments, this kind of method comprises the pharmaceutical composition of the present invention through lung delivery treatments effective dose, at some in this kind of embodiment, by use MDI delivering compositions with realize pharmaceutical preparation through lung administration.Intend the disease for the treatment of or symptom can be selected from and anyly can produce the inflammation of responsing reaction or obstructive pulmonary disease or symptom to such as activating agent of the present invention.In certain embodiments, activating agent combination comprises at least one activating agent be selected from LAMA, LABA or corticosteroid active agent.In a particular embodiment, pharmaceutical composition of the present invention can be used for treating the disease or symptom that are selected from following group: the airway hyperreactivity deterioration of asthma, COPD, other drug therapy secondary, allergic rhinitis, sinusitis, Pulmonary Vascular contraction, inflammation, allergy, respiratory disorder, respiratory distress syndrome, pulmonary hypertension, Pulmonary Vascular are shunk, emphysema and anyly can produce other pulmonary disease and symptoms of responsing reaction, character, genotype or phenotype to activating agent administering drug combinations of the present invention.In certain embodiments, pharmaceutical composition of the present invention can be used for the treatment pneumonia relevant to cystic fibrosis and obstruction.

In addition, the pharmaceutical composition of the present invention that MDI sends can provide required pharmacodynamics (PD) performance.In a particular embodiment, send pharmaceutical composition of the present invention through lung and lung capacity can be made to occur significantly to improve fast, this can use patient's forced expiratory volume in one second (FEV ₁) improvement degree characterize.Such as, in a particular embodiment, this application provides and a kind ofly realize clinical FEV ₁the method of remarkable increase, this kind of method comprises to be provided common suspension composition containing LABA or LAMA activating agent of the present invention and gives those patients suffering pneumonia or block by MDI by this compositions.In this kind of embodiment, the activating agent that compositions comprises comprises the one combination be selected from following group: the combination of LABA and LAMA activating agent, the combination of LABA and corticosteroid active agent, the combination of LAMA and corticosteroid active agent, and the combination of LABA, LAMA and corticosteroid active agent.With regard to object of the present invention, clinical FEV ₁remarkable recruitment is 100ml or more, in the specific embodiment of the method for the invention, the present composition is given patient and can make FEV in 1 hour or shorter time ₁there is the remarkable increase on clinical meaning.In other this kind of embodiment, give patient by MDI by compositions of the present invention and can make FEV in 0.5 hour or shorter time ₁there is the remarkable increase on clinical meaning.

In a further embodiment, the invention provides and can make FEV ₁increase the method for more than 100ml.Such as, in a particular embodiment, described method is included in be selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter time and makes FEV ₁increase 150ml or more.In other embodiments, described method can make to make FEV being selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter and 2 hours or shorter time ₁increase 200ml or more.In another other these type of embodiments, described method can make to make FEV being selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter and 2 hours or shorter time ₁increase 250ml or more.In another other these type of embodiments, described method can make to make FEV being selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter and 2 hours or shorter time ₁increase 300ml or more.In another other these type of embodiments, described method can make to make FEV being selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter and 2 hours or shorter time ₁increase 350ml or more.In specific this kind of embodiment, activating agent contained by compositions comprises the one combination be selected from following combination: the combination of LABA and LAMA activating agent, the combination of LABA and corticosteroid active agent, the combination of LAMA and corticosteroid active agent, the combination of LABA, LAMA and corticosteroid active agent, wherein said compositions is delivered to patient by MDI.

In a still further embodiment, this application provides a kind of realization and maintenance FEV ₁the method of the remarkable increase on clinical meaning.In a particular embodiment, when given by MDI patient's dose be formulated into the activating agent of the compositions described in the application time, FEV can be made being selected from 0.5 hour or shorter, 1 hour or shorter and 1.5 hours or shorter time ₁reach the remarkable increase on clinical meaning, and FEV ₁remarkable increase on this clinical meaning can maintain 12 hours even longer.In specific this kind of embodiment, FEV ₁recruitment can be selected from 150ml or more, 200ml or more, 250ml or more, 300ml or more and 350ml or more, and FEV ₁recruitment time of maintaining the significant quantity on clinical meaning can be selected from up to 4 hours, up to 6 hours, up to 8 hours, up to 10 hours and up to 12 hours or longer.In specific this kind of embodiment, activating agent contained by compositions comprises the one combination be selected from following combination: the combination of LABA and LAMA activating agent, the combination of LABA and corticosteroid active agent, the combination of LAMA and corticosteroid active agent, the combination of LABA, LAMA and corticosteroid active agent, wherein said compositions is delivered to patient by MDI.

Compositions of the present invention, system and method are not only suitable for realizing required pharmacodynamics performance at short notice, and the ratio realizing this kind of result is in patients also very high.Such as, method of the present invention 50% or more suffer can make FEV in pneumonia or the patient of blocking ₁recruitment reach 10% or higher.Such as, in a particular embodiment, the FEV of patient is made ₁the method increasing by 10% or higher comprises, common suspension composition containing activating agent combination of the present invention is provided, wherein at least one activating agent is selected from LABA, LAMA of the present invention and corticosteroid active agent, and gives those patients suffering pneumonia or block by MDI by this compositions.In specific this kind of embodiment, giving compositions can at the FEV being selected from 0.5 hour or shorter, 1 hour or shorter, 1.5 hours or shorter and 2 hours the patient making 50% or more ₁recruitment reaches 10% or higher.In other this kind of embodiment, giving compositions can at the FEV being selected from 0.5 hour or shorter, 1 hour or shorter, 1.5 hours or shorter and 2 hours or shorter time the patient making 60% or more ₁recruitment reaches 10% or higher.In other this kind of embodiment, giving compositions can at the FEV being selected from 0.5 hour or shorter, 1 hour or shorter, 1.5 hours or shorter and 2 hours or shorter time the patient making 70% or more ₁recruitment reaches 10% or higher.In other this kind of embodiment, giving compositions can at the FEV being selected from 0.5 hour or shorter, 1 hour or shorter, 1.5 hours or shorter and 2 hours or shorter time the patient making 80% or more ₁recruitment reaches 10% or higher.In specific this kind of embodiment, activating agent contained by compositions comprises the one combination be selected from following combination: the combination of LABA and LAMA activating agent, the combination of LABA and corticosteroid active agent, the combination of LAMA and corticosteroid active agent, the combination of LABA, LAMA and corticosteroid active agent, wherein said compositions is delivered to patient by MDI.

In a particular embodiment, method of the present invention can treat those patients suffering pneumonia or block, wherein the method comprises the common suspension composition that provides and combine containing activating agent of the present invention and gives those patients suffering pneumonia or block by MDI by this compositions, gives by MDI the FEV that said composition can make those patients ₁from basic value increase at least 200ml, or from basic value increase by 12% or more and FEV ₁total recruitment at least 150ml.In specific this kind of embodiment, give compositions and in 50% or more patient, FEV can be made in 1 hour or shorter, 1.5 hours or shorter, 2 hours or shorter and 2.5 hours or shorter time ₁from basic value increase at least 200ml, or from basic value increase by 12% or more and FEV ₁total recruitment at least 150ml.In other this kind of embodiment, give compositions and in 60% or more patient, FEV can be made in 1 hour or shorter, 1.5 hours or shorter, 2 hours or shorter and 2.5 hours or shorter time ₁from basic value increase at least 200ml, or from basic value increase by 12% or more and FEV ₁total recruitment at least 150ml.In other this kind of embodiment, give compositions and in 70% or more patient, FEV can be made in 1 hour or shorter, 1.5 hours or shorter, 2 hours or shorter, 2.5 hours or shorter and 3 hours or shorter time ₁from basic value increase at least 200ml, or from basic value increase by 12% or more and FEV ₁total recruitment at least 150ml.In other this kind of embodiment, give compositions and in 80% or more patient, FEV can be made in 1 hour or shorter, 1.5 hours or shorter, 2 hours or shorter, 2.5 hours or shorter and 3 hours or shorter time ₁from basic value increase at least 200ml, or from basic value increase by 12% or more and FEV ₁total recruitment at least 150ml.At some in this kind of embodiment, the activating agent that compositions comprises comprise be selected from LABA and LAMA activating agent combination, the combination of LABA and corticosteroid active agent, one in LAMA and the combination of corticosteroid active agent and the combination of LABA, LAMA and corticosteroid active agent, wherein said compositions is delivered to patient by MDI.

In certain embodiments, of the present invention for realizing and maintaining the FEV of the remarkable increase on clinical meaning ₁method make FEV ₁increase, this shows FEV compared with the improvement that the compositions of only sending single-activity agent provides ₁obtain remarkable improvement.For to compositions of the present invention with only to send single-activity agent send FEV ₁the object that performance compares, by FEV ₁remarkable improvement be defined as and improve 60ml or more.Such as, in a particular embodiment, the FEV that the improvement tool realizing providing relative to the compositions of only sending single-activity agent is significantly improved ₁method comprise altogether suspension composition of the present invention be provided, described compositions comprises the combination of activating agent, wherein at least one activating agent is selected from LABA, LAMA of the present invention and corticosteroid active agent, and gives such composition the patient suffering from pneumonia or obstruction by MDI.In some this type of embodiment, the FEV reached with the compositions by sending single-activity agent ₁aUC _0-12compare, give common suspension composition and make FEV ₁aUC _0-12improve at least 70ml.In other these type of embodiments, the FEV reached with the compositions by sending single-activity agent ₁aUC _0-12compare, give common suspension composition and make FEV ₁aUC _0-12improve at least 80ml.In another other embodiments, the FEV reached with the compositions by sending single-activity agent ₁aUC _0-12compare, give common suspension composition and make FEV ₁aUC _0-12improve at least 90ml.

