JP5982688B2 - 埋込み型デバイス用の吸収性コーティング - Google Patents
埋込み型デバイス用の吸収性コーティング Download PDFInfo
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Description
本発明は、埋込み型デバイス用吸収性コーティング、並びにそれを作製する方法及び使用する方法に関する。
経皮的冠動脈インターベンション(PCI)は、心疾患を治療するための処置である。バルーン部分を有するカテーテルアセンブリを、上腕又は大腿動脈を介して患者の心血管系に経皮的に導入する。カテーテルアセンブリを、バルーン部分が閉塞性病変の端から端に至るよう位置決めされるまで、冠血管系内を前進させる。病変の端から端に至るよう位置決めされた後、バルーンを所定のサイズに膨張させて、病変のアテローム斑を半径方向に圧縮し、管腔壁を再造形する。次いでバルーンを収縮させて、より小さいプロファイルにし、カテーテルを患者の血管系から引き出すことができるようにする。
一態様では、本発明は、埋込み型医療用デバイス上に生体吸収性コーティングを提供する。このコーティングは、第1の分子量を有する生体吸収性ポリマーを含むプライマー層と、第2の分子量の生体吸収性ポリマーを含む第2の層とを含む。第1の分子量は第2の分子量よりも高く、コーティングは、人体に埋め込まれると約3カ月〜約6カ月の期間内で完全に又は実質的に完全に吸収される。
高い分子量(HMW)又は非常に高い分子量(VHMW)の吸収性ポリマーを含むプライマー層を、埋込み型デバイスの表面に形成するステップと、
低分子量(LMW)吸収性ポリマーを含む第2の層を形成し、それによってコーティングを形成するステップであって、第1の分子量が第2の分子量よりも高いものであるステップと
を含み、
このコーティングは、人体に埋め込まれると約3カ月〜約6カ月の期間内で完全に又は実質的に完全に吸収されるものである。
i)長時間にわたるeビーム照射(e−beaming)、コーティング後の多数回のeビーム照射、ビーム下で、合計でより長い時間にわたる、より低い線量率でのeビーム照射、又は室温でのeビーム照射のステップ、
ii)真空/従来の乾燥の前に高湿度環境でより長い時間乾燥させる、コーティングされた埋込み型デバイスをより高い温度で処理するステップ、
iii)コーティングがBHTを含む場合には、コーティング中のBHT含量を低下させるステップ、
iv)ラクチドモノマー及び/又はオリゴマーをコーティングに添加するステップ、
v)D,L−PLAの−COOH末端オリゴマーをコーティングに添加するステップ、
vi)eビームで使用され得る場合と同じ線量(即ち、31kGy)のγ放射線により滅菌するステップ、
vii)コーティングに、乳酸エチル、DMSO、NMP、及び安息香酸ベンジルから選択された可塑剤を添加して、コーティングのガラス転移温度(Tg)が低下するようにし、分解を加速させるステップ、
viii)吸湿性添加剤をコーティングに添加するステップ、
ix)微粒子化されたNaO2又はKO2又はスーパーオキシド塩をコーティングに添加するステップ、
x)より多くの第1スズオクトエートを添加して、そのレベルを、材料仕様書(material specification)により認められた最大レベルまで上昇させるステップ、
xi)3〜6カ月以内に分解するように調整されたMWを有する、LMW D,L−PLAを添加するステップ、
xii)制御された相転換動力学のプロセスにより、微孔性D,L−PLAコーティングを形成するステップ、及び
xiii)ステップi)〜xii)の任意の組合せ
から選択されたステップを含む。
一態様では、本発明は、埋込み型医療用デバイス上に生体吸収性コーティングを提供する。このコーティングは、約3カ月〜約6カ月の吸収期間を有し、その間にコーティングは、人体に埋め込まれると完全に又は実質的に完全に吸収される。コーティングは、第1の分子量を有する生体吸収性ポリマーを含んだ、埋込み型デバイスの表面のプライマー層と、第2の分子量の生体吸収性ポリマーを含んだ第2の層とを含み、第1の分子量は第2の分子量より高いものである。いくつかの実施形態では、コーティングは、高い又は非常に高い分子量(HMW又はVHMW)の吸収性ポリマーを含むプライマー層と、低分子量(LMW)吸収性ポリマーを含む第2の層とを含む。第2の層は、薬物の層の上、又は薬物を含んでいても含んでいなくてもよいマトリックス層の上に在る、トップコートとすることができる。いくつかの実施形態では、マトリックス層は薬物を含むことができる。
