Capsaicinoids for Use in Treating ACRAL Lick Granuloma
The invention provides methods for treating acral lick granuloma in a canine using a capsaicinoid, such as capsaicin. The invention also provides methods for deactivating a nerve fiber selected from the group consisting of a C-fiber and an A-delta fiber, each being located in or proximal to an acral lick granuloma in a canine, using a capsaicinoid, such as capsaicin.
1 . A method of treating acral lick granuloma in a canine, comprising
administering to a canine in need thereof a therapeutically effective amount of a liquid capsaicin injectable formulation by performing multiple subcutaneous injections of the liquid capsaicin injectable formulation to tissue proximal to the lower boundary of the granuloma, wherein, after the first subcutaneous injection of the formulation to tissue proximal to the lower boundary of the granuloma, any subsequent subcutaneous injection of the formulation into tissue proximal to the lower boundary of the granuloma is performed at a location laterally distal to any prior injection of the formulation to tissue proximal to the lower boundary of the granuloma, to thereby disperse capsaicin throughout the area under the acral lick granuloma in proximity to the boundary between healthy tissue and the granuloma; wherein
the administering delivers capsaicin in an amount ranging from about 1.2 μg to about 1.8 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma;
the liquid capsaicin injectable formulation contains capsaicin in an amount ranging from about 0.3 mg/mL to about 0.5 mg/mL; and
the capsaicin comprises greater than about 95% trans-capsaicin, to thereby treat the acral lick granuloma.
2 . The method of claim 1 , wherein the administering delivers capsaicin in an amount of about 1.5 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma.
3 . The method of claim 1 or 2 , wherein the multiple subcutaneous injections of a liquid capsaicin injectable formulation to tissue proximal to the lower boundary of the granuloma are injections of the liquid capsaicin injectable formulation into healthy tissue proximal to the lower boundary of the granuloma.
4 . The method of any one of claims 1 - 3 , wherein the administering delivers from about 0.3 mL to about 5 mL of the formulation.
5 . The method of claim 3 , further comprising injecting a liquid capsaicin injectable formulation into acral lick granuloma tissue.
6 . The method of any one of claims 1 - 5 , wherein the administering provides one or more of the following:
at least a 30% reduction in the number of times the canine engaged in licking the acral lick granuloma on the day that is 28 days after receiving the capsaicin compared to the average number of times the canine engaged in licking the acral lick granuloma per day for the 7 day period prior to receiving the capsaicin;
at least a 30% reduction in the number of times the canine engaged in biting at the acral lick granuloma on the day that is 28 days after receiving the capsaicin compared to the average number of times the canine engaged in biting at the acral lick granuloma per day for the 7 day period prior to receiving the capsaicin;
at least a 30% reduction in the number of times the canine engaged in scratching the acral lick granuloma on the day that is 28 days after receiving the capsaicin compared to the average number of times the canine engaged in scratching the acral lick granuloma per day for the 7 day period prior to receiving the capsaicin; or
hair regrows over at least about 30% of the topical area of the original lesion due to the acral lick granuloma by day twenty-eight after receiving the capsaicin.
7 . The method of any one of claims 1 - 6 , wherein the administering provides one or more of the following:
at least a 40% reduction in CSOM score at day 14 after receiving capsaicin compared to the CSOM score observed on the day that was 7 days prior to receiving capsaicin; or
at least a 20% reduction in CSOM score at day 28 after receiving capsaicin compared to the CSOM score observed on the day that was 7 days prior to receiving capsaicin.
8 . The method of any one of claims 1 - 7 , wherein the administering provides relief from itch due to the acral lick granuloma for a duration of at least 6 weeks.
9 . The method of any one of claims 1 - 8 , wherein the administering provides relief from pain due to the acral lick granuloma for a duration of at least 6 weeks.
10 . The method of any one of claims 1 - 9 , wherein the administering provides deactivation of a nerve fiber selected from the group consisting of a C-fiber and an A-delta fiber, each being located in or proximal to an acral lick granuloma in the canine, for a duration of at least 4 weeks.
11 . A method of treating acral lick granuloma in a canine, comprising administering to a canine in need thereof a therapeutically effective amount of a capsaicinoid to the granuloma or tissue proximal thereto, to thereby treat the acral lick granuloma.
12 . The method of claim 11 , wherein the capsaicinoid is administered to the granuloma.
13 . The method of claim 11 , wherein the capsaicinoid is administered to the granuloma and tissue proximal to the granuloma.
14 . The method of claim 11 , wherein the capsaicinoid is administered to tissue proximal to the granuloma.
15 . A method of deactivating a nerve fiber selected from the group consisting of a C-fiber and an A-delta fiber, each being located in or proximal to an acral lick granuloma in a canine, comprising administering to a canine in need thereof an effective amount of a capsaicinoid to the granuloma or tissue proximal thereto, to thereby deactivate a said nerve fiber.
16 . The method of claim 15 , wherein the administering deactivates a C-fiber.
17 . The method of claim 15 , wherein the administering deactivates a A-delta fiber.
18 . The method of claim 15 , wherein the administering deactivates a C-fiber and an A-delta fiber.
19 . The method of any one of claims 11 - 18 , wherein the capsaicinoid is administered by injection.
