Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F6/00—Contraceptive devices; Pessaries; Applicators therefor
  • A61F6/06—Contraceptive devices; Pessaries; Applicators therefor for use by females
  • A61F6/08—Pessaries, i.e. devices worn in the vagina to support the uterus, remedy a malposition or prevent conception, e.g. combined with devices protecting against contagion
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
  • A61M31/002—Devices for releasing a drug at a continuous and controlled rate for a prolonged period of time
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0031—Rectum, anus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/02—Holding devices, e.g. on the body
  • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible

Definitions

• the present invention relates in general to a device and method for the prolonged delivery of an active agent to a body cavity.
• the delivery may be for local or systemic treatment.
• AF anal fissure
• AF is a small split or tear in the mucosa that may cause painful bowel movements and bleeding.
• AF is extremely common in young infants but may occur at any age. Studies suggest that 80% of infants will have had AF by age one year. Most fissures heal on their own or as a result of minimal treatment; however, some fissures may require more serious medical treatment.
• AF AF-related fibroblasts
• Fissures are much less common among school-aged children than among infants. In adults, fissures may be caused by constipation, particularly when passing large, hard stools, or by prolonged diarrhea. In older adults, AF may be caused by decreased blood flow to the area (3). AF is also common in women after childbirth and in people with Crohn's disease. The pain involved with AF causes both physical and emotional stress (4,5). This, in turn, causes the anus to contract during bowel movements, thereby aggravating the area even more. In some cases, one may be required to stay home, or even be hospitalized as a result of the AF.
• recurrence generally occurs between 30-70% of the time.
• the simplest method of treating acute AF comprises warm baths and a diet rich in fiber. Approximately 80% of sufferers of acute AF are cured by following this approach, within a time span of three weeks. Use of additional means such as steroid creams, anesthetics, dilators, etc. will not help to quicken the speed of recovery, and it is best to not even use them (2).
• nitric oxide cream to rub around the anus. This cream relaxes the internal anal sphincter. It is reported that 92% of individuals who use nitric oxide cream are cured within only two weeks (6).
• Anal dilation is another method of treatment of chronic AF. This is a crude and painful technique, wherein a series of increasingly larger diameter tubes are inserted to the rectum to enlarge the sphincter opening. There are several drawbacks to this method, including lack of control over the final size of the opening, and the chances of incontinence are greater than those following IS. Also, the success rate of anal dilation is relatively low (2).
• Topical nitroglycerin is a cream that is used for treating chronic AF.
• the claimed success rate is between 68-85% within eight weeks.
• Drawbacks include reports of headaches by 58% of treated patients, and a high chance of relapse.
• Advantages include no reports of incontinence (7).
• BT butulinum toxin
• JP 2003-062007 discloses a device capable of prolonging the effect of a hemorrhoids treating medicine.
• the device comprises a rod shaped core surrounded by a sheet member made of an absorptive material.
• An anus inserting member comprising a medicament is formed in a protruded shape on the surface of the sheet member.
• the device is inserted to the patient's anus and adhered externally to his buttocks by an adhesive materiel situated on the surface of the outer flaps of the sheet member.
• the core member is made of a thermally softening material to make it more comfortable for the individual to engage in daily activities.
• the core member still maintains the protruding shape of the device within the rectum, which, due to the pressing on the rectal wall will give rise to the urge to perform a bowel movement, which, in turn, will force the device out of the anus.
• studies have shown that when the lesion is in a moist environment and includes internal fluids and secretions with the active ingredient (the medicament), the pace of healing process is increased.
• an absorptive outer layer is provided, such that internal fluids and secretions are not accessible to the device for combination with the medicament to assist in the healing process.
• the present invention relates to a device for application to a body cavity, wherein said device is insertable into said cavity of a subject in need, comprising: a. a non-absorbable, flexible tube comprising an elongated shape; b. a removable core element situated within said tube; and c. a retention mechanism for maintaining said device within said cavity.
• the present invention further relates to a device for the prolonged delivery of an active agent to a body cavity, wherein said device is insertable into said cavity of a subject in need, and comprises: a. a non-absorbable, flexible tube comprising an elongated shape having; b. a removable core element situated within said tube; c. an active agent; and, d. a retention mechanism for maintaining said device within said cavity.
• the tube is preferably liquid impermeable or at least liquid semi-permeable.
• the tube may be naturally-occurring or synthetic, for example, a polymer, selected from the group consisting of: a. cellulose; b. a polysaccharide, such as chitosan; c. poly(lactic acid); d. poly(glycolic acid); e. silicone, polyamide; f. polypeptide; and, g. polyolef ⁇ n.
