Use of anthelmintic compositions for treating Anoplocephala perfoliata infections in equidae

Abstract: The Invention relates to an anthelmintic composition for oral use comprising an effective amount of praziquantel and an effective amount of at least one anthelmintic agent selected from avermectins, milbemycins or derivatives thereof and to the use of such a composition for the preparation of a medicament for orally controlling and treating infestations by cestodes and nematodes in equine animals.

Description: The present invention relates to the use of a composition for the control and the treatment of parasitic infestations in Equidae and, in particular, for simultaneous control and treatment of infestations by Anoplocephala perfoliata in such animals. Avermectins and milbemycins are currently used in the treatment and control of roundworms and bots in horses and ponies. However, these compounds are known to be inactive against tapeworms. The widespread use of the anthelmintic ivermectin has recently been linked to a rise in the prevalence of the equine tapeworm Anoplocephala perfoliata. Anoplocephala perfoliata is found mainly in the caecum but tends also to cluster in the ileum near the ileocecal valve where it is associated with ulceration and reactive inflammation of the ileal wall. This clustering results in ulceration of the mucous membrane and inflammation with thickening and induration of the deeper layers of the intestinal wall. These pathological changes probably account for some cases of persistent diarrhoea and may predispose to intussusception of the ileum into the caecum or rupture of the bowel wall in the vicinity of the ileocecal valve. It is therefore highly desirable to have a composition which has activity against both cestode and nematode infestations in Equidae and more particularly in horses. The invention relates to the use of an anthelmintic composition comprising an amount of praziquantel suitable for administering to equine animals a dose of 0.5 to 2.0 mg of praziquantel per kg of animal body weight, together with an effective amount of one anthelmintic agent selected from avermectins or milbemycins or derivatives thereof for the preparation of a medicament for orally controlling and treating infestations by Anoplocephala perfoliata in equine animals. Indeed, trials have shown that, when praziquantel is orally administered to horses in combination with an avermectin or a milbemycin or a derivative thereof, a surprising increase of the anthelmintic spectrum is obtained due to the administration in combination. Furthermore a synergistic effect is observed to the extend that when in combination with avermectins or milbemycins the required dosage rate for praziquantel in equine animals is between 0.5 and 2.0 mg per kg of animal body weight. This synergistic activity is even higher with a paste formula. In one preferred embodiment, the anthelmintic agent is an avermectin. Advantageously, said avermectin is abamectin. In another preferred embodiment, the anthelmintic agent is ivermectin. In yet another preferred embodiment, the anthelmintic agent is moxidectin. Whatever the embodiment, the composition comprises an amount of praziquantel suitable for administering to equine animals a dose of 0.5 to 2.0 mg of praziquantel per kg of animal body weight. Advantageously, when the anthelmintic agent is abamectin or ivermectin, the composition comprises abamectin or ivermectin suitable for administering to equine animals doses of about 0.2 mg of abamectin or ivermectin per kg of animal body weight. Preferably, the composition is in the form of a paste. Anthelmintic formulations containing praziquantel together with another anthelmintic such as for example levamisole, albendazole, oxfendazole, moxidectin, ivermetin, have been disclosed in the British Patent Application 2 252 730 of Ancare Distributors Limited. However, the various associations disclosed in this Patent Application are not synergistic and only increase the anthelmintic spectrum in sheep. According to Ancare Distributors Limited, the recommended dose rate of praziquantel in such associations is between 2.0 and 7.5 mg per kg of animal body weight. According to the present invention, it has been discovered that the association between praziquantel