JP2013530020A - 生体活性剤を送達する医療デバイスのための脂質コーティング - Google Patents
生体活性剤を送達する医療デバイスのための脂質コーティング Download PDFInfo
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Abstract
Description
この出願は、米国企業であるSurModics, Inc.社と米国市民であるRalph a. Chappa氏およびEmily R. Rolfes Meyering氏の名において、2011年6月30日にPCT国際特許出願として出願されたものであり、米国を除く全指定国についてはSurModics, Inc.社をその出願人とし、米国を指定国とする場合についてはRalph a. Chappa氏およびEmily R. Rolfes Meyering氏をその出願人とする。また、この出願は、米国特許出願第61/360,212号(出願日:2010年6月30日)を基礎出願とするものである。
本発明は、医療デバイスの拡大および折り畳み可能な構造上の脂質コーティング、並びに、これら脂質コーティングおよび医療デバイスの作製方法および使用方法に関する。一つまたは複数の脂質を含んでいるコーティングは、送達部位における上記デバイスから放出される治療薬の量を増加させることができる。
埋め込まれている医療デバイスからの薬物の放出は、デバイスの機能および様々な病状の処置として有益であることが示されてきた。例えば、デバイス表面からの薬物の送達によって、上記埋め込み可能なデバイスの存在により生起される細胞応答を抑制することができる。また、上記デバイスから放出された薬物により、埋め込み後の上記デバイスの機能寿命を縮めかねない状態を抑制することができる。さらに、上記デバイスから放出された薬物は、体の罹患部の処置において使用されてもよい。
本発明は、拡大および折り畳み可能な構造を含んでいる医療デバイス用の脂質コーティング、並びに、これらの製造方法および使用方法に関する。一つまたは複数の脂質を含むコーティングは、上記送達部位の上記デバイスから放出される治療薬の量を増加させる。
図1は、拡大および折り畳み可能な構造上のコーティングを概略的に示す。
本発明は、対象内の部位に生体活性剤を送達する医療デバイスに関する。本発明はまた、本発明のデバイスの作製方法および使用方法に関する。上記医療デバイスの少なくとも一部は、上記対象内に挿入されることができる。上記対象内に挿入されることができる上記医療デバイスの一部は、拡大および折り畳み可能な構造を含む。実施形態では、上記拡大および折り畳み可能な構造は、バルーンカテーテルのバルーンである。上記拡大および折り畳み可能な構造上において、上記デバイスは、生体活性剤を含んでいるコーティング(薬剤コーティング)を含む。また、上記デバイスは、上記生体活性剤を含んでいる上記コーティングの全体または一部の上に脂質コーティングを含む。
本発明の脂質の組成物は、脂質または脂質の混合物を含むことができる。上記脂質または脂質の混合物は、例えば、室温では固体(例えば、ワックス状またはペースト状)または半固体であり、対象の体温では軟質体または液体であることができる。
本発明の脂質の組成物は、一つまたは複数の脂肪酸を含むことができ、遊離脂肪酸がエステル化されたものでなく、または誘導体化脂肪酸を意味する。上記脂肪酸は、カルボン酸塩(例えば、脂肪酸塩)を含むことができるか、または、カルボン酸塩(例えば、脂肪酸塩)とすることができる。好適な脂肪酸として、飽和脂肪酸および不飽和脂肪酸が挙げられる。好適な不飽和脂肪酸として、単不飽和脂肪酸および多価不飽和脂肪酸が挙げられる。実施形態では、上記脂肪酸の組成物は、単不飽和脂肪酸を含む。実施形態では、上記脂肪酸の組成物が飽和脂肪酸を含む。実施形態では、上記脂肪酸の組成物が飽和脂肪酸および単不飽和脂肪酸を含む。
