The patent specification
14 In describing the field of the invention, the complete specification of the patent (the specification) says that the invention relates to new pharmaceutical compositions comprising entacapone, levodopa and carbidopa (or their pharmaceutically acceptable salts or hydrates), including an oral solid fixed dose combination; to a method of preparing such compositions; and to the use of the compositions in a therapeutic method: page 1, lines 4-10.
15 By way of background, the specification discloses that levodopa and carbidopa are the most commonly used drugs in the treatment of Parkinson's disease and that they are available for administration in the form of combination tablets. These tablets are taken several times a day with a separate entacapone tablet. The specification says that patient compliance can be improved significantly by using a fixed dose combination of entacapone, levodopa and carbidopa: page 2, lines 7-12.
16 The specification says that, so far as the patentee is aware, no patent or other publication describes an oral solid composition comprising entacapone, levodopa and carbidopa or their pharmaceutically acceptable salts or hydrates: page 3, lines 3-6.
17 In the description which follows, we will only refer to the combination of entacapone, levodopa and carbidopa, it being understood that this description is to be taken as including a reference to the pharmaceutically acceptable salts and hydrates of these active agents.
18 The specification discloses the desirability of releasing entacapone, levodopa and carbidopa from the oral composition as soon as possible after ingestion. However, it is very difficult to adjust the absorption of the three different active agents. The specification discloses that, usually, in practice, the absorption of one active agent may decrease, while another increases. The specification also teaches the importance of considering numerous factors (such as the bioavailabilities of the active agents and the stability of the composition) when selecting appropriate excipients, disintegrants and other auxiliary agents to be used in a composition containing several active agents.
19 When summarising the invention, the specification states (at page 3, lines 13-21):
Applicants have discovered that entacapone, levodopa and carbidopa, or their pharmaceutically acceptable salts or hydrates, can be combined into one oral solid composition with particularly interesting properties.
The invention thus provides an oral solid fixed dose composition comprising pharmacologically effective amounts of entacapone, levodopa and carbidopa, or pharmaceutically acceptable salts or hydrates thereof, and comprising at least one pharmaceutically acceptable excipient (hereinafter referred to as a composition according to the invention), which has i.a. preferable stability and bioavailability characteristics and which is easy to swallow.
20 The appellants place particular significance on this passage. They submit that the second paragraph stands as, in effect, a consistory statement which confines the invention to an oral solid fixed dose composition of entacapone, levodopa and carbidopa that has preferable stability and bioavailability characteristics, with ease of swallowing.
21 The respondents also place particular significance on this passage. They submit that the invention described in the first paragraph of the passage is a three-in-one composition of entacapone, levodopa and carbidopa with particularly interesting properties. The second paragraph then defines "a composition according to the invention" as a composition with pharmacologically effective amounts of the three active agents together with at least one pharmacologically acceptable excipient. The respondents say that this paragraph conveys that there are preferred embodiments of the invention that are able to achieve preferable stability, bioavailability and ease of swallowing, which embodiments are then described in succeeding passages of the specification.
22 Immediately following the passage at page 3, lines 13-21, the specification discloses a particular embodiment in which at least one pharmaceutically acceptable excipient is sugar alcohol (preferably, mannitol), starch (preferably, maize starch) or sugar alcohol and starch: page 3, lines 22-27.
23 The specification discloses another embodiment in which microcrystalline cellulose (MCC) is not used as an excipient: page 4, lines 1-5.
24 The summary of the invention then turns to consider the question of bioavailability. The specification states (at page 4, lines 6-15):
Applicants have found that a particularly interesting way to increase the bioavailability of carbidopa from an oral solid composition comprising entacapone, levodopa, and carbidopa is to add carbidopa separately, for instance by granulating first levodopa and entacapone together and then adding carbidopa to these granules separately.
Accordingly, the invention further provides an oral solid composition comprising pharmacologically effective amounts of entacapone, levodopa, and carbidopa, or pharmaceutically acceptable salts or hydrates thereof, and a pharmaceutically acceptable excipient, wherein a substantial portion of carbidopa is separated from entacapone and/or levodopa.
25 The specification discloses that there are several techniques to accomplish this separation. One technique is to granulate entacapone and levodopa together, and then add carbidopa separately "as such or in a form of granules": page 4, lines 16-19.
26 The summary of the invention says that the oral solid composition "includes a tablet, a capsule and the like": page 5, lines 3-4. However, a tablet form is preferred.
