JP5675611B2 - 生分解性エラストマ及び放出可能なタキサン剤をコーティングした埋込み医療器具 - Google Patents
生分解性エラストマ及び放出可能なタキサン剤をコーティングした埋込み医療器具 Download PDFInfo
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- JP5675611B2 JP5675611B2 JP2011523828A JP2011523828A JP5675611B2 JP 5675611 B2 JP5675611 B2 JP 5675611B2 JP 2011523828 A JP2011523828 A JP 2011523828A JP 2011523828 A JP2011523828 A JP 2011523828A JP 5675611 B2 JP5675611 B2 JP 5675611B2
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/148—Materials at least partially resorbable by the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/16—Biologically active materials, e.g. therapeutic substances
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/416—Anti-neoplastic or anti-proliferative or anti-restenosis or anti-angiogenic agents, e.g. paclitaxel, sirolimus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
- A61L2300/606—Coatings
- A61L2300/608—Coatings having two or more layers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2420/00—Materials or methods for coatings medical devices
- A61L2420/08—Coatings comprising two or more layers
Description
本願は、2008年8月22日に出願された米国仮特許出願第61/091,045号による35U.S.C.第119条(e)に基づく優先日を主張しており、該出願の内容はこれに言及することにより本願に参照として組み入れられている。
第一の実施例には、血管内に埋め込まれるとタキサン剤などの治療薬を放出する多層コーティングを備えている埋込み医療器具が提供されている。一つの実施例においては、コーティングは、少なくとも2つの層すなわち第一の層と第二の層とを有し、該第一の層は、医療器具の表面の少なくとも一部分と前記第二の層との間に配置されている治療薬を含み、第二の層は、生体吸収性エラストマを含んでおり且つ前記第一の層の少なくとも一部分の周りに配置されてこの部分を覆っている。
一つの実施例においては、治療薬剤はタキサン剤である。本発明の一つの態様は、パクリタキセルなどのタキサン剤を含む配合物をコーティングする方法に関する。一般的にはタキサン特にパクリタキサンは、微小管阻害剤更に特定すると安定剤として機能することによって、細胞周期阻害剤として機能すると考えられる。本明細書において使用されている“パクリタキセル“という用語は、以下においては、幾つかの置換基を有している4つの縮合環を有しているコア構造からなる構造式(1)(構造式(1)内において陰影が付されている“コアのタキサン構造”)として示されている化学構造の化合物を指している。
タキサン剤は1以上のタイプのタキサン剤を含んでいる。同じ分子構造を有しているタキサン剤分子は種々の固体形態で配列される。タキサン剤分子は、埋め込み前に種々の溶出媒体(例えば、シクロデキストリン又はブタ血清)内での溶解速度を含む1以上の物理的特性によって特徴付けられ且つ区別することができる。典型的には、溶媒和された固体形態のタキサン剤は、水性環境例えば血管内では、非溶媒和固体形態よりも更にゆっくりと溶解するが、非溶媒和固体形態よりも耐久性が低い。特定の分子構造を有しているが種々の固体形態から発生するタキサン剤分子は、ひとたび溶解すると溶液内では識別できない。
