JP7478338B2 - 植え込み可能な眼用薬剤送達装置および方法 - Google Patents
植え込み可能な眼用薬剤送達装置および方法 Download PDFInfo
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Description
本出願は、2019年3月21日に出願された米国仮特許出願第16/360,777号の利益を主張するものである。先行出願の開示は、本出願の開示の一部とみなされる(また、参照により本出願の開示に組み込まれる)。
本文書は、薬剤送達のための装置に関する。例えば、本文書は、薬剤を眼の前房内に分配する、植え込み可能な眼用薬剤送達装置に関する。
眼の疾患は、世界中で蔓延している。米国だけでも、4500万人を超える、40歳以上のアメリカ人が、白内障、緑内障、糖尿病網膜症、加齢性黄斑変性、ドライアイ、および重症感染症などの、一般的な眼疾患を患っている。失明および不可逆性視力喪失(irreversible vision loss)を引き起こす眼疾患には、米国では毎年500億ドル近くの費用がかかっている。眼合併症は、治療薬剤で治療されることが多く、100億ドル超の価値がある眼用薬剤送達テクノロジーの市場を創出している。しかしながら、現在の送達の選択肢は、しばしば効果的でなく、高い投薬頻度および濃度を必要とし、患者コンプライアンスが不十分となる。眼用薬剤の持続したバイオアベイラビリティをより良く実現するために、最近の研究は、投与部位での薬剤滞留時間を長くし、眼関門(ocular barriers)にわたる薬剤浸透を増大させ、放出を制御し、かつ標的組織への薬剤曝露を局在化することを含む、所望の特徴を達成するために、新規な眼用薬剤送達システムに目を向けている。
キセフ、モキサラクタム)、ペニシリン(例えば、アムジノシリン、アムジノシリンピボキシル、アモキシシリン、アンピシリン、アパルシリン、アスポキシシリン、アジドシリン、アズロシリン、バカンピシリン、ベンジルペニシリン酸、ベンジルペニシリンナトリウム、カルベニシリン、カリンダシリン、クロメトシリン、クロキサシリン、シクラシリン、ジクロキサシリン、エピシリン、フェンベニシリン、フロキサシリン、ヘタシリン、レナンピシリン、メタンピシリン、メチシリンナトリウム、メズロシリン、ナフシリンナトリウム、オキサシリン、ペナメシリン、ペネタマートヨウ化水素酸塩(penethamate hydriodide)、ペニシリンGベネタミン、ペニシリンGベンザチン、ペニシリンGベンズヒドリルアミン、ペニシリンGカルシウム、ペニシリンGヒドラバミン、ペニシリンGカリウム、ペニシリンGプロカイン、ペニシリンN、ペニシリンO、ペニシリンV、ペニシリンVベンザチン、ペニシリンVヒドラバミン、ペニメピサイクリン、フェネチシリンカリウム、ピペラシリン、ピバンピシリン、プロピシリン、キナシリン、スルベニシリン、スルタミシリン、タランピシリン、テモシリン、チカルシリン)、他のもの(例えば、リチペネム)、リンコサミド(例えば、クリンダマイシン、リンコマイシン)、マクロライド(例えば、アジスロマイシン、カルボマイシン、クラリスロマイシン、ジリスロマイシン、エリスロマイシン、エリスロマイシンアシストラート、エリスロマイシンエストレート、エリスロマイシングルコヘプトナート(erythromycin glucoheptonate)、エリスロマイシンラクトビオン酸塩、エリスロマイシンプロピオナート、ステアリン酸エリスロマイシン、ジョサマイシン、ロイコマイシン、ミデカマイシン、ミオカマイシン、オレアンドマイシン、プリマイシン、ロキタマイシン、ロサラマイシン、ロキシスロマイシン、スピラマイシン、トロレアンドマイシン)、ポリペプチド(例えば、アンホマイシン、バシトラシン、カプレオマイシン、コリスチン、エンデュラシジン(enduracidin)、エンビオマイシン、フサファンギン、グラミシジンS、グラミシジン、ミカマイシン、ポリミキシン、プリスチナマイシン、リストセチン、テイコプラニン、チオストレプトン、ツベラクチノマイシン、チロシジ
