US20140274991A1 - Ceftolozane pharmaceutical compositions - Google Patents
Ceftolozane pharmaceutical compositions Download PDFInfo
- Publication number
- US20140274991A1 US20140274991A1 US14/213,532 US201414213532A US2014274991A1 US 20140274991 A1 US20140274991 A1 US 20140274991A1 US 201414213532 A US201414213532 A US 201414213532A US 2014274991 A1 US2014274991 A1 US 2014274991A1
- Authority
- US
- United States
- Prior art keywords
- ceftolozane
- pharmaceutical composition
- sodium
- sodium chloride
- composition
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
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- JHFNIHVVXRKLEF-DCZLAGFPSA-N ceftolozane Chemical compound CN1C(N)=C(NC(=O)NCCN)C=[N+]1CC1=C(C(O)=O)N2C(=O)[C@@H](NC(=O)C(=N/OC(C)(C)C([O-])=O)\C=3N=C(N)SN=3)[C@H]2SC1 JHFNIHVVXRKLEF-DCZLAGFPSA-N 0.000 title claims abstract description 136
- 229960002405 ceftolozane Drugs 0.000 title claims abstract description 107
- 239000008194 pharmaceutical composition Substances 0.000 title claims abstract description 65
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims abstract description 144
- 239000011780 sodium chloride Substances 0.000 claims abstract description 71
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 claims description 41
- 239000000203 mixture Substances 0.000 claims description 41
- 239000011734 sodium Substances 0.000 claims description 41
- 229910052708 sodium Inorganic materials 0.000 claims description 41
- 229960001995 ceftolozane sulfate Drugs 0.000 claims description 28
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 claims description 27
- 238000004128 high performance liquid chromatography Methods 0.000 claims description 24
- 239000012535 impurity Substances 0.000 claims description 21
- 238000000034 method Methods 0.000 claims description 16
- 239000007864 aqueous solution Substances 0.000 claims description 12
- 239000002552 dosage form Substances 0.000 claims description 12
- WEVYAHXRMPXWCK-UHFFFAOYSA-N Acetonitrile Chemical compound CC#N WEVYAHXRMPXWCK-UHFFFAOYSA-N 0.000 claims description 10
- LPQZKKCYTLCDGQ-WEDXCCLWSA-N tazobactam Chemical compound C([C@]1(C)S([C@H]2N(C(C2)=O)[C@H]1C(O)=O)(=O)=O)N1C=CN=N1 LPQZKKCYTLCDGQ-WEDXCCLWSA-N 0.000 claims description 10
- ODKSFYDXXFIFQN-BYPYZUCNSA-N L-arginine Chemical compound OC(=O)[C@@H](N)CCCN=C(N)N ODKSFYDXXFIFQN-BYPYZUCNSA-N 0.000 claims description 9
- 229930064664 L-arginine Natural products 0.000 claims description 9
- 235000014852 L-arginine Nutrition 0.000 claims description 9
- 239000007853 buffer solution Substances 0.000 claims description 9
- 238000004108 freeze drying Methods 0.000 claims description 9
- BAZAXWOYCMUHIX-UHFFFAOYSA-M sodium perchlorate Chemical compound [Na+].[O-]Cl(=O)(=O)=O BAZAXWOYCMUHIX-UHFFFAOYSA-M 0.000 claims description 9
- 229910001488 sodium perchlorate Inorganic materials 0.000 claims description 9
- 229960003865 tazobactam Drugs 0.000 claims description 9
- 206010035664 Pneumonia Diseases 0.000 claims description 8
- 208000015181 infectious disease Diseases 0.000 claims description 6
- 230000014759 maintenance of location Effects 0.000 claims description 6
- 238000007911 parenteral administration Methods 0.000 claims description 6
- 230000008569 process Effects 0.000 claims description 5
- 208000036209 Intraabdominal Infections Diseases 0.000 claims description 4
- 238000004519 manufacturing process Methods 0.000 claims description 4
- 208000019206 urinary tract infection Diseases 0.000 claims description 4
- 239000000243 solution Substances 0.000 description 23
- 239000000523 sample Substances 0.000 description 11
- 239000003814 drug Substances 0.000 description 10
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 9
- 229940079593 drug Drugs 0.000 description 9
- 238000009472 formulation Methods 0.000 description 9
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 9
- 229930186147 Cephalosporin Natural products 0.000 description 7
- 229940124587 cephalosporin Drugs 0.000 description 7
- 239000000843 powder Substances 0.000 description 7
- 150000003839 salts Chemical class 0.000 description 7
- 239000000126 substance Substances 0.000 description 7
- 150000001780 cephalosporins Chemical class 0.000 description 6
- 239000008215 water for injection Substances 0.000 description 6
- 208000035143 Bacterial infection Diseases 0.000 description 5
- 241000124008 Mammalia Species 0.000 description 5
- 208000022362 bacterial infectious disease Diseases 0.000 description 5
- 150000001875 compounds Chemical class 0.000 description 5
- 238000004090 dissolution Methods 0.000 description 5
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- 239000002033 PVDF binder Substances 0.000 description 4
- 238000001035 drying Methods 0.000 description 4
- 238000011049 filling Methods 0.000 description 4
- 238000002347 injection Methods 0.000 description 4
- 239000007924 injection Substances 0.000 description 4
- 238000001990 intravenous administration Methods 0.000 description 4
- 239000012528 membrane Substances 0.000 description 4
- 229920002981 polyvinylidene fluoride Polymers 0.000 description 4
- 239000003381 stabilizer Substances 0.000 description 4
- 238000011146 sterile filtration Methods 0.000 description 4
- 238000012546 transfer Methods 0.000 description 4
- QTBSBXVTEAMEQO-UHFFFAOYSA-N Acetic acid Chemical compound CC(O)=O QTBSBXVTEAMEQO-UHFFFAOYSA-N 0.000 description 3
- 241000606768 Haemophilus influenzae Species 0.000 description 3
- 238000004458 analytical method Methods 0.000 description 3
- 230000003115 biocidal effect Effects 0.000 description 3
- 229940126600 bulk drug product Drugs 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 229940088679 drug related substance Drugs 0.000 description 3
- 239000000706 filtrate Substances 0.000 description 3
- 238000001802 infusion Methods 0.000 description 3
- 238000004806 packaging method and process Methods 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 239000012488 sample solution Substances 0.000 description 3
- 239000007787 solid Substances 0.000 description 3
- 238000012360 testing method Methods 0.000 description 3
- 241000588626 Acinetobacter baumannii Species 0.000 description 2
- IJGRMHOSHXDMSA-UHFFFAOYSA-N Atomic nitrogen Chemical compound N#N IJGRMHOSHXDMSA-UHFFFAOYSA-N 0.000 description 2
- 241000606124 Bacteroides fragilis Species 0.000 description 2
- 108090000204 Dipeptidase 1 Proteins 0.000 description 2
- 208000008745 Healthcare-Associated Pneumonia Diseases 0.000 description 2
- 241000588747 Klebsiella pneumoniae Species 0.000 description 2
- 108700020474 Penicillin-Binding Proteins Proteins 0.000 description 2
- 241000589517 Pseudomonas aeruginosa Species 0.000 description 2
- 241000191967 Staphylococcus aureus Species 0.000 description 2
- 239000008186 active pharmaceutical agent Substances 0.000 description 2
- 239000000654 additive Substances 0.000 description 2
- 239000003242 anti bacterial agent Substances 0.000 description 2
- 230000000844 anti-bacterial effect Effects 0.000 description 2
- 230000001580 bacterial effect Effects 0.000 description 2
- 239000003781 beta lactamase inhibitor Substances 0.000 description 2
- 102000006635 beta-lactamase Human genes 0.000 description 2
- 229940126813 beta-lactamase inhibitor Drugs 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 239000003085 diluting agent Substances 0.000 description 2
- 238000011156 evaluation Methods 0.000 description 2
- 238000001914 filtration Methods 0.000 description 2
- 238000012792 lyophilization process Methods 0.000 description 2
- 244000005700 microbiome Species 0.000 description 2
- VLTRZXGMWDSKGL-UHFFFAOYSA-N perchloric acid Chemical compound OCl(=O)(=O)=O VLTRZXGMWDSKGL-UHFFFAOYSA-N 0.000 description 2
- 239000000546 pharmaceutical excipient Substances 0.000 description 2
- 229960002292 piperacillin Drugs 0.000 description 2
- WCMIIGXFCMNQDS-IDYPWDAWSA-M piperacillin sodium Chemical compound [Na+].O=C1C(=O)N(CC)CCN1C(=O)N[C@H](C=1C=CC=CC=1)C(=O)N[C@@H]1C(=O)N2[C@@H](C([O-])=O)C(C)(C)S[C@@H]21 WCMIIGXFCMNQDS-IDYPWDAWSA-M 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 238000011160 research Methods 0.000 description 2
