EP1135146A1

EP1135146A1 - Pharmaceutical composition containing fish oil, vitamin e and c and acetylsalicyl acid against arteriosclerosis

Info

Publication number: EP1135146A1
Application number: EP99942931A
Authority: EP
Inventors: Wolfgang Langhoff; Udo Laumann
Original assignee: Individual
Current assignee: Individual
Priority date: 1998-12-02
Filing date: 1999-09-01
Publication date: 2001-09-26
Also published as: DE19855426A1; WO2000032210A1

Abstract

The invention relates to a pharmaceutical composition containing fish oil, vitamin E and/or the physiologically acceptable derivatives thereof, L ascorbic acid (vitamin C) and/or the physiologically acceptable derivatives thereof and acetylsalicyl for the treatment of arteriosclerosis.

Description

PHARMACEUTICAL COMPOSITION CONTAINING FISH OIL, VITAMIN E AND C AND ACETYLSALICYLIC ACID AGAINST ARTERIOSclerosis

The invention relates to a pharmaceutical composition for the therapy and prophylaxis of arteriosclerosis.

Diseases of arteriosclerosis represent a significant part of the cases to be treated in our society. This causes a not insignificant economic damage through sick days and early retirement.

Atherosclerosis is a chronic disease of the arterial wall associated with thickening and hardening. The symptoms associated with arteriosclerosis include poor blood circulation, high blood pressure and general poor performance and concentration. The most common form of atherosclerosis is atherosclerosis, which is the leading cause of death in western industrialized nations. The changes in the wall of the vessels lead to wall instability, narrowing of the vessels and the formation of clots due to lipid storage, increased connective tissue and calcification with irregular distribution. Depending on the preferred location, circulatory disorders in the brain (cerebrovascular insufficiency, stroke), in the heart (coronary heart disease, heart attack) and in the peripheral arteries (arterial occlusive disease) are the result. Theories about the development of arteriosclerosis include chemical, mechanical or immunological disturbance of the integrity of the vascular inner wall, disturbance of the growth control of smooth muscle cells of the vascular wall and impairment of the degradation of aged cell components. Factors that are often correlated with arteriosclerosis, the so-called risk factors, are considered to be the causal conditions for the development of arteriosclerosis. According to this concept, apart from age and genetic factors, hyperlipidemia, hypertension, cigarette smoking, high blood sugar and diabetes mellitus, fat addiction and physical inactivity increase the risk of developing the disease. The goal of medical efforts is therefore prevention by reducing the risk factors and keeping the vessels healthy.

It is known that the daily supply of fish oil (containing eicosapentaenoic and ducosahexaenoic acid in the form of their triglycerides) has a positive effect on this type of vascular disease. One became aware of these fatty acids by the fact that Eskimos, which much Eat fish, hardly prone to heart diseases, although they eat a high-calorie and high-fat diet.

It is known from acetylsalicylic acid that, at a concentration of approx. 75 mg / person and day, supports the formation of the highly efficient, intracellular radical scavenger, ferritin, which is found in the body. Ferritin is known as a cytoprotective antioxidant protein that traps free iron ions in the cell metabolism and thus counteracts the oxygen-dependent radical formation. This leads to the catalyst (iron ions) being removed from the formation of vascular-damaging radicals.

US Pat. No. 5,648,380 describes anti-inflammatory compositions for wound healing which, in addition to an anti-inflammatory compound, also comprise a composition for wound healing. In addition to antioxidants such as vitamin A, carotene, vitamin C, vitamin E and their derivatives, the wound healing composition also comprises a mixture of saturated and unsaturated fatty acids. The unsaturated fatty acids have up to 3 double bonds. In various configurations, the compositions for wound healing can also contain α-ketopropionic acid or its derivatives (pyruvates) or lactic acid or its derivatives (lactates). Non-steroids and steroids as well as salicylic acid derivatives are proposed as anti-inflammatory agents. The compositions described are described in connection with a large number of therapeutic applications, but not for the treatment or prophylaxis of arteriosclerosis.

FR-A-2720647 describes a composition for administration for the prophylaxis of arteriosclerosis comprising fish oil (90 mg / day), oil of the black currant kernel (60 mg / day), aspirin (150 mg / day), selenium (0.050 mg / day), organically bound chromium (0.030 mg / day), vitamin E (30 mg / day), vitamin B3 (20 mg / day) and cystine (25 mg / day). A particular disadvantage of this preferred composition is that the proposed daily dosage of aspirin (150 mg / day) is so high that it is not without negative effects on the stomach for a longer period of time.

