bendamustine medicament composition and application thereof
Technical Field
The present invention relates to the field of pharmaceutical compositions for neoplastic and autoimmune diseases, in particular to novel pharmaceutical compositions of the nitrogen mustard bendamustine, such as bendamustine hydrochloride or pharmaceutically acceptable esters, salts or solvates thereof.
Background
bendamustine (Bendamustine), chemical name: 4- {5- [ bis (2-chloroethyl) amino ] -1-methyl-2-benzimidazolyl } butanoic acid, of the formula:
Bendamustine was first synthesized in the Deutsche-Democratic republic (GDR) in 1963, and from 1971 to 1992is manufactured by Jena pharmaceuticals, and since 1993, by ribosepharm GmbHis commercially available under the trade name of (1). 2008, USABendamustine Hydrochloride (Bendamustine Hydrochloride) for injection manufactured by Cephalon company is marketed in the United states under the trade name of Bendamustine Hydrochloridefor the treatment of relapsed refractory B-cell non-hodgkin's lymphoma that is ineffective with rituximab. In the same year, 3 months, the FDA in the united states first approved bendamustine hydrochloride for the treatment of Chronic Lymphocytic Leukemia (CLL). In the same year at 10 months, the FDA has approved the 2 nd indication of this drug, namely rituximab: (B)Rituximab) or indolent B cell non-hodgkin lymphoma (NHL) patients whose disease is still progressing during treatment with the rituximab-containing regimen, or within 6 months of treatment. The bendamustine freeze-dried powder injection is white to off-white, has the specification of 100 mg/branch and 20 mg/branch, contains bendamustine hydrochloride and mannitol, has the storage temperature of not more than 30 ℃, is stored in a dark place, and is prepared temporarily before use.
Because bendamustine degrades in aqueous solutions (nitrogen mustards, like other nitrogen mustards, are difficult to formulate into pharmaceutical products due to their high reactivity in aqueous solutions, and are supplied for administration in lyophilized form), the lyophilized products need to be reconstituted by skilled hospital personnel prior to administration. The product is re-dissolved by 20mL of sterile water for injection, the dissolving time is generally not more than 5 minutes, a proper amount of bendamustine aqueous solution is extracted as required within 30 minutes after the dissolution, the bendamustine aqueous solution is transferred to 500mL of sodium chloride injection (0.9%) or glucose sodium chloride injection (2.5%/0.45%), the final concentration of the bendamustine in the injection is ensured to be between 0.2 and 0.6mg/mL, and the bendamustine aqueous solution is used up within 30 to 60 minutes after intravenous infusion. The problems in clinical use are: the reconstitution of the existing bendamustine lyophilized powder is difficult, and clinical reports show that the reconstitution requires at least 15 minutes, and may require as long as 30 minutes. In addition to being cumbersome and time consuming for the health care professional reconstituting the product, prolonged exposure of bendamustine to water during reconstitution increases the likelihood of failure and impurity formation due to hydrolysis of the product by water. Secondly, to avoid hydrolysis, once the product is prepared, intravenous injection is needed within 30-60 minutes, resulting in poor patient adaptability. Furthermore, high infusion volumes and longer infusion times are associated with many side effects, such as: currently with bendamustine treatment, the need to administer large doses of sodium-containing injection is contraindicated for patients with heart disease (congestive heart failure and/or renal failure), patients who would otherwise benefit from bendamustine treatment are unable to take this medication, or in the absence of alternative therapy, patients are forced to receive significant physical harm resulting from the injection of large amounts of sodium-containing injection. Also, high infusion volumes cause unhealthy stress on the affected organs of the patient, including the heart and kidneys.
Therefore, there is a clinical need for new formulations of bendamustine that are easy to formulate and can be administered to patients via smaller infusion volumes in a shorter time, and that are also most beneficial for patients with infusion volume and sodium intake limitations.
Disclosure of Invention
The invention aims to solve the problem of clinical treatment of bendamustine, in particular to a patient with limited infusion amount and sodium intake, and provides a novel pharmaceutical preparation composition of bendamustine, which meets the treatment requirement by improving the product stability and the patient compliance.
