Methods of administering topical antifungal formulations for the treatment of fungal infections

Abstract

The present invention relates to topical antifungal formulations comprising one or more antifungal (e.g., terbinafine), a lipid and a surfactant, and uses thereof for the treatment of skin and nail fungal infections.

Description

PRIORITY[0001]This application claims the benefit of U.S. Provisional Application No. 61 / 083,115, filed Jul. 23, 2008, U.S. Provisional Application No. 61 / 102,111, filed Oct. 2, 2008, U.S. Provisional Application No. 61 / 150,187, filed Feb. 5, 2009, and U.S. Provisional Application No. 61 / 162,122, filed Apr. 9, 2009. The contents of each of these applications is hereby incorporated by reference herein their entirety.1. FIELD OF INVENTION[0002]The present invention relates to topical formulations of an antifungal comprising one or more antifungals, a lipid and a surfactant, and uses thereof for the treatment of skin and nail fungal infections.2. BACKGROUND[0003]Onychomycosis is a fungal infection of the fingernails and toenails that results in thickening, discoloration, splitting of the nails and lifting of the nails from the nail bed. The disease is caused by dermophytes and has a high incidence within the general population, especially among older individuals. Onychomycosis is most ...

AI Technical Summary

Benefits of technology

[0009]The antifungal formulations of the invention facilitate the delivery of antifungal to the infected area in an amount sufficient to treat the fungal infection. In the case of onychomycosis, the formulation can be administered to the nail and / or the surrounding skin. The formulation may also be administered to the entire toe and / or finger tip. The formulation may preferably be administered to the distal phalanx of the finger or toe. In the case of skin infection, the formulation can be administered to the infected area of the skin. In one embodiment, the topical terbinafine formulation is applied to the surface of the nail (i.e., the nail plate) and to the skin surrounding the nail. In another embodiment, the topical terbinafine formulation is applied epicutaneously.

[0029]Further provided herein is a regimen for the treatment of onychomycosis in a human subject comprising the administration of a pharmaceutically acceptable formulation comprising an antifungal as described herein, e.g., terbinafine, a lipid, preferably a phospholipid, and a surfactant, preferably a nonionic surfactant, to an infected nail and / or to the skin surrounding the infected nail. The formulation is to be administered for a period of time, preferably spanning two or more weeks, including three, four, five, six, seven, eight, nine, ten, eleven, twelve weeks or more. In one embodiment, the formulation is to be administered for a period of ten to twelve weeks. The formulation is to be administered for a period of time to result in a mycological cure rate, preferably greater than about 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% in the infected nail in the human subject. Alternatively, the formulation is administered for a period of time to prevent recurrence of fungal infection.

[0033]In certain embodiments, the antifungal formulations provided herein preferably form vesicles or other extended surface aggregates (ESAs), wherein the vesicular preparations have improved permeation capability through the semi-permeable barriers, such as skin and / or nails. While not to be limited to any mechanism of action, the preferred antifungal formulations are able to form vesicles characterized by their deformability and / or adaptability. The vesicles' deformability and / or adaptability allows the vesicles to penetrate the pores of the skin and / or nails and deliver antifungal to the site of infection in an amount sufficient to treat the infection. The adaptability or deformability of the vesicles may be determined by the ability of the vesicles to penetrate a barrier with pores having an average pore diameter at least 50% smaller than the average vesicle diameter before the penetration. Thus, in certain embodiments, the formulation comprises deformable vesicles capable of penetrating a barrier with pores having an average pore diameter at least 50% smaller than the average vesicle diameter before the penetration. In some embodiments, the pores are human skin pores or animal skin pores. In some embodiments, the average pore diameter is from about 10 microns to about 100 microns, about 30 to about 70 microns, or about 40 to about 60 microns.

[0041]The antifungal formulations disclosed herein may be safer than oral, systemic terbinafine formulations. Because the antifungal formulations of the invention are only applied to the site of the infection, the risk of side-effects associated with e.g., oral terbinafine, is reduced, gastrointestinal effects (e.g., feelings of fullness, loss of appetite, dyspepsia, nausea, abdominal pain, diarrhea), skin reactions (e.g., rash, urticaria), musculoskeletal reactions (arthralgia or myalgia) or malaise or tiredness. Other risks reduced by the antifungal formulations disclosed herein include elevated liver enzymes and / or liver failure.

[0042]In one embodiment, the invention encompasses a method for preventing onychomycosis, particularly recurrence of onychomycosis, comprising topically administering to a subject a pharmaceutical formulation comprising a therapeutically effective amount of an antifungal described herein, e.g., terbinafine, a lipid, and a surfactant. The antifungal formulations disclosed herein may result in a low rate of recurrence of onychomycosis in a patient. More specifically, the antifungal formulations disclosed herein may have a lower rate of recurrence of onychomycosis than currently available treatments (e.g., Lamisil™ Cream, Lamisil™ Lotion, Lamisil™ Gel or oral Lamisil) after 2 weeks, 6 weeks, 12 weeks, 24 weeks and 48 weeks after last administration.

Problems solved by technology

Onychomycosis is a fungal infection of the fingernails and toenails that results in thickening, discoloration, splitting of the nails and lifting of the nails from the nail bed.

Other treatment options including chemical or surgical removal of the infected nail(s) can lead to nail bed shrinkage and dorsal dislocation of the nail bed.

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