One- and three-month release injectable microspheres of the LH-RH superagonist leuprorelin acetate.

The biodegradable polymers poly(lactic/glycolic acid) (PLGA) and poly(lactic acid) (PLA) were used as wall materials in the preparation of microspheres (msp) containing the LH-RH superagonist leuprorelin (leuprolide) acetate. A novel W/O/W emulsion-solvent evaporation method was devised for the preparation of msp containing this water-soluble peptide. This method achieved high entrapment efficiency and sustained drug release over a long period predominantly due to polymer bioerosion. The msp are fine microcapsules with polycores containing the peptide at a high concentration and are easily injectable through a conventional fine needle. Leuprorelin msp made with PLGA(75/25)-14,000 or PLA-15,000 released the drug in a zero-order fashion, maintained constant serum drug levels and attained persistent objective suppression of the pituitary-gonadal system ('chemical castration') over 1 or 3 months after i.m. or s.c. injection into animals. These results indicate that depot formulations may be potentially useful in the therapy of endocrine diseases in humans. In this paper, studies on the formulation, drug release and pharmacological effects in animals for these leuprorelin depot formulations are reviewed.

[1]  H. Fuse,et al.  Leuprorelin Acetate Depot: Results of a Multicentre Japanese Trial , 1990, The Journal of international medical research.

[2]  James M. Anderson,et al.  Biocompatibility studies of naltrexone sustained release formulations , 1992 .

[3]  T. Kondo,et al.  Mechanism of hydrolytic degradation of poly(L-lactide) microcapsules: effects of pH, ionic strength and buffer concentration. , 1986, Journal of microencapsulation.

[4]  C. Romanini,et al.  Efficacy of leuprorelin acetate depot in symptomatic fibromatous uteri: the Italian Multicentre Trial. , 1992, Clinical Therapeutics.

[5]  Toshiaki Tanaka,et al.  A Dose Finding Study of a Super Long-Acting Luteinizing Hormone-Releasing Hormone Analog (Leuprolide Acetate Depot, TAP-144-SR) in the Treatment of Central Precocious Puberty. , 1991 .

[6]  R. Jones The effect of a luteinizing hormone releasing hormone (LRH) agonist (Wy-40,972), levonorgestrel, danazol and ovariectomy on experimental endometriosis in the rat. , 1984, Acta endocrinologica.

[7]  H. Okada,et al.  In vivo release profiles of leuprolide acetate from microcapsules prepared with polylactic acids or copoly(lactic/glycolic) acids and in vivo degradation of these polymers. , 1988, Chemical & pharmaceutical bulletin.

[8]  E. Knobil,et al.  The neuroendocrine control of the menstrual cycle. , 1980, Recent progress in hormone research.

[9]  C. Flamigni,et al.  Comparison of the suppressive capacity of different depot gonadotropin-releasing hormone analogs in women. , 1993, The Journal of clinical endocrinology and metabolism.

[10]  G. Golomb,et al.  Continuous versus pulsatile administration of erythropoietin (EPO) via the uterus in anemic rats , 1994 .

[11]  W. Vale,et al.  "Medical oophorectomy" using a long-acting GNRH agonist--a possible new approach to the treatment of endometriosis. , 1982, The Journal of clinical endocrinology and metabolism.

[12]  H. Okada,et al.  A radioimmunoassay for a highly active luteinizing hormone-releasing hormone analogue and relation between the serum level of the analogue and that of gonadotropin. , 1980, Endocrinologia japonica.

[13]  J. D. Miller,et al.  Depot leuprolide versus danazol in treatment of women with symptomatic endometriosis. I. Efficacy results. , 1992, American journal of obstetrics and gynecology.

[14]  T. Shimamoto,et al.  Vaginal absorption of a potent luteinizing hormone-releasing hormone analogue (leuprolide) in rats. IV: Evaluation of the vaginal absorption and gonadotropin responses by radioimmunoassay. , 1984, Journal of pharmaceutical sciences.

[15]  L. Bachrach,et al.  Two-year results of treatment with depot leuprolide acetate for central precocious puberty. , 1992, The Journal of pediatrics.