実施形態では、上記脂質の組成物は、リン脂質を含む。好適なリン脂質としては、例えば、ホスファチジン酸、ホスファチジルコリン、ホスファチジルエタノールアミン、ホスファチジルセリン、または、その混合物が挙げられる。
本発明はまた、本発明のデバイスを利用して、対象に生体活性剤を送達する方法も含む。本発明の方法は、本発明の医療デバイスを提供することを含むことができる。また、上記方法は、上記医療デバイスを対象に挿入すること、次いで拡大および折り畳み可能な構造を当該対象内で拡大することを包含することができる。拡大直後または拡大後、上記生体活性剤の有効量が上記対象の組織へ向けて放出される。
本発明の医療デバイスは、生体活性剤を含んでいる多様なコーティングのうち任意のコーティングを含むことができる。多数の好適なコーティングおよびそのようなコーティングに有用なポリマーは、本明細書中に記載されている。上記拡大および折り畳み可能な構造から生体活性剤を放出することに好適なある実施形態では、数秒から数分の間に上記送達部位で上記生体活性剤の効果的な量を放出することができる。上記生体活性剤は、上記コーティングまたは上記コーティングのポリマーマトリックスに取り込まれた非結晶の形態とすることができる。
上記コーティングは、非拡大状態において、上記生体活性剤の固定化を可能にするポリマー材料(一つまたは複数のポリマー)から形成されることができる。上記ポリマー材料は、上記マトリックスの形成に有用な、一つまたは複数のホモポリマー、コポリマー、これらの組み合わせ、または、これらの混合物を含むことができる。一様態では、上記ポリマー材料は、上記コーティングとして可塑性ヒドロゲルマトリックスを形成するために用いられる。
上記生分解性ポリマーは、インビボにおいてインプラントの形態にて用いられる、一つまたは複数(例えば、一つ、二つ、三つ、または、四つ)の特定の生分解性ポリマーを含むことができる。適切なポリマーは、生分解性となり、生体適合性溶媒系中で実質的に溶解可能となる。特に、上記生分解性ポリマーは、上記生体適合性溶媒系中において、25℃、1atmの条件下で少なくとも約50g/Lの溶解性を有することができる。一実施形態では、上記生分解性ポリマーは、上記生体適合性溶媒系中では実質的に不溶性のポリマーを含まない。実施形態では、上記生分解性ポリマーは、水または体液に対して実質的に不溶性の生分解性ポリマーを含まない。
本発明に有用な生分解性ポリマーの好適な一分類は、ポリ(エーテルエステル)マルチブロックコポリマーを含む。これらマルチブロックコポリマーは、DL−ラクチド、グリコリド、e−カプロラクトン、およびポリエチレングリコールの異なる組み合わせの多様なプレポリマー構築ブロックから構成されている。上記分子の組成、分子量(Mw1,200〜6,000)、および、上記プレポリマーのブロックの比率を変化させることによって、上記最終ポリマーに異なる機能性を取り入れることができる。そして、これにより、多様な生理化学的性質を有するポリマーを作製することができる。疎水性ポリマーおよび親水性/膨潤性ポリマーと緩徐分解性ポリマーおよび急速分解性ポリマーとの両方を設計することができる。
nはMwが300〜1,000のポリエチレングリコールであり;
oはe−カプロラクトンであり;および、
qはDL−ラクチドである。
zはゼロまたは正の整数である;
R3は、ポリ(エチレングリコール)などのポリエーテルであり、存在(z≠0)していてもよく、欠如(z=0)していてもよい。R3は生理学的条件下では非晶質になる;
R4は、脂肪族のC2〜C8アルキレン基であり、C1〜C10アルキレンによって適宜置換され、直鎖状のまたは環状の脂肪族基であり、ここでR4は具体的にはブチレン、−(CH2)4−基であり、C1〜C10アルキレン側基は保護されたS、N、P、または、O部位を含むことができる;
