Abstract:
Human growth hormone factor (GFR) containing pharmaceutical compositions are described, and more precisely, lyophilized compositions of hGRF stabilized by means of saccharose.

Description:
FIELD OF THE INVENTION  
       [0001]     The present invention concerns Growth Hormone Releasing Factor (GRF) containing pharmaceutical compositions. More precisely, it concerns compositions of saccharose-stabilized GRF.  
       BACKGROUND OF THE INVENTION  
       [0002]     In the early 1980&#39;s several groups isolated and characterized growth hormone releasing factor (GRF).  
         [0003]     GRF (also called Somatorelin) is a peptide secreted by the hypothalamus, which acts on its receptor and can promote the release of growth hormone (GH) from the anterior pituitary. It exists as 44-, 40-, or 37-amino acid peptide; the 44-amino acid form may be converted physiologically into shorter forms. All three forms are reported to be active, the activity residing mainly in the first 29 amino acid residues. A synthetic peptide corresponding to the 1-29 amino acid sequence of human GRF [hGRF(1-29)], also called Sermorelin, has been prepared by recombinant DNA technology as described in European Patent EP 105 759.  
         [0004]     Sermorelin has been used in the form of acetate for the diagnosis and treatment of growth hormone deficiency.  
         [0005]     GRF has indeed a therapeutic value for the treatment of certain growth hormone related disorders. The use of GRF to stimulate the release of GH is a physiological method in promoting long bone growth or protein anabolism.  
         [0006]     It is well known that the natural form of GRF can suffer from chemical degradation in aqueous solution, primarily of Asn at position 8, which results in reduced biological potency (Friedman, A. R. et al.,  Int. J. Peptide. Protein Res.,  37, 14-20, 1991; Bongers, J., et al.,  Int. J. Peptide. Protein Res.  39, 364-374, 1992).  
         [0007]     The main hydrolytic reactions occurring in GRF are sensitive to pH and reported to be: rearrangement of Asp 3 , at pH 4-6.5, cleavage of the Asp 3 -Ala 4  bond at pH 2.5-4.5, deamidation and rearrangement of Asn 8  at pH above 7 (Felix A. M. et al.,  Peptides , editors: Giralt E. and Andreu D., pp 732-733, Escom Publishers 1991). Due to the combined degradation pathways, unstabilized aqueous solutions GRF are most stable in the pH range 4-5. Bongers et al. (Bongers et al., 1992) have shown that the deamidation reaction at Asn 8  increases rapidly as the pH is raised above pH 3.  
         [0008]     WO 98/53844 describes stable liquid pharmaceutical compositions of hGRF containing nicotinamide and propylene glycol.  
         [0009]     Various workers have made analogues of GRF by substitution of amino acids into the natural GRF sequence to improve the chemical stability (Serono Symposia USA, 1996; Friedman, 1991). While modification can be an effective means to improve the stability and retain bioactivity, it may be undesirable due to altered immunogenicity, which could be a problem for chronic therapies such as growth hormone deficiency.  
         [0010]     According to EP 189 673 and U.S. Pat. No. 4,963,529 (Sumitomo Pharma Inc.) GRF formulations can be prepared by lyophilization and stabilized by human serum albumin or glycine. JP 3083931 and EP 417 930 describe a GRF-containing nasal preparation which is rendered low-irritating to nasal mucosa by adding sodium chloride and/or sugar alcohols, such as mannitol or sorbitol thereto.  
         [0011]     In order that materials like hGRF be provided to health care personnel and patients, these materials must be prepared as pharmaceutical compositions. Such compositions must maintain activity for appropriate periods of time, must be acceptable in their own right to easy and rapid administration to humans, and must be readily manufacturable. In many cases pharmaceutical formulations are provided in frozen or in lyophilized form. In this case, the composition must be thawed or reconstituted prior to use. The frozen or lyophilized form is often used to maintain biochemical integrity and the bioactivity of the medicinal agent contained in the compositions under a wide variety of storage conditions, as it is recognized by those skilled in the art that lyophilized preparations often maintain activity better than their liquid counterparts. Such lyophilized preparations are reconstituted prior to use by the addition of suitable pharmaceutically acceptable diluent(s), such as sterile water for injection or sterile physiological saline solution, and the like.  
         [0012]     Human GRF is found on the market in lyophilized formulations stabilized with mannitol GEREF®, Serono. 
     