20 . The method of any one of claims 11 - 19 , wherein the capsaicinoid is administered by subcutaneous injection.
21 . The method of any one of claims 11 - 20 , wherein the capsaicinoid is capsaicin.
22 . The method of claim 21 , wherein the capsaicin is administered in an amount in the range of about 0.1 mg to about 10 mg.
23 . The method of claim 21 , wherein the capsaicin is administered in an amount in the range of about 1 μg to about 2 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma.
24 . The method of claim 21 , wherein the capsaicin is administered in an amount in the range of about 1.2 μg to about 1.8 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma.
25 . The method of claim 21 , wherein the capsaicin is administered in an amount in the range of about 1.4 μg to about 1.6 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma.
26 . The method of claim 21 , wherein the capsaicin is administered in an amount of about 1.5 μg of capsaicin per square millimeter of topical surface area of the acral lick granuloma.
27 . The method of any one of claims 21 - 26 , wherein the capsaicin consists essentially of trans-capsaicin.
28 . The method of any one of claims 21 - 26 , wherein the capsaicin comprises greater than about 90% wt/wt trans-capsaicin.
29 . The method of any one of claims 21 - 26 , wherein the capsaicin comprises greater than about 95% wt/wt trans-capsaicin.
30 . The method of any one of claims 21 - 26 , wherein the capsaicin comprises greater than about 98% wt/wt trans-capsaicin.
31 . The method of any one of claims 11 - 30 , wherein the capsaicinoid is administered in the form of a pharmaceutical composition formulated for injection.
32 . The method of claim 31 , wherein the pharmaceutical composition formulated for injection contains capsaicinoid in an amount ranging from about 0.3 mg/mL to about 0.5 mg/mL.
33 . The method of claim 31 or 32 , wherein the administering delivers from about 0.3 mL to about 5 mL of the pharmaceutical composition formulated for injection.
34 . The method any one of claims 31 - 33 , wherein the pharmaceutical composition formulated for injection contains water and a polyethylene glycol.
35 . The method claim 34 , wherein the polyethylene glycol is polyethylene glycol having a number-average molecular weight of about 300 g/mol.
36 . The method claim 34 or 35 , wherein upon a volume basis there is 3-6 times more water than polyethylene glycol.
37 . The method of any one of claims 11 - 36 , wherein the administering provides relief from itch due to the acral lick granuloma for a duration of at least 2 weeks.
38 . The method of any one of claims 11 - 36 , wherein the administering provides relief from itch due to the acral lick granuloma for a duration of at least 4 weeks.
39 . The method of any one of claims 11 - 38 , wherein the administering provides relief from pain due to the acral lick granuloma for a duration of at least 2 weeks.
40 . The method of any one of claims 11 - 38 , wherein the administering provides relief from pain due to the acral lick granuloma for a duration of at least 4 weeks.
41 . The method of any one of claims 11 - 40 , wherein the administering provides deactivation of a nerve fiber selected from the group consisting of a C-fiber and an A-delta fiber, each being located in or proximal to an acral lick granuloma in the canine, for a duration of at least 2 weeks.
42 . The method of any one of claims 11 - 40 , wherein the administering provides deactivation of a nerve fiber selected from the group consisting of a C-fiber and an A-delta fiber, each being located in or proximal to an acral lick granuloma in the canine, for a duration of at least 4 weeks.
43 . The method of any one of claims 11 - 42 , wherein the administering provides one or more of the following:
at least a 30% reduction in the number of times the canine engaged in licking the acral lick granuloma on the day that is 28 days after receiving the capsaicinoid compared to the average number of times the canine engaged in licking the acral lick granuloma per day for the 7 day period prior to receiving the capsaicinoid;
at least a 30% reduction in the number of times the canine engaged in biting at the acral lick granuloma on the day that is 28 days after receiving the capsaicinoid compared to the average number of times the canine engaged in biting at the acral lick granuloma per day for the 7 day period prior to receiving the capsaicinoid;
at least a 30% reduction in the number of times the canine engaged in scratching the acral lick granuloma on the day that is 28 days after receiving the capsaicinoid compared to the average number of times the canine engaged in scratching the acral lick granuloma per day for the 7 day period prior to receiving the capsaicinoid; or
hair regrows over at least about 30% of the topical area of the original lesion due to the acral lick granuloma by day twenty-eight after receiving the capsaicinoid.
44 . The method of any one of claims 11 - 43 , wherein the administering provides one or more of the following:
at least a 40% reduction in CSOM score at day 14 after receiving capsaicinoid compared to the CSOM score observed on the day that was 7 days prior to receiving capsaicinoid; or
at least a 20% reduction in CSOM score at day 28 after receiving capsaicinoid compared to the CSOM score observed on the day that was 7 days prior to receiving capsaicinoid.
45 . The method of any one of claims 1 - 44 , further comprising administering, prior to the capsaicinoid, an anesthetic agent.
46 . The method of claim 45 , wherein the anesthetic agent is an agent that causes general sedation of the canine.
47 . The method of claim 45 , wherein the anesthetic agent is a caine analgesic administered proximal to the granuloma.
48 . The method of claim 47 , wherein the caine analgesic is lidocaine or a pharmaceutically acceptable salt thereof.