xおよびyの両方は正の整数であり、ともに少なくとも1とすることができ、xとyの合計(x+y)が具体的には最大で1,000であり、より具体的には最大で500であり、または、最大で100とすることができる。Q1〜Q6は、上記プレポリマーと上記多機能の鎖の延長剤との反応によって得られる結合ユニットである。Q1〜Q6は互いに独立してアミン、ウレタン、アミド、カーボネート、エステル、または、無水物である。全結合基(linking groups)Qが異なる事態は稀であり、好ましいものではない。
本発明に有用な生分解性ポリマーの適切な一分類は、ポリ(エチレングリコール)(PEDG)およびポリ(ブチレンテレフタラート)(PBT)に基づいた上記ポリ(エーテルエステル)マルチブロックコポリマーを含み、当該ポリ(エーテルエステル)マルチブロックコポリマーは以下の一般式(IV)で表すことができる:
nは各親水性PEGブロックのエチレンオキシド単位の数を示し、
xは上記コポリマーの親水性ブロックの数を示し、
yは上記コポリマーの疎水性ブロックの数を示す。
本発明に有用な生分解性ポリマーの適切な一分類として、下記式(V)のサブユニットを有するポリエステルアミドポリマーを含む:
yはC2〜C12であり、そして、
Rは、−CH(CH3)2、−CH2CH(CH3)2、−CH(CH3)CH2CH3、−CH2(CH2)2CH3、−CH2C6H5、−CH2(CH2)2SCH3、または、アミノ酸の一部を示す。
本発明に有用な生分解性ポリマーの適切な一分類として、上記ポリ(エステルアミド)ポリマーを含む。このようなポリマーは、ジオールと、ジカルボン酸と、α−アミノ酸とをエステル結合およびアミド結合によって(DACA)nの形態で重合させることにより、調製することができる。(DACA)nポリマーの例を下記の式(VI)に示す。適切なアミノ酸としては、任意の天然または合成α−アミノ酸、特に中性アミノ酸が挙げられる。
mは2〜12(例えば、4または8)であり;そして、
Rは−CH(CH3)2、−CH2CH(CH3)2、−CH(CH3)CH2CH3、−CH2(CH2)2CH3、−CH2(C6H5)、または、CH2(CH2)SCH3である。
本発明に有用な生分解性のポリマーに好適な一分類は、Eureka(商標)SOLO polymerの商品名で販売されているものなどの天然の生分解性ポリサッカリドの疎水性誘導体を含む。天然の生分解性ポリサッカリドの疎水性誘導体は、ポリサッカリドに付着した一つまたは複数の疎水性ペンダント基を有する天然の生分解性ポリサッカリドをいう。多くの場合、上記疎水性誘導体は、上記ポリサッカリドに付着した炭化水素のセグメントを含む複数の基を含む。炭化水素のセグメントを含んでいる複数の基が付着している場合、当該複数の基は、上記疎水性誘導体の“疎水性部分”と総称する。したがって、上記疎水性誘導体は疎水性部分とポリサッカリド部分とを含む。
例として、生分解性のマルチブロックコポリマー(グリコール酸、カプロラクトン、および、PEGポリマーブロックを含むマルチブロックコポリマー)を含むコーティングの組成物を30mg/mLの濃度でアセトンに溶解し、(ヒドロゲルの下地塗りを行った、または行っていない)拡大および折り畳み可能な構造(例えば、バルーン)上に溶液を噴射して調製することで、当該構造上の生分解性コーティングを作製することができる。生体活性剤(例えば、生体活性剤の形態)は、上記コーティング溶液に(1重量%〜50重量%の割合で)溶解させるか、または、上記生分解性コーティングが形成された後に用いられることができる。例えば、上記生分解性コーティングに対して、(メタノールに溶解しているか、または、水中の生体活性剤として存在している)パクリタキセルを用いることができる。