In other embodiments, the FEV that the improvement tool realizing providing relative to the compositions of only sending single-activity agent is significantly improved ₁method comprise altogether suspension composition of the present invention be provided, described compositions comprises the combination of activating agent, wherein at least one activating agent is selected from LABA, LAMA of the present invention and corticosteroid active agent, give such composition the patient experiencing pneumonia or obstruction by MDI, described administration makes the peak FEV reached with the compositions of sending single-activity agent ₁compare, FEV ₁peak variable quantity (peak FEV ₁) significantly improve.In some this type of embodiment, the peak FEV reached with the compositions of sending single-activity agent ₁compare, give the peak FEV that suspension composition altogether of the present invention reaches ₁improve at least 70ml.In other these type of embodiments, the peak FEV reached with the compositions of sending single-activity agent ₁compare, give the peak FEV that suspension composition altogether of the present invention reaches ₁improve at least 80ml.In this type of embodiment further, the peak FEV reached with the compositions of sending single-activity agent ₁compare, give the peak FEV that suspension composition altogether of the present invention reaches ₁improve at least 90ml.

Present invention also provides a kind of method making the patient respiratory capacity (IC) suffering from pneumonia or obstruction occur clinical remarkable increase.As used herein, when IC is defined as the complete air-breathing after normal exhalation, can suck the maximum volume of the gas of pulmonary, the clinical remarkable increase of IC refers to the increase of 70ml or more.Such as, in a particular embodiment, the method of the IC of improvement as described in the present invention comprises provides suspension composition altogether of the present invention, described compositions comprises the combination of activating agent, wherein at least one activating agent is selected from LABA, LAMA of the present invention and corticosteroid active agent, give such composition the patient suffering from pneumonia or obstruction by MDI, the IC that makes of wherein said compositions increases 70ml or more.In some this type of embodiment, give compositions of the present invention and make IC increase 100ml or more.In other these type of embodiments, give compositions of the present invention and make IC increase 200ml or more.In other these type of embodiments, give compositions of the present invention and make IC increase 300ml or more.In other these type of embodiments, give compositions of the present invention and make IC increase 350ml or more.In other these type of embodiments specific, described IC increases sharply.Such as, in described each method, can being selected from 1 hour or following and 2 hours or following time, the clinical remarkable increase of IC of patient or IC increase and are selected from 100ml or more, 200ml or more, 300ml or more, or 350ml or more.

The method of increase IC of the present invention can not only realize rapidly the clinical remarkable increase of IC in the short period of time, and it can also be used for the clinical remarkable increase at a period of time maintenance IC.Such as, the clinical effectiveness provided in embodiment 12 is outstanding to be indicated: after administration, patient experiences rapidly the clinical remarkable increase of the IC provided by method of the present invention, reach 12 hours upon administration or in the longer time period, the increase of IC maintains clinical significance, even after long term administration (such as, many days successive administrations), the increase of IC still maintains clinical significance.

And, increase according to the IC that compositions of the present invention provides the IC increase being significantly higher than and being provided by the compositions of only sending single-activity agent.In the embodiment of the method for increase IC of the present invention, the IC that giving suspension composition altogether of the present invention provides increases and increases at least high 70ml or more than the IC provided by the compositions of only sending single-activity agent.In this type of embodiment, the IC that giving suspension composition altogether of the present invention provides increases and increases at least high 100ml or more than the IC provided by the compositions of only sending single-activity agent.In another this type of embodiment, the IC that giving suspension composition altogether of the present invention provides increases and increases at least high 125ml or more than the IC provided by the compositions of only sending single-activity agent.

In certain embodiments, the feature of the method for reaching required pharmacodynamic action of the present invention is send the activating agent of relatively low quantities.In some this type of embodiment, such as of the present invention for reaching FEV ₁the method of clinical remarkable increase comprises and gives altogether suspension of the present invention, described suspension altogether comprises the combination of Glycopyrrolate and formoterol active agent, wherein give for twice every day to be at the most total to suspension described in patient by metered-dose inhaler, and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 150 μ g and formoterol is no more than 12ug.In other these type of embodiments, of the present invention for reaching FEV ₁the method of clinical remarkable increase comprises and gives altogether suspension of the present invention, described suspension altogether comprises the combination of Glycopyrrolate and formoterol active agent, wherein give for twice every day to be at the most total to suspension described in patient by metered-dose inhaler, and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 100 μ g and formoterol is no more than 12ug.In other these type of embodiments, of the present invention for reaching FEV ₁the method of clinical remarkable increase comprises and gives altogether suspension of the present invention, described suspension altogether comprises the combination of Glycopyrrolate and formoterol active agent, wherein give for twice every day to be at the most total to suspension described in patient by metered-dose inhaler, and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 80 μ g and formoterol is no more than 12ug.In other embodiments, of the present invention for reaching FEV ₁the method of clinical remarkable increase comprises and gives altogether suspension of the present invention, described suspension altogether comprises the combination of Glycopyrrolate and formoterol active agent, wherein give for twice every day to be at the most total to suspension described in patient by metered-dose inhaler, and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 50 μ g and formoterol is no more than 12ug.

In certain embodiments, method for reaching the clinical remarkable increase of IC of the present invention comprises and gives patient altogether suspension composition of the present invention by metered-dose inhaler, wherein said suspension altogether comprises Glycopyrrolate and formoterol active agent, give for twice every day to be at the most total to suspension described in patient by metered-dose inhaler, and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 150 μ g and formoterol is no more than 12ug.In some this type of embodiment, the such as method for reaching the clinical remarkable increase of IC of the present invention comprises and gives altogether suspension of the present invention, the described combination being total to suspension and comprising Glycopyrrolate and formoterol active agent, wherein gives for twice to be total to suspension described in patient by metered-dose inhaler at the most every day and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 100 μ g and formoterol is no more than 12ug.In other these type of embodiments, method for reaching the clinical remarkable increase of IC of the present invention comprises and gives altogether suspension of the present invention, the described combination being total to suspension and comprising Glycopyrrolate and formoterol active agent, wherein gives for twice to be total to suspension described in patient by metered-dose inhaler at the most every day and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 80 μ g and formoterol is no more than 12ug.In other these type of embodiments, method for reaching the clinical remarkable increase of IC of the present invention comprises and gives altogether suspension of the present invention, the described combination being total to suspension and comprising Glycopyrrolate and formoterol active agent, wherein gives for twice to be total to suspension described in patient by metered-dose inhaler at the most every day and total dosage delivered that total dosage delivered that each administration gives patient's Glycopyrrolate is no more than 50 μ g and formoterol is no more than 12ug.

The compositions provided in method of the present invention and send can comprise common suspension composition, and it comprises the combination of any activating agent as described in the present invention.Such as, in a particular embodiment, of the present invention for reaching FEV ₁or the method for the clinical remarkable increase of IC comprises the common suspension composition providing and comprise two or more activating agents, at least one wherein in those activating agents is selected from LABA, LAMA of the present invention or corticosteroid, and gives such composition the patient suffering from pneumonia or obstruction by MDI.In this type of embodiment, the described activating agent in described altogether suspension composition comprises and is selected from one of following combination: the combination of the combination of LABA and LAMA activating agent, LABA and corticosteroid active agent, LAMA and the combination of corticosteroid active agent and the combination of LABA, LAMA and corticosteroid active agent.In the specific embodiment of the method for the invention, the common suspension composition providing and give can be any specific detailed in this article suspension composition altogether.

Specific embodiment in the application only for the object of example, and not will be understood that it forms any restriction to the application.In addition, compositions disclosed in the present application, system and method are described in those relative specific embodiments, many details are wherein only the object of example, the application can comprise other embodiment, can change the specific detail described by the application when not departing from its general principles, this point is easy understand to those skilled in the art.Any activating agent used in the following example or reagent can be obtained by commercial channel, or can be obtained by the technique in normative document by those skilled in the art under the instruction that the application provides helps.The full content of all publications referenced by the application, granted patent and patent application all by reference to mode be incorporated in the application.

embodiment 1

Prepare exemplary suspension composition altogether of the present invention, and it is assessed.Said composition comprises the combination of Glycopyrrolate (GP) and formoterol fumarate (FF) activating agent.GP is present in propellant with the form of micronized lenticular active agent particle.It suspends altogether with spray-dired particle, and this particle contains the FF in the material being dispersed in those formation particles.For realizing this object, FF crystal suspension is used for preparing in the raw material based on the particle of lipid at those.

By using jet mill, micronize process is carried out thus formation GP active agent particle to Glycopyrrolate.By the particle size distribution using the Laser diffraction particle size analyser (such as SympatecGmbH, Clausthal-Zellerfeld, Germany) with dry powder dispenser to measure Glycopyrrolate active agent particle with Fraunhofer diffraction pattern.The active agent particle of 50% volume presents the optical diameter being less than 1.7 μm, and the granule of 90% volume presents the optical diameter being less than 3.5 μm.