The bendamustine pharmaceutical compositions provided by the present invention comprise: 1.5 to 5 percent of bendamustine or pharmaceutically acceptable salt or ester or solvate thereof, 0 to 20 percent of stabilizer, 0.05 to 2 percent of antioxidant, 0 to 0.008 percent of pH regulator and the balance of exclusive solvent. In clinical use, the bendamustine hydrochloride can be diluted into a final concentration of 0.1mg/mL-10mg/mL by adopting 10-100mL injection according to the administration dosage of a patient.
the invention is realized by the following technical scheme:
Adding stabilizer and antioxidant into bendamustine hydrochloride as main active substance, mixing, dissolving in special solvent, adjusting pH to required range, adding active carbon, stirring, filtering with 0.45 μm filter membrane to remove carbon, filtering with 0.22 μm filter membrane to remove bacteria, and packaging into ampoule bottles with concentration of 1-50mg/mL according to 1-5mL per bottle. The bendamustine hydrochloride is diluted to a final concentration of 0.1mg/mL to 10mg/mL by using 10mL to 100mL of injection before use.
The method comprises the following specific steps:
Step A: taking 1.5% -5% of bendamustine hydrochloride, adding 0% -20% of stabilizing agent, uniformly mixing or dissolving, then adding 0.05% -2% of antioxidant, stirring and dissolving;
and B: taking a special solvent, fixing the volume of the solution prepared in the step 1 to a required volume, uniformly stirring, and adjusting the pH value to a required range;
and C: adding medicinal activated carbon with the required volume of 0.05-1%, stirring for 30-60min, filtering with 0.45 μm filter membrane to remove carbon, filtering the filtrate with 0.22 μm filter membrane to remove bacteria to obtain bendamustine hydrochloride with concentration of 1-50mg/mL, and packaging into ampoule bottles with volume of 1-10 mL.
In step A, the stabilizer comprises: lecithin, cholesterol, propylene glycol, glycerol, PEG3000-5000-PLA2000-5000、PEG3000-5000-PLA2000-5000-PEG3000-5000polyethylene glycol 400, poloxamer 188, PLGA (50: 50);
in the step A, the method for uniformly mixing or dissolving after adding the stabilizer comprises the following steps: directly stirring for dissolving, and dissolving the stabilizer and the medicine by a reverse evaporation method;
in step A, the antioxidant comprises: one or two of sodium pyrosulfite, sodium bisulfite, sodium sulfite, thioglycerol, sodium thiosulfate and lipoic acid;
In step B, the pH value range is as follows: 2-3;
In step B, the exclusive solvent comprises: water for injection, polyethylene glycol 400, propylene glycol, glycerol and dimethylacetamide.
The novel bendamustine preparation can reduce the volume of injection required by clinical compatibility, shorten the infusion time and greatly improve the stability of bendamustine hydrochloride. Moreover, the medicine has better stability in the preparation, transportation and storage processes, and avoids the hidden troubles brought to the medication safety of patients by the reduction of curative effect and the generation of impurities due to the degradation of the medicine.
Detailed Description
the following examples are given to illustrate the practice of the present invention, and the following examples are given on the premise of the present invention, and give detailed embodiments and specific procedures, but the scope of the present invention is not limited to the following examples.
The first embodiment is as follows:
Putting 6-9% of lecithin and 4-6% of cholesterol into a round bottom flask, reversely evaporating, adding 2-3% of bendamustine hydrochloride 10-20% of propylene glycol solution, uniformly mixing, adding 0.5% of sodium metabisulfite, supplementing sufficient water for injection, adjusting the pH to 2-3, adjusting the concentration of bendamustine hydrochloride to 25mg/mL, adding activated carbon, stirring, filtering with a 0.45-micrometer filter membrane to remove carbon, filtering with a 0.22-micrometer filter membrane to remove bacteria, and subpackaging to obtain the finished product.
