WO2016107894A1 - Composition for joint and cartilage disorders comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane - Google Patents
Composition for joint and cartilage disorders comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane Download PDFInfo
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- 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
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/192—Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid
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- 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
- A61K31/095—Sulfur, selenium, or tellurium compounds, e.g. thiols
- A61K31/10—Sulfides; Sulfoxides; Sulfones
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- 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
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/7008—Compounds having an amino group directly attached to a carbon atom of the saccharide radical, e.g. D-galactosamine, ranimustine
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- 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
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
- A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
- A61K31/728—Hyaluronic acid
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- 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
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
- A61K31/737—Sulfated polysaccharides, e.g. chondroitin sulfate, dermatan sulfate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
Definitions
- the present invention relates to a new pharmaceutical composition
- a new pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane which has therapeutic effect against pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
- Degenerative joint disorders are painful degenerative condition that results in the deterioration of cartilage tissues that support the weight-bearing joints in the body. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bones, causing further pain and stiffness. It is believed that degenerative joint disorders affect 80% of people over the age of 60. Degenerative joint disorders include, for example, osteoarthritis, rheumatoid arthritis, other rheumatic disorders with cartilage breakdown, chondrolysis after joint trauma, for example, after meniscus or patella injuries or torn ligaments, or chondrolysis associated with prolonged immobilization of joints.
- Osteoarthritis is the most prevalent form of arthritis which is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or the small joints of the hands. It is characterized by pain and progressive degeneration of cartilage in synovial joints and vertebrae, leading to significant reduction of mobility and quality of life. Osteoarthritis usually develops in joints that are injured by repeated overuse in the performance of a particular job or a favorite sport or from carrying around excess body weight. Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint so that the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells.
- Rheumatoid arthritis is an autoimmune inflammatory disease in which the body releases enzymes that attack its own healthy tissues. In rheumatoid arthritis, these enzymes destroy the linings of joints causing pain, swelling, stiffness, deformity, and reduced movement and function. Rheumatoid arthritis also may include systemic symptoms.
- Analgesic & anti-inflammatory treatment Relief from pain and inflammation of the soft tissue surrounding the joint.
- Flurbiprofen is a well known propionic acid derivative, also known as NSAID (nonsteroidal anti-inflammatory drug), with the analgesic and anti-inflammatory activities it possesses. It is used in muscle-skeletal and joint disorders such as ankylosing spondylitis, osteoarthritis and rheumatoid arthritis, in soft-tissue disorders such as sprains and strains and for postoperative pains and mild to moderate pain including dysmenorrhoea and migraine. Its chemical structure is illustrated with Formula I given below.
- Flurbiprofen is mostly administrated orally in dosages about 150 to 200 mg, may also be increased to 300 mg daily in acute or severe conditions if necessary.
- One disadvantage of the oral administration of compositions comprising flurbiprofen is that the patient is likely to experience unpleasant side effects, including gastrointestinal (Gl) adverse effects including inflammation, spontaneous gastric bleeding, ulceration and perforation of the stomach, which can be life threatening.
- Gl gastrointestinal
- Glucosamine is an amino sugar and aprominent precursor in the biochemical synthesis of glycosylated proteins and lipids.
- Glucosamine is part of the structure of the polysaccharides chitosan and chitin and it is naturally present in the shells of shellfish, animal bones and bone marrow. It is also present in some fungi and can be also synthetically derived.
- Glucosamine is used for the treatment of osteoarthritis. Its chemical name is (3R,4R,5S)-3-Amino-6-(hydroxymethyl)oxane-2,4,5-triol.
- Chemical structure of glucosamine sulfate (GS) is shown in the formula II. Recent studies indicate that it also slows the deterioration of cartilage and relieves pain. Tablet form of glucosamine sulfate is authorized in the strength of 500 and 750mg. Daily recommended dose is between 500 to 2500 mg.
- Chondroitin sulfate is a sulfated glycosaminoglycan (GAG) composed of a chain of alternating sugars. Chondroitin sulfate is an important structural component of cartilage and provides much of its resistance to compression. Chondroitin sulfate is mostly administrated orally. Tablet form is authorized in the strength of 120, 250 and 400mg and daily recommended dose is 1200mg. However, it is also authorized as a topical gel for the treatment of osteoarthritis. Chemical structure of chondroitin sulfate is shown in the formula III.
- glucosamine and chondroitin combination authorized in U.S.
- the main benefit of glucosamine and chondroitin combination is prevention of cartilage degeneration in the joints, especially in those affected by osteoarthritis. It also helps to reduce the pain associated with overuse conditions, such as knee tendonitis and other sports-related injuries and helps to reduce inflammation while increasing the health of the muscle and other tissue.
- US 2008/0227747 A1 discloses a therapeutic composition and methods for the treatment and prevention of a degenerative joint disorder and/or cardiovascular disease comprising polycosanols, glucosamine and chondroitin.
- Composition further may comprise NSAIDs, but neither an example nor flurbiprofen as one of the NSAIDs is disclosed in the patent application in combination with glucosamine.
- Hyaluronic acid exists as a naturally-occurring polysaccharide (also known as a mucoid polysaccharide) that can be extracted from such diverse sources as rooster comb, umbilical cord, vitreous humor, synovial fluid, pathologic joints, skin and group A and C hemolytic Streptococci.
- the hyaluronic acid is also defined as a high viscosity naturally occurring glycosaminoglycan having a polymeric structure containing alternating N-acetyl-D-glucosamine and D-glucuronic acid monosaccharide units linked with [beta] 1 -4 bonds and the disaccharide units linked with [beta] 1 -3 glycoside bonds
- Hyaluronic acid is a naturally occurring glycosaminoglycan. HA is ubiquitous in the organism, with the highest concentration found in soft connective tissue and joint fluid. It is a constituent of the intercellular matrix of connective tissue that exists in almost all vertebrates. It plays an important role in a number of physiological functions, including protection and lubrication of cells, maintenance of the structural integrity of tissues, transport of molecules and cells, cell migration, cell function and differentiation, and fluid retention and regulation. Natural Hyaluronic acid is polydisperse in respect of molecular weight and is known to show excellent biocompatibility even when implanted or injected into the body by virtue of the absence of species and organ specificity.
