WO2005066241A1 - Biobeneficial polyamide/polyethylene glycol polymers for use with drug eluting stents - Google Patents
Biobeneficial polyamide/polyethylene glycol polymers for use with drug eluting stents Download PDFInfo
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- WO2005066241A1 WO2005066241A1 PCT/US2004/041205 US2004041205W WO2005066241A1 WO 2005066241 A1 WO2005066241 A1 WO 2005066241A1 US 2004041205 W US2004041205 W US 2004041205W WO 2005066241 A1 WO2005066241 A1 WO 2005066241A1
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08G—MACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
- C08G69/00—Macromolecular compounds obtained by reactions forming a carboxylic amide link in the main chain of the macromolecule
- C08G69/44—Polyester-amides
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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
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/28—Materials for coating prostheses
- A61L27/34—Macromolecular materials
-
- 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
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/54—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
- 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
- A61L31/08—Materials for coatings
- A61L31/10—Macromolecular materials
-
- 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
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P39/00—General protective or antinoxious agents
- A61P39/06—Free radical scavengers or antioxidants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
- A61P7/02—Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
-
- 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
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T428/00—Stock material or miscellaneous articles
- Y10T428/31504—Composite [nonstructural laminate]
- Y10T428/31551—Of polyamidoester [polyurethane, polyisocyanate, polycarbamate, etc.]
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T428/00—Stock material or miscellaneous articles
- Y10T428/31504—Composite [nonstructural laminate]
- Y10T428/31725—Of polyamide
Definitions
- PTCA Percutaneous transluminal coronary angioplasty
- Stents are used not only mechanically, but also to provide biological therapy. Mechanically, stents act as scaffoldings, physically holding open and, if desired, expanding the vessel wall. Typically, stents compress for insertion through small vessels and then expand to a larger diameter once in position.
- U. S. Patent No. 4,733,665, issued to Palmaz; U. S. Patent No. 4,800,882, issued to Gianturco; and U. S. Patent No. 4,886,062, issued to ' Wiktor disclose examples of PTCA stents.
- Medicating the stent provides for pharmacological therapy. Medicated stents allow local drug administration at the diseased site.
- One proposed method for medicating stents involves coating a polymeric carrier onto a stent surface. This method applies a solution that includes a solvent, a dissolved polymer, and a dissolved or dispersed drug to the stent. As the solvent evaporates, it leaves a drug impregnated, polymer coating on the stent.
- This invention relates to biobeneficial copolymers, some of which are useful in medical device applications. Some of these medical devices are implantable within a mammalian body, such as in a body lumen or blood vessel.
- biobeneficial is a description for any surface that bestows biological benefit to an implantable medical device without releasing drug(s).
- the copolymers comprise at least two different blocks, at least one l block with the formula shown in Formula I, below
- the Ll block can be as shown in Formula III, below.
- the Ll blocks are the same or different.
- R are the same or different for each occurrence and are 1-16 carbon (un)substituted, (un)branched alkyl or (un)substituted, (un)branched diol or triol oligomers.
- k are the same or different ' for each Ll block ranging from 6 to 460.
- the L2 blocks are the same or different, and j are the same or different for each L2 block ranging from 2 to 30.
- Exemplary R include oligomers of ethylene glycol, propylene glycol (1,2- and 1,3 -substituted isomers), tetramethylene glycol (1,2-, 1,3-, 1,4-, and 2,3-substituted isomers), and hexamethylene glycol (1,2-, 1,3-, 1,4- 1,5-, 1,6-, 2,3-, 2,4-, 2,5-, 3,4-substituted isomers).
- any of the preceding glycols will yield unbranched moieties when substituted at the first and last carbon atom and will yield branched moieties with other substitutions patterns.
- Some embodiments are envisioned that use mixtures of polyols.
- R can be (un)branched alkyl, alkenyl, or alkynyl moieties.
- R-group is- specified as an ethylene or ethylene glycol unit.
- the formula is intended to represent its genus with an R-groups as defined in this paragraph and is intended to represent the species with the specified R-group shown.