Adopt the particle of preparation containing FF with the following method: PFOB (perfluoro bromide octane) emulsion of the water bag fluorine carbon that preparation 654mL uses phospholipid stable; By high-shear mixer by 26.5g phospholipid, DSPC (DSPC) and 2.4g calcium chloride to be dissolved in 276mL hot water (80 DEG C) and to carry out homogeneity process; 142mLPFOB is added lentamente in dispersive process.Use the thick emulsion 5 times of high-pressure homogenizer (C3 type, Avestin, Ottawa, CA) homogenize gained further under up to the pressure of 170MPa.552mgFF is dissolved in 273mL hot water (50 DEG C), by high-shear mixer, most solutions and emulsion is mixed.Following spray drying condition is used to carry out spraying dry to emulsion under a nitrogen: inlet temperature 95 DEG C; Outlet temperature 68 DEG C; Emulsion feed speed 2.4mL/min; And total gas flow rate 498L/min.The final mass of formoterol in a spray-dried powders point rate is 2%.

Similar approach is used to prepare the particle containing FF of second batch.In this batch, the final mass mark of FF in spray-dried powders is 1%.The 3rd batch of prepared particle be not containing FF.

Use the particle size distribution (VMD) of determination of laser diffraction particle.For two batches of particles containing FF, wherein the granule of 50% volume be less than 3.5 μm and distribution geometric standard deviation be 1.7.For not containing FF particle for, wherein the granule of 50% volume be less than 3.2 μm and distribution geometric standard deviation be 1.8.

Take the active agent particle of aim parameter and particle and be filled in the 19mL volume aluminium pot (Presspart, Blackburn, UK) that fluoroethylene polymer (FEP) is coated, thus obtained metered-dose inhaler.Container tank with 63 μ l valves (#BK357, Bespak, King ' sLynn, UK) carry out curling sealing and loading 12.4gHFA134a (1,1,1 via valve rod in overvoltage mode, 2-tetrafluoroethane) (IneosFluor, Lyndhurst, UK).Assuming that trigger deposition is 20%, table 1a lists suspension concentration and the targeted delivery dosage of three kinds of different preparation groups (preparation group 1A to 1C).After injection propellant, container tank supersound process 15 seconds is also vibrated 30 minutes on wrist type shaking table.Container tank is configured with the polypropylene trigger (#BK636, Bespak, King ' sLynn, UK) with 0.3mm aperture.

table 1a: the Glycopyrrolate-formoterol fumarate combination of embodiment 1 is total to the preparation situation of suspension

Metered-dose inhaler after loading is stored in two kinds of different conditions when valve is downward under: 5 DEG C of cold preservations under the condition not having outer package, and under the condition of paper tinsel outer wrapping 25 DEG C/60%RH storage in room temperature.In different time point determining aerosol performances and dosage delivered uniformity.Aerosol performance evaluates according to USP<601> (U.S. Pharmacopeia Monographs 601) immediately after the production.Ram of new generation (NGI) is used to measure particle size distribution under the flow velocity of 30L/min.Be arranged on by shuttle tank in a trigger, this trigger has other consume startup effect of twice consume startup effect and twice.The material that 5 startup effects produce is collected in the NGI with USP throat.Use the solvent flush valve of capacity distribution, trigger, throat, NGI cup, (stages) at different levels and filter.Use the chromatography working sample solution of drug specificity.Use and define minuteness particle mark by 3rd level to the total amount of filter.The dosage delivered uniformity in use procedure is measured according to USP<601> using dosage uniformity sampling apparatus.Fixing and the pre-fill inhaler according to preceding method.Collect at the leading portion of use procedure, stage casing and latter end material that twice startup effect produce and measure.

During research, (3 months) are not observed aerosol performance and dosage delivered uniformity and to be changed trend, or it changes along with storage temperature.Therefore, the result of all aerosol performance tests is gathered.Table 1b lists the average behavior of different preparation group.Minuteness particle dosage for the 3rd level at impacter is to the quality summation collected by filter, and is calibrated with sign dosage.The Mean aerosol performance of all three preparation groups is equivalent.

table 1b: the Mean aerosol performance being total to suspension in embodiment 1

Test the dose-content uniformity of two kinds of activating agents within container tank effect duration in combination product.The dosage that the trigger that Fig. 1 and 2 respectively illustrates preparation group 1A and 1B is disengaged, calibrates with the actual sign dosage of container tank.Assuming that trigger deposition is 20%, then the trigger of two kinds of activating agent targets disengages dosage is 80%.The dosage of FF and GP represents with point and triangle respectively.Closed line represents the meansigma methods of formoterol dosage, and broken line represents the meansigma methods of Glycopyrrolate dosage.Fig. 3 and 4 respectively illustrates the ratio of the dosage that the trigger of preparation group 1A and 1B after calibration is disengaged.Result shows, and within the effect duration of container tank, dose ratio remains unchanged.In addition, the transmutability of dose ratio is far below the transmutability of individual dose, and this shows to define a kind of common suspension with constant carrier/activating agent ratio, and it can remain unchanged within container tank effect duration.

Result shows, and when carrying out preparation according to the inventive method, the particle containing a kind of active constituents of medicine can be used to form the common suspension of combination product, is FF in this example.The ratio of particle and active agent particle can be regulated thus the uniformity of realize target dosage level maintain similar aerosol performance.

embodiment 2

Preparation is containing FF, GP or both MDI, and wherein the aimed concn of FF and GP is respectively each startup effect 2.4 and 18 μ g.GP active agent particle is carried out micronize process, makes the d that it is recorded by the laser diffractometry described in embodiment 1 ₁₀, d ₅₀, d ₉₀0.6,1.7,3.6 and 1.9 μm is respectively with span.FF is incorporated in spray-dired particle, and is prepared according to the method described in embodiment 1 thus obtains a kind of containing 2%FF, 91.5%DSPC and 6.5%CaCL ₂compositions.Take the active agent particle of aim parameter and particle and to be filled in the aluminium pot (Presspart, Blackburn, UK) of the coated 19mL volume of fluoroethylene polymer (FEP) thus the MDI of obtained GP, FF and GP+FF.Container tank with 50 μ l valves (#BK357, Bespak, King ' sLynn, UK) carry out curling sealing and loading 10.2gHFA134a (1,1,1 via valve rod in overvoltage mode, 2-tetrafluoroethane) (IneosFluor, Lyndhurst, UK).After injection propellant, container tank supersound process 15 seconds is also vibrated 30 minutes on wrist type shaking table.Container tank is configured with the polypropylene trigger (#BK636, Bespak, King ' sLynn, UK) with 0.3mm aperture.

Assess long-time stability and the delivery characteristics of these MDI compositionss.Particularly, according to the method described in embodiment 1 according to USP<601>, measure these compositionss aerosol particle size distribution under various conditions and dosage delivered characteristic, condition determination can extend up to 12 months in some embodiments.Such as; as shown in Figure 5; the dosage delivered uniformity of the compositions prepared by embodiment 1 remains unchanged substantially; even if said composition be store after 12 months at 5 DEG C or after sample being placed in aluminium foil bag storage 4.5 months under 25 DEG C and 60% relative humidity (RH) (namely; " shielded storage "), wherein sample is placed in aluminium foil bag and the moisture entered in MDI container tank can be made to minimize.

Also to said composition under not protected storage requirement up to the aerosol performance in 12 months and under shielded storage requirement assessing up to the aerosol performance in 6 months.As shown in Figure 6, to store 12 months and storage is after 6 months under 25 DEG C and the not protected condition of 60%RH under 5 DEG C of shielded conditions, GP and the FF particle size distribution of this common suspension composition remains unchanged substantially.As shown in Figure 7, even if under the condition of bearing pressure (40 DEG C, 75%RH), GP and FF delivered from metered-dose inhaler after 6 months does not show obvious decline particle size distribution yet.

Compare with the compositions only containing a kind of activating agent to assess, whether the preparation of the combination simultaneously containing GP and FF there will be decline this point in aerosol performance, and the aerosol performance of the aerosol performance of common suspension composition with the suspension composition only containing a kind of activating agent contrasts by the application.

Visible according to Fig. 8, the aerosol performance that the aerosol performance that the combination comprising GP and FF activating agent is total to suspension composition and the suspension composition comprising independent FF or independent GP realize does not have difference, and this shows that the aerosol performance of each activating agent that the common suspension of one-component or binary composition realizes is substantially the same.

embodiment 3

In clinical trial, the pharmacokinetics of metered-dose inhaler of the common suspension of Glycopyrrolate and formoterol fumarate combination is contained to those and safety is assessed.This clinical trial is the crossing research of monocentric, random, double blinding, single dose, the fourth phase a, quadruple chemotherapy, and it is used for assessment 4 kinds of anapnotherapys by MDI administration.Four kinds of therapies comprise formoterol fumarate (FF) inhalation aerosol, Glycopyrrolate (GP) inhalation aerosol, GP+FF inhalation aerosol and send FF inhalation aerosol continuously immediately after sending GP inhalation aerosol.The preparation method of GP+FF inhalation aerosol and FF inhalation aerosol and GP inhalation aerosol as described in Example 2.GP+FF inhalation aerosol combines also referred to as GP and FF " fixing ", and the therapy of sending FF inhalation aerosol after sending GP inhalation aerosol immediately is continuously called " loose " combination of GP and FF.

Under study for action experimenter's random assortment is become four treatment groups, each treatment group comprises four kinds of all treatments.Each experimenter accepts the treatment of 4 kinds of single doses, the interval time of 7 to 21 days between often kind of therapy.There are 16 experimenters eligible and are used as safety analysis.Have 3 experimenters because there is no one or more in acceptance 4 in therapy so it excluded from PK analyzes, separately have two experimenters because the reason of suction technology difference cause dosage to make a mistake thus the reason cannot carrying out assessing so it is excluded from PK analyzes.