- Hyaluronic acid is an important component of the intercellular matrix. Specifically, the highest levels are found in the eye and synovial fluid of joints. In joints, its primary role is that of lubrication, reducing pain, and inflammation. In arthritic joints HA is deficient. In regards to the joints, synovial fluid supplies nutrition to the articular cartilage and has incomparable functions as a lubricant and a shock absorber.
- Hyaluronic acid Concentration and molecular weight analyses of Hyaluronic acid demonstrated the concentration and molecular weight of Hyaluronic acid in the synovial fluid from patients with arthritis such as osteoarthritis and chronic articular rheumatism generally tended to be lower than in normal synovial fluid, and the lower concentration and molecular weight of Hyaluronic acid were closely associated with development of locomotor dysfunction and pain attributable to the weaker lubricating action and the weaker protecting action on the surface of the articular cartilage of synovial fluid.
- Chemical structure Hyaluronic acid is shown in the formula IV.
- Hyaluronic acid Methylsulfonylmethane is an organosulfur compound with the formula (CH 3) 2SO 2. It occurs naturally in some primitive plants, is present in small amounts in many foods and beverages, and is marketed as a dietary supplement. MSM is sold as a dietary supplement and marketed with a variety of combinations, often in combination with glucosamine and/or chondroitin for helping to treat or prevent osteoarthritis. Small- scale studies of possible treatments with MSM have been conducted on both animals and humans. These studies of MSM have suggested some benefits, particularly for treatment of osteoarthritis.
- the object is to provide a new pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane. Accordingly, based on said drawbacks, a novelty is required in the art of pharmaceutical combinations having therapeutic effects against pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
- the main object of the present invention is to treat, reduce, or prevent the degenerative joint and cartilage disorders by administering to a subject in need thereof a therapeutically effective amount of a pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid, methylsulfonylmethane and at least one pharmaceutically acceptable excipient which overcomes the above described problems in prior art and have additional advantages over them.
- a further object of the invention is to eliminate the Gl adverse effects of flurbiprofen when it is administered orally in high terapeutic effective amounts for a long time. It is known that the treatment of the degenerative joint and cartilage disorders, especially osteoarthritis and rheumatoid arthritis needs a long treatment period. Therefore to use of flurbiprofen for a long time with high terapeutic effective amounts may increase the possibility of Gl adverse effects of flurbiprofen. As a rule, after a long-term administration of a drug, drug addiction develops and as a consequence its dosage should be increased. This certainly affects the occurrence of side effects.
- the present invention provides the solution to this problem by using the amount of flurbiprofen is not more than 15 % by weight of the total formulation by combining it with glucosamine sulfate, chondroitin sulfate, hyaluronic acid, methylsulfonylmethane. It has been found surprisingly that this ratios have an increased/synergistic effect over the flurbiprofen's analgesic and antiinflammatory activity even with low doses.
- glucosamine sulfate plays in the treatment or prevention of the degenerative joint and cartilage disorders is most likely associated directly its ability to act as the most important substrate for glycosaminoglycans and a basis of hyaluronic acid.
- a successful treatment of osteoarthritis and rheumatoid arthritis must control pain effectively as well as slow down or ensure the reverse development of joint degeneration process. It has been found that the introduction of the amount of glucosamine sulfate is not more than 45 % by weight of the total formulation makes it possible to ensure a chondroprotective and anti-inflammatory effect of the composition and prevents destructive effect of glucocorticoids on chondrocytes and to reduce a need for NSAID (i.e.
- flurbiprofen in high dosage for patients suffering from osteoarthritis and rheumatoid arthritis which in turn makes it possible to decrease side effect risks. Accordingly, when flurbiprofen is used for a long period of time, it may have a desensitising effect. It has been also found that when flurbiprofen is used by combination with glucosamine, chondroitin, hyaluronic acid methylsulfonylmethane makes it possible to ensure increased analgesic and anti-inflammatory effect of the composition, whilst reducing the pain and inflammation syndrome in degenerative joint and cartilage disorders synergisticly. Thus this also reduces the risk of the Gl side effects.
- the amount of chondroitin sulfate is not more than 25 % by weight of the total formulation.
- the amount of hyaluronic acid is not more than 15 % by weight of the total formulation.
- the amount of methylsulfonylmethane is not more than 15 % by weight of the total formulation.
- flurbiprofen to glucosamine sulfate is in the range of 0.01 to 10.0, preferably 0.01 to 5.0, and more preferably 0.10 to 2.0;
- flurbiprofen to chondroitin sulfate is in the range of 0.1 to 15.0, preferably 0.1 to 10.0, and more preferably 0.1 to 5.0;
- flurbiprofen to hyaluronic acid is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
- flurbiprofen to methylsulfonylmethane (MSM) is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
- hyaluronic acid to methylsulfonylmethane is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
- chondroitin sulfate to glucosamine sulfate is in the range of 0.01 to 15.0, preferably 0.1 to 10.0, and more preferably 0.1 to 5.0; helps the composition to be easily processed into a tablet or capsule dosage form, in desired weight which can easily be swallowed by the patients, whilst maintaining or increasing the therapeutic effective doses for the joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
- composition comprising;
- microcrystalline cellulose at 10-15% by weight
- the process of the present invention for preparing the pharmaceutical formulation comprises the following steps;
- Flurbiprofen, glucosamin sulfate, chondroitin sulfate, hyaluranic asit, methylsulfonylmethane (MSM), lactose spray dried, half of microcrystalline cellulose, croscarmellose sodium and hydroxypropyl cellulose are mixed. Colloidal silicon dioxide and rest of microcrystalline cellulose are sieved and added to the mixture and blended. Magnesium stearate is added to the mixture and blended. The final powder mixture is compressed to tablets or filled into capsules. Optionally, the tablets are coated by HPMC aqueous solution for coated tablets. According to the challenges mentioned above the selection of the excipients thus very important.
