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Numéro de document de brevet: 2512475
(54) Titre anglais: COMPOSITIONS AND METHODS FOR COMBINATION ANTIVIRAL THERAPY
(54) Titre français: COMPOSITIONS ET METHODES DESTINEES A UNE THERAPIE DE COMBINAISON ANTIVIRALE
Revendications:
Nota : Les revendications sont présentées dans la langue officielle dans laquelle elles ont été soumises.
WHAT IS CLAIMED IS:
1. Use of a therapeutically effective amount of a composition
comprising [2-(6-amino-purin9-yl)-1methyl-ethoxymethyl]-phosphonic acid
diisopropoxycarbonyloxymethyl ester fumarate, hereinafter called tenofovir
disoproxil fumarate, and (2R, 5S, cis)-4-amino-5-fluoro-1-(2-hydroxymethyl-1,3-
oxathiolan-5-yl)-(1H)pyrimidin-2-one, hereinafter called emtricitabine, in the
manufacture of a medicament for the treatment of a patient in need of
antiviral
therapy consisting of anti-HIV therapy.
2. The use according to claim 1, wherein the anti-HIV active
ingredients in the composition consists of tenofovir disoproxil fumarate and
emtricitabine.
3. The use according to claim 2, wherein the composition comprises
about 300 mg of tenofovir disoproxil fumarate and about 200 mg of
emtricitabine.
4. The use according to claim 1, wherein the amount of the total
tenofovir disoproxil fumarate and emtricitabine in the composition in relation
to
carrier material is about 5% to about 95% of the total composition, the
percentage being expressed weight by weight, exclusive of coating.
5. The use according to claim 1, wherein tenofovir disoproxil fumarate
and emtricitabine are both present in a same tablet.
6. The use according to claim 5, wherein tenofovir disoproxil fumarate
and emtricitabine are present in an amount of 300 mg and 200 mg, respectively.
50
7. The use according to claim 1,wherein the manufacture is by wet
granulation.
8. The use according to claim 4,wherein the weight ratio of the total of
tenofovir disoproxil fumarate and emtricitabine in the composition in relation
to
ingredients other than tenofovir disoproxil fumarate and emtricitabline is
50:50,
excluding coating.
9. The use according to claim 8,wherein the composition comprises in
weight percent, excluding coating tenofovir disoproxil fumarate 30,
emtricitabine 20,
pregelatinized starch 5, croscarmellose, sodium 6, lactose monohydrate 8,
microcrystalline cellulose 30, magnesium stearate 1.
10. The use according to claim 1,wherein the composition further
comprises a third active ingredient selected from an HIV protease inhibitor
(P1), an HIV
nucleoside reverse transcriptase inhibitor (NRTI), an HIV non-nucleoside
reverse
transcriptase inhibitor (NNRTI), and an HIV integrase inhibitor.
11. The use according to claim 10,wherein the third active ingredient is
selected from the Reyataz,* Kaletra,*or Sustiva*anti-HIV agents.
12. The use according to claim 1,wherein the composition further
comprises a pharmaceutically acceptable glidant.
13. The use according to claim 12,wherein the glidant is selected from
silicon dioxide, powdered cellulose, microcrystalline cellulose, metallic
stearates, sodium
aluminosilicate, sodium benzoate, calcium carbonate, calcium silicate, corn
starch,
magnesium carbonate, asbestos free talc, Stearowet C*, starch, starch 1500,
magnesium lauryl sulfate, magnesium oxide, and formulations thereof.
* Trademarks
51
14. The use according to claim 13,wherein the metallic stearates are
selected from calcium stearate, magnesium stearate, zinc stearate, and
formulations
thereof.
15. A pharmaceutical formulation comprising [2-(6-amino-purin-9-yl)-1-
methyl-ethoxymethyl]-phosphonic acid diisopropoxycarbonyloxymethyl ester
fumarate, hereafter called tenofovir disoproxil fumarate, and (2R, 5S, cis)-4-
amino-5-fluoro-1-(2-hydroxymethyl-1,3-oxathiolan-5-yl)-(1H)pyrimidin-2-one,
hereinafter called emtricitabine.