27 The summary also says that the invention provides a method of treating Parkinson's disease by administering "an oral solid composition according to the invention" (page 5, line 8) up to, for example, eight to ten times per day, and an oral solid composition for the treatment of Parkinson's disease in different stages of the disease.
28 The specification includes a number of figures (Figures 1 to 6) showing, respectively, entacapone, levodopa and carbidopa plasma concentrations after a single dose of certain described formulations or compositions (Formulations 1 to 4) containing the three active agents. Two other formulations (Formulations 5 and 6) are also disclosed.
29 The specification includes three examples (Examples 1 to 3) with corresponding tables (Tables 1 to 3). These tables list the ingredients of each exemplified formulation.
30 Example 1 was designed to assess the absorption in healthy volunteers of the active agents in two fixed dose combination tablets (Formulations 1 and 2) compared to the separate administration of entacapone (200 mg tablet) and levodopa/carbidopa (100/25 mg tablet) (the reference products). In Formulation 1, the combination tablets were prepared by wet granulating all the active agents at the same time. In Formulation 2, the combination tablets were prepared by dry granulating (compaction granulating) all the active agents at the same time. The blood plasma levels of entacapone (Figure 1), levodopa (Figure 2) and carbidopa (Figure 3) respectively were measured in the volunteers after Formulation 1, Formulation 2 and the reference products were administered. It was found that, for Formulation 1, the bioavailability of carbidopa was too low compared to the reference products. For Formulation 2, the bioavailability of carbidopa was acceptable. However, this formulation included polyethylene glycol which was found to cause stability problems.
31 In Example 2, the combination tablets (Formulations 3 and 4) were prepared differently to Formulations 1 and 2. In Formulation 3, entacapone and levodopa, with certain excipients, were wet granulated together. Carbidopa was wet granulated, with certain excipients, separately. The entacapone/levodopa granules (and excipients) and the carbidopa granules (and excipients) were mixed together and compressed into tablets which were then coated. Formulation 4 was prepared analogously, except that carbidopa was added in a powder form. The excipients used in Formulations 3 and 4 were different to the excipients used in Formulations 1 and 2.
32 The blood plasma levels of entacapone (Figure 4), levodopa (Figure 5) and carbidopa (Figure 6) respectively were measured after Formulation 3, Formulation 4 and the reference products were administered to the volunteers. The results showed that Formulation 3 and Formulation 4 were comparable with the reference products, in terms of absorption of the active agents.
33 In Example 3, two formulations (Formulations 5 and 6) were prepared according to the procedure used for Formulation 3, but using different amounts of entacapone, levodopa and carbidopa. The core tablets were then coated.
34 In giving a detailed description of the invention, the specification states (at page 7, lines 1-12):
Applicants have surprisingly discovered that an oral solid composition enabling sufficient absorption of active agents can be achieved by combining entacapone, levodopa and carbidopa, or a pharmaceutically acceptable salt or hydrate thereof, in a single formulation. This has been achieved, inter alia, by improving the bioavailability and the stability of the composition, and improving the method for preparing the composition.
Applicants have found that absorptions of levodopa, carbidopa and entacapone from the digestive tract are highly variable. The bioavailabilities of levodopa and carbidopa vary both intra- and interindividually. The bioavailability of entacapone has also been extensively studied by the Applicant to arrive at the present invention.
35 The appellants place particular reliance on the last sentence of the first paragraph quoted above.
36 The specification continues by referring to the fact that "[i]t is very challenging to harmonize the absorptions of three active ingredients from one and the same oral solid composition" and that "the method for preparing the composition has a significant effect on the bioavailability of carbidopa": page 7, lines 13-16. Here, the specification refers to the low bioavailability of carbidopa in Formulation 1 compared to the levodopa/carbidopa reference product, and the stability problems caused by the use of polyethylene glycol in Formulation 2.
37 The specification then says that "a preferred way to increase the bioavailability of carbidopa from an oral solid composition comprising entacapone, levodopa and carbidopa" (page 8, lines 3-5) has been found - namely, to mix levodopa and entacapone together and then add carbidopa, separately, to this mixture.
38 The specification continues (at page 8, lines 7-10):
The invention therefore provides an oral solid composition of entacapone, levodopa, and carbidopa, or pharmaceutically acceptable salts or hydrates thereof, and a pharmaceutically acceptable excipient, wherein a substantial portion of carbidopa is separated from entacapone and levodopa.