適用可能である場合には、以下に示される本発明の記述全体を通して使用されるいくつかの用語に対する定義が、適用されるものとする。
本明細書に記述されるコーティングを形成するポリマーの分子量を、様々な方法によって低減又は低下させることができる。分子量は、埋込み型デバイスをコーティングした後、この埋込み型デバイスを展開する前に(t=0)、又は埋込み型デバイスを埋め込んだ後に、例えばコーティングの加水分解を強化することによって低下させることができる。そのような方法には、例えば下記の事項の1つ又は組合せが含まれる。
1)長時間にわたるeビーム照射、コーティング後の多数回のeビーム照射、ビーム下で、合計でより長い時間にわたる、より低い線量率でのeビーム照射、又は室温でのeビーム照射。
2)真空/従来の乾燥の前に、高湿度環境で乾燥するための、コーティングされたデバイス(例えば、ステント)のより高い温度での処理(例えば、50℃〜70℃での処理)。本明細書で使用される場合、「高湿度環境」という用語は、周囲よりも高い湿度を有する環境を指す。
3)コーティング中のBHT含量を低下させる。
4)コーティングへのラクチドモノマー/オリゴマーの添加。
5)d,l−PLAの−COOH末端オリゴマーの添加。
6)eビームで使用され得る場合と同じ線量(即ち、31kGy)でのγ放射線による滅菌。
6)コーティングのガラス転移温度(Tg)を低下させると考えられるその他の可塑剤、例えば乳酸エチル、DMSO、NMP、安息香酸ベンジルをコーティングに添加して、分解を加速させる。
7)存在する場合にはD,L−PLAの水の吸着を増加させるための、吸湿性添加剤の、コーティングへの添加であり、この吸湿性添加剤は、例えば、低MW PVP、低MW PEGとすることができる。コーティング中の水の濃度がより高いと、加水分解速度が増大し、照射滅菌中に水が存在することにより、このステップではMWの低下が加速することになる。吸湿性添加剤は両親媒性であり、より良好な均質性を可能にする。
8)微粒子化されたNaO2又はKO2又はスーパーオキシド塩の添加。これらの化合物は、有機物には不溶であるが、水和したときに非常に活発にエステル結合を切断することになり、コーティング中のポリマーのMWが低下するようになる。
9)より多くの第1スズオクトエートを添加して、そのレベルを、材料仕様書により認められた最大レベルまで上昇させる。第1スズオクトエートは、押出し、eビーム滅菌、及びin−vivo展開中にMW降下を増大させることになる。
10)3〜6カ月以内に分解するように調整されたMWを有する、LMW D,L−PLAの添加。一般に、そのようなLMW D,L−PLAは、完全なコーティングを形成しないと考えられる。HMW又はVHMW再吸収性ポリマーで形成されたプライマーは、LMW D,L−PLAがこのように不完全であっても、そのようなLMW D,L−PLAを使用してコーティングを形成できるようにすると考えられる。3〜6カ月以内に分解するLMW D,L−PLAは、一般に、60,000Daよりも低い分子量を有する。
11)制御された相転換動力学のプロセスによる、微孔性D,L−PLAコーティングの形成。そのような微孔性D,L−PLAコーティングは、水の取込みを強化して、コーティングの加水分解を増大させることができる。相転換は、商業的に利用可能なプロセスであるので(膜フィルタを製作するのに使用される。)、当技術分野の一般知識の範囲内である。
いくつかの実施形態では、本明細書に記述される埋込み型デバイスは、少なくとも1種の生物学的に活性な(「生物活性」)薬剤を任意選択で含むことができる。少なくとも1種の生物活性剤は、患者に対して治療、予防、又は診断効果を発揮することが可能な任意の物質を含むことができる。
本明細書に記述される1つ又は複数のその他の実施形態と任意選択で組み合わせた、本発明のいくつかの実施形態によれば、埋込み型デバイス(例えば、ステント)の上に配置されたコーティングは、任意のデザインの構成を有することができる。コーティングは、以下に示す層(1)である、本明細書に記述される少なくとも1つのプライマー層と、以下に示す層(2)である、少なくとも1つのリザーバ(reservoir)層とを含む、多層構造にすることができ、下記の(3)、(4)、及び(5)層のいずれか、又はこれらの組合せを含むことができる。
(1)プライマー層、
(2)少なくとも1種のポリマーを含む薬物−ポリマー層(薬物−ポリマー層)、又は、代替としてポリマーを含まない薬物層とすることができる、リザーバ層(「マトリックス層」又は「薬物マトリックス」とも呼ばれる。)、
(3)放出制御層(「速度制限層」とも呼ばれる。)、
(4)トップコート層、及び/又は
