FR2901702A1 - USE OF GRANISETRON FOR THE TREATMENT OF ROSACEA SUBTYPES AND PHARMACEUTICAL COMPOSITIONS - Google Patents

Abstract

The invention relates to the use of granisetron or its salts as active principle in a pharmaceutical composition, more particularly dermatological. Preferably, the composition is applied topically. It is intended for the treatment and / or prevention of papulopapustous rosacea, phymatic rosacea and / or ocular rosacea.

Description

The invention relates to the use of granisetron or its salts as

  active ingredient in a pharmaceutical composition, more particularly dermatological, for the treatment and / or prevention of papulopapustular rosacea, phymatous rosacea and ocular rosacea.

  Granisetron, or endo-1-methyl-N- (9-methyl-9-azabicyclo [3,3,1] non-3-yl) -1H-indazole-3-carboxamide, is a compound already known and described in particular and claimed in European Patent EP0200444. Granisetron is a 5HT3 neuronal receptor antagonist associated with peripheral neurons, such as sensory nerves of the skin, and central neurons. In particular, granisetron is approved as a palliative therapy to treat or prevent postoperative or chemotherapy-induced nausea and vomiting.

  In addition, this compound has been described as an analgesic and anti-inflammatory agent.

  For example, in vivo data from Voog et al. show that granisetron has analgesic action in polyarthritic patients in "influence of serotonin on the analgesic effect of granisetron on temporomandibular joint arthritis" Voog U et al. Mediators Inflamm. 2004 Dec; 13 (5-6): 373-6 ..

  More generally in "Physiology and pathophysiology of the 5-HT3 receptor Farber L et al., Scand J Rheumatol Suppl 2004; (119): 2-8, the effects of 5HT3 receptor antagonists have been described in the literature. following disorders: intestinal disorders (particularly in the treatment of irritable bowel syndrome and diarrhea), cardiac disorders, central nervous system disorders such as anxiety, drug dependence, disorders of function cognitive and thermoregulatory effects, pain perception (nociception) especially in the case of rheumatoid arthritis, tendon diseases, facial muscle pain, chronic fatigue syndrome and some forms of pruritus. long-term (by local or intra-articular injection) have also been described.

  In addition, Jansen, Graue and Grabbe described in a poster presented at the 14th European Academy of Dermatology and Venereology (EADV) congress held in London from 12 to 16 October 2005 entitled "Effect of the 5- hydroxytryptamine type 3 receptor antagonist granisetron on erythema and flushing reactions in rosacea ", effects of granisetron on erythema and redness in patients with rosacea.

2

  These symptoms are characteristic of the erythematotelangiectatic rosacea subtype. There is, however, no published data on the use of granisetron for the treatment and / or prevention of other subtypes and symptoms of rosacea, including the characteristic symptoms of papulopustular rosacea, phymatous rosacea or ocular rosacea. However, it is not obvious that an effective compound in the treatment of erythema and redness also has an activity in the treatment of these other symptoms.

  Thus, the present invention relates to the use of an effective amount of at least one compound selected from granisetron and its salts for the preparation of a pharmaceutical composition for the treatment and / or prevention of papulopustular rosacea , phymatic rosacea or ocular rosacea, preferably orally or topically.

  The second subject of the present invention is a pharmaceutical composition, preferably for topical application, comprising, in a pharmaceutically acceptable vehicle, an effective amount of at least one compound chosen from granisetron and its salts.

  By effective amount is meant an amount sufficient to prevent and / or treat papulopustular rosacea, phymatic rosacea or ocular rosacea, particularly the symptoms associated with them, preferably orally or topically.

  In addition, the present invention also relates to a new method for the treatment and / or prevention of papulopustular rosacea, phymatic rosacea or ocular rosacea, and the symptoms associated with them, preferably orally or topically. by orally administering or topically applying a pharmaceutical composition comprising granisetron or its salts.

  By salts of granisetron is meant its pharmaceutically acceptable ionic salts, and preferably its hydrochloride form (granisetron HCl or endo-1-methyl-N- (9-methyl-9-azabicyclo [3,3,1] non-3 hydrochloride -yl) -1H-indazole-3-carboxamide).

