US3317384A - Treatment of topical viral infections with glucocorticoids and nucleosides - Google Patents
Treatment of topical viral infections with glucocorticoids and nucleosides Download PDFInfo
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- US3317384A US3317384A US373501A US37350164A US3317384A US 3317384 A US3317384 A US 3317384A US 373501 A US373501 A US 373501A US 37350164 A US37350164 A US 37350164A US 3317384 A US3317384 A US 3317384A
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- Prior art keywords
- topical
- treatment
- glucocorticoid
- glucocorticoids
- pharmaceutical
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- Expired - Lifetime
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- 230000000699 topical effect Effects 0.000 title claims description 41
- 239000002777 nucleoside Substances 0.000 title claims description 22
- 239000003862 glucocorticoid Substances 0.000 title claims description 20
- 229940037128 systemic glucocorticoids Drugs 0.000 title claims description 5
- 208000036142 Viral infection Diseases 0.000 title claims description 4
- 238000011282 treatment Methods 0.000 title description 19
- 125000003835 nucleoside group Chemical group 0.000 title description 3
- 230000009385 viral infection Effects 0.000 title description 2
- 150000003833 nucleoside derivatives Chemical class 0.000 claims description 16
- 230000003110 anti-inflammatory effect Effects 0.000 claims description 10
- 230000000840 anti-viral effect Effects 0.000 claims description 9
- 238000002360 preparation method Methods 0.000 claims description 9
- 239000000825 pharmaceutical preparation Substances 0.000 claims description 8
- 238000000034 method Methods 0.000 claims description 7
- 230000000694 effects Effects 0.000 claims description 5
- 230000002939 deleterious effect Effects 0.000 claims description 4
- 239000002253 acid Substances 0.000 claims description 3
- 150000003839 salts Chemical class 0.000 claims description 3
- 230000009286 beneficial effect Effects 0.000 description 10
- 241000283973 Oryctolagus cuniculus Species 0.000 description 9
- 235000019271 petrolatum Nutrition 0.000 description 8
- 241000700584 Simplexvirus Species 0.000 description 7
- 208000015181 infectious disease Diseases 0.000 description 7
- 239000003242 anti bacterial agent Substances 0.000 description 6
- 239000007788 liquid Substances 0.000 description 6
- 239000003981 vehicle Substances 0.000 description 6
- PGBHMTALBVVCIT-VCIWKGPPSA-N framycetin Chemical compound N[C@@H]1[C@@H](O)[C@H](O)[C@H](CN)O[C@@H]1O[C@H]1[C@@H](O)[C@H](O[C@H]2[C@@H]([C@@H](N)C[C@@H](N)[C@@H]2O)O[C@@H]2[C@@H]([C@@H](O)[C@H](O)[C@@H](CN)O2)N)O[C@@H]1CO PGBHMTALBVVCIT-VCIWKGPPSA-N 0.000 description 5
- 229940053050 neomycin sulfate Drugs 0.000 description 5
- 208000003322 Coinfection Diseases 0.000 description 4
- 239000004264 Petrolatum Substances 0.000 description 4
- 125000000066 S-methyl group Chemical group [H]C([H])([H])S* 0.000 description 4
- 239000002674 ointment Substances 0.000 description 4
- 229940066842 petrolatum Drugs 0.000 description 4
- 231100000444 skin lesion Toxicity 0.000 description 4
- 206010040882 skin lesion Diseases 0.000 description 4
- 239000003871 white petrolatum Substances 0.000 description 4
- 210000002268 wool Anatomy 0.000 description 4
- QTBSBXVTEAMEQO-UHFFFAOYSA-N Acetic acid Chemical compound CC(O)=O QTBSBXVTEAMEQO-UHFFFAOYSA-N 0.000 description 3
- 239000000443 aerosol Substances 0.000 description 3
- ALEXXDVDDISNDU-JZYPGELDSA-N cortisol 21-acetate Chemical compound C1CC2=CC(=O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)C)(O)[C@@]1(C)C[C@@H]2O ALEXXDVDDISNDU-JZYPGELDSA-N 0.000 description 3
- 239000006071 cream Substances 0.000 description 3
- 229960001067 hydrocortisone acetate Drugs 0.000 description 3
- 230000003612 virological effect Effects 0.000 description 3
- 241000282693 Cercopithecidae Species 0.000 description 2
- ITRJWOMZKQRYTA-RFZYENFJSA-N Cortisone acetate Chemical compound C1CC2=CC(=O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)C)(O)[C@@]1(C)CC2=O ITRJWOMZKQRYTA-RFZYENFJSA-N 0.000 description 2
- 208000009889 Herpes Simplex Diseases 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 2
- 241000124008 Mammalia Species 0.000 description 2
- FQISKWAFAHGMGT-SGJOWKDISA-M Methylprednisolone sodium succinate Chemical compound [Na+].C([C@@]12C)=CC(=O)C=C1[C@@H](C)C[C@@H]1[C@@H]2[C@@H](O)C[C@]2(C)[C@@](O)(C(=O)COC(=O)CCC([O-])=O)CC[C@H]21 FQISKWAFAHGMGT-SGJOWKDISA-M 0.000 description 2
- ISAKRJDGNUQOIC-UHFFFAOYSA-N Uracil Chemical compound O=C1C=CNC(=O)N1 ISAKRJDGNUQOIC-UHFFFAOYSA-N 0.000 description 2
- 206010046865 Vaccinia virus infection Diseases 0.000 description 2
