Neuroactive steroids and their use to facilitate neuroprotection
The present disclosure teaches generally neuroprotection and in particular the use of non-hormonal neuroactive steroids to ameliorate inflammation of the central nervous system (CNS). More specifically, the present claims define methods of treating inflammation or ameliorating a neuroinflammatory-promoting condition in the CNS by administration of a steroid with certain properties formulated in a sulfobutyl ether beta-cyclodextrin composition. The steroid is neuroactive, devoid of hormonal endocrine activity and activates a pregnane X receptor. Examples of such steroids include alphaxalone, alphadolone allopregnanolone, pregnanolone, ganaxolone, hydroxydione, minaxolone, Org20599, Org21465, CT1341 and compounds of Formula (I). Dependent claims further define the type of the neuroinflammatory-promoting conditions, the type of cyclodextrin, the molar ratio of neuroactive steroid to the cyclodextrin and the inclusion of other active agents or excipients in the composition and their nature.
1. A method of treating inflammation or ameliorating a neuroinflammatory-promoting condition in the central nervous system (CNS) in a subject, said method comprising administering to the subject an effective amount of alphaxalone, alphadolone and/or alphadolone acetate or a pharmaceutically acceptable salt of any one or more thereof formulated in a sulfobutyl ether beta-cyclodextrin.
2. The method of claim 1 wherein the alphaxalone, alphadolone and/or alphadolone acetate does not induce substantive apoptosis of neurones or glial cells.
3. The method of claim 1 wherein prolonged use of the alphaxalone, alphadolone and/or alphadolone acetate does not cause neurocognitive impairment in human subjects.
4. The method of claim 1 wherein the neuroinflammatory-promoting condition is an infection or a neurodegenerative condition.
5. The method of claim 1 wherein the sulfobutyl ether beta-cyclodextrin is (7) sulfobutyl ether beta-cyclodextrin.
6. The method of claim 5 wherein the molar ratio of alphaxalone, alphadolone and/or alphadolone acetate to cyclodextrin is from about 1:1 to 1:6 except for alphadolone wherein the molar ratio is from 1:2 to 1:6.
7. The method of claim 6 wherein the molar ratio of alphaxalone, alphadolone and/or alphadolone acetate to cyclodextrin is from about 1:2 to about 1:4.
8. The method of claim 7 wherein the molar ratio of alphaxalone, alphadolone and/or alphadolone acetate to cyclodextrin is about 1:2.
9. The method of claim 1 further comprising one or more of an antimicrobial agent, a preservative, a buffer and/or a co-polymer.
10. The method of claim 9 wherein the co-polymer is selected from hydroxy propyl methyl cellulose, polyvinyl pyrollidone and carboxymethyl cellulose.
11. The method of claim 9 wherein if a buffer is present, the pH is from about pH 5.5 to about pH 8.
12. The method of claim 1 wherein alphaxalone and/or alphadolone and/or alphadolone acetate is/are used at anaesthetic concentration of 0.25 mg/kg to 100 mg/kg body weight.
13. The method of claim 1 wherein alphaxalone is used at a sedating concentration of 0.05 mg/kg to 10 mg/kg body weight.
14. The method of claim 4 where the neurodegenerative condition is selected from the group consisting of Alzheimer's disease, Parkinson's disease, dementia, stroke, Huntington's disease and traumatic brain injury.
15. The method of claim 4 wherein the infection is herpes, AIDS or meningitis.