3

  Rosacea is a common, but highly visible, chronic and progressive inflammatory dermatosis. Its causes are little known. It can lead to significant deformities of the face, eye complications and serious emotional disorders especially distress.

  A standard classification review of rosacea was published in June 2004 in the Journal of the American Academy of Dermatology. This classification was developed by the National Rosacea Society Expert Committee on Classification and Staging of Rosacea and reviewed by rosacea experts around the world. It describes the characteristics, or signs and symptoms, or manifestations, primary and secondary, of rosacea (described below) and recognizes 4 patterns of signs and symptoms related to rosacea, designated in subtypes: Subtype 1: Erythematotelangiectatic rosacea Subtype 1 is characterized by reddening and persistent erythema on the middle parts of the face. Telangiectasia is a common but not essential feature of diagnosis. Subtype 2: papulopustular rosacea Subtype 2 includes persistent erythema in the center of the face with transient papules and / or pustules distributed over the middle parts of the face. Burning and tingling sensations may also appear. Subtype 3: Phosphate Rosacea This subtype may include thickening of the skin, appearance of irregular surface nodularities, and increased volume of a portion of the face. Phymatous rosacea usually occurs as rhinophyma (at the nose) but may appear elsewhere, for example at the chin, forehead, cheeks or ears. Open follicles may appear in the phymatous zone. Signs of telangiectasia may be present.

  Subtype 4: Ocular Rosacea 35 Ocular rosacea may include, in the eye, a moist (excessive tearing) or injected (hyperemia of the interpalbral conjunctiva) appearance, foreign body sensation, burning sensation or tingling, 20

  4 dryness, pruritus, photophobia, blurred vision, conjunctival telangiectasia and margins of the eyelids, or periocular and eyelid erythema. Blepharitis, conjunctivitis and irregularities in the eyelid may also occur. Meibomian gland dysfunction in the form of a chalazion, or chronic infection manifested by a stye is common. Some patients may lose vision due to corneal complications (punctate keratitis, corneal infiltrates, ulcers, or marginal keratitis).

  Erythema and telangiectasia in the middle part of the face are predominant in the early stages of rosacea. This progresses to chronic inflammatory infiltrates with papules and pustules in the middle part of the face. Chronic or persistent facial edema may also appear. Some patients develop rhinophyma, that is, hypertrophy of the connective tissue and sebaceous glands of the nose that is visible due to small dents on the nose.

  The major symptom of rosacea is the intermittent appearance of redness and erythema on the middle part of the face. Pruritus is usually absent. However, some patients complain of stinging (sometimes intense) pain associated with episodes of redness of the skin. These blushing episodes can be socially embarrassing and can occur at any time or be related to environmental, chemical, dietary or emotional factors. These factors usually include exposure to the sun, cold, sudden emotion (laughter or embarrassment), hot drinks, and alcohol consumption.

  Thus, in the context of the present invention, the characteristic symptoms of: - papulopustular rosacea preferably include the appearance of papules and / or pustules; - phymatous rosacea preferably include the appearance of irregular surface nodularities, increased volume of parts of the face (nose, forehead, chin, cheeks, ears), the appearance of open follicles; - ocular rosacea preferably include an injected conjunctiva, excessive tearing, foreign body sensation, burning or tingling sensation, dryness, pruritus, photophobia, blurred vision, blepharitis of conjunctivitis, 5 irregularities in the eyelid, dysfunction of Meibomian glands; rosacea-related oedemas can also be treated by the use of the composition according to the invention. According to the present invention, granisetron is administered by any route, that is to say, oral, enteral, parenteral (subcutaneous, cutaneous, intravenous, intramuscular), topical or ocular. Preferably, the oral, topical or ocular routes are used.

  Topical granisetron, for example in the form of cream, gel, lotion or oral form, for example in the form of tablets, capsules, powder, syrup or liquid, is effective for treating and / or preventing papulopustular rosacea, rosacea phymatous and / or ocular rosacea. For this, topical or oral granisetron can be given once or twice daily.