- 239000000460 chlorine Substances 0.000 description 2
- 210000004087 cornea Anatomy 0.000 description 2
- 229960003290 cortisone acetate Drugs 0.000 description 2
- OPTASPLRGRRNAP-UHFFFAOYSA-N cytosine Chemical compound NC=1C=CNC(=O)N=1 OPTASPLRGRRNAP-UHFFFAOYSA-N 0.000 description 2
- SYWHXTATXSMDSB-GSLJADNHSA-N fludrocortisone acetate Chemical compound C1CC2=CC(=O)CC[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)C)(O)[C@@]1(C)C[C@@H]2O SYWHXTATXSMDSB-GSLJADNHSA-N 0.000 description 2
- 229960003336 fluorocortisol acetate Drugs 0.000 description 2
- 229910052736 halogen Inorganic materials 0.000 description 2
- 150000002367 halogens Chemical class 0.000 description 2
- JYGXADMDTFJGBT-VWUMJDOOSA-N hydrocortisone Chemical compound O=C1CC[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 JYGXADMDTFJGBT-VWUMJDOOSA-N 0.000 description 2
- 239000012442 inert solvent Substances 0.000 description 2
- 206010023332 keratitis Diseases 0.000 description 2
- 239000006210 lotion Substances 0.000 description 2
- 229960004584 methylprednisolone Drugs 0.000 description 2
- 231100000252 nontoxic Toxicity 0.000 description 2
- 230000003000 nontoxic effect Effects 0.000 description 2
- 239000003883 ointment base Substances 0.000 description 2
- -1 polyoxyethylene phenol Polymers 0.000 description 2
- 239000000843 powder Substances 0.000 description 2
- 229960005205 prednisolone Drugs 0.000 description 2
- OIGNJSKKLXVSLS-VWUMJDOOSA-N prednisolone Chemical compound O=C1C=C[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 OIGNJSKKLXVSLS-VWUMJDOOSA-N 0.000 description 2
- VZGDMQKNWNREIO-UHFFFAOYSA-N tetrachloromethane Chemical compound ClC(Cl)(Cl)Cl VZGDMQKNWNREIO-UHFFFAOYSA-N 0.000 description 2
- 229940100611 topical cream Drugs 0.000 description 2
- 229960002117 triamcinolone acetonide Drugs 0.000 description 2
- YNDXUCZADRHECN-JNQJZLCISA-N triamcinolone acetonide Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@H]3OC(C)(C)O[C@@]3(C(=O)CO)[C@@]1(C)C[C@@H]2O YNDXUCZADRHECN-JNQJZLCISA-N 0.000 description 2
- 208000007089 vaccinia Diseases 0.000 description 2
- PTJWIQPHWPFNBW-FTFTVQOISA-N 5-[(3S,4S,5R)-3,4-dihydroxy-5-(hydroxymethyl)oxolan-2-yl]-1H-pyrimidine-2,4-dione Chemical compound C1([C@@H](O)[C@H](O)[C@H](O1)CO)C=1C(NC(NC=1)=O)=O PTJWIQPHWPFNBW-FTFTVQOISA-N 0.000 description 1
- ZCYVEMRRCGMTRW-UHFFFAOYSA-N 7553-56-2 Chemical compound [I] ZCYVEMRRCGMTRW-UHFFFAOYSA-N 0.000 description 1
- 108010001478 Bacitracin Proteins 0.000 description 1
- 208000035143 Bacterial infection Diseases 0.000 description 1
- WKBOTKDWSSQWDR-UHFFFAOYSA-N Bromine atom Chemical compound [Br] WKBOTKDWSSQWDR-UHFFFAOYSA-N 0.000 description 1
- ZAMOUSCENKQFHK-UHFFFAOYSA-N Chlorine atom Chemical compound [Cl] ZAMOUSCENKQFHK-UHFFFAOYSA-N 0.000 description 1
- KRKNYBCHXYNGOX-UHFFFAOYSA-K Citrate Chemical compound [O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O KRKNYBCHXYNGOX-UHFFFAOYSA-K 0.000 description 1
- 229920000742 Cotton Polymers 0.000 description 1
- FEWJPZIEWOKRBE-JCYAYHJZSA-N Dextrotartaric acid Chemical compound OC(=O)[C@H](O)[C@@H](O)C(O)=O FEWJPZIEWOKRBE-JCYAYHJZSA-N 0.000 description 1
- NIPNSKYNPDTRPC-UHFFFAOYSA-N N-[2-oxo-2-(2,4,6,7-tetrahydrotriazolo[4,5-c]pyridin-5-yl)ethyl]-2-[[3-(trifluoromethoxy)phenyl]methylamino]pyrimidine-5-carboxamide Chemical compound O=C(CNC(=O)C=1C=NC(=NC=1)NCC1=CC(=CC=C1)OC(F)(F)F)N1CC2=C(CC1)NN=N2 NIPNSKYNPDTRPC-UHFFFAOYSA-N 0.000 description 1
- 229930193140 Neomycin Natural products 0.000 description 1
- JAWMENYCRQKKJY-UHFFFAOYSA-N [3-(2,4,6,7-tetrahydrotriazolo[4,5-c]pyridin-5-ylmethyl)-1-oxa-2,8-diazaspiro[4.5]dec-2-en-8-yl]-[2-[[3-(trifluoromethoxy)phenyl]methylamino]pyrimidin-5-yl]methanone Chemical compound N1N=NC=2CN(CCC=21)CC1=NOC2(C1)CCN(CC2)C(=O)C=1C=NC(=NC=1)NCC1=CC(=CC=C1)OC(F)(F)F JAWMENYCRQKKJY-UHFFFAOYSA-N 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 230000000844 anti-bacterial effect Effects 0.000 description 1
- 229940088710 antibiotic agent Drugs 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- DRTQHJPVMGBUCF-CCXZUQQUSA-N arauridine Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@H]1N1C(=O)NC(=O)C=C1 DRTQHJPVMGBUCF-CCXZUQQUSA-N 0.000 description 1
- 229960003071 bacitracin Drugs 0.000 description 1
- 229930184125 bacitracin Natural products 0.000 description 1
- CLKOFPXJLQSYAH-ABRJDSQDSA-N bacitracin A Chemical compound C1SC([C@@H](N)[C@@H](C)CC)=N[C@@H]1C(=O)N[C@@H](CC(C)C)C(=O)N[C@H](CCC(O)=O)C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H]1C(=O)N[C@H](CCCN)C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@H](CC=2C=CC=CC=2)C(=O)N[C@@H](CC=2N=CNC=2)C(=O)N[C@H](CC(O)=O)C(=O)N[C@@H](CC(N)=O)C(=O)NCCCC1 CLKOFPXJLQSYAH-ABRJDSQDSA-N 0.000 description 1