医療器具の溶出特性は、固体形態の比率、コ−ティング層の組成及び/又は厚み並びに生体吸収性エラストマに対するタキサン剤の比率を含むタキサン剤の固体形態などのバラメータを変えることによって変えることができる。例えば、溶出速度は、(1)タキサン剤に対する生体吸収性エストラマの重量比率を増大させること、(2)隣接して下に横たわっているタキサン剤コーティング層に対する生体吸収性エラストマの相対的厚みを増すこと、(3)コーティング層内のタキサン剤の全体の量を減らすこと、及び(4)溶媒和された固体形態(例えば、二水和パクリタキセル)の比率を増大させることによって遅くすることができる。
一つの実施例においては、生体吸収性エラストマは、埋め込まれたときに周囲の組織に対して不所望なレベルの刺激が無い状態で医療器具の変形から容易に復元する機械的に安定したコーティング層を提供するように選択されたポリマーである。該生体吸収性エラストマとしては、ヒドロゲル、エラスチン状ペプチド、ポリ水酸化アルカノエート(PHA)、ポリヒドロキシブチレート化合物、又はこれらの組み合わせがある。生体吸収性エラストマは、治療薬剤の所望の放出速度及び溶解メカニズムを含む種々の設計基準に基づいて選択することができる。幾つかの実施例においては、生体吸収性エラストマは、エステルなどの1以上の加水分解化学結合、所望程度の架橋結合、最小の不均質溶解の溶解メカニズム、及び非毒性モノマーを含む。
別の実施例には、埋め込み医療器具の表面をコーティングする方法が提供されている。コーティングは、適当な方法によって埋込み医療器具の表面に適用される。コーティング層は連続的なやり方で医療器具に適用される。タキサン剤を含む層が最初に埋込み医療器具の表面に適用され、生分解エストラマを含んでいる別の層が、タキサン剤を覆うように適用されるのが好ましい。コーティング層は、埋込み医療器具の表面に付着させるか又は医療器具の表面の穴若しくは凹部に局部的に付着される。コーティング層を適用するための3つの好ましい方法、すなわち(1)スプレーガンコーティング、(2)超音波スプレーコーティング、及び(3)静電スプレーコーティングが、本明細書に記載されている。
該コーティングはまた、径方向に圧縮した状態における経皮経カテーテルの配備に耐える十分な耐久性を有していることも好ましく、この耐久性としては、カテーテル給送装置上ヘの捲縮中の剥離、切削、又はコーティングの崩壊に対する抵抗性がある。
医療器具コーティングは、特定の溶出媒体内のコーティングの溶出特性を測定することによって特性を決定することができる。溶出特性は、タキサン剤がコーティングされた医療器具から溶出媒体内へ放出される速度とコーティングが溶出媒体と接触する時間との関数として示したグラフである。溶出特性は、所望の速度及び/又は所望の期間に治療薬剤の徐放を提供する特に好ましいコーティング構造を特定するために使用することができる。ブタ血清内で約15〜20日間に亘るコーティングからタキサン剤の約70〜90%の放出によって決定される持続放出コーティングの特性は、幾つかの用途に対して特に好ましい。該コーティングはまた、治療期間に亘って治療に有効な投与量のタキサン剤を放出する構造とされている。再狭窄に対する治療期間は、変動するかも知れないが、動脈壁の一つの部分に対して約10〜15mgのタキサン剤を供給する場合に約15日とすることができる。
コーティングは、種々の構造及び機能の埋込み又は挿入可能な医療器具に適用することができる。典型的な被験体(本明細書では、“患者”とも称される)は、例えば、ウシ、ヒツジ、ブタ、ヤギ、ウマ、イヌ、ネコ、及びヒトなどの哺乳類を含む脊椎動物被験体(すなわち、亜門類の構成体)である。典型的な医療器具の配置部位としては、冠状血管系及び末梢血管系(本明細書では、これらは集合的に血管系と称されている)、心臓、食道、気管、結腸、胃腸管、膀胱、前立腺、脳、及び外科部位がある。該医療器具が血管系内に挿入される場合には、例えば治療薬剤は、該器具に隣接している血管へと徐放され且つ同様に下流の血管組織へも徐放される。
本発明による治療方法は、上記した構造のいずれかを有しているコーティングされた医療器具を患者の体内に挿入することを含む。例えば、医療器具が上記したコーティング方法によってコーティングされたステントである場合には、該治療方法は、該ステントを患者の血管系内へ埋め込むこと、及び治療薬剤が該コーティングされたステントの薬剤溶出特性によって示されている制御方法で該ステントから放出されるようにすることを含んでいる。
非晶質パクリタキセル固体形態、無水パクリタキセル固体形態、及び二水和のパクリタキセル固体形態の塊状サンプルを下に記した方法で調製する。これらの調製は、Jeong Hoon Leeらによる“Preparation and Characterization of Solvent Induced Dihydrate, Anhydrous and Amorphous Paclitaxel(溶媒誘導の二水和パクリタキセル、無水パクリタキセル、及び非晶質パクリタキセルの調製及び特性)”,Bull. Korean Chem. Soc. v. 22, no. 8,第925〜928頁(2001)に基づいている。
