JP5758388B2 - 適応制御を有する電解質薬物送達ポンプ - Google Patents
適応制御を有する電解質薬物送達ポンプ Download PDFInfo
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Description
本願は、米国仮特許出願第61/234,742号(2009年8月18日出願)の優先権の利益を主張し、この出願の全体を本明細書に参照によって援用する。
種々の実施形態において、本発明は、薬物送達ポンプに関する。具体的には、本発明の実施形態は、その作動が動的かつ適応的に制御され得る薬物送達ポンプに関する。
(項目1)
薬物送達ポンプであって、
薬物貯蔵部と、
該貯蔵部から標的部位まで液体を誘導するカニューレと、
該液体を該貯蔵部から該カニューレを通して押し進めるポンプアクチュエータと、
回路であって、該回路は、該アクチュエータを制御することにより、i)最初に、実質的に固定した投与量の該液体を経時的に該標的部位に送達することと、ii)該実質的に固定した投与量の該液体の該標的部位への経時的な送達を維持または再開するように、該ポンプの状態の変化を補償することとを行う、回路と
を備える、ポンプ。
(項目2)
前記回路は、以前の送達事象のときにおける前記ポンプの状態を保存するメモリを備える、項目1に記載のポンプ。
(項目3)
前記カニューレを通る前記液体の流量を測定する流量センサをさらに備える、項目1に記載のポンプ。
(項目4)
前記回路は、前記流量の解析に少なくとも部分的に基づいて、前記アクチュエータを制御する、項目3に記載のポンプ。
(項目5)
前記回路は、以前の投与からの保存された前記ポンプの状態に基づいて、前記アクチュエータをさらに制御する、項目4に記載のポンプ。
(項目6)
前記回路は、前記アクチュエータからのリアルタイムデータに基づいて、該アクチュエータをさらに制御する、項目4に記載のポンプ。
(項目7)
前記アクチュエータは、
電解液チャンバと、
拡張可能なダイヤフラムであって、該チャンバと前記貯蔵部とを分離し、それらの間に流体障壁を提供するダイヤフラムと、
該電解液チャンバ内にガスの発生を引き起こして、該ダイヤフラムを拡張させる電解電極であって、それにより、該液体が該貯蔵部から前記カニューレの中に押し進められる、電解電極と
を備える、項目1に記載のポンプ。
(項目8)
ダイヤフラムの拡張は、前記電極に供給される作動電流を変化させることによって調整される、項目7に記載のポンプ。
(項目9)
ダイヤフラムの拡張は、前記電極の作動時間を変化させることによって調整される、項目7に記載のポンプ。
(項目10)
前記電解電極は、定電流によって駆動される、項目7に記載のポンプ。
(項目11)
前記電解電極は、時変電流波形によって駆動される、項目7に記載のポンプ。
(項目12)
前記実質的に固定した投与量の前記液体は、周期的な時間間隔で前記標的部位に送達される、項目1に記載のポンプ。
(項目13)
前記実質的に固定した投与量の前記液体は、前記標的部位に経時的に連続して注入される、項目1に記載のポンプ。
(項目14)
薬物送達ポンプから患者まで薬物を送達する方法であって、該薬物送達ポンプは、薬物貯蔵部と、該貯蔵部から患者の中に液体を押し進めるポンプアクチュエータとを備え、該方法は、
該薬物貯蔵部と該患者との間に流体的な連絡を確立することと、
該ポンプアクチュエータを制御することであって、それにより、i)最初に、実質的に固定した投与量の該液体を該薬物貯蔵部から該患者の中に経時的に送達することと、ii)該実質的に固定した投与量の該液体の該患者の中への経時的な該送達を維持または再開するように、該ポンプの状態の変化を補償することとを行う、ことと
を含む、方法。
(項目15)
以前の送達事象のときにおける前記ポンプの状態を保存することをさらに含む、項目14に記載の方法。
(項目16)
前記患者の中への前記液体の流量を測定することをさらに含む、項目14に記載の方法。
(項目17)
前記ポンプアクチュエータを制御することは、前記流量、以前の投与からの保存された前記ポンプの状態、または該ポンプアクチュエータからのリアルタイムデータのうちの少なくとも1つを解析することを含む、項目16に記載の方法。