- 208000022362 bacterial infectious disease Diseases 0.000 description 1
- 239000003899 bactericide agent Substances 0.000 description 1
- 239000000022 bacteriostatic agent Substances 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000031709 bromination Effects 0.000 description 1
- 238000005893 bromination reaction Methods 0.000 description 1
- GDTBXPJZTBHREO-UHFFFAOYSA-N bromine Substances BrBr GDTBXPJZTBHREO-UHFFFAOYSA-N 0.000 description 1
- 229910052794 bromium Inorganic materials 0.000 description 1
- 238000004113 cell culture Methods 0.000 description 1
- 238000005660 chlorination reaction Methods 0.000 description 1
- 229910052801 chlorine Inorganic materials 0.000 description 1
- 208000027738 cloudy cornea Diseases 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 238000002425 crystallisation Methods 0.000 description 1
- 230000008025 crystallization Effects 0.000 description 1
- 229940104302 cytosine Drugs 0.000 description 1
- 229960003957 dexamethasone Drugs 0.000 description 1
- UREBDLICKHMUKA-CXSFZGCWSA-N dexamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-CXSFZGCWSA-N 0.000 description 1
- 229960004833 dexamethasone phosphate Drugs 0.000 description 1
- VQODGRNSFPNSQE-CXSFZGCWSA-N dexamethasone phosphate Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)COP(O)(O)=O)(O)[C@@]1(C)C[C@@H]2O VQODGRNSFPNSQE-CXSFZGCWSA-N 0.000 description 1
- 239000003085 diluting agent Substances 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 238000001704 evaporation Methods 0.000 description 1
- 125000001475 halogen functional group Chemical group 0.000 description 1
- 125000005843 halogen group Chemical group 0.000 description 1
- 230000026030 halogenation Effects 0.000 description 1
- 238000005658 halogenation reaction Methods 0.000 description 1
- 231100001261 hazardous Toxicity 0.000 description 1
- 229950000208 hydrocortamate Drugs 0.000 description 1
- FWFVLWGEFDIZMJ-FOMYWIRZSA-N hydrocortamate Chemical compound C1CC2=CC(=O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)CN(CC)CC)(O)[C@@]1(C)C[C@@H]2O FWFVLWGEFDIZMJ-FOMYWIRZSA-N 0.000 description 1
- 229960000890 hydrocortisone Drugs 0.000 description 1
- 239000000017 hydrogel Substances 0.000 description 1
- 229910052740 iodine Inorganic materials 0.000 description 1
- 239000011630 iodine Substances 0.000 description 1
- 210000003292 kidney cell Anatomy 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 229960001293 methylprednisolone acetate Drugs 0.000 description 1
- PLBHSZGDDKCEHR-LFYFAGGJSA-N methylprednisolone acetate Chemical compound C([C@@]12C)=CC(=O)C=C1[C@@H](C)C[C@@H]1[C@@H]2[C@@H](O)C[C@]2(C)[C@@](O)(C(=O)COC(C)=O)CC[C@H]21 PLBHSZGDDKCEHR-LFYFAGGJSA-N 0.000 description 1
- 238000002156 mixing Methods 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 229960004927 neomycin Drugs 0.000 description 1
- 239000002997 ophthalmic solution Substances 0.000 description 1
- 230000002688 persistence Effects 0.000 description 1
- 235000010482 polyoxyethylene sorbitan monooleate Nutrition 0.000 description 1
- 239000000244 polyoxyethylene sorbitan monooleate Substances 0.000 description 1
- 229940068968 polysorbate 80 Drugs 0.000 description 1
- 229920000053 polysorbate 80 Polymers 0.000 description 1
- 208000022076 postinfectious encephalitis Diseases 0.000 description 1
- VJZLQIPZNBPASX-OJJGEMKLSA-L prednisolone sodium phosphate Chemical compound [Na+].[Na+].O=C1C=C[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@@](CC4)(O)C(=O)COP([O-])([O-])=O)[C@@H]4[C@@H]3CCC2=C1 VJZLQIPZNBPASX-OJJGEMKLSA-L 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 229920006395 saturated elastomer Polymers 0.000 description 1
- 239000011734 sodium Substances 0.000 description 1
- 229910052708 sodium Inorganic materials 0.000 description 1
- 238000000638 solvent extraction Methods 0.000 description 1
- 150000003431 steroids Chemical class 0.000 description 1
- KDYFGRWQOYBRFD-UHFFFAOYSA-L succinate(2-) Chemical compound [O-]C(=O)CCC([O-])=O KDYFGRWQOYBRFD-UHFFFAOYSA-L 0.000 description 1
- 239000004094 surface-active agent Substances 0.000 description 1
- 229940095064 tartrate Drugs 0.000 description 1
- 229940100615 topical ointment Drugs 0.000 description 1
- 238000011269 treatment regimen Methods 0.000 description 1
- MDYZKJNTKZIUSK-UHFFFAOYSA-N tyloxapol Chemical compound O=C.C1CO1.CC(C)(C)CC(C)(C)C1=CC=C(O)C=C1 MDYZKJNTKZIUSK-UHFFFAOYSA-N 0.000 description 1
- 229940035893 uracil Drugs 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
Definitions
- This invention relates to pharmaceutical preparations, more particularly pharmaceutical preparations adapted for topical pharmaceutical applications.