• a polymer selected from the group consisting of: a. cellulose; b. a polysaccharide, such as chitosan; c. poly(lactic acid); d. poly(glycolic acid); e. silicone, polyamide; f. polypeptide; and, g. polyolef ⁇ n.
• the tube is essentially cylindrical.
• the core element may be chosen from the group consisting of: a. a rigid material; b. a gaseous substance.
• the tube further comprises an open end through which the core element is removed from said tube.
• the rigid material is maintained in an essentially solid state outside of the body, and in converted to a liquid state when situated in said body.
• the active agent may be any one of the group consisting of: a. analgesic; b. anthelmintic; c. antibacterial; d. antiviral; e. antiprotozoal; f. antidiarrheal; g. antihemorrhoidal; h. hemostatic; i. anti-inflammatory; j. a diagnostic aid; k. a hair remover;
• a disinfectant comprising: m. antifungal; n. an alkylating agent; o. a muscle relaxant; p. an antacid; q. a sedative; r. mucolytic; s. contrast media; t. an antidote; u. a metabolic/endocrinal preparation; and v. an anti-cancer agent.
• the active agent is situated at any one of the following locations: a. the external surface of the tube; b. the internal surface of said tube; and, c. within a network of pores of which said tube is comprised.
• the active agent is an integral component of the tube.
• the retention mechanism comprises any one of the group consisting of: a. an external portion; b. an internal portion; and, c. a combination thereof.
• the external portion comprises at least one wing extending from the open end of the tube, and wherein at least one surface of said wing comprises adhesive material for adhering said wing to the subject in need.
• the internal portion comprises at least one flap portion situated longitudinally along the elongated tube, wherein said flap is an integral portion of said tube, and wherein the outer surface of said flap comprises adhesive material for adhering said outer surface to Hie internal wall of the cavity of the subject in need.
• the inner surface of the flap comprises adhesive material for adhering said inner surface to the internal wall of the cavity of the subject in need.
• the internal portion comprises an inflatable object situated within the tube, wherein when inflated, said object comprises dimensions that are larger than the maximum diameter of the opening of the cavity.
• the object may be selected from the group consisting of: a. an inflatable ring; and, b. inflatable arms.
• the device may be biodegradable, or alternatively, non-biodegradable
• the body cavity may be chosen from the group consisting of: a. rectum; b. large intestine; c. small intestine; d. esophagus; e. stomach; f. trachea; g. bronchus; h. outer ear canal; i. inner ear canal; j. nasal canal; k. air sinuses;
• vagina 1. vagina; m. cervix; n. uterus; o. fallopian tubes; p. urethra (including prostate); q. bladder; and, r. intra-articular cavity.
• the device is capable of delivery for any one of the group consisting of: a. local treatment; and, b. systemic treatment.
• the present invention further relates to a method of delivering an active agent to a body cavity for a prolonged period, said method comprising: a. providing a device comprising; i. a non-absorbable, flexible tube comprising an elongated shape; ii. a removable core element situated within said tube; iii. an active agent; and, iv. a retention mechanism for maintaining said device within said cavity. b. inserting said device into said cavity; and, c. removing said core element from said tube, thereby allowing said tube to collapse within said cavity.
• Fig. 1 illustrates a schematic perspective view of a preferred embodiment of the present invention.
• Fig. 2 illustrates a longitudinal cross-sectional view taken along A-A of Fig. 1.
• FIGs. 3 a and 3b illustrate a portion of the device of the present invention disposed within the rectum of a person in need, in an initial position (Fig. 3 a) and after an outwardly directed force is applied (Fig. 3 b).
• Figs. 4a and 4b illustrate the device of the present invention, wherein the core element is partially removed therefrom (Fig. 4a), and in a collapsed position after the core element is removed (Fig. 4b).
• the present invention relates in general to a device and method for application to a body cavity, and more specifically to a device and method for the prolonged delivery of an active agent to a body cavity.
• a device and method for the prolonged delivery of an active agent to a body cavity As an illustrative, but non-limitative, example of the apparatus of the invention, embodiments of the device for prolonged rectal delivery of the active agent, particularly for anal fissure, will be described hereinbelow.
• Anal fissure is a common rectal disorder that can affect men and women, both young and old. Treatments for AF range from a warm bath to a surgical procedure, depending on the severity of the affliction, as described herein above. While some treatments have a better success rate than others, all have negative side affects in one form or another, including incontinence and relapse.
• the present invention provides a device for prolonging the rectal delivery of an active agent, in which the healing process is hastened, and negative side affects involved in AF treatment are minimized.