    
     DESCRIPTION OF THE INVENTION  
       [0013]     We have now found that saccharose confers a better stability to lyophilized formulations of hGRF.  
         [0014]     The main object of the present invention is to provide pharmaceutical compositions comprising a solid intimate mixture of human GRF and a stabilizing amount of saccharose.  
         [0015]     A further object is to provide a process for the preparation of said pharmaceutical composition, comprising the step of lyophilizing an aqueous solution of the components in the containers. Another object is to provide a presentation form of said pharmaceutical composition comprising the said solid mixture hermetically closed in a sterile condition within containers suitable for storage before use and suitable for reconstitution of the mixture for injectable substances. Such containers may be suitable for single dose administration or for multidose administration. Such lyophilized compositions also preferably contain a bacteriostatic agent. The bacteriostatic agent is preferably m-cresol.  
         [0016]     The lyophilized compositions of the invention may further comprise buffering agents. Any buffer which is appropriate for pharmaceutical preparations may be used, for example acetate, phosphate or citrate. The amount of buffering agent to be added to the preparation will be such that the pH of the lyophilized compositions is kept within the desired range after reconstitution. The desired pH range according to this invention is between 2 and 7, preferably between 4 and 6.  
         [0017]     Another object is to provide a solution of said solid mixture reconstituted into an injectable solution, such as water for injectable or physiological saline solution. Conveniently such reconstitution is carried out just before use for injection.  
         [0018]     There is no critical limitation to the amount of saccahrose to be added to the active ingredient, but it will be appropriate to add from 1 to 200 mg/vial, preferably from 20 to 100 mg/vial of saccharose.  
         [0019]     According to this invention the word “hGRF” is intended to cover any human GRF peptide, with particular reference to the 1-44, 1-40, 1-29 peptides and the corresponding amides thereof (containing —NH 2  at their end) or even a mixture thereof. They are all commercial compounds. The preferred hGRF is hGRF(1-29)-NH 2 . There is no critical limitation to the amount of active ingredient present in each vial. Such amount is preferably comprised between 0.1 and 100 mg/vial.  
         [0020]     The invention will now be described by means of the following Examples, which should not be construed as in any way limiting the present invention.  
       EXAMPLES  
       [0021]     In order to evaluate the excipient&#39;s effect on the stability of the active ingredients, three formulations of recombinant hGRF have been prepared with various excipients: saccharose, mannitol and mannnitol/phosphate buffer. The filling volume was 2 ml. The compositions of the various formulations, which were prepared, are reported in Table 1.  
                                   TABLE 1                                       Phosphoric           Formu-   hGRF   Mannitol   Saccharose   Acid   Sodium       lation   (mg/ml)   (mg/ml)   (mg/ml)   (mg/ml)   Hydroxide                   1   5   18.2   —   —   —       2   5   18.2   —   0.98   q.s. to pH 4       3   5   —   34.2   —   —                  
 
         [0022]     The preparation of the lyophilizate was performed by dissolving the hGRF bulk powder in the solutions containing the stabilizers. The obtained solutions were filtered and filled into glass vials and lyophilized. The study of the stability of such formulations stored at 40° C. and 50° C. for 4 weeks, was performed by determinations of pH and peptide purity.  
         [0023]     The chromatographic assay methodology (reverse phase HPLC) to evaluate the purity of hGRF was a gradient elution through a C-18 column, using a mobile phase (TFA/water/acetonitrile) at 1 ml/min and UV detection at 214 nm.  
         [0024]     The pH was determined by a pHmeter on vials reconstituted with 5 ml of water for injection.  
         [0025]     The results are summarized in Tables 2 and 3.  
                                                                   TABLE 2                                       pH                40° C.   50° C.            Formulation   T = 0   3 weeks   4 weeks   2 weeks   3 weeks   4 weeks               1   6.8   7.4   7.4   7.2   7.3   7.4       2   4.8   5.2   5.4   5.6   5.4   5.7       3   5.5   5.4   5.5   5.4   5.4   5.4                  
 