16. The pharmaceutical formulation according to claim 15, further comprising
one or more pharmaceutically acceptable carriers or excipients.
17. The pharmaceutical formulation according to claim 16, wherein the
pharmaceutically acceptable carriers or excipients are selected from
pregelatinized starch,
croscarmellose sodium, povidone, lactose monohydrate, microcrystalline
cellulose, and
magnesium stearate, and formulations thereof.
18. The pharmaceutical formulation according to claim 16, wherein the
amount of the total renofovir disoproxil fumarate and emtricitabine in the
formulation in relation to carrier and excipient material is 5% to 95%
expressed
in weight by weight, excluding coating (weight ratio 0.08).
19. The pharmaceutical formulation according to claim 18,wherein the weight
ratio of tenofovir disoproxil fumarate and entricitabine together: total
carrier and
excipient in the formulation, excluding coating, is 500:1000, 400:900,
325:825, 225:725,
200:700, 500:700, 500:670, 500:763, 500:2840 or 500:2270.
20. The pharmaceutical formulation according to claim 19,wherein the weight
ratio, excluding coating, is 0.50, 0.44, 0.39, 0.31, 0.29, 0.71, 0.75, 0.65,
0.18 or 0.22.
52
21. The pharmaceutical formulation according to claim 18,wherein the weight
ratio, excluding coating, is from 0.18 to 0.75.
22. The pharmaceutical formulation according to claim 15,in pharmaceutical
dosage form.
23. The pharmaceutical formulation according to claim 22,wherein the
pharmaceutical dosage form is a tablet.
24. The pharmaceutical formulation according to claim 15,wherein tenofovir
disoproxil fumarate and emtricitabine are present in a ratio of about 300:200
by weight.
25. The pharmaceutical formulation according to claim 24,comprising about
300 mg of tenofovir disoproxil fumarate and about 200 mg of emtricitabine.
26. The pharmaceutical formulation according to claim 15,suitable for oral
administration.
27. The pharmaceutical formulation according to claim 26,wherein the
pharmaceutical dosage form is a capsule.
28. The pharmaceutical formulation according to claim 15,suitable for
administration once per day to an infected human.
29. A patient pack comprising (a) at least one coformulated
pharmaceutical formulation comprising [2-(6-amino-purin-9-yl)-1methyl-
ethoxymethyl]-phosphoric acid diisopropoxycarbonyloxymethyl ester fumarate
hereinafter called tenofovir disoproxil fumarate, and (2R, 5S, cis)-4-amino-5-
53
fluoro-1-(2-hydroxymethyl-1,3-oxathiolan-5-yl)-(1H)pyrimidin-2-one hereinafter
called emtricitabine, and (b) an information insert containing directions for
the
use of tenofovir disoproxil fumarate and emtricitabine in formulation for the
treatment of a patient in need of antiviral treatment consisting of anti-HIV
therapy.
30. The patient pack according to claim 29,wherein the pharmaceutical
dosage form is a tablet, caplet, or capsule comprising 300 mg of tenofovir
disoproxil
fumarate and 200 mg of emtricitabine.
31. The pharmaceutical formulation of any one of claims 15 or 29,
which further comprises a third antiviral agent.
32. The formulation of claim 31,wherein the third agent is selected from an
HIV protease inhibitor (PI), an HIV nucleoside reverse transcriptase inhibitor
(NRTI), an
HIV non- nucleoside reverse transcriptase inhibitor (NNRTI), and an HIV
integrase
inhibitor.
33. The formulation of claim 32,wherein the third antiviral agent is a PI.
34. The formulation of claim 32,wherein the third antiviral agent is an
NNRTI.
35. The formulation of claim 33 wherein the third antiviral agent is selected
from the Reyataz,*Kaletra*, or Sustiva*anti-HIV agents.