- one or more pharmaceutically acceptable the excipient is selected from the group comprising buffering agents, stabilizers, binders, diluents, dispersing agents, lubricants, glidants, disintegrants, plasticizers, preservatives, sweeteners, flavoring agents, coloring agents or mixtures thereof.
- Suitable buffering agents may comprise but not limited to alkali metal citrate, citric acid/sodium citrate, tartaric acid, fumaric acid, sorbic acid, citric acid, succinic acid, adipic acid, ascorbic acid, glutaric acid, potassium hydrogen tartrate, sodium hydrogen tartrate, potassium hydrogen phthalate, sodium hydrogen phthalate, potassium dihydrogen phosphate, sodium dihydrogen phosphate, disodium hydrogen phosphate, hydrochloric acid/sodium hydroxide or mixtures thereof, and preferably citric acid, fumaric acid, ascorbic acid, sodium dihydrogen phosphate or mixtures thereof.
- Suitable stabilizers may comprise but not limited to citric acid, fumaric acid, tartaric acid, sodium citrate, sodium benzoate, sodium dihydrogen phosphate, calcium carbonate, magnesium carbonate, arginine, lysine, meglamine, tocopherol, butylhydroxyanisole (BHA), butylhydroxytoluene (BHT), ascorbic acid, gallic acid esters or the mixtures thereof, and preferably, citric acid, fumaric acid, arginine or mixtures thereof.
- Suitable binders may include but not limited to polyvinylpyrrolidone, polyethylene glycol, polyvinyl alcohol, starch, pregelatinized starch, glucose, glucose syrup, natural gums, sucrose, sodium alginate, hydroxypropyl methyl cellulose, hydroxypropyl cellulose, carboxy methyl cellulose, methyl cellulose, gelatin, carrageenan, guar gum, carbomer, polymethacrylates, methacrylate polymers, collagens gelatin, agar, alginate, alginic acid, xanthan gum, hyaluronic acid, pectin, polysaccharides, carbomer, poloxamer, polyacrylamide, aluminium hydroxide, laponit, bentonit, polyoxyethylene- alkyl ether, polydextrose, polyethylene oxide or mixtures thereof.
- Suitable diluents may comprise but not limited to lactose spray dried, microcrystalline cellulose, mannitol, spray-dried mannitol, lactose, starch, dextrose, sucrose, fructose, maltose, sorbitol, xylitol, inositol, kaolin, inorganic salts, calcium salts, polysaccharides, dicalcium phosphate, sodium chloride, dextrates, lactitol, maltodextrin, sucrose- maltodextrin mixture, trehalose, sodium carbonate, sodium bicarbonate, calcium carbonate or mixtures thereof.
- Suitable dispersing agents may comprise but not limited to calcium silicate, magnesium aluminum silicate or mixtures thereof.
- Suitable lubricants may comprise but not limited to magnesium stearate, calcium stearate, zinc stearate, talc, waxes, boric acid, hydrogenated vegetable oil, sodium chlorate, magnesium lauryl sulfate, sodium oleate, sodium acetate, sodium benzoate, polyethylene glycol, stearic acid, fatty acid, fumaric acid, glyseryl palmito sulphate, sodium stearyl fumarate, sodium lauryl sulphate or mixtures thereof.
- Suitable glidants may comprise but not limited to colloidal silicon dioxide, talc, aluminium silicate, colloidal silica, starch or mixtures thereof.
- Suitable disintegrants may comprise but not limited to croscarmellose sodium, cross- linked polyvinil pyrrolidone (crospovidone), povidone, cross-linked carboxymethyl cellulose (croscarmellose sodium), low-substituted hydroxypropyl cellulose, pregelatinized starch, sodium carboxymethyl cellulose, calcium carboxymethyl cellulose, carboxymethyl cellulose, docusate sodium, guar gum, , polyacryline potassium, sodium alginate, corn starch, sodium starch glycolate, alginic acid, alginates, ion-exchange resins, magnesium aluminium silica, sodium dodesyl sulphate, poloxamer, sodium glycine carbonate, sodium lauryl sulphate or mixtures thereof.
- Suitable plasticizers may comprise but not limited to polyethylene glycols of different molecular weights, propylene glycol, glycerine, triethyl citrate (TEC), triacetin, diethyl phthalate (DEP), dibutyl phthalate (DBP), tributhyl citrate (TBC), castor oil, dibutyl sebacate (DBS), diacetylated monogglycerides or mixtures thereof.
- TEC triethyl citrate
- DEP diethyl phthalate
- DBP dibutyl phthalate
- THC tributhyl citrate
- DBS dibutyl sebacate
- Suitable preservatives may comprise but not limited to methyl paraben, propyl paraben and their salts (such as sodium, potassium), sodium benzoate, citric acid, benzoic acid, butylated hydroxytoluene, boric acid, sorbic acid, benzyl alcohol, benzalconium chloride, parahydroxybenzoic acids or butylated hydroxyanisole or mixtures thereof.
- Suitable sweeteners may comprise but not limited to aspartame, potassium acesulfame, sodium saccharinate, neohesperidine dihydrochalcone, sucralose, saccharin, sugars such as sucrose, glucose, lactose, fructose or sugar alcohols such as mannitol, sorbitol, xylitol, erythritol or mixtures thereof.
- Suitable flavoring agents may comprise but not limited to menthol, peppermint, cinnamon, chocolate, vanillin or fruit essences such as cherry, orange, strawberry, grape, black currant, raspberry, banana, red fruits, wild berries or mixtures thereof.