Give GP+FF inhalation aerosol, make every experimenter receive the GP of 72 μ g dosage, the FF (four startup effects, each startup acts on 18 μ gGP and 2.4 μ gFF) of 9.6 μ g dosage.Give GP inhalation aerosol, make every experimenter receive the GP (four startup effects, each startup acts on 18 μ gGP) of 72 μ g dosage.Give FF inhalation aerosol, make every experimenter receive the FF (four startup effects, each startup acts on 2.4 μ gFF) of 9.6 μ g dosage.For the consideration of blind state, before carrying out aforementioned three kinds of therapies, first give four placebo by MDI.Give described send GP inhalation aerosol after send the Loosely coupled of FF inhalation aerosol immediately continuously, every experimenter is made to receive the GP of 72 μ g dosage and FF (four startup effects of 9.6 μ g dosage, each startup acts on 18 μ gGP, four startup effects subsequently, each startup acts on 2.4 μ gFF).

The Loosely coupled of GP and FF and fixed Combination all have good safety and toleration, and the result of other the three kinds of therapies assessed in the security features of fixed Combination and clinical trial is similar.To collect before administration and the blood sample of 2,5,15 and 30 minutes and 1,2,4,6,8 and 12 hour after administration, to measure the plasma concentration of GP and FF thus to calculate various PK parameter.Fig. 9 shows the situation of change of plasma concentration along with the time of GP and FF after administration in 12 hours.As shown in Figure 9, when giving the fixed Combination of GP and FF, after administration, the plasma concentration of GP and FF is suitable with the result giving GP and FF Loosely coupled.For the vitro delivered dose mentioned in embodiment 2 and particle size distribution feature, the fixed Combination not observing GP+FF inhalation aerosol in vivo share effect.

embodiment 4

Prepare exemplary binary of the present invention suspension composition and the metered-dose inhaler containing said composition altogether.Compositions comprises the combination of Glycopyrrolate (GP) and formoterol fumarate (FF), and wherein often kind of activating agent all provides with the material of micronized crystallike form.The MDI tank that interwoven crystal shape is total to suspension is prepared by semi-automatic suspension completion method.Binary altogether suspension is made up of the combination of active constituents of medicine (being also referred to as " API " of " APIs " or singulative) GP and FF of two kinds of microcrystalline form, and wherein this active constituents of medicine and particle suspend altogether in HFA134a propellant.The common suspension of binary is formulated into each startup effect can provide 18 μ gGP and 4.8 μ gFF.When preparing binary and being total to suspension composition, FFAPI material used in specific compositions represented with " slightly ", and FFAPI material used in other compositionss represented with " carefully ".No matter this common suspension composition contains thick FF or thin FF, and said composition is all formulated into the dosage delivered that each startup effect provides 4.8 μ gFF.Table 2 lists in the present embodiment in detail for preparing the grain diameter characteristic of the described altogether thick FF that suspension composition is used, thin FF and GPAPI material.Except binary altogether suspension composition, the application has also prepared the suspension composition altogether of the monotherapy only containing FF active agent materials.This FF monotherapy altogether suspension uses thick FFAPI.Use this FF monotherapy to be total to suspension to prepare monotherapy MDI, and FF monotherapy MDI is mixed with the dosage delivered that each startup effect can provide 4.8 μ gFF.

Particle is prepared by spray-dried emulsion; material concentration is 80mg/mL; this emulsion is that a kind of DSPC (DSPC) of 93.44% that contains (is equivalent to the DSPC:CaCl of mol ratio 2:1 with the compositions of 6.56% anhydrous calcium chloride ₂), in emulsion preparation process, by DSPC and CaCl ₂be dispersed in the container containing hot water (80 ± 3 DEG C) by the high-shear mixer of 8000-10000rpm, add PFOB lentamente in the process.Then by emulsion, in high-pressure homogenizer, (10000-25000psi) processes 6 times.Then emulsion is by being configured with 0.42 " spray dryer of atomizer nozzle carries out spraying dry under the nebulizer air-flow of the 18SCFM set.Be 72SCFM by dry gas flow rate set, inlet temperature is 135 DEG C, and emulsion flow velocity is 58mL/min.

For preparation MDI, use medicine to add container (DAV) in such a way and carry out suspension filling: the particle first adding half amount, then load the material of microcrystalline form, finally add the particle of residue half amount to top.Under the humidity controlled environment of <10%RH, material is joined in container.Then DAV and 4L suspension vessel is connected, uses HFA134a propellant to carry out rinsing the married operation thus formation unguentum then carrying out gentleness.Then unguentum to be transferred back in suspension mixer and to dilute with HFA-134a, forming the final suspension with aimed concn by the stirring of agitator arm gentleness.In the production process of whole batch, all the temperature in container is maintained 21-23 DEG C.After recirculation 30min, by 50 μ L valves (Bespak, King ' sLynn, UK), slurry compositions is filled in the coated aluminium pot (Presspart, Blackburn, UK) of 14mL fluoroethylene polymer (FEP).Stochastic choice is for carrying out the shuttle tank of all container tank determination tests to guarantee correct amount of formulation.Optical diameter and the particle size distribution of the micronize formoterol granule of two batches is measured by the laser diffraction method described in embodiment 1.Table 2 lists the d of different batches micronize material used ₁₀, d ₅₀and d ₉₀value.D ₁₀, d ₅₀and d ₉₀the cumulative volume that the instrument of representative particle size determination respectively records reaches 10%, 50% and 90% particle diameter.

The particle size distribution of the particle size distribution of the common suspension preparation prepared by embodiment 4 with the common suspension preparation prepared by embodiment 1 is compared.Table 3 lists comparative result, wherein " %FPFFF " and " %FPFGP " represent by NGI 3rd level to the minuteness particle quality of the particular active agent of filter divided by trigger quality and be multiplied by 100 result.

table 2: for the preparation of the binary micronize formoterol fumarate of suspension and the particle size distribution of Glycopyrrolate altogether

Title	d ₁₀(μm)	d ₅₀(μm)	d ₉₀(μm)	Span
					Thick FF API	0.6	1.9	4.4	2.0
Thin FF API	0.5	1.3	2.3	1.5
					GP API	0.5	1.3	3.0	1.9

table 3: different exemplary GP/FF is total to the particle size distribution of suspension

Measure the aerosol performance of those binary prepared by the present embodiment suspension composition altogether, and follow those common suspension compositions prepared by embodiment 1 to compare, wherein the method for mensuration aerosol performance as described in Example 1.Figure 10 to 12 shows comparative result.Can be readily seen that according to these figures, is thick or thin irrelevant with the binary lenticular formoterol material that altogether suspension is used, substantially identical altogether in the particle size distribution of FF with GP of suspension composition and the common suspension composition of embodiment 1 of binary.

In addition, the method according to embodiment 1, the dosage delivered uniformity binary in the present embodiment being total to GP and FF of suspension composition measures.Result as shown in figure 13.Binary altogether suspension preparation can provide the DDU characteristic of GP and FF of expectation because all startup effects can send meansigma methods ± 25% within the dosage of this expectation.

embodiment 5

Present invention also provides the binary suspension preparation altogether of salmeterol xinafoate (SX) active agent particle and FLUTICASONE PROPIONATE (FP) active agent particle.FP and SX in propellant is micronized lenticular granule.Micronised active agent granule and the spray-dired particle of this two type suspend altogether.

Micronized SX (4-hydroxyl-alpha 1-[[[6-(4-phenylbutoxy) hexyl] ammonia] methyl]-1; 3-benzene dimethanol; 1-hydroxyl-2-naphthoic acid ester) be buy from manufacturer (InkeSA, Germany) place and be used as active agent particle.By the particle size distribution of determination of laser diffraction SX.The micronised particles of 50% volume presents the optical diameter being less than 2 μm, and the granule of 90% volume presents the optical diameter being less than 3.9 μm.

Micronized FP (S-(methyl fluoride) 6 ^α, 9-bis-fluoro-11 ^β-17-dihydroxy-16 ^α-methyl-3-oxoandrost-Isosorbide-5-Nitrae-diene-17 ^β-thiocarboxylic, 17-propionic ester) to buy from manufacturer (HovioneFarmaCienciaSA, LouresPortugal) place and to be used as active agent particle.By the particle size distribution of determination of laser diffraction FP.The micronised particles of 50% volume presents the optical diameter being less than 2.6 μm, and the granule of 90% volume presents the optical diameter being less than 6.6 μm.

Adopt and prepare particle with the following method: PFOB (perfluoro bromide octane) emulsion of the water bag fluorine carbon that preparation 150mL uses phospholipid stable.In 100mL hot water (70 DEG C), use high-shear mixer to 12.3g phospholipid, DSPC (DSPC) and 1.2g calcium chloride carry out homogeneity process.65mLPFOB is added lentamente in Homogenization.Use the thick emulsion 3 times of high-pressure homogenizer (C3 type, Avestin, Ottawa, CA) homogenize gained further under up to the pressure of 140MPa.