例1において調製された3つの固体試料(非晶質パクリタキセル、二水和パクリタキセル、及び無水パクリタキセル)をエタノール内で溶解して噴霧試料溶液を形成する。これら3つの試料の各々の紫外線スペクトルを(Agilent製のIn-Line紫外線分光計を使用して)取得して図3Aに示されているスペクトル100から区別できる3つのスペクトルを得る。これらのスペクトルは全てパクリタキセル内のタキサンコア構造を示すピークを227nmに有し、これは、例1のパクリタキセル固体形態が溶液内のパクリタキセルのUVスペクトルに基づいて相互に区別できないことを示している。
例1において調製された試料の各々のFTIR赤外スペクトルを以下の手順で得た。すなわち、室温(約23℃)において乳鉢と乳棒とを使用してパクリタキセル結晶をKBrと混ぜ合わせることによってKBrのペレットを形成し、この結果として得られた固体を真空中に置いて残留しているメタノール溶液(0.025mmHg)を除去した。パクリタキセルの各固体形態の代表的なスペクトルを記録した。上記したパクリタキセルの固体形態の各々の代表的なスペクトルが図3B〜3Dに提供されている。赤外スペクトルは減衰全反射赤外法(ATR−IR)を使用してコーティングから得ることができ、又はコーティングから固体タキサン試料の少量のサンプルを得ることもできる。一つの適切なATR−IR装置は、PerkinElmer製のHorizontal ATR モデル L1200361である。
パクリタキセルの二水和固体形態と非晶質固体形態との両方を含んでいるパクリタキセルコーティングからなるコーティングを備えたステントを、パクリタキセルとメタノールと水とを含む溶液をスプレーコーティングすることによって調製する。メタノールと水内のパクリタキセル溶液を準備する。特に、予め作られた68%のメタノールと32%の水との溶液5ml内に7.43mgのパクリタキセルを溶解させることによって68%メタノール内に1.74mMのパクリタキセル溶液を調製する。該溶液をグローブボックス(密閉透明容器)内の超音波スプレーガン(Sono-tek製のモデル06−04372)から噴霧する。噴霧前に、グローブボックスは137.9kPa(20psi)で15分間窒素によって浄化する。グローブボックス内の雰囲気は、酸素濃度計がグローブボックス内に一定の200ppmを読み取るまで調整する。グローブボックス内の熱は31℃(88°F)に設定し、空気囲いは13.8kPa(2.0psi)に設定し、超音波出力は1.0Wに設定する。該パクリタキセル溶液を注射器内に装填し、超音波コーティング装置内の注射器ポンプ上に配置し、裸の金属ステント(6×20 Zilver、インディアナ州ブルーミントンにあるCook Inc., 製)をスプレーノズルと整合させた心棒に取り付ける。該溶液を、0.03mL/分の流速、0.635mm(0.025in)/秒のコーティング速度、1.0Wのノズル出力、13.8kPa(2.0psi)のプロセスガス圧力、及び約12mmのノズル−ステント間距離で、ステントを60rpmの軸線回転速度で回転させながら、60kHzノズルを使用してステントに吹き付ける。ステントの管腔外面のみをコーティングする。
パクリタキセルをコーティングされたステントを、エタノールなどの適切な揮発性溶媒内のパクリタキセルの溶液を医療器具の管腔外面に吹き付けることによって調製する。コーティングは、適当な程度の持続性を提供するのに十分な量のパクリタキセルを非晶質(透明な)固体形態で含んでいるのが好ましい。コーティングは、この例においては、少なくとも約5時間好ましくは約12〜15時間又はそれ以上に亘って、温度を約35℃〜50℃まで(又はそれ以上まで)上昇させ且つ約75%〜100%の相対湿度レベルまで上昇させることによって調製される。
Zilver(登録商標)ステントを、約3μg/mm2(約200μg)の非晶質パクリタキセルか50〜60%の二水和パクリタキセルを含んでいる同量の組成物でコーティングする。コーティングは超音波ノズルを使用して行う。
非晶質形態と約50〜60%の二水和固体形態との両方のパクリタキセルによって構成されているコーティングを有しているZILVER(インディアナ州ブルーミントンにあるCook Inc., 製)を、例4に記載されているものに基づく手順を使用して調製した。次いで、ステントをアセトン溶媒を使用してPLAでコーティングした。
14 管腔外面、 16 管腔内面、
20 フレーム、 30 第一の層、
40 第二の層、 110 医療器具、
