REGROWTH

FIELD OF INVENTION

The inventor has discovered that a composition comprising minoxidil, finasteride and a prostaglandin analogue shows improved properties in terms of reducing hair loss and increasing hair regrowth when compared to conventional therapies, such as the topical application of a solution of 5% minoxidil.

BACKGROUND OF THE INVENTION

Androgenetic alopecia(AGA) is hair loss (at scalp level) caused by the thinning of hair follicles. It is very common in men between the age of 19 and 70 years. Notably, more than 50% of Caucasian men in their fifties are affected by it. Women's hair loss mostly becomes an issue after menopause.

Individuals affected by androgenetic alopecia (AGA) show a diminution of their self-esteem that can effect negatively many facets of their lives. The inventor has discovered that a composition for topical administration comprising minoxidil, finasteride and a prostaglandin analogue is effective in reducing hair loss and increasing hair regrowth.

There are several hair loss prevention products on the market. By way of example, minoxidil has been in use since the 1990s in topical form at 2% concentration (without prescription) and at 3% and 5% concentration (with prescription). While studies demonstrate the efficiency of 5% minoxidil over the 2% concentration, minoxidil is less than 40% effective in promoting regrowth of the hair. Minoxidil is considered the topical gold standard available for treatment of hair loss.

Another hair loss prevention product is finasteride. It is administered orally usually at a dosage of 1 mg/day. There are a number of side effects associated with the administration of finasteride including lowered libido, impotence, ejaculation disorders, allergic reactions, testicular pain, male infertility, male breast cancer and depression. At higher concentrations (5 mg), finasteride can cause benign prostate hyperplasia.

Latanoprost, a PGF _2a prostaglandin analog, is widely used in ophthalmology to treat open angle glaucoma and ocular hypertension. One of its side effects has been an augmentation of periocular hirsuteness, which includes a surge in the thickness, length and pigmentation of eyelashes which is to be distinguished from hair growth. Some of its other adverse effects are erythema, folliculitis, sensation of burning and erysipelas. A latanoprost ophthalmic solution has a concentration of 0.005%. It should be noted that scalp hair follicles and eyelash follicles are not identical and one cannot simply extrapolate from a drug effect on one type of hair to another.

The inventor has discovered that a composition comprising minoxidil, finasteride and a prostaglandin analogue for topical application to the scalp reduces hair loss and increases hair regrowth. Such a composition shows superior improvements to those seen for each of the components of the composition taken individually and the results obtained to date suggest that the improvements may be superior to those of the sum of the said components.

SUMMARY OF INVENTION

The invention relates to a composition comprising 2% to 5% minoxidil, 0.01% to 15%

finasteride and 0.01% to 15% of a prostaglandin analogue. In one embodiment, the prostaglandin analogue is latanoprost. In another embodiment, the composition comprises 5% minoxidil, 0.1% finasteride and 0.03% latanoprost. The invention also relates to the use of a composition comprising 2% to 5% minoxidil, 0.01% to 15% finasteride and 0.01% to 15% of a prostaglandin analogue to reduce hair loss and/or increase regrowth of hair in a human subject.

BRIEF DESCRIPTION OF THE FIGURES

Figures 1 A to 1L are a series of photographs showing the scalp of participant 1 prior to treatment and at intervals throughout the course of a six month treatment with a composition of the invention. Figures 1A and IB show the scalp before treatment on the first day of month 1 , Figures 1C and ID show the scalp on month 2, Figures IE and IF on month 3, Figures 1G and 1H on month 4, Figures II and 1 J on month 5 and Figures IK and 1L on month 6; Figures 2A to 2L are a series of photographs showing the scalp of participant 2 prior to treatment and at intervals throughout the course of a six month treatment with a composition of the invention. Figures 2 A and 2B show the scalp before treatment on the first day of month 1, Figures 2C and 2D show the scalp on month 2, Figures 2E and 2F on month 3, Figures 2G and 2H on month 4, Figures 21 and 2J on month 5 and Figures 2K and 2L on month 6;

Figures 3A to 3L are a series of photographs showing the scalp of participant 3 prior to treatment and at intervals throughout the course of a six month treatment with a composition of the invention. Figures 3 A and 3B show the scalp before treatment on the first day of month 1, Figures 3C and 3D show the scalp on month 2, Figures 3E and 3F on month 3, Figures 3G and 3H on month 4, Figures 31 and 3J on month 5 and Figures 3K and 3L on month 6;

Figures 4A to 4L are a series of photographs showing the scalp of participant 4 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 5% minoxidil only. Figures 4 A and 4B show the scalp before treatment on the first day of month 1 , Figures 4C and 4D show the scalp on month 2, Figures 4E and 4F on month 3, Figures 4G and 4H on month 4, Figures 41 and 4J on month 5 and Figures 4K and 4L on month 6;

