CN101829319A - 用于胰岛素治疗的药用组合物及方法 - Google Patents
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Abstract
公开了用胰岛素治疗患者的组合物和方法,其组合了胰岛素、渗透增强剂以及保持酸性pH的载体。
Description
本申请是申请日为2004年12月2日、申请号为200480041300.9、名称为“用于胰岛素治疗的药用组合物及方法”的发明申请的分案申请。
本申请对2003年12月8日提交的系列号为60/527,728的美国临时申请要求其优先权,该临时申请所公开的全部内容在此通过参考一并结合到本文中。
本发明涉及胰岛素释药组合物及释放方法,更特别地涉及除了通过注射、穿透皮肤、机体腔膜如眼、鼻、口、颊、肛门、直肠、阴道和血脑屏障等以外的胰岛素释放方法。
胰岛素通常用于治疗患有糖尿病的患者。通常,胰岛素通过注射给予患者。
美国专利5,023,252描述了通过非注射途径释放胰岛素的组合物。更特别地,该专利描述了组合物的使用,其中包括不需注射而使胰岛素穿透皮肤和体腔膜释放的渗透增强剂。
本发明涉及对该组合物及其用途的改良。
按照本发明,提供了一种药用组合物,该组合物包含:(A)胰岛素;(B)渗透增强剂;以及(C)使其中的组合物为酸性pH的液体载体。
申请者已发现在采用含有胰岛素和渗透增强剂的组合的组合物时,当该组合物在酸性pH值时能获得改良效果。
本发明进一步涉及用胰岛素、渗透增强剂以及液体载体的组合物治疗需要胰岛素的患者;该组合物具有不超过4.5的酸性pH。所述组合物优选的pH为不大于4也不低于2。pH优选至少为2。
通常,该组合物的pH至少为2并且不大于4.5。在优选实施方案中,所述pH为不大于4。优选的pH范围为2.5-3.8。在一个优选实施方案中所述pH约为3。
所述组合物的pH可以通过采用适合的缓冲剂维持。维持所需pH的缓冲剂的选择是在此处所述的本领域技术人员的知识范围内的。作为适合的缓冲剂的代表性实例可能提及一般使用的并且适于药物制剂的柠檬酸缓冲剂、磷酸缓冲剂等。
通常,所用的渗透增强剂为增强胰岛素组合物穿透体腔膜的物质。
通常,所用的渗透增强剂为增强胰岛素组合物透过体腔膜特别是透过鼻粘膜的物质。
在包含有效量胰岛素的组合物中,优选的渗透增强剂为具有以下结构的化合物:
其中的X和Y为氧、硫或具以下结构的亚氨基基团:
或者=N-R,条件是当Y为亚氨基时,X为亚氨基,并且当Y为硫时,X为硫或亚氨基,A为具以下结构的基团
其中的X和Y为上述定义,m和n为具有1-20数值的整数并且m+n的和不大于25,p为具有0或1数值的整数,q为具有0或1数值的整数,r为具有0或1数值的整数,并且R、R1、R2、R3、R4、R5和R6各自独立为氢或具有1-6个碳原子的直链或支链的烷基基团(条件是R1-R6中只有一个可为烷基基团),并且条件是当p、q和r具有数值0并且Y为氧、m+n至少为11并且进一步条件是当X为亚氨基、q等于1、Y为氧并且p和r为0,则m+n至少为11,所述化合物将会增加药物穿透体膜的速率。在下文中这些化合物称为增强剂。当R、R1、R2、R3、R4、R5或R6为烷基时,它可以为甲基、乙基、丙基、异丙基、丁基、异丁基、仲丁基、戊基、己基等。在美国专利5,023,252和美国专利5,731,303中描述了此类渗透增强剂。
优选地,本发明化合物为环内酯类(其中X和Y为氧,q为1并且r为0的化合物)、环二酯类(其中X和Y为氧,并且q和r都为1的化合物)以及环酮类(其中q和r均为0并且Y为氧的化合物)。在环二酯类中,m+n优选至少为3。在环酮类中,m+n优选为11-15并且p优选为0。