(項目18)
前記ポンプは電解駆動式ポンプであり、該ポンプを制御することは、電解電極に供給される作動電流を変化させることを含む、項目14に記載の方法。
(項目19)
前記ポンプは電解駆動式ポンプであり、該ポンプを制御することは、電解電極の作動時間を変化させることを含む、項目14に記載の方法。
(項目20)
前記ポンプは電解駆動式ポンプであり、該ポンプを制御することは、定電流によって電解電極を駆動することを含む、項目14に記載の方法。
(項目21)
前記ポンプは電解駆動式ポンプであり、該ポンプを制御することは、時変電流波形によって電解電極を駆動することを含む、項目14に記載の方法。
(項目22)
前記実質的に固定した投与量の前記液体は、周期的な時間間隔で前記患者の中に送達される、項目14に記載の方法。
(項目23)
前記実質的に固定した投与量の前記液体は、前記患者の中に経時的に連続して注入される、項目14に記載の方法。
本明細書に開示される本発明の実施形態の利点および特徴とともに、これらおよび他の目的は、以下の説明、添付の図面、および特許請求の範囲を参照することによって、より明白になるであろう。さらに、本明細書に記載される種々の実施形態の特徴は、たとえ本明細書に明示的に記載されていなくても、相互に排他的ではなく、種々の組み合わせおよび順列で存在することができることを理解されたい。
本発明の実施形態は、様々な種類の薬物送達ポンプとともに(それらが外部ポンプまたは患者の体内に移植可能なポンプであろうとも)用いることができる。図1および2は、患者の眼104の中に移植された例示的な移植可能な薬物送達ポンプ100(すなわち、例示的な電解ポンプまたは電解駆動式ポンプ100)の2つの変形例を概略的に示す。しかしながら、ポンプ100は、代わりに患者の身体の他の部分に移植されてもよい。例えば、ポンプは、(例えば、脳の柔組織に直接投与することによって)脳に化学療法を提供するため、または別の種類の治療を提供するために、脳のくも膜下腔内に;化学療法を提供するために、患者の身体のいずれかの部分にある腫瘍の近くに;インスリンの放出をトリガする薬剤(例えば、タンパク質、ウイルスベクター等)を提供するために、グルコースに応答不良な膵臓内に;患者の外部からではあるが、皮下または腹腔内に留置されたカニューレを用いてインスリンを送達するために;変形性関節症または他の軟骨疾患を治療する薬物を提供するために膝の中に、;鎮痛剤もしくは抗炎症剤を提供するために脊椎の近くに、または他の場所に移植されてもよい。
一般に、電解電極134に供給される所与の入力電流に対する電解駆動式ポンプ100の反応は、薬物貯蔵部108の中にどの程度の液体が残っているかに依存する。例えば、薬物貯蔵部108がほぼ空である場合、圧力が上昇し始めることができ、ポンピングを開始することができる前に薬物貯蔵部108をその「充填された」構成にするためには、より多くの電流が必要である。その一方で、薬物貯蔵部108が完全に充填されている場合、薬物の送達を開始する前にごくわずかな電流が必要である。同様に、所与の入力電流に対する電解駆動式ポンプ100の反応は、電解チャンバ112内のガス/液体比にも依存する。具体的には、ポンプ100の反応は、薬物貯蔵部108が薬物で充填されているとき(例えば、電解チャンバ112が低いガス/液体比で動作する場合)は、薬物貯蔵部108がほぼ空であるとき(例えば、電解チャンバ112が高いガス/液体比で動作する場合)とは非常に異なる。また、例えば、電解電極134の劣化、電解チャンバ112内の電解質濃度の変化、逆止弁140の流量特性の変化、および組織成長または特定の他の機構に起因して、カニューレ120の出口において形成される制約を含む他の要因も、電解駆動式ポンプ100の反応を経時的に変化させる。
Icurrent=Foptimal/Fmax,previous×Iprevious
式中、Icurrentは、現在の投与の間に電解電極134に供給される電流であり、Foptimalは、カニューレ120を通る薬物の所望の最大流量であり、Fmax,previousは、以前の投与の間にカニューレ120を通った薬物の最大流量であり、Ipreviousは、以前の投与の間に電解電極134に供給された電流である。