- the above Ll block is written below in Formula IV with R defined as it would be if the polyether portion of the Ll block were selected to be PEG and the Ll portion is a- diamide.
- Ll and L2 independently, represent linkages with the formula shown in Formula V, above.
- Formula VI 0 II provided that if Y and Z are the same, they are not • c ° .
- the heavy circle indicates the position at which Y or Z attaches to the phenyl ring of Ll or L2, respectively.
- these polymers compose structural polymeric medical devices and compose coatings for polymeric, metallic, ceramic, glass, or composite medical devices.
- these polymers can be mixed with other polymers, with drugs, or with both. Methods of making medical devices using these polymers are disclosed, as well.
- This disclosure reveals a family of biobeneficial, polyamide-polyethylene-glycol polymers.
- these polymers compose the base material for implantable medical devices.
- implantable medical devices comprise these polymers.
- these polymers compose implantable medical device coatings.
- This polymer family comprises the reaction products of various reactants, wherein reactants comprise the following basic components: terephthalic acid (Formula VII, below) or a similar 1,4- difunctionally substituted benzyl group, amine-terminated polyethylene glycol or another group, as described below, and at least one aliphatic diamine.
- 1,4- disubstituted phenyl or benzyl rings axe referred to or depicted.
- such reference or depiction includes variations in which the phenyl or benzyl rings are additionally substituted at least at the 2, 3, 5, or 6 positions. Any substitution is allowed.
- Invention embodiments contain amine-terminated polyethylene glycol, such as the ED series of Jeffamine polymers (from Huntsman Chemical) or mono-amine-terminated PEG (from Shearwater Polymers). These Jeffamine polymers have a polyethylene glycol backbone with some polypropylene glycol units at the chain ends. The polypropylene units contain the primary amine.
- amine-terminated polyethylene glycol such as the ED series of Jeffamine polymers (from Huntsman Chemical) or mono-amine-terminated PEG (from Shearwater Polymers). These Jeffamine polymers have a polyethylene glycol backbone with some polypropylene glycol units at the chain ends. The polypropylene units contain the primary amine.
- invention embodiments contain an aliphatic diamine, such as 1,2-ethanediamine (Formula VIII, below),
- diamines are biocompatible in the unlikely event that in-vivo use causes their release.
- the synthesis of invention polymers is straightforward using standard nylon polymerization techniques.
- Other useful diamines are 1,5-pentanediamine, 1,6-heaxanediamine, and 1 ,6-diaminocyclohexane.
- Embodiments that have branching from the diamine backbone are . within the scope of this description.
- the diamine is selected from straight chain or branched, aliphatic diamino compounds where the amino groups are primary or secondary and the total number of carbons per diamine is 16 or less.
- R can be polyethylene, polypropylene, polyisobutylene, polyis ⁇ prene, polybutene, poly(hexamethylene glycol), poly(tetramethylene glycol), or poly(propylene glycol), and R has a molecular weight of 26 to 500 Daltons.
- R can be described as having an optional linkage between the R and the PEG. This linkage could be any of those shown in Structure Table I, above.
- Some invention embodiments select the amine-terminated polyethylene glycol, or the aliphatic diamines, or both, to be primary amines.
- One of ordinary skill in the art recognizes that similar chemistry would arise from using secondary amines for the amine-terminated polyethylene glycol or the aliphatic diamines.
- This disclosure defines a linkage prepared using secondary amines as a "substituted amide linkage" shown in Formula XI, below:
- Some invention embodiments select the amine-terminated polyethylene glycol or the aliphatic diamines or both to be secondary amines. On the other hand, some invention embodiments specifically exclude secondary amines from being the amine-terminated polyethylene glycol or the aliphatic diamines or both. Likewise, some invention embodiments exclude primary amines from- being the amine-terminated polyethylene glycol or the aliphatic diamines or both.
- the biobeneficial component should also be bioabsorbable.
- the biobeneficial component would ideally be biostable, as well. This is because the biobeneficial feature has both acute and chronic, long-term effects.