具上述结构式的增强剂本文称为“Hsieh增强剂”,并在上述提及的美国专利5,023,252和5,731,303(下文的“Hsieh专利”)中有描述。此类增强剂为亲脂性的并且为“膜-兼容性的”,意味着它们不会对本发明组合物所要作用的膜(下文“靶膜”)造成破坏。该类增强剂对靶膜产生低水平的刺激性或无刺激性,实际上还充当软化剂。
本发明所使用的优选增强剂为大环增强剂。此外所用的术语“大环”指在环内具有至少12个碳原子的环化合物。本发明所用的优选的大环增强剂的实例包括:(A)大环酮类,例如,3-甲基环十五酮(麝香酮)、9-环十七碳烯(cycloheptadecen)-1-酮(灵猫酮)、环十六酮(cyclohexadecanone)和环十五酮(去甲麝香酮);和(B)大环酯类,例如,十五酸内酯如氧杂环十六烷-2-酮(oxacyclohexadecan-2-one)(环十五烷内酯(cyclopentadecanolide,ω-十五酸内酯)。
氧杂环十六烷-2-酮和环十五烷酮为特别优选的。
尽管上述为优选的渗透增强剂,在本领域内普通的技术人员会知道本文讲述内容也适用于其它渗透增强剂。在本发明中有效的其它渗透增强剂的非-限制性实例为在不同药典中的“一般认为安全”(GRAS)的简单长链酯类。这些可能包括简单脂肪族、非饱和或饱和的(但优选饱和的)酯类,其含有最多为中长链。此类酯类的非限制性实例包括肉豆蔻酸异丙酯、棕榈酸异丙酯、肉豆蔻酸肉豆蔻酯、棕榈酸辛酯等。所述的增强剂为适于在药用组合物中使用的类型。普通技术工人会知道那些粘膜不相容的或刺激粘膜的物料都应该避免。
所述增强剂以有效增强胰岛素穿透膜而释放的浓度存在于所述组合物中。在确定增强剂的使用量时应该进行各种考虑。此类考虑包括,例如,所达到的流出量(通过膜的速率)、稳定性以及在制剂中各成分的兼容性。所述的增强剂通常使用量为组合物重量的约0.01-25%,更通常为组合物重量的约0.1-15%,在优选实施方案中为约组合物重量的0.5-15%。
所述液体载体以可以有效作为组合物合适载体的浓度存在于组合物中的。通常,所述载体的使用量约为组合物重量40-98%,在优选实施方案中的量约为组合物重量的50-98%。
本发明的胰岛素组合物优选以鼻喷雾释放。在此实施方案中,优选的液体载体为水,而治疗有效量的胰岛素分散或溶解于其中。
在一个优选实施方案中,所述的渗透增强剂在包含胰岛素的水相中乳化。所述乳化可以通过采用一或多种合适的表面活性剂完成。合适的表面活性剂的选择是本领域技术人员根据本文讲述内容能够完成的。本质上任何合适的表面活性剂或表面活性剂混合物可以在本发明实践中应用,包括,例如,阴离子的、阳离子的和非离子的表面活性剂。优选的表面活性剂为非离子的表面活性剂,那些具有亲水-亲脂平衡(HLB)约7-14的为特别优选的。此类非离子表面活性剂的实例为PEG-60玉米甘油酯、PEG-20脱水山梨醇一硬脂酸酯、苯氧基-聚(乙烯氧基)乙醇、脱水山梨糖醇一油酸酯等。特别优选的是典载(compendial)表面活性剂,如那些在如食品化学索引、美国国家药品集、美国药典以及联邦法规法典等典籍中描述的表面活性剂。优选的乳滴平均直径为约500mn-20μm并优选为约1μm-10μm。通常所述表面活性剂以不超过组合物重量2%的量存在,并且更常见不超过组合物重量的0.5%。
在其中一个优选实施方案中,包含渗透增强剂的乳化或不连续相为液滴形式。通常,越小的液滴带来越高的稳定性。较大的液滴可能导致不稳定并且降低储存期。在优选的实施方案中,液滴的尺寸范围是0.1微米-20微米并优选0.1-5微米。