36. An oral pharmaceutical dosage form comprising tenofovir disoproxtil
fumarate, emtricitabine and Reyataz*
* Trademarks
54
37. An oral pharmaceutical dosage form comprising tenofovir disoproxil
fumarate, emtricitabine and Kaletra.*
38. An oral pharmaceutical dosage form comprising tenofovir disoproxil
fumarate, emtricitabine and Sustiva.*
39. The pharmaceutical formulation of claim 15,comprising in weight percent
excluding coating tenofovir disoproxil fumarate 30, emtricitabine 20,
pregelatinized
starch 5, croscarmellose sodium 6, lactose monohydrate 8, microcrystalline
cellulose 30,
and magnesium stearate 1.
40. A tablet comprising 300 mg of tenofovir disoproxil fumarate,
200 mg of emtricitabine and carriers, excipients mixtures of carriers and
excipients sufficient to produce less than 5% acid degradation of tenofovir
disoproxil fumarate or emtricitabine after six months storage with desiccant
at
40 C/25% relative humidity.
41. An oral dosage form comprising Sustiva*, 300 mg tenofovir
disoproxil fumarate, 200 mg of emtriva and pharmaceutically acceptable
carriers
or excipients.
42. A chemically stable combination of tenofovir disoproxil fumarate
and emtricitabine.
43. The chemically stable combination of claim 42 wherein the
combination is a pharmaceutical dosage form.
44. The chemically stable combination of claim 43 wherein the dosage
form is oral.
*Trademarks
45. The chemically stable combination of any one of claims 42 to 44
which further comprises a third antiviral agent.
46. The chemically stable combination of claim 45 wherein the third
antiviral agent is an NNRTI or PI.
47. The chemically stable combination of claim 46 wherein the third
antiviral agent is a PI.
48. The chemically stable combination of clam 46 wherein the third
antiviral agent is an NNRTI.
49. The chemically stable combination of Claim 48 wherein the third
antiviral agent is selected from Reyataz*, Kaletra* or Sustiva*.
50. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate and emtricitabine.
51. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Reyataz*.
52. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Kaletra*.
53. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Sustiva*.
*Trademarks
56
WHAT IS CLAIMED IS:
1. Use of a therapeutically effective amount of a composition
comprising [2-(6-amino-purin9-yl)-1methyl-ethoxymethyl]-phosphonic acid
diisopropoxycarbonyloxymethyl ester fumarate, hereinafter called tenofovir
disoproxil fumarate, and (2R, 5S, cis)-4-amino-5-fluoro-1-(2-hydroxymethyl-1,3-
oxathiolan-5-yl)-(1H)pyrimidin-2-one, hereinafter called emtricitabine, in the
manufacture of a medicament for the treatment of a patient in need of
antiviral
therapy consisting of anti-HIV therapy.
2. The use according to claim 1, wherein the anti-HIV active
ingredients in the composition consists of tenofovir disoproxil fumarate and
emtricitabine.
3. The use according to claim 2, wherein the composition comprises
about 300 mg of tenofovir disoproxil fumarate and about 200 mg of
emtricitabine.
4. The use according to claim 1, wherein the amount of the total
tenofovir disoproxil fumarate and emtricitabine in the composition in relation
to
carrier material is about 5% to about 95% of the total composition, the
percentage being expressed weight by weight, exclusive of coating.
5. The use according to claim 1, wherein tenofovir disoproxil fumarate
and emtricitabine are both present in a same tablet.
6. The use according to claim 5, wherein tenofovir disoproxil fumarate
and emtricitabine are present in an amount of 300 mg and 200 mg, respectively.
50
7. The use according to claim 1,wherein the manufacture is by wet
granulation.
8. The use according to claim 4,wherein the weight ratio of the total of
tenofovir disoproxil fumarate and emtricitabine in the composition in relation
to
ingredients other than tenofovir disoproxil fumarate and emtricitabline is
50:50,
excluding coating.