ン、チロスリシン、バンコマイシン、バイオマイシン、ヴァージニアマイシン、亜鉛バシトラシン)、テトラサイクリン(例えば、アピサイクリン(apicycline)、クロルテトラサイクリン、クロモサイクリン、デメクロサイクリン、ドキシサイクリン、グアメサイクリン(guamecycline)、リメサイクリン、メクロサイクリン、メタサイクリン、ミノサイクリン、オキシテトラサイクリン、ペニメピサイクリン、ピパサイクリン(pipacycline)、ロリテトラサイクリン、サンサイクリン、テトラサイクリン)、および他のもの(例えば、サイクロセリン、ムピロシン、ツベリン)、クロラムフェニコール、ゲンタマイシン、ニトロフラゾン;合成抗菌物質、例えば、2,4-ジアミノピリミジン(例えば、ブロジモプリム、テトロキソプリム、トリメトプリム)、ニトロフラン(例えば、フラルタドン、塩化フラゾリウム、ニフラデン、ニフラテル、ニフルホリン、ニフルピリノール、ニフルプラジン、ニフルトイノール、ニトロフラントイン)、キノロンおよび類似体(例えば、シノキサシン、シプロフロキサシン、クリナフロキサシン、ジフロキサシン、エノキサシン、フレロキサシン、フルメキン、グレパフロキサシン、ロメフロキサシン、ミロキサシン、ナジフロキサシン、ナリジクス酸、ノルフロキサシン、オフロキサシン、オキソリン酸、パズフロキサシン、ペフロキサシン、ピペミド酸、ピロミド酸、ロソキサシン、ルフロキサシン、スパルフロキサシン、テマフロキサシン、トスフロキサシン、トロバフロキサシン)、スルホンアミド(例えば、アセチルスルファメトキシピラジン(acetyl sulfamethoxypyrazine)、ベンジルスルファミド(benzylsulfamide)、クロラミンB、クロラミンT、ジクロラミンT、n2-ホルミルスルフィソミジン(n2-formylsulfisomidine)、n4-β-d-グルコシルスルファニルアミド(n4-β-d-glucosylsulfanilamide)、マフェニド、4'-(メチルスルファモイル)スルファニルアニリド(4'-(methylsulfamoyl)sulfanilanilide)、ノプリルスルファミド(noprylsulfamide)、フタリルスルファセタミド、フタリルスルファチアゾール、サラゾスルファジミジン、サクシニルスルファチアゾール、スルファベンザミド、スルファセタミド、スルファクロルピリダジン、スルファクリソイジン(sulfachrysoidine)、スルファシチン、スルファジアジン、スルファジクラミド、スルファジメトキシン、スルファドキシン、スルファエチドール、スルファグアニジン、スルファグアノール(sulfaguanol)、スルファレン、スルファロクス酸、スルファメラジン、スルファメータ、スルファメタジン、スルファメチゾール、スルファメトミジン、スルファメトキサゾール、スルファメトキシピリダジン、スルファメトロール、スルファミドクリソイジン、スルファモキソール、スルファニルアミド、4-スルファニルアミドサリチル酸(4-sulfanilamidosalicylic acid)、n4-スルファニリルスルファニルアミド(n4-sulfanilylsulfanilamide)、スルファニリル尿素、n-スルファニリル-3,4-キシラミド、スルファニトラン、スルファペリン(sulfaperine)、スルファフェナゾール、スルファプロキシリン、スルファピラジン、スルファピリジン、スルファソミゾール、スルファシマジン、スルファチアゾール、スルファチオ尿素、スルファトラミド、スルフイソミジン、スルフイソキサゾール);スルホン(例えば、アセダプソン、アセジアスルホン(acediasulfone)、アセトスルホンナトリウム、ダプソーン、ジアチモスルホン、グルコスルホンナトリウム、ソラスルホン、スクシスルホン、スルファニル酸、p-スルファニリルベンジルアミン(p-sulfanilylbenzylamine)、スルホキソンナトリウム、チアゾスルホン)、および他のもの(例えば、クロホクトール、ヘキセジン、メテナミン、メテナミンアンヒドロメチレン-シトレート(methenamine