包含胰岛素的组合物一般储存在冰箱中,而此类冷藏可能导致渗透抑制剂的结晶。为了抑制或避免此类结晶,在一个优选实施方案中,所述组合物包括一或多种结晶抑制剂以抑制渗透增强剂的结晶。如果任由结晶进行,则会导致乳剂不稳定并对储存期具有不良影响。优选的结晶抑制剂的作用在于降低所涉及化合物的结晶温度。此类结晶抑制剂的实例包括天然油类、含油物质、蜡类、酯类和烃类。天然油类或含油物质的实例包括乙酸维生素E酯、棕榈酸辛酯、芝麻油、豆油、红花油、鳄梨油、棕榈油以及棉子油。适合的结晶抑制剂的选择被认为是在本领域内那些技术人员根据本文讲述内容能够完成的。优选的结晶抑制剂功能在于降低渗透增强剂的结晶温度。
能将所涉及化合物的结晶温度降低到低于约25℃的抑制剂为特别优选的,能将所涉及化合物结晶温度降至低于约5℃的为特别优选的。特别优选用于抑制氧杂环十六烷-2-酮(oxacyclohexadecan-2-one)结晶的结晶抑制剂实例包括十六烷、十四烷酸异丙酯、十六烷酸辛酯、棉子油、红花油和乙酸维生素E酯,各自可以在药用制剂中使用。
所述结晶抑制剂以有效抑制渗透增强剂结晶的浓度存在于组合物中。通常的结晶抑制剂以约0.001-5%的组合物重量存在,更通常以约0.01-2%的组合物重量的量存在。在一个优选实施方案中结晶抑制剂是以约0.1-1%的组合物重量的量存在。当所述增强剂具有的结晶温度高于约0摄氏度时优选使用所述的结晶抑制剂。特别地,例如,当增强剂为十五酸内酯和/或环十六烷酮时优选使用结晶抑制剂,因为这些是在室温之上结晶的。
本发明的组合物通常通过鼻喷雾给药器释放。如果需要鼻内应用,该组合物可以置于鼻内喷雾给药装置或雾化器中并通过在患者鼻内喷雾应用使释放至鼻粘膜。应用足够量以达到所需的全身或局部水平。对于鼻内喷雾,多达约200微升为典型应用,应用约50-150微升为优选的。可以对一或多个鼻孔给药并且当需要时或者必须时即可进行应用。在优选实施方案中,选择提供组合物液滴平均大小在约10微米-200微米的鼻喷雾给药器。更通常,液滴大小为约30微米-100微米。
本发明的胰岛素喷雾组合物通常应用于根据所治疗的患者制定的给药方案中。因此,使用频率和剂量可能是患者与患者之间不同的。通常,剂量是在约3IU-15IU的数量(从鼻粘膜吸收后的内化量)并且给药频率是每天3-4次。本领域内已知,对于象通过胰岛素治疗的糖尿病这类疾病的治疗是患者与患者不同的,在己知胰岛素疗法以及在本文讲述内容基础上,本领域内技术人员可以为特定患者或患者群选择给药方案和剂量。
本发明组合物包含胰岛素。所述胰岛素以治疗有效量存在于组合物中。通常所述胰岛素以组合物重量的约0.01-15%的量存在,更通常为组合物重量的约0.01-10%的量存在。在一个实施方案中,所述胰岛素以组合物重量的约0.1-5%存在。
尽管优选实施方案为预先形成剂型的组合物,但用上述未预先形成剂型的组合物治疗患者也是在本发明范围内的;即,在液体载体中的胰岛素和增强剂可以在应用的时候混合,如在喷射所述组合物时在雾化器中进行混合。
以下实施例说明了本发明优选实施方案而并不被视为限制。
实施例1
本发明的四种独立的水性胰岛素乳剂(制剂A、B、C和D)按下表中所描述的配方制备。成分CPE-215为申请者的专利化合物,也称为环十五酸内酯;它促进胰岛素透过鼻粘膜。
实例例2
C-肽血液水平可以指示一个人是否正在产生胰岛素并大概估计有多少。胰岛素是在胰腺中首先以胰岛素原合成的。在该形式中,活性胰岛素的α和β链通过第三个被称之为连接肽或简称为C-肽的多肽链所连接。由于胰岛素和C-肽分子都会被分泌,对于在血液中的每一个胰岛素分子,都会有一个C-肽。因此,在血液中的C-肽水平可以被测量并且被用作在某些情况下胰岛素产生的指示剂,即其中外源性胰岛素(来自注射)存在并且与内源性胰岛素混合(由机体产生)的情况下,会使得胰岛素本身的测量变得无意义。C-肽检测还可以用于帮助评估高血糖是否是由于胰岛素产生减少或者是由于细胞摄取葡萄糖减少。在1型糖尿病人的血液中有很少的或无C-肽,而在2型糖尿病中的C-肽水平可以是降低或正常的。在非-糖尿病中的C-肽的浓度在0.5-3.0ng/ml水平。