- Suitable coloring agents may comprise but not limited to ferric oxide, titanium dioxide, Food, Drug & Cosmetic (FD&C) dyes (such as; FD&C blue, FD&C green, FD&C red, FD&C yellow, FD&C lakes), poncau, indigo Drug & Cosmetic (D&C) blue, indigotine FD&C blue, carmoisine indigotine (indigo Carmine); iron oxides (such as; iron oxide red, yellow, black), quinoline yellow, flaming red, carmine, carmoisine, sunset yellow or mixtures thereof.
- FD&C Food, Drug & Cosmetic
- said pharmaceutical composition is for oral administration.
- the pharmaceutical form of said composition is solid dosage form.
- the solid dosage form is selected from the group comprising tablets, compressed tablets, coated or uncoated tablets, bilayer tablets, multilayer tablets, buccal tablets, sublingual tablets, tablet in tablets, in-lay tablets, effervescent compositions, effervescent tablets, immediate release tablets, modified release tablets, ODT-ER (orally disintegrating tablets-extended release), film-coated tablets, orally disintegrating tablets, gastric disintegrating tablets, mini tablets; pills, capsules, hard or soft gelatin capsules, powders, pellets, coated bead systems, granules, microspheres, ion exchange resin systems, dragees, sachets; orally administrable thin films, solutions or solids.
- the solid dosage form is preferably tablet or capsule.
- the solid dosage form is preferably in the form of a film coated tablet.
- the pharmaceutical composition is for use in the treatment of pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis
- Flurbiprofen, glucosamin sulfate, chondroitin sulfate, hyaluranic asit, methylsulfonylmethane (MSM), lactose spray dried, half of microcrystalline cellulose, croscarmellose sodium and hydroxypropyl cellulose are mixed.
- Colloidal silicon dioxide and rest of microcrystalline cellulose are sieved from 630 ⁇ sieve and added to the mixture and blended progressively for about 20 min.
- Magnesium stearate is added to the mixture and blended progressively for about 5 min.
- the final powder mixture is compressed to tablets.
- the tablets are coated by HPMC aqueous solution (12% w/w) and film coated tablets are obtained.
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Abstract
The present invention, relates to a new pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane which has therapeutic effect against pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
Description
COMPOSITION FOR JOINT AND CARTILAGE DISORDERS COMPRISING FLURBIPROFEN, GLUCOSAMINE SULFATE, CHONDROITIN SULFATE, HYALURONIC ACID AND METHYLSULFONYLMETHANE Field of Invention
The present invention, relates to a new pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane which has therapeutic effect against pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
Background of Invention Joint and cartilage disorders, is a painful degenerative condition that results in the deterioration of cartilage tissues that support the weight-bearing joints in the body. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bones, causing further pain and stiffness. It is believed that degenerative joint disorders affect 80% of people over the age of 60. Degenerative joint disorders include, for example, osteoarthritis, rheumatoid arthritis, other rheumatic disorders with cartilage breakdown, chondrolysis after joint trauma, for example, after meniscus or patella injuries or torn ligaments, or chondrolysis associated with prolonged immobilization of joints.
Osteoarthritis is the most prevalent form of arthritis which is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or the small joints of the hands. It is characterized by pain and progressive degeneration of cartilage in synovial joints and vertebrae, leading to significant reduction of mobility and quality of life. Osteoarthritis usually develops in joints that are injured by repeated overuse in the performance of a particular job or a favorite sport or from carrying around excess body weight. Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint so that the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom a person has with osteoarthritis is pain that worsens following exercise or immobility.
Rheumatoid arthritis is an autoimmune inflammatory disease in which the body releases enzymes that attack its own healthy tissues. In rheumatoid arthritis, these enzymes destroy the linings of joints causing pain, swelling, stiffness, deformity, and reduced movement and function. Rheumatoid arthritis also may include systemic symptoms.
Hence, pharmacological treatment of arthritis involves two therapeutic goals:
• Analgesic & anti-inflammatory treatment: Relief from pain and inflammation of the soft tissue surrounding the joint.
• Disease-modifying treatment to treat the underlying pathology.
Flurbiprofen is a well known propionic acid derivative, also known as NSAID (nonsteroidal anti-inflammatory drug), with the analgesic and anti-inflammatory activities it possesses. It is used in muscle-skeletal and joint disorders such as ankylosing spondylitis, osteoarthritis and rheumatoid arthritis, in soft-tissue disorders such as sprains and strains and for postoperative pains and mild to moderate pain including dysmenorrhoea and migraine. Its chemical structure is illustrated with Formula I given below.
Formula I. Flurbiprofen
Flurbiprofen is mostly administrated orally in dosages about 150 to 200 mg, may also be increased to 300 mg daily in acute or severe conditions if necessary.One disadvantage of the oral administration of compositions comprising flurbiprofen, is that the patient is likely to experience unpleasant side effects, including gastrointestinal (Gl) adverse effects including inflammation, spontaneous gastric bleeding, ulceration and perforation of the stomach, which can be life threatening. Thus, using flurbiprofen in high dosages may increase the Gl adverse effects.
There are various patent applications in prior art in relation to flurbiprofen compositions, for example, US3755427 describes the flurbiprofen molecule and the antiinflammatory, analgesic, antipyretic and anti-toxic effects of flurbiprofen. The document US4014993 discloses the use of flurbiprofen in platelet aggregation. The document EP137668 discloses the use of flurbiprofen in the treatment of alveolar bone resorption.
Glucosamine is an amino sugar and aprominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is part of the structure of the polysaccharides chitosan and chitin and it is naturally present in the shells of shellfish, animal bones and bone marrow. It is also present in some fungi and can be also synthetically derived. Glucosamine is used for the treatment of osteoarthritis. Its chemical name is (3R,4R,5S)-3-Amino-6-(hydroxymethyl)oxane-2,4,5-triol. Chemical structure of glucosamine sulfate (GS) is shown in the formula II. Recent studies indicate that it also slows the deterioration of cartilage and relieves pain. Tablet form of glucosamine sulfate is authorized in the strength of 500 and 750mg. Daily recommended dose is between 500 to 2500 mg.