         [0026]    
       
         
               
               
             
               
               
               
             
               
               
               
               
               
               
               
             
           
               
                   
                 TABLE 3 
               
             
             
               
                   
                   
               
               
                   
                   
               
               
                   
                 Peptide Purity (%) 
               
             
          
           
               
                   
                 40° C. 
                 50° C. 
               
             
          
           
               
                 Formulation 
                 T = 0 
                 3 weeks 
                 4 weeks 
                 2 weeks 
                 3 weeks 
                 4 weeks 
               
               
                   
               
               
                 1 
                 97.7 
                 96.3 
                 95.7 
                 93.7 
                 92.9 
                 91.8 
               
               
                 2 
                 97.7 
                 95.6 
                 94.8 
                 89.4 
                 88.5 
                 84.2 
               
               
                 3 
                 97.8 
                 97.9 
                 97.8 
                 97.8 
                 97.8 
                 97.6 
               
               
                   
               
             
          
         
       
     
         [0027]     Results showed that the formulation containing saccharose presented a better stability profile when compared to the formulations containing mannitol or mannitol/phosphate buffer.  
         [0028]     Additional formulations having the composition of formulation 3 described in Table 1 were manufactured in different containers (vials); the composition is reported in Table 4.  
                                     TABLE 4                           hGRF   Saccharose       Formulation   (mg/vial)   (mg/vial)                                3a   3   20.5       3b   10   68.4                  
 
         [0029]     The formulations were stored at 5° C., 25° C. and 40° C. and tested for stability using the analytical methods described before (pH, purity and titre by RP).  
         [0030]     Stability data have been generated up to 24 weeks; the results are reported in Tables 5 to 7.  
                                                 TABLE 5                                       pH                        5° C.   25° C.   40° C.       Formulation   T = 0   4 weeks   4 weeks   4 weeks               3a   4.95   5.03   5.02   5.12       3b   4.96   5.09   5.06   5.13                  
 
         [0031]    
       
         
               
             
               
               
               
               
               
               
             
               
               
               
               
               
               
             
           
               
                 TABLE 6 
               
             
             
               
                   
               
               
                   
               
               
                 Formulation 3a 
               
               
                 Storage Temperature = 40° C. 
               
             
          
           
               
                 Test 
                 0 Time 
                 4 weeks 
                 8 weeks 
                 12 weeks 
                 24 weeks 
               
               
                   
               
             
          
           
               
                 Purity (%) 
                 97.8 
                 97.8 
                 97.3 
                 97.0 
                 96.0 
               
               
                 Assay (mg/vial) 
                 2.8 
                 2.9 
                 2.9 
                 2.8 
                 2.9 
               
               
                 pH 
                 4.95 
                 5.12 
                 5.25 
                 5.30 
                 5.43 
               
               
                   
               
             
          
         
       
     
         [0032]    
       
         
               
             
               
               
               
               
               
               
             
               
               
               
               
               
               
             
           
               
                 TABLE 7 
               
             
             
               
                   
               
               
                   
               
               
                 Formulation 3b 
               
               
                 Storage Temperature = 40° C. 
               
             
          
           
               
                 Test 
                 0 Time 
                 4 weeks 
                 8 weeks 
                 12 weeks 
                 24 weeks 
               
               
                   
               
             
          
           
               
                 Purity (%) 
                 97.9 
                 97.9 
                 97.4 
                 97.1 
                 95.1 
               
               
                 Assay (mg/vial) 
                 9.8 
                 9.8 
                 10.0 
                 9.8 
                 8.8 
               
               
                 pH 
                 4.96 
                 5.13 
                 5.16 
                 5.38 
                 5.53 
               
               
                   
               
             
          
         
       
     