In nitrogen, following spray drying condition is used by emulsion to carry out spraying dry: inlet temperature 90 DEG C, outlet temperature 69 DEG C, emulsion feed speed 2.4mL/min, total gas flow rate 498L/min.Use the particle size distribution VMD of determination of laser diffraction particle.The particle of 50% volume is less than 2.7 μm, and the geometric standard deviation of distribution is 2.0.In addition, the aerodynamic size distribution of particle is measured by time-of-flight method particle size analyzer.The particle of 50% volume has the aerodynamic particle diameter being less than 1.6 μm.Greatest differences between aerodynamic particle diameter and optical diameter shows that particle has the low grain density of <0.5kg/L.This result have also been obtained the confirmation of ultramicroscope, and its display particle has the form of hollow, thin-walled.

Take the micronize FP of aim parameter, SX and particle, and they to be filled in the aluminium pot (Presspart, Blackburn, UK) of the coated 19mL volume of fluoroethylene polymer (FEP) thus obtained MDI.By container tank with 63 μ l valves (#BK357, Bespak, King ' sLynn, UK) carry out curling sealing and loading 10mLHFA134a (1,1,1 via valve rod in overvoltage mode, 2-tetrafluoroethane) (IneosFluor, Lyndhurst, UK).After injection propellant, container tank supersound process 15 seconds is also vibrated 30 minutes on wrist type shaking table.Container tank is configured with the polypropylene trigger (#BK636, Bespak, King ' sLynn, UK) with 0.3mm aperture.Method after obtaining immediately according to embodiment 1 measures aerosol performance according to USP601.Table 4 lists test result.

table 4: the result of the common suspension of FLUTICASONE PROPIONATE (FP) and salmeterol xinafoate (SX) in embodiment 5

* trend is not observed

Dosage delivered uniformity in use procedure is measured, wherein all each dosage delivered all meansigma methods ± 20% in, relative standard deviation (also referred to as " RSD ") is 6.1%.Carried out the visualization of common suspension by vial, do not observe active agent particle and there occurs settlement action.Suspension occurs lentamente to flocculate and forms uniform single paste layer.

embodiment 6

Present invention also provides the combination suspension composition altogether that salmeterol xinafoate (SX) active agent particle and FLUTICASONE PROPIONATE (FP) particle are formed.SX in propellant is micronized lenticular granule.It and spray-dired particle suspend altogether, and wherein this particle contains the micronize FP in the material being dispersed in those formation particles.For realizing this object, FP crystal suspension is used for preparing in the raw material based on the particle of lipid at those.For the formation of the same with described in embodiment 5 of FP with SX of the active agent particle in the present embodiment and particle.

Adopt the particle of preparation containing FP with the following method: the PFOB emulsion of the water bag fluorine carbon that preparation 200mL uses phospholipid stable.By high-shear mixer, 3.3g phospholipid (DSPC) and 0.8g micronize FP and 0.3g calcium chloride dihydrate are dispersed in or are dissolved in 100mL hot water (70 DEG C).44mLPFOB is added lentamente in dispersive process.The thick emulsion 3 times of high-pressure homogenizer further homogenize gained is used under the pressure of 140MPa.The particle diameter of suspension FP crystal is reduced by the process that homogenizes.Following spray drying condition is used to carry out spraying dry to emulsion under a nitrogen: inlet temperature 95 DEG C; Outlet temperature 72 DEG C; Emulsion feed speed 2.4mL/min; And total gas flow rate 525L/min.

Take the micronize SX active agent particle of aim parameter and the particle containing FP; and the aluminium pot (Presspart they are filled into through the coated 19mL volume of fluoroethylene polymer (FEP); Blackburn, UK) in thus obtained MDI.Container tank with 63 μ l valves (#BK357, Bespak, King ' sLynn, UK) carry out curling sealing and loading 10mLHFA134a (1,1,1 via valve rod in overvoltage mode, 2-tetrafluoroethane) (IneosFluor, Lyndhurst, UK).After injection propellant, container tank supersound process 15 seconds is also vibrated 30 minutes on wrist type shaking table.Container tank is configured with the polypropylene trigger (#BK636, Bespak, King ' sLynn, UK) with 0.3mm aperture.Method after obtaining immediately according to embodiment 1 measures aerosol performance according to USP601.Table 5 lists test result.

table 5: the result of the common suspension of salmeterol xinafoate (SX) active agent particle and the particle containing FLUTICASONE PROPIONATE.

* there is slight ascendant trend

Dosage delivered uniformity in use procedure is measured, wherein all each dosage delivered all meansigma methods ± 25% in, the RSD of FP is the RSD of 9.0%, SX is 13%.The visualization of suspension is carried out in vial altogether, does not observe active agent particle and there occurs settlement action.Bottle is left standstill 24 hours when not stirring.Suspension occurs lentamente to flocculate and defines uniform single paste layer, and this shows the sign that SX and particle are not separated.

embodiment 7

Present invention also provides the preparation of binary containing budesonide active agent particle and momestasone furoate active agent particle suspension composition altogether.Budesonide (BD) in propellant and momestasone furoate (MF) are all micronized lenticular granules, and they and spray-dired particle suspend altogether.

Micronized BD is obtained, 16 from manufacturer (AARTI, Mumbai, India) place; 17-(butylidene two (oxygen base))-11,21-dihydroxy-, (11-β, 16-α)-pregnant steroid-1; 4-diene-3,20-diketone, and used as active agent particle.By the particle size distribution of determination of laser diffraction budesonide.The micronised particles of 50% volume presents the optical diameter being less than 1.9 μm, and the granule of 90% volume presents the optical diameter being less than 4.3 μm.

Micronized MF is obtained, 9 α, 21-bis-chloro-11 β, 17-dihydroxy-16 Alpha-Methyl pregnant steroid-Isosorbide-5-Nitrae-diene-3,20-diketone 17-(2--furoate) from manufacturer (AARTI, Mumbai, India) place, and used as active agent particle.By the particle size distribution of determination of laser diffraction momestasone furoate.The micronised particles of 50% volume presents the optical diameter being less than 1.6 μm, and the granule of 90% volume presents the optical diameter being less than 3.5 μm.

Adopt and produce particle with the following method: PFOB (perfluoro bromide octane) emulsion of the water bag fluorine carbon that preparation 500mL uses phospholipid stable.High-shear mixer is used in the 400mL hot water (75 DEG C) to homogenize 18.7g phospholipid, DSPC (DSPC) and 1.3g calcium chloride.100mLPFOB is added lentamente in Homogenization.Use the thick emulsion 5 times of high-pressure homogenizer (C3 type, Avestin, Ottawa, CA) homogenize gained further under up to the pressure of 170MPa.Following spray drying condition is used to carry out spraying dry to emulsion under a nitrogen: inlet temperature 95 DEG C; Outlet temperature 72 DEG C; Emulsion feed speed 2.4mL/min; And total gas flow rate 498L/min.

Take micronised active agent granule and the particle of aim parameter, and they are filled into coated have in the vial of 15mL volume thus obtained MDI.Container tank is carried out curling sealing and loading 9.2gHFA134a (1 via valve rod in overvoltage mode with 63 μ l valves (Valois, LesVaudreuil, France), 1,1,2-tetrafluoroethane) (IneosFluor, Lyndhurst, UK).After injection propellant, container tank supersound process 15 seconds is also vibrated 30 minutes on wrist type shaking table.The suspended concentration of BD active agent particle is the suspended concentration of 0.8mg/mL, MF is 1.1mg/mL, and the suspended concentration of particle is 6mg/mL.The ratio of particle and active agent particle is 7.5 for BD is 5.5 for MF.

The visual observations display of suspension configuration group altogether, not there is settlement action in active agent particle.Suspension there occurs and flocculates and define paste layer.Bottle is left standstill 16 hours when not stirring.Any active agent particle is not found in the bottom of common suspension bottle.These results show, the dissimilar active agent particle that the budesonide of lenticular and momestasone furoate are formed there occurs association with particle, thus form suspension altogether of the present invention.The intensity of the association between active agent particle and particle is enough to the impact overcoming buoyancy, thus can the sedimentation of successfully inhibit activities agent granule.

embodiment 8

The particle containing momestasone furoate (MF) or budesonide (BD) is used to prepare binary suspension composition altogether, and the MDI of preparation containing said composition.Suspension composition comprises the combination of lenticular Glycopyrrolate (GP) and the formoterol fumarate (FF) suspended altogether with the particle containing MF or BD altogether.Often kind of API provides with micronized crystalline material.

Adopt the particle of preparation containing 50% (w/w) BD or MF with the following method: in 400mL hot water (75 DEG C), use high-shear mixer high shear to homogenize process containing 2.8gDSPC (1; 2-distearyl acyl group-sn-glycerol-3-phosphocholine) and the dispersion of 0.26g calcium chloride, add 56.6gPFOB lentamente simultaneously.Micronize MF or BD (be 1:1 with the mass ratio of DSPC) is joined in the thick emulsion of gained, uses high-pressure homogenizer (C3 type, Avestin, Ottawa, CA) to homogenize under up to the pressure of 170MPa process 3 to 5 times further.Following spray drying condition is used to carry out spraying dry to emulsion: inlet temperature 90-95 DEG C; Outlet temperature 95-72 DEG C; Emulsion feed speed 2-8mL/min; Total dry nitrogen flow velocity 525-850L/min.By the particle size distribution of determination of laser diffraction gained powder, the particle of 50% volume is less than 1.8 μm, and distribution span is 1.6 μm.