- PEG for example, works by resisting protein adhesion and denaturation at the implant surface.
- This disclosure reveals, among other embodiments, a biostable version of a polyester, biodegradable eopolyiher POLYACTIVE in which at least some replacement of the ester linkages by amide (or other) linkages occurs.
- POLYACTIVE is a trade name of a PBT-PEG ' group of products and is available from IsoTisCorp. of.Holland.
- the molar ratio between the units derived from ethylene glycol and the units derived from butylene terephthalate falls between about 0.01 :1 and about 1:1.
- the molecular weight of the units derived from ethylene glycol can be between about 300 and about 10,000 Daltons.
- the structure of POLYACTIVE is shown in Formula.XII, below.
- k ranges from 4 to 230, or more narrowly, from 7 to 91.
- the values of 1, m, and n constrain each other for a given molecular weight. LTherefore, the value of m is set to unity and the values of 1 and n will give the ratio of the two blocks and the total molecular weight. 1 ranges from 0.003 to 0.60, or more narrowly, from 0.01 to 0.45. And n ranges from 30 to 500, or more narrowly, from 100 to 375.
- k ranges from 4 to 230, or more narrowly, from 7 to 91. 1 ranges from 0.005 to 2.0, or more narrowly, from 0.01 to 1.6. m is set at unity. And n ranges from 20 to 600, or more narrowly, from 40 to 450.
- amide linkages replace all ester linkages in POLYACTIVE. Alternatively, in some embodiments, amide linkages replace 25-100 percent of the ester linkages; amide linkages replace 50-100 percent of the ester linkage; amide linkages replace 75- 100 percent of the ester linkages; amide linkages replace 95-100 percent of the ester linkages; or amide linkages replace 99-100 percent of the ester linkages.
- 25-100 percent of the ester linkages remain after some amide linkage replacement; 50-100 percent of the ester linkage remain after some amide linkage replacement; 75 -100- percent of the ester linkages remain after some amide linkage replacement; 95-100 percent of the ester linkages remain after some amide linkage replacement; or 99-100 percent of the ester linkages remain after some amide linkage replacement.
- This amide substitution removes the ester linkage from POLYACTIVE or reduces the number of ester linkages compared with the number in POLYACTIVE.
- Ester linkages hydrolyze in-vivo. But amide linkages are many times more stable.
- Some invention embodiments select the polymer formulation such that the resulting polymer is substantially broken down by the in vivo environment in an amount of time of from 1 to 24 months; alternatively, in an amount of time of from 2 to 18 months; alternatively, in an amount of time of from 3 to 12 months.
- substantially broken down means that non- invasive diagnostic procedures as skilled artisans normally employ cannot detect the polymer in vivo.
- biocompatible means that the material passes or is found acceptable by at least one of the following in vitro tests, as specified by ISO 10993.
- in vitro tests would include ISO 10993-5 cytotoxicity (this is a L929 mouse fibroblast test using extracts of the material); ISO 10993-4 hemocompatibility (this is a specific test for thrombosis, coagulation, platelet consumption, hematology, and immunology); ISO 10993-3 genotoxicity (this includes the Ames test, mouse cell lymphoma test, and Chinese hamster ovary cell test).
- invention polymers comprise at least one Ll block, shown in Formula III, above and at least one L2 block, shown in Formula II, above.
- the Ll blocks are the same or different and k are the same or different for each Ll block and range from 6 to 460.
- the L2 blocks are the same or different and j are the same or different for each L2 block and range from 2 to 30.
- k, 1, m, n take the above-disclosed values, m equals one, leaving 1 to define the ratio of 1 to m and n to define to total molecular weight, j ranges from 2 to 30, or more narrowly, from 2 to 6.
- Ll and L2 independently have Formula V, as shown above. Some embodiments independently select Ll and L2, as indicated above. In other embodiments, Ll and L2 are purposely chosen to be the same. Other embodiments purposely choose Ll and L2 to be different from each other. In any of these embodiments, appropriate selection of Y and Z yields Y and Z that are both more resistant to in vivo hydrolysis than an ester moiety, appropriate selection of Y and Z yields Y and Z in which one or the other is more resistant to in vivo hydrolysis than an ester moiety, or appropriate selection of Y and Z yields Y and Z that are both less resistant to in vivo hydrolysis than an ester moiety.