Formula II. Glucosamine sulfate
Chondroitin sulfate (CS) is a sulfated glycosaminoglycan (GAG) composed of a chain of alternating sugars. Chondroitin sulfate is an important structural component of cartilage and provides much of its resistance to compression. Chondroitin sulfate is mostly administrated orally. Tablet form is authorized in the strength of 120, 250 and 400mg and daily recommended dose is 1200mg. However, it is also authorized as a topical gel for the treatment of osteoarthritis. Chemical structure of chondroitin sulfate is shown in the formula III.
Formula III. Chondroitin sulfate
In the state of art, there are capsule and tablet forms of glucosamine and chondroitin combination authorized in U.S. The main benefit of glucosamine and chondroitin combination is prevention of cartilage degeneration in the joints, especially in those affected by osteoarthritis. It also helps to reduce the pain associated with overuse conditions, such as knee tendonitis and other sports-related injuries and helps to reduce inflammation while increasing the health of the muscle and other tissue. US 2008/0227747 A1 discloses a therapeutic composition and methods for the treatment and prevention of a degenerative joint disorder and/or cardiovascular disease comprising polycosanols, glucosamine and chondroitin. Composition further may comprise NSAIDs, but neither an example nor flurbiprofen as one of the NSAIDs is disclosed in the patent application in combination with glucosamine.
Hyaluronic acid (HA) exists as a naturally-occurring polysaccharide (also known as a mucoid polysaccharide) that can be extracted from such diverse sources as rooster comb, umbilical cord, vitreous humor, synovial fluid, pathologic joints, skin and group A and C hemolytic Streptococci. The hyaluronic acid is also defined as a high viscosity naturally occurring glycosaminoglycan having a polymeric structure containing alternating N-acetyl-D-glucosamine and D-glucuronic acid monosaccharide units linked with [beta] 1 -4 bonds and the disaccharide units linked with [beta] 1 -3 glycoside bonds
Hyaluronic acid is a naturally occurring glycosaminoglycan. HA is ubiquitous in the organism, with the highest concentration found in soft connective tissue and joint fluid. It is a constituent of the intercellular matrix of connective tissue that exists in almost all vertebrates. It plays an important role in a number of physiological functions, including protection and lubrication of cells, maintenance of the structural integrity of tissues, transport of molecules and cells, cell migration, cell function and differentiation, and fluid retention and regulation.
Natural Hyaluronic acid is polydisperse in respect of molecular weight and is known to show excellent biocompatibility even when implanted or injected into the body by virtue of the absence of species and organ specificity. However, because of the relatively short in vivo residence time of Hyaluronic acid solution in biological applications, improvements in the persistency of Hyaluronic acid by chemical crosslinking with various chemical modifiers has been attempted to broaden its use for medical materials. Hyaluronic acid is an important component of the intercellular matrix. Specifically, the highest levels are found in the eye and synovial fluid of joints. In joints, its primary role is that of lubrication, reducing pain, and inflammation. In arthritic joints HA is deficient. In regards to the joints, synovial fluid supplies nutrition to the articular cartilage and has incomparable functions as a lubricant and a shock absorber. It is clarified that its excellent viscoelastisity heavily owes to one of the main components, Hyaluronic acid. Concentration and molecular weight analyses of Hyaluronic acid demonstrated the concentration and molecular weight of Hyaluronic acid in the synovial fluid from patients with arthritis such as osteoarthritis and chronic articular rheumatism generally tended to be lower than in normal synovial fluid, and the lower concentration and molecular weight of Hyaluronic acid were closely associated with development of locomotor dysfunction and pain attributable to the weaker lubricating action and the weaker protecting action on the surface of the articular cartilage of synovial fluid. Chemical structure Hyaluronic acid is shown in the formula IV.
Formula IV. Hyaluronic acid
Methylsulfonylmethane (MSM) is an organosulfur compound with the formula (CH 3) 2SO 2. It occurs naturally in some primitive plants, is present in small amounts in many foods and beverages, and is marketed as a dietary supplement. MSM is sold as a dietary supplement and marketed with a variety of combinations, often in combination with glucosamine and/or chondroitin for helping to treat or prevent osteoarthritis. Small- scale studies of possible treatments with MSM have been conducted on both animals and humans. These studies of MSM have suggested some benefits, particularly for treatment of osteoarthritis. A review by Brien, et al., (Systematic review of the nutritional supplements dimethyl sulfoxide ( DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis, Osteoarthritis and Cartilage, 2008; 16:1277) of the two small randomized controlled trials of methylsulfonylmethane in osteoarthritis knee pain relief reported significant improvement in pain outcomes in the treatment group compared to comparator treatments. After several reports that MSM helped arthritis in animal models, one study by Usha et al. (Double- blind, parallel, placebo- controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis, Clinical Drug Investigation, 2004; 24:353-63) had confirmed that 1 .5 g per day MSM (alone or in combination with glucosamine sulfate) was helpful in relieving symptoms of knee osteoarthritis. Chemical structure methylsulfonylmethane is shown in the formula V.
Formula V. Methylsulfonylmethane (MSM)
The combination of chondroitin sulfate with glucosamine, with or without the presence of other materials, was described by Towheed, T. E. et al., in JAMA 283(1 1 ):1483-1484 (2000). The same combination was reported by Canapp, S. O. et al., in Am. J. Vet. Res., 60(12):1552-7 (1999), who believed that orally administered glucosamine hydrochloride and chondroitin sulfate had a protective effect against chemically induced synovitis and associated bone remodeling in dogs. U.S. Pat. Nos. 6,162,787; 6,136,795; 5,929,050; 5,916,565; 5,888,514; 5,840,715; 4,772,591 ; and 4,473,551 , also report glucosamine combinations with chondroitin sulfate. Henderson, R. W., in
WO 9827988 described an aminosugar and glycosaminoglycan composition for the treatment and repair of connective tissue. A commercial dietary supplement, Flex-A- Min(R), is reported to provide a combination of glucosamine, chondroitin sulfate and methylsulfonylmethane, and is directed at subjects with arthritis and joint pain.