本发明组合物的评估在体内进行,如下所述。
鼻内CPE-215/胰岛素制剂在Yucatan小型猪中的药动学和药效学
本研究是按NIH的《实验动物的照料和使用指南》(“Guide For theCare and Use of Laboratory Animals”以及联邦动物福利法规进行的,并且是按New Hampshire Institutional动物照料和使用委员会所批准的规程进行。本研究的目的是为了评估和描绘胰岛素制剂在鼻内释放给Yucatan小型猪后的药动学和药代学。
此前,它在beagles(Hseih,1993)中已被确定,环十五烷内酯促进胰岛素穿透鼻粘膜。为了在小型猪上验证这一点,作为评估志愿者的一个步骤,就胰岛素血液水平和葡萄糖动态变化(glucodynamics)评估了制剂。
材料、方法和制剂
被检测制剂为水性胰岛素乳剂,含有药用级人重组胰岛素,得自Diosynth,Inc.,为Akzo Nobel,Inc.的分公司。这些制剂在组成上有轻微不同;然而,每个包含1%w/w胰岛素和2%w/w CPE-215。这些制剂从鼻内雾化器中给药,由美国Valois为人类所开发。预先用内置颈导管插管的每头猪各喷给100微升两揿。每100微升喷雾含1微克或大约25IU胰岛素。采用了驱动器延长器,也是由美国Valois提供的,其使用的必要性(为了将制剂输送至前庭和迷路鼻甲区的吸收表面)已在先前小规模研究中被确定。相同的喷出100微升的驱动器,与相连的延长器一起使用。这些鼻内释放给药与作为阳性对照的3个单位的皮下注射(SQ)胰岛素进行对照。
动物方案
购自UNH Miniature Swine Research Farm的四只雌性Yucatan小型猪,在整个研究过程中,这些猪被饲养在一个控制环境的动物研究房内(温度25+/-2℃并12小时/光/黑暗循环),饲以商业研究猪食,并且所有时候都可自由喝水。这些猪为21周大的Yucatan雌猪:
猪#1,Tag 121-5;研究开始时重量:16.8kg;DOB 11/26/02
猪#2,Tag 121-4;研究开始时重量:22.3kg;DOB 11/26/02(注:#1和#2为同窝出生仔畜)
猪#3,Tag 122-7;研究开始时重量:18.3kg;DOB 12/1/02
猪#4,Tag 122-9;研究开始时重量:15.5kg;DOB 12/1/02[注:#3和#4为同窝出生仔畜]
导管插入方法学
带有外科植入的颈动脉插管动物在研究开始前4-6天准备。在静脉内注入大镇静量的赛拉嗪和氯胺酮后,上述动物被掩蔽(maskeddown)并在吸入异氟烷(isofluorane)麻药和氧气下维持深度外科麻醉的效果。在脊麻醉下的动物,在右颈动脉沟进行皮肤切口,随后通过钝器解剖皮下和血管周围结缔组织以暴露出胸入口的右颈静脉颅侧。长度为0.050英寸的钻孔的Tygon静脉内导管通过一个在夹紧的血管和在尾部安置的小切口穿过前面的腔静脉(离颈静脉切口大约12-15cm)。该导管穿过颈静脉并且深部皮下组织缝合。该颈静脉导管颅侧以聚丙烯缝合线结扎。导管的游离末端以钝器解剖法穿过皮下组织通入肩胛背,穿过小的皮肤切口并通过聚丙烯缝合线与皮肤固定。该导管盖以注射器对接装置并且用抗血栓制剂进行填充。该抗血栓剂由60%(w/v)聚乙烯吡咯烷酮(10,000mw,PVP-10)和生理盐水/肝素钠(每100mL 50,000单位肝素)组成。皮下组织和在颈静脉沟中的皮肤切口用合成的可吸收的和聚丙烯缝合线分别缝合。所述动物被舒适地绷紧以保护导管和皮肤切口并且披上为了狗导管工作而制备的背心。肌注布托啡诺作为手术时和手术后12小时的止痛剂。