(5)コーティングの生物学的応答を調節するために存在する、仕上げコート層。
本明細書に記述される1つ又は複数のその他の実施形態と任意選択で組み合わせた、本発明のその他の実施形態から、埋込み型デバイスの製作方法が得られる。一実施形態では、方法は、生分解性ポリマー又はコポリマーを含有する材料の、埋込み型デバイスを形成するステップを含む。
本発明による埋込み型デバイスは、様々な状態又は障害を治療し、予防し、又は診断するのに使用することができる。そのような状態又は障害の例には、アテローム性動脈硬化症、血栓症、再狭窄、出血、血管の解離、血管の穿孔、血管動脈瘤、不安定プラーク、慢性完全閉塞、卵円孔開存、は行、静脈及び人工グラフトの吻合部増殖、動静脈吻合、胆管閉塞、尿管閉塞、及び腫瘍閉塞が含まれるが、これらに限定するものではない。埋込み型デバイスの一部又はデバイス全体そのものは、本明細書に記述される材料で形成することができる。例えば、材料は、デバイスの少なくとも一部の上に配置されたコーティングにすることができる。
Claims (18)
- プライマー層と、第2の層とを含む、埋込み型医療用デバイス上の生体吸収性コーティングであって、
プライマー層が、60,000ダルトン以上かつ200,000ダルトンよりも下の数平均分子量の高い分子量(HMW)の生体吸収性ポリマー、又は200,000ダルトン以上の数平均分子量の非常に高い分子量(VHMW)の生体吸収性ポリマー、を含み、
プライマー層が、PLLA、85/15 PLGA、75/25 PLGA、ポリ(エステルアミド)、PLA−PCL−GAターポリマー、PCL−GA、及びこれらのコポリマーから選択されたHMW又はVHMWポリマーを含み、
第2の層が、60,000ダルトンよりも下の数平均分子量の低分子量(LMW)生体吸収性ポリマーを含み、
第2の層が、LMW D,L−PLAを含み、
第2の層が、薬物を含まず、且つプライマー層の上に在る薬物の層の上に形成され、
人体に埋め込まれると3カ月〜6カ月の期間内で完全に又は実質的に完全に吸収される、生体吸収性コーティング。 - プライマー層が、85/15 PLGA、75/25 PLGA、PLA−PCL−GAターポリマー、PCL−GA、及びこれらのコポリマーから選択されたHMW又はVHMWポリマーを含む、請求項1に記載の生体吸収性コーティング。
- 微孔性であり、プライマー層がD,L−PLAを含む、請求項1に記載の生体吸収性コーティング。
- 埋込み型医療用デバイスがステントである、請求項1に記載の生体吸収性コーティング。
- 薬物の層が、パクリタキセル、ドセタキセル、エストラジオール、17−β−エストラジオール、酸化窒素供与体、スーパーオキシドジスムターゼ、スーパーオキシドジスムターゼ模倣体、4−アミノ−2,2,6,6−テトラメチルピペリジン−1−オキシル(4−アミノ−TEMPO)、ビオリムス、タクロリムス、デキサメタゾン、ラパマイシン、ラパマイシン誘導体、40−O−(2−ヒドロキシ)エチル−ラパマイシン(エベロリムス)、40−O−(3−ヒドロキシ)プロピル−ラパマイシン、40−O−[2−(2−ヒドロキシ)エトキシ]エチル−ラパマイシン、及び40−O−テトラゾール−ラパマイシン、40−エピ−(N1−テトラゾリル)−ラパマイシン(ABT−578)、ゾタロリムス、ノボリムス、ミオリムス、テムシロリムス、デホロリムス、γ−ヒリジン、クロベタゾール、ピメクロリムス、メシル酸イマチニブ、ミドスタウリン、フェノフィブラート、これらのプロドラッグ、これらのコドラッグ、及びこれらの組合せからなる群から選択された薬物を含む、請求項1に記載の生体吸収性コーティング。
- 埋込み型医療用デバイスを製作する方法であって、
60,000ダルトン以上かつ200,000ダルトンよりも下の数平均分子量の高い分子量(HMW)又は200,000ダルトン以上の数平均分子量の非常に高い分子量(VHMW)の生体吸収性ポリマーを含むプライマー層を、埋込み型医療用デバイスの表面に形成するステップと、
60,000ダルトンよりも下の数平均分子量の低分子量(LMW)生体吸収性ポリマーを含む第2の層を形成し、それによってコーティングを形成するステップと、を含み、
第2の層が、薬物を含まず、且つプライマー層の上に在る薬物の層の上に形成され、
プライマー層が、PLLA、85/15 PLGA、75/25 PLGA、ポリ(エステルアミド)、PLA−PCL−GAターポリマー、PCL−GA、及びこれらのコポリマーから選択されたHMW又はVHMWポリマーを含み、
第2の層が、LMW D,L−PLAを含み、