[16]  Y. Ikada,et al.  A formulation method using D,L-lactic acid oligomer for protein release with reduced initial burst , 1993 .

[17]  A. Daugherty,et al.  Delivery Systems for Recombinant Methionyl Human Growth , 1986 .

[18]  G E Visscher,et al.  Effect of particle size on the in vitro and in vivo degradation rates of poly(DL-lactide-co-glycolide) microcapsules. , 1988, Journal of biomedical materials research.

[19]  H. Okada,et al.  One-month release injectable microspheres of leuprolide acetate inhibit steroidogenesis and genital organ growth in rats , 1989 .

[20]  Toguchi Hajime,et al.  Drug delivery using biodegradable microspheres , 1994 .

[21]  H. Okada,et al.  Controlled-release of leuprolide acetate from polylactic acid or copoly(lactic/glycolic) acid microcapsules: influence of molecular weight and copolymer ratio of polymer. , 1988, Chemical & pharmaceutical bulletin.

[22]  G E Visscher,et al.  Biodegradation of and tissue reaction to 50:50 poly(DL-lactide-co-glycolide) microcapsules. , 1985, Journal of biomedical materials research.

[23]  R. Bodmeier,et al.  Polylactic acid microspheres containing quinidine base and quinidine sulphate prepared by the solvent evaporation technique. II. Some process parameters influencing the preparation and properties of microspheres. , 1987, Journal of microencapsulation.

[24]  James M. Anderson,et al.  In vivo biocompatibility studies of medisorb® 65/35 D,L-lactide/glycolide copolymer microspheres , 1993 .

[25]  E. Mini,et al.  Leuprorelin Acetate Depot in Advanced Prostatic Cancer: A Phase II Multicentre Trial , 1990, The Journal of international medical research.

[26]  A. Lemay,et al.  Luteinizing hormone-releasing hormone agonist and uterine leiomyoma: a pilot study. , 1985, American journal of obstetrics and gynecology.

[27]  Robert E. Johnson,et al.  Stability of atriopeptin III in poly(d,l-lactide-co-glycolide) microspheres , 1991 .

[28]  J. Benoit,et al.  In vivo peptide release from poly(dl-lactic acid-co-glycolic acid) copolymer 5050 microspheres , 1991 .

[29]  G. E. Visscher,et al.  Biodegradation of and tissue reaction to poly(DL-lactide) microcapsules. , 1986, Journal of biomedical materials research.

[30]  N. Faure,et al.  Inhibition of serum androgen levels by chronic intranasal and subcutaneous administration of a potent luteinizing hormone-releasing hormone (LH-RH) agonist in adult men. , 1982, Fertility and sterility.

[31]  Smadar Cohen,et al.  Characterization of PLGA microspheres for the controlled delivery of IL-1α for tumor immunotherapy , 1997 .

[32]  P. A. Lee,et al.  Depot leuprolide acetate dosage for sexual precocity. , 1991, The Journal of clinical endocrinology and metabolism.

[33]  "Add-back" estrogen reverses cognitive deficits induced by a gonadotropin-releasing hormone agonist in women with leiomyomata uteri. , 1997, The Journal of clinical endocrinology and metabolism.

[34]  Rajendra S. Pradhan,et al.  Formulation and in vitro release study on poly (DL-lactide) microspheres containing hydrophilic compounds : glycine homopeptides , 1994 .

[35]  M. Fujino,et al.  Synthetic analogs of luteinizing hormone releasing hormone (LH-RH) substituted in position 6 and 10. , 1974, Biochemical and biophysical research communications.

[36]  J M Brady,et al.  Degradation rates of oral resorbable implants (polylactates and polyglycolates): rate modification with changes in PLA/PGA copolymer ratios. , 1977, Journal of biomedical materials research.

[37]  A. Schindler,et al.  Experience with leuprorelin acetate depot in the treatment of fibroids: a German multicentre study. , 1992, Clinical therapeutics.

[38]  T Yashiki,et al.  Vaginal absorption of a potent luteinizing hormone-releasing hormone analog (leuprolide) in rats I: absorption by various routes and absorption enhancement. , 1982, Journal of pharmaceutical sciences.

