Combination therapy for COPD
Aerosol formulations comprising glycopyrronium bromide in combination with formoterol are useful for the prevention or treatment of chronic obstructive pulmonary disease. The formulation further comprises a HFA propellant, a co-solvent, and an amount of inorganic acid sufficient to stabilize both the glycopyrronium bromide and the formoterol components. Optionally the formulation may further comprise beclometasone dipropionate.
1. A pharmaceutical composition for use with a pressurized metered dose inhaler, comprising:
(a) glycopyrronium bromide in an amount sufficient to deliver 5 to 26 μg per actuation;
(b) formoterol fumarate in an amount sufficient to deliver 5 to 15 μg per actuation; and
(c) beclometasone dipropionate in an amount sufficient to deliver 50 to 250 μg per actuation;
dissolved in HFA-134a and ethanol, wherein:
the composition comprises hydrochloric acid in an amount equivalent to 0.19 to 0.245 μg/μl of 1M HCl;
the composition comprises ethanol in an amount of 8 to 15% w/w of the composition; and
the composition comprises HFA-134a in an amount of 85 to 90% w/w of the composition.
2. A pharmaceutical composition according to claim 1 , comprising glycopyrronium bromide in an amount of 0.015 to 0.04% w/w of the composition.
3. A pharmaceutical composition according to claim 1 , comprising formoterol fumarate in an amount of 0.005 to 0.07% w/w of the composition.
4. A pharmaceutical composition according to claim 1 , which has been purged of oxygen.
5. An aerosol canister, comprising a pharmaceutical composition according to claim 1 .
6. A canister according to claim 5 , from which oxygen has been removed from the headspace.
7. A method of filling a canister according to claim 5 , comprising:
(a) preparing a solution of glycopyrronium bromide, formoterol fumarate, and beclometasone dipropionate, in ethanol, to which hydrochloric acid has been added in an amount equivalent to 0.19 to 0.245 μg/μl of 1M HCl;
(b) filling an aerosol canister with the solution;
(c) placing a valve onto the can and vacuum crimping; and
(d) pressure-filling the canister with HFA-134a through the valve.
8. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 1 to a subject in need thereof.
9. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 2 to a subject in need thereof.
10. A method for the prevention or treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 3 to a subject in need thereof.
11. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 4 to a subject in need thereof.
12. A pharmaceutical composition according to claim 1 , comprising formoterol fumarate in an amount sufficient to deliver 6 to 12 μg per actuation.
13. A pharmaceutical composition according to claim 1 , comprising beclometasone dipropionate in an amount sufficient to deliver about 50 μs per actuation.
14. A pharmaceutical composition according to claim 1 , further comprising water in an amount of 0.005 to 0.3% w/w of the composition.
15. A pharmaceutical composition according to claim 1 , comprising beclometasone dipropionate in an amount sufficient to deliver 100 μg per actuation.
16. A pharmaceutical composition according to claim 1 , comprising beclometasone dipropionate in an amount sufficient to deliver about 200 μg per actuation.
17. A pharmaceutical composition according to claim 1 , comprising:
formoterol fumarate in an amount sufficient to deliver about 6 μg per actuation; and
beclometasone dipropionate in an amount sufficient to deliver about 100 μg per actuation.
18. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 12 to a subject in need thereof.
19. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 13 to a subject in need thereof.
20. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 14 to a subject in need thereof.
21. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 15 to a subject in need thereof.
22. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 16 to a subject in need thereof.
23. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 17 to a subject in need thereof.
24. An aerosol canister according to claim 5 , comprising a metering valve capable of delivering a volume of about 63 μl per actuation.
25. A pharmaceutical composition according to claim 1 , wherein the ethanol is anhydrous ethanol.
26. A pharmaceutical composition according to claim 1 , comprising beclometasone dipropionate in an amount of 0.07 to 0.41% w/w of the composition.
27. A pharmaceutical composition according to claim 1 , comprising:
glycopyrronium bromide in an amount of 0.015 to 0.04% w/w of the composition;
formoterol fumarate in an amount of 0.005 to 0.07% w/w of the composition; and
beclometasone dipropionate in an amount of 0.07 to 0.41% w/w of the composition.
28. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 1 to a subject in need thereof.
29. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 12 to a subject in need thereof.
30. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 13 to a subject in need thereof.
31. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 14 to a subject in need thereof.
32. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 2 to a subject in need thereof.
33. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 3 to a subject in need thereof.
34. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 4 to a subject in need thereof.
35. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 15 to a subject in need thereof.
36. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 16 to a subject in need thereof.
37. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 17 to a subject in need thereof.
38. A composition according to claim 1 , wherein the glycopyrronium bromide is the racemic mixture (3S,2′R),(3R,2'S)-3-[(cyclopentylhydroxyphenylacetyl)oxy]-1,1-dimethylpyrrolidinium bromide.
39. A composition according to claim 1 , wherein the composition is free of excipients other than the ethanol, the HFA-134a, and the hydrochloric acid.
40. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 25 to a subject in need thereof.
41. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 25 to a subject in need thereof.
42. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 27 to a subject in need thereof.
43. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 27 to a subject in need thereof.
44. A method for the treatment of chronic obstructive pulmonary disease, comprising administering an effective amount of a pharmaceutical composition according to claim 39 to a subject in need thereof.
45. A method for the treatment of asthma, comprising administering an effective amount of a pharmaceutical composition according to claim 39 to a subject in need thereof.