and an avermectin or a milbemycin or a derivative thereof shows a surprising synergy in the treatment of horse tapeworms. It allowed the use of praziquantel against Anoplocephala perfoliata in Equidae at a dose rate between 0.5 and 2.0 mg per kg of animal body weight. These dosages are significantly lower than in the already described formulations. Campbell et al. in the South African Patent Application 842571 disclose compositions containing avermectin compounds with one compound selected from various anthelmintic agents, and having some synergetic effects in the treatment of parasitic diseases. One of these anthelmintic compounds is praziquantel. However, Campbell et al. do not contemplate the possibility of using the compositions described therein for the treatment of infestations by Anoplocephala perfoliata in horses. Furthermore, when the avermectin compound is associated with praziquantel, the latter is administered at a dosage rate from 5 to 50 mg/kg of body weight. Kitano in the European Patent Application 0 059 074 also discloses associations of macrolide anthelmintic agents (avermectins) and a variety of several anthelmintic agents like benzimidazole, salicylamide and isoquinoline compounds with enhanced anthelmintic activity. However, Kitano studies on cestodes did not show any evident synergy of any association on Anoplocephala perfoliata. According to the present invention, the activity of praziquantel against Anoplocephala perfoliata is increased in association with an avermectin or a milbemycin compound or a derivative thereof. Moreover, the association exhibits higher synergistic activity as a paste formula which allowed a better biodisponibility of praziquantel in horses. Praziquantel (2(cyclohexylcarbonyl)-1,2,3,6,7,-11b-hexahydro-4H-pyrazino[2,1-a]isoquinolin-4-one) is a relatively insoluble material in water and consequently the applicant has devised formulations for administration of the compound subject of this invention in the form of paste, drench, tablet or pellet. Examples of formulations in accordance with the present invention will be described hereafter without limiting the generality of the invention as above described. The range of active percentages of a typical formula in accordance with this invention could be as indicated thereafter : Praziquantel 0.1-30% w/v and Ivermectin 0.05-5% w/v or Abamectin 0.05-5% w/v or Moxidectin 0.05-5% w/v or Doramectin 0.05-5% w/v and one or more of the following ingredients to enhance stability and/or other characteristics of the composition : surfactants, preservatives, viscosity agents, stabilisers, flavours and colours. Ivermectin is a semisynthetic derivative of avermectins. Ivermectin contains at least 80% of 22,23-dihydroavermectin B1a and less than 20% of 22,23-dihydroavermectin B1b. Ivermectin is disclosed in Australian Patent 519569. Abamectin or avermectin B1 contains at least 80% of avermectin B1a and not more than 20% of avermectin B1b. Abamectin is disclosed in Australian Patent 513641. Moxidectin [spiro (11,5-methano-2Hm13G, 17H-furo(4,3,2-pg) (2,6) benzodioxacyclo octadectin-13,2'-(2H) pyran-7-one,20,20b-dihydroxy-6'(1,3-dimethyl-T-butenyl)= 4'-(methoxymino)-3',4',5',6,6',7,10,11,14,15,17a,20,20a, 20b-tetradecahydro-5'6,8,19-teramethyl-(6R-(2aZ,4E,5'S*, 6R*(E),8E,11R*,13S*,15R*,17aR*,20R*,20bS*)] is a new broad spectrum endectocide. Doramectin (25-cyclohexyl-5-O-demethyl-25-de-1(methylpropyl)avermectin A1a is an avermectin. According to the invention, when praziquantel is orally administered in combination with an avermectin, a milbemycin or a derivative thereof, the dosage rate of praziquantel required for efficiently treating equine animals against nematodes and more particularly against Anoplocephala perfoliata is between 0.5 and 2.0 mg per kg of animal body weight. However, it has been observed that praziquantel may be administered in higher dosage rates without adverse effects and in this regard dosage rates of up to 7.5 mg per kg of body weight have been tested. EXAMPLE 1 : ABAMECTIN-PRAZIQUANTEL PASTE FOR HORSES ABAMECTIN (AVERMECTIN B1) 0,4 g PRAZIQUANTEL 50 g DIETHYLENE GLYCOL PALMITO STEARATE 80 g SODIUM METABISULFITE 1 g SORBITOL SOLUTION (NON-CRYSTALLISING) 120 g GLYCEROL FORMAL 60 ml POLYETHYLENE GLYCOL 400 60 ml METHYL HYDROXYBENZOATE 0,5 g PROPYL HYDROXYBENZOATE 0,05 g BENZYL ALCOHOL 10 g OAT MEAL FLOUR 300 g PURIFIED WATER q.s. to 1 litre The manufacture of the formulations of Example 1 is in accordance with the following procedures : 1. Heat 400 ml of purified water in a separate container to 80 degrees - 85 degrees Celsius. 