Aerosol pirfenidone and pyridone analog compound and uses thereof
Disclosed herein are formulations of pirfenidone or pyridone analog compounds for aerosolization and use of such formulations for aerosol administration of pirfenidone or pyridone analog compounds for the prevention or treatment of various fibrotic and inflammatory diseases, including disease associated with the lung, heart, kidney, liver, eye and central nervous system. In some embodiments, pirfenidone or pyridone analog compound formulations and delivery options described herein allow for efficacious local delivery of pirfenidone or pyridone analog compound. Compositions include all formulations, kits, and device combinations described herein. Methods include inhalation procedures, indications and manufacturing processes for production and use of the compositions described.
1. A method of modulating NLRP3 inflammasome activation or NF-KappaB activation in a viral pneumonia patient comprising:
administering to the viral pneumonia patient by inhalation an aqueous solution of pirfenidone, wherein the pirfenidone has a concentration from about 0.1 mg/mL to about 20 mg/mL; sodium citrate; citric acid; sodium chloride; and sodium saccharin wherein the molar ratio of sodium saccharin to pirfenidone is between 1 to 53.9 and 1 to 215.9; wherein the osmolality of the aqueous solution is from about 200 mOsmol/kg to about 500 mOsmol/kg; and wherein the pH of the solution is about 5 to about 6, and wherein the administration of the aqueous solution of pirfenidone reduces local inflammation in the lung and reduces pro-fibrotic cellular responses resulting from viral pneumonia.
2. The method of claim 1 , wherein the reduction of pro-fibrotic cellular responses inhibits the formation or progression of pulmonary fibrosis.
3. The method of claim 1 , wherein administration of the aqueous solution of pirfenidone is on a continuous dosing schedule.
4. The method of claim 1 , wherein the viral pneumonia induces acute respiratory distress.
5. The method of claim 1 , wherein the viral pneumonia patient exhibits acute respiratory distress.
6. The method of claim 1 , wherein the aqueous solution of pirfenidone is administered with a liquid nebulizer.
7. The method of claim 6 , wherein the liquid nebulizer is a jet nebulizer, an ultrasonic nebulizer, a pulsating membrane nebulizer, a nebulizer comprising a vibrating mesh or plate with multiple apertures, a nebulizer comprising a vibration generator and an aqueous chamber, or a nebulizer that uses controlled device features to assist inspiratory flow of the aerosolized aqueous solution to the patient.
8. The method of claim 7 , wherein the liquid nebulizer:
(i) after administration of the inhaled dose, achieves lung deposition of at least 7% of the pirfenidone administered to the viral pneumonia patient;
(ii) provides a Geometric Standard Deviation (GSD) of emitted droplet size distribution of the aqueous solution of about 1.0 to about 2.5;
(iii) provides droplets of the aqueous solution emitted with the high efficiency liquid with:
a) a mass median aerodynamic diameter (MMAD) of about 1 μm to about 5 μm;
b) a volumetric mean diameter (VMD) of about 1 μm to about 5 μm; and/or
c) a mass median diameter (MMD) of about 1 μm to about 5 μm;
(iv) provides a fine particle fraction (FPF=%≤5 μm) of droplets emitted from the liquid nebulizer of at least about 30%;
(v) provides an output rate of at least 0.1 mL/min; and/or
(vi) provides at least about 25% of the aqueous solution.
9. The method of claim 1 , wherein the dose of the aqueous solution of pirfenidone is administered at least once a week.
10. The method of claim 1 , wherein the aqueous solution of pirfenidone is administered on a continuous daily dosing schedule.
11. The method of claim 1 , wherein the aqueous solution of pirfenidone is administered once a day, twice a day, three times a day, four times a day, five times a day, or six times a day.
12. The method of claim 1 , wherein the step of administering the aqueous solution of pirfenidone by inhalation is completed in less than 20 minutes.
13. The method of claim 1 , wherein the method further comprises administration of one or more additional therapeutic agents to the viral pneumonia patient.
14. The method of claim 1 , wherein the administering step is comprised of administration of the aqueous solution of pirfenidone to a mechanically ventilated viral pneumonia patient.
15. The method of claim 14 , wherein the administration to the mechanically ventilated viral pneumonia patient is performed with an in-line nebulizer.