Use HFA134a propellant to load and include those tanks containing the particle of 50% (w/w) MF or BD, make its each startup effect can produce the target dose of 50 μ gMF or 100 μ gBD.Measure aerocolloidal particle size distribution according to the method described in embodiment 1, result is listed by table 6.Prepare a series of tank with making comparisons, these tanks include those particles containing MF or BD and GP and FF active agent particle.Be filled in these tanks by the micronize GP of q.s and FFAPI material, amount of fill is enough to make each startup effect can produce the targeted delivery dosage of 36 μ gGP and 6 μ gFF.Prepare other blank particle (also referred to as " placebo " particle) not containing any activating agent according to method described herein, and make total suspension concentration reach 5.5mg/mL with its filling tank.

Method according to embodiment 1 measures the aerosol particle size distribution that the present embodiment is total to suspension composition, and result is listed by table 7.The mass median dynamic diameter of the corticosteroid in one pack system suspension and being equal in triple combination preparation, this triple combination preparation uses two kinds of dissimilar active agent particles and prepares with particle containing BD or MF that it suspends altogether.As the common suspension composition containing two kinds of different activating agent combinations, the ternary prepared by the present invention altogether suspension composition avoids combined effect.

table 6: the suspension MDI of the HFA134a propellant containing corticosteroid particle.The aerosol performance recorded by drug specificity cascade impact method, mass aerodynamic diameter and minuteness particle mark.

table 7: the HFA134a propellant triple combination suspension MDI comprising particle (momestasone furoate or budesonide), LAMA (Glycopyrrolate) and the LABA (formoterol fumarate) containing corticosteroid.By aerosol performance, mass median dynamic diameter and minuteness particle mark measured by the cascade impact method of drug specificity.

* blank particle is added

embodiment 9

Prepare ternary of the present invention suspension composition altogether, and the MDI of preparation containing said composition.Compositions contains the combination of Glycopyrrolate (GP), formoterol fumarate (FF) and momestasone furoate (MF) active agent particle, and often kind of activating agent all provides with the form of micronized lenticular API material.

Ternary suspension is altogether prepared by semi-automatic suspension completion method.The ternary active pharmaceutical ingredient that suspension forms three kinds of microcrystalline form of three kinds of different activities agent granules by those altogether forms: MF (corticosteroid); GP (LAMA); And FF (LABA).Particle in the active agent particle of this three types and HFA134a propellant suspends altogether.This ternary is total to suspension preparation become can provide following targeted delivery dosage: each startup effect generation 50 μ gMF; Each startup effect generation 36 μ gGP; And each startup effect generation 4.8 μ gFF.Except ternary suspension altogether, also prepare the suspension altogether of the monotherapy only containing MF.Monotherapy MF altogether suspension is included in the MF active agent particle suspended altogether with the particle described in the present embodiment in propellant, and is mixed with the targeted delivery dosage that can provide each startup effect generation 50 μ gMF.

Particle is prepared by spray-dried emulsion; material concentration is 80mg/mL; this emulsion is (be equivalent to the DSPC:CaCl of mol ratio 2:1 containing the DSPC (DSPC) of 93.44% with the compositions of 6.56% anhydrous calcium chloride ₂).In emulsion preparation process, by DSPC and CaCl ₂be dispersed in the container containing hot water (80 ± 3 DEG C) by the high-shear mixer of 8000-10000rpm, add PFOB lentamente in this process kind.Then emulsion is processed 5 times in high-pressure homogenizer (10000-25000psi).Then by emulsion by being configured with 0.42 " the spray dryer of atomizer nozzle carry out spraying dry with the nebulizer air-flow of 18SCFM.The rate setting of dry gas stream is 72SCFM, and inlet temperature is 135 DEG C, and outlet temperature is 70 DEG C, and emulsion flow velocity is 58mL/min.

For preparation MDI, add container (DAV) according to using medicine in the following manner and load suspension: the particle first adding half amount, then load crystalline material, finally add the particle of residue half amount to top.Under the humidity controlled environment of <10%RH, material is joined in container.Then DAV and 4L suspension vessel is connected, uses HFA134a propellant to rinse, and then mix with magnetic stirring bar.In the production process of whole batch, all the temperature in container is maintained 21-23 DEG C.After recirculation 30min, by 50 μ LEPDM valves, slurry compositions is filled in container tank.Stochastic choice is used for the shuttle tank of all container tank determination tests to guarantee correct amount of formulation.Before beginning product property is analyzed, first the ternary of brand-new is total to suspension MDI batch of isolation one week.Similar suspension loading method is adopted to prepare the MDI only containing momestasone furoate.

Adopt the initial particle distribution of all crystallite API of determination of laser diffraction according to the method for embodiment 1, result is listed by table 9.Method according to embodiment 1 adopts the aerodynamic size of drug specificity cascade impact method mensuration all components when starting suspension MDI to distribute and mass median dynamic diameter, and result is listed by table 9.

table 9: the ternary crystallite in HFA134a propellant MDI is suspension altogether.The initial particle distribution recorded by laser diffractometry (Sympatec).

table 10: the HFA134a propellant ternary suspension MDI altogether of the corticosteroid (momestasone furoate) containing microcrystalline form, LABA (formoterol fumarate) and LAMA (Glycopyrrolate).By aerosol performance, mass median dynamic diameter and minuteness particle mark that the cascade of drug specificity (NGI) method of impacting records.

Method according to embodiment 1 is assessed the aerosol performance of the common suspension of ternary prepared by the present embodiment and dosage delivered uniformity.Figure 14 shows the DDU of GP, FF and MF that two container tank only containing MF and two container tank containing MF, GP and FF prepared by the present embodiment realize.The DDU of the MF that MF monotherapy configuration group is sent is equal to the DDU that ternary is total to the MF that suspension composition realizes.The ternary also prepared by the present embodiment combination preparation that suspension composition contains two kinds of activating agent FF and GP with those altogether compares at aerosol aspect of performance.As shown in figs, the aerodynamic size distribution of FF with GP that the compositions containing two kinds of activating agents is sent with the compositions containing three kinds of activating agents is equal to difference mutually.

As the common suspension composition that those contain two kinds of different activities agent combinations, the ternary prepared by the present invention altogether suspension composition avoids combined effect.

embodiment 10

Prepare according to exemplary ternary of the present invention suspension composition and the metered-dose inhaler containing said composition altogether.Ternary altogether suspension comprises the combination with formoterol fumarate (FF) and momestasone furoate (MF) activating agent of Glycopyrrolate (GP) or TB (TB), and often kind of API used provides with micronized crystalline material form.

The suspension MDI of preparation two different batches, it contains three kinds of active constituents of medicine (API): corticoid, LAMA and LABA.API provides with the form of crystalline material, and it suspends with the particle prepared by the present invention altogether with the form of active agent particle.Active agent particle and particle to be joined in HFA134a propellant thus obtained ternary described in the present embodiment suspension composition altogether.

Common for the ternary of first batch suspension (ternary GFM) is mixed with each startup effect and can sends following dosage: 40 μ gMF; 13 μ gGP; And 4.8 μ gFF.Active agent particle suspends altogether with particle; wherein particle contains 93.46%DSPC (1 by spraying dry; 2-distearyl acyl group-sn-glycerol-3-phosphocholine) and the emulsion of 6.54% anhydrous calcium chloride prepare, material concentration is 80mg/mL.DSPC:CaCl in particle ₂mol ratio be 2:1.Particle and activating agent are combined in propellant, thus preparation obtains the preparation that concentration of suspended particles is 6mg/mL.Method according to embodiment 1 uses Sympatec laser diffraction method to measure the initial particle of crystallite active agent particle, and result is as shown in table 11.

Use different LAMAAPI, anhydrous tiotropium bromide (TB) replaces GP thus the ternary preparing second batch suspends (TFM) altogether.The ternary of second batch is total to suspension preparation becomes each startup effect can send following dosage: 50 μ gMF; 9 μ gTB; And 4.8 μ gFF.Prepare particle according to method used in ternary GFM altogether suspension, make active agent particle follow particle to suspend altogether, wherein the concentration of particle in suspension is 6mg/mL.Method according to embodiment 1 adopts Sympatec laser diffraction method to measure the initial particle of crystallite active agent particle, and result is listed by table 12.

Adopt ternary GFM and ternary TFM to be total to suspension composition and prepare MDI, the method according to embodiment 1 measures aerosol performance, minuteness particle mark and mass median dynamic diameter.Table 13 lists MMAD and the FPF performance of ternary GFM and ternary TFM, and Figure 17 shows the aerosol performance (respectively illustrating the dynamic particle size distribution that ternary GFM and ternary TFM realizes) that ternary GFM and ternary TFM is total to the expectation that suspension realizes.

table 11: the initial particle distribution of the ternary GFM recorded by laser diffraction (Sympatec) method.

table 12: the initial particle distribution of the ternary TFM recorded by laser diffraction (Sympatec) method.

table 13: impact the aerosol performance of ternary GFM and the ternary TFM recorded, mass median dynamic diameter and minuteness particle mark by drug specificity cascade

embodiment 11

Prepare exemplary binary of the present invention suspension composition altogether, and preparation is total to the MDI of suspension composition containing this binary.Compositions comprises the combination of Glycopyrrolate (GP) and formoterol fumarate (FF), and wherein often kind of activating agent all provides with the form of micronized crystalline material, and its particle size distribution is listed by table 14.GP and the FF material of microcrystalline form provides the active agent particle of two types, and particle is then prepared according to the method described in embodiment 4.When preparing the binary described in the present embodiment and being total to suspension, GP active agent particle, FF active agent particle and particle are combined in HFA134a propellant.

