Drug – bio-affecting and body treating compositions – Solid synthetic organic polymer as designated organic active... – Monomer contains oxygen
Reexamination Certificate
2000-09-14
2003-09-23
Page, Thurman K. (Department: 1615)
Drug, bio-affecting and body treating compositions
Solid synthetic organic polymer as designated organic active...
Monomer contains oxygen
C424S464000, C424S449000, C424S422000, C560S185000
Reexamination Certificate
active
06623730
ABSTRACT:
BACKGROUND TO THE INVENTION
The present invention is generally in the field of therapeutic formulations for delivering gamma-hydroxybutyrate.
Gamma-hydroxybutyrate (“GHB”) is a naturally occurring substance that is widely distributed in the mammalian body, being present, for example, in the brain, kidney, heart, liver, lung and muscle (Nelson, et al.,
J. Neurochem
., 37:1345-48 (1981)). When administered exogenously, GHB readily crosses the blood-brain barrier and penetrates the brain, producing a number of neuropharmacological effects. For over 35 years, GHB has been used as an intravenous agent for the induction of anesthesia and for long-term sedation, without serious side-effects on circulation or respiration (Entholzner, et al.,
Anesthetist
, 44:345-50 (1995)), and without an accompanying seizure-inducing activity in humans (Tunnicliff,
Clinical Toxicology
, 35:581-90 (1997)). Patients with chronic schizophrenia characterized by autism, inactivity, and apathy; catatonic schizophrenia; chronic schizophrenia with hallucination and delusion; atypical psychoses; and chronic brain syndrome due to trauma, as well as neurotic patients (Tanaka, et al.,
Folia Psychiatrica et Neurologica
, 20:9-17 (1966)), have all been treated using GHB. It also has recently been suggested that GHB may be a suitable agent for total intravenous anesthesia in patients with coronary artery disease (Kleinschmidt, et al.,
Euro. J. Anesthesiology
, 14:590-99 (1997)), as well as for sedation during spinal anesthesia (Kleinschmidt, et al.,
Euro. J. Anaesthesiology
, 16:23-30 (1999)).
In addition to these uses, GHB also is used to treat narcolepsy, a chronic sleep disorder that usually begins in adolescence or early adulthood and lasts hroughout life. Narcolepsy is characterized by sudden sleep attacks lasting usually from a few to thirty minutes, paralysis upon lying down or waking, visual or auditory hallucinations at the onset of sleep, and temporary loss of muscle tone while awake (cataplexy) or asleep. Treatment with GHB substantially reduces these signs and symptoms of narcolepsy in humans (Scharf,
Sleep
, 21:507-14 (1998)).
Other uses of GHB include its application in the pharmacotherapy of alcoholism, where it has been found to reduce alcohol craving and consumption, and to ameliorate symptoms of alcohol withdrawal syndrome in alcoholics (Colombo, et al.,
Physiology & Behavior
, 64:293-302 (1998); Addolorato, et al.,
The Lancet
, 351:38-(1998) and references therein). GHB also reportedly aids patients undergoing withdrawal from opiates (Andriamampandry, et al.,
Biochem. J
. 334:43-50 (1998) and references therein) and relieves anxiety, tremor, and muscle rigidity in patients with Parkinson's disease (Tanaka, et al.,
Folia Psychiatrica et Neurologica
, 20:9-17 (1966)). Administration of GHB also has been reported to protect neurons and intestinal epithelium against cell death resulting from experimental ischemia (Kaufman & Nelson,
Neurochemical Research
, 16:965-74 (1991) and references therein), to drop blood pressure in hypertensive patients (Tanaka, et al.,
Folia Psychiatrica et Neurologica
, 20:9-17 (1966)), to increase plasma levels of growth hormone after injection in healthy subjects (Gerra, et al.,
Int'l Clinical Psychopharmacology
, 9:211-15 (1994)), and to stimulate growth hormone and prolactin production (U.S. Pat. No. 5,840,331 to Van Cauter, et al.). Administration of GHB also is purported to be an effective anorectic, heighten sexual desire, produce pleasurable effects such as euphoria and smooth muscle relaxation, promote muscle mass, and be able to induce rapid eye movement sleep (Ropero-Miller & Goldberger,
Clinics in Laboratory Medicine
, 18:727-46 (1998)). PCT WO 99/09972 and U.S. Pat. No. 5,990,162 to Scharf discloses the use of GHB in treatment of fibromyalgia and chronic fatigue syndrome. Administration of GHB also has been shown to increase gastric emptying (Poggioli, et al.,
Life Sci
. 64:2149-54 (1999)), and could be used as a prokinetic drug for treatment of a number of conditions where improvement in gastrointestinal motility and gastric emptying is desired. Such conditions include treatment of malabsorption disorders, and increased uptake of poorly absorbed drugs. Gamma-butyrolactone which is metabolized to GHB has been shown to potentiate the effect of gamma-aminobutyric acid on gastric secretions (Watanabe, et al.,
Jpn. J. Pharmacol
. 33:1163-69 (1983)). GHB has shown anti-ulcer activity against ulcers induced by indomethacin, restraint stress or pyloric ligation (Yong, et al.,
Chung Kuo Yao Li Hsueh Po
; 10:350-53 (1989)). Other uses of GHB have been described in Tanaka, et al.,
Folia Psychiatrica et Neurologica
, 20:9-17 (1966).