- any amides selected for Y or Z would be substituted amides.
- Some invention embodiments specifically exclude Y or Z equal to one of or any combination of esters, amides, urethanes, ureas, ethers, carbonates, or thioesters, or corresponding substituted amides.
- Some invention embodiments specifically exclude Ll and L2 from being any one or any combination of the moieties listed above in Structure Table II, above.
- invention embodiments comprise linear polymers, some exclusively so. But various invention embodiments can contain polymers that are branched or cross-linked, partially cross-linked, or not cross-linked, as desired. In some embodiments, invention polymers have less than 0.1 mole percent of branched polymers in which the branches have more than 10 atoms; alternatively, invention polymers have less than 0.01 mole percent of such branched polymers; alternatively, invention polymers have legs than 0.001 mole percent of such branched polymers.
- invention polymers have greater than 0.1 mole percent of branched polymers in which the branches have more than 10 atoms; alternatively, invention polymers have greater than 0.01 mole percent of such branched polymers; alternatively, invention polymers have greater than 0.001 mole percent of such branched polymers. In some embodiments, invention polymers have less than 0.1 mole percent of cross-linked polymers; alternatively, invention polymers have less than 0.01 mole percent of cross-linked polymers; alternatively, invention polymers have less than 0.001 mole percent of cross-linked polymers.
- invention polymers have greater than 0.1 mole percent of cross-linked polymers; alternatively, invention polymers have greater than 0.01 mole percent of cross-linked polymers; alternatively, invention polymers have greater than 0.001 mole percent of cross-linked polymers.
- Partially cross-linked means having greater than 0.001 mole percent and less than 0.1 mole percent of cross-linked polymers.
- cross-linking occurs through functional groups pendant from the polymer backbone.
- urethanes or amides in the backbone can serve as the cross-linking site, via the use of diisocyanates.
- Those of ordinary skill in the art will recognize that other ways of achieving cross-links between polymer chains function with invention copolymers.
- some embodiments may have UV polymerizable groups in the monomers. Such groups are typically acrylates or methacrylates.
- One general scheme would include placing acrylate or methacrylate groups onto the phenyl groups after the condensation polymerization.
- the acrylate or methacrylate groups would be present on the PEG based-diamine, aliphatic diamine, or the dif nctional phenyl moiety (e.g., terephthalic acid).
- This scheme is workable if the condensation reactions are selective enough not to react with the acrylate or methacrylate groups. This gives rise to another class of polymers.
- Some embodiments comprise invention polymers coated onto a medical device containing or constructed from a polymer, a medical device containing or constructed from a metal, or a bare medical device, or invention polymers coated on top of a drug coating already present on a medical device.
- some embodiments comprise invention polymers disposed between a medical device and a drug coating.
- some embodiments comprise invention polymers composing polymer-based medical " devices or invention polymers composing medical device substrates (implantable or not).
- Some invention embodiments comprise medical devices not made from polymer-containing or -constructed stents.
- Some invention embodiments comprise stents not made from metal-containing or. constructed stents.
- invention polymers serve as the base material for coatings on medical devices.
- coatings may contain a primer layer composed of an invention polymer or composed of a type-two polymer, as described below. Some embodiments exclude a primer layer.
- invention polymers add conventional drugs ' , such as small, hydrophobic drugs, to invention polymers (as discussed in any of the embodiments, above), making them biostable, drug systems.
- invention polymers can be coated as blends with a variety of biobeneficial polymers. Moreover, they can serve as base or topcoat layers for biobeneficial polymer layers.
- the selected drug can inhibit vascular, smooth muscle cell activity. More specifically, the drug activity can aim at inhibiting abnormal or inappropriate migration or proliferation of smooth muscle cells to prevent, inhibit, reduce, or treat restenosis.
