Therapeutically effective topical application of ST1435

Drug – bio-affecting and body treating compositions – Preparations characterized by special physical form – Cosmetic – antiperspirant – dentifrice

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424443, 424448, 424449, 514841, 514843, 514944, 514946, 514947, 514953, A61K 906

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active

056519737

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BRIEF SUMMARY
BACKGROUND OF THE INVENTION

This invention relates to a method of contraception. It has now been found that the transdermal application of the progestin analog ST1435 to the skin (hereinafter "topical application") is effective in attaining therapeutically effective serum levels of ST1435.
The most common form of hormonal contraception is oral contraceptives, which are widely popular as one of the most effective means of contraception available. Oral contraceptives usually contain a combination of the hormones estrogen and progestin. Unfortunately, natural hormones and many synthetic hormones are unsuited to oral administration. Most hormones suffer some degradation in the digestive tract and many are rapidly degraded by the liver in the so-called hepatic first-pass metabolism. Since even synthetic hormones may be metabolized to some extent during absorption, a large excess of hormone is frequently administered. Decreasing the dosage of hormones would have the effect of decreasing the risk of side effects but would decrease the efficacy of the hormones. A synthetic estrogen such as ethinylestradiol is ordinarily used as the estrogen component in oral contraceptives since less than ten percent of the natural estrogen, 17-.beta.-estradiol, survives hepatic first-pass metabolism. In contrast, approximately 40% of ethinylestradiol survives hepatic first pass metabolism. Likewise, natural progesterone is ineffective when given orally except in micronized form and in large doses. Additionally, many synthetic hormones are unsuited to oral administration; for instance, the synthetic progestin ST1435 (16-methylene-17-.alpha.-acetoxy-19-nor-4-pregnene-3,20-dione) is ineffective when given orally due to rapid first-pass metabolism.
In order to circumvent hepatic metabolism, methods of hormone administration involving implants and topical applications have been developed. A typical implantable device is described in U.S. Pat. No. 3,854,480 issued Dec. 17, 1974 to Zaffaroni. Such a device consists of an inner core within which solid particles of drug are dispersed and an outer membrane that surrounds the inner core. The inner core is relatively permeable to the hormone and the outer membrane is relatively impermeable. The outer membrane thus regulates the rate of hormone delivery from the implant. Such implants are normally placed under the skin and have the advantage of prolonged drug release at a controlled rate.
The feasibility of a topical delivery system for contraception was realized when it was shown that testosterone, testosterone conjugates and estradiol could be absorbed through the skin. Topical delivery of contraceptive steroids has potential advantages over some of the present contraceptive dosage forms that are available to the public. Such advantages include: convenience of application and removal by the user; avoidance of hepatic first-pass metabolism and gastrointestinal incompatibility; controlled sustained release of the contraceptive drugs; maintenance of a steady-state plasma level of the drug(s), resulting in enhanced efficacy; and reduced frequency of dosing, as compared to daily oral contraception.
The advantages of topical administration of steroids have been widely acknowledged in recent years. Estradiol is used routinely in commercial preparations for the relief of postmenopausal symptoms. Whitehead et al., "Endometrial Responses to Transdermal Estradiol in Postmenopausal Women", Am. J. Obstet. Gynecol., 152:1079-1084 (1985). It has also been shown that transdermally administered testosterone is effective in long-term treatment of male hypogonadism. Ahmed et al., "Transdermal Testosterone Therapy in the Treatment of Male Hypogonadism", J. Clin. Endocrinol. Metab., 66:546-551 (1988).
Known topical applications for hormones are comprised of hormone dissolved or suspended in any of several liquid, semisolid, or solid vehicles. Liquid and semisolid vehicles have heretofore been used for therapeutic but not contraceptive administration of hormones. Such vehicles include but are not limited to gel

REFERENCES:
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Pertti Lahteenmaki, "Contraceptive Action of A Synthetic Progestin," ST-1435, Steroid Research Laboratory, Department of Medical Chemistry, Univ. of Helsinki, pp. 12-44, (1986).
Pertti Lahteenmaki, "Pituitary and Ovarian Function During Contraception With One Subcutaneous Implant Releasing a Progestin, ST-1435", Contraception, vol. 25. No. 3, pp. 299-306, Mar. (1982).
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Lahteenmaki et al., "Pituitary and Ovarian Function During Contraception With One Subcutaneous Implant Releasing a Progestin, ST-1435", Contraception, 25,3:299-306 (1982).
Coutinho et al., "Fertility Control With Sub-Dermal Silastic Capsules Containing a New Progestin (ST-1435)", Int. J. Fertil., 21:103-108 (1976).
Lahteenmaki et al., "Contraception With Subcutaneous Capsules Containing ST-1435. Pituitary and Ovarian Function and Plasma Levels of ST-1435", Contraception, 23,1:63-75 (1981).
Lahteenmaki et al., "Contraceptive Action of a Synthetic Progestin, ST-1435", Thesis, University of Helsinki, Helsinki, Finland, pp. 35-36 (1986).
Lahteenmaki, "Intestinal Absorption of ST-1435 in Rats", Contraception, 30,2:143-151 (1984).
World Health Organization (WHO), "The WHO Programme for the Standardization and Quality Control of Radioimmunoassay of Hormones in Reproductive Physiology", Horm. Res. 9:440-449 (1978).
Laurikka-Routti et al., "Suppression of Ovarian Function with the Transdermally Given Synthetic Progestin ST 1435", Fertility and Sterility, 58,4:680-684 (1992).
Haukkama et al., "Transdermal Absorption of the Progestin ST-1435: Therapeutic Serum Steroid Concentrations and High Excretion of the Steroid in Saliva", Contraception, 44,3:269-276 (1991).
Suhonen et al, "Endometrial Effect of Transdermal Estradiol and Progestin ST-1435 in Postmenopausal Women", Fertility and Sterility, 57,6:1211-1215 (1992).

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