114 管腔外面、 116 管腔内面、
120 フレーム、 125 凹部、
130 第一の層、第一の治療薬層、
132 第二の治療薬層、
140 第一のコーティング層、
142 第二のコーティング層、
144 第三のコーティング層、
150 医療器具、 160 フレーム、
162 穴、 170 複数の層
Claims (15)
- 医療器具の表面に付着されてタキサン剤を放出させるように構成されたコーティングを備えた、コーティングされた埋込み医療器具であって、
前記コーティングが、
a.少なくとも20%の二水和パクリタキセルを含むタキサン剤を有する第一の層と、
b.前記第一の層を覆うように配置されており、75,000〜240,000Daの分子量を有し、且つ前記第一の層内の治療薬の重量の1〜20倍の量で存在している生分解性エラストマを有している第二の層と、を備える器具。 - 前記生分解性エラストマが、ポリ(乳酸)、ポリ(グリコール酸)、ポリ(4−ヒドロキシブチレート)、及びポリ(グリセロール−シバケート)からなる群から選択された少なくとも一つのポリマーを含んでいるポリマー又はコポリマーからなる、ことを特徴とする請求項1に記載の器具。
- 前記生分解性エラストマが、ポリ(L−乳酸)、ポリ(D−乳酸)、及びポリ(D,L−乳酸)からなる群から選択されたポリ(乳酸)である、ことを特徴とする請求項2に記載の器具。
- 前記タキサン剤が、少なくとも40%の二水和パクリタキセルを含んでいる、ことを特徴とする請求項1に記載のコーティングされた埋込み医療器具。
- 前記タキサン剤が、少なくとも60%の二水和パクリタキセルを含んでいる、ことを特徴とする請求項1に記載のコーティングされた埋込み医療器具。
- 管腔内面と管腔外面とを有している径方向に拡張可能な血管ステントを備えている、ことを特徴とする請求項1から5のいずれか1項に記載の器具。
- 前記第二の層が、前記管腔外面の1平方ミリメートルの面積当たり0.05〜20mgの前記生分解性エラストマを含んでいる、ことを特徴とする請求項6に記載の器具。
- 前記タキサン剤がパクリタキセルであり、前記コーティングされた血管ステントが、前記管腔外面の1平方ミリメートルの面積当たり0.06〜0.90μgのパクリタキセルを含んでおり、前記管腔内面が0.01μg未満のパクリタキセルを含んでいる、ことを特徴とする請求項1から7のいずれか1項に記載の器具。
- 前記第一の層が、実質的にポリマーを含んでおらず、主としてタキサン剤からなる、ことを特徴とする請求項1から8のいずれか1項に記載の器具。
- 前記第二の層が、主として該第二の層の1平方ミリメートルの表面積当たり0.1mg未満のタキサン剤を含んでいる生分解性エラストマからなる、ことを特徴とする請求項1から9のいずれか1項に記載の器具。
- 薬剤給送装置を形成するために埋込み医療器具をコーティングする方法であって、
a.表面を有する医療器具を準備するステップと、
b.前記医療器具の表面上にタキサン剤を含む第一の層を堆積させるステップであって、
i.第一の溶媒を含んでおり且つポリマーを含んでいない第一の溶液と、前記第一の溶媒内に分散したタキサン剤とを前記表面に塗布し、
ii.前記第一の溶媒を蒸発させ、
iii.前記塗布と前記蒸発とを、前記第一の層が1平方ミリメートルの表面積当たり0.05〜1.00μgのタキサン剤を含むようになるまで繰り返し、このとき前記タキサン剤が少なくとも20%の二水和パクリタキセルを含む、ステップと、
c.前記医療器具上の前記第一の層を覆うように生分解性エラストマを含む第二の層を堆積させるステップであって、
i.第二の溶媒と該第二の溶媒内に分散された75,000〜240,000Daの分子量を有する生分解性エラストマとを含む第二の溶液を前記第一の層に塗布し、
ii.前記第二の溶媒を蒸発させ、
iii.前記第二の層内の生分解性エラストマの重量が前記第一の層内のタキサン剤の重量の1〜20倍になるまで前記塗布と蒸発とを繰り返すステップと、を含んでいる、方法。 - 前記第二の溶媒がアセトンであることを特徴とする請求項11に記載の方法。
- 前記タキサン剤の少なくとも一部分が、1735〜1700cm−1の範囲内に3つよりも少ないピークを有している振動スペクトルによって特徴付けられる固体形態で存在する、ことを特徴とする請求項11又は12に記載の方法。
- 前記タキサン剤が、少なくとも40%の二水和パクリタキセルを含んでいる、ことを特徴とする、請求項11から13のいずれか1項に記載の方法。
- 前記タキサン剤が、少なくとも60%の二水和パクリタキセルを含んでいる、ことを特徴とする、請求項11から13のいずれか1項に記載の方法。
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