Figures 5A to 5L are a series of photographs showing the scalp of participant 5 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1% finasteride only. Figures 5 A and 5B show the scalp before treatment on the first day of month 1, Figures 5C and 5D show the scalp on month 2, Figures 5E and 5F on month 3, Figures 5G and 5H on month 4, Figures 51 and 5J on month 5 and Figures 5K and 5L on month 6;

Figures 6A to 6L are a series of photographs showing the scalp of participant 6 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1% finasteride only. Figures 6A and 6B show the scalp before treatment on the first day of month 1, Figures 6C and 6D show the scalp on month 2, Figures 6E and 6F on month 3, Figures 6G and 6H on month 4, Figures 61 and 6J on month 5 and Figures 6K and 6L on month 6;

Figures 7A to 7G are a series of photographs showing the scalp of participant 7 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1% finasteride only. Figures 7 A and 7B show the scalp before treatment on the first day of month 1, Figure 7C shows the scalp on month 2, Figure 7D on month 3, Figure 7E on month 4, Figure 7F on month 5 and Figure 7G on month 6;

Figures 8A to 8L are a series of photographs showing the scalp of participant 8 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1% finasteride only. Figures 8 A and 8B show the scalp before treatment on the first day of month 1 , Figures 8C and 8D show the scalp on month 2, Figures 8E and 8F on month 3, Figures 8G and 8H on month 4, Figures 81 and 8J on month 5 and Figures 8K and 8L on month 6;

Figures 9A to 9L are a series of photographs showing the scalp of participant 9 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.03 %> latanoprost only. Figures 9A and 9B show the scalp before treatment on the first day of month 1 , Figures 9C and 9D show the scalp on month 2, Figures 9E and 9F on month 3, Figures 9G and 9H on month 4, Figures 91 and 9 J on month 5 and Figures 9K and 9L on month 6;

Figures 10A to 10L are a series of photographs showing the scalp of participant 10 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.03%) latanoprost only. Figures 10A and 10B show the scalp before treatment on the first day of month 1 , Figures IOC and 10D show the scalp on month 2, Figures 10E and 10F on month 3, Figures 10G and 10H on month 4, Figures 101 and 10J on month 5 and Figures 10K and 10L on month 6.

Figure 6 is a series of photographs showing the scalp of participant 6 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1 % finasteride only;

Figure 7 is a series of photographs showing the scalp of participant 7 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1% finasteride only;

Figure 8 is a series of photographs showing the scalp of participant 8 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.1 % finasteride only; Figure 9 is a series of photographs showing the scalp of participant 9 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.03% latanoprost only; and

Figure 10 is a series of photographs showing the scalp of participant 10 prior to treatment and at intervals throughout the course of a six month treatment with a solution of 0.03% latanoprost only.

DETAILED DESCRIPTION OF THE INVENTION

The invention relates to a composition comprising minoxidil, finasteride and a prostaglandin analog which shows improved properties for the reduction of hair loss and for the increase of hair regrowth in human subjects, when compared to minoxidil, fmesteride and latanoprost taken alone.

Minoxidil or (6-(l-pipedidinyl)-2,4-pyrimidinediamine 3-oxide) has the following structural formula:

Minoxidil is a crystalline solid which has a solubility in mg/ml of 75 in propylene glycol, of 44 in methanol, of 29 in ethanol, of 6.7 in 2-propanol, of 6.5 in DMSO, of 2.2 in water, of 0.5 in chloroform, and of <0.5 in acetone. Minoxidil has a pKa of 4.61. Finasteride or ((5a,17 )-N-(l,l-Dimethylethyl)-3-oxo-4-azaandrost-l-ene-17-carboxam ide) has the following structural formula:

n

Finasteride is conventionally administered orally at a daily dose of 1 mg.

Finasteride is an anhydrous crystalline solid. Finasteride is freely soluble in chloroform, DMSO, ethanol, methanol, n-propanol; sparingly soluble in propylene glycol, polyethylene glycol 400; and very slightly soluble in 0.1N HC1 and 0.1N NaOH. Finasteride is not soluble in water.

Latanoprost or ((5Z)-7-[(lR,2R,3R,5SO-3,5-Dihydroxy-2-[(3 )-3-hydroxy-5-phenylpentyl] cyclopentyl]-5-heptenoic acid 1 -methylethyl ester) has the following structural formula:

Latanoprost is an oil. Latanoprost is very soluble in acetonitrile; freely soluble in acetone, ethanol, ethyl acetate, isopropanol, methanol and octanol. It is practically insoluble in water.