- 238000012430 stability testing Methods 0.000 description 2
- 238000011179 visual inspection Methods 0.000 description 2
- 238000005406 washing Methods 0.000 description 2
- 229940126085 β‑Lactamase Inhibitor Drugs 0.000 description 2
- JHFNIHVVXRKLEF-DCZLAGFPSA-O (6r,7r)-3-[[3-amino-4-(2-aminoethylcarbamoylamino)-2-methylpyrazol-1-ium-1-yl]methyl]-7-[[(2z)-2-(5-amino-1,2,4-thiadiazol-3-yl)-2-(2-carboxypropan-2-yloxyimino)acetyl]amino]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid Chemical compound CN1C(N)=C(NC(=O)NCCN)C=[N+]1CC1=C(C(O)=O)N2C(=O)[C@@H](NC(=O)C(=N/OC(C)(C)C(O)=O)\C=3N=C(N)SN=3)[C@H]2SC1 JHFNIHVVXRKLEF-DCZLAGFPSA-O 0.000 description 1
- BDKLKNJTMLIAFE-UHFFFAOYSA-N 2-(3-fluorophenyl)-1,3-oxazole-4-carbaldehyde Chemical compound FC1=CC=CC(C=2OC=C(C=O)N=2)=C1 BDKLKNJTMLIAFE-UHFFFAOYSA-N 0.000 description 1
- NDIURPSCHWTXDC-UHFFFAOYSA-N 2-(4,5-dimethoxy-2-nitrophenyl)acetohydrazide Chemical compound COC1=CC(CC(=O)NN)=C([N+]([O-])=O)C=C1OC NDIURPSCHWTXDC-UHFFFAOYSA-N 0.000 description 1
- 241001135228 Bacteroides ovatus Species 0.000 description 1
- 241000606123 Bacteroides thetaiotaomicron Species 0.000 description 1
- 241000599985 Beijerinckia mobilis Species 0.000 description 1
- YVZLNGIGXCWYHR-VBPSCSMUSA-N CN1C(N)=C(NC(=O)NCN)C=[N+]1CC1=C(C(=O)O)N2C(=O)[C@@H](CC(=O)/C(=N\OC(C)(C)C(=O)O)C3=NSC(N)=N3)[C@H]2SC1.O=[SH](=O)O[O-] Chemical compound CN1C(N)=C(NC(=O)NCN)C=[N+]1CC1=C(C(=O)O)N2C(=O)[C@@H](CC(=O)/C(=N\OC(C)(C)C(=O)O)C3=NSC(N)=N3)[C@H]2SC1.O=[SH](=O)O[O-] YVZLNGIGXCWYHR-VBPSCSMUSA-N 0.000 description 1
- VEXZGXHMUGYJMC-UHFFFAOYSA-M Chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 description 1
- 241000588917 Citrobacter koseri Species 0.000 description 1
- 241000193468 Clostridium perfringens Species 0.000 description 1
- 241000194032 Enterococcus faecalis Species 0.000 description 1
- 241000588724 Escherichia coli Species 0.000 description 1
- 201000008225 Klebsiella pneumonia Diseases 0.000 description 1
- 241000588655 Moraxella catarrhalis Species 0.000 description 1
- 241000588772 Morganella morganii Species 0.000 description 1
- 241000588652 Neisseria gonorrhoeae Species 0.000 description 1
- 241000606210 Parabacteroides distasonis Species 0.000 description 1
- 206010035717 Pneumonia klebsiella Diseases 0.000 description 1
- 241001135223 Prevotella melaninogenica Species 0.000 description 1
- 241000588770 Proteus mirabilis Species 0.000 description 1
- 241000588767 Proteus vulgaris Species 0.000 description 1
- 241000588777 Providencia rettgeri Species 0.000 description 1
- 241000588778 Providencia stuartii Species 0.000 description 1
- 241001138501 Salmonella enterica Species 0.000 description 1
- 241000607715 Serratia marcescens Species 0.000 description 1
- 241000191963 Staphylococcus epidermidis Species 0.000 description 1
- 241000193985 Streptococcus agalactiae Species 0.000 description 1
- 201000005010 Streptococcus pneumonia Diseases 0.000 description 1
- 241000193998 Streptococcus pneumoniae Species 0.000 description 1
- 241000193996 Streptococcus pyogenes Species 0.000 description 1
- 238000010171 animal model Methods 0.000 description 1
- 230000037396 body weight Effects 0.000 description 1
- 239000000872 buffer Substances 0.000 description 1
- 210000004027 cell Anatomy 0.000 description 1
- 210000002421 cell wall Anatomy 0.000 description 1
- -1 cephalosporin (6R,7R)-3-[(5-amino-4-{[(2-aminoethyl)carbamoyl]amino}-1-methyl-1H-pyrazol-2-ium-2-yl)methyl]-7-({(2Z)-2-(5-amino-1,2,4-thiadiazol-3-yl)-2-[(1-carboxy-1-methylethoxy)imino]acetyl}amino)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate Chemical class 0.000 description 1
- 239000013522 chelant Substances 0.000 description 1
- 239000000470 constituent Substances 0.000 description 1
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- 238000000354 decomposition reaction Methods 0.000 description 1
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- 235000005911 diet Nutrition 0.000 description 1
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- 238000002845 discoloration Methods 0.000 description 1
- 239000003937 drug carrier Substances 0.000 description 1
- 229940126534 drug product Drugs 0.000 description 1
- 229940032049 enterococcus faecalis Drugs 0.000 description 1
- 230000029142 excretion Effects 0.000 description 1
- 229940047650 haemophilus influenzae Drugs 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
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- 229940076266 morganella morganii Drugs 0.000 description 1
- 229910052757 nitrogen Inorganic materials 0.000 description 1
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- 229940007042 proteus vulgaris Drugs 0.000 description 1
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- 229940083542 sodium Drugs 0.000 description 1
- 235000017281 sodium acetate Nutrition 0.000 description 1
- 239000007974 sodium acetate buffer Substances 0.000 description 1
- 229940087562 sodium acetate trihydrate Drugs 0.000 description 1
- 229960002668 sodium chloride Drugs 0.000 description 1
- IXGNPUSUVRTQGW-UHFFFAOYSA-M sodium;perchlorate;hydrate Chemical compound O.[Na+].[O-]Cl(=O)(=O)=O IXGNPUSUVRTQGW-UHFFFAOYSA-M 0.000 description 1
- 238000013112 stability test Methods 0.000 description 1
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- 238000007920 subcutaneous administration Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 229960000373 tazobactam sodium Drugs 0.000 description 1
Images
Classifications
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- 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
- A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
- A61K31/542—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
- A61K31/545—Compounds containing 5-thia-1-azabicyclo [4.2.0] octane ring systems, i.e. compounds containing a ring system of the formula:, e.g. cephalosporins, cefaclor, or cephalexine
- A61K31/546—Compounds containing 5-thia-1-azabicyclo [4.2.0] octane ring systems, i.e. compounds containing a ring system of the formula:, e.g. cephalosporins, cefaclor, or cephalexine containing further heterocyclic rings, e.g. cephalothin
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- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
- A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
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- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
- A61K31/425—Thiazoles
- A61K31/429—Thiazoles condensed with heterocyclic ring systems
- A61K31/43—Compounds containing 4-thia-1-azabicyclo [3.2.0] heptane ring systems, i.e. compounds containing a ring system of the formula, e.g. penicillins, penems
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- A61K31/425—Thiazoles
- A61K31/429—Thiazoles condensed with heterocyclic ring systems
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- A61K31/431—Compounds containing 4-thia-1-azabicyclo [3.2.0] heptane ring systems, i.e. compounds containing a ring system of the formula, e.g. penicillins, penems containing further heterocyclic rings, e.g. ticarcillin, azlocillin, oxacillin
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- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
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- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
- A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
- A61K47/183—Amino acids, e.g. glycine, EDTA or aspartame
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- A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
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- A61K31/542—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
- A61K31/545—Compounds containing 5-thia-1-azabicyclo [4.2.0] octane ring systems, i.e. compounds containing a ring system of the formula:, e.g. cephalosporins, cefaclor, or cephalexine
Definitions
- This disclosure relates to pharmaceutical compositions comprising ceftolozane.
