“First, the necessity to use oils or oil based carriers may lend the preparations an unpleasant taste or otherwise reduce palatability, in particular for the purposes of long-term therapy. These effects can be masked by presentation in gelatine capsule form. However, in order to maintain the cyclosporin in solution, the ethanol content has to be kept high. Evaporation of the ethanol, e.g. from capsules or from other forms, e.g. when opened, results in the development of a cyclosporin precipitate. Where such compositions are presented in e.g. soft gelatine encapsulated form, this particular difficulty necessitates packaging of the encapsulated product in an air-tight compartment, for example an air-tight blister or aluminium-foil blister-package. This in turn renders the product both bulky and more expensive to produce. The storage characteristics of formulations as aforesaid are far from ideal.”
“Bioavailability levels achieved using existing oral cyclosporin dosage systems are also low and exhibit wide variation between individuals, individual patient types and even for single individuals at different times during the course of therapy. Thus reports in the literature indicate that currently available therapy employing the commercially available Ciclosporin drink solution provides an average absolute bioavailability of ca. 30% only, with marked variation between individual groups, e.g. between liver (relatively low bioavailability) and bone-marrow (relatively high bioavailability) transplant recipients. Reported variation in bioavailability between subjects has varied from anything between one or a few percent for some patients to as much as 90% or more for others. And as already noted, marked change in bioavailability for individuals with time is frequently observed.”
“By the present invention there are provided novel cyclosporin galenic formulations in the form of a micro-emulsion pre-concentrate and/or based on the use of particular solvent media as hereinafter defined, which meet or substantially reduce difficulties in cyclosporin, e.g. Ciclosplorin, therapy hitherto encountered in the art. In particular it has been found that the compositions of the invention permit the preparation of solid, semi-solid and liquid compositions containing a cyclosporin in sufficiently high concentration to permit, e.g. convenient oral administration, while at the same time achieving improved efficacy, e.g. in terms of bioavailability characteristics.”
“In a first aspect, the present invention specifically provides pharmaceutical compositions comprising a cyclosporin as active ingredient, which compositions are in the form of an “oil-in-water microemulsion pre-concentrate”.”
“By the term “oil-in-water microemulsion pre-concentrate” as used herein is meant a system capable on contacting with, e.g. addition to, water of providing an oil-in-water microemulsion. The term microemulsion as used herein is used in its conventionally accepted sense as a non-opaque or substantially non-opaque colloidal dispersion comprising water and organic components including hydrophobic (lipophilic) organic components. Microemulsions are identifiable as possessing one or more of the following characteristics. They are formed spontaneously or substantially spontaneously when their components are brought into contact, that is without substantial energy supply, e.g. in the absence of heating or the use of high shear equipment or other substantial agitation. They exhibit thermodynamic stability. They are monophasic. They are substantially non-opaque, i.e. are transparent or opalescent when viewed by optical microscopic means. In their undisturbed state they are optically isotropic, though an anisotropic structure may be observable using e.g. x-ray technique. Microemulsions comprise a dispersed or particulate (droplet) phase, the particles of which are of a size less than 2,000 A, hence their optical transparency. The particles of a microemulsion may be spherical, though other structures are feasible, e.g. liquid crystals with lamellar, hexagonal or isotropic symmetries. Generally, microemulsions comprise droplets or particles having a maximum dimension (e.g. diameter) of less than 1,500 A, e.g. typically from 100 to 1,000 A. [For further discussion of the characteristics of microemulsions see, e.g. Rosof . . . ; Friberg . . . ; and Müller . . . . ] From the foregoing it will be understood that the “oil-in-water microemulsion pre-concentrates” of the invention are galenic systems comprising a cyclosporin as active ingredient capable of forming an oil-in-water microemulsion, spontaneously or substantially spontaneously on contact with water alone.”
‘A. I would not take it that far. I think my attitude at the time was, "Thank goodness somebody has used a microemulsion formulation at last" because I worked on it in 1972. I thought they were excellent systems. I was somewhat surprised that nobody had picked it up before. Now somebody has picked it up.’
‘Q… I am trying to sort out what your opinion is. I am talking about the use of the word "microemulsion" now in the context of the 770 patent. I am asking whether it is your contention that the word as used in the 770 patent extends to cover something which is in part a microemulsion and in part contains particle sizes greater than 200nm. A. The patent does talk about having systems with other components in which are greater than that particular size. It is quite hard to divorce the two things. If you are asking me about how it defines the microemulsion patents and microemulsion which is 82(a) and (b), I agree, it does not say anything about a part there, but in the patent as a whole, it does imply that there may be mixed systems.’