Prostaglandins regulate a number of physiological functions. It has been found that most hair cell types are endowed with prostaglandin metabolism machinery and are thus able to produce PGE ₂ and/or PGF _2a . The epithelial part of the hair bulb is the main source of prostaglandin synthesis and interconversion. From Colombe et al. {Prostaglandin Metabolism in Human Hair Follicle, Exp Dermatol. 2007 Sep., 16(9): 762 to 769) and as minoxidil has also been found to enhance prostaglandin endoperoxide synthase- 1 (PGHS-1) activity, this suggests that prostaglandins are involved in hair growth and differentiation control and that there is a link between prostaglandin synthesis and hair growth. Minoxidil has been demonstrated to be a potent activator of purified PGHS-1 by assaying oxygen consumption in prostaglandin PGE ₂ production suggesting that the mechanism beyond the hair-growth stimulating effect of minoxidil is stimulation of PGE ₂ synthesis (Michelet et al., Activation of Cytoprotected Prostaglandin Synthase-1 by Minoxidil as a Possible Explanation for Its Hair Growth-Stimulating Effect, J. Invest Dermatol 1997: 108: 205-209). This has been confirmed by the role of PGHS-2 in the control of hair cycle (Muller- Decker et al., Expression of Cyc o-Oxygenase Isozymes During Morphogenesis and Cycling of Telage Hair Follicles in Mouse Skin, J. Invest Dermatol 2003: 121 : 661-668). It has been shown that the human hair follicle can sustain a complete PGE ₂ and PGF _2a metabolism. Human hair follicle express (i) mPGES-1 , mPGES-2 and cPGES which catalyse PGE ₂ synthesis from PGH ₂ , (ii) AK 1C3/PGFS which converts PGH ₂ into PGF _2ct and (iii) CDR1 and AKR1C1 aldo- ketoreductase, which could control PGE ₂ PGF _2a interconversion. As such, it has been shown that human hair follicles appear fully enzymatically equipped to self-process prostaglandin synthesis and metabolism, meaning PGE and PGF _2a could be produced and inter-converted by hair follicles. While the composition tested comprised latanoprost, a PGF _2a prostaglandin analogue, it is surmised that other prostaglandin analogues can also be used given the role played by prostaglandin in hair growth and differentiation. By way of example, other suitable prostaglandin analogues include travoprost, bimatoprost, tafluprost and unoprostone.

The composition of the invention comprises 2% to 5% minoxidil, 0.01% to 15% finasteride and 0.01% to 15%) of a prostaglandin analogue. In a preferred embodiment, the composition comprises 2% to 5% minoxidil, 0.01% to 5% finasteride and 0.01% to 5% of a prostaglandin analogue. In a more preferred embodiment, the composition comprises 5% minoxidil, 0.5% finasteride and 0.1% of a prostaglandin analogue. In a yet other preferred embodiment, the prostaglandin analogue is latanoprost, travoprost, bimatoprost, tafluprost or unoprostone. In a further preferred embodiment, the prostaglandin analogue is latanoprost. In an even more preferred embodiment, the composition comprises 5% minoxidil, 0.1% finasteride and 0.03% latanoprost as set out in Table 1 below.

In order to demonstrate the improved properties of a composition suitable for topical application comprising minoxidil, finasteride and a prostaglandin analogue, latanoprost, the composition was compared to compositions comprising 5% minoxidil only, 0.1% finasteride only and 0.03% latanoprost only. The various compositions were prepared as follows.

Example 1;

Preparation of Composition Comprising Finasteride. Latanoprost and Minoxidil

In order to prepare the composition, latanoprost was diluted to obtain a concentration of 10,000 mcg/ml of solute on in absolute ethyl alcohol, and prepared as a stock solution and kept in a freezer to enhance stability (-20°C). Absolute ethyl alcohol was mixed with propylene glycol and heated to 55 ⁰ -65°C. Minoxidil powder was then added to the alcohol/propylene glycol mixture. In a containment hood, finasteride was added to the solution and stirred until dissolved. The preparation was cooled to room temperature. Ethoxy diglycol and latanoprost were added to the cooled solution and stirred well, until in solution. The final solution was brought to volume with absolute ethyl alcohol.

The amounts used are set out in Table 1 below:

Absolute ethyl alcohol Solvent QS 60 ml 39.87

TOTAL 60 ml 100%

Various modifications for the preparation of the composition of the invention will be apparent to the skilled worker. Furthermore, other pharmaceutically acceptable additives such as suspending agents, emulsifying agents, non-aqueous vehicles and preservatives can be added. The techniques for the preparation of these compositions are well known in the art and reference may be had to Remington's Pharmaceutical Sciences, 18 ^th edition, Mack Publishing Co., Easton, Pennsylvania, USA 18042.