9. The use according to claim 8,wherein the composition comprises in
weight percent, excluding coating tenofovir disoproxil fumarate 30,
emtricitabine 20,
pregelatinized starch 5, croscarmellose, sodium 6, lactose monohydrate 8,
microcrystalline cellulose 30, magnesium stearate 1.
10. The use according to claim 1,wherein the composition further
comprises a third active ingredient selected from an HIV protease inhibitor
(P1), an HIV
nucleoside reverse transcriptase inhibitor (NRTI), an HIV non-nucleoside
reverse
transcriptase inhibitor (NNRTI), and an HIV integrase inhibitor.
11. The use according to claim 10,wherein the third active ingredient is
selected from the Reyataz,* Kaletra,*or Sustiva*anti-HIV agents.
12. The use according to claim 1,wherein the composition further
comprises a pharmaceutically acceptable glidant.
13. The use according to claim 12,wherein the glidant is selected from
silicon dioxide, powdered cellulose, microcrystalline cellulose, metallic
stearates, sodium
aluminosilicate, sodium benzoate, calcium carbonate, calcium silicate, corn
starch,
magnesium carbonate, asbestos free talc, Stearowet C*, starch, starch 1500,
magnesium lauryl sulfate, magnesium oxide, and formulations thereof.
* Trademarks
51
14. The use according to claim 13,wherein the metallic stearates are
selected from calcium stearate, magnesium stearate, zinc stearate, and
formulations
thereof.
15. A pharmaceutical formulation comprising [2-(6-amino-purin-9-yl)-1-
methyl-ethoxymethyl]-phosphonic acid diisopropoxycarbonyloxymethyl ester
fumarate, hereafter called tenofovir disoproxil fumarate, and (2R, 5S, cis)-4-
amino-5-fluoro-1-(2-hydroxymethyl-1,3-oxathiolan-5-yl)-(1H)pyrimidin-2-one,
hereinafter called emtricitabine.
16. The pharmaceutical formulation according to claim 15, further comprising
one or more pharmaceutically acceptable carriers or excipients.
17. The pharmaceutical formulation according to claim 16, wherein the
pharmaceutically acceptable carriers or excipients are selected from
pregelatinized starch,
croscarmellose sodium, povidone, lactose monohydrate, microcrystalline
cellulose, and
magnesium stearate, and formulations thereof.
18. The pharmaceutical formulation according to claim 16, wherein the
amount of the total renofovir disoproxil fumarate and emtricitabine in the
formulation in relation to carrier and excipient material is 5% to 95%
expressed
in weight by weight, excluding coating (weight ratio 0.08).
19. The pharmaceutical formulation according to claim 18,wherein the weight
ratio of tenofovir disoproxil fumarate and entricitabine together: total
carrier and
excipient in the formulation, excluding coating, is 500:1000, 400:900,
325:825, 225:725,
200:700, 500:700, 500:670, 500:763, 500:2840 or 500:2270.
20. The pharmaceutical formulation according to claim 19,wherein the weight
ratio, excluding coating, is 0.50, 0.44, 0.39, 0.31, 0.29, 0.71, 0.75, 0.65,
0.18 or 0.22.
52
21. The pharmaceutical formulation according to claim 18,wherein the weight
ratio, excluding coating, is from 0.18 to 0.75.
22. The pharmaceutical formulation according to claim 15,in pharmaceutical
dosage form.
23. The pharmaceutical formulation according to claim 22,wherein the
pharmaceutical dosage form is a tablet.
24. The pharmaceutical formulation according to claim 15,wherein tenofovir
disoproxil fumarate and emtricitabine are present in a ratio of about 300:200
by weight.
25. The pharmaceutical formulation according to claim 24,comprising about
300 mg of tenofovir disoproxil fumarate and about 200 mg of emtricitabine.
26. The pharmaceutical formulation according to claim 15,suitable for oral
administration.
27. The pharmaceutical formulation according to claim 26,wherein the
pharmaceutical dosage form is a capsule.