- the drug can also include any substance capable of exerting a therapeutic or prophylactic effect in the practice of the present invention. Examples of such active agents include antiproliferative, antineoplastic, antiinflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antimitotic, antibiotic, and antioxidant substances as well as their combinations.
- An example of an antiproliferative substance is actinomycin D, or derivatives and analogs thereof (manufactured by Sigma-Aldrich 1001 West Saint Paul Avenue, Milwaukee, WI 53233; or COSMEGEN available from Merck).
- actinomycin D Synonyms of actinomycin D include dactinomycin, actinomycin IV, actinomycin Ii, actinomycin Xi, and actinomycin C ⁇ .
- antineoplastics include paclitaxel and docetaxel.
- antiplatelets examples include aspirin, sodium heparin, low molecular weight heparin, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prosfacyclin analogs, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein Ilb/IIIa platelet membrane receptor-antagonist, recombinant hirudin, thrombin inhibitor (available from Biogen), and 7E-3B® (an antiplatelet drug from Centocor).
- aspirin sodium heparin, low molecular weight heparin, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prosfacyclin analogs
- dextran D-phe-pro-arg-chloromethylketone
- D-phe-pro-arg-chloromethylketone synthetic antithrombin
- dipyridamole
- antimitotic agents include methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, adriamycin, and mutamycin.
- cytostatic or antiproliferative agents include angiopeptin (a somatostatin analog from Ibsen), angiotensin converting enzyme inhibitors such as CAPTOPRIL (available from Squibb), CILAZAPRIL (available from Hoffman-LaRoche), or LISINOPRIL (available from Merck & Co., Whitehouse Station, NJ), calcium channel blockers (such as Nifedipine), colchicine, fibroblast growth factor (FGF) antagonists, histamine antagonist, LOVASTATIN (an inhibitor of HMG-CoA reductase, a cholesterol lowering drug from Merck &Co.), monoclonal antibodies (such as PDGF receptors), nitroprusside, phosphodiesterase inhibitors, prostaglandin inhibitor (available from Glazo), Seramin
- a PDGF antagonist triazolopyrimidine
- Other useful drugs may include alpha-interferon, genetically engineered epithelial cells, dexamethasone, estradiol, clobetasol propionate, cisplatin, insulin sensitizers, receptor tyrosine kinase inhibitors, and carboplatin. Exposure of the composition to the drug should not adversely alter the drug's composition or characteristic. Accordingly, drug-containing embodiments choose drugs that are compatible with the blended composition. • Rapamycin is a suitable drug. Additionally, 40-O-(2-hydroxy)ethyl-rapamycin, or a functional analog or structural derivative thereof, is suitable, as well.
- Examples of analogs or derivatives of 40-O-(2-hydroxy)ethyl-rapamycin include, among others, 40-O-(3-hydroxy)propyl-rapamycin and 40-O-2-(2-hydroxy)ethoxyethyl-rapamycin.
- Those of ordinary skill in the art know of various methods and coatings for advantageously controlling the release rate of drugs, such as 40-O-(2-hydroxy)ethyl-rapamycin.
- Some embodiments choose the drug such that it does not contain at least one of or any combination of antiproliferative, antineoplastic, antiinflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antimitotic, antibiotic, or antioxidant substances.
- Some invention embodiments choose the drug such that it does not contain at least one of or any combination of actinomycin D, derivatives and analogs of Actinomycin D, dactinomycin, actinomycin IV, actinomycin L, actinomycin X[, actinomycin Ci, paclitaxel, docetaxel, aspirin, sodium heparin, low molecular weight heparin, hirudin, argatroban, forskolin, vapiprost, prostacyclin, prostacyclin analogs, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein Ilb/IIIa platelet membrane receptor antagonist, reco binant hirudin, thrombin inhibitor and 7E-3B, methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, adriamycin, mutamycin, angiopeptin, an
- Some invention embodiments comprise a drug or drug combination, and some require a drug or combination of drugs. Of the drugs specifically listed above, some invention embodiments exclude a single or any combination of these drugs.