Vaccumulated+F/Fmax,previous×Vshutoff,previous=Vtarget
式中、Vaccumulatedは、現在の投与でこれまでに送達された薬物の全体積であり、Fは、カニューレ120を通る薬物のリアルタイムの流量であり、Fmax,previousは、以前の投与からのカニューレ120を通った薬物の最大流量であり、Vshutoff,previousは、以前の投与において、ポンプアクチュエータ204が遮断された後に、送達された薬物の体積であり、Vtargetは、送達される薬物の標的体積である。この方法において、適応制御装置212は、ポンプ200が作動される態様を常に調整し、ポンプ200の特性における系統的な非ランダムな変化の原因となる。
Istarting,current=tprevious/toptimal×Istarting,previous
次に図4を参照すると、上述の適応制御が薬物の投与量レベルに与える影響を示す例示的なグラフ300が示される。この例において、各放出事象の間に送達される標的投与量レベルは200ナノリットル(nL)である。事象1は、基準パラメータ値を使用した計算に基づいて初回投与量180nLに対応する。次いで、適応制御装置212は、事象2で標的送達量である200nLが達成されるまで、ポンプ200のパラメータに対する適切な調整値を計算する(例えば、上述のように、標的部位に送達される薬物の体積を増加させるために、電解電極134に供給される電流の量および/またはその作動時間が増加されてもよい)。図示するように、事象1と事象2との間の期間にポイント304があってもよく、その間に適応制御装置212が過補償し、ポンプ200が標的投与量よりも多く(例えば、205nL)を送達する。この場合、適応制御装置212は、事象2において標的送達量である200nLが実際に達成されるまで、ポンプ200のパラメータに対するその調整値を精密に決定する(例えば、上述のように、標的部位に送達される薬物の体積を増加させるために、電解電極134に供給される電流の量および/またはその作動時間が増加されてもよい)。
他の実施形態において、図1〜3を再び参照すると、適応制御装置212はまた、薬物送達治療領域を監視する標的部位センサ(単数または複数)148から情報を受信し、その後、特定期間の間、標的投与量を変更することもできる。より具体的には、治療領域における変化(例えば、症状の悪化または改善、生物学的または生化学的パラメータの変化、電気活性の変化、圧力の変化等)が、より多くのもしくはより少ない投与レベルまたは投薬頻度の変更を必要とする場合に、適応制御装置212は、投与量を調整し、別の変更が必要となるまでそれを新しいレベルにおいて維持するように、ポンプアクチュエータ204を制御することができる。換言すると、適応制御装置212は、特定の生理学的状態または生化学的パラメータの調整等の所望の結果を達成するように、ポンプ200を作動させることができる。前と同様に、標的センサ(単数または複数)148によって感知されるパラメータ(例えば、圧力、温度等)は、(例えば、送達される薬物の適切な投与量を決定する際の比較のため等)後に使用するために、コンピュータメモリ208内に保存されてもよい。
図6は、本発明の一実施形態にしたがって患者の眼の中に移植された薬物送達ポンプ100、200を概略的に示す。図示するように、ポンプ100、200は、眼の結膜上に配置され、カニューレ120の遠位端は、そこを通って眼の後眼房内に挿入される。そのため、カニューレ120の遠位端(つまりは薬物貯蔵部108)は、患者と流体的に連絡している。次いで、薬物送達ポンプ100、200は、カニューレ120と、前述のように、液体の逆流を防止するために用いられてもよい逆止弁140とを介して、眼の後眼房に治療液を投与する。具体的には、ポンプアクチュエータ204は、薬物貯蔵部108からカニューレ120を通して患者の眼の中に1種類以上の投与量の液体を送達するために、本明細書で上述した方法のうちのいずれかにおいて(例えば、ポンプ自体の状態の変化に基づいて、および/または標的部位の状態に基づいて)、適応制御装置212および他の制御回路132の使用によって制御されてもよい。