• the present invention is described herein in terms of treatment of AF, it is understood that a wide variety of rectal disorders are treatable with the device of the present invention. Some of those disorders include hemorrhoids, perianal abscess, perianal fistula, inflammatory bowel disease, gastrointestinal polypoid disease (Peutz-Jaeger Syndrome) and juvenile polypoids, among others. More generally, however, the present invention relates to the prolonged rectal delivery of any active agent, for local and/or systemic delivery, preferably in a moist environment. Systemic delivery may include delivery of the active agent to the colon, etc.
• the present invention may be utilized in the prolonged delivery of an active agent to other cavities, such as the large intestine, small intestine, esophagus, stomach, trachea, bronchus, outer ear canal, inner ear canal, nasal canal, air sinuses, vagina, cervix, uterus, fallopian tubes, urethra (including prostate), bladder, intraarticular cavity, etc., although embodiments of the present invention may vary slightly according to the particular body cavity to which the device is inserted. It is understood that a surgical procedure is required for inserting the present invention into one or more of the above-mentioned body cavities.
• a preferred embodiment of the device of the present invention shown in Fig. 1 and designated generally by the numeral (100), comprises a flexible hollow tube (110) comprising an open end. (I l l) and a closed end (112), and a core element (120) situated within tube (110), for maintaining the elongated cylindrical shape of tube (100).
• Tube (100) is essentially cylindrical in shape when core element (120) is situated therein, however, it is understood that the general shape and structure of tube (100) is not limited to that shown in the figures herein, and may vary accordingly.
• Device (100) is insertable to the rectum of a subject in need, and comprises a retention mechanism for maintaining device (100) within the rectum, following insertion therein.
• the retention mechanism comprises both internal and external portions, however, in other embodiments, only one of the portions may be present.
• Fig. 2 shows a longitudinal cross-sectional view of device (100) taken along A-A of Fig. 1.
• the external portion of the retention mechanism comprises wings (130), which outwardly extend from the open end (111) of tube (110). Wings (130) are preferably integral extensions from the open end (111) of tube (110).
• device (100) comprises two wings, (130), each extending in opposing directions from each other, from open end (111) of tube (110). Alternatively, additional wings may be present, or alternatively, the wing may comprise a continuous sheet extending in all directions from the open end (111) of tube (110).
• the lower surface (132) of wings (130) comprise adhesive material (134).
• glue or any bonding substance, is situated near the upper portion of flap (140), for adhesion to the rectal wall upon insertion therein, as described herein below. It may be desirable for adhesive material (146) to extend along the length of the external surface of flap (140). Additional adhesive material (148) is situated along the inner surface (150) of flaps (140) for providing adhesion to the rectal wall when an outwardly directed force is applied, as described herein below.
• Top edge (144) of flaps (140) are shown in Fig. 2 slightly peeled for illustrative purposes.
• tube (110) is provided initially as having an essentially continuous outer surface.
• flaps (140) it may be preferable to provide flaps (140) in the slightly peeled configuration, as shown.
• Fig. 3a shows cross-section A-A of device (100) disposed within a rectum (116). Core element (120) and wings (130) are not shown, for purposes of clarity.
• adhesive material (146) naturally adheres to rectum wall (118).
• Fig. 3 b if internal pressure builds up such that device (100) is forced in the direction of anal orifice, as indicated by arrow (102), flaps (140) will peel along the perforations. If enough force is applied, flaps (140) will flip over, and adhesive material (148) will adhere to rectal wall (118).
• device (100) is adhered to the patient internally at two locations, i.e. at the locations of adhesive material (146) and (148), and externally, at the location of adhesive material (134).
• core element (120), (Figs. 1 and 2) comprises a rigid material.
• the rigid material is any hard polymeric material, for example polyolefin or polypropylene.
• core element (120) is removed.
• a string, tab or other protruding object is joined to the upper surface of core element (120) at the open end of tube (110).
• the protruding object is pulled outward, leaving tube (110) within the rectum, as described herein below.
• core element (120) is made of, or at least coated with a non-stick material such as TeflonTM to allow core element (120) to be removed from tube (110) without adhesive material (148) adhering thereto.
• core element (120) is made of a material, which is maintained in an essentially solid state when outside of the body, and is converted to a liquid state when situated within the body.
• core element (120) may be in an essentially solid state when subject to at least ambient temperature, and when subject to higher temperatures, particularly body temperature, is transformed to a liquid state.
• the open end (111) of tube (110) is provided with an absorptive sponge-like material for absorbing core element (120) as it melts (not shown in the figures).
• core element (120) is a solidified gel or liquid, or a compressed powder.
• core element (120) may at least partially comprise saccharides, fillers and other water soluble materials, and manufactured by techniques known in the art.
• the core element is comprised of a gaseous substance and sealed inside a thin housing within tube (110).