- blends could also be formulated to modulate or tune the release rate of drugs from coatings, reservoirs, or particles composed of these blends and drugs or therapeutic agents.
- Blends with other polymers can be formulated to modulate the mechanical properties of invention polymers. Therefore, some invention embodiments comprise polymer blends with other polymeric components. For purposes of this disclosure, these other polymeric components are sometimes referred to as type-two polymers. For instance, type-two polymers could be blended into invention polymers to modify mechanical or biological properties or vice versa.
- Type-two polymers include, among others, polycaprolactone, poly(D,L-lactide), poly(L-lactide), poly(D,L-la ' ctide-co-L-lactide), poly(glycolide), poly(D,L-lactide-co-glycolide), poly(dioxanone), poly(4-hydroxybutyrate), poly(3-hydroxybutyrate), poly(3-hydroxy valerate), poly(3-hydroxybutyrate-co-3-hydroxyvalerate), poly(tyrosine derived carbonates), poly(tyrosine arylates), poly(imino carbonates), poly(trimethylene carbonate), poly(anhydrides), poly(orthoesters), and poly(ester amides) or combinations of these polymers.
- polymer blends with invention polymers do not contain at least one of polycaprolactone, poly(D,L-lactide), poly(L-lactide), poly(D J L-lactide-co-L-lactide), poly(glycolide), poly(D,L-lactide-co-glycolide), poly(dioxanone), poly(4-hydroxybutyrate), poly(3-hydroxybutyrate), poly(3-hydroxy valerate), poly(hydroxybutyrate-co-hydroxyvalerate), poly(tyrosine derived carbonates), poly(tyrosine arylates), poly(imino carbonates), poly(trimethylene carbonate), poly( anhydrides), poly(orthoesters), or poly(ester amides).
- polycaprolactone poly(D,L-lactide), poly(L-lactide), poly(D J L-lactide-co-L-lactide), poly(glycolide), poly(D,L-lactide-co-
- Type-two polymers also include ethylene vinyl alcohol copolymer, poly (hydro xyvalerate); poly(L-iactic acid); polycaprolactone; poly(lactide-co-glycolide); polyfhydroxybutyrate); poly(hydroxybutyrate-co-valerate); polydioxanone; polyorthoester; polyanl ydride; po!y(gIycolic acid); poly(D,L-lactic acid); poly(glycolic acid-co-trimethylene carbonate); polyphosphoester; polyphosphoester urethane; poly(amino acids); cyanoacrylates; poly(trimethylene carbonate); poly(iminocarbonate); copoly(ether-esters) (e.g.
- PEO/PLA polyalkylene oxalates; polyphosphazenes; biomolecules, such as fibrin, fibrinogen, cellulose, starch, collagen and hyaluronic acid; ; poly(ester-urethanes); poly(ether-urethanes); poly(urea- urethanes); poly(silicone-urethanes); polyurethanes; silicones; polyesters; polyolefins; polyisobutylene and ethylene-alphaolefin copolymers; acrylic polymers- and copolymers; vinyl halide polymers and copolymers, such as polyvinyl chloride; polyvinyl ethers, such as polyvinyl methyl ether; polyvinylidene halides, such as polyvinylidene fluoride and polyvinylidene chloride; poly(vinylidene fluoride-co-hexafluoropropene), poly(vinylidene fluoride-co- chloro
- Some invention embodiments comprise, and some invention embodiments require, a type-two polymer used along with invention polymers. Some invention embodiments comprise and some invention embodiments require combining at least two type-two polymers with invention polymers. Of the . type-two polymers disclosed above, some invention embodiments exclude a single or any combination of type-two polymers.
- invention polymers are used with type-two polymers
- the invention polymers are mixed or blended with the type-two polymers.
- some embodiments comprise invention polymers physically blended with PEG, POLYACTIVE, or other biobeneficial polymers. Additionally, some embodiments employ invention polymers blended with biobeneficial polymers and type-two polymers.