  More particularly, oral or topical administration of granisetron is suitable for treating and / or preventing the signs or symptoms related to each of the papulopustular, phymatous and / or ocular subtypes of rosacea, separately or in combination, and thereby significantly reduce or eradicate these signs or symptoms in patients.

  Therefore, the invention relates to the use of an effective amount of at least one compound selected from granisetron and its salts for the preparation of a pharmaceutical composition for the treatment and / or prevention of one or more of subtypes of rosacea selected from the papulopustular rosacea subtype, the rosacea phymatous subtype, and the ocular rosacea subtype.

  Rosacea is a chronic condition that recurs and usually requires long-term treatment. Symptom control can be effectively maintained by oral or topical use of granisetron.

  According to a preferred embodiment, the pharmaceutical composition according to the invention is intended for topical use. More particularly, the pharmaceutical composition is a dermatological composition.

  Such a composition according to the invention is a composition comprising, in a pharmaceutically acceptable vehicle, an effective amount of at least one compound chosen from granisetron and its salts.

  By pharmaceutically acceptable vehicle is meant a vehicle compatible with the skin, superficial body growths and / or mucous membranes.

  In what follows, the term "topical" means any technique for administering a product by direct application to a surface or an external part of the body, such as the skin (cutaneous route) and its appendices or the eye (eye canal ). For the topical route, the pharmaceutical compositions comprising granisetron or its salts, which are thus more particularly intended for the treatment of the skin, superficial body growths and mucous membranes, may be in any of the galenical forms normally used for topical application. In particular, they may be in the form of creams, milks, ointments, ointments, gels which may be aqueous, anhydrous or lipophilic gels, lotions, aqueous solutions, hydroalcoholic or oily shampoos, any type of emulsions or suspensions, powders . They may contain particles containing or not containing granisetron or its salts. These particles may be lipid or polymeric microspheres or nanospheres, microcapsules or nanocapsules, mono- or multi-lamellar vesicles, micelles. They may contain excipients such as polymers to control the release of granisetron or its salts. The shapes can be applied using any suitable packaging.

  The forms can be sprayed, applied as patches, wipes or simply after massage. In these forms, granisetron or its salts can be solubilized, dispersed or in both states. In addition, these compositions for topical applications may be in anhydrous form or in aqueous form. Pharmaceutical compositions for topical application which are particularly suitable in the context of the present invention are given as examples. According to a preferred embodiment, the topical composition is in the form of creams, gels or lotions. For the ocular route, the compositions according to the present invention are mainly in the form of solutions or gels.

  In the context of the present invention, the term "oral" means any technique for the administration of a product by digestive absorption.

  For the oral route, the compositions according to the present invention are in the form of tablets, capsules, pills, coated tablets, powders, granules, syrup, emulsions, solutions, suspensions, polymeric, lipidic, microspherical or nanospheric vesicles for controlled or controlled release. delayed.

  The compositions, preferably for topical or oral use, according to the invention comprise granisetron or its salts at a concentration of between 0.0001% and 20% by weight of the total weight of the pharmaceutical composition, preferably at a concentration of between 0.01% and 6%. For the oral route, the compositions according to the invention are administered administered at a dose of between 0.01 mg / kg and 100 mg / kg body weight, in one or more doses per day. In addition, said composition also finds application in the cosmetic field to improve the aspects of the skin. In particular, said composition can improve the appearance of the skin and / or the shine and / or roughness of the skin.

  The compositions according to the invention may also comprise inert additives, or combinations of such additives, and in particular: wetting agents; emollients such as glycerine; moisturizing agents such as glycerol, PEG 400 or alternatively urea.

  The compositions according to the invention may also comprise flavor enhancers, preservatives such as parahydroxybenzoic acid esters, stabilizing agents, moisture regulating agents, pH regulating agents, modifying agents and the like. osmotic pressure, emulsifiers, UV-A and / or UV-B screening agents, and anti-oxidants such as alpha-tocopherol, butylhydroxyanisole or butylhydroxytoluene. 20

  Of course, those skilled in the art will take care to choose the optional compound (s) to be added to these compositions in such a way that the advantageous properties of the compounds of the present invention are not or not substantially impaired by the intended addition.