Claims (12)
- 薬物送達ポンプであって、
各ポンピング周期で減少する薬物体積を有する薬物貯蔵部と、
該貯蔵部から標的部位まで液体を誘導するカニューレと、
電極を内部に含む電解チャンバと、
該ポンプの作動時に、該薬物貯蔵部内に残留する薬物体積と該電解チャンバ内の液体/ガス比とを含むパラメータを保存するメモリと、
該電解チャンバ内の電解を引き起こして該電解チャンバを該薬物貯蔵部に対して拡張させることによって、該液体を該貯蔵部から該カニューレを通して押し進めるポンプアクチュエータと、
回路であって、該回路は、該アクチュエータを制御することにより、i)最初に、実質的に固定した投与量の該液体を経時的に該標的部位に送達することと、ii)該ポンプの以前の作動からの該保存されたパラメータに基づいて該電極に最適な作動電流を提供することと、iii)該実質的に固定した投与量の該液体の該標的部位への経時的な送達を維持または再開するように、該ポンプの状態の変化を補償することとを行う、回路と
を備える、ポンプ。 - 前記カニューレを通る前記液体の流量を測定する流量センサをさらに備える、請求項1に記載のポンプ。
- 前記回路は、前記流量の解析に少なくとも部分的に基づいて、前記アクチュエータを制御する、請求項2に記載のポンプ。
- 前記回路は、前記アクチュエータからのリアルタイムデータに基づいて、該アクチュエータをさらに制御する、請求項3に記載のポンプ。
- 前記アクチュエータは、拡張可能なダイヤフラムを備え、
該ダイヤフラムは、前記電解チャンバと前記貯蔵部とを分離し、それらの間に流体障壁を提供し、
前記電極は、該電解チャンバ内にガスの発生を引き起こして、該ダイヤフラムを拡張させ、それにより、該液体が該貯蔵部から前記カニューレの中に押し進められる、請求項1に記載のポンプ。 - ダイヤフラムの拡張は、前記電極に供給される作動電流を変化させることによって調整される、請求項5に記載のポンプ。
- ダイヤフラムの拡張は、前記電極の作動時間を変化させることによって調整される、請求項5に記載のポンプ。
- 前記電極は、定電流によって駆動される、請求項5に記載のポンプ。
- 前記電極は、時変電流波形によって駆動される、請求項5に記載のポンプ。
- 前記実質的に固定した投与量の前記液体は、以前のポンプ周期および後続のポンプ周期から時間的に分離されている各ポンプ周期で前記標的部位に送達される、請求項1に記載のポンプ。
- 前記実質的に固定した投与量の前記液体は、前記標的部位に経時的に連続して注入される、請求項1に記載のポンプ。
- 前記保存されたパラメータは、前記電極の状態をさらに含む、請求項1に記載のポンプ。
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EP2467797B1 (en) | 2017-07-19 |
KR20120068867A (ko) | 2012-06-27 |
US20110202032A1 (en) | 2011-08-18 |
AU2010284216A1 (en) | 2012-03-15 |
CN102576385A (zh) | 2012-07-11 |
US20140074058A1 (en) | 2014-03-13 |
JP2013502279A (ja) | 2013-01-24 |
CA2771584A1 (en) | 2011-02-24 |
KR101697388B1 (ko) | 2017-01-17 |
CN102576385B (zh) | 2016-02-24 |
EP2467797A1 (en) | 2012-06-27 |
AU2010284216B2 (en) | 2015-10-15 |
WO2011022484A1 (en) | 2011-02-24 |
US9199035B2 (en) | 2015-12-01 |
MX2012002063A (es) | 2012-08-01 |
US9283322B2 (en) | 2016-03-15 |
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