- Ceftolozane is a cephalosporin antibacterial agent.
- the antibacterial activity of ceftolozane is believed to result from its interaction with penicillin binding proteins (PBPs) to inhibit the biosynthesis of the bacterial cell wall which acts to stop bacterial replication.
- Antibacterial pharmaceutical compositions can include ceftolozane as a pharmaceutically acceptable salt formulated for intravenous administration.
- Ceftolozane sulfate is a pharmaceutically acceptable ceftolozane salt of formula (I) that can be formulated for intravenous administration or infusion.
- the formulation of pharmaceutical compositions can be selected to minimize decomposition of the constituent drug substances and to produce a composition that is stable under a variety of storage conditions.
- a number of safe and effective injectable cephalosporin pharmaceutical compositions (e.g., as listed in FIG. 1 , Table 1) comprise up to about 85 mg of sodium per gram of cephalosporin activity (i.e., 0-85 mg sodium per gram of cephalosporin activity).
- ceftolozane sulfate pharmaceutical compositions with similar levels of sodium exhibit undesirable levels of instability as measured by high pressure liquid chromatography (HPLC) during stability testing.
- HPLC high pressure liquid chromatography
- certain ceftolozane sulfate pharmaceutical compositions were characterized by at least 1.5-fold greater formation of an additional impurity identified by a retention time of 63 minutes (“RT63 Impurity”) during a stability study as disclosed herein.
- RT63 Impurity retention time of 63 minutes
- stability testing of ceftolozane pharmaceutical compositions with lower sodium levels also resulted in greater reduction in total ceftolozane purity.
- ceftolozane sulfate pharmaceutical compositions with greater stability including improved pharmaceutical compositions that are not characterized by the RT63 Impurity after a three month stability test also described herein.
- ceftolozane pharmaceutical compositions with improved stability.
- the invention is based in part on the surprising discovery that ceftolozane in solid (e.g., powder) pharmaceutical compositions comprising about 1000 mg of ceftolozane active per 189 mg sodium from sodium chloride demonstrate improved chemical stability and purity compared with pharmaceutical compositions comprising ceftolozane with comparatively less sodium chloride.
- the invention is based in part on the discovery of the absence of the RT63 Impurity in HPLC analysis of pharmaceutical compositions comprising about 1,000 mg of ceftolozane and 189 mg sodium from sodium chloride.
- ceftolozane formulations containing an amount of ceftolozane per 189 mg of sodium from sodium chloride effective to maintain the level of RT63 Impurity below the detection limit (e.g., 0.03%) measured by HPLC using a Develosil column ODS-UG-5; 5 micrometers; 250 ⁇ 4.6 mm, a mobile phase of sodium perchlorate buffer solution (pH 2.5)/CH 3 CN 90:10 (v/v) at a 1.0 mL/min flow rate and oven temperature of 45° C.
- FIG. 1 is a table (Table 1) of FDA-approved parenteral cephalosporin antibiotic products, including the amount of sodium per 1 g of the cephalosporin antibiotic, as provided in the prescribing information.
- FIG. 2 is a diagram of a lyophilization process that can be used to obtain a lyophilized ceftolozane composition comprising sodium chloride.
- FIGS. 3A and 3B are chromatograms of ceftolozane drug substance obtained according to the analytical method described in Example 2.
- FIG. 4 is a table (Table 2) of peaks for the ceftolozane prepared by a lyophilization process obtained by HPLC according to the analytical method of Example 2.
- FIG. 5 is a table (Table 3a) showing the composition of various ceftolozane pharmaceutical compositions in which the sodium chloride concentration is varied.
- FIG. 6 is a table (Table 3b) showing data obtained by HPLC for the RT 63 impurity as detected in the pharmaceutical compositions described in FIG. 5 containing ceftolozane.
- FIG. 7 is a table (Table 4) showing the composition of various additional ceftolozane pharmaceutical compositions in which the sodium chloride content is varied.
- FIG. 8 is a table (Table 5) showing the total purity of ceftolozane in the pharmaceutical compositions of FIG. 7 , as measured by HPLC peak area according to the analytical method of described in Example 2.
- FIG. 9 is a graph showing the total purity of certain pharmaceutical compositions disclosed in FIG. 7 , as measured by HPLC peak area.
- FIG. 10 is a table (Table 6) showing the composition of various ceftolozane pharmaceutical compositions in which the sodium chloride concentration is varied.
- FIG. 11 is a table (Table 7) showing the purity of Ceftolozane in CXA-201 Compositions with varying amounts of sodium from sodium chloride at time zero, 1 day, 3 days and 7 days at 60° C.
- FIG. 12 is a table (Table 8) showing purities of ceftolozane and a control (no excipient) in a lyophilized ceftolozane and sodium chloride composition at time zero, 1 day, 3 days and 7 days at 60° C., measured by HPLC.
- Ceftolozane is the cephalosporin (6R,7R)-3-[(5-amino-4- ⁇ [(2-aminoethyl)carbamoyl]amino ⁇ -1-methyl-1H-pyrazol-2-ium-2-yl)methyl]-7-( ⁇ (2Z)-2-(5-amino-1,2,4-thiadiazol-3-yl)-2-[(1-carboxy-1-methylethoxy)imino]acetyl ⁇ amino)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate, and is also referred to as “CXA-101,” FR264205, or (6R,7R)-3-[5-Amino-4-[3-(2-aminoethyl)ureido]-1-methyl-1H-pyrazol-2-ium-2-ylmethyl]-7-[2-(5-amino-1,2,4-thiadiazol
- compositions comprising ceftolozane sulfate and about 1000 mg ceftolozane active per 189 mg sodium from sodium chloride exhibited unexpectedly improved chemical stability over the course of time and/or in the presence of heat, and less impurities than those pharmaceutical compositions comprising ceftolozane and less sodium chloride (e.g., see Example 3).
- compositions comprising ceftolozane can be formulated to treat infections by parenteral administration (including subcutaneous, intramuscular, and intravenous) administration.
- Pharmaceutical compositions may additionally comprise excipients, pH adjusting additives (e.g., buffers) and the like.
- pH adjusting additives e.g., buffers
- Non-limiting examples of these additives include citric acid and L-arginine.
- L-arginine can be used to adjust pH and to increase the solubility of ceftolozane; and citric acid can be used to prevent discoloration of the product, due to its ability to chelate metal ions.
- the pharmaceutical compositions described herein are formulated for administration by intravenous injection or infusion.
- compositions comprising ceftolozane and sodium chloride can be obtained by lyophilization.
- lyophilization is a process of freeze-drying in which water is sublimed from a frozen solution of one or more solutes. Specific methods of lyophilization are described in Remington's Pharmaceutical Sciences, Chapter 84, page 1565, Eighteenth Edition, A. R. Gennaro, (Mack Publishing Co., Easton, Pa., 1990).
- a pharmaceutical composition comprising ceftolozane can be prepared by adding sodium chloride in a fixed ratio to ceftolozane in an aqueous solution prior to lyophilization.
- the method can comprise the steps of: (1) forming a solution comprising sodium chloride and ceftolozane or a salt thereof followed by lyophilizing the solution; and (2) combining the lyophilized ceftolozane with other components (e.g., a ⁇ -lactamase inhibitor, such as tazobactam, or a lyophilized ⁇ -lactamase inhibitor, such as a lyophilized tazobactam) to obtain the pharmaceutical composition.
