WO2003004034B1 - Method for inducing analgesia comprising administration alternatively of an opioid receptor agonist and an opioid receptor like receptor 1 agonist for and an implantable infusion pump - Google Patents

Method for inducing analgesia comprising administration alternatively of an opioid receptor agonist and an opioid receptor like receptor 1 agonist for and an implantable infusion pump

Info

Publication number
WO2003004034B1
WO2003004034B1 PCT/US2002/006721 US0206721W WO03004034B1 WO 2003004034 B1 WO2003004034 B1 WO 2003004034B1 US 0206721 W US0206721 W US 0206721W WO 03004034 B1 WO03004034 B1 WO 03004034B1
Authority
WO
WIPO (PCT)
Prior art keywords
agonist
opioid receptor
mammal
receptor
time
Prior art date
Application number
PCT/US2002/006721
Other languages
French (fr)
Other versions
WO2003004034A1 (en
Inventor
Gregory A Demopulos
Pamela Pierce Palmer
Original Assignee
Omeros Corp
Univ California
Gregory A Demopulos
Pamela Pierce Palmer
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Omeros Corp, Univ California, Gregory A Demopulos, Pamela Pierce Palmer filed Critical Omeros Corp
Priority to EP02721261A priority Critical patent/EP1406629A1/en
Priority to CA002490386A priority patent/CA2490386A1/en
Priority to JP2003510045A priority patent/JP2005502619A/en
Priority to US10/187,249 priority patent/US20030040479A1/en
Priority to US10/187,454 priority patent/US7737118B2/en
Priority to US10/189,335 priority patent/US20030032651A1/en
Publication of WO2003004034A1 publication Critical patent/WO2003004034A1/en
Publication of WO2003004034B1 publication Critical patent/WO2003004034B1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M5/14244—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
    • A61M5/14276—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body specially adapted for implantation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
    • A61K31/4436—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a heterocyclic ring having sulfur as a ring hetero atom
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
    • A61K31/4439—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. omeprazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445—Non condensed piperidines, e.g. piperocaine
    • A61K31/4468—Non condensed piperidines, e.g. piperocaine having a nitrogen directly attached in position 4, e.g. clebopride, fentanyl
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445—Non condensed piperidines, e.g. piperocaine
    • A61K31/4523—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems
    • A61K31/4535—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems containing a heterocyclic ring having sulfur as a ring hetero atom, e.g. pizotifen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
    • A61K31/485—Morphinan derivatives, e.g. morphine, codeine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/07—Tetrapeptides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/08—Peptides having 5 to 11 amino acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/10—Peptides having 12 to 20 amino acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
    • A61P25/36—Opioid-abuse
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/04—Liquids
    • A61M2202/0468—Liquids non-physiological
    • A61M2202/048—Anaesthetics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/35—Communication
    • A61M2205/3507—Communication with implanted devices, e.g. external control
    • A61M2205/3523—Communication with implanted devices, e.g. external control using telemetric means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16804—Flow controllers
    • A61M5/16827—Flow controllers controlling delivery of multiple fluids, e.g. sequencing, mixing or via separate flow-paths
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16877—Adjusting flow; Devices for setting a flow rate

Abstract

A method of producing analgesia in a mammal is provided by rotational (alternating) intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor agonist, such as a ν-, δ- or λ-opioid receptor agonist for a first period of time, followed by intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 (ORL-1) agonist for a second period of time. The intrathecal drug administration of the first and second periods of time may be repeated a plurality of times without attaining tolerance in the mammal to either drug. Implantable apparatus for rotational administration of the active agents is also disclosed.

