Rapamycin for the treatment of lymphangioleiomyomatosis
The present invention relates to methods and compositions for treating lymphangioleiomyomatosis in a human subject in need of such treatment. The methods comprise administering to the subject via inhalation an aerosol composition comprising rapamycin or a prodrug or derivative (including analog) thereof.
1. A method for treating a lung disease or disorder characterized by aberrant activation of the mammalian target of rapamycin (mTOR) signaling pathway in a subject in need thereof comprising administering to the subject by inhalation, a pharmaceutical dry powder composition comprising:
i) microparticulate rapamycin or an analogue thereof blended onto
ii) carrier particles,
wherein the microparticulate rapamycin comprises particles having a mass median aerodynamic diameter (MMAD) of from 2 to 3 microns.
2. The method of claim 1 , wherein the rapamycin in the composition is present in an amount of from 50 to 250 micrograms.
3. The method of claim 1 , wherein the composition has a fine particle fraction (FPF) greater than 20% with a corresponding fine particle dose (FPD) ranging from 10 micrograms to 2 milligrams, following 1 to 12 months of storage.
4. The method of claim 1 , wherein the composition is produced by a process comprising mechanically reducing the particle size of the rapamycin by jet milling.
5. The method of claim 1 , wherein the carrier is selected from the group consisting of arabinose, glucose, fructose, ribose, mannose, sucrose, trehalose, lactose, maltose, starches, dextran, mannitol, lysine, leucine, isoleucine, dipalmitylphosphatidylcholine, lecithin, polylactic acid, poly (lactic-co-glutamic) acid, and xylitol, and combinations thereof.
6. The method of claim 1 , wherein the carrier comprises of a blend of two different lactose carriers.
7. The method of claim 5 , wherein the carrier comprises a blend of two different lactose carriers.
8. The method of claim 1 , wherein the administering to the subject by inhalation is effective to achieve a respirable dose of the rapamycin of from 5 to 400 micrograms delivered to the lung.
9. The method of claim 1 , wherein the administering to the subject by inhalation is effective to produce a blood trough level in the subject of less than 5 ng/ml or less than 2 ng/ml.
10. The method of claim 1 , wherein the lung disease or disorder is lymphangioleiomyomatosis (LAM).
11. The method of claim 1 , wherein the pharmaceutical dry powder composition has a fine particle fraction (FPF) greater than 20% with a corresponding fine particle dose (FPD) ranging from 10 micrograms to 500 micrograms following 1 to 12 months of storage.
12. The method of claim 1 , where the pharmaceutical dry powder composition is formulated for once daily administration.
13. The method of claim 1 , wherein the rapamycin is selected from everolimus (Affinitor; RAD001), temsirolimus (CCI-779), ridaforolimus (previously known as deforolimus; AP23573), umirolimus (Biolimus A9), zotarolimus (ABT-578), novolimus, myolimus, AP23841, KU-0063794, INK-128, EX2044, EX3855, EX7518, AZD08055 or OSI027 or an analogue thereof.