- the resulting pharmaceutical composition can be a powder for reconstitution to obtain an injectable pharmaceutical composition that can be intravenously administered to a patient.
- the method comprises adding about 1000 mg of ceftolozane active per 189 mg sodium from sodium chloride in an aqueous solution, then lyophilizing the solution to obtain a lyophilized material comprising sodium chloride and ceftolozane sulfate in a ratio effective to provide a product with less than 0.03% of the RT63 Impurity as detected by HPLC in Example 2.
- Another embodiment of the invention is a vial containing a unit dosage form of a pharmaceutical composition formulated for parenteral administration for the treatment of complicated intra-abdominal infections or complicated urinary tract infections.
- the vial can be obtained by a process comprising the steps of: a) lyophilizing an aqueous solution comprising about 1000 mg ceftolozane active in the form of ceftolozane sulfate per 189 mg sodium from sodium chloride and further comprising citric acid, and L-arginine to obtain a lyophilized ceftolozane composition; and b) filling a sufficient quantity of the lyophilized composition into a vial to obtain a unit dosage form comprising about 1,000 mg of ceftolozane active in the form of ceftolozane sulfate per 189 mg sodium from sodium chloride.
- the pH of the aqueous solution is 6.0 to 7.0.
- the pharmaceutical composition is formulated for parenteral administration by reconstituting the pharmaceutical composition in the vial (e.g., with 10 mL of diluent such as water for injection or isotonic saline) followed by addition of the reconstituted pharmaceutical composition to a carrier for injection (e.g., about 100 mL of isotonic saline or other pharmaceutically acceptable carrier for intravenous administration).
- a carrier for injection e.g., about 100 mL of isotonic saline or other pharmaceutically acceptable carrier for intravenous administration.
- the vial is also filled with tazobactam (e.g., a lyophilized tazobactam such as tazobactam sodium).
- the pharmaceutical composition is a solid (e.g., amorphous powder, crystal or combination thereof) obtained from a liquid composition comprising sodium chloride in an amount providing 189 mg sodium from sodium chloride, 1,000 mg of ceftolozane active and tazobactam in an amount providing about 500 mg tazobactam acid equivalent per 1,000 mg of ceftolozane active, the resulting solid pharmaceutical composition being formulated for parenteral administration and the pH of the aqueous solution is 6.0 to 7.0.
- a liquid composition comprising sodium chloride in an amount providing 189 mg sodium from sodium chloride, 1,000 mg of ceftolozane active and tazobactam in an amount providing about 500 mg tazobactam acid equivalent per 1,000 mg of ceftolozane active
- the pharmaceutical compositions can be administered for the treatment of infections, such as complicated intra-abdominal infections, complicated urinary tract infections (cUTIs) and pneumonia (e.g., community-acquired, hospital-acquired, etc).
- infections such as complicated intra-abdominal infections, complicated urinary tract infections (cUTIs) and pneumonia (e.g., community-acquired, hospital-acquired, etc).
- cUTIs complicated intra-abdominal infections
- pneumonia e.g., community-acquired, hospital-acquired, etc.
- a method for the treatment of bacterial infections in a mammal comprising administering to said mammal a therapeutically effective amount of a pharmaceutical composition comprising ceftolozane sulfate and sodium chloride.
- Non-limiting examples of bacterial infections that can be treated by the methods of the invention include infections caused by: aerobic and facultative gram-positive microorganisms (e.g., Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumonia, Streptococcus pyogenes, Viridans group streptococci ), aerobic and facultative gram-negative microorganisms (e.g., Acinetobacter baumanii, Escherichia coli, Haemophilus influenza, Klebsiella pneumonia, Pseudomonas aeruginosa, Citrobacter koseri, Moraxella catarrhalis, Morganella morganii, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Providencia stuartii
- bacterial infection is associated with one or more of the following conditions: complicated intra-abdominal infections, complicated urinary tract infections (cUTIs) and pneumonia (e.g., community-acquired, or nosocomial pneumonia).
- cUTIs complicated intra-abdominal infections
- pneumonia e.g., community-acquired, or nosocomial pneumonia.
- Community-acquired pneumonia can include infections caused by piperacillin-resistant, beta-lactamase producing strains of Haemophilus influenza.
- Nosocomial pneumonia caused by piperacillin-resistant, beta-lactamase producing strains of Staphylococcus aureus and by Acinetobacter baumanii, Haemophilus influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
- treating describes the management and care of a patient for the purpose of combating a disease, condition, or disorder and includes the administration of a pharmaceutical composition of the present invention to alleviate the symptoms or complications of a disease, condition or disorder, or to eliminate the disease, condition or disorder.
- the term “treat” can also include treatment of a cell in vitro or an animal model.
- a “therapeutically effective amount” of a compound of the invention is meant a sufficient amount of the compound to treat the disorder (e.g., bacterial infection).
- the specific therapeutically effective amount that is required for the treatment of any particular patient or organism will depend upon a variety of factors including the disorder being treated and the severity of the disorder; the activity of the specific compound or composition employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific compound employed; the duration of the treatment; drugs used in combination or coincidental with the specific compound employed; and like factors well known in the medical arts (see, for example, Goodman and Gilman's, “The Pharmacological Basis of Therapeutics”, Tenth Edition, A.
- the phrase “about 1000 mg ceftolozane” refers to an amount of ceftolozane that is considered a bioequivalent by the United States Food and Drug Administration (FDA), i.e. for which 90% CI of the relative mean Cmax, AUC(0-t) and AUC(0- ⁇ ) is within 80.00% to 125.00% of the reference formulation in the fasting state (see: “Guidance for Industry: Bioavailability and Bioequivalence Studies for Orally Administered Drug Products—General Considerations” Center for Drug Evaluation and Research, United States Food and Drug Administration, 2003).
- FDA United States Food and Drug Administration
- 189 mg sodium from sodium chloride per 1000 mg of ceftolozane refers to a ratio of sodium from the sodium chloride to ceftolozane active.
- “189 mg sodium from sodium chloride per 1000 mg of ceftolozane” includes, for example, 94.4 mg sodium from sodium chloride per 500 mg of ceftolozane, as well as, for example, 47.2 mg sodium from sodium chloride per 250 mg ceftolozane.
- 1,000 mg of ceftolozane as ceftolozane sulfate refers to an amount of ceftolozane sulfate effective to provide 1,000 mg of ceftolozane.
- “189 mg sodium from sodium chloride” refers to the amount of sodium chloride (e.g., 480 mg) effective to provide 189 mg of sodium.
- the amount of sodium from sodium chloride per gram of ceftolozane activity in a pharmaceutical composition containing ceftolozane sulfate, chloride and sodium chloride can be calculated using the relevant molecular weights of ceftolozane, ceftolozane sulfate, sodium chloride and sodium. For example, a composition comprising about 1,147 mg ceftolozane sulfate and 189 mg sodium from sodium chloride contains 480 mg sodium chloride per 1,000 mg ceftolozane active.
- 1000 mg ceftolozane refers to an amount of ceftolozane that is considered a bioequivalent by the United States Food and Drug Administration (FDA), i.e. for which 90% CI of the relative mean Cmax, AUC(0-t) and AUC(0- ⁇ ) is within 80.00% to 125.00% of the reference formulation in the fasting state (see: “Guidance for Industry: Bioavailability and Bioequivalence Studies for Orally Administered Drug Products—General Considerations”. Center for Drug Evaluation and Research, United States Food and Drug Administration, 2003).
- FDA United States Food and Drug Administration
- a pharmaceutical composition can comprise ceftolozane in the form of ceftolozane sulfate and 189 mg sodium from sodium chloride per 1,000 mg of ceftolozane.
- the pharmaceutical composition of can further comprise L-arginine.
- the pharmaceutical composition can further comprise citric acid.
- the pharmaceutical composition can further comprise a lyophilized composition of the ceftolozane in the form of ceftolozane sulfate and the sodium from the sodium chloride.