本発明は、標的組織に生体活性剤を送達するための方法およびデバイスを提供する。本発明では、生体活性剤を放出することのできる拡大および折り畳み可能な構造を備える多様な種類の医療デバイスを意図している。一実施形態では、上記挿入可能な医療デバイスはバルーンカテーテルである。上記生体活性剤は、挿入可能な医療デバイスの拡大および折り畳み可能な表面とコーティング剤により結び付いている。上記デバイスを対象内に挿入し、上記生体活性剤が送達されることができる部分と標的組織とが接触する位置に上記拡大および折り畳み可能な表面を配置することができる。上記拡大および折り畳み可能な表面を拡大させることができ、これにより、その拡大および折り畳み可能な構造の表面上のコーティングから上記生体活性剤を(例えば、微粒子形態で)放出または分離させる。代わりに、上記拡大および折り畳み可能な表面が、生分解性のコーティング剤を含むことができ、当該生分解性コーティング剤が、上記拡大および折り畳み可能な構造の拡大時に上記拡大および折り畳み可能な構造から放出される結果、(例えば、微粒子形態の)当該生体活性剤と共に輸送される。
実施形態では、挿入可能な上記医療デバイスは拡大および折り畳み可能な構造を備え、当該拡大および折り畳み可能な構造はバルーン(例えば、血管形成術用バルーン)を備えるか、または、バルーン(例えば、血管形成術用バルーン)そのものである。このようなデバイスを疾患している脈管構造の処置に使用することができる。上記脈管構造に放出することができる好適な生体活性剤として、抗増殖剤、抗炎症剤、抗血小板剤、または、これらの複数が挙げられる。好適な抗増殖剤として、パクリタキセルが挙げられる。疾患している動脈の処置のための血管形成において、バルーンカテーテルが一般に使用されている。バルーン血管形成は、一般的に、管腔内の詰まった経路の膨張または再開口を起こす。
用語“生体活性剤”は、合成または天然とすることができ、動物(鳥類およびヒトを含む哺乳類を含むが、これに限定されない)にインビボで投与される場合に生物学的作用を引き起こす無機または有機分子をいう。生体活性剤の一部リストを以下に示す。以下に挙げる生体活性剤の一つを任意に選択して、単独で含めてもよいが、任意の他の生体活性剤と組み合わせて含めてもよい。生体活性剤の包括的リストは、当該生体活性剤の水溶性に関する情報と併せて、The Merck Index, Thirteenth Edition(Merck & Co.社)(2001年)に記載されている。
上記生体活性剤は、賦形剤と共に処方されることができる。上記賦形剤は、コーティング内での上記生体活性剤の安定性を向上させることができるか、または、上記生体活性剤の物理的特性を変化させることができる。上記賦形剤の例としては、グリセロール、ジエチレングリコール、ソルビトール、ソルビトールエステル、マルチトール、スクロース、フルクトース、転化糖、コーンシロップ、および、これらの組み合わせが挙げられる。上記賦形剤の量および種類は、公知の基準および技法に応じることができる。上記賦形剤は、抗酸化剤とすることができる。
上記生体活性剤は、微粒子形態にすることができる。上記微粒子は、コーティング剤により上記基板と結び付き、その後当該基板を拡大させたときに当該基板から分離するのに十分なサイズおよび形状を有する三次元の任意の粒子にすることができる。
[実施例1]本発明のバリア層による、組織への薬物送達の増加
50重量%のドデカン酸および50重量%のオレイン酸のコーティングの組成物である、本発明のバリア層の実施形態では、エキソビボモデルにおける上記バルーンカテーテルから動脈組織へのパクリタキセルの移送が増大した。
(カテーテルのコーティング)