2. While mixing, add and dissolve methyl hydroxybenzoate and propyl hydroxybenzoate. Continue mixing until all has dissolved. 3. While mixing, add Sorbitol solution. Maintain the temperature at 70 degrees Celsius. 4. In a separate container, add glycerol formal, polyethylene glycol 400, benzyl alcohol. Start mixing while warming to 35 degrees - 40 degrees Celsius. 5. While mixing, add abamectin. Continue mixing until all has dissolved. Maintain temperature at 35 degrees - 40 degrees Celsius. 6. In the ointment tank, add half of the Oat Flour, the praziquantel, then start mixing. Continue mixing for 5-10 minutes until a homogeneous blended powder is formed. The add the rest of the Oat Flour and continue mixing. 7. While mixing the powders, add the solution from step 5 in a thin stream. When all is added, continue mixing until an homogenous mass is formed. 8. Melt diethylene glycol palmitostearate in a separate container. While mixing the solution form step 3, add the melted wax and continue mixing to form an homogeneous emulsion. Stop heating and mix to cool to 40 degrees - 45 degrees Celsius. 9. Add and dissolve sodium metabisulphite in the emulsion. 10. While mixing the mass from step 7, add gradually and in a thin stream the emulsion from step 9. The emulsion when added should be at 40 degrees - 45 degrees Celsius. 11. When all is added, continue mixing for 10-15 minutes. 12. Complete the batch to volume with purified water while mixing. Continue mixing for 30 minutes. Stop when the batch temperature is not higher than 30 degrees Celsius. Check on Specific Gravity (1.05 - 1.09). 13. Homogenise the batch. 14. Pack in syringes. Combinations with other avermectins or milbemycin type compounds can be formulated in a manner similar to that of Example 1. EXAMPLE 2 : ABAMECTIN-PRAZIQUANTEL PASTE FOR HORSES We use the ingredients, dosages and manufacturing process for Example 1 except for abamectin which is used in an amount of 2 g instead of 0.4 g. EXAMPLE 3 : ABAMECTIN-PRAZIQUANTEL PASTE FOR HORSES We use the ingredients, dosages and manufacturing process of Example 1 except for abamectin which is used in an amount of 4 g instead of 0.4 g. EXAMPLE 4 : ABAMECTIN-PRAZIQUANTEL PASTE FOR HORSES We use the ingredients, dosages and manufacturing process of Example 1 except for abamectin which is used in an amount of 8 g instead of 0.4 g. EXAMPLE 5 : ABAMECTIN-PRAZIQUANTEL PASTE FOR HORSES We use the ingredients, dosages and manufacturing process of Example 1 except for abamectin which is used in an amount of 20 g instead of 0.4 g. EXAMPLE 6 : IVERMECTIN-PRAZIQUANTEL ORAL DRENCH FOR HORSES IVERMECTIN 2 g PRAZIQUANTEL 50 g GLYCEROL FORMAL 250 ml TWEEN 80 120 g BENZYL ALCOHOL 30 g XANTHAM GUM 1 g PURIFIED WATER q.s. to 1 litre Other Avermectins such as abamectin or doramectin or milbemycins such as moxidectin may be used in place of ivermectin. EXAMPLE 7 : IVERMECTIN-PRAZIQUANTEL ORAL DRENCH FOR HORSES We use the ingredients, dosages and manufacturing process of Example 6 except for ivermectin which is used in an amount of 4 g instead of 2 g. EXAMPLE 8 : IVERMECTIN-PRAZIQUANTEL ORAL DRENCH FOR HORSES We use the ingredients, dosages and manufacturing process of Example 6 except for ivermectin which is used in an amount of 8 g instead of 2 g. EXAMPLE 9 : ABAMECTIN-PRAZIQUANTEL TABLET FOR HORSES 1 Tablet/200 kg body weight Per Tablet ABAMECTIN 40 mg PRAZIQUANTEL 200 mg SODIUM STARCH GLYCOLLATE 12 mg HYDROXY PROPYL CELLULOSE 4 mg LACTOSE 178 mg COLLOIDAL SILICON DIOXIDE 4 mg MAGNESIUM STEARATE 2 mg Other avermectins or milbemycins can be used instead of abamectin. TRIALS Trials of formulations in accordance with the present invention have been conducted in Australia. The method of evaluating the activity of the formulation was a modified critical test (Lyons et al., 1986) which involved killing the horses 24 hours after treatment. Efficacy is the number of worms count dead and removed versus the number of worms count alive and