Example two:
putting 6-9% of lecithin and 4-6% of cholesterol into a round bottom flask, reversely evaporating, adding 2-3% of 5-10% of glycerol solution of bendamustine hydrochloride, uniformly mixing, adding 0.5% of sodium metabisulfite, supplementing water for injection to a sufficient amount, adjusting the pH to 2-3, adjusting the concentration of the bendamustine hydrochloride to 25mg/mL, adding activated carbon, stirring, filtering with a 0.45 mu m filter membrane to remove carbon, filtering with a 0.22 mu m filter membrane to remove bacteria, and subpackaging to obtain the finished product.
Example three:
Putting 6-9% of lecithin and 4-6% of cholesterol into a round bottom flask, reversely evaporating, adding 2-3% of 10-20% of propylene glycol solution of bendamustine hydrochloride and 0.1-0.5% of thioglycerol, uniformly mixing, adding different antioxidants in the table, adding sufficient water for injection, adjusting the pH to 2-3, adding activated carbon, stirring, filtering with a 0.45-micrometer filter membrane to remove carbon, filtering with a 0.22-micrometer filter membrane to remove bacteria, and subpackaging to obtain the finished product, wherein the concentration of bendamustine hydrochloride is 25 mg/mL.
Example four:
taking 2% -5% of bendamustine hydrochloride and 1% -10% of different stabilizers in the table, adding 5% -15% of propylene glycol, directly stirring and uniformly mixing, adding 0.5% of thioglycerol, supplementing PEG400 to a sufficient amount, adjusting the pH to 2-3, adjusting the concentration of the bendamustine hydrochloride to 25mg/mL, adding activated carbon, stirring, filtering through a 0.45-micrometer filter membrane to remove carbon, filtering through a 0.22-micrometer filter membrane to remove bacteria, and subpackaging to obtain the bendamustine hydrochloride.
example five:
Taking 2% -5% bendamustine hydrochloride and different stabilizers in the table, directly stirring and uniformly mixing, adding 0.5% thioglycerol, supplementing PEG400 or dimethylacetamide to a sufficient amount to enable the concentration of the bendamustine hydrochloride to be 25mg/mL, adding activated carbon, stirring, filtering through a 0.45-micrometer filter membrane to remove carbon, filtering through a 0.22-micrometer filter membrane to remove bacteria, and subpackaging to obtain the bendamustine hydrochloride.
Example six:
Taking 2% -5% bendamustine hydrochloride and different stabilizers in the table, directly stirring and uniformly mixing, adding 0.5% thioglycerol, supplementing PEG400 or dimethylacetamide or propylene glycol to a sufficient amount to enable the concentration of the bendamustine hydrochloride to be 25mg/mL, adding activated carbon, stirring, filtering through a 0.45-micrometer filter membrane to remove carbon, filtering through a 0.22-micrometer filter membrane to remove bacteria, and subpackaging to obtain the bendamustine hydrochloride injection.
Example seven:
Taking the above formula, the accelerated stability was examined at 25 ℃ and 40 ℃ for 10 days, respectively, and the results are shown in the following table:
The results show that the bendamustine medicament composition disclosed by the invention is better in stability when being placed at 25 ℃ and 40 ℃ for 10 days, the total impurities do not exceed the limit requirement, and accelerated stability tests show that the novel dosage form can be placed at 25 ℃ and 5 ℃ for at least 15 months.
Example eight:
The above formulation was diluted with 50mL of 100mL of 0.9% sodium chloride injection and the stability was examined at 25 ℃ and 40 ℃ for 12h and 48h, respectively, and the results are shown in the following table:
50ml 0.9% sodium chloride injection dilution
100ml 0.9% sodium chloride injection dilution
The results show that the bendamustine medicament composition disclosed by the invention is stable after being diluted by 10-100mL of injection before use and placed for 48 hours at 25 ℃ or 5 ℃, and meets the clinical treatment requirements. Compared with the existing preparation, the volume of the used diluted liquid is reduced (the existing freeze-dried preparation needs 500mL of injection for redissolving), and the stability after dilution is improved, so that the transfusion amount is reduced, the transfusion time is shortened, and the compliance of a patient is improved.