上記バルーンカテーテルの上記バルーンの上記拡大および折り畳み可能な表面に、パクリタキセル微粒子を結合させた可塑性のヒドロゲルコーティングを設けた。上記バルーンカテーテルをMinnesota Medtec社(Maple Grove, MN)から購入した。上記バルーンの壁厚が5μm〜10μmの上記バルーンの上記拡大および折り畳み可能な構造をナイロンから作製した。
採取されたブタ動脈を取得し、長さ1.5インチとなるようにカットした。その後、上記ブタ動脈の断片を、事前に水槽内で37℃まで予熱した4mLのPBS(リン酸緩衝生理食塩水)(pH値:7.4)で満たした琥珀ガラス(容量4mL)瓶内に移した。
本実施例の脂質コーティングは、模擬使用試験のコーティングカテーテルからの粒子の放出を著しく減少させた(図2を参照)。上記カテーテルを、蛇行した経路内を通し、膨張させ、収縮させ、回収した。データセット1は、粒子をヒドロゲルコーティング内部に埋め込んだ場合、本実施例の脂質コーティング不在化での当該粒子の放出を示す。データセット2は、薬剤粒子を含む上記ヒドロゲルコーティングを本実施例の脂質コーティングの組成物(50重量%のドデカン酸と50重量%のオレイン酸)の実施形態で覆っていた場合に放出された粒子の著しい減少を示している。データセット3および4は、上記ヒドロゲルコーティングまたは上記脂質コーティングの不在時に第1および第2カテーテル系から放出される粒子を示している。得られた結果を3.5mm×15mmのバルーンサイズで標準化した。
Claims (32)
- 拡大および折り畳み可能な構造、
生体活性剤を含んでいる、上記拡大および折り畳み可能な構造上の薬剤コーティング、および、
室温より高く、対象の体温より低い融点または軟化点を有する、上記薬剤コーティング上の脂質コーティングを含んでおり、
上記生体活性剤を対象体内の部位へ送達することに効果的である、医療デバイス。 - 上記脂質コーティングが複数の脂肪酸を含む、請求項1に記載の医療デバイス。
- 上記脂質コーティングが二つの脂肪酸を含む、請求項2に記載の医療デバイス。
- 上記複数の脂肪酸が、室温では固体であり、そして上記対象の体温では軟質体または液体である脂肪酸の混合物である、請求項2に記載の医療デバイス。
- 上記複数の脂肪酸が、室温より高く、上記対象の体温より低い軟化温度を有する脂肪酸の混合物である、請求項2に記載の医療デバイス。
- 上記複数の脂肪酸が、室温より高く、上記対象の体温より低い融点を有する脂肪酸の混合物である、請求項5に記載の医療デバイス。
- 上記脂肪酸の混合物が、オレイン酸、ドデカン酸、または、これらの塩を含む、請求項5に記載の医療デバイス。
- 上記脂肪酸が、
式「CH3(CH2)nCOOH」で表され、当該式中のnが4≦n≦20である飽和脂肪酸、および、
式「CH3(CH2)mC=C(CH2)OCOOH」で表され、当該式中のmおよびoが互いに独立して2以上、20以下である不飽和脂肪酸、またはそれらの塩を含む、請求項2に記載の医療デバイス。 - 上記薬剤コーティングが、一つまたは複数の溶媒および上記生体活性剤を含む、請求項1に記載の医療デバイス。
- 上記拡大および折り畳み可能な構造が、バルーンの全体または一部である、請求項1に記載の医療デバイス。
- 上記バルーンが血管形成術用バルーンである、請求項10に記載の医療デバイス。
- 上記生体活性剤が、抗増殖剤、抗炎症剤、または、抗血小板剤を含む、請求項1に記載の医療デバイス。
- 上記生体活性剤がパクリタキセルを含む、請求項12に記載の医療デバイス。
- 微粒子が治療薬を含む、請求項1に記載の医療デバイス。
- 上記薬剤コーティングが可塑性ヒドロゲルマトリックスを含む、請求項14に記載の医療デバイス。
- 上記微粒子の大部分が、上記可塑性ヒドロゲルマトリックスの内部に不均一に分散されており、上記可塑性ヒドロゲルマトリックスの表面に部分的に埋め込まれている、請求項15に記載の医療デバイス。
- 上記微粒子が上記治療薬から成る、請求項14に記載の医療デバイス。