实验设计
在给药时,上述猪在布悬带中束缚。这些猪然后在各自单独的围栏中自由行动并且仅在采血的时候暂时地用可移动的木门束缚在该围栏前部的封闭区域。每头猪在两个星期周期内,四种不同制剂每个给药2次并且两次治疗中间间隔至少18小时。鼻内给药(制剂B、C、D)通过气雾定量器(人用型鼻内雾化器)限定喷射100μL 1%的胰岛素乳剂,每个鼻孔各一次(总剂量50IU),或者皮下给药(制剂A),采用配有22ga.针头的1cc无菌注射器(3IU)注入1200μL 0.1%缓冲的无菌溶液。猪之间的给药间隔计时,并且大约是5分钟。
在静脉或SQ胰岛素给药之前收集基准静脉血样,并且随后在用药后0(刚在治疗前)、15、30、45、60、90、120和180分钟采血样。猪之间的采血间隔大约5分钟,按给药时间相应调节该间隔在目标时间的1分钟内。每头猪以手提式商业葡萄糖计量器在每个采血时间点进行监控以确保动物的健康。
血液被收集在钠肝素化的玻璃管中。回收血浆并贮藏在-20℃直到对胰岛素、C-肽和葡萄糖进行分析。有8天的治疗时间,每天治疗4头猪。每头猪每天按下表接受不同的治疗以对猪进行相互交叉(两个连续的同等拉丁方(identical latin squares)):
治疗表
治疗/天数
天数 | 猪1 | 猪2 | 猪3 | 猪4 |
1 | A | B | C | D |
2 | B | C | D | A |
3 | C | D | A | B |
4 | D | A | B | C |
5 | A | B | C | D |
6 | B | C | D | A |
7 | C | D | A | B |
8 | D | A | B | C |
样品收集和分析方法
采用商业RIA胰岛素分析(Linco研究,Inc.;人胰岛素特效RIS试剂盒,Cat#HI-14K)对肝素化血浆进行胰岛素浓度分析。胰岛素以微国际单位)/毫升血浆(μU/mL)报告。采用商业猪C-肽特异性试剂盒(Linco研究,Inc.;猪C-肽RIA试剂盒,Cat#PCP-22K)分析C-肽并以ng/mL为单位报告。
收集各时间点的葡萄糖采用葡萄糖计量器(Lifescan(J&J)OneTouch Fast TakeTM)测量,并且在实验室中采用商业酶分析(SigmaDiagnostics,Procedure 315)并且以mg/dL计。
偏离方案
未偏离方案
葡萄糖结果
在血液中通过己糖激酶方法测量,所得结果表明血液葡萄糖值良性下降,并历史性地与阳性对照SQ胰岛素相当;该SQ剂量在给药后(Post Rx)平均30分钟达到最低葡萄糖水平。对于鼻内制剂B,观察到极好的葡萄糖动态降低,其起效更加快速,15分钟或更快即达谷底,但比SQ(180分钟)持续时间短性(90-120分钟)。制剂C具有与B类似的快速起效,但具有较小值。D制剂缺乏可评估的葡萄糖动态活性。其重现性,包括剂量内和日间剂量,都很好(任何治疗无显著性差异,P<0.05)。(见图1)
酶法葡萄糖试验与相应的在血液收集时间进行的葡萄糖计量结果相关性良好(r=0.9575;p<0.0001)。
胰岛素结果
结果显示制剂A,SQ阳性对照良好的胰岛素血液水平,在15分钟具有平均Cmax为59.85μU/mL的平均峰值。(见图2)。
制剂B显示出远高于任何其它制剂的血液水平,在15分钟具有平均Cmax为182.4μU/mL。(见图2)