There are various patent applications in prior art in relation to separately or combinations of 2 or 3 active agents but not all 4 or 5 active agents in combination, therefore none of them are specifically comprises glucosamine sulfate, flurbiprofen, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane in oral administration as tablet or capsule dosage form.
It is well known that drugs used in the same therapeutic area or even for treating the same indication cannot always be combined a priori with the expectation of at least additive therapeutic effects. The scientific literature is full of examples wherein compounds of different classes, which are used to treat the same indications, cannot be combined into safe and efficacious dosage forms thereby resulting in incompatible drug combinations. The reasons for this unexpected lack of compatibility are varied; however, it is often found that the incompatible drug combinations result in increased side effects, unwanted drug interactions or new side effects.
However, no orally-administrable pharmaceutical composition has been produced until today, which contains a combination of flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane. Even if some medicaments comprising either of these active agents have been administered concomitantly in practice, this fact requires the patients to carry more than one drug and causes application-related difficulties. Additionally, administering and formulating a combination, in place of the individual use of each active agent, may provide improved treatment features. Another problem is related to combine these five active ingredients in one dosage form such as tablet or capsule, it would require a dosage form having approximately or more than 1000 mg active ingredients in total without any further tablet or capsule excipients. This is an amount that would create a very large tablet or capsule size that would not be swallowable or it would require composition that would require ingesting multiple tablets to achieve the desired effect.
In this present invention, the object is to provide a new pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid and methylsulfonylmethane. Accordingly, based on said drawbacks, a novelty is required in the art of pharmaceutical combinations having therapeutic effects against pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
Detailed description of the invention The main object of the present invention is to treat, reduce, or prevent the degenerative joint and cartilage disorders by administering to a subject in need thereof a therapeutically effective amount of a pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid, methylsulfonylmethane and at least one pharmaceutically acceptable excipient which overcomes the above described problems in prior art and have additional advantages over them.
A further object of the invention is to eliminate the Gl adverse effects of flurbiprofen when it is administered orally in high terapeutic effective amounts for a long time. It is known that the treatment of the degenerative joint and cartilage disorders, especially osteoarthritis and rheumatoid arthritis needs a long treatment period. Therefore to use of flurbiprofen for a long time with high terapeutic effective amounts may increase the possibility of Gl adverse effects of flurbiprofen. As a rule, after a long-term administration of a drug, drug addiction develops and as a consequence its dosage should be increased. This certainly affects the occurrence of side effects.
The present invention provides the solution to this problem by using the amount of flurbiprofen is not more than 15 % by weight of the total formulation by combining it with glucosamine sulfate, chondroitin sulfate, hyaluronic acid, methylsulfonylmethane. It has been found surprisingly that this ratios have an increased/synergistic effect over the flurbiprofen's analgesic and antiinflammatory activity even with low doses.
The role which glucosamine sulfate plays in the treatment or prevention of the degenerative joint and cartilage disorders is most likely associated directly its ability to act as the most important substrate for glycosaminoglycans and a basis of hyaluronic acid. A successful treatment of osteoarthritis and rheumatoid arthritis must control pain
effectively as well as slow down or ensure the reverse development of joint degeneration process. It has been found that the introduction of the amount of glucosamine sulfate is not more than 45 % by weight of the total formulation makes it possible to ensure a chondroprotective and anti-inflammatory effect of the composition and prevents destructive effect of glucocorticoids on chondrocytes and to reduce a need for NSAID (i.e. flurbiprofen) in high dosage for patients suffering from osteoarthritis and rheumatoid arthritis which in turn makes it possible to decrease side effect risks. Accordingly, when flurbiprofen is used for a long period of time, it may have a desensitising effect. It has been also found that when flurbiprofen is used by combination with glucosamine, chondroitin, hyaluronic acid methylsulfonylmethane makes it possible to ensure increased analgesic and anti-inflammatory effect of the composition, whilst reducing the pain and inflammation syndrome in degenerative joint and cartilage disorders synergisticly. Thus this also reduces the risk of the Gl side effects.
In one embodiment, the amount of chondroitin sulfate is not more than 25 % by weight of the total formulation.
In another embodiment, the amount of hyaluronic acid is not more than 15 % by weight of the total formulation.
Another preferred embodiment, the amount of methylsulfonylmethane is not more than 15 % by weight of the total formulation.
According to another preferred embodiment of the present invention, it has been found that when the pharmaceutical composition of the present invention comprises in certain ratios of;
a) flurbiprofen to glucosamine sulfate is in the range of 0.01 to 10.0, preferably 0.01 to 5.0, and more preferably 0.10 to 2.0;
b) flurbiprofen to chondroitin sulfate is in the range of 0.1 to 15.0, preferably 0.1 to 10.0, and more preferably 0.1 to 5.0;
c) flurbiprofen to hyaluronic acid is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
d) flurbiprofen to methylsulfonylmethane (MSM) is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
e) hyaluronic acid to methylsulfonylmethane (MSM) is in the range of 0.1 to 15.0, preferably 0.5 to 10.0, and more preferably 0.5 to 5.0;
f) chondroitin sulfate to glucosamine sulfate is in the range of 0.01 to 15.0, preferably 0.1 to 10.0, and more preferably 0.1 to 5.0; helps the composition to be easily processed into a tablet or capsule dosage form, in desired weight which can easily be swallowed by the patients, whilst maintaining or increasing the therapeutic effective doses for the joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
The pharmaceutical composition comprising;
a) flurbiprofen at 5-10% by weight,
b) glucosamin sulfate at 30-40% by weight,
c) chondroitin sulfate at 15-20% by weight,
d) hyaluranic asit at 5-10% by weight,
e) methylsulfonylmethane (MSM) at 5-10% by weight,
f) lactose spray dried at 5-20% by weight,
g) microcrystalline cellulose at 10-15% by weight,
h) croscarmellose sodium at 1 -5% by weight,
i) hydroxypropyl cellulose at 1 -5% by weight,
j) colloidal silicon dioxide at 0.1 -5% by weight,
k) magnesium stearate at 0.1 -5% by weight,
I) film coating (HPMC base) at 1 -5% by weight.