- the pharmaceutical composition can also comprise 189 mg sodium from sodium chloride, 1,000 mg of ceftolozane in the form of ceftolozane sulfate, and further comprise L-arginine and citric acid.
- CXA-101 bulk drug product manufacturing process There are four main steps in the manufacture of CXA-101 bulk drug product: dissolution, sterile filtration, bulk lyophilization, and packaging into Sterbags®. These four main steps are composed of a total of 20 minor steps.
- the CXA-101 bulk drug product manufacturing process is presented below.
- a sterile tilter-set which consists of a 0.2 um polyvinylidene fluoride membrane filter (Durapore®, Millipore) and a 0.1 urn polyvinylidene fluoride membrane filter (Durapore®, Millipore) connected in tandem. Confirm the integrity of each filter before and after the filtration. Take approximately 100 mL of the filtrate in order to check bioburden.
- a sterile filter-set which consists of a 0.2 um polyvinylidene fluoride membrane filter and a 0.1 urn polyvinylidene fluoride membrane filter connected in tandem, and introduce the final filtrate into an aseptic room. Confirm the integrity of each filter before and after the filtration.
- Adjust the fill weight of the filtered compounded solution to 11.37 g (corresponds to 10 mL of the compounded solution), then start filling operation. Check the filled weight in sufficient frequency and confirm it is in target range (11.37 g ⁇ 1%, 11.26 to 11.43 g). When deviation from the control range (11.37 g ⁇ 2%, 11.14 to 11.59 g) is occurred, re-adjust the filling weight.
- Sodium Perchlorate Buffer Solution was made by dissolving 14.05 g of sodium perchlorate Monohydrate in 1000.0 mL of water followed by adjusting pH to 2.5 with diluted perchloric acid (1 in 20).
- Sodium Acetate Buffer Solution pH 5.5 (Diluent) was made by dissolving 1.36 g of sodium acetate trihydrate in 1000.0 mL of water followed by adjusting to pH 5.5 with diluted acetic acid (1 in 10).
- Sample solution dissolve 20.0 mg, exactly weighed, of Sample, in 20.0 mL of water (Prepare just before injection into HPLC system).
- System Suitability Solution (1%): take 1.0 mL of the Sample Solution (use first sample if more are present) and transfer into a 100.0 mL volumetric flask, dilute with water to volume and mix.
- the amount of sodium per mg of sodium chloride can be calculated (as known to one of ordinary skill in the art) based on the relative molar weight ratio of sodium and sodium chloride (e.g., 50 mg sodium chloride contains about 20 mg of sodium, etc).
- ceftolozane in ceftolozane sulfate can similarly be calculated based on the respective molecular molar weights of ceftolozane and ceftolozane sulfate (e.g., 1,147 mg ceftolozane sulfate contains about 1,000 mg of ceftolozane). Accordingly, a composition comprising about 1,147 mg ceftolozane sulfate and 480 mg of sodium chloride also contains 480 mg of sodium chloride per 1,000 mg of ceftolozane.
- Sodium chloride was screened as a stabilizing agent.
- the purity of the ceftolozane in a composition comprising 100 mg ceftolozane and 100 mg of sodium chloride after 3 days at 60° C. was compared to a composition comprising 100 mg cefolozane comprising no stabilizing agent.
- the ceftolozane composition comprising sodium chloride was demonstrated to be more stable than the ceftolozane composition comprising no stabilizing agent.
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Abstract
Description
- This application claims priority to U.S. Provisional Patent Application No. 61/792,092, filed Mar. 15, 2013, and U.S. Provisional Patent Application No. 61/793,007, filed Mar. 15, 2013, both of which are incorporated herein in their entirety.
- This disclosure relates to pharmaceutical compositions comprising ceftolozane.
- Ceftolozane is a cephalosporin antibacterial agent. The antibacterial activity of ceftolozane is believed to result from its interaction with penicillin binding proteins (PBPs) to inhibit the biosynthesis of the bacterial cell wall which acts to stop bacterial replication. Antibacterial pharmaceutical compositions can include ceftolozane as a pharmaceutically acceptable salt formulated for intravenous administration. Ceftolozane sulfate is a pharmaceutically acceptable ceftolozane salt of formula (I) that can be formulated for intravenous administration or infusion.
- The formulation of pharmaceutical compositions can be selected to minimize decomposition of the constituent drug substances and to produce a composition that is stable under a variety of storage conditions. A number of safe and effective injectable cephalosporin pharmaceutical compositions (e.g., as listed in
FIG. 1 , Table 1) comprise up to about 85 mg of sodium per gram of cephalosporin activity (i.e., 0-85 mg sodium per gram of cephalosporin activity). - In contrast, ceftolozane sulfate pharmaceutical compositions with similar levels of sodium (e.g., about 20-75 mg sodium from sodium chloride per gram of ceftolozane) exhibit undesirable levels of instability as measured by high pressure liquid chromatography (HPLC) during stability testing. For example, certain ceftolozane sulfate pharmaceutical compositions were characterized by at least 1.5-fold greater formation of an additional impurity identified by a retention time of 63 minutes (“RT63 Impurity”) during a stability study as disclosed herein. In addition, stability testing of ceftolozane pharmaceutical compositions with lower sodium levels also resulted in greater reduction in total ceftolozane purity.
- Accordingly, there is a need for improved ceftolozane sulfate pharmaceutical compositions with greater stability, including improved pharmaceutical compositions that are not characterized by the RT63 Impurity after a three month stability test also described herein.
- The present disclosure provides ceftolozane pharmaceutical compositions with improved stability. The invention is based in part on the surprising discovery that ceftolozane in solid (e.g., powder) pharmaceutical compositions comprising about 1000 mg of ceftolozane active per 189 mg sodium from sodium chloride demonstrate improved chemical stability and purity compared with pharmaceutical compositions comprising ceftolozane with comparatively less sodium chloride. For example, the invention is based in part on the discovery of the absence of the RT63 Impurity in HPLC analysis of pharmaceutical compositions comprising about 1,000 mg of ceftolozane and 189 mg sodium from sodium chloride. By comparison, reducing sodium chloride relative to ceftolozane in tested compositions resulted in at least 1.5-fold greater impurity at RT=63 minutes (observed by HPLC using a Develosil column ODS-UG-5; 5 micrometers; 250×4.6 mm, a mobile phase of sodium perchlorate buffer solution (pH 2.5)/CH3CN 90:10 (v/v) at a 1.0 mL/min flow rate and oven temperature of 45° C.). The ceftolozane formulations with reduced levels of sodium were not as stable as the ceftolozane formulation containing about 1,000 mg of ceftolozane per 189 mg sodium from sodium chloride. This includes preferred ceftolozane formulations containing an amount of ceftolozane per 189 mg of sodium from sodium chloride effective to maintain the level of RT63 Impurity below the detection limit (e.g., 0.03%) measured by HPLC using a Develosil column ODS-UG-5; 5 micrometers; 250×4.6 mm, a mobile phase of sodium perchlorate buffer solution (pH 2.5)/CH3CN 90:10 (v/v) at a 1.0 mL/min flow rate and oven temperature of 45° C.