- the preparations of the instant invention are advantageously useful in topical pharmaceutical applications to mammals, for they demonstrate unexpected activity in ophthalmic disorders as shown by their effectiveness in treating herpetic conditions in the eyes.
- the pharmaceutical application of glucocorticoids in such conditions is widespread but often hazardous and accompanied by deleterious side effects. Secondary encephalitis is a hazard of such application and can result in death. Perforation does not occur during such application in disciform keratitis. Keratitis profunda and keratouveitis sometimes occur during or following glucocorticoid applications. Prolonged persistence of herpes simplex virus in the cornea often occurs.
- glucocorticoids are known to mask progress of herpetic conditions in the eye whereby infection progresses despite apparent improvement of the eye. It has now been found that the pharmaceutical preparations of the instant invention unexpectedly minimize or abolish such hazards and deleterious side effects while providing beneficial effectiveness in treating herpetic involvement.
- Other beneficial topical pharmaceutical applications to mammals are in viral skin lesions of vaccinia and herpes simplex.
- compositions comprising in combination a topical anti-inflammatory glucocorticoid and a topical antiviral nucleoside.
- topical pharmaceutical means which adapt the preparations for topical pharmaceutical applications are added to the combination.
- topical anti-inflammatory glucocorticoid means steroids of natural and synthetic origin which demonstrate topical anti-inflammatory properties; for example, cortisone acetate, dexamethasone, deXa-methasone phosphate sodium, fludrocortisone acetate,fiuorometholone, hydrocortamate hydrochloride, hydrocortisone, hydrocortisone acetate, methylprednisolone, methylprednisolone acetate, prednisolone, prednisolone phosphate sodium, and triamcinolone acetonide.
- topical antiviral nucleoside means those nucleosides demonstrating beneficial activity in the treatment of viral ophthalmic conditions and viral skin lesions.
- the antiviral nucleosides are arabinofuranosyl nucleosides of uracil and cytosine and are selected from the group consisting of 1- ⁇ 3- D-arabinofuranosyluracil, its S-bromo, -chloro, -fluoro, -iodo, and -methyl derivatives, 1-B-D-arabinofuranosy1cytosine, its S-methyl derivative, and the pharmaceutically acceptable acid addition salts thereof, such as the hydrochloride, citrate, succinate and tartrate.
- Topical pharmaceutical means which adapt the preparation for topical pharmaceutical applications means lotion vehicles; ointment bases; cream bases; hydrogel pastes; fatty pastes; aqueous solutions, preferably isotonic, especially lbufiered ophthalmic solutions containing a surfactant such as polysorbate 80 and p-isoocytyl polyoxyethylene phenol (Triton WR-1339); aqueous suspending vehicles;
- micronized diluents preferably make up a major amount of the weight or volume of the preparation.
- Such topical pharmaceutical means preferably are sterile and contain a nontoxic bactericidal or bacteriostatic agent.
- the topical anti-inflammatory glucocorticoid and the topical antiviral nucleoside are the essential active ingredients. They are preferably micronized. However, nontoxic antibacterial agents, preferably topically effective antibiotics such as neomycin, polymycin, and bacitracin, can be added to control any secondary bacterial infections.
- the percentage of the topical anti-inflammatory glucocorticoid ranges from about 0.025% to about 2.5% of the preparation.
- the percentage in a liquid vehicle adapted for aerosol formation varies from about 0.01% to about 0.3%.
- the percentage of the antiviral component ranges from about 0.1% to about 10% within which the prefered range is from about 0.5 to about 2%.
- Herpes simplex virus was isolated from a herpetic lip lesion and was subjected to 8 passages in rabbit kidney cell cultures. A titer of approximately 10 plaque forming units per milliliter was obtained. A culture of this titer was used undiluted for infecting rabbit eyes by rubbing the cornea thoroughly with a cotton swab saturated with the culture. 16 rabbits were so infected in all eyes and separated into 4 groups of 4 rabbits each.
- the treatment schedule was identical to that for the control group.
- TOPICAL ANTIVIRAL NUCLEOSI-DE GROUP A sterile ointment was compounded of wool fat, liquid petrolatum, white petrolatum, 0.5 of neomycin sulfate as antibacterial agent to prevent secondary infection and 1% of l-,8-D-arabinofuranosylcytosine hydrochloride. The treatment schedule was identical to that for the control group.
- Example 3 .-C0mbinati0n 0 f glucocorticoid and nucleoside
- a topical cream base is prepared. 0.5% of micronized prednisolone and 5.0% of micronized l-fi-D-arabinofuranosylcytosine are incorporated therein.