制剂C显示出比A或B低的血液水平,表明与酸性形式相比,在生理学pH时胰岛素释放降低,在15分钟时Cmax为64.59μU/mL。(见图2)
制剂D显示出较之禁食的基线水平的微小变化。未观察到Cmax。(见图2)。
C-肽结果
对于禁食的、未经处理的动物(0时间)的C-肽平均为0.35ng/mL(n=36)。四种治疗作用开始与各自得到的葡萄糖动态曲线是类似的。治疗B具有更快的C-肽衰退开始,接着为A,然后C,最后D。治疗A具有最长的C-肽衰退,大约3小时,然而其它的治疗在此时之前具有正常水平,反映出内源性胰岛素产生的恢复。
图1是示出了给予根据本发明的制剂A、B、C和D的葡萄糖试验结果的曲线图;
图2是示出了给予根据本发明的制剂A、B、C和D的胰岛素试验结果的曲线图。
Claims (18)
1.一种适于以经鼻给药形式给予患者的药用组合物,包含:治疗有效量的胰岛素、渗透增强剂以及液体载体,所述渗透增强剂为具有以下结构的Hsieh增强剂:
其中X和Y为氧、硫或具有以下结构的亚氨基:
或=N-R,条件是当Y为亚氨基时,X为亚氨基,而当Y为硫时,X为硫或亚氨基,A为具有以下结构的基团
其中X和Y定义同上,m和n为1-20的整数且m+n的和不超过25,p为0或1,q为0或1,r为0或1,且R、R1、R2、R3、R4、R5和R6各自独立为氢或具有1-6个碳原子的直链或支链烷基,条件是R1-R6中仅有一个可为烷基,须满足的前提是当p、q和r为0,且Y为氧时,则m+n至少为11,且更一步的前提是当X为亚氨基,q等于1,Y为氧,且p和r为0时,则m+n至少为11;
其中在给予所述药用组合物后约60分钟内血浆葡萄糖水平存在至少约30%的降低。
2.权利要求1的药用组合物,其中在给予所述药用组合物后约60分钟内血浆葡萄糖水平存在至少约40%的降低。
3.权利要求2的药用组合物,其中在给予所述药用组合物后约60分钟内血浆葡萄糖水平存在至少约50%的降低。
4.权利要求1的药用组合物,其中在给予所述药用组合物后约50分钟内血浆葡萄糖水平存在至少约30%的降低。
5.权利要求4的药用组合物,其中在给予所述药用组合物后约40分钟内血浆葡萄糖水平存在至少约30%的降低。
6.权利要求5的药用组合物,其中在给予所述药用组合物后约30分钟内血浆葡萄糖水平存在至少约30%的降低。
7.一种适于以经鼻给药形式给予患者的药用组合物,包含:治疗有效量的胰岛素、渗透增强剂以及液体载体,所述渗透增强剂为具有以下结构的Hsieh增强剂:
其中X和Y为氧、硫或具有以下结构的亚氨基:
或=N-R,条件是当Y为亚氨基时,X为亚氨基,而当Y为硫时,X为硫或亚氨基,A为具有以下结构的基团
其中X和Y定义同上,m和n为1-20的整数且m+n的和不超过25,p为0或1,q为0或1,r为0或1,且R、R1、R2、R3、R4、R5和R6各自独立为氢或具有1-6个碳原子的直链或支链烷基,条件是R1-R6中仅有一个可为烷基,须满足的前提是当p、q和r为0,且Y为氧时,则m+n至少为11,且更一步的前提是当X为亚氨基,q等于1,Y为氧,且p和r为0时,则m+n至少为11;
其中在给予所述药用组合物后约30分钟内血浆胰岛素水平存在至少约2倍的增加。
8.权利要求7的药用组合物,其中在给予所述药用组合物后约30分钟内血浆胰岛素水平存在至少约3倍的增加。
9.权利要求8的药用组合物,其中在给予所述药用组合物后约30分钟内血浆胰岛素水平存在至少约4倍的增加。
10.权利要求9的药用组合物,其中在给予所述药用组合物后约30分钟内血浆胰岛素水平存在至少约5倍的增加。