- modulate biological outcome means adjusting the polymer biobeneficial-component content in order to minimize fibrinogen absorption, platelet, binding, the number of adherent macrophages and inflammatory cells, and the degree of inflammatory cell activation.
- Some embodiments comprise invention polymers combined with other polymers in multilayer arrangements.
- an invention polymer could under- or over-lay another polymer such as a polymer coated on a device, a medical device, an implantable medical device, or a stent.
- the invention polymer can be used neat in this regard, or it can first B mixed with a ' separate invention polymer or a type-two polymer before layering.
- invention polymers do not underlay another polymer; in other embodiments, invention polymers must overlay another polymer.
- implantable devices useful in the present invention include self- expandable stents, balloon-expandable stents, stent-grafts, grafts (e.g., aortic grafts), vascular grafts, artificial heart valves, cerebrospinal fluid shunts, pacemaker electrodes, guidewires, ventricular assist devices, artificial hearts, cardiopulmonary by-pass circuits, blood oxygenators, and endocardial leads (e.g., FINELINE and ENDOTAK, available from Guidant Corporation, Santa Clara, CA).
- the underlying structure of the device can be of virtually any design.
- the device can comprise a metallic material or an alloy such as, but not limited to, cobalt chromium alloy (ELGILOY), stainless steel (316L), high nitrogen stainless steel, e.g., BIODUR 108, cobalt chrome alloy L-605, "MP35N,” “MP20N,” ELASTINITE (Nitinol), tantalum, nickel-titanium alloy, platinum-iridium alloy, gold, magnesium, or combinations thereof.
- ELGILOY cobalt chromium alloy
- 316L stainless steel
- high nitrogen stainless steel e.g., BIODUR 108, cobalt chrome alloy L-605, "MP35N,” “MP20N,” ELASTINITE (Nitinol), tantalum, nickel-titanium alloy, platinum-iridium alloy, gold, magnesium, or combinations thereof.
- BIODUR 108 cobalt chrome alloy L-605, "MP35N,” “MP20N,” ELASTINITE (Nitinol), tantalum, nickel-titanium
- MP35N consists of 35% cobalt, 35% nickel, 20% chromium, and 10% molybdenum.
- MP20N consists of 50% cobalt, 20% nickel, 20% chromium, and 10% molybdenum.
- Devices made from bioabsorbable or biostable polymers could also be used with the embodiments of the present invention.
- Some invention embodiments define the genre of medical devices to exclude at least one of self-expandable stents, balloon-expandable stents, stent-grafts, grafts (e.g., aortic grafts), vascular grafts, artificial heart valves, cerebrospinal fluid shunts, pacemaker electrodes, guidewires, ventricular assist devices, artificial hearts, cardiopulmonary by-pass circuits, blood oxygenators; or endocardial leads.
- grafts e.g., aortic grafts
- vascular grafts e.g., vascular grafts
- pacemaker electrodes e.g., guidewires, ventricular assist devices, artificial hearts, cardiopulmonary by-pass circuits, blood oxygenators; or endocardial leads.
- a coating for an implantable medical device such as a stent, according to embodiments of the present invention, can be a multi-layer structure that can include the following three layers:
- a drug-polymer layer also referred to as “reservoir”, or “reservoir layer” or alternatively a polymer-free drug layer;
- Some invention embodiments comprise multilayered structures in which an invention polymer is present in one or more of the layers of the multilayered structure.
- each medical device coating layer comprises dissolving the polymer or a polymer blend in a solvent or a solvent mixture, and applying the solution onto the medical device (such as by spraying the medical device with the solution or by dipping the medical device into the solution). After applying the solution onto the medical device, the coating dries by solvent evaporation. Drying at elevated temperatures accelerates the process.
- Combining the drug with the polymer solution, as described above, provides for incorporating the drug into the reservoir layer.
- dissolving the drug in a suitable solvent or solvent mixture an applying the drug solution to the medical device provides for a substantially polymer-free drug layer.
- the drug can be introduced as a colloid, such as a suspension in a solvent.