39 This is the consistory statement for claim 1 of the patent.
40 The specification states, in general terms, how such a composition can be obtained: page 8, lines 11-16. It then describes a process for preparing an oral solid composition of the invention which stands as the consistory statement for claims 12 and 13 of the patent: page 8, lines 17-23. The specification says that examples of "these kinds of formulations according to the invention" are described in Example 2: page 9, lines 10-11.
41 The detailed description then turns to discuss the compatibility of the ingredients of compositions of the invention. The specification discloses that entacapone, levodopa and carbidopa are compatible with each other, but many commonly used excipients are not suitable to be used in compositions containing these active agents. The specification says that most available levodopa/carbidopa formulations available in the market contain MCC and that certain recent formulations of entacapone (such as those used in the entacapone reference product) contain considerable amounts of MCC. The specification says that, for compounds of the invention, it was unexpectedly found that MCC destabilises the formulations on long term storage. The specification states (at page 10, lines 6-10):
Accordingly, the invention provides a stable oral solid pharmaceutical composition comprising pharmacologically effective amounts of entacapone, levodopa, and carbidopa, or pharmaceutically acceptable salts or hydrates thereof, and at least one pharmaceutically acceptable excipient other than microcrystalline cellulose.
42 This is the consistory statement for claim 11 of the patent.
43 Additionally, the specification discloses that polyethylene glycol as an excipient resulted in tablets that were found to be unstable in a standard stability test: see [30] above. It also discloses (at page 10, lines 11-21) that other surface-active substances (for example, polysorbate and sodium lauryl sulphate) have been found to be incompatible with the fixed dose composition, as have colloidal silicone oxide and copolyvidone.
44 The specification then says (at page 10, line 22 to page 11, line 4):
Accordingly, as a preferred embodiment of the invention, a stable oral solid pharmaceutical composition is provided comprising pharmacologically effective amounts of entacapone, levodopa, and carbidopa, or a pharmaceutically acceptable salt of hydrate thereof, and at least one pharmaceutically acceptable excipient other than microcrystalline cellulose and/or surface active agents and/or silica.
45 The specification also says that, despite the several incompatibilities found, "the oral solid composition according to the invention can still surprisingly be prepared by using few compatible excipients alone or two or more together": page 11, lines 5-7. The specification gives sugar alcohols (preferably, mannitol) and starch (preferably, maize starch) as appropriate excipients to be used.
46 The specification continues (at page 11, lines 10-14):
Accordingly, the present invention provides an oral solid composition comprising pharmacologically effective amounts of entacapone, levodopa, and carbidopa, or a pharmaceutically acceptable salt or hydrate thereof, and comprising at least one pharmaceutically acceptable excipient being a sugar alcohol, starch or sugar alcohol and starch.
47 This is the consistory statement for claim 4 of the patent.
48 After discussing other suitable excipients, disintegrants and binders, the detailed description turns to consider the amounts of entacapone, levodopa and carbidopa to be used in the composition. These amounts are said to be known to one skilled in the art. The specification also says that other pharmacologically active agents can be used, additionally, in the composition. The specification gives embodiments containing dosages of the three active agents that are "particularly preferred": page 13, lines 3-11.
49 The specification continues (at page 13, lines 12-21):
As a further aspect the invention provides an oral solid fixed dose composition comprising pharmacologically effective amounts of entacapone, levodopa, and carbidopa, or a pharmaceutically acceptable salt or hydrate thereof, and comprising at least one pharmaceutically acceptable excipient, whereby the therapeutic effect achieved with the said composition in the treatment of Parkinson's disease is comparable, e.g. similar, to that achieved with the known separate formulations of entacapone, levodopa and carbidopa, e.g. entacapone tablets and levodopa-carbidopa tablets referred to herein, which are administered concomitantly, at the same doses of the active agents as the combination formulation of the invention.
50 This is the consistory statement for claim 21 of the patent.
51 After describing certain other embodiments of the invention, which are said to be pharmacokinetically comparable to the known separate formulations of entacapone and levodopa/carbidopa at the same doses, the detailed description turns to consider the question of tablet size.
52 Here, the specification discloses that compaction granulation is used for entacapone tablets. The specification says that compaction granulation requires large amounts of excipients to be used in order to obtain the desired fast dissolution behaviour of an immediate release formula. But, notwithstanding these large amounts of excipients, a 200 mg tablet can be prepared which, the specification says, is relatively easy to swallow. The specification says that the compactability of the fixed dose combination tablets of the invention was found to be surprisingly worse than for entacapone tablets alone and that these tablets can become too large, especially for parkinsonism patients who have difficulties in swallowing. Polyethylene glycol was found to be a useful compression aid that improved compactability but, as stated above, this excipient was found to produce tablets that were unstable in storage: page 15, line 19 to page 20, line 9.
