Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Ester doai
Reexamination Certificate
1998-12-17
2001-01-16
Chang, Ceila (Department: 1625)
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Ester doai
C514S211070, C514S213010, C514S259500, C514S307000, C514S356000, C514S398000, C514S401000
Reexamination Certificate
active
06174917
ABSTRACT:
TECHNICAL FIELD
The present invention relates to a method for the treatment of liver disease. The invention also relates to compositions suitable for the use in the treatment of liver disease.
Diltiazem is the generic name given to the active component of a composition that is primarily used for the treatment of heart disease. Specifically it is known as 3-acetoxy-5-(2-(dimethylaminoethyl)-2,3-dihydro-2-(4-methoxy phenyl)-1,5-benzothiazepine4)5H-one. This compound is the active ingredient in the heart treatment drug Cardizem. Cardizem has particular efficacy in the treatment of ischaemic heart disease including angina pectoris and hypertension.
Diltiazem is a member of a broad class of benzothiazepine derivatives that are the subject of Australian Patent 426146. The class of compounds are referred to in that specification as having particular utility as anti-depressants, tranquilizers and coronary vasodilators.
Diltiazem primarily acts as a calcium channel antagonist (a calcium blocker), calcium being involved in several biological processes in the human body including vasoconstriction and vasodilation. Calcium blockers interfere with the transport of calcium through the cell membrane, thus reducing the contraction of vascular smooth muscle and causing the arteries to dilate. The discovery of calcium blockers constituted a major advance in cardiovascular treatment
Diltiazem contributed significantly to this advance. Generally, during cardiovascular treatment using Diltiazem, a patient in need thereof is administered the drug in doses of from 180 mg to 360 mg per day.
The liver is a large gland situated in the upper part of the abdomen on the right side. Its domed upper surface fits closely against the inferior surface of the right diaphragm. It has a double blood supply from the hepatic artery (oxygenated arterial blood) and the portal vein (deoxygenated venous blood carrying substances absorbed from the stomach, small intestine and large intestine). It comprises thousands of minute lobules (lobuli hepatis), the functional units of the liver. Its manifold functions include the storage and filtration of blood, the secretion of bile, the excretion of bilirubin and other substances formed elsewhere in the body, and numerous metabolic functions, including the conversion of sugars into glycogen, which it stores. It is essential to life and accordingly liver disfunction is debilitating and life threatening.
Prior art treatments of liver disease have included use of a number of drugs. For example, choline has been administered as an adjunct to the dietary treatment of fatty acid infiltration and early cirrhosis of the liver. Methionine has a lipotropic action similar to choline. It has also been used as an adjunct in the treatment of liver diseases in patients unable to take an adequate diet, though there is evidence that in cases of severe liver damage large doses of methionine may aggravate the toxaemia. Litrison is a composition of methionine, choline, vitamins of the B complex and Vitamin E. It has been used for the treatment of hepatic parenchymal degenerative changes and to maintain the function of the liver. Neurogem is a composition of high potency essential Vitamin B-complex and Vitamin C which has been used for supplementary or maintenance therapy. Finally, Ripason is a protein-free total extract from livers of healthy animals. It has been used to treat chronic hepatitis, cirrhosis, medicamentous liver damage and liver parenchyma disorders.
The treatment of liver disease, however, has been an ongoing difficulty in the prior art and none of the drugs used have proved to be particularly effective. In particular, none of these agents reverses the relative hypoxia, or oxygen lack, which appears to contribute to the pathology and progression of chronic liver disease. Accordingly, liver disease continues to be a life-threatening disease and ultimately may require surgery or even transplants in some cases.
Accordingly, it is an object of the present invention to overcome, or at least alleviate, one of more of the difficulties or deficiencies related to the prior art.
Accordingly, in a first aspect of the present invention, there is provided a method for the treatment of liver disease selected from the group consisting of cirrhosis of the liver, toxic and medicamentary liver damage, a liver-parenchymic disorder or hepatitis, which method includes administering orally to a human or animal subject in need thereof a vasodilating agent at a dose less than the oral dose required to produce a significant effect on the heart or peripheral circulation whereby said vasodilating agent selectively increases the supply of oxygenated blood to the liver by increasing hepatic arterial inflow.
The vasodilating agent may include a calcium blocker, e.g. a thiazepine derivative, preferably a benzothiazepine derivative, nifedipine, felodipine, verapamil or other vasodilator. Other vasodilators may be used indirectly.
The method of treatment may be utilised in the treatment of various diseases of the liver such as cirrhosis of a liver, toxic and medicamentary liver damage or liver parenchymic disorders and related diseases such as hepatitis including chronic active hepatitis.
The method of treatment may be directional in that significantly lower doses may be used then are normally administered in the treatment of heart disease or like indications.
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Chang Ceila
McDermott & Will & Emery
Pharmacy and Therapeutic Advisory Consultancy Ltd.
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