anhydromethylene-citrate)、ヒプル酸メテナミン、マンデル酸メテナミン、スルホサリチル酸メテナミン、ニトロキソリン、タウロリジン、キシボルノール);抗真菌性抗生物質、例えば、ポリエン(例えば、アンフォテリシンB、カンジシジン、デルモスタチン、フィリピン、ファンジクロミン(fungichromin)、ハチマイシン、ハマイシン、ルセンソマイシン、メパルトリシン、ナタマイシン、ナイスタチン、ペチロシン、ペリマイシン)、他のもの(例えば、アザセリン、グリセオフルビン、オリゴマイシン、ウンデシレン酸ネオマイシン、ピロールニトリン、シッカニン、ツベルシジン、ビリジン);合成抗真菌薬、例えば、アリルアミン(例えば、ブテナフィン、ナフチフィン、テルビナフィン)、イミダゾール(例えば、ビホナゾール、ブトコナゾール、クロルダントイン、クロルミダゾール、クロコナゾール、クロトリマゾール、エコナゾール、エニルコナゾール、フェンチコナゾール、フルトリマゾール、イソコナゾール、ケトコナゾール、ラノコナゾール、ミコナゾール、オモコナゾール、硝酸オキシコナゾール、セルタコナゾール、スルコナゾール、チオコナゾール)、チオカルバメート(例えば、トルシクラート、トリンダート、トルナフタート)、トリアゾール(例えば、フルコナゾール、イトラコナゾール、サペルコナゾール、テルコナゾール);他のもの(例えば、アクリゾルシン、アモロルフィン、ビフェナミン、ブロモサリチルクロラニリド(bromosalicylchloranilide)、ブクロサミド、プロピオン酸カルシウム、クロルフェネシン、シクロピロクス、クロキシキン(cloxyquin)、コパラフィネート、ジアムタゾールジヒドロクロライド、エキサラミド、フルシトシン、ハレタゾール、ヘキセチジン、ロフルカルバン、ニフラテル、ヨウ化カリウム、プロピオン酸、ピリチオン、サリチルアニリド、プロピオン酸ナトリウム、スルベンチン、テノニトロゾール、トリアセチン、ウジョチオン(ujothion)、ウンデシレン酸、プロピオン酸亜鉛);抗新生物薬、例えば、抗生物質および類似体(例えば、アクラシノマイシン、アクチノマイシンF1、アントラマイシン、アザセリン、ブレオマイシン、カクチノマイシン、カルビシン、カルジノフィリン、クロモマイシン、ダクチノマイシン、ダウノルビシン、6-ジアゾ-5-オキソ-L-ノルロイシン、ドキソルビシン、エピルビシン、イダルビシン、メノガリル、マイトマイシン、マイコフェノール酸、ノガラマイシン、オリボマイシン(olivomycines)、ペプロマイシン、ピラルビシン、プリカマイシン、ポルフィロマイシン、ピューロマイシン、ストレプトニグリン、ストレプトゾシン、ツベルシジン、ジノスタチン、ゾルビシン)、代謝拮抗物質(例えば、葉酸類似体(例えば、デノ
プテリン、エダトレキサート、メトトレキサート、ピリトレキシム、プテロプテリン、Tomudex(登録商標)、トリメトレキサート)、プリン類似体(例えば、クラドリビン、フルダラビン、6-メルカプトプリン、チアミプリン、チオグアニン)、ピリミジン類似体(例えば、アンシタビン、アザシチジン、6-アザウリジン、カルモフール、シタラビン、ドキシフルリジン、エミテフール、エノシタビン、フロクスウリジン、フルオロウラシル、ゲムシタビン、テガフール);緑内障治療用物質、例えば:βブロッカー(例えば、チモロール、ベタキソロール、アテノロール、プロスタグランジン(例えば、アラキドン酸の代謝産物誘導体)、脂質受容体作動薬(lipid-receptor agonists)またはプロスタグランジン類似体(例えば、ビマトプロスト、トラボプロスト、ラタノプロスト、ウノプロストンなど)、αアドレナリン作動薬、ブリモニジンまたはジピベフリン、炭酸脱水酵素阻害剤(例えば、アセタゾラミド、メタゾラミド、ジクロフェナミド、ダイアモックス、エトキシゾラミド)、および、神経保護薬(例えば、ニモジピンおよび関連する化合物)、アプラクロニジン;抗ウイルス剤、例えば:トリフルオロチミジン、アシクロビル、ガンシクロビル、DDI、AZT、ホスカメット(foscamet)、ビダラビン、トリフルオロウリジン、イドクスウリジン、リバビリン、プロテアーゼ阻害剤および抗サイトメガロウイルス薬、抗アレルギー剤(例えば、メタピリレン;クロルフェニラミン、ピリラミン、プロフェンピリダミン、トリナトリウムホスホノホルメート(trisodium