It was now an object of the invention to provide a pharmaceutical composition which is improved in its action in the treatment and prophylaxis of arteriosclerosis. In particular, the present invention relates to a pharmaceutical composition comprising

(a) fish oil

(b) Vitamin E and / or its physiologically acceptable derivatives, (c) L-ascorbic acid (vitamin C) and / or its physiologically acceptable derivatives and (d) acetylsalicylic acid.

The composition according to the invention contains neither α-ketopropionic acid or pyruvates nor lactic acid or lactates.

In a preferred embodiment, the pharmaceutical composition is characterized in that it additionally contains (e) L-proline and / or (f) L-lysine.

The invention preferably relates to a pharmaceutical composition comprising

(a) 60 to 70% by weight fish oil

(b) 17.5 to 23% by weight of vitamin E and / or its physiologically acceptable derivatives

(c) 11 to 13% by weight of vitamin C and / or its physiologically acceptable derivatives and

(d) 1.5 to 4% by weight of acetylsalicylic acid, based on the composition consisting of (a), (b), (c) and (d).

In a further preferred embodiment, the composition according to the invention, based on 100 parts by weight of the composition (a) to (d), (e) comprises 5 to 30 parts by weight of L-proline and / or (f) 5 to 30 parts by weight of L-lysine.

It has surprisingly been found that the combination of active ingredients (a) to (d) in the therapy and prophylaxis of arteriosclerosis compared to the individual main components of fish oil, vitamin E and vitamin C and / or the physiologically acceptable derivatives of vitamin E or C and acetylsalicylic acid is greatly improved. A further improvement in effectiveness is found if the composition also contains L-proline and / or L-lysine. As is known, fish oils contain the ω-3-unsaturated fatty acids, eicosapentaenoic acid (EPA; 20: 5, n-3) and docosahexaenoic acid (DHA; 22: 6, n-3) in the form of their respective triglycerides, regularly as a mixture of the triglycerides.

The fish oils used according to the invention contain the triglycerides of eicosapentaenoic acid and docosahexaenoic acid in purified form in proportions of up to 40% by weight, preferably 10 to 35% by weight, particularly preferably 15 to 35% by weight. Suitable, already cleaned and possibly concentrated fish oils are commercially available [e.g. Ameu® (18% by weight EPA and 12% by weight DHA) or Bilatin® (14% by weight EPA and 10% by weight DHA)]. Preferred fish oils are in particular salmon oil, mackerel oil, sardine oil or anchovy oil. The composition according to the invention is free of cod liver oil. The composition according to the invention preferably contains up to 65% by weight of fish oil.

Vitamin E is used in pure form and / or in the form of its physiologically acceptable derivatives. The composition according to the invention contains 17.5 to 23% by weight, preferably 15% to 20% by weight, of vitamin E, based on the composition consisting of (a) to (d). Preferred physiologically acceptable derivatives are selected from the group consisting of vitamin E acetate and vitamin E nicotinate.

Vitamin C is used in its pure form and / or in the form of its physiologically acceptable derivatives. The composition according to the invention contains 11 to 13% by weight, preferably 12% by weight of vitamin C and / or the above-mentioned derivatives based on the composition consisting of (a) to (d). Preferred physiologically acceptable derivatives of L-ascorbic acid are selected from the group consisting of their C ₁₂ -C ₂₂ carboxylic acid esters, sodium, potassium and magnesium L-ascorbate. The carboxylic acid ester group-forming C ₁₂ -C ₂₂ carboxylic acid is selected from the group consisting of lauric, myristic, palmitic, stearic, arachic and behenic acid. Acetylsalicylic acid (aspirin, ASA) can be used in pure form and / or as gastric juice-resistant and / or as a sustained release form. The composition according to the invention comprises 1.5 to 4% by weight of ASA, preferably 2 to 3.5% by weight, based on the composition consisting of (a) to (d).

ASA is preferably used in the form of an enteric formulation, that is to say a formulation which does not contain the active ingredient in the stomach but only in the small intestine releases, for example in the form of a conventional microencapsulated dosage form known from the prior art.

The composition according to the invention is intended for oral administration and can accordingly be in the form of a powder, a tablet, a dragee, a capsule, a solution, a concentrate, a syrup, a suspension, a gel or in the form of a dispersion. Furthermore, it can also be present in a sustained release form with regard to individual constituents or in an enteric formulation with respect to individual constituents.