Example 2:

Preparation of Composition Comprising Minoxidil

A composition comprising 5% minoxidil was prepared. Absolute ethyl alcohol was mixed with propylene glycol and heated to 55° to 65°C. The minoxidil powder was added to the alcohol/propylene glycol mixture. Ethoxy diglycol was added and the solution was stirred. The final solution was brought to volume with absolute ethyl alcohol to obtain a solution comprising 5% minoxidil.

Example 3:

Preparation of Composition Comprising Finasteride

A composition comprising 0.1% finasteride was also prepared. Absolute ethyl alcohol was mixed with propylene glycol. Finasteride was added to the alcohol/propylene glycol mixture to obtain a solution having a concentration of 0.1% finasteride. Absolute ethyl alcohol also serves the function of preservative. Example 4;

Preparation of Composition Comprising Latanoprost

A solution comprising 0.03% latanoprost was prepared. Absolute ethyl alcohol was mixed with propylene glycol. The latanoprost was added to the alcohol/propylene glycol mixture. The final solution was brought to volume with absolute ethyl alcohol in order to obtain a solution having a concentration of 0.03% latanoprost. The absolute ethyl alcohol also serves the function of preservative in this composition.

Example 5:

Treatment of Participants With Composition of Invention and Comparators - Analysis and

Measurements

For each participant, the distance between the base of the nose and the middle of the hair crown was noted, as well as the distance separating the most distal part of the helix and the hair crown. A square area of two centimeters by two centimeters was measured around the middle point of the hair crown (marked by a washable felt crayon). Photographs were taken of each participant's scalp.

The participants were seen at monthly intervals over a six-month period and their hair was analysed in the manner described above and photographs taken.

Results

A. Treatment With Composition Comprising Finasteride, Latanoprost and Minoxidil

Each participant first had his hair analysed as described above and photographs taken. Following the first analysis, each participant was provided with a solution comprising 0.1% finasteride, 0.03% latanoprost and 5% minoxidil prepared as described in Example 1 above. The participants applied 1 ml to the scalp, once a day after cleansing. The 1 ml was applied as 10 metered dose sprays of 0.1 ml. The results for three participants are provided. Participant 1 was a male of 61 years of age (Figure 1). Participant 2 was a male of 23 years of age (Figure 2) while participant 3 was a male of 29 years of age (Figure 3). All three participants had androgenetic alopecia, as did the participants of the comparator groups.

Figures 1 , 2 and 3 clearly show a marked decrease of hair loss and an increase in hair regrowth in all three participants.

B. Comparison with Treatment With Minoxidil, Finasteride and Latanoprost Alone

Each participant first had his hair analysed as described in part A above and photographs taken. Following the first analysis, each participant was provided with a solution comprising either 5% minoxidil, 0.1% finasteride, or 0.03% latanoprost. The compositions were prepared as described in Examples 2 to 4 above. The participants applied 1 ml to the scalp, once a day after cleansing. The 1 ml was applied as 10 metered dose sprays of 0.1 ml.

The results for the participants of each group are provided.

The participant for the minoxidil group was a 64 year old male. Figure 4 shows the results obtained for this participant. Only a slight improvement in hair regrowth is observed and the results are very inferior to those seen with the composition of the invention.

Four participants used a solution of 0.1% finasteride only. These participants were respectively 30 (participant 5), 33 (participant 6), 36 (participant 7) and 46 years of age (participant 8). Figures 5, 6, 7 and 8 show the results for participants 5, 6, 7 and 8 respectively. Only a slight improvement in hair regrowth is observed. The results are far inferior to those seen with the composition of the invention.

Two participants used a solution comprising 0.03% latanoprost only. These participants were respectively 48 (participant 9) and 52 (participant 10) years of age. Figures 9 and 10 show the results for participants 9 and 10 respectively. Only a slight improvement in hair regrowth was observed. The results obtained are far inferior to those observed with the composition of the invention. The composition comprising minoxidil, finasteride and latanoprost shows improved properties in terms of reduction of hair loss and increase of regrowth of hair when compared to a solution of 5% minoxidil alone, a solution of 0.1% finasteride alone or a solution of 0.03% latanoprost alone. The improvements shown in the reduction of hair loss and the increase of regrowth hair for the composition of the invention are superior to the improvements seen for each of the components of the composition taken individually and the results obtained to date suggest that the improvements may be superior to those of the sum of the said components.

While the composition of the invention has been tested on males, similar results are expected on females as the mechanism of hair growth is the same for both genders.

While the present invention has been described in connection with specific embodiments thereof and in a specific use, various modifications will occur to those skilled in the art. The scope of the claims should not be limited by the preferred embodiments or the examples but should be given the broadest interpretation consistent with the description as a whole.