phosphomonoformate))、非ステロイド性抗炎症薬、例えば:シクロオキシゲナーゼ-1(COX-1)阻害剤(例えば、アセチルサリチル酸(例えば、ドイツのレーヴァクーゼン所在のBayer AGからのASPIRIN)、イブプロフェン(例えば、ペンシルベニア州カレッジビル所在のWyethからのADVIL、インドメタシン、メフェナム酸)、COX-2阻害剤(例えば、ニュージャージー州ピーパック所在のPharmacia Corp.からのCELEBREX);COX-1阻害剤(例えば、NEPAFENAC)、非ステロイド性グルココルチコイド拮抗薬;免疫抑制剤、例えば:シロリムス(ペンシルベニア州カレッジビル所在のWyethからのRAPAMUNE)、またはマトリックスメタロプロテイナーゼ(MMP)阻害剤(例えば、テトラサイクリンおよびテトラサイクリン誘導体);抗凝固剤、例えば:ヘパリン、抗フィブリノゲン(antifibrinogen)、フィブリノリジン、組織プラスミノーゲンアクチベーター(tPA)など;抗糖尿病薬、例えば:アセトヘキサミド、クロルプロパミド、グリピジド、グリブリド、トラザミド、トルブタミド、インスリン、アルドースレダクターゼ阻害剤;抗癌剤、例えば:5-フルオロウラシル、アドリアマイシン、アスパラギナーゼ、アザシチジン、アザチオプリン、ブレオマイシン、ブスルファン、カルボプラチン、カルムスチン、クロラムブチル、シスプラチン、シクロホスファミド、シクロスポリン、シタラビン、ダカルバジン、ダクチノマイシン、ダウノルビシン、ドキソルビシン、エストラムスチン、エトポシド、エトレチナート、フィルグラスチム、フロクスウリジン、フルダラビン、フルオロウラシル、フルオキシメステロン、フルタミド、ゴセレリン、ヒドロキシ尿素、イホスファミド、ロイプロリド、レバミソール、ロムスチン、ナイトロジェンマスタード、メルファラン、メルカプトプリン、メトトレキサート、マイトマイシン、ミトテン、ペントスタチン、ピポブロマン、プリカマイシン、プロカルバジン、サルグラモスチム、ストレプトゾシン、タモキシフェン、タキソール、テニポシド、チオグアニン、ウラシルマスタード、ビンブラスチン、ビンクリスチンおよびビンデシン;抗アレルギー薬、例えば:アンタゾリン、メタピリレン、クロルフェニラミン、ピリラミンおよびプロフェンピリダミン;免疫調節薬、例えば:腫瘍壊死因子阻害剤(例えば、サリドマイド);ならびに、他の潜在的な治療薬、例えば:ACE阻害剤、内因性サイトカイン、サイトカイン、基底膜に影響を与える薬品、アドレナリン作動薬またはアドレナリン遮断薬、コリン作動薬またはコリン作動性遮断薬、アルドースレダクターゼ阻害剤、鎮痛薬、麻酔薬、抗アレルギー性物質、抗ウイルス物質、抗原虫薬、抗感染症薬、抗腫瘍薬、抗血管新生薬(例えば、抗VEGF薬)、小分子薬剤、タンパク質、核酸、多糖類、生物製剤、脂質、ホルモン、ステロイド、糖脂質、糖タンパク質、および他の巨大分子。例としては以下が含まれる:内分泌ホルモン、例えば、下
垂体剤、インスリン、インスリン関連成長因子、甲状腺剤、成長ホルモン;熱ショックタンパク質;免疫反応調節剤、例えば、ムラミルジペプチド、シクロスポリン、インターフェロン(α、β、およびγインターフェロンを含む)、インターロイキン-2、サイトカイン、FK506(タクロリムスとしても知られる、エポキシ-ピリド-オキサアザシクロトリコシン-テトロン(epoxy-pyrido-oxaazcyclotricosine-tetrone))、腫瘍壊死因子、ペントスタチン、チモペンチン、形質転換因子β2、エリスロポエチン;抗新生タンパク質(antineogenesis