[39]  T Yashiki,et al.  Vaginal absorption of a potent luteinizing hormone-releasing hormone analogue (leuprolide) in rats II: mechanism of absorption enhancement with organic acids. , 1983, Journal of pharmaceutical sciences.

[40]  M. Hibberd,et al.  Clinical Efficacy and Safety of a New Leuprorelin Acetate Depot Formulation in Patients with Advanced Prostatic Cancer , 1990, The Journal of international medical research.

[41]  A. Magoun,et al.  A biologic comparison of polyglactin 910 and polyglycolic acid synthetic absorbable sutures. , 1975, Surgery, gynecology & obstetrics.

[42]  T. Kondo,et al.  Preparation and in vitro degradation properties of polylactide microcapsules. , 1985, Chemical & pharmaceutical bulletin.

[43]  H. Okada,et al.  New method for analysis of biodegradable polyesters by high-performance liquid chromatography after alkali hydrolysis. , 1992, Biomaterials.

[44]  E. Cittadini,et al.  Role of leuprolide acetate depot in hysteroscopic surgery: a controlled study , 1993 .

[45]  R. Barbieri,et al.  A randomized, placebo-controlled, double-blind study evaluating the efficacy of leuprolide acetate depot in the treatment of uterine leiomyomata. , 1989, Fertility and sterility.

[46]  M. Eandi,et al.  Pharmacokinetics, endocrine and antitumour effects of leuprolide depot (TAP-144-SR) in advanced prostatic cancer: a dose-response evaluation. , 1989, Drugs under experimental and clinical research.

[47]  J. D. Miller,et al.  Depot leuprolide acetate versus danazol in the treatment of women with symptomatic endometriosis: a multicenter, double-blind randomized clinical trial. II. Assessment of safety. The Lupron Endometriosis Study Group. , 1993, American journal of obstetrics and gynecology.

[48]  W. Saltzman,et al.  Stabilization of nerve growth factor in controlled release polymers and in tissue. , 1996, Journal of biomaterials science. Polymer edition.

[49]  A. Harris,et al.  CONTINUOUS SUBCUTANEOUS PUMP INFUSION OF SOMATOSTATIN ANALOGUE SMS 201‐995 VERSUS SUBCUTANEOUS INJECTION SCHEDULE IN ACROMEGALIC PATIENTS , 1987, Clinical endocrinology.

[50]  R. Gleason,et al.  A Prospective, Randomized Trial of Gonadotropin‐Releasing Hormone Agonist Plus Estrogen‐Progestin or Progestin “Add‐Back” Regimens for Women With Leiomyomata Uteri , 1993, The Journal of clinical endocrinology and metabolism.

[51]  M. Nozaki,et al.  Efficacy of a low-dose leuprolide acetate depot in the treatment of uterine leiomyomata in Japanese women. , 1992, Fertility and sterility.

[52]  G. Lübben,et al.  Efficacy and safety of leuprorelin acetate depot for prostate cancer. The German Leuprorelin Study Group. , 1996, Urologia internationalis.

[53]  W. White,et al.  Regression of rat mammary tumors effected by a gonadoliberin analog. , 1976, Cancer research.

[54]  W. Bischoff 3.75 and 7.5 mg Leuprorelin Acetate Depot in the Treatment of Advanced Prostatic Cancer: Preliminary Report , 1990, The Journal of international medical research.

[55]  Toguchi Hajime,et al.  Factors influencing the profiles of TRH release from copoly(d,l-lactic/glycolic acid) microspheres , 1991 .

[56]  James M. Anderson,et al.  Tissue Responses to Drug Delivery Systems , 1984 .

[57]  R. Kimmig,et al.  Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. , 1992, Clinical therapeutics.

[58]  L. Illum,et al.  (D) Routes of delivery: Case studies , 1992 .

[59]  R. Gupta,et al.  Stabilization of tetanus toxoid in poly(DL-lactic-co-glycolic acid) microspheres for the controlled release of antigen. , 1996, Journal of pharmaceutical sciences.

