Rapid action insulin formulations and pharmaceutical delivery systems
The present invention provides rapid-acting insulin and insulin analog formulations. The invention further provides delivery devices, particularly infusion sets, which allow for the rapid absorption of insulin and insulin analogs, as well as other active agents. Methods of using the insulin and insulin analog formulations as well as the insulin delivery devices for treating subjects with diabetes mellitus are also provided.
1. A pharmaceutical composition formulated for subcutaneous or intra-dermal administration comprising an aqueous formulation of:
(i) an insulin analogue that is predominately in monomeric and/or dimeric form at a concentration of at least 100 insulin units per mL (100 IU);
(ii) one or more calcium ion-chelating agents and one or more additional excipients; and
wherein the composition comprises less than 0.05 moles of zinc per mole of insulin analogue.
2. The pharmaceutical composition of claim 1 , wherein the calcium ion-chelating agent comprises one or more amino polycarboxylic acid compounds.
3. The pharmaceutical composition of claim 2 , wherein the calcium ion-chelating agent comprises one or more of ethylenediamine tetraacetic acid (EDTA), ethylene glycol tetraacetic acid (EGTA), and cyclohexane diamino tetraacetic acid (CDTA), and wherein the agent is optionally a sodium or magnesium salt.
4. The pharmaceutical composition of claim 1 , wherein the calcium ion-chelating agent comprises an anionic polysaccharide.
5. The pharmaceutical composition of claim 4 , wherein the calcium ion-chelating agent comprises alginic acid.
6. The pharmaceutical composition of claim 1 , wherein the calcium ion-chelating agent comprises one or more organosulfur compounds.
7. The pharmaceutical composition of claim 6 , wherein the calcium ion-chelating agent comprises alpha lipoic acid.
8. The pharmaceutical composition of claim 1 , wherein the calcium ion-chelating agent comprises one or more di- or tri-carboxylic acids.
9. The pharmaceutical composition of claim 8 , wherein the calcium ion-chelating agent comprises citric acid or oxalic acid.
10. The pharmaceutical composition of claim 1 , wherein the calcium ion-chelating agent(s) comprise one or more of penicillamine, and extract or partial extract of chlorella and/or cilantro.
11. The pharmaceutical composition of claim 1 , wherein the composition provides an onset of insulin activity of less than about 40 minutes after subcutaneous administration.
12. The pharmaceutical composition of claim 11 , wherein the composition provides a duration of insulin activity of from 1 to 2 hours.
13. The pharmaceutical composition of claim 1 , wherein the composition is stable for at least about one month at 25° C.
14. The pharmaceutical composition of claim 13 , wherein the monomeric insulin analogue has one or more mutations that reduce or eliminate fibril formation.
15. The pharmaceutical composition of claim 14 , wherein the monomeric insulin analogue comprises one or more mutations at positions corresponding to the following positions of native human insulin: B2, B3, B4, B10, B13, B17, B28, B29, A8, A10, A12, A13, A14, A17, and A21, and is optionally a single chain insulin.
16. The pharmaceutical composition of claim 15 , wherein the monomeric insulin analogue contains one or more of:
Leu at the position corresponding to A3;
Glu, His, Gln at the position corresponding to A8;
Cys at the position corresponding to A10;
Asp or Thr at the position corresponding to A12;
Trp, Tyr, His, Glu, Ala, or Phe at the position corresponding to A13;
His or Glu at the position corresponding to A14;
Trp, Tyr, Ala, His, Glu, Gln, Phe, or Apn, at the position corresponding to A17
Gly at the position corresponding to A21;
Cys at the position corresponding to B2;
Lys at the position corresponding to B3;
Cys at the position corresponding to B4;
Asp at the position corresponding to B10;
Trp, Tyr, Ala, His, Glu, Phe, Apn, or Gln at the position corresponding to B13;
Trp, Tyr, His, or Gln at the position corresponding to B17;
Trp, Tyr, His, Gln, Asp, Thr, Ala, Phe, or Cha at the position corresponding to B24; and
Glu at the position corresponding to B29.
17. The pharmaceutical composition of claim 13 , wherein the monomeric insulin analogue has a deletion of amino acids B1-B3.
18. The pharmaceutical composition of claim 1 , wherein the monomeric insulin analogue is a single chain insulin having a peptide linker between the A and B chains.
19. The pharmaceutical composition of claim 1 , wherein the composition comprises one or more pharmaceutically acceptable excipients.
20. The pharmaceutical composition of claim 19 , wherein the composition comprises one or more of a pharmaceutically acceptable buffer, stabilizing agent(s), surfactant(s), solubilizing agent, anti-aggregation agent, diffusion-enhancing agent, absorption enhancing agent, and preservative(s).
21. The pharmaceutical composition of claim 1 , wherein the composition is provided within an insulin infusion set.
22. A method for treating a subject with diabetes mellitus, comprising: administering the pharmaceutical composition of claim 1 to said subject.
23. The method of claim 1 , wherein the additional excipient comprises arginine.
24. The pharmaceutical composition of claim 1 , wherein the composition comprises EDTA or EGTA as the calcium ion-chelating agent at from 5 to 25 mM.
25. The pharmaceutical composition of claim 1 , further comprising isosorbide mononitrate.
26. The pharmaceutical composition of claim 1 , further comprising Lidocaine.
27. The pharmaceutical composition of claim 1 , further comprising a surfactant.