11.权利要求7的药用组合物,其中在给予所述药用组合物后约20分钟内血浆胰岛素水平存在至少约2倍的增加。
12.权利要求11的药用组合物,其中在给予所述药用组合物后约15分钟内血浆胰岛素水平存在至少约2倍的增加。
13.一种适于以经鼻给药形式给予患者的药用组合物,其包含:治疗有效量的胰岛素、渗透增强剂以及液体载体,所述渗透增强剂为具有以下结构的Hsieh增强剂:
其中X和Y为氧、硫或具有以下结构的亚氨基:
或=N-R,条件是当Y为亚氨基时,X为亚氨基,而当Y为硫时,X为硫或亚氨基,A为具有以下结构的基团
其中X和Y定义同上,m和n为1-20的整数且m+n的和不超过25,p为0或1,q为0或1,r为0或1,且R、R1、R2、R3、R4、R5和R6各自独立为氢或具有1-6个碳原子的直链或支链烷基,条件是R1-R6中仅有一个可为烷基,须满足的前提是当p、q和r为0,且Y为氧时,则m+n至少为11,且更一步的前提是当X为亚氨基,q等于1,Y为氧,且p和r为0时,则m+n至少为11;
其中在给予所述药用组合物后血浆葡萄糖水平存在至少约10%的降低并且其中所述降低的持续时间为约30分钟至约120分钟。
14.权利要求13中的药用组合物,其中所述降低在给予所述药用组合物后的持续时间为约70分钟至约120分钟。
15.权利要求13中的药用组合物,其中所述降低在给予所述药用组合物后的持续时间为约30分钟至约70分钟。
16.权利要求13中的药用组合物,其中在给予所述药用组合物后血浆葡萄糖水平存在至少约20%的降低并且其中所述降低的持续时间为约30分钟至约90分钟。
17.权利要求16中的药用组合物,其中所述降低在给予所述药用组合物后的持续时间为约45分钟至约90分钟。
18.权利要求16中的药用组合物,其中所述降低在给予所述药用组合物后的持续时间为约30分钟至约60分钟。
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- 2006-07-06 NO NO20063135A patent/NO330737B1/no not_active IP Right Cessation
- 2006-08-24 US US11/509,417 patent/US7651996B2/en active Active
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2007
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2008
- 2008-12-18 US US12/337,924 patent/US20090156464A1/en not_active Abandoned
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2009
- 2009-07-15 JP JP2009166623A patent/JP2009292820A/ja active Pending
- 2009-11-06 US US12/614,335 patent/US8044020B2/en not_active Expired - Fee Related
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2010
- 2010-09-10 AU AU2010219399A patent/AU2010219399A1/en not_active Abandoned
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