- the cream is used in topical pharmaceutical applications to rabbit eyes infected with herpes simplex virus. Equally beneficial unexpected results to those with the previous examples are obtained.
- Example 4.-C0ml7inati0n of glucocorticoid and nucleoside A sterile topical ointment base is prepared. 0.1% of sterile methylprednisolone and 10.0% of sterile l-fl-D- arabinofuranosylcytosine are incorporated therein. The sterile preparation is used in topical pharmaceutical applications to rabbit eyes infected with herpes simplex virus. Equally beneficial unexpected results to those with the previous examples are obtained.
- Example 5 Combination of glacocorticoid and nucleoside An aqueous lotion vehicle is prepared. An amount of triamcinolone acetonide equivalent to 1 mg. per ml. of the vehicle and an amount of I-B-D-arabinofuranosylcytosine hydrochloride equivalent to 25 mg. per ml. are prepared.
- Example 7.--C0mbinati0n of glucocorticoid and nucleoside A finely divided powder for topical pharmaceutical applications is prepared by blending parts by Weight of micronized 1-,8-D-arabinofuranosylcytosine hydrochloride and 1 part by Weight of micronized fiuorometholone. The powder is applied topically with beneficial results in herpes simplex skin lesions in rabbits and vaccinia skin lesions in monkeys.
- Example 8.Other combinations of glucocorticoid and nucleoside Pharmaceutical preparations combining the following concentrations of glucocorticoid and nucleoside are prepared with topical pharmaceutical means.
- the S-halo derivatives of 1-fi-D-arabinofuranosyluracil ar prepared by direct halogenation by reacting the parent compound with, for example, chlorine, bromine and iodine in the presence of an inert solvent which can be aqueous or nonaqueous.
- the inert solvent depends on the particular halogen, for example, chlorination in a mixture of acetic acid and carbon tetrachloride, bromination in water alone.
- the halo compounds are recovered 'by removing excess halogen, evaporating the volatile components, solvent extraction and crystallization. See Ser. No. 51,301 filed Aug. 23, 1960. Brown et a1., Chem. Soc. J.
- a process for minimizing deleterious effects of topical anti-inflammatory glucocorticoids in topical viral infections which comprises application to the infected area of a pharmaceutical preparation comprising in combination (a) from about 0.025% to about 2.5% of a topical anti-inflammatory glucocorticoid,
- topical pharmaceutical means which adapt the preparation for topical pharmaceutical application.
- topical antiviral nucleoside is present in an amount of from about 0.5% to about 2% 3.
- the l-fi-D-arabinofuranosylcytosine hydrochloride is present in an amount of about 1%.
- LEWIS GOTTS Primary Examiner.
- RICHARD L. HUFF Assistant Examiner.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Molecular Biology (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Description
United States Patent O 3,317,384 TREATMENT OF TOPICAL VIRAL INFECTIONS WiTlli GLUCOCORTHCOIDS AND NUCLEOSIDES Gerald E. Underwood, Galesburg, Mich., assignor to The Upjohn Company, Kalamazoo, Mich., a corporation of Delaware No Drawing. Filed June 8, 1964, Ser. No. 373,501
3 Claims. (Cl. 16758) This application is a continuation-in-part of copending application Ser. No. 296,095, filed July 18, 1963, now abandoned.
This invention relates to pharmaceutical preparations, more particularly pharmaceutical preparations adapted for topical pharmaceutical applications.
The preparations of the instant invention are advantageously useful in topical pharmaceutical applications to mammals, for they demonstrate unexpected activity in ophthalmic disorders as shown by their effectiveness in treating herpetic conditions in the eyes. The pharmaceutical application of glucocorticoids in such conditions is widespread but often hazardous and accompanied by deleterious side effects. Secondary encephalitis is a hazard of such application and can result in death. Perforation does not occur during such application in disciform keratitis. Keratitis profunda and keratouveitis sometimes occur during or following glucocorticoid applications. Prolonged persistence of herpes simplex virus in the cornea often occurs. Moreover, glucocorticoids are known to mask progress of herpetic conditions in the eye whereby infection progresses despite apparent improvement of the eye. It has now been found that the pharmaceutical preparations of the instant invention unexpectedly minimize or abolish such hazards and deleterious side effects while providing beneficial effectiveness in treating herpetic involvement. Other beneficial topical pharmaceutical applications to mammals are in viral skin lesions of vaccinia and herpes simplex.
In accordance with the present invention, there are provided pharmaceutical preparations comprising in combination a topical anti-inflammatory glucocorticoid and a topical antiviral nucleoside. Suitably, topical pharmaceutical means which adapt the preparations for topical pharmaceutical applications are added to the combination.
The term topical anti-inflammatory glucocorticoid means steroids of natural and synthetic origin which demonstrate topical anti-inflammatory properties; for example, cortisone acetate, dexamethasone, deXa-methasone phosphate sodium, fludrocortisone acetate,fiuorometholone, hydrocortamate hydrochloride, hydrocortisone, hydrocortisone acetate, methylprednisolone, methylprednisolone acetate, prednisolone, prednisolone phosphate sodium, and triamcinolone acetonide. The term topical antiviral nucleoside means those nucleosides demonstrating beneficial activity in the treatment of viral ophthalmic conditions and viral skin lesions. The antiviral nucleosides are arabinofuranosyl nucleosides of uracil and cytosine and are selected from the group consisting of 1-{3- D-arabinofuranosyluracil, its S-bromo, -chloro, -fluoro, -iodo, and -methyl derivatives, 1-B-D-arabinofuranosy1cytosine, its S-methyl derivative, and the pharmaceutically acceptable acid addition salts thereof, such as the hydrochloride, citrate, succinate and tartrate. Topical pharmaceutical means which adapt the preparation for topical pharmaceutical applications means lotion vehicles; ointment bases; cream bases; hydrogel pastes; fatty pastes; aqueous solutions, preferably isotonic, especially lbufiered ophthalmic solutions containing a surfactant such as polysorbate 80 and p-isoocytyl polyoxyethylene phenol (Triton WR-1339); aqueous suspending vehicles;
micronized diluents; propellent-containing liquid vehicles adapted to form an aerosol; and the like. Any utilized means preferably makes up a major amount of the weight or volume of the preparation. Such topical pharmaceutical means preferably are sterile and contain a nontoxic bactericidal or bacteriostatic agent.