-
FIG. 1 is a table (Table 1) of FDA-approved parenteral cephalosporin antibiotic products, including the amount of sodium per 1 g of the cephalosporin antibiotic, as provided in the prescribing information. -
FIG. 2 is a diagram of a lyophilization process that can be used to obtain a lyophilized ceftolozane composition comprising sodium chloride. -
FIGS. 3A and 3B are chromatograms of ceftolozane drug substance obtained according to the analytical method described in Example 2. -
FIG. 4 is a table (Table 2) of peaks for the ceftolozane prepared by a lyophilization process obtained by HPLC according to the analytical method of Example 2. -
FIG. 5 is a table (Table 3a) showing the composition of various ceftolozane pharmaceutical compositions in which the sodium chloride concentration is varied. -
FIG. 6 is a table (Table 3b) showing data obtained by HPLC for the RT 63 impurity as detected in the pharmaceutical compositions described inFIG. 5 containing ceftolozane. -
FIG. 7 is a table (Table 4) showing the composition of various additional ceftolozane pharmaceutical compositions in which the sodium chloride content is varied. -
FIG. 8 is a table (Table 5) showing the total purity of ceftolozane in the pharmaceutical compositions ofFIG. 7 , as measured by HPLC peak area according to the analytical method of described in Example 2. -
FIG. 9 is a graph showing the total purity of certain pharmaceutical compositions disclosed inFIG. 7 , as measured by HPLC peak area. -
FIG. 10 is a table (Table 6) showing the composition of various ceftolozane pharmaceutical compositions in which the sodium chloride concentration is varied. -
FIG. 11 is a table (Table 7) showing the purity of Ceftolozane in CXA-201 Compositions with varying amounts of sodium from sodium chloride at time zero, 1 day, 3 days and 7 days at 60° C. -
FIG. 12 is a table (Table 8) showing purities of ceftolozane and a control (no excipient) in a lyophilized ceftolozane and sodium chloride composition at time zero, 1 day, 3 days and 7 days at 60° C., measured by HPLC. - Ceftolozane is the cephalosporin (6R,7R)-3-[(5-amino-4-{[(2-aminoethyl)carbamoyl]amino}-1-methyl-1H-pyrazol-2-ium-2-yl)methyl]-7-({(2Z)-2-(5-amino-1,2,4-thiadiazol-3-yl)-2-[(1-carboxy-1-methylethoxy)imino]acetyl}amino)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate, and is also referred to as “CXA-101,” FR264205, or (6R,7R)-3-[5-Amino-4-[3-(2-aminoethyl)ureido]-1-methyl-1H-pyrazol-2-ium-2-ylmethyl]-7-[2-(5-amino-1,2,4-thiadiazol-3-yl)-2-[(Z)-1-carboxy-1-methylethoxyimino]acetamido]-3-cephem-4-carboxylic acid). Ceftolozane sulfate is a pharmaceutically acceptable salt of ceftolozane that can be combined with sodium chloride and other components to obtain an antibiotic composition suitable for administration by injection or infusion.
- Surprisingly, pharmaceutical compositions comprising ceftolozane sulfate and about 1000 mg ceftolozane active per 189 mg sodium from sodium chloride exhibited unexpectedly improved chemical stability over the course of time and/or in the presence of heat, and less impurities than those pharmaceutical compositions comprising ceftolozane and less sodium chloride (e.g., see Example 3).
- Pharmaceutical compositions comprising ceftolozane can be formulated to treat infections by parenteral administration (including subcutaneous, intramuscular, and intravenous) administration. Pharmaceutical compositions may additionally comprise excipients, pH adjusting additives (e.g., buffers) and the like. Non-limiting examples of these additives include citric acid and L-arginine. For example, L-arginine can be used to adjust pH and to increase the solubility of ceftolozane; and citric acid can be used to prevent discoloration of the product, due to its ability to chelate metal ions. In one particular embodiment, the pharmaceutical compositions described herein are formulated for administration by intravenous injection or infusion.
- Pharmaceutical compositions comprising ceftolozane and sodium chloride can be obtained by lyophilization. As is known to those skilled in the art, lyophilization is a process of freeze-drying in which water is sublimed from a frozen solution of one or more solutes. Specific methods of lyophilization are described in Remington's Pharmaceutical Sciences, Chapter 84, page 1565, Eighteenth Edition, A. R. Gennaro, (Mack Publishing Co., Easton, Pa., 1990). A pharmaceutical composition comprising ceftolozane can be prepared by adding sodium chloride in a fixed ratio to ceftolozane in an aqueous solution prior to lyophilization. For example, the method can comprise the steps of: (1) forming a solution comprising sodium chloride and ceftolozane or a salt thereof followed by lyophilizing the solution; and (2) combining the lyophilized ceftolozane with other components (e.g., a β-lactamase inhibitor, such as tazobactam, or a lyophilized β-lactamase inhibitor, such as a lyophilized tazobactam) to obtain the pharmaceutical composition. The resulting pharmaceutical composition can be a powder for reconstitution to obtain an injectable pharmaceutical composition that can be intravenously administered to a patient. In yet a further embodiment, the method comprises adding about 1000 mg of ceftolozane active per 189 mg sodium from sodium chloride in an aqueous solution, then lyophilizing the solution to obtain a lyophilized material comprising sodium chloride and ceftolozane sulfate in a ratio effective to provide a product with less than 0.03% of the RT63 Impurity as detected by HPLC in Example 2.
- Another embodiment of the invention is a vial containing a unit dosage form of a pharmaceutical composition formulated for parenteral administration for the treatment of complicated intra-abdominal infections or complicated urinary tract infections. The vial can be obtained by a process comprising the steps of: a) lyophilizing an aqueous solution comprising about 1000 mg ceftolozane active in the form of ceftolozane sulfate per 189 mg sodium from sodium chloride and further comprising citric acid, and L-arginine to obtain a lyophilized ceftolozane composition; and b) filling a sufficient quantity of the lyophilized composition into a vial to obtain a unit dosage form comprising about 1,000 mg of ceftolozane active in the form of ceftolozane sulfate per 189 mg sodium from sodium chloride. In one aspect, the pH of the aqueous solution is 6.0 to 7.0. In another aspect the pharmaceutical composition is formulated for parenteral administration by reconstituting the pharmaceutical composition in the vial (e.g., with 10 mL of diluent such as water for injection or isotonic saline) followed by addition of the reconstituted pharmaceutical composition to a carrier for injection (e.g., about 100 mL of isotonic saline or other pharmaceutically acceptable carrier for intravenous administration). Optionally, the vial is also filled with tazobactam (e.g., a lyophilized tazobactam such as tazobactam sodium). In yet another aspect, the pharmaceutical composition is a solid (e.g., amorphous powder, crystal or combination thereof) obtained from a liquid composition comprising sodium chloride in an amount providing 189 mg sodium from sodium chloride, 1,000 mg of ceftolozane active and tazobactam in an amount providing about 500 mg tazobactam acid equivalent per 1,000 mg of ceftolozane active, the resulting solid pharmaceutical composition being formulated for parenteral administration and the pH of the aqueous solution is 6.0 to 7.0.
- The pharmaceutical compositions can be administered for the treatment of infections, such as complicated intra-abdominal infections, complicated urinary tract infections (cUTIs) and pneumonia (e.g., community-acquired, hospital-acquired, etc). In one aspect, provided herein is a method for the treatment of bacterial infections in a mammal, comprising administering to said mammal a therapeutically effective amount of a pharmaceutical composition prepared according to the methods described herein. A method for the treatment of bacterial infections in a mammal can comprise administering to said mammal a therapeutically effective amount of a pharmaceutical composition comprising ceftolozane sulfate and sodium chloride. Non-limiting examples of bacterial infections that can be treated by the methods of the invention include infections caused by: aerobic and facultative gram-positive microorganisms (e.g., Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pneumonia, Streptococcus pyogenes, Viridans group streptococci), aerobic and facultative gram-negative microorganisms (e.g., Acinetobacter baumanii, Escherichia coli, Haemophilus influenza, Klebsiella pneumonia, Pseudomonas aeruginosa, Citrobacter koseri, Moraxella catarrhalis, Morganella morganii, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Providencia stuartii, Providencia rettgeri, Salmonella enterica), gram-positive anaerobes (Clostridium perfringens), and gram-negative anaerobes (e.g., Bacteroides fragilis group (e.g., B. fragilis, B. ovatus, B. thetaiotaomicron, and B. vulgates), Bacteroides distasonis, Prevotella melaninogenica). In certain embodiments of the methods described herein, bacterial infection is associated with one or more of the following conditions: complicated intra-abdominal infections, complicated urinary tract infections (cUTIs) and pneumonia (e.g., community-acquired, or nosocomial pneumonia). Community-acquired pneumonia (moderate severity only) can include infections caused by piperacillin-resistant, beta-lactamase producing strains of Haemophilus influenza. Nosocomial pneumonia (moderate to severe) caused by piperacillin-resistant, beta-lactamase producing strains of Staphylococcus aureus and by Acinetobacter baumanii, Haemophilus influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
- As used herein, “treating,” “treat,” or “treatment” describes the management and care of a patient for the purpose of combating a disease, condition, or disorder and includes the administration of a pharmaceutical composition of the present invention to alleviate the symptoms or complications of a disease, condition or disorder, or to eliminate the disease, condition or disorder. The term “treat” can also include treatment of a cell in vitro or an animal model.