[60]  J. D. Miller,et al.  Lupron depot (leuprolide acetate for depot suspension) in the treatment of endometriosis: a randomized, placebo-controlled, double-blind study. Lupron Study Group. , 1990, Fertility and sterility.

[61]  H. Okada,et al.  Persistent suppression of the pituitary-gonadal system in female rats by three-month depot injectable microspheres of leuprorelin acetate. , 1996, Journal of pharmaceutical sciences.

[62]  G Quesnel,et al.  Potential new treatment of endometriosis: reversible inhibition of pituitary-ovarian function by chronic intranasal administration of a luteinizing hormone-releasing hormone (LH-RH) agonist. , 1982, Fertility and sterility.

[63]  T. Yashiki,et al.  Vaginal absorption of a potent luteinizing hormone-releasing hormone analogue (leuprolide) in rats III: Effect of estrous cycle on vaginal absorption of hydrophilic model compounds. , 1983, Journal of pharmaceutical sciences.

[64]  T. Yashiki,et al.  Regression of rat mammary tumors by a potent luteinizing hormone-releasing hormone analogue (leuprolide) administered vaginally. , 1983, Cancer research.

[65]  M. Soloway,et al.  Clinical study of leuprolide depot formulation in the treatment of advanced prostate cancer. The Leuprolide Study Group. , 1990, The Journal of urology.

[66]  W. Crowley,et al.  Use of a potent, long acting agonist of gonadotropin-releasing hormone in the treatment of precocious puberty. , 1986, Endocrine reviews.

[67]  H. Schneider,et al.  Estrogen and progesterone receptor content of enucleated uterine myomata after luteinizing hormone‐releasing hormone: Analogue depot therapy , 1994, Acta obstetricia et gynecologica Scandinavica.

[68]  D. Blake,et al.  Long-acting delivery systems for narcotic antagonists. 1. , 1973, Journal of medicinal chemistry.

[69]  H. Okada,et al.  One-month release injectable microcapsules of a luteinizing hormone-releasing hormone agonist (leuprolide acetate) for treating experimental endometriosis in rats. , 1988, The Journal of pharmacology and experimental therapeutics.

[70]  A. Shahzamani,et al.  A month–long effect from a single injection of microencapsulated human growth hormone , 1996, Nature Medicine.

[71]  T. Kissel,et al.  Factors influencing the release of peptides and proteins from biodegradable parenteral depot systems , 1992 .

[72]  R. N. Brogden,et al.  Leuprorelin. A review of its pharmacology and therapeutic use in prostatic cancer, endometriosis and other sex hormone-related disorders. , 1994, Drugs.

[73]  T. Shimamoto,et al.  Desensitization of gonadotropin-releasing response following vaginal consecutive administration of leuprolide in rats. , 1983, Journal of pharmacobio-dynamics.

[74]  P. Doubilet,et al.  A randomized, placebo-controlled, double-blind study evaluating leuprolide acetate depot treatment before myomectomy. , 1989, Fertility and sterility.

[75]  M. Dowsett,et al.  A dose-comparative endocrine-clinical study of leuprorelin in premenopausal breast cancer patients. , 1990, British Journal of Cancer.

[76]  B. Giraud Interim Report of a Large French Multicentre Study of Efficacy and Safety of 3.75 mg Leuprorelin Depot in Metastatic Prostatic Cancer , 1990, The Journal of international medical research.

[77]  T. Epperly,et al.  A new long-acting injectable microcapsule system for the administration of progesterone. , 1979, Fertility and sterility.

[78]  P. Fornara,et al.  Clinical study results of the new formulation leuprorelin acetate three-month depot for the treatment of advanced prostate carcinoma. , 1996, Urologia internationalis.

[79]  R. Clemons,et al.  Long-term effectiveness of depot gonadotropin-releasing hormone analogue in the treatment of children with central precocious puberty. , 1993, American journal of diseases of children.

[80]  A. Schally,et al.  Inhibition of prostate tumor growth in two rat models by chronic administration of D-Trp6 analogue of luteinizing hormone-releasing hormone. , 1981, Proceedings of the National Academy of Sciences of the United States of America.