The topical anti-inflammatory glucocorticoid and the topical antiviral nucleoside are the essential active ingredients. They are preferably micronized. However, nontoxic antibacterial agents, preferably topically effective antibiotics such as neomycin, polymycin, and bacitracin, can be added to control any secondary bacterial infections.
The percentage of the topical anti-inflammatory glucocorticoid ranges from about 0.025% to about 2.5% of the preparation. The percentage in a liquid vehicle adapted for aerosol formation varies from about 0.01% to about 0.3%. The percentage of the antiviral component ranges from about 0.1% to about 10% within which the prefered range is from about 0.5 to about 2%.
The following examples describe the manner and process of making and using the invention and set forth the best mode contemplated by the inventor of carrying out in the invention but are not to be construed as limiting.
Treatment of rabbit eyes infected with herpes simplex virus demonstrates beneficial unexpected activity of the novel topical pharmaceutical preparation.
Herpes simplex virus was isolated from a herpetic lip lesion and was subjected to 8 passages in rabbit kidney cell cultures. A titer of approximately 10 plaque forming units per milliliter was obtained. A culture of this titer was used undiluted for infecting rabbit eyes by rubbing the cornea thoroughly with a cotton swab saturated with the culture. 16 rabbits were so infected in all eyes and separated into 4 groups of 4 rabbits each.
CONTROL GROUP 42 hours after infection, treatment of all eyes in this group was started with a sterile ointment composed of wool fat, liquid petrolatum and white petrolatum with 0.5% of neomycin sulfate as antibacterial agent to prevent secondary infection. The treatment was continued every hour from 8 a.m. to 5 pm. for six consecutive days.
ANTI-INFLAMMATORY GLUCOCORTICOID GROUP 42 hours after infection, treatment of all eyes in this group was started with a sterile ointment composed of wool fat, liquid petrolatum, white petrolatum, 0.5 neomycin sulfate as antibacterial agent to prevent secondary infection and 1.5% of hydrocortisone acetate. The treatment schedule was identical to that for the control group.
TOPICAL ANTIVIRAL NUCLEOSI-DE GROUP A sterile ointment was compounded of wool fat, liquid petrolatum, white petrolatum, 0.5 of neomycin sulfate as antibacterial agent to prevent secondary infection and 1% of l-,8-D-arabinofuranosylcytosine hydrochloride. The treatment schedule was identical to that for the control group.
Example 1.-C0mbinati0n of glucocorticoid and nucleoside A sterile ointment was compounded of wool fat, liquid petrolatum, white petrolatum, 0.5% of neomycin sulfate as antibacterial agent to prevent secondary infection, 1.5 of hydrocortisone acetate, and 1% of l-B-Darabinofuranosylcytosine hydrochloride. The same treatment regimen was followed.
METHOD OF OBSERVING AND RECORDING RESULTS Each eye was observed daily with the aid of an ophthalmoscope to ascertain the degree of herpetic involvement, which was recorded as the latter showing deep .stromal involvement with cloudy cornea. In the following recapitulation the digits represent the number of observed eyes.
to form an aerosol. Equally beneficial unexpected results are obtained therefrom in topical application to monkey eyes infected with herpes simplex virus.
Day 2 of Treatment Day 4 of Treatment Day 6 of Treatment Day 2 Post Treatment Treatment Group Control 3 4 1 0 0 0 5 0 0 1 7 O 0 2 6 Glueocorticold 4 4 0 0 0 1 7 0 0 0 4 4 2 4 (1 dead) Nucleoside 8 0 0 0 8 0 0 0 7 1 0 0 7 1 0 0 Example 1 8 0 0 0 7 1 0 0 7 0 1 0 5 1 1 1 Day 4 Post Treatment Day 6 Post Treatment Day 9 Post Treatment Day 14 Post Treatment Treatment Group Control 1 2 0 5 4 0 2 2 2 0 4 2 3 3 2 0 Glucocortieoid 1 3 1 1 1 1 1 1 (2 dead) (3 dead) (3 dead) (3 dead) Nucleoside 4 3 1 0 3 0 5 0 3 1 4 0 5 2 1 0 Example 1- 3 2 1 1 4 3 0 1 5 2 0 1 5 2 0 1 The data show that the glucocorticoid-nucleoside com- Example 6 ggiratign prsgll ctm ft 23 P ;vili ffig zleiggggl 82 5: A topical cream base is prepared. 0.025% by weight P6 16 n ve en P S of m-rcronized fiuorometholone, 2% by weight of micronetfects of the glucocortrcoid.