  Examples follow to illustrate, without limitation, various formulations according to the invention.

EXAMPLE 1

  An example of a formulation according to the invention, in the form of gel for topical application is given below:

  Granisetron HCI 0.05 g 15 Carbopol 980 (Goodrich) 0.6 g Polyethylene glycol 400 3 g Sodium Hydroxide q.s. pH 5 Preservatives q.s. Demineralized water q.s.p.100 g EXAMPLE 2

  An example of a formulation according to the invention in the form of cream for topical application is given below: Methyl glucose sesquistearate polyoxyethylene with 20 moles EO 5g Carbopol 981 (Goodrich) 0.4 g Glycerol 7 g Cyclomethicone 4 g Sodium Hydroxide qs pH 5 Preservatives q.s. 10 Granisetron HCI 0.75 g Methyl glucose sesquistearate 1 g Stearyl alcohol 0.5 g Liquid paraffin oil 6 g Polyethylene glycol 400 2 g

9 Demineralized water q.s. 100 g

  EXAMPLE 3 An example of a formulation according to the invention in the form of a lotion for topical application is given below: Granisetron HCI Alcohol Benzyl Glycerol Alcohol Stearyl Light mineral oil Carbomer 941 Glyceryl Stearate Potassium Sorbate Cyclomethicone PEG-8 Steareth 21 Lactic Acid Sodium Hydroxide Purified Water 1.50 g 1.30 7.00 g 2.00 g 6.00 g 0.15 g 3.00 g 0.20 g 4.00 g 2.00 g 3.00 g qs pH adjusted q.s. pH adjusted q.s. 100.00 g EXAMPLE 4

  An example of a formulation according to the invention in the form of capsule powder for oral administration is given below: Granisetron HCl Mannitol Corn starch Anhydrous colloidal silica Magnesium stearate 5 mg 83.5 mg 10 mg 0.5 mg 1 mg

Claims (12)

  Use of an effective amount of at least one compound selected from granisetron and its salts for the preparation of a pharmaceutical composition for the treatment and / or prevention of papulopustular rosacea, phymatous rosacea or ocular rosacea.   2. Use according to claim 1, characterized in that the pharmaceutical composition is intended for the treatment and / or prevention of the appearance of papules and / or pustules associated with papulopustular rosacea.   3. Use according to claim 1, characterized in that the pharmaceutical composition is intended for the treatment and / or prevention of the appearance of irregular surface nodularities and / or the increase in volume of parts of the face and / or the appearance of open follicles, associated with phymatous rosacea.   4. Use according to claim 1, characterized in that the pharmaceutical composition is for the treatment and / or prevention of injected conjunctiva, excessive tearing, foreign body sensation, burning sensation or tingling, dryness, pruritus, photophobia, blurred vision, conjunctivitis blepharitis, eyelid irregularities and / or Meibomian gland dysfunction associated with ocular rosacea.   5. Use according to one of the preceding claims, characterized in that the composition is suitable for oral administration.   6. Use according to one of claims 1 to 4, characterized in that the composition is suitable for topical administration.   7. Use according to claim 6, characterized in that the composition is in the form of gel, cream or lotion.   8. Use according to one of the preceding claims, characterized in that the amount of granisetron or its salts present in said composition is between 0.0001% and 20% by weight of the total weight of the pharmaceutical composition and, preferably, between 0.01 and 6% by weight of the total weight of the pharmaceutical composition.   9. A pharmaceutical composition comprising, in a pharmaceutically acceptable carrier, an effective amount of at least one compound selected from granisetron and its salts.   10. Composition according to claim 9, characterized in that it is in the form of gel, cream or lotion. 10   11. A composition according to claim 9 or 10, characterized in that the amount of granisetron or its salts present in said composition is between 0.0001% and 20% by weight of the total weight of the pharmaceutical composition and, preferably, between 0.01 and 6% by weight of the total weight of the pharmaceutical composition.   12. Cosmetic use of a composition according to one of claims 9 to 11 to improve the appearance of the skin.