[81]  E. Zerhouni,et al.  A Placebo-Controlled Trial of a Depot Gonadotropin-Releasing Hormone Analogue (Leuprolide) in the Treatment of Uterine Leiomyomata , 1989, Obstetrics and gynecology.

[82]  H. Akaza,et al.  Long-term clinical study on Luteinising hormone-releasing hormone agonist depot formulation in the treatment of stage D prostatic cancer , 1992 .

[83]  R. Bruskewitz,et al.  Leuprolide acetate 22.5 mg 12-week depot formulation in the treatment of patients with advanced prostate cancer. , 1996, Clinical therapeutics.

[84]  D. Lewis,et al.  Controlled release of a luteinizing hormone-releasing hormone analogue from poly(d,l-lactide-co-glycolide) microspheres. , 1984, Journal of pharmaceutical sciences.

[85]  H. Okada,et al.  Controlled Release of LHRH Agonist, Leuprolide Acetate, from Microcapsules: Serum Drug Level Profiles and Pharmacological Effects in Animals , 1989, The Journal of pharmacy and pharmacology.

[86]  H. Okada,et al.  Biodegradable microspheres in drug delivery. , 1995, Critical reviews in therapeutic drug carrier systems.

[87]  G. E. Visscher,et al.  Tissue Response to Biodegradable Injectable Microcapsules , 1987, Journal of biomaterials applications.

[88]  Michel Vert,et al.  MORE ABOUT THE DEGRADATION OF LA/GA – DERIVED MATRICES IN AQUEOUS MEDIA , 1991 .

[89]  D. E. Cutright,et al.  Histologic comparison of polylactic and polyglycolic acid sutures. , 1971, Oral surgery, oral medicine, and oral pathology.

[90]  M. Mulholland,et al.  Efficacy of two comparative antibiotic regimens in the treatment of serious intra-abdominal infections: results of a multicenter study. , 1992, Clinical therapeutics.

[91]  J. D. Miller,et al.  Treatment of leiomyomata uteri with leuprolide acetate depot: A double‐blind, placebo‐controlled, multicenter study , 1991, Obstetrics and gynecology.

[92]  M. Alonso,et al.  Development of biodegradable microspheres and nanospheres for the controlled release of cyclosporin A , 1993 .

[93]  J. Benoit,et al.  Biodegradation and brain tissue reaction to poly(D,L-lactide-co-glycolide) microspheres. , 1993, Biomaterials.

[94]  H. Okada,et al.  In vitro and in vivo evaluation of thyrotrophin releasing hormone release from copoly(dl-lactic/glycolic acid) microspheres. , 1994, Journal of pharmaceutical sciences.

[95]  S. Corson,et al.  Long-term management of adenomyosis with a gonadotropin-releasing hormone agonist: a case report. , 1993, Fertility and sterility.

[96]  R. Bodmeier,et al.  Polylactic acid microspheres containing quinidine base and quinidine sulphate prepared by the solvent evaporation method. III. Morphology of the microspheres during dissolution studies. , 1988, Journal of microencapsulation.

[97]  W. Crowley,et al.  A conservative approach to the management of uterine leiomyoma: pituitary desensitization by a luteinizing hormone-releasing hormone analogue. , 1983, American journal of obstetrics and gynecology.

[98]  W. White,et al.  Endocrine-dependent rat mammary tumor regression: use of a gonadotropin releasing hormone analog. , 1976, Science.

[99]  T Yashiki,et al.  A new technique to efficiently entrap leuprolide acetate into microcapsules of polylactic acid or copoly(lactic/glycolic) acid. , 1988, Chemical & pharmaceutical bulletin.

[100]  Toguchi Hajime,et al.  Effects of counteranion of TRH and loading amount on control of TRH release from copoly(dl-lactic/glycolic acid) microspheres prepared by an in-water drying method , 1991 .

[101]  J. Carel,et al.  Treatment of central precocious puberty with depot leuprorelin. French Leuprorelin Trial Group. , 1995, European journal of endocrinology.