• the gaseous substance is preferably air or any inert gas such as nitrogen.
• the gaseous substance is pressurized to provide tube (110) with its elongated cylindrical shape.
• the gaseous substance that comprises core element (120) is released from open end (111) of tube, for instance, by rupturing of the sealed housing via squeezing of tube (110).
• the gaseous substance may be provided within the tube, and the tube may be sealed at both ends (not shown in the figures).
• one end of the tube preferably the end disposed toward the outside of the body, is ruptured, thereby releasing the gaseous substance.
• the internal retention mechanism may comprise an object, such as a ring having a diameter larger than the anal orifice, which is situated within tube (110), for preventing tube (110) from exiting the rectum.
• the gaseous substance may enter at least one inflatable member (e.g. an arm, a ring, etc.), thereby causing the member to expand, thereby preventing the removal of tube (110) from the rectum.
• Fig. 4a shows cross-section A-A of device (100) (wings (130) not shown, for clarity) inserted to rectum (116), and core element (120) is partially removed from tube (110).
• tube (110) looses its original cylindrical shape and collapses inward, as indicated by arrows (104).
• flaps (140) which are adhered to rectal wall (118) by adhesive material (146) are peeled from the body of tube (110).
• tube (110) After core element (120) is completely removed from tube (110), as shown in Fig. 4b, tube (110) essentially completely collapses; however, adhesion to rectal wall (118) is maintained by adhesive material (146).
• adhesive material (146) When internal pressure forces tube (110) in the direction of the anal orifice, as indicated by arrow (102), flaps (140) flip over and adhere to rectal wall (118) at adhesive material (148) as described herein above.
• flaps (140) flip over and adhere to rectal wall (118) at adhesive material (148) as described herein above.
• the description of the removal of core element (120), as described above, relates to the core element (120) as described in its three different aspects above.
• the removal of core element (120) includes the removal of the rigid body, melting of the rigid body, or releasing of the gaseous substance, to allow tube (100) to collapse, mutatis mutandis.
• Tube (110) is preferably made of, or coated with, a non-absorptive material having nonstick properties.
• Tube (110) may be made of any non-toxic flexible polymeric material, which enables safe and smooth insertion of device (100) according to the invention to a body cavity.
• polymeric material may, for example, comprise polysaccharides, such as cellulose or chitosan, polypeptides, such as gelatin, synthetic polymers, such as poly(lactic acid), poly(glycolic acid), silicone, polyamide, polyolefin, and mixtures and derivatives thereof.
• Tube (110) may contain other synthetic or natural physiologically acceptable materials, comprising polymers, fibers, tissues, membranes, and foils.
• tube (110) is comprised of dialysis tubing.
• tube (110) comprises a network of pores or micro-pores, within which an active agent is impregnated.
• the active agent may be an integral component of tube (110), for instance, by melting the agent within the material of tube (110), which serves as a matrix for the active agent.
• the active agent preferably consists of a diluted paste that is affixed to the outer and/or inner surface of tube (110).
• Tube (110) is preferably liquid impermeable, however, when the active agent is affixed to the inner surface thereof, tube (110) is semi-permeable to allow the active agent to be released to the surrounding area.
• the device of the invention provides benefit to patients suffering from anal fissure even in the absence of an active agent.
• the active agent may be any one of the following: analgesic, anthelmintic, antibacterial, antiviral, antiprotozoal, antidiarrheal, hemostatic, anti-inflammatory, a diagnostic aid, a hair remover, a disinfectant, antifungal, an alkylating agent, a muscle relaxant, an antacid, a sedative, mucolytic, contrast media, an antidote, or any miscellaneous preparation, such as metabolic/endocrinal preparation or any anti-cancer agent.
• Tube (110) may be nonbiodegradable, and thereby, removable, for example, when the patient performs a bowel movement.
• Tube (110) may alternatively be biodegradable.
• tissue growth factor TGF
• fibrin producing agent TGF
• homeopathic preparations and natural oils selected from the group consisting of tea tree oil, calendula oil, propolis extract, and hammamelis extract.
• Anal examination revealed anal fissure 15 mm. long, of moderate depth. The remainder of the physical examination was good.
• the patient was instructed in the use of the device, which was inserted in the anal canal and left in place until the next bowel movement when it was displaced and flushed from the body. Within 10 minutes of application of the device, while still in the clinic, the patient reported that the pain had disappeared. Upon examination three days late, the area of the previously seen anal fissure appeared to be fully epithelialized. The patient was instructed to continue treatment with the device for another two days. The next year was without complaints. The following year the patient had another episode of pain that seemed to arise from the same cause, i.e., anal fissure. She was instructed to begin treatment immediately with devices that were supplied. Rapid improvement was seen once again. Patient stopped treatment after three days. Since 2002, there were no other complaints.