not removed (scolex attached for Anaplocephala perfoliata). EXAMPLE 10 TRIAL 1 A trial involving abamectin paste (1ml per 20 kg of body weight equivalent to 0.2 mg of Abamectin per kg B.W.), praziquantel paste (0.1 to 5 mg of Praziquantel per kg of body weight), and formulations in accordance with examples 1,2,3,4 and 5. Eleven groups of ten horses per group were involved in the study. Area of origin of the horses was well known for having internal parasitism problem and specifically tapeworms (Anoplocephala perfoliata) infestation. A high level of efficacy was demonstrated by the combination formula of Examples 2, 3, 4 and 5 against roundworms, arthropod parasites and tapeworms. Synergistic activity of praziquantel and abamectin shows 100% removal of Anoplocephala perfoliata with 0.2 mg of abamectin per kg B.W. and 1 mg of praziquantel per kg B.W. EFFICACY OF THE FORMULATION OF EXAMPLES 1, 2, 3, 4 AND 5 AGAINST NEMATODES, ARTHROPOD PARASITES AND CESTODES IN HORSES IN A CRITICAL TRIAL Anthelmintic Dosage mg/kg % Efficacy Strongylidae % Efficacy Gasterophilus spp. % Efficacy Parascaris equorum % Efficacy Anoplocephala perfoliata Abamectin 0.2 100 100 100 0 Praziquantel 0.1 0 0 0 0 Praziquantel 0.5 0 0 0 27 Praziquantel 1 0 0 0 58 Praziquantel 2 0 0 0 71 Praziquantel 5 0 0 0 83 Abamectin 0.2 100 100 100 Praziquantel 0.1 39 Abamectin 0.2 100 100 100 Praziquantel 0.5 89 Abamectin 0.2 100 100 100 Praziquantel 1 100 Abamectin 0.2 100 100 100 Praziquantel 2 100 Abamectin 0.2 100 100 100 Praziquantel 5 100 EXAMPLE 11 : TRIAL 2 A trial involving Ivermectin drench (1 ml per 10 kg of body weight equivalent to 0.2 mg of Ivermectin per kg B.W.), praziquantel drench (0.5 to 2 mg of praziquantel per kg of body weight), and formulations in accordance with Examples 6, 7 and 8. Seven groups of 6 horses per group were involved in the study. Area of origin of the horses was well known for having internal parasitism problem and specifically tapeworms (Anoplocephala perfoliata) infestation. A high level of efficacy was demonstrated by the combination formula of Examples 7 and 8 against roundworms, arthropod parasites and tapeworms. Synergistic activity of praziquantel and ivermectin shows 100 % removal of Anoplocephala perfoliata with 0.2 mg of ivermectin per kg B.W. and 2 mg of praziquantel per kg B.W. EFFICACY OF THE FORMULATION OF EXAMPLES 6, 7 AND 8 AGAINST NEMATODES, ARTHROPOD PARASITES AND CESTODES IN HORSES IN A CRITICAL TRIAL Anthelmintic Dosage mg/kg % Efficacy Strongylidae % Efficacy Gasterophilus spp. % Efficacy Parascaris aquorum % Efficacy Anoplocephala perfilia ta Ivermectin 0.2 100 100 100 0 Praziquantel 0.5 0 0 0 21 Praziquantel 1 0 0 0 43 Praziquantel 2 0 0 0 59 Ivermectin 0.2 100 100 100 Praziquantel 0.5 68 Ivermectin 0.2 100 100 100 Praziquantel 1 91 Ivermectin 0.2 100 100 100 Praziquantel 2 100

Claims: Use of an anthelmintic composition comprising an amount of praziquantel suitable for administering to equine animals a dose of 0.5 to 2.0 mg of praziquantel per kg of animal body weight, together with an effective amount of an anthelmintic agent selected from avermectins or milbemycins or derivatives thereof for the preparation of a medicament for orally controlling and treating infestations by Anoplocephala perfoliata in equine animals. Use of an anthelmintic composition according to claim 1, wherein the anthelmintic agent is abamectin. Use of an anthelmintic composition according to claim 1, wherein the anthelmintic agent is ivermectin. Use of an anthelmintic composition according to claim 1, wherein the anthelmintic agent is moxidectin. Use of an anthelmintic composition according to claim 2, which comprises an amount of abamectin suitable for administering to equine animals about 0.2 mg of abamectin per kg of animal body weight. Use of an anthelmintic composition according to claim 3, which comprises an amount of ivermectin suitable for administering to equine animals about 0.2 mg of ivermectin per kg of animal body weight. Use of an anthelmintic composition according to anyone of preceding claims, which is in the form of a paste.

Inventors: BEUVRY VINCENT, FORSTER MICHAEL, BEUVRY, VINCENT, FORSTER, MICHAEL
Applicants: VIRBAC SA, VIRBAC S.A.
Application year: 1995
Main classification: A61K31
IPC codes: A61K31, A01N43