Claims

23
AMENDED CLAIMS
[received by the International Bureau on 3 February 2003 (03.02.2003); new claims 23-28 added; remaining claims unchanged (2 pages)]
23. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist for a second period of time, wherein the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one μ-opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
24. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist, selected from the group consisting of moφhine, hydromorphone, fentanyl, sufentanil, methadone, meperidine and DAMGO, for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist for a second period of time, wherein the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one μ-opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
25. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist, selected from the group consisting of moφhine, hydromoφhone, fentanyl, sufentanil, methadone, meperidine and DAMGO, for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist, selected from the group consisting of nociceptin, Phepsi; RO 64-6198, and l-phenyl-l,3,8-triaza- spiro[4.5]decan-4-ones, for a second period of time, wherein the at least one opioid receptor-like receptor 1 agonist and the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one μ-opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
26. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist , δ-opioid receptor agonist, or -opioid receptor agonist for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist for a second period of time, wherein the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
27. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist, selected from the group consisting of moφhine, hydromoφhone, fentanyl, sufentanil, methadone, meperidine and DAMGO, one δ-opioid receptor agonist, selected from the group consisting of deltoφhin and DPDPE, or the K- opioid receptor agonist U-50,488H, for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist for a second period of time, wherein the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
28. A method of producing analgesia in a mammal comprising alternating intrathecal administration to the mammal of a pharmaceutically effective dose of at least one μ-opioid receptor agonist , selected from the group consisting of moφhine, hydromoφhone, fentanyl, sufentanil, methadone, meperidine and DAMGO, one δ-opioid receptor agonist, selected from the group consisting of deltoφhin and DPDPE, or a - opioid receptor agonist U-50,488H, for a first period of time, and intrathecal administration to the mammal of a pharmaceutically effective dose of at least one opioid receptor-like receptor 1 agonist, selected from the group consisting of nociceptin, Phepsi; RO 64-6198, and l-phenyl-l,3,8-triaza-spiro[4.5]decan-4-ones, for a second period of time, wherein the at least one opioid receptor-like receptor 1 agonist and the first and second time periods are selected to delay the development of tolerance in the mammal to the at least one opioid receptor agonist and the at least one opioid receptor-like receptor 1 agonist.
PCT/US2002/006721 2001-07-02 2002-02-28 Method for inducing analgesia comprising administration alternatively of an opioid receptor agonist and an opioid receptor like receptor 1 agonist for and an implantable infusion pump WO2003004034A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
EP02721261A EP1406629A1 (en) 2001-07-02 2002-02-28 Method for inducing analgesia comprising administration alternatively of an opioid receptor agonist and an opioid receptor like receptor 1 agonist for and an implantable infusion pump
CA002490386A CA2490386A1 (en) 2001-07-02 2002-02-28 Method for producing analgesia comprising administration of an opioid receptor agonist in rotation with an opioid receptor like-1 receptor agonist
JP2003510045A JP2005502619A (en) 2001-07-02 2002-02-28 A method for producing analgesia comprising administering an opioid receptor agonist in place of an opioid receptor-like receptor 1 agonist
US10/187,249 US20030040479A1 (en) 2001-07-02 2002-07-01 Rotational intrathecal analgesia method and device
US10/187,454 US7737118B2 (en) 2001-07-02 2002-07-01 Rotational intrathecal analgesia
US10/189,335 US20030032651A1 (en) 2001-07-02 2002-07-02 Intrathecal analgesia method

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US30279601P 2001-07-02 2001-07-02
US60/302,796 2001-07-02

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US30279601P Continuation 2001-07-02 2001-07-02

Related Child Applications (3)

Application Number Title Priority Date Filing Date
US10/187,454 Continuation US7737118B2 (en) 2001-07-02 2002-07-01 Rotational intrathecal analgesia
US10/187,249 Continuation US20030040479A1 (en) 2001-07-02 2002-07-01 Rotational intrathecal analgesia method and device
US10/189,335 Continuation-In-Part US20030032651A1 (en) 2001-07-02 2002-07-02 Intrathecal analgesia method

Publications (2)

Publication Number Publication Date
WO2003004034A1 WO2003004034A1 (en) 2003-01-16
WO2003004034B1 true WO2003004034B1 (en) 2003-08-07

Family

ID=23169245

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2002/006721 WO2003004034A1 (en) 2001-07-02 2002-02-28 Method for inducing analgesia comprising administration alternatively of an opioid receptor agonist and an opioid receptor like receptor 1 agonist for and an implantable infusion pump

Country Status (5)

Country Link
US (2) US7737118B2 (en)
EP (1) EP1406629A1 (en)
JP (2) JP2005502619A (en)
CA (1) CA2490386A1 (en)
WO (1) WO2003004034A1 (en)

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Also Published As

Publication number Publication date
JP2009102396A (en) 2009-05-14
WO2003004034A1 (en) 2003-01-16
JP2005502619A (en) 2005-01-27
US20030040486A1 (en) 2003-02-27
CA2490386A1 (en) 2003-01-16
US7737118B2 (en) 2010-06-15
EP1406629A1 (en) 2004-04-14
US20030032651A1 (en) 2003-02-13

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