The composition according to the invention is generally preferably dosed such that the total amount of fish oil (a) supplied to the body during therapy is between 1000 and 2000 mg / day, preferably 1200 to 1800 mg, particularly preferably 1400 to 1600 mg per day (and Person with a body weight of 75 kg). Dosages of 1000 to 1400 mg / day are sufficient and preferred for prophylaxis. The quantitative proportions of the components (b) to (d) can be calculated on the basis of the quantity of fish oil on the basis of their percentage proportions mentioned above.

The composition according to the invention can be administered in several individual doses throughout the day. In addition, it is also possible to administer components (a) to (d) not only in a mixture, but also individually.

For this purpose, the active ingredient combination can be made available in an arrangement in which the individual components are present separately from one another and can be mixed or administered separately before administration (kit-of-parts).

The composition according to the invention can also, in physiologically compatible amounts, additionally and independently of one another, coenzyme Q, beta-carotene, biologically active selenium, one or more water-soluble vitamins, physiologically valuable elements, garlic and / or hawthorn extract and for formulation (galenics ) usually contain common components. In a preferred embodiment, the composition according to the invention is free from vitamin A and vitamin K.

By way of example only, it should be mentioned that the composition according to the invention, based on 100 parts by weight of the composition consisting of (a), (b), (c) and (d), can also contain, independently of one another: 0.1 to 1 part by weight, preferably 0.4 to 0.8 part by weight of coenzyme Q;

0.1 to 1 part by weight, preferably 0.4 to 0.8 part by weight of beta-carotene;

1x10 ^"3 to 3x10 ^'3 parts by weight, preferably 1, 3x10 ^{' 3} to 2.7x10 ^'3 parts by weight of biologically active selenium; one or more of the water-soluble vitamins thiamine, riboflavin, niacin, pyridoxine,

Pantothenic acid, biotin, cobalamin and folic acid, especially in the following

Parts by weight:

one or more of the elements in its physiologically compatible form selected from the group consisting of magnesium, iron, copper, iodine, manganese, zinc, molybdenum and chromium, in particular in the following parts by weight:

as well as other customary components, such as antioxidants, dispersants and / or suspending agents and other auxiliaries customary for galenics, such as, for example Flavors, colors, thickeners and common physiologically harmless release agents.

Preferred as an additive to the composition consisting of components (a), (b), (c) and (d) and optionally (e) and / or (f) is a combination consisting of beta-carotene, coenzyme Q, carnitine, thiamine, riboflavin , Niacin, pyridoxine, biotin, cobalamin, folic acid, magnesium, copper, manganese, zinc, molybdenum and chromium, each in the proportions indicated above.

The composition according to the invention may further contain, based on 100 parts by weight of the composition consisting of (a), (b), (c) and (d):

0.1 to 1 part by weight, preferably 0.2 to 0.8 part by weight of garlic extract;

0.1 to 1 part by weight, preferably 0.2 to 0.8 part by weight of hawthorn extract; or - 0.1 to 2 parts by weight, preferably 0.2 to 1.8 parts by weight of combinations of garlic and hawthorn extract.

The pharmaceutical composition described above can be used for the prophylaxis and / or therapy of arteriosclerosis in the human body. The composition according to the invention can be used in processes for the production of medicaments, for the treatment and / or prophylaxis of the abovementioned disease using this composition and can then be used in the above-mentioned dosages.

It has surprisingly been found for the composition according to the invention that the combination of fish oil, vitamin E, vitamin C and / or the physiologically acceptable derivatives of vitamin E or C and acetylsalicylic acid leads to an action against arteriosclerosis which goes far beyond what is to be expected, ie leads to a synergistic effect. The administration of fish oil, vitamin E, vitamin C and / or the physiologically acceptable derivatives of vitamin E or C as well as acetylsalicylic acid in combination with L-lysine and / or L-proline led to an effect that was still compared to the administration of the individual components is further strengthened, manifested, in addition to improved blood circulation and reduced blood pressure, through long-term higher mobility as well as improved concentration and performance increase. The compositions according to the invention are therefore particularly suitable as agents for the treatment and therapy of arteriosclerosis.

Examples:

For the following examples, the respective doses were administered to 30 test subjects over 25 weeks.

The effects of the following formulations were compared in 30 people (body weight about 75 kg +/- 10%) who primarily suffer from arteriosclerosis:

A) 100 mg acetylsalicylic acid (ASA, commercially available)

B) 1500 mg salmon oil (Ameu® - capsules with 500 mg fish oil)

C) 100 mg ASA

400 mg vitamin E (commercially available)

D) 150 mg ASA 30 mg vitamin E.