proteins)(例えば、抗VEGF、インターフェロン)、脳神経成長因子(BNGF)、毛様体神経成長因子(CNGF)、血管内皮成長因子(VEGF)、および、このような成長因子に対するモノクローナル抗体、ワクチン、細胞の成長を阻害するか、または細胞死を促進する治療用物質で、細胞の成長を阻害するか、または細胞死を促進するように活性化され得るもの、成長因子、タンパク質、ペプチドまたはペプチド模倣薬、生物活性剤、光感作薬、放射性核種、トキシン、シグナリングモジュレーター(signaling modulators)、抗癌抗生物質、抗癌抗体、血管新生阻害剤、放射線治療、化学療法化合物、眼内圧低下剤、細胞輸送/移動性切迫剤(cell transport/mobility impending agents)、例えば、コルヒチン、ビンクリスチン、サイトカラシンBおよび関連する化合物、充血緩和剤(例えば、フェニレフリン、ナファゾリン、およびテトラヒドロゾリン)、縮瞳薬、ムスカリン作用薬、抗コリンエステラーゼ薬(例えば、ピロカルピン、カルバコール、ジイソプロピルフルオロホスフェート、フォスフォリンアイオダイド、臭化デメカリウム)、散瞳薬(例えば、硫酸アトロピン、シクロペントラート、ホマトロピン、スコポラミン、トロピカミド、ユーカトロピン)、交感神経興奮剤(例えば、エピネフリン、血管収縮薬、血管拡張剤)、鎮痛剤(例えば、リドカインおよび関連する化合物、ベンゾジアゼパム(benzodiazepam)および関連する化合物)。
本明細書に記載される装置の少なくともいくつかの実施形態では、以下の要件が、薬剤送達システムの薬物動態および投薬能力を制御するために変更され得る:DREの数、DREの外形、例えば高さもしくは容積、入口の数、入口の外形、および入口の場所、DREに組み込まれるポリマーの性質(例えば、透過性)、ならびに、治療用物質およびそれらのそれぞれの賦形剤の特徴(例えば、可溶性)。これらの要件は、治療される症状、インプラントを受ける患者、および治療用物質の所望の投与期間にも左右され得る。いくつかの実施形態では、生分解性DREは、次の3つの形態のうちの少なくとも1つによって説明され得る:1)均質な生分解性ポリマーマトリックス、2)少なくとも2つの不均質な生分解性ポリマーマトリックス、3)少なくとも1つの治療用物質が封入または結合により包含された、少なくとも1つのポリマーマトリックスに埋め込まれた微粒子またはナノ粒子の集合。
2 装置
3 装置
4 インプラント装置
5 装置
6 装置
7 装置
101 クロスバータブ
102 マイクロチャネル
103 窓
104 薬剤放出体(DRE)
105 上部外側ポリマー層
105 底部外側ポリマー層
106 内側ポリマー層
107 チャネル壁
109 入口
110 リザーバ
111 丸い角
201 クロスバータブ
202 入口開口部
202 入口部分
203 リザーバ
301 DRE
302 かかり
401 DRE
402 入口
403 上部表面
404 底部表面
501 外部表面部分
501 ナノテクスチャ
503 DRE
601 DRE
601 DREマトリックス
602 DRE
603 DRE
604 内側表面
701 DRE
801 強膜組織
802 結膜
802 結膜組織
804 角膜組織
805 前房
809 涙膜
810 眼組織線
901 角膜縁
Claims (15)
- 植え込み可能な眼用薬剤送達装置であって、
遠位端部分および近位端部分を有する本体であって、前記本体は、前記本体が眼の強膜に植え込まれたときに、前記遠位端部分を前記眼の前房に位置付け、かつ前記近位端部分を前記眼の涙膜に位置付けるのに十分な長手方向長さを有し、
前記本体は、2つの内部チャンバと、前記本体の外側表面を通る、前記内部チャンバへの2つの入口開口と、を画定し、前記内部チャンバは、前記入口開口を介して前記本体の周囲の外部領域と連絡する、本体と、
前記内部チャンバ内の薬物と、を含み、
各内部チャンバに対応する各入口開口は、前記本体の遠位端に設けられて、各内部チャンバを前記外部領域と連絡させる、植え込み可能な眼用薬剤送達装置。 - 前記本体は、前記遠位端部分と前記近位端部分との間に延びる内腔を画定し、前記内腔は、前記本体が前記眼の前記強膜に植え込まれたときに、前記前房と前記涙膜との間に流体連通を提供する、請求項1に記載の装置。