- 伸縮性構造の拡張において、上記拡大および折り畳み可能な構造またはコーティングと結び付いた上記微粒子の約10%〜約100%が、上記医療デバイスから放出される、請求項14に記載の医療デバイス。
- 上記薬剤コーティングが、ポリ(アクリルアミド)、ポリ(メタクリルアミド)、ポリ(ビニルピロリドン)、ポリ(アクリル酸)、ポリ(エチレングリコール)、ポリ(ビニルアルコール)、ポリ(HEMA)、メチルビニルエーテル/無水マレイン酸のコポリマー、ビニルピロリドン/(メタ)アクリルアミドのコポリマー、または、これらの混合物を含む、請求項1に記載の医療デバイス。
- 上記薬剤コーティングが、ペンダント型の反応性の光官能基を有するポリマーを含み、当該ポリマーが、当該ペンダント型の反応光官能基によって上記コーティング内の他のポリマーまたは上記拡大および折り畳み可能な構造の表面と共有結合されていることを特徴とする請求項1に記載の医療デバイス。
- 上記薬剤コーティングが、約5μm〜約100μmの厚さを有する、請求項1に記載の医療デバイス。
- 微粒子が治療薬を含み、当該微粒子の最大径の平均が約0.1μm〜約10μmである、請求項1に記載の医療デバイス。
- 上記薬剤コーティングが生分解性ポリマーを含む、請求項1に記載の医療デバイス。
- 上記生分解性ポリマーが、ポリラクチド、ポリグリコリド、ポリジオキサノン、ポリ(ラクチド−co−グリコリド)、ポリ(グリコリド−co−ポリジオキサノン)、ポリアンヒドリド、ポリ(グリコリド−co−トリメチレンカーボネート)、および、ポリ(グリコリド−co−カプロラクトン)、生分解性ポリ(エステル−アミド)、生分解性ポリエーテルエステルコポリマー、生分解性エステル含有ブロックコポリマー、分解性デキストラン系ポリマー、分解性マルトデキストリン系ポリマー、これらのコポリマー、または、これらの混合物を含む、請求項23に記載の医療デバイス。
- 上記生分解性ポリマーが、上記生分解性ポリマーと架橋するペンダント重合基を含む、請求項23に記載の医療デバイス。
- 上記薬剤コーティングが、約5μm〜約100μmの厚さを有する、請求項23に記載の医療デバイス。
- 上記生分解性ポリマーが、分解性マルトデキストリン系ポリマーを含む、請求項23に記載の医療デバイス。
- 上記対象の体内で上記拡大および折り畳み可能な構造を拡張させると、上記薬剤コーティングが、粉砕され、上記拡大および折り畳み可能な構造から薄い層状に剥がれることができる、請求項23に記載の医療デバイス。
- 生分解性コーティングが不連続である、請求項23に記載の医療デバイス。
- 上記拡大および折り畳み可能な構造と上記薬剤コーティングの間に可塑性ヒドロゲルマトリックスを含んでいる放出コーティングを更に含む、請求項1に記載の医療デバイス。
- バルーンと、
生体活性剤を含んでいる、上記バルーン上の薬剤コーティングと、
室温より高く、対象の体温より低い融点または軟化点を有する、上記薬剤コーティング上の脂質コーティングを含んでおり、
上記生体活性剤を対象体内の部位へ送達することに効果的である、バルーンカテーテル。 - 生体活性剤を対象体内の部位へ送達する方法であって、
拡大および折り畳み可能な構造と、
生体活性剤を含んでいる、当該拡大および折り畳み可能な構造上の薬剤コーティングと、
室温より高く、上記対象の体温より低い融点または軟化点を有する、当該薬剤コーティング上の脂質コーティングとを含んでいる医療デバイスを提供する工程と、
上記拡大および折り畳み可能な構造を上記対象体内の上記部位で拡張させ、上記対象体内の部位の組織に上記薬剤コーティング、上記脂質コーティング、または、これら両方を接触させ、生体活性剤を当該組織へ放出させる工程とを包含している方法。
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