The process of the present invention for preparing the pharmaceutical formulation comprises the following steps;
Flurbiprofen, glucosamin sulfate, chondroitin sulfate, hyaluranic asit, methylsulfonylmethane (MSM), lactose spray dried, half of microcrystalline cellulose, croscarmellose sodium and hydroxypropyl cellulose are mixed. Colloidal silicon dioxide and rest of microcrystalline cellulose are sieved and added to the mixture and blended. Magnesium stearate is added to the mixture and blended. The final powder mixture is compressed to tablets or filled into capsules. Optionally, the tablets are coated by HPMC aqueous solution for coated tablets.
According to the challenges mentioned above the selection of the excipients thus very important. According to this embodiment, one or more pharmaceutically acceptable the excipient is selected from the group comprising buffering agents, stabilizers, binders, diluents, dispersing agents, lubricants, glidants, disintegrants, plasticizers, preservatives, sweeteners, flavoring agents, coloring agents or mixtures thereof.
Suitable buffering agents may comprise but not limited to alkali metal citrate, citric acid/sodium citrate, tartaric acid, fumaric acid, sorbic acid, citric acid, succinic acid, adipic acid, ascorbic acid, glutaric acid, potassium hydrogen tartrate, sodium hydrogen tartrate, potassium hydrogen phthalate, sodium hydrogen phthalate, potassium dihydrogen phosphate, sodium dihydrogen phosphate, disodium hydrogen phosphate, hydrochloric acid/sodium hydroxide or mixtures thereof, and preferably citric acid, fumaric acid, ascorbic acid, sodium dihydrogen phosphate or mixtures thereof. Suitable stabilizers may comprise but not limited to citric acid, fumaric acid, tartaric acid, sodium citrate, sodium benzoate, sodium dihydrogen phosphate, calcium carbonate, magnesium carbonate, arginine, lysine, meglamine, tocopherol, butylhydroxyanisole (BHA), butylhydroxytoluene (BHT), ascorbic acid, gallic acid esters or the mixtures thereof, and preferably, citric acid, fumaric acid, arginine or mixtures thereof.
Suitable binders may include but not limited to polyvinylpyrrolidone, polyethylene glycol, polyvinyl alcohol, starch, pregelatinized starch, glucose, glucose syrup, natural gums, sucrose, sodium alginate, hydroxypropyl methyl cellulose, hydroxypropyl cellulose, carboxy methyl cellulose, methyl cellulose, gelatin, carrageenan, guar gum, carbomer, polymethacrylates, methacrylate polymers, collagens gelatin, agar, alginate, alginic acid, xanthan gum, hyaluronic acid, pectin, polysaccharides, carbomer, poloxamer, polyacrylamide, aluminium hydroxide, laponit, bentonit, polyoxyethylene- alkyl ether, polydextrose, polyethylene oxide or mixtures thereof.
Suitable diluents may comprise but not limited to lactose spray dried, microcrystalline cellulose, mannitol, spray-dried mannitol, lactose, starch, dextrose, sucrose, fructose, maltose, sorbitol, xylitol, inositol, kaolin, inorganic salts, calcium salts, polysaccharides, dicalcium phosphate, sodium chloride, dextrates, lactitol, maltodextrin, sucrose- maltodextrin mixture, trehalose, sodium carbonate, sodium bicarbonate, calcium carbonate or mixtures thereof.
Suitable dispersing agents may comprise but not limited to calcium silicate, magnesium aluminum silicate or mixtures thereof. Suitable lubricants may comprise but not limited to magnesium stearate, calcium stearate, zinc stearate, talc, waxes, boric acid, hydrogenated vegetable oil, sodium chlorate, magnesium lauryl sulfate, sodium oleate, sodium acetate, sodium benzoate, polyethylene glycol, stearic acid, fatty acid, fumaric acid, glyseryl palmito sulphate, sodium stearyl fumarate, sodium lauryl sulphate or mixtures thereof.
Suitable glidants may comprise but not limited to colloidal silicon dioxide, talc, aluminium silicate, colloidal silica, starch or mixtures thereof.
Suitable disintegrants may comprise but not limited to croscarmellose sodium, cross- linked polyvinil pyrrolidone (crospovidone), povidone, cross-linked carboxymethyl cellulose (croscarmellose sodium), low-substituted hydroxypropyl cellulose, pregelatinized starch, sodium carboxymethyl cellulose, calcium carboxymethyl cellulose, carboxymethyl cellulose, docusate sodium, guar gum, , polyacryline potassium, sodium alginate, corn starch, sodium starch glycolate, alginic acid, alginates, ion-exchange resins, magnesium aluminium silica, sodium dodesyl sulphate, poloxamer, sodium glycine carbonate, sodium lauryl sulphate or mixtures thereof.
Suitable plasticizers may comprise but not limited to polyethylene glycols of different molecular weights, propylene glycol, glycerine, triethyl citrate (TEC), triacetin, diethyl phthalate (DEP), dibutyl phthalate (DBP), tributhyl citrate (TBC), castor oil, dibutyl sebacate (DBS), diacetylated monogglycerides or mixtures thereof.
Suitable preservatives may comprise but not limited to methyl paraben, propyl paraben and their salts (such as sodium, potassium), sodium benzoate, citric acid, benzoic acid, butylated hydroxytoluene, boric acid, sorbic acid, benzyl alcohol, benzalconium chloride, parahydroxybenzoic acids or butylated hydroxyanisole or mixtures thereof.