Landscapes

• Health & Medical Sciences (AREA)
• Engineering & Computer Science (AREA)
• Life Sciences & Earth Sciences (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Animal Behavior & Ethology (AREA)
• Medicinal Chemistry (AREA)
• Hematology (AREA)
• Anesthesiology (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Chemical & Material Sciences (AREA)
• Reproductive Health (AREA)
• Vascular Medicine (AREA)
• Medicinal Preparation (AREA)
• Materials For Medical Uses (AREA)
• Infusion, Injection, And Reservoir Apparatuses (AREA)

Priority Applications (3)

Applications Claiming Priority (2)

Publications (2)

Family

ID=38371902

Family Applications (1)

Country Status (6)

Cited By (3)

Families Citing this family (11)

Citations (5)

Family Cites Families (18)

• 2006
  • 2006-02-16 IL IL173762A patent/IL173762A0/en unknown
• 2007
  • 2007-02-15 US US12/279,362 patent/US20100168563A1/en not_active Abandoned
  • 2007-02-15 CN CNA2007800126510A patent/CN101553274A/zh active Pending
  • 2007-02-15 JP JP2008554908A patent/JP2009529355A/ja active Pending
  • 2007-02-15 WO PCT/IL2007/000217 patent/WO2007094004A2/en not_active Ceased
  • 2007-02-15 EP EP07713261A patent/EP1986569A4/en not_active Withdrawn

Patent Citations (5)

Non-Patent Citations (14)

Also Published As

Similar Documents

Legal Events