150 mg salmon oil

E) 90 mg ASA

300 mg vitamin C (commercially available) 1500 mg salmon oil

F) 90 mg ASA

300 mg vitamin C 400 mg vitamin E 1500 mg salmon oil

G) Composition F) plus 600 mg L-lysine and 300 mg L-proline

The total amounts mentioned above were administered daily, if necessary in single doses, over a period of 25 weeks. In an evaluation (1 = very good, 2 = good, 3 = satisfactory, 4 = sufficient, 5 = hardly noticeable, 6 = no relief, 6 ^' = Ab- break of the test series), the test subjects described the effect of the above compositions as follows:

rating

It was found that oral administration of compositions A, B, C and F had less effect (blood circulation, blood pressure, mobility and concentration and performance) than administration of G.

Administration of D led to an early termination of the test series due to gastrointestinal complaints. Such side effects could not be observed in the other test series according to the invention listed.

The test series E showed a slightly better effect than the test series A, B, C before.

The combination F showed an improved effect compared to the combinations A to E, the combination G showed an even more improved effect compared to the combination F.

Claims

Claims:

1. A pharmaceutical composition comprising (a) fish oil, (b) vitamin E and / or its physiologically acceptable derivatives,

(c) L-ascorbic acid (vitamin C) and / or its physiologically acceptable derivatives and

(d) acetylsalicylic acid.

2. Composition according to claim 1, characterized in that it additionally

(e) L-proline and / or

(f) contains L-lysine.

3. Composition according to claim 1, characterized in that the physiologically acceptable derivatives of vitamin E are selected from the group consisting of vitamin E acetate and vitamin E nicotinate.

4. Composition according to claim 1, characterized in that the physiologically acceptable derivatives of L-ascorbic acid are selected from the group consisting of their C ₁₂ -C ₂₂ carboxylic acid esters, sodium, potassium and magnesium L-ascorbate.

5. Composition according to any one of claims 1 to 4, characterized in that the fish oil contains eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or mixtures thereof in the form of their triglycerides.

6. Composition according to claim 5, characterized in that the fish oil contains 10-40% by weight of eicosapentaenoic acid and docosahexaenoic acid in the form of their triglycerides, based on the fish oil.

7. Composition according to any one of claims 1 to 5, characterized in that the fish oil is selected from the group consisting of salmon oil, mackerel oil, sardine oil and anchovy oil.

8. The composition according to claim 4, characterized in that the C ₁₂ -C ₂₂ carboxylic acid ester group-forming carboxylic acid is selected from the group consisting of lauric, myristic, palmitic, stearic, arachic and behenic acid.

9. Composition according to any one of claims 1 to 8, characterized in that the composition

(a) 60 to 70% by weight fish oil

(c) 11 to 13% by weight of vitamin C and / or its physiologically acceptable derivatives, and

10. Composition according to any one of claims 1 to 9, characterized in that it consists in each case 5 parts by weight to 30 parts by weight of L-proline and / or L-lysine, based on 100 parts by weight of the composition from (a) to (d).

11. The composition according to any one of claims 1 to 10, characterized in that the composition further comprises coenzyme Q, beta-carotene, biologically active selenium, one or more water-soluble vitamins, one or more elements in their physiologically acceptable form, or mixtures thereof Contains components.

12. Composition according to any one of claims 1 to 11, characterized in that it additionally contains garlic extract and / or hawthorn extract.

13. The composition according to claim 12, characterized in that the total amount of garlic extract and / or hawthorn extract in the pharmaceutical composition 0.1 to 2.0 parts by weight, based on 100 parts by weight of the composition consisting of (a), (b), (c) and (d) contains.

14. A composition comprising the composition according to any one of claims 1 to 13 for the therapy and prophylaxis of arteriosclerosis.

15. Use of the composition as defined in any one of claims 1 to 13 for the therapy and prophylaxis of arteriosclerosis.

16. Use of the composition as defined in any one of claims 1 to 13 for the manufacture of a medicament for the treatment and / or prophylaxis of arteriosclerosis.

17. A method for the treatment of arteriosclerosis, characterized by administration of the composition according to any one of claims 1 to 13 in a dosage of 1400 to 2000 mg of fish oil per person per day.

18. A method for the prophylaxis of arteriosclerosis, characterized by administration of the composition according to any one of claims 1 to 13 in a dosage of 1000 to 1400 mg fish oil per person per day.