‘Q…If it was written like that and you had something with particles less than 2000 angstrom and particles more than 2000 angstroms, whether you would call the resultant product a microemulsion or not? A. I think there is probably a misunderstanding here. I would call a microemulsion coexisting with something else anyway. I would never call it, if it had two populations, a microemulsion per se. That would just be totally wrong. I would say that the particles that are microemulsion particles and particles that are something else. Does that answer your question? Q. It is the answer you have given to my question. Let me add one further rider to that description. Assume that it is said that the particles are of a size less than 2000 angstroms hence their optical transparency. You have added into it optical transparency. Would you then be prepared to call a mixture of 2000 angstrom and smaller particles and 2000 angstrom larger particles a microemulsion or not? A. Absolutely not. I would not call it a microemulsion. I thought a microemulsion was something else so the same thing still stands. If I could prove that there are particles of less than 2000 angstroms that are thermodynamically stable, isotropic, have the correct components making them a form of microemulsion droplets. Q. Would you call the system a microemulsion? A. No, I have just said that it would be whatever it was. For example, a suspoemulsion. You get suspensions and emulsions. You could have suspomicroemulsions. It is appropriate for whatever components are in there.’
‘Q. But an oil in water microemulsion is quite hard to produce. A. It is. It is just relating one to the other. Q. If you look at the phase diagram at the bottom of the page, Fig. 1, you will see a rather small section of the phase diagram. A skilled person would take from that that there was a pretty narrow window of opportunity that one had. A. They would recognise it as a challenge, yes. Q. That phase diagram, which is a ternary diagram, involves a concentration of the surfactant, the primary surfactant, being constant. A skilled person would take from this that both a primary surfactant and a cosurfactant were required; is that right? A. Yes. Q. They would also take from this, would they not, that in order to prepare an oil in water microemulsion, it was necessary to follow a four-step procedure which is set out in that little section. A. I would agree, but I do not think the steps are particularly difficult, are they? They are just mixing things with other things.’
‘As discussed in [770 and GB 2 257 359] the cyclosporins present highly specific difficulties in relation to administration generally and galenic composition in particular, including in particular problems of stability, drug bioavailability, and variability in inter– and intra–patient dose response. In order to meet these and related difficulties, in GB patent publication no. 2 222 770 and 2 257 359A, galenic compositions are disclosed comprising a cyclosporin as active ingredient and which take the form of, inter alia, an emulsion, e.g. microemulsion, or emulsion, e.g. microemulsion, pre-concentrate. Such compositions typically comprise 1) a hydrophilic component, 2) a lipophilic component, and 3) a surfactant. In accordance with the present invention it has now surprisingly been found that particularly stable emulsion e.g. microemulsion, or emulsion, e.g. microemulsion, pre-concentrate galenic compositions with difficultly soluble active agents having particularly interesting bioavailability characteristics and reduced variability in inter– and intra–subject bioavailability parameters, are obtainable using at least one component selected from the group consisting of (i) fatty acids, (ii) N-methyl pyrrolidone, and (iii) a transesterification product of hydrogenated palm kernel and/or hydrogenated palm oil with polyethylene glycol 15000, hereinafter referred to as “secondary component”.’
‘An “emulsion, e.g. microemulsion, pre-concentrate is defined in this specification as being a composition which spontaneously forms an emulsion, e.g. microemulsion, in an aqueous medium, for example, in water…’
‘a composition according to any preceding claim wherein the ratio of the cyclosporin or other macrolide : second component : lipophilic component : surfactant is 1 : 0.1 to 10 : 1 to 10 : 1 to 10 on the basis of weight.’
‘The size distribution of the particles resulting from the complete dispersion of the product in an aqueous phase advantageously ranges to a maximum of 1000nm.’
‘4.13 "Comprising" vs. "consisting" While in everyday language the word "comprise" may have both the meaning "include", "contain" or "comprehend" and "consist of", in drafting patent claims legal certainty normally requires it to be interpreted by the broader meaning "include", "contain" or "comprehend". On the other hand, if a claim for a chemical compound refers to it as "consisting of components A, B and C" by their proportions expressed in percentages, the presence of any additional component is excluded and therefore the percentages should add up to 100% (see T 759/91 and T 711/90, both not published in OJ).’
‘The second component may include further hydrophilic co-components, for example lower alkanols such as ethanol. These co-components will generally be present in partial replacement of other components of the second component. While the use of ethanol in the compositions is not essential, it has been found to be of particular advantage when the compositions are to be manufactured in soft gelatine, encapsulated form. This is because storage characteristics are improved, in particular the risk of active agent precipitation following encapsulation procedures is reduced. Thus the shelf life stability may be extended by employing ethanol or some other such co-component as an additional ingredient of the second component. In a further alternative aspect the ethanol may comprise 0 to 60 % by weight of the second component; preferably 20 to about 55% by weight and more preferably about 40 to 50 % by weight. Small quantities of liquid polyethylene glycols may also be included in the second component.’
‘Q. So you are regarding this as being a microemulsion exercise simply without regard to the ability to solubilize cyclosporin. A. No, I guess the point that if I was trying to improve on a formulation which already exists, you are right, one of the first things I do is to have a look at the solvents. I have no problem with that. I do not believe that from what I was trying to formulate n-methylpyrrolidone would be one of them. Q. But some sort of fatty acid would be. A. Yes, it would be.’