Example 2.C0mbinati0n of glucocorticoid and nucleoside Example 3 .-C0mbinati0n 0 f glucocorticoid and nucleoside A topical cream base is prepared. 0.5% of micronized prednisolone and 5.0% of micronized l-fi-D-arabinofuranosylcytosine are incorporated therein. The cream is used in topical pharmaceutical applications to rabbit eyes infected with herpes simplex virus. Equally beneficial unexpected results to those with the previous examples are obtained.
Example 4.-C0ml7inati0n of glucocorticoid and nucleoside A sterile topical ointment base is prepared. 0.1% of sterile methylprednisolone and 10.0% of sterile l-fl-D- arabinofuranosylcytosine are incorporated therein. The sterile preparation is used in topical pharmaceutical applications to rabbit eyes infected with herpes simplex virus. Equally beneficial unexpected results to those with the previous examples are obtained.
Example 5 .Combination of glacocorticoid and nucleoside An aqueous lotion vehicle is prepared. An amount of triamcinolone acetonide equivalent to 1 mg. per ml. of the vehicle and an amount of I-B-D-arabinofuranosylcytosine hydrochloride equivalent to 25 mg. per ml. are
ized 1-;8-D-a-rabinofuranosylcytosine and 0.5% of neomycin sulfate are incorporated therein. The cream is used in topical pharmaceutical applications to rabbit eyes infected with herpes simplex virus. Equally beneficial unexpected results to those with the previous examples are obtained.
Example 7.--C0mbinati0n of glucocorticoid and nucleoside A finely divided powder for topical pharmaceutical applications is prepared by blending parts by Weight of micronized 1-,8-D-arabinofuranosylcytosine hydrochloride and 1 part by Weight of micronized fiuorometholone. The powder is applied topically with beneficial results in herpes simplex skin lesions in rabbits and vaccinia skin lesions in monkeys.
Example 8.Other combinations of glucocorticoid and nucleoside Pharmaceutical preparations combining the following concentrations of glucocorticoid and nucleoside are prepared with topical pharmaceutical means.
Percent Cortisone acetate 0.5 to 2.5 Fludrocortisone acetate 0.05 to 0.25
5 -methyl derivative of 1-[i-D-arabinofuranosylcytosine 1 These combinations are prepared preferably with the said topical pharmaceutical means to provide preparations which are also beneficial .in topical pharmaceutical applications.
The S-halo derivatives of 1-fi-D-arabinofuranosyluracil ar prepared by direct halogenation by reacting the parent compound with, for example, chlorine, bromine and iodine in the presence of an inert solvent which can be aqueous or nonaqueous. The inert solvent depends on the particular halogen, for example, chlorination in a mixture of acetic acid and carbon tetrachloride, bromination in water alone. The halo compounds are recovered 'by removing excess halogen, evaporating the volatile components, solvent extraction and crystallization. See Ser. No. 51,301 filed Aug. 23, 1960. Brown et a1., Chem. Soc. J. 23882393 (July) 1956 describes B-B-D-arabofuranosyluracil (1 B D-arabinofuranosyluracil). The procedure of Fox et al., J.A.C.S., 79, 2775-2778 (1957) yields the S-methyl derivative, also known as phongothymidine. Walwich et =al., Proc. Chem. Soc., 84 (March), 1959 describes 3-fl-Darabinofuranosylcytosine (l-B-D- ara'binofuranosylcytosine). Its S-methyl derivative is de- .scribed in U.S. 3,116,282.
What is claimed is:
1. A process for minimizing deleterious effects of topical anti-inflammatory glucocorticoids in topical viral infections which comprises application to the infected area of a pharmaceutical preparation comprising in combination (a) from about 0.025% to about 2.5% of a topical anti-inflammatory glucocorticoid,
(b) from about 0.1% to about of a topical antiviral nucleoside selected from the group consisting of 1 ,8 D arabinofuranosyluracil, its 5-bromo,
6 -chloro, -fluoro, -iodo, and -methyl derivatives, l-B- D-arabinofuranosylcytosine, its S-methyl derivative, and pharmaceutically acceptable acid addition salts thereof, and (c) topical pharmaceutical means which adapt the preparation for topical pharmaceutical application. 2. The process of claim 1 wherein the topical antiviral nucleoside is present in an amount of from about 0.5% to about 2% 3. The process of claim 2 wherein the l-fi-D-arabinofuranosylcytosine hydrochloride is present in an amount of about 1%.
Kaufman et al.: Arch. Ophthalmol, vol. 69 pp. 626- 629, May 1963.
Underwood: Society for Experimental Biology and Medicine, Proceedings, vol. 111, No. 3, pp. 660-664, December 1962.
LEWIS GOTTS, Primary Examiner. RICHARD L. HUFF, Assistant Examiner.