- 前記本体の材料は、前記内部チャンバ全体を前記内腔から分離する、請求項2に記載の装置。
- 前記本体は、1つまたは複数の窓を画定する、請求項1から3のいずれか一項に記載の装置。
- 前記内部チャンバの入口部分は、前記入口部分よりもさらに内部に位置する前記内部チャンバの残りの部分より小さな断面積を有する、請求項1から4のいずれか一項に記載の装置。
- 前記内部チャンバの入口部分は、前記入口部分よりもさらに内部に位置する前記内部チャンバの残りの部分より大きな断面積を有する、請求項1から5のいずれか一項に記載の装置。
- 前記本体は、前記内部チャンバへの1つまたは複数の追加の入口を画定する、請求項1から6のいずれか一項に記載の装置。
- 前記本体は、1つまたは複数の追加の内部チャンバと、前記1つまたは複数の追加の内部チャンバへの、対応する入口と、を画定する、請求項1から7のいずれか一項に記載の装置。
- 前記薬物は、第1の薬物であり、前記装置は、前記1つまたは複数の追加の内部チャンバの中に第2の薬物をさらに含み、前記第1および第2の薬物は、異なるタイプの薬物である、請求項8に記載の装置。
- 前記近位端部分は、前記遠位端部分より前記長手方向に直交する横方向に広い、請求項1から9のいずれか一項に記載の装置。
- 前記近位端部分は、前記遠位端部分より前記長手方向に直交する横方向に広いクロスバータブを含む、請求項1から10のいずれか一項に記載の装置。
- 前記本体は、前記本体の中心体部分から前記長手方向に直交する横方向に延びる、少なくとも2つのかかりを含む、請求項1から11のいずれか一項に記載の装置。
- 前記薬物は、ポリ(乳酸)、ポリ(グリコール酸)、ポリ(ラクチド-co-グリコリド)、ポリ(無水物)、ポリ(ジオキサノン)、ポリ(アミド)、ポリ(ヒドロキシ酪酸)、ポリエステル、ポリ(カプロラクトン)、ポリ(アジピン酸)、ポリ(セバシン酸)、ポリ(テレフタル酸)、ポリ(アミノ酸)、ポリ(グルタミン酸)、ポリ(イミノカーボネート)、ポリ(ホスフェート)、ポリ(ホスホネート)、ポリ(ホスファゼン)、ポリ(シアノアクリレート)、ポリ(ウレタン)、ポリ(オルトエステル)、ポリ(アセタール)、ポリ(ジメチルシロキサン)、ポリ(ウレタン)、ポリ(アミドアミン)、ポリ(アミドエナミン)、ポリ(アクリレート)、ポリ(アクリルアミド)、ポリ(カルボフィル)、ポリ(アクリル酸)、ポリ(エチレン酢酸ビニル)、ポリ(ビニルアルコール)、ポリ(エノールケトン)、ポリ(エチレン)、ポリ(プロピレン)、ポリ(塩化ビニル)、ポリ(オルトエステル)、ポリ(エーテルエステル)、コラーゲン、アルブミン、ゼラチン、アルジネート、シクロデキストリン、キトサン、デキストラン、アガロース、ヒアルロン酸、デンプン、またはセルロースを含む、ポリマーマトリックスを含む、請求項1から12のいずれか一項に記載の装置。
- 前記本体の外部表面の少なくとも一部は、レーザー彫刻またはプラズマ処理によって、テクスチャを付けられている、請求項1から13のいずれか一項に記載の装置。
- 前記本体は、前記装置の長さにわたって延びるマイクロチャネルを画定しない、請求項1から14のいずれか一項に記載の装置。
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US16/360,777 US11039954B2 (en) | 2019-03-21 | 2019-03-21 | Implantable ocular drug delivery devices and methods |
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PCT/US2020/023919 WO2020191318A1 (en) | 2019-03-21 | 2020-03-20 | Implantable ocular drug delivery devices and methods |
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