Suitable sweeteners may comprise but not limited to aspartame, potassium acesulfame, sodium saccharinate, neohesperidine dihydrochalcone, sucralose, saccharin, sugars such as sucrose, glucose, lactose, fructose or sugar alcohols such as mannitol, sorbitol, xylitol, erythritol or mixtures thereof.
Suitable flavoring agents may comprise but not limited to menthol, peppermint, cinnamon, chocolate, vanillin or fruit essences such as cherry, orange, strawberry, grape, black currant, raspberry, banana, red fruits, wild berries or mixtures thereof.
Suitable coloring agents may comprise but not limited to ferric oxide, titanium dioxide, Food, Drug & Cosmetic (FD&C) dyes (such as; FD&C blue, FD&C green, FD&C red, FD&C yellow, FD&C lakes), poncau, indigo Drug & Cosmetic (D&C) blue, indigotine FD&C blue, carmoisine indigotine (indigo Carmine); iron oxides (such as; iron oxide red, yellow, black), quinoline yellow, flaming red, carmine, carmoisine, sunset yellow or mixtures thereof.
In a preferred embodiment, said pharmaceutical composition is for oral administration. In another preferred embodiment, the pharmaceutical form of said composition is solid dosage form. The solid dosage form is selected from the group comprising tablets, compressed tablets, coated or uncoated tablets, bilayer tablets, multilayer tablets, buccal tablets, sublingual tablets, tablet in tablets, in-lay tablets, effervescent compositions, effervescent tablets, immediate release tablets, modified release tablets, ODT-ER (orally disintegrating tablets-extended release), film-coated tablets, orally disintegrating tablets, gastric disintegrating tablets, mini tablets; pills, capsules, hard or soft gelatin capsules, powders, pellets, coated bead systems, granules, microspheres, ion exchange resin systems, dragees, sachets; orally administrable thin films, solutions or solids.
According to the embodiment of the present invention, the solid dosage form is preferably tablet or capsule.
In another preferred embodiment, the solid dosage form is preferably in the form of a film coated tablet.
In this present invention, the pharmaceutical composition is for use in the treatment of pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis
Example: Film coated tablet
Production process of the formulation: Flurbiprofen, glucosamin sulfate, chondroitin sulfate, hyaluranic asit, methylsulfonylmethane (MSM), lactose spray dried, half of microcrystalline cellulose, croscarmellose sodium and hydroxypropyl cellulose are mixed. Colloidal silicon dioxide and rest of microcrystalline cellulose are sieved from 630 μηι sieve and added to the mixture and blended progressively for about 20 min. Magnesium stearate is added to the mixture and blended progressively for about 5 min. The final powder mixture is compressed to tablets. The tablets are coated by HPMC aqueous solution (12% w/w) and film coated tablets are obtained.
Claims
1 ) A pharmaceutical composition comprising flurbiprofen, glucosamine sulfate, chondroitin sulfate, hyaluronic acid, methylsulfonylmethane and at least one pharmaceutically acceptable excipient.
2) The pharmaceutical composition according to claim 1 , wherein the amount of flurbiprofen is not more than 15 % by weight of the total formulation. 3) The pharmaceutical composition according to claim 1 , wherein the amount of glucosamine sulfate is not more than 45 % by weight of the total formulation.
4) The pharmaceutical composition according to claim 1 , wherein the amount of chondroitin sulfate is not more than 25 % by weight of the total formulation.
5) The pharmaceutical composition according to claim 1 , wherein the amount of hyaluronic acid is not more than 15 % by weight of the total formulation.
6) The pharmaceutical composition according to claim 1 , wherein the amount of methylsulfonylmethane is not more than 15 % by weight of the total formulation.
7) The pharmaceutical composition according to any of the preceding claims comprising;
a) flurbiprofen at 5-10% by weight,
b) glucosamin sulfate at 30-40% by weight,
c) chondroitin sulfate at 15-20% by weight,
d) hyaluranic asit at 5-10% by weight,
e) methylsulfonylmethane (MSM) at 5-10% by weight,
f) lactose spray dried at 5-20% by weight,
g) microcrystalline cellulose at 10-15% by weight,
h) croscarmellose sodium at 1 -5% by weight,
i) hydroxypropyl cellulose at 1 -5% by weight,
j) colloidal silicon dioxide at 0.1 -5% by weight,
k) magnesium stearate at 0.1 -5% by weight,
I) film coating (HPMC base) at 1 -5% by weight.
8) The pharmaceutical composition according to any of the preceding claims, wherein the excipient is selected from the group comprising buffering agents, stabilizers, binders, diluents, dispersing agents, lubricants, glidants, disintegrants, plasticizers, preservatives, sweeteners, flavoring agents, coloring agents or mixtures thereof.
9) The pharmaceutical composition according to claim 1 , wherein said composition is for oral administration.
10) The pharmaceutical composition according to claim 9, wherein said compostion is in the form of solid dosage form.
1 1 ) The pharmaceutical composition according to claim 10, wherein the solid dosage form is selected from the group comprising tablets, compressed tablets, coated or uncoated tablets, bilayer tablets, multilayer tablets, buccal tablets, sublingual tablets, tablet in tablets, in-lay tablets, effervescent compositions, effervescent tablets, immediate release tablets, modified release tablets, ODT-ER (orally disintegrating tablets-extended release), film-coated tablets, orally disintegrating tablets, gastric disintegrating tablets, mini tablets; pills, capsules, hard or soft gelatin capsules, powders, pellets, coated bead systems, granules, microspheres, ion exchange resin systems, dragees, sachets; orally administrable thin films, solutions or solids.
12) The pharmaceutical composition according to claim 1 1 , wherein the solid dosage form is preferably tablet or capsule.
13) The pharmaceutical composition according to claim 12, wherein the solid dosage form is preferably in the form of a film coated tablet.
14) The pharmaceutical composition according to any of the preceding claims, for use in the treatment of pain and inflammatory symptoms associated with joint and cartilage disorders, especially with osteoarthritis and rheumatoid arthritis.
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