- Dispersing the drug in the solvent uses conventional techniques. Depending on a variety of factors, e.g., the nature of the drug, those having ordinary skill in the art can select the solvent for the suspension, as well as the quantity of the dispersed -drug. ' Some embodiments mix these suspensions with a polymer solution and apply the mixture onto the device, as described above. Alternatively, some embodiments apply the drug suspension to the device without mixing it with the polymer solution.
- the drug-polymer layer can be applied directly onto at least a part of the medical device surface to serve as a reservoir for at least one active agent or. a drug.
- the optional primer layer can be applied between the device and the reservoir to improve polymer adhesion to the medical device.
- Some embodiments apply the topcoat layer over at least a portion of the reservoir layer, and the topcoat layer serves as a rate limiting membrane, which helps to control the rate of release of the drug.
- Some drug releasing processes include at least two steps. First, the topcoat polymer absorbs the drug at the drug-polymer-topcoat interface. Next, the drug diffuses through the topcoat using empty spaces between the polymer molecules as diffusion pathways. Next, the drug arrives to the outer surface of the topcoat, and desorbs into the blood stream.
- Invention polymers can be prepared by polycondensation reactions. First, the amine- terminated PEG is combined with terephthaloyl chloride with added pyridine to absorb the released HC1. After this block has reacted, the aliphatic diamine is added with additional teraphthaloyl chloride. Irganox 1330 can be added as an antioxidant to protect the PEG, as it is used in the synthesis of POLYACTIVE. Routes that use dimethyl terephthalate would avoid using the acid chloride. Application of heat and vacuum to remove the generated methanol will drive the polymerization. [0058] Of course, modifications to this synthesis must be made when Ll or L2 are not prepared to contain amide linkages, i.e. when Ll and L2 do not have the structure shown below. Such modifications are well within the skill level of one of ordinary skill in the art.
- Terephthaloyl chloride (47.51 g, 0.234 moles) is slowly added to the reaction vessel and the solution slowly heated to 60 °C and allowed to react for 4 hours. After cooling, slow addition of the reaction mixture into 2 liters of stirred, deionized water will cause precipitation of the polymer, the formula of which is shown below in Formula XVII.
- Formulas Formula XIX-Formula XXII represent the same polymer, the only difference in the orientations of the benzoyl-derived group.
- listing one of formulas Formula XLX-Formula XXII represents each of Formula XIX-Formula XXII.
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EP20040813517 EP1694743A1 (en) | 2003-12-19 | 2004-12-09 | Biobeneficial polyamide/polyethylene glycol polymers for use with drug eluting stents |
JP2006545750A JP2007518850A (ja) | 2003-12-19 | 2004-12-09 | 薬剤溶出用ステントと共に使用する生体有益性ポリアミド/ポリエチレングリコールポリマー |
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US10/741,214 US7435788B2 (en) | 2003-12-19 | 2003-12-19 | Biobeneficial polyamide/polyethylene glycol polymers for use with drug eluting stents |
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2003
- 2003-12-19 US US10/741,214 patent/US7435788B2/en not_active Expired - Fee Related
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2004
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- 2004-12-09 JP JP2006545750A patent/JP2007518850A/ja active Pending
- 2004-12-09 WO PCT/US2004/041205 patent/WO2005066241A1/en not_active Application Discontinuation
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2008
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- 2008-09-09 US US12/207,424 patent/US7786249B2/en not_active Expired - Fee Related
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2010
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Also Published As
Publication number | Publication date |
---|---|
US20090012243A1 (en) | 2009-01-08 |
US20090012259A1 (en) | 2009-01-08 |
US7435788B2 (en) | 2008-10-14 |
US20100297211A1 (en) | 2010-11-25 |
US7772359B2 (en) | 2010-08-10 |
US20050137381A1 (en) | 2005-06-23 |
EP1694743A1 (en) | 2006-08-30 |
US20090012606A1 (en) | 2009-01-08 |
US7879953B2 (en) | 2011-02-01 |
JP2007518850A (ja) | 2007-07-12 |
US7632914B2 (en) | 2009-12-15 |
US7786249B2 (en) | 2010-08-31 |
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