53 The specification then describes the following process (at page 16, lines 10-23):
The invention thus provides an advantageous process for preparing an oral solid composition of the invention, wherein the method comprises a) mixing pharmacologically effective amounts of entacapone and levodopa, or a pharmaceutically acceptable salt or hydrate thereof, with at least one pharmaceutically acceptable excipient and optionally a disintegrant to obtain a first mixture; b) granulating the first mixture to obtain a first granule batch; c) mixing a pharmacologically effective amount of carbidopa, or a pharmaceutically acceptable salt or hydrate thereof, with at least one pharmaceutically acceptable excipient and optionally a disintegrant to obtain a second mixture; d) granulating the second mixture to obtain a second granule batch; e) mixing the first granule batch, the second granule batch, optionally a lubricant, and optionally one or more pharmaceutically acceptable excipients, to obtain a third mixture; f) formulating the third mixture to a plurality of dosage forms, e.g. compressing the third mixture into a plurality of tablets and optionally coating the tablets.
54 This is the consistory statement for claim 16.
55 A further process is described (at page 17, lines 1-11):
An oral solid composition according to the invention can also be prepared by a) mixing pharmacologically effective amounts of entacapone and levodopa, or a pharmaceutically acceptable salt or hydrate thereof, with at least one pharmaceutically acceptable excipient and optionally a disintegrant to obtain a first mixture; b) granulating the first mixture to obtain a plurality of granules; c) adding a pharmacologically effective amount of carbidopa, or a pharmaceutically acceptable salt or hydrate thereof, optionally a lubricant and optionally one or more pharmaceutically acceptable excipients, to the granules to obtain a second mixture; d) formulating the second mixture to a plurality of dosage forms, e.g. compressing the second mixture into a plurality of tablets and optionally coating the tablets.
56 This is the consistory statement for claim 17.
57 The specification says that, by using the process of the invention, tablet compositions of the invention may be made which, for the dosages contained therein, are particularly small and convenient to administer: page 17, lines 18-20.
58 The specification discloses a particular oral pharmaceutical tablet (at page 18, lines 4-9):
In another aspect the present invention provides an oral pharmaceutical tablet comprising 200mg entacapone, 50-150mg levodopa, and 10-37.5 mg carbidopa and having preferably substantially the following characteristics:
weight 400-750 mg, e.g. 550-590 mg,
volume dimensions for oval tablet preferably from 200 to 1000 mm3, e.g. 250 to 800 mm3, such as 300 to 600 mm3, e.g. 300 to 550 mm3.
59 This is the consistory statement for claim 19.
60 The specification discloses another oral pharmaceutical tablet (at page 18, lines 10-17):
In yet a further aspect the present invention provides an oral pharmaceutical tablet comprising 200mg entacapone, 50-150mg levodopa, and 10-37.5 mg carbidopa and having substantially the following characteristics:
weight 400-750 mg, e.g. 550-590 mg,
volume dimensions for oval tablet preferably,
length 13-18 mm, e.g. 14-18 mm,
width 6-9 mm,
height 4-7 mm, e.g. 5-6 mm.
61 This is the consistory statement for claim 20.
62 The specification proceeds to discuss the Examples to which we have referred at [30]-[33] above.
63 Following these Examples, the specification states (at page 24, line 23 to page 25, line 2):
Those skilled in the art will recognize that while specific embodiments have been illustrated and described, various modifications and changes may be made without departing from the spirit and scope of the invention.
Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.
64 The specification also provides the following explanation (at page 25, lines 3-5):
Throughout the description and claims of the specification the word "comprise" and variations of the word, such as "comprising" and "comprises", is not intended to exclude other additives, components, integers or steps.
65 As we will come to explain, the scope to be given to "comprise" and its variants, so as not to exclude other additives, components, integers or steps, assumed considerable importance for the primary judge's construction of the claims in suit, particularly in relation to claim 17.
66 The specification ends with 24 claims.
67 Relevantly, claim 17 is directed to a method of preparing an oral solid composition comprising entacapone, levodopa and carbidopa. Claims 19 and 20 are directed to particular oral pharmaceutical tablets comprising entacapone, levodopa and carbidopa. Claim 21 is directed to an oral solid fixed dose composition comprising pharmacologically effective amounts of entacapone, levodopa and carbidopa. We will refer in more detail to these claims when summarising the primary judge's findings that are relevant to this appeal.