- By a “therapeutically effective amount” of a compound of the invention is meant a sufficient amount of the compound to treat the disorder (e.g., bacterial infection). The specific therapeutically effective amount that is required for the treatment of any particular patient or organism (e.g., a mammal) will depend upon a variety of factors including the disorder being treated and the severity of the disorder; the activity of the specific compound or composition employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific compound employed; the duration of the treatment; drugs used in combination or coincidental with the specific compound employed; and like factors well known in the medical arts (see, for example, Goodman and Gilman's, “The Pharmacological Basis of Therapeutics”, Tenth Edition, A. Gilman, J. Hardman and L. Limbird, eds., McGraw-Hill Press, 155-173, 2001, which is incorporated herein by reference in its entirety). The therapeutically effective amount for a given situation can be readily determined by routine experimentation and is within the skill and judgment of the ordinary clinician.
- Unless otherwise indicated, as used herein, the phrase “about 1000 mg ceftolozane” refers to an amount of ceftolozane that is considered a bioequivalent by the United States Food and Drug Administration (FDA), i.e. for which 90% CI of the relative mean Cmax, AUC(0-t) and AUC(0-∞) is within 80.00% to 125.00% of the reference formulation in the fasting state (see: “Guidance for Industry: Bioavailability and Bioequivalence Studies for Orally Administered Drug Products—General Considerations” Center for Drug Evaluation and Research, United States Food and Drug Administration, 2003).
- As used herein, “189 mg sodium from sodium chloride per 1000 mg of ceftolozane” refers to a ratio of sodium from the sodium chloride to ceftolozane active. For example, “189 mg sodium from sodium chloride per 1000 mg of ceftolozane” includes, for example, 94.4 mg sodium from sodium chloride per 500 mg of ceftolozane, as well as, for example, 47.2 mg sodium from sodium chloride per 250 mg ceftolozane. In addition, “1,000 mg of ceftolozane as ceftolozane sulfate” refers to an amount of ceftolozane sulfate effective to provide 1,000 mg of ceftolozane. “189 mg sodium from sodium chloride” refers to the amount of sodium chloride (e.g., 480 mg) effective to provide 189 mg of sodium. The amount of sodium from sodium chloride per gram of ceftolozane activity in a pharmaceutical composition containing ceftolozane sulfate, chloride and sodium chloride can be calculated using the relevant molecular weights of ceftolozane, ceftolozane sulfate, sodium chloride and sodium. For example, a composition comprising about 1,147 mg ceftolozane sulfate and 189 mg sodium from sodium chloride contains 480 mg sodium chloride per 1,000 mg ceftolozane active.
- As used herein, “1000 mg ceftolozane” refers to an amount of ceftolozane that is considered a bioequivalent by the United States Food and Drug Administration (FDA), i.e. for which 90% CI of the relative mean Cmax, AUC(0-t) and AUC(0-∞) is within 80.00% to 125.00% of the reference formulation in the fasting state (see: “Guidance for Industry: Bioavailability and Bioequivalence Studies for Orally Administered Drug Products—General Considerations”. Center for Drug Evaluation and Research, United States Food and Drug Administration, 2003).
- A pharmaceutical composition can comprise ceftolozane in the form of ceftolozane sulfate and 189 mg sodium from sodium chloride per 1,000 mg of ceftolozane. The pharmaceutical composition of can further comprise L-arginine. The pharmaceutical composition can further comprise citric acid. The pharmaceutical composition can further comprise a lyophilized composition of the ceftolozane in the form of ceftolozane sulfate and the sodium from the sodium chloride. The pharmaceutical composition can also comprise 189 mg sodium from sodium chloride, 1,000 mg of ceftolozane in the form of ceftolozane sulfate, and further comprise L-arginine and citric acid.
- There are four main steps in the manufacture of CXA-101 bulk drug product: dissolution, sterile filtration, bulk lyophilization, and packaging into Sterbags®. These four main steps are composed of a total of 20 minor steps. The CXA-101 bulk drug product manufacturing process is presented below.
- I. Dissolution
- 1. The prescribed amount of WFI is charged into the dissolution reactor.
- 2. A prescribed amount of citric acid is added.
- 3. The solution is cooled at 5° C. to 10° C.
- 4. A prescribed amount of CXA-101 drug substance is added to the solution.
- 5. A prescribed amount of L-arginine is slowly added to the solution.
- 6. A check for complete dissolution is performed. Solution pH is verified to be in the target range of 6.5 to 7.0.
- 7. A prescribed amount of sodium chloride is added to the solution.
- 8. A check for complete dissolution is performed. Solution pH is verified to be in the target range of 6.0 to 7.0. If the pH is out of this range adjust with either L-Arginine or citric acid.
- 9. WFI is added to bring the net weight to 124.4 kg and the solution is mixed well.
- 10. Samples are withdrawn for testing of final pH.
- II. Sterile filtration
- 11. The solution is passed through the filter (pore size 0.45 μm) followed by double filters (pore size 0.22 μm) onto a shelf on the Criofarma lyophilizer.
- 12. The line is washed with WFI.
- 13. The washing solution is passed from Step 12 through sterile filtration.
- III. Bulk lyophilization
- 14. The washing solution is loaded onto a separate shelf in the lyophilizer (and later discarded).
- 15. The solution is lyophilized until dry.
- 16. The product shelf is cooled to 20° C.±5° C.
- IV. Packaging into Sterbags®
- 17. The lyophilized bulk drug product powder is milled.
- 18. The milled powder is sieved.
- 19. The sieved powder is blended for 30 minutes.
- 20. The powder is then discharged into Sterbags®
- Filtrate the compounded solution with a sterile tilter-set which consists of a 0.2 um polyvinylidene fluoride membrane filter (Durapore®, Millipore) and a 0.1 urn polyvinylidene fluoride membrane filter (Durapore®, Millipore) connected in tandem. Confirm the integrity of each filter before and after the filtration. Take approximately 100 mL of the filtrate in order to check bioburden.
- Filter the prefiltered compounded solution through a sterile filter-set which consists of a 0.2 um polyvinylidene fluoride membrane filter and a 0.1 urn polyvinylidene fluoride membrane filter connected in tandem, and introduce the final filtrate into an aseptic room. Confirm the integrity of each filter before and after the filtration.
- Wash a sufficient quantity of 28 mL vials with water for injection and sterilize the washed vials by a dry-heat sterilizer. Then transfer the sterilized vials into a Grade A area located in an aseptic room.
- Wash a sufficient quantity of stoppers with, water for injection. Sterilize and dry the washed stoppers by steam sterilizer. Then transfer the sterilized stoppers into a Grade A area located in an aseptic room.
- Sterilize a sufficient quantity of flip-off caps by steam sterilizer. Then transfer the sterilized flip-off caps into a Grade A or B area located in an aseptic room.
- Adjust the fill weight of the filtered compounded solution to 11.37 g (corresponds to 10 mL of the compounded solution), then start filling operation. Check the filled weight in sufficient frequency and confirm it is in target range (11.37 g±1%, 11.26 to 11.43 g). When deviation from the control range (11.37 g±2%, 11.14 to 11.59 g) is occurred, re-adjust the filling weight.
- Immediately after a vial is filled, partially stopper the vial with a sterilized stopper. Load the filled and partially stoppered vials onto the shelves of a lyophilizer aseptically.
- After all filled and partially stoppered vials are loaded into a lyophilizer, start the lyophilization program shown in
FIG. 2 . Freeze the loaded vials at −40° C. and keep until all vials freeze. Forward the program to primary drying step (shelf temperature; −20° C., chamber pressure; 100 to 150 mTorr). Primary drying time should be determined by monitoring the product temperature. Forward the program to secondary drying step (shelf temperature; 30° C., chamber pressure; not more than 10 mTorr) after completion of the primary drying step. After all vials are dried completely, return the chamber pressure to atmospheric pressure with sterilized nitrogen. Then stopper vials completely. - Unload the lyophilized vials from the chamber and crimp with sterilized flip-off caps.