The medicine by first appropriate micronize GP and FF active agent particle and particle being distributed to inside with humidity controlled chamber (RH<5%) to add in container (DAV) thus binary suspension altogether described in obtained the present embodiment.Then DAV is carried out under a nitrogen sealing and the suspension vessel be connected to containing 12kgHFA-134a.Subsequently 0.5-1kgHFA-134a is joined DAV, then it shifted out from suspension vessel and carry out gentle rotation thus form unguentum.Then unguentum to be transferred back in suspension mixer and to dilute with HFA-134a, carry out gentle stirring by agitator arm thus form the final suspension with aimed concn.Then suspension is recycled in fill system via pump with the shortest time before starting filling.Continue to carry out mixing and recirculation in whole filling process.Valve is arranged in MDI container tank, then removes air by the curling method of vacuum or HFA-134a irrigation, carry out the curling process of valve subsequently.By valve appropriate suspension is filled in the container tank of curling subsequently, hopper can be used regulate.

table 14: the particle size distribution of Glycopyrrolate and formoterol fumarate.

Title	d ₁₀(μm)	d ₅₀(μm)	d ₉₀(μm)	Span
					FF API	0.6	1.9	4.1	1.8
GP API	0.5	1.3	3.0	1.9

The medicine by first appropriate micronize Glycopyrrolate and formoterol fumarate crystal and particle being filled into inside with humidity controlled chamber (RH<5%) to add in container (DAV) thus obtained pressure filling suspension.In the present embodiment, add particle carrier by three equal parts mode, after first time and second time add, add GP and FF respectively.DAV is carried out under a nitrogen seal and in the suspension vessel be connected to containing 12kgHFA-134a.Subsequently 0.5-1kgHFA-134a is joined DAV, then it shifted out from suspension vessel and carry out gentle rotation thus form unguentum.Then unguentum to be transferred back in suspension mixer and to dilute with HFA-134a, carry out gentle stirring by agitator arm thus form the final suspension with aimed concn.Then suspension is recycled in fill system via pump with the shortest time before starting filling.Continue to carry out mixing and recirculation in whole filling process.Valve is arranged in container tank, then removes air by the curling method of vacuum or HFA-134a irrigation, carry out the curling process of valve subsequently.By valve appropriate suspension is filled in the container tank of curling subsequently, hopper can be used regulate.

Preparation is total to the MDI of suspension containing the binary described in the present embodiment, and it contains GP and FF of two kinds of various dose respectively.Particularly, first batch of obtained binary altogether suspension composition at every turn startup effect can produce 18 μ gGP and 4.8 μ gFF (" low dosage "), second batch of obtained binary altogether suspension composition at every turn startup effect can produce 36 μ gGP and each startup acts on 4.8 μ gFF (" high dose ").Except binary suspension composition altogether, also prepare monotherapy FF and GP suspension composition altogether.Except only containing except the active agent particle (GP or FF) of a type, the preparation method of the common suspension composition of monotherapy is total to the same of suspension composition with binary.Common for monotherapy suspension and monotherapy MDI are mixed with following targeted delivery dosage can be provided: each startup acts on 18 μ gGP, each startup effect 0.5,1.0,3.6 or 4.8 μ gFF.Compositions and the MDI of each startup effect generation 0.5 μ gFF and 1 μ gFF are called as " ultralow " dosage.

The aerodynamic sizes distribution of the drug specificity that the MDI that the method according to embodiment 1 measures the common suspension composition containing the present embodiment realizes.Figure 18 shows, and the binary of low dosage and high dose is total to the ratio of the GP aerodynamic sizes distribution that suspension realizes and the equivalence between binary and the common suspension of monotherapy.In an identical manner, Figure 19 shows binary containing ultra low-volume, low dosage and high dose composition and the monotherapy ratio of FF aerodynamic sizes distribution that realizes of suspension altogether.

The dosage delivered uniformity of ultra low-volume FF monotherapy MDI is measured according to the method described in embodiment 1.Figure 20 shows the MDI that those compositionss with each startup effect generation 1 μ g and 0.5 μ gFF and system realize.Even if desired dose delivery uniformity also can be realized under ultra low-volume.

embodiment 12

Have evaluated in clinical trial and give the safety of the combination of altogether suspension composition of the present invention, effectiveness and PK performance by metered-dose inhaler (MDI).The combination of described suspension composition altogether contains Glycopyrrolate and formoterol fumarate.Described clinical trial be suffer from carry out in moderate to the patient of very serious chronic obstructive pulmonary disease (COPD) random, double blinding, customization, non-equilibrium, incomplete district group, intersection, multicenter study.Four kinds of active positive control composition of one of the two kinds of activating agents comprise the combination of two kinds of different common suspension compositions as herein described and placebo and the combination of only sending described compositions compare.

Two kinds of combinations of the common suspension composition comprised in described clinical research comprise the Glycopyrrolate (GP) and formoterol fumarate (FF) activating agent sent with fixed Combination.Substantially as described in Example 4, described GP and FF active agent particle provides with micronize, crystalline GP and FF raw material form, and described particle comprises DSPC and CaCl in the preparation of the described combination of suspension altogether ₂spray-dried granules, described suspension media is formed by HFA134a.As described herein, prepare by the combination of MDI to the described suspension composition altogether of patient delivery, and be made into GP and the FF activating agent being convenient to give two kinds of various dose.The combination compositions that suspends described first altogether make MDI at every turn startup effect to patient delivery 36 μ gGP and 4.8 μ gFF, and for giving patient 72 μ gGP and 9.6 μ gFF (every day twice gives twice MDI startup effect) every day for twice.Also described first compositions and treatment are called " GP/FF72/9.6 " and " GP/FF72/9.6 treatment " in the present embodiment and accompanying drawing.The combination compositions that suspends described second altogether make MDI at every turn startup effect to patient delivery 18 μ gGP and 4.8 μ gFF, and for giving patient 36 μ gGP and 9.6 μ gFF (every day twice gives twice MDI startup effect) every day for twice.Also described second compositions and treatment are called " GP/FF36/9.6 " and " GP/FF36/9.6 treatment " in the present embodiment and accompanying drawing.

Described GP/FF72/9.6 and GP/FF36/9.6 treatment is compared from placebo with containing the active compound that one of FF, GP or tiotropium bromide are different as five kinds of single-activity agent.The first compositions is active control, Si Lihua inhaler (tiotropium bromide suction powder).Si Lihua is a kind of Diskus (DPI) product, gives patient every day once, and each DPI capsule comprises the tiotropium bromide of 18 μ g dosage.The second composition F oradilAerolizer (formoterol fumarate suction powder) is also a kind of active control.Foradil is also DPI product, but gives patient twice its every day, and each DPI capsule comprises the FF of 12 μ g dosage.The third compositions is only containing the common suspension composition of GP as activating agent.By single therapy GP altogether suspension composition (GP36) make by the product of MDI to pulmonary delivery, and daily twice, each administration is to the GP of patient delivery 36 μ g dosage.All the other two kinds of compositionss be two kinds different only containing the single therapy altogether suspension composition (FF9.6 and FF7.2) of FF as activating agent.By the FF of single therapy altogether suspension composition make by the product of MDI to pulmonary delivery, and daily twice, the FF (FF9.6) of each administration to patient delivery 9.6 μ g dosage or the FF (FF7.2) of 7.2 μ g dosage.Use micronize, crystalline GP or FF material as active agent particle, comprise DSPC and CaCl ₂spray-dried granules prepare GP and FF single therapy suspension composition altogether as particle and HFA134a as suspension media.

118 patients are included at random in research and gave seminar's compound within 7 day time period.Treatment the 7th day, assess every patient and giving each seminar compound FEV after 12 hours ₁improvement situation, and calculate the FEV that provides at 12 hours Duan Neige seminar compounds ₁relative to the area under curve (AUC of the improvement situation of basic value _0-12).By AUC time treatment the 7th day (the 7th day) _0-12as the Primary Endpoint of research.Secondary endpoints is included in the 1st day and FEV after the compound administration of the 7th Tian Ge seminar ₁peak change (peak FEV ₁), after long term administration in continuous 7 days but before administration in the 7th day the paddy FEV of patient ₁(early morning paddy FEV ₁) and safety evaluation.Two kinds of described GP/FF altogether suspension composition are safe with well-tolerated.

When treatment the 1st day (the 1st day), compared with basic value>=12%FEV ₁the percentage rate of the patient improved and this type of ratio improved are see Figure 21.As shown in figure 21, GP/FF72/9.6 and GP/FF36/9.6 treats the cumulative acknowledgements that provides and initial rate and is significantly higher than the cumulative acknowledgements and initial rate that Si Lihua provides.Compared with only having the active compound of single-activity agent, the 7th day time, GP/FF72/9.6 and GP/FF36/9.6 treatment provides the higher FEV relative to basic value ₁change (see Figure 22-Figure 24).

For Primary Endpoint, GP/FF72/9.6 and GP/FF36/9.6 is better than all positive controls.Figure 25 shows the FEV that GP/FF72/9.6, GP/FF36/9.6 and each active positive control realize the 7th day time compared with placebo ₁aUC _0-12improvement.As shown in figure 25, compared with each positive control composition, the 7th day time, GP/FF72/9.6 and GP/FF36/9.6 provides obviously better FEV ₁aUC _0-12improve, the FEV that when the 7th day, GP/FF72/9.6 and GP/FF36/9.6 provides ₁aUC _0-12improve than each positive control composition height at least 80ml.As shown in figure 26, the 7th day time FEV ₁aUC _0-12difference give prominence to further, such as the 7th day time compare with Foradil positive control with GP36, FF9.6, Si Lihua, the FEV that GP/FF36/9.6 compositions provides ₁aUC _0-12improvement more obvious.