In animals, GHB produces electroencephalographic (EEG) and behavioral changes, resembling generalized absence seizures. The treated animals show arrest of activity which can be aborted by anti-absence drugs. For this reason, GHB has been used to provide a reproducible, consistent, pharmacologically specific model for the study of generalized absence seizures, which is analogous to other models of absence in the rat (Snead,
Neuropharmacology
, 30:161-67 (1991) and references therein). GHB administration also has been used in animals to normalize cardiovascular function of hemorrhage and as an anti-ischemic (Cash,
Neuroscience
&
Behavioral Rev
., 18:291-304, 1994). In mice, GHB was found to exert a radioprotective effect (Cash,
Neuroscience & Behavioral Rev
., 18:291-304 (1994)).
Infusion of GHB also has been found to possess an angiogenesis inhibitory effect, making GHB potentially useful in the treatment of cancer as an anti- angiogenesis agent (Yonekura, et al.,
Clin. Cancer Res
., 5:2185-91 (1999)). GHB also has been used prophylactically in rats as an antihypoxant, antioxidant, or actoprotector, increasing survival rates of rats with myocardial infarction (Dubovaia, et al.,
Eksp. Klin. Farmakol
. 59:51-54 (1996); Tsorin, et al.,
Eksp. lin. Farmakol
. 56:25-27 (1993)). GHB reportedly prevents heart damage after acute blood loss (Meerson, et al., Kardiologiia 22:38-44 (1982)).
GHB may also be administered prophylactically to reduce inflammation or ischemic or reperfusion injury during surgery. Prophylactic administration of GHB prevented liver damage to tetrachloromethane poisoning (
Eksp Kim Farmakol
., 59(4):51-54 (1996)). The lithium salt of GHB depressed carrageenan inflammation in a hamster cheek pouch assay (Aleksandrov & Speranskaia,
Biull. Eskp. Biol. Med
. 106:233-35 (1988)) Prophylactic administration of lithium salt of GHB prevented inflammation in acute paw edema assay (Aleksandrov & Speranskaia,
Biull. Eskp. Biol. Med
. 103:188-90 (1987)). GHB has been shown to improve blood flow to ischemic heart tissue (Matsievskii, et al.,
Biull Eksp Biol. Med
; 106:531-33 (1988)). GHB also has been used to protect frozen liver tissue for transplantation (Sherman, et al.,
Transplantation
57:8-11 (1994)).
Sodium 4-hydroxybutyrate has been shown to affect metabolism (Petrin, et al.,
Vopr. Med Khim
, 39:36-39 (1993)), as its administration reduced nucleotide catabolism, glycolysis, lipolysis, and lipid peroxidation. Sodium hydroxybutyrate also has been shown to stimulate the pentosophosphate cycle and interfere with metabolic acidosis (Lopatin, et al.,
Farmakol. Toksikol
, 47:53-55 (1984). Thus GHB may be used to improve me damaging effects of injury, surgery, ischemia and shock.
GHB has been shown to prevent the proliferation of cancer and functions as an antineoplastic agent (Basaki, et al.,
Gan To Kagaku Ryoho
, 27:93-98 2000)). GHB and gamma-butyrolactone have been shown to reduce angiogenesis induced by certain types of cancer cells (Yonekura, et al., Clinical
Cancer Research
, 5:2185-91 (1999)). GHB also has been shown to be beneficial for the treatment of lung cancer patients during and after surgery (Leonenkov, et al.,
Vopr. Onkol
, 39:75-79 (1993)) and this benefit was attributed to the antihypoxic effects of GHB. Accordingly, GHB can be used to prevent the spread or proliferation of a canc
Martin David P.
Williams Simon F.
Fubara Blessing
Holland & Knight LLP
Page Thurman K.
Tepha, Inc.
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