28. The pharmaceutical formulation according to claim 15,suitable for
administration once per day to an infected human.
29. A patient pack comprising (a) at least one coformulated
pharmaceutical formulation comprising [2-(6-amino-purin-9-yl)-1methyl-
ethoxymethyl]-phosphoric acid diisopropoxycarbonyloxymethyl ester fumarate
hereinafter called tenofovir disoproxil fumarate, and (2R, 5S, cis)-4-amino-5-
53
fluoro-1-(2-hydroxymethyl-1,3-oxathiolan-5-yl)-(1H)pyrimidin-2-one hereinafter
called emtricitabine, and (b) an information insert containing directions for
the
use of tenofovir disoproxil fumarate and emtricitabine in formulation for the
treatment of a patient in need of antiviral treatment consisting of anti-HIV
therapy.
30. The patient pack according to claim 29,wherein the pharmaceutical
dosage form is a tablet, caplet, or capsule comprising 300 mg of tenofovir
disoproxil
fumarate and 200 mg of emtricitabine.
31. The pharmaceutical formulation of any one of claims 15 or 29,
which further comprises a third antiviral agent.
32. The formulation of claim 31,wherein the third agent is selected from an
HIV protease inhibitor (PI), an HIV nucleoside reverse transcriptase inhibitor
(NRTI), an
HIV non- nucleoside reverse transcriptase inhibitor (NNRTI), and an HIV
integrase
inhibitor.
33. The formulation of claim 32,wherein the third antiviral agent is a PI.
34. The formulation of claim 32,wherein the third antiviral agent is an
NNRTI.
35. The formulation of claim 33 wherein the third antiviral agent is selected
from the Reyataz,*Kaletra*, or Sustiva*anti-HIV agents.
36. An oral pharmaceutical dosage form comprising tenofovir disoproxtil
fumarate, emtricitabine and Reyataz*
* Trademarks
54
37. An oral pharmaceutical dosage form comprising tenofovir disoproxil
fumarate, emtricitabine and Kaletra.*
38. An oral pharmaceutical dosage form comprising tenofovir disoproxil
fumarate, emtricitabine and Sustiva.*
39. The pharmaceutical formulation of claim 15,comprising in weight percent
excluding coating tenofovir disoproxil fumarate 30, emtricitabine 20,
pregelatinized
starch 5, croscarmellose sodium 6, lactose monohydrate 8, microcrystalline
cellulose 30,
and magnesium stearate 1.
40. A tablet comprising 300 mg of tenofovir disoproxil fumarate,
200 mg of emtricitabine and carriers, excipients mixtures of carriers and
excipients sufficient to produce less than 5% acid degradation of tenofovir
disoproxil fumarate or emtricitabine after six months storage with desiccant
at
40 C/25% relative humidity.
41. An oral dosage form comprising Sustiva*, 300 mg tenofovir
disoproxil fumarate, 200 mg of emtriva and pharmaceutically acceptable
carriers
or excipients.
42. A chemically stable combination of tenofovir disoproxil fumarate
and emtricitabine.
43. The chemically stable combination of claim 42 wherein the
combination is a pharmaceutical dosage form.
44. The chemically stable combination of claim 43 wherein the dosage
form is oral.
*Trademarks
45. The chemically stable combination of any one of claims 42 to 44
which further comprises a third antiviral agent.
46. The chemically stable combination of claim 45 wherein the third
antiviral agent is an NNRTI or PI.
47. The chemically stable combination of claim 46 wherein the third
antiviral agent is a PI.
48. The chemically stable combination of clam 46 wherein the third
antiviral agent is an NNRTI.
49. The chemically stable combination of Claim 48 wherein the third
antiviral agent is selected from Reyataz*, Kaletra* or Sustiva*.
50. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate and emtricitabine.
51. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Reyataz*.
52. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Kaletra*.
53. A chemically stable oral pharmaceutical dosage form comprising
tenofovir disoproxil fumarate, emtricitabine and Sustiva*.
*Trademarks
56