GP/FF72/9.6 is used to treat the FEV provided ₁aUC _0-12improve point in contrast, when Figure 32 shows the 7th day GP/FF36/9.6 and each positive control all patients, suffer from moderate COPD patient and the FEV provided in the patient of severe extremely severe COPD is provided ₁aUC _0-12improvement percentage rate.The result shown in Figure 32 shows: regardless of the order of severity of COPD, and the response of patient is consistent.

For the secondary endpoints of research, GP/FF72/9.6 and GP/FF36/9.6 is also better than other all positive controls.Peak FEV shown in Figure 27 ₁show all to provide change relative to basic value in administration the 1st day and each activity research compositions when the 7th day compared with placebo.As shown in figure 27, when the 1st day and the 7th day, GP/FF72/9.6 and GP/FF36/9.6 provided better peak FEV ₁.Figure 28 highlights when the 1st day and the 7th day, compares with Si Lihua with Foradil, the peak FEV that GP/FF72/9.6 and GP/FF36/9.6 provides ₁improvement.Figure 29 shows compared with placebo, the paddy FEV in early morning that GP/FF72/9.6, GP/FF36/9.6 and each active positive control provide ₁improvement.Can easily understand by reference to Figure 29, the better FEV that the combination being total to suspension by two kinds provides ₁increase can maintain a period of time better, and compared with other active positive controls, GP/FF72/9.6 and GP/FF36/9.6 compositions is to paddy FEV in early morning ₁provide the improvement of about 50%.

Figure 30 shows FEV before the administration in the 7th day that GP/FF72/9.6 and GP/FF36/9.6 provide ₁increase and the administration in the 7th day that provides of GP36, FF9.6, Si Lihua and Foradil positive control before FEV ₁increase between difference.Easily can understand by reference to Figure 30, compare with GP36, FF9.6, Si Lihua with Foradil positive control, GP/FF36/9.6 treatment is to the FEV before administration in the 7th day ₁provide obviously higher improvement.

Except specifically studying except secondary endpoints, also have evaluated the improvement of respiratory capacity (IC).When the 1st day and the 7th day, the IC that GP/FF72/9.6 and GP/FF36/9.6 provides increased all higher than each positive control.For using the patient of GP/FF72/9.6, GP/FF36/9.6 and Si Lihua, Figure 31 shows the IC peak occurred the 1st day time to be improved at (the 1st day peak), the IC of the patient still kept before specific testing combination administration in the 7th day improves (before administration in the 7th day), and the IC peak that patient occurs after particular composition administration in the 7th day improves at (the 7th day peak).

Claims

1. Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is provided for the patient breaths's capacity (IC) suffering from pulmonary disease or disease increases at least 200ml, and wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

2. purposes according to claim 1, wherein said Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine increases at least 300ml for making the patient breaths's capacity (IC) suffering from pulmonary disease or disease, and wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

3. purposes according to claim 1, wherein said Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine increases at least 350ml for making the patient breaths's capacity (IC) suffering from pulmonary disease or disease, and wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

4. Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is for making the patient's forced expiratory volume in one second (FEV suffering from pulmonary disease or disease ₁) increase at least 200ml, wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

5. purposes according to claim 4, wherein said Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is for making the patient's forced expiratory volume in one second (FEV suffering from pulmonary disease or disease ₁) increase at least 300ml, wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

6. purposes according to claim 4, wherein said Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is for making the patient's forced expiratory volume in one second (FEV suffering from pulmonary disease or disease ₁) increase at least 350ml, wherein each administration is no more than the Glycopyrrolate of 50 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 12 μ g.

7. the purposes according to aforementioned any one claim, wherein said medicine is the pharmaceutically acceptable suspension being applicable to be sent by metered-dose inhaler, and described suspension comprises:

Comprise the suspension media of pharmaceutically acceptable HFA propellant, described propellant is substantially free of other materials;

First can suck activating agent, comprises described Glycopyrrolate or its pharmaceutically acceptable salt;

Second can suck activating agent, comprises formoterol or its pharmaceutically acceptable salt; With

Can suck by described first and second multiple that activating agent formed respectively and suck particle, and described particle comprises the microgranular phospholipid material being substantially insoluble to suspension media, the wherein said gross mass sucking particle exceedes the gross mass that described first and second can suck activating agent, described first and second can suck activating agent and the described multiple particle that sucks coexists in described suspension media to form common suspension, and each startup effect of described medicine being made metered-dose inhaler is sent and to be no more than described in 50 μ g first and can to suck activating agent and be no more than described in 12 μ g the preparation that second can suck activating agent.

8. Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or being combined in of its pharmaceutically acceptable salt prepare purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is for making patient paddy in the early morning FEV suffering from pulmonary disease or disease ₁increase at least 150ml, wherein each administration is no more than the Glycopyrrolate of 72 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 9.6.

9. purposes according to claim 8, wherein said Glycopyrrolate or its pharmaceutically acceptable salt and formoterol or its pharmaceutically acceptable salt are preparing purposes in medicine, wherein by giving compositions described in patient through breathing twice every day, described medicine is for making patient paddy in the early morning FEV suffering from pulmonary disease or disease ₁increase at least 200ml, wherein each administration is no more than the Glycopyrrolate of 72 μ g or its pharmaceutically acceptable salt to patient delivery and is no more than formoterol or its pharmaceutically acceptable salt of 9.6.

10. the purposes according to Claim 8 described in-9, wherein said medicine is the pharmaceutically acceptable suspension being applicable to be sent by metered-dose inhaler, and described suspension comprises:

Can suck by described first and second multiple that activating agent formed and suck particle, and described particle comprises the microgranular phospholipid material being substantially insoluble to suspension media, the wherein said gross mass sucking particle exceedes the gross mass that described first and second can suck activating agent, described first and second can suck activating agent and the described multiple particle that sucks coexists in described suspension media to form common suspension, and described medicine is made often inhaling to send and being no more than described in 72 μ g first and can sucking activating agent and be no more than described in 9.6 μ g the preparation that second can suck activating agent of dosage metered-dose inhaler.

11. purposes according to claim 7-10, wherein saidly suck particle and described first and second activating agents are included in described pharmaceutical composition with certain amount, the wherein said proportion sucking the gross mass of particle and the gross mass of described first activating agent and the second activating agent is for being greater than 1 and can up to 200.

12. purposes according to claim 11, the wherein said described ratio sucked between the gross mass of particle and the gross mass of described first and second activating agents is selected from lower group: 10 to 200,60 to 200,15 to 60 and 15 to 170.

13. purposes according to claim 11, the wherein said described ratio sucked between the gross mass of particle and the gross mass of described first and second activating agents is between 15 to 60.

14. purposes according to the aforementioned claim of any one, wherein said pulmonary disease or disease are selected from following at least one: the contraction of asthma, COPD, allergic rhinitis, sinusitis, Pulmonary Vascular, inflammation, allergy, respiratory disorder, respiratory distress syndrome, pulmonary hypertension, the pneumonia relevant to cystic fibrosis and the pulmonary obstruction relevant with cystic fibrosis.

15. purposes according to the aforementioned claim of any one, wherein said pulmonary disease or disease are COPD.

16. purposes according to the aforementioned claim of any one, described Glycopyrrolate or its pharmaceutically acceptable salt comprise the granule that can suck lenticular.

17. purposes according to the aforementioned claim of any one, described formoterol or its pharmaceutically acceptable salt comprise the granule that can suck lenticular.

18. purposes according to the aforementioned claim of any one, wherein use Glycopyrrolate pharmaceutically acceptable salt and the pharmaceutically acceptable salt of described Glycopyrrolate is selected from fluoride, chloride, bromide, iodide, nitrate, sulfate, phosphate, formates, acetate, trifluoroacetate, propionate, butyrate, lactate, citrate, tartrate, malate, maleate, succinate, benzoate, parachlorobenzoic-acid salt, diphenyl acetic acid salt or triphenylacetic acid salt, oxybenzoic acid salt, p-hydroxybenzoate, 1-hydroxynaphenyl-2-carboxylate, 3-hydroxynaphenyl-2-formates, mesylate and benzene sulfonate.

19. purposes according to claim 18, the pharmaceutically acceptable salt of wherein said Glycopyrrolate is selected from fluoride, chloride, bromide and iodide salt.

20. purposes according to claim 19, the pharmaceutically acceptable salt of wherein said Glycopyrrolate is bromination 3-[(cyclopenta-hydroxyphenylacetyl) oxygen base]-1,1-dimethyl pyrrolidine.

21. purposes according to the aforementioned claim of any one, wherein use formoterol pharmaceutically acceptable salt and the pharmaceutically acceptable salt of described formoterol is selected from hydrochloric acid, hydrobromic acid, sulphuric acid, phosphoric acid, fumaric acid, maleic acid, acetic acid, lactic acid, citric acid, tartaric acid, ascorbic acid, succinic acid, 1,3-propanedicarboxylic acid, gluconic acid, tricarballylic acid, oleic acid, benzoic acid, p-Methoxybenzoic acid, salicylic acid, neighbour and P-hydroxybenzoic acid, parachlorobenzoic-acid, methanesulfonic acid, p-methyl benzenesulfonic acid and 3-hydroxyl-2-naphthalenic carboxylic acid salt.

22. purposes according to claim 21, the pharmaceutically acceptable salt of wherein said formoterol is formoterol fumarate.