- Subject all crimped vials to visual inspection and label and package all passed vials.
-
-
Column Develosil ODS-UG-5; 5 μm, 250 × 4.6 mm (Nomura Chemical, Japan) Mobile phase Sodium Perchlorate Buffer Solution (PH 2.5)/ CH3CN 90:10 (vlv) Flow rate 1.0 mL/min Wavelength 254 nm Injection volume 10 μL Oven Temperature 45° C. Run Time 85 minutes Gradient Profile: Time (min) A % B % 0 75 25 30 70 30 60 0 100 85 0 100 85.1 75 25 110 75 25
B. Mobile phase preparation. - Sodium Perchlorate Buffer Solution was made by dissolving 14.05 g of sodium perchlorate Monohydrate in 1000.0 mL of water followed by adjusting pH to 2.5 with diluted perchloric acid (1 in 20).
- Mobile Phase was then made by mixing Sodium Perchlorate Buffer Solution (pH 2.5) and acetonitrile in the ratio 90:10 (v/v).
- Sodium Acetate Buffer Solution pH 5.5 (Diluent) was made by dissolving 1.36 g of sodium acetate trihydrate in 1000.0 mL of water followed by adjusting to pH 5.5 with diluted acetic acid (1 in 10).
- Sample solution: dissolve 20.0 mg, exactly weighed, of Sample, in 20.0 mL of water (Prepare just before injection into HPLC system).
- System Suitability Solution (1%): take 1.0 mL of the Sample Solution (use first sample if more are present) and transfer into a 100.0 mL volumetric flask, dilute with water to volume and mix.
-
- 1. Inject Blank (water)
- 2. Inject System Suitability Solution and check for tailing factor and theoretical plate number for CXA-101 peak:
- The tailing factor must not be greater than 1.5
- Theoretical plates number must not be less than 10000
- 3. Inject Sample Solution
- 4. Inject System Suitability Solution and check for tailing factor and theoretical plate number for CXA-101 peak.
- The tailing factor must not be greater than 1.5
- Theoretical plates number must not be less than 10000
- 5. Identify the peaks of Related Substances in the Sample chromatogram based on the reference chromatogram reported in
FIGS. 3A and 3B or, alternatively, on the basis of the RRT (Retention Time Relative to CXA-101) values reported in Table 2 (FIG. 4 ) -
- I. Report for each related substance its amount as expressed by area percent.
-
-
- wherein:
- Ci=Amount of related substance i in the Sample, area %
- Ai=Peak area of related substance i in the Sample chromatogram
- At=Area of CXA-101 peak in the Sample chromatogram
- At+ΣAi=Total peaks area in the Sample chromatogram
- Consider as any Unspecified Impurity, each peak in the chromatogram except CXA-101, peaks from 1 to 11 and every peak present in the blank chromatogram and report the largest.
- II. Report the total impurities content as expressed by the following formula:
-
-
- wherein:
- CT=total impurities content in the Sample, area %
- At=area of CXA-101 peak in the sample chromatogram
- ΣAi=total peak areas of impurities in the sample chromatogram
- Multiple stability studies were performed on ceftolozane sulfate, wherein the effect of varying amounts of sodium chloride on the stability of ceftolozane was examined.
- The amount of sodium per mg of sodium chloride can be calculated (as known to one of ordinary skill in the art) based on the relative molar weight ratio of sodium and sodium chloride (e.g., 50 mg sodium chloride contains about 20 mg of sodium, etc).
- The amount of ceftolozane in ceftolozane sulfate can similarly be calculated based on the respective molecular molar weights of ceftolozane and ceftolozane sulfate (e.g., 1,147 mg ceftolozane sulfate contains about 1,000 mg of ceftolozane). Accordingly, a composition comprising about 1,147 mg ceftolozane sulfate and 480 mg of sodium chloride also contains 480 mg of sodium chloride per 1,000 mg of ceftolozane.
- A stability study was carried out at 25° C. as described above. High, mid, and low salt formulations contained 189, 49.2 and 24.6 mg sodium from sodium chloride (480, 125, and 62.5 mg sodium chloride) per 1000 mg ceftolozane active, respectively. Compositions of blend Drug Product are listed in Table 3a in
FIG. 5 . Test results are summarized in Table 3b inFIG. 6 . - Conclusion: At the three month time point, the reduced salt formulations were observed to be not as stable as the full salt formulation; and trends indicate that reduction in salt causes at least 1.5-fold greater impurity at RT=63 minutes (HPLC).
- B. CXA-101 Peak Trends with NaCl
- A stability study was carried out at 60° C. as described above. Sodium chloride content in test samples is described in Table 4 (
FIG. 7 ). The results are provided in Table 5,FIG. 8 and the graph inFIG. 9 . These results show that less total impurities were formed in the presence of 189 grams sodium from sodium chloride (481 grams sodium chloride) than with 74.7, 49.2, 29.5 or 19.7 mg sodium from sodium chloride (190.0, 125.0, 75.0 or 50.0 mg sodium chloride) per gram CXA-201 at 1, 3 and 7 days at 60° C./60% relative humidity. - C. Improvement in the Purity of Ceftolozane in CXA-201 Pharmaceutical Compositions with Varying Amounts of Sodium Chloride
- A stability study was carried out at 60° C. as described above. The sodium chloride content in the CXA-201 compositions is described in Table 6 in
FIG. 10 . The HPLC data at 60° C. are summarized in Table 7 inFIG. 11 . - Sodium chloride was screened as a stabilizing agent. The purity of the ceftolozane in a composition comprising 100 mg ceftolozane and 100 mg of sodium chloride after 3 days at 60° C. was compared to a composition comprising 100 mg cefolozane comprising no stabilizing agent.
- As shown in Table 8,
FIG. 12 , the ceftolozane composition comprising sodium chloride was demonstrated to be more stable than the ceftolozane composition comprising no stabilizing agent.
Claims (17)
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US14/214,417 Abandoned US20140274997A1 (en) | 2013-03-15 | 2014-03-14 | Cephalosporin pharmaceutical compositions |
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US14/522,893 Abandoned US20150045336A1 (en) | 2013-03-15 | 2014-10-24 | Tazobactam and ceftolozane antibiotic compositions |
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US14/214,417 Abandoned US20140274997A1 (en) | 2013-03-15 | 2014-03-14 | Cephalosporin pharmaceutical compositions |
US14/285,185 Active US8968753B2 (en) | 2013-03-15 | 2014-05-22 | Ceftolozane-tazobactam pharmaceutical compositions |
US14/522,893 Abandoned US20150045336A1 (en) | 2013-03-15 | 2014-10-24 | Tazobactam and ceftolozane antibiotic compositions |
US14/531,352 Abandoned US20150150883A1 (en) | 2013-03-15 | 2014-11-03 | Ceftolozane-tazobactam pharmaceutical compositions |
US15/071,530 Active US9925196B2 (en) | 2013-03-15 | 2016-03-16 | Ceftolozane-tazobactam pharmaceutical compositions |
US15/895,279 Abandoned US20180169106A1 (en) | 2013-03-15 | 2018-02-13 | Ceftolozane-tazobactam pharmaceutical compositions |
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US9320740B2 (en) | 2016-04-26 |
US20140274996A1 (en) | 2014-09-18 |
US20140274990A1 (en) | 2014-09-18 |
US20140275000A1 (en) | 2014-09-18 |
US9925196B2 (en) | 2018-03-27 |
US20140274993A1 (en) | 2014-09-18 |
US20150045336A1 (en) | 2015-02-12 |
US20140262868A1 (en) | 2014-09-18 |
US20140274998A1 (en) | 2014-09-18 |
US20180169106A1 (en) | 2018-06-21 |
US20140274997A1 (en) | 2014-09-18 |
US8968753B2 (en) | 2015-03-03 |
US20150150883A1 (en) | 2015-06-04 |
US20160193221A1 (en) | 2016-07-07 |
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