コーティングが、人体に埋め込まれると3カ月〜6カ月の期間内で完全に又は実質的に完全に吸収される方法。 - プライマー層が、85/15 PLGA、75/25 PLGA、PLA−PCL−GAターポリマー、PCL−GA、及びこれらのコポリマーから選択されたHMW又はVHMWポリマーを含む、請求項6に記載の方法。
- コーティングが、微孔性であり、制御された相転換動力学のプロセスによって形成され、プライマー層がD,L−PLAを含む、請求項6に記載の方法。
- 埋込み型医療用デバイスがステントである、請求項6に記載の方法。
- コーティングの分解速度を速くするステップをさらに含む、請求項6に記載の方法。
- 分解速度を速くするステップが、
埋込み型医療用デバイスの展開前に、プライマー層及び/又は第2の層中の生体吸収性ポリマーの分子量を低下させるステップ、又は
プライマー層及び/又は第2の層の生体吸収性ポリマーの加水分解速度を速くするステップ
を含む、請求項10に記載の方法。 - コーティングの分解速度を速くするステップが、
i)長時間にわたるeビーム照射、コーティング後の多数回のeビーム照射、ビーム下で、合計でより長い時間にわたる、より低い線量率でのeビーム照射、又は室温でのeビーム照射のステップ、
ii)真空/従来の乾燥の前に高湿度環境で乾燥させる、コーティングされた埋込み型医療用デバイスをより高い温度で処理するステップ、
iii)コーティングがBHTを含む場合には、コーティング中のBHT含量を低下させるステップ、
iv)ラクチドモノマー及び/又はオリゴマーをコーティングに添加するステップ、
v)D,L−PLAの−COOH末端オリゴマーをコーティングに添加するステップ、
vii)コーティングに、乳酸エチル、DMSO、NMP、及び安息香酸ベンジルから選択された可塑剤を添加して、コーティングのガラス転移温度(Tg)が低下するようにし、分解を加速させるステップ、
viii)吸湿性添加剤をコーティングに添加するステップ、
ix)微粒子化されたNaO2又はKO2又はスーパーオキシド塩をコーティングに添加するステップ、
x)追加の第1スズオクトエートを添加するステップ、
xii)制御された相転換のプロセスにより、微孔性D,L−PLAコーティングを形成するステップ、及び
xiii)ステップi)〜v)、vii)〜x)及びxii)の任意の組合せ
から選択されたステップを含む、請求項10に記載の方法。 - 埋込み型医療用デバイスが、再狭窄、アテローム性動脈硬化症、血栓症、出血、血管の解離又は穿孔、血管動脈瘤、不安定プラーク、慢性完全閉塞、は行、吻合部増殖(静脈及び人工グラフトの場合)、胆管閉塞、尿管閉塞、腫瘍閉塞、又はこれらの組合せから選択される医学的状態を治療し、予防し、又は改善させるために使用される、請求項1に記載の生体吸収性コーティング。
- 埋込み型医療用デバイスが、再狭窄、アテローム性動脈硬化症、血栓症、出血、血管の解離又は穿孔、血管動脈瘤、不安定プラーク、慢性完全閉塞、は行、吻合部増殖(静脈及び人工グラフトの場合)、胆管閉塞、尿管閉塞、腫瘍閉塞、又はこれらの組合せから選択される医学的状態を治療し、予防し、又は改善させるために使用される、請求項6に記載の方法。
- 薬物の層がポリマーを含まない、請求項1に記載の生体吸収性コーティング。
- BHTを含む、請求項1に記載の生体吸収性コーティング。
- 薬物の層がポリマーを含まない、請求項6に記載の方法。
- コーティングがBHTを含む、請求項6に記載の方法。
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US20160303295A1 (en) | 2016-10-20 |
EP2552505B1 (en) | 2016-11-30 |
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EP3130362A1 (en) | 2017-02-15 |
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EP2752205A1 (en) | 2014-07-09 |
US9387282B2 (en) | 2016-07-12 |
US8685433B2 (en) | 2014-04-01 |
EP3130362B1 (en) | 2019-08-21 |
US20140161862A1 (en) | 2014-06-12 |
US20180093020A1 (en) | 2018-04-05 |
JP2013523258A (ja) | 2013-06-17 |
WO2011123209A1 (en) | 2011-10-06 |
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