Ophthalmic formulations of methotrexate
The present disclosure provides formulations of methotrexate for ocular administration, including intravitreal administration, and use of the formulations for treating proliferative vitreoretinopathy (PVR), intraocular lymphoma (e.g., PVRL), and intraocular inflammation.
1. A composition suitable for intravitreal administration, comprising:
methotrexate, a density enhancing agent, and a phosphate buffer, wherein the composition has a transit rate of less than 10 min in 1 mL of silicone oil (SiO) having a viscosity of at least 1000 centistoke and depth of 1 cm; the methotrexate is at a concentration of about 7 mg/mL to about 9 mg/mL, the density enhancing agent comprises sucrose at a concentration of about 7.0% w/v to about 8.0% w/v; the phosphate buffer is sodium phosphate dibasic dihydrate at a concentration of about 0.113 mg/mL to 0.142 mg/mL, and the composition is in a pre-filled syringe and has an administration volume of about 40 μL, about 45 μL, about 50 μL, or about 60 μL.
2. The composition of claim 1 , wherein the transit rate is less than 8 min.
3. The composition of claim 1 , wherein the SiO is polydimethyl siloxane 5000 centistoke oil or polydimethyl siloxane 1000 centistoke oil.
4. The composition of claim 1 , wherein the composition has a density of about 1.0 to about 1.20 g/cm 3 at 20° C.
5. The composition of claim 1 , wherein the composition has a pH of about 5.5 to about 8.5.
6. The composition of claim 1 , wherein the composition has an osmolarity of 250 mOsm/L to 350 mOsm/L.
7. The composition of claim 1 , wherein the composition is in a pre-filled syringe and has an administration volume of about 50 μL.
8. A method of treating proliferative vitreoretinopathy (PVR), comprising administering to a subject in need thereof the composition of claim 1 ; wherein a volume of the composition of about 40 μL, about 45 μL, about 50 μL, or about 60 μL is administered to the subject.
9. The method of claim 8 , wherein the methotrexate is at a concentration of about 8 mg/mL; the sucrose is at a concentration of about 7.5% w/v; and the volume of composition administered is about 50 μL.
10. The method of claim 9 , wherein the composition has a pH of 7.4±0.2.
11. The method of claim 8 , wherein the composition is administered intravitreally once every 4 weeks, once every two weeks, once a week, two times a week, three times a week, or four times a week.
12. The method of claim 8 , wherein the treatment includes an induction phase, and optionally a consolidation phase, and/or optionally a maintenance phase.
13. The method of claim 12 , wherein the induction phase comprises administration of the composition two times a week, or up to four times a week.
14. The method of claim 12 , wherein the consolidation phase, when present, comprises administration once a week or once every two weeks.
15. The method of claim 12 , wherein the maintenance phase, when present, comprises administration once every two weeks or once every month.
16. The method of claim 8 , wherein the subject has a prior history of one or more of: chronic ocular inflammation, infectious retinitis, multiple retinal detachments, large retinal breaks or giant retinal tears, multiple retinal breaks, ocular trauma, retinal detachment associated with vitreous hemorrhage, and choroidal detachment; and combinations thereof.