         [0033]     The stability of reconstituted solutions with 1.5 and 5 ml 0.3% m-cresol at 5±3° C. and 25±2° C. up to 1 month was also studied.  
         [0034]     The stability data on the reconstituted solutions are reported in Tables 8 to 10.  
                                                         TABLE 8                                       Storage   pH            Formulation   (° C.)   T = 0   1 week   2 weeks   3 weeks   4 weeks               3a    5° C.   4.94   5.03   5.04   5.05   5.18       3b    5° C.   4.96   5.07   5.04   5.14   5.25       3a   25° C.   4.94   5.05   5.07   5.07   5.19       3b   25° C.   4.96   5.14   5.12   5.14   5.24                  
 
         [0035]    
       
         
               
               
               
             
               
               
               
               
               
               
               
             
           
               
                   
                 TABLE 9 
               
             
             
               
                   
                   
               
               
                   
                   
               
               
                   
                 Storage 
                 Peptide Purity (%) 
               
             
          
           
               
                 Formulation 
                 (° C.) 
                 T = 0 
                 1 week 
                 2 weeks 
                 3 weeks 
                 4 weeks 
               
               
                   
               
               
                 3a 
                  5° C. 
                 97.6 
                 97.6 
                 97.5 
                 97.6 
                 97.4 
               
               
                 3b 
                  5° C. 
                 97.6 
                 97.5 
                 97.4 
                 97.5 
                 97.4 
               
               
                 3a 
                 25° C. 
                 97.6 
                 96.4 
                 95.4 
                 94.5 
                 93.5 
               
               
                 3b 
                 25° C. 
                 97.6 
                 96.3 
                 95.4 
                 94.7 
                 93.5 
               
               
                   
               
             
          
         
       
     
         [0036]    
       
         
               
               
               
             
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
             
           
               
                   
                 TABLE 10 
               
             
             
               
                   
                   
               
               
                   
                   
               
               
                   
                 Storage 
                 Peptide Content (mg/vial) 
               
             
          
           
               
                 Formulation 
                 (° C.) 
                 T = 0 
                 1 week 
                 2 weeks 
                 3 weeks 
                 4 weeks 
               
               
                   
               
             
          
           
               
                 3a 
                  5° C. 
                 2.9 
                 3.0 
                 2.5 
                 3.0 
                 2.9 
               
               
                 3b 
                  5° C. 
                 9.6 
                 10.0 
                 9.1 
                 10.0 
                 9.9 
               
               
                 3a 
                 25° C. 
                 2.9 
                 2.9 
                 2.8 
                 2.8 
                 2.8 
               
               
                 3b 
                 25° C. 
                 9.6 
                 10.0 
                 9.3 
                 9.5 
                 9.4 
               
               
                   
               
             
          
         
       
     
       Example of Pharmaceutical Manufacturing  
       [0037]     Materials: extra pure saccharose DAB, Ph Eur, BP, NF (Merck); water for injectables.  
         [0038]     As containers have been used vials DIN 2R and DIN 6R (borosilicate glass type I), rubber closures (Pharmagummi W1816 V50) and aluminum rings and flip-off caps (Pharma-Metal GmbH).  
         [0039]     Preparation of hGRF solution containing saccharose: (for 200 vials containing each 3 or 10 mg hGRF).  
         [0040]     Saccharose (17.1 g) are dissolved into water for injectables (500 ml) in order to obtain the starting saccharose solution.  
         [0041]     The bulk of the hGRF 2 g) is added to the saccharose solution so as to obtain a final weight of 400 g the solution is filtered through a 0.22 μm Durapore sterile filter (Millipore).  
         [0000]     Filling Up and Lyophilization  
         [0042]     The vials are filled up with 0.6 and 2 ml of hGRF sterile solution, transferred to the freeze-dryer and lyophilized according to the following cycle: 
        freezing: −25° C. for 3 hrs 
            −15° C. for 1 hr     −45° C. for 3 hrs    
            primary drying: −110° C. for 13 hrs     secondary drying: from −10° C. to +40° C. in 8 hrs; +40° C. till end of cycle