Claims (1)
1. A PROCESS FOR MINIMIZING DELETERIOUS EFFECTS OF TOPICAL ANTI-INFLAMMATORY GLUCOCORTICOIDS IN TOPICAL VIRAL INFECTIONS WHICH COMPRISES APPLICATION TO THE INFECTED AREA OF A PHARMACEUTICAL PREPARATION COMPRISING IN COMBINATION (A) FROM ABOUT 0.025% TO ABOUT 2.5% OF A TOPICAL ANTI-INFLAMMATORY GLUCOCORTICOID, (B) FROM ABOUT 0.1% TO ABOUT 10% OF A TOPICAL ANTIVIRAL NUCLEOSIDE SELECTED FROM THE GROUP CONSISTING OF 1 - B - D - ARABINOFURANOSYLURACIL, ITS 5-BROMO, -CHLORO, -FLUORO, -IODO, AND -METHYL DERIVATIVES, L-BD-ARABINOFURANOSYLCYTOSINE, ITS 5-METHYL DERIVATIVE, AND PHARMACEUTICALLY ACCEPTABLE ACID ADDITION SALTS THEREOF, AND (C) TOPICAL PHARMACEUTICAL MEANS WHICH ADAPT THE PREPARATION FOR TOPICAL PHARMACEUTICAL APPLICATION.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US373501A US3317384A (en) | 1964-06-08 | 1964-06-08 | Treatment of topical viral infections with glucocorticoids and nucleosides |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US373501A US3317384A (en) | 1964-06-08 | 1964-06-08 | Treatment of topical viral infections with glucocorticoids and nucleosides |
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| US3317384A true US3317384A (en) | 1967-05-02 |
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| Application Number | Title | Priority Date | Filing Date |
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| US373501A Expired - Lifetime US3317384A (en) | 1964-06-08 | 1964-06-08 | Treatment of topical viral infections with glucocorticoids and nucleosides |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3898330A (en) * | 1973-08-01 | 1975-08-05 | Squibb & Sons Inc | Corticosteroid phosphate salts/neomycin sulfate ophthalmic |
| WO1996024355A1 (en) * | 1995-02-06 | 1996-08-15 | Astra Aktiebolag | Novel pharmaceutical combination |
| WO1997026882A1 (en) * | 1996-01-26 | 1997-07-31 | Smithkline Beecham Plc | Nucleoside analogs in combination therapy of herpes simplex infections |
| US20240009101A1 (en) * | 2018-10-05 | 2024-01-11 | Jupiter Wellness, Inc. | Minoxidil adjuvant therapies |
| US12527729B2 (en) | 2018-10-05 | 2026-01-20 | Caring Brands, Inc. | Minoxidil adjuvant therapies |
| US12533309B2 (en) | 2018-10-05 | 2026-01-27 | Caring Brands, Inc. | Minoxidil adjuvant therapies |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA588163A (en) * | 1959-12-01 | P. Aterno Joseph | Ophthalmic composition | |
| US3116282A (en) * | 1960-04-27 | 1963-12-31 | Upjohn Co | Pyrimidine nucleosides and process |
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- 1964-06-08 US US373501A patent/US3317384A/en not_active Expired - Lifetime
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA588163A (en) * | 1959-12-01 | P. Aterno Joseph | Ophthalmic composition | |
| US3116282A (en) * | 1960-04-27 | 1963-12-31 | Upjohn Co | Pyrimidine nucleosides and process |
Cited By (19)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3898330A (en) * | 1973-08-01 | 1975-08-05 | Squibb & Sons Inc | Corticosteroid phosphate salts/neomycin sulfate ophthalmic |
| EP1419803A3 (en) * | 1995-02-06 | 2004-06-09 | Medivir Ab | Pharmaceutical composition for topical administration comprising an antiviral substance and a glucocorticoid |
| MY119365A (en) * | 1995-02-06 | 2005-05-31 | Medivir Ab | Novel pharmaceutical combination |
| AU716809B2 (en) * | 1995-02-06 | 2000-03-09 | Medivir Ab | Novel pharmaceutical combination |
| US6337324B1 (en) | 1995-02-06 | 2002-01-08 | Medivir, Ab | Pharmaceutical combination |
| USRE39264E1 (en) * | 1995-02-06 | 2006-09-05 | Medivir Ab | Pharmaceutical combination |
| CN1131034C (en) * | 1995-02-06 | 2003-12-17 | 阿斯特拉公司 | Novel pharmaceutical composition |
| KR100431042B1 (en) * | 1995-02-06 | 2004-06-16 | 메디비르 아베 | Novel Pharmaceutical Combination |
| WO1996024355A1 (en) * | 1995-02-06 | 1996-08-15 | Astra Aktiebolag | Novel pharmaceutical combination |
| WO1997026882A1 (en) * | 1996-01-26 | 1997-07-31 | Smithkline Beecham Plc | Nucleoside analogs in combination therapy of herpes simplex infections |
| CN1133433C (en) * | 1996-01-26 | 2004-01-07 | 诺瓦蒂斯国际药品有限公司 | Nucleoside analogues for use in combination therapy for herpes simplex virus infection |
| US20040185433A1 (en) * | 1996-01-26 | 2004-09-23 | Boyd Malcolm Richard | Nucleoside analogs in combination therapy of herpes simplex infections |
| US20050222016A1 (en) * | 1996-01-26 | 2005-10-06 | Boyd Malcolm R | Nucleoside analogs in combination therapy of herpes simplex infections |
| US6514980B1 (en) | 1996-01-26 | 2003-02-04 | Novartis International Pharmaceutical Ltd. | Nucleoside analogs in combination therapy of herpes simplex infections |
| CZ297841B6 (en) * | 1996-01-26 | 2007-04-11 | Novartis International Pharmaceutical Ltd. | Combined pharmaceutical compositions containing famciclovir or penciclovir and immunosuppressant for treating herpes simplex virus infections |
| US20080287389A1 (en) * | 1996-01-26 | 2008-11-20 | Malcolm Richard Boyd | Nucleoside analogs in combination therapy of herpes simplex infections |
| US20240009101A1 (en) * | 2018-10-05 | 2024-01-11 | Jupiter Wellness, Inc. | Minoxidil adjuvant therapies |
| US12527729B2 (en) | 2018-10-05 | 2026-01-20 | Caring Brands, Inc. | Minoxidil adjuvant therapies |
| US12533309B2 (en) | 2018-10-05 | 2026-01-27 | Caring Brands, Inc. | Minoxidil adjuvant therapies |
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