Classifications

• • 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
  • 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
  • A61L27/14—Macromolecular materials
  • A61L27/22—Polypeptides or derivatives thereof, e.g. degradation products
  • A61L27/227—Other specific proteins or polypeptides not covered by A61L27/222, A61L27/225 or A61L27/24
• • 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
  • A61L31/04—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
  • A61L31/08—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
  • 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
  • A61L2300/602—Type of release, e.g. controlled, sustained, slow

Definitions

• the present invention relates to drug-coated medical devices.
• the present invention provides a medical device coated with carrier macromolecules, wherein the carrier macromolecules are conjugated with a therapeutic agent.
• the carrier macromolecules are antibodies or antibody fragments.
• the therapeutic agent is conjugated to the antibodies at the antigen binding site, whereas in other embodiments, the therapeutic agent is conjugated to the antibodies via a covalent bond.
• the antibodies release the therapeutic agent upon exposure to a trigger.
• the antibodies are bispecific antibodies.
• the carrier macromolecules may be dispersed within a coating on the medical device and the carrier macromolecules may diffuse out of the coating or be affixed to the coating. Also provided are methods of controlling the release and targeting of therapeutic agents eluted from a medical device. BRIEF DESCiEUPTION OF THE DRAWINGS
• FIG. I is a cross-section schematic representation of a fragmentary portion of a medical device according to an embodiment of the present invention.
• FIG. 2 is a cross-section schematic representation of a fragmentary portion of a medical device according to another embodiment.
• FIG. 3 is a cross-section schematic representation of a fragmentary portion of a medical device according to yet another embodiment.
• FIG. 4A is a cross-section schematic representation of a fragmentary portion of a medical device according to yet another embodiment where the carrier macromolecules are bispecific antibodies.
• FIG. 4B is a cross-section schematic representation of the medical device of FIG. 4 A showing a bispecific antibody binding to a cell surface antigen.
• FIG. 4C is a cross-section schematic representation of the medical device of FIG. 4B showing a bispecific antibody releasing the therapeutic agent.
• the present invention provides a medical device having a coating of carrier macromolecules disposed thereon wherein the carrier macromolecules carry therapeutic agents.
• the carrier macromolecules are antibodies.
• the term antibody refers to an immunoglobulin, whether produced naturally or synthetically (e.g. recombinant), either in whole or in part.
• the term antibody also encompasses antibody fragments, which refers to any derivative of an antibody that is less than full length while retaining at least a portion of the full-length antibody's specific binding ability.
• antibody fragments include, but are not limited to, Fab, Fab', F(ab) 2 , F(ab') 2 , Fv, dsFv, single- chain Fvs (scFv), diabodies, and bispecific antibodies.
• the fragment can include multiple chains
• an Fv antibody fragment is composed of one variable heavy domain (V H ) and one variable light (V L ) domain linked by noncovalent interactions.
• a dsFv refers to an Fv with an engineered intermolecular disulfide bond which stabilizes the V H -V L pair.
• scFv refer to antibody fragments that contain a variable light chain (V L ) and variable heavy chain (V H ) covalently bonded by a polypeptide linker in any order.
• the linker is of a length such that the two variable domains are bridged without substantial interference.
• Exemplary linkers are (Gly-Ser) n residues with some GIu or Lys residues dispersed throughout to increase solubility.
• diabodies are dimeric scFv.
• antibody includes any protein having a binding domain that is homologous or substantially homologous to an immunoglobulin binding domain.
• the antibodies can be monoclonal antibodies (including full length monoclonal antibodies), polyclonal antibodies, or multispecific antibodies (e.g., bispecific antibodies).
• Antibodies include members of any immunoglobulin class, including IgG, IgM, IgA, IgD, and IgE.
• the antigen binding site of the antibodies is directed at therapeutic agents.
• the antibodies carry the therapeutic agent by binding the therapeutic agent at the antigen binding site.
• Antibodies directed to therapeutic agents are commercially available or can be created by various methods known in the art. For example, the use of commercially available anti-paclitaxel antibodies of high affinity and high specificity is described in U.S. Patent No. 5,981,777 (Durzan et al.), which is incorporated by reference herein.
• the therapeutic agent may be conjugated to the antibodies by covalent bonding.
• a paclitaxel-antibody conjugate can be formed by reacting paclitaxel with glutaric anhydride to form 2'-glutaryl-paclitaxel having a cleavable ester bond.
• the 2'-glutaryl-paclitaxel is then activated by removal of a hydroxyl group in a carbodiimide reaction.
• the antibody then forms an amide bond to the activated 2'-glutaryl-paclitaxel via an amino group. See Guillemard et al., Cancer Research 61 :694-699 (2001), which is incorporated be reference herein.
• the antigen binding site of the antibodies may be directed to various targets, which include, but are not limited to, components of connective tissue or extracellular matrix such as glycoproteins, collagen, or fibrin; or components on or within cell membranes, such as surface antigens, receptors, proteins, lipids, carbohydrates, and molecules processed on the cell surface.
• the antibodies may be targeted to cell surface components of white blood cells, endothelial cells, or smooth muscle cells of the arterial wall.
• the therapeutic agent can be released from the carrier macromolecule. This release may be triggered by various events or conditions, such as exposure to an aqueous environment, or a change in the pH or ionic strength of the environment.
• the carrier macromolecule may be an antibody directed to a therapeutic agent, where the antibody's binding affinity for the therapeutic agent decreases with a change in the pH or ionic strength of the environment.
• the release of therapeutic agent may also be triggered by temperature, magnetic fields, ultrasound, or osmotic pressure.
• the therapeutic agent is not released from the carrier macromolecules.
• the carrier macromolecule-therapeutic agent complex itself may be the biologically active agent.
• paclitaxel-antibody conjugates have been shown to be a potent cytotoxic agent. See Guillemard et al., Cancer Research 61:694-699 (2001), which is incorporated be reference herein.
• the carrier macromolecules are bispecific antibodies.
• bispecific antibodies are antibodies constructed to have two antigen binding sites, each directed to a different antigen or a different part of an antigen. Methods for making bispecific antibodies are known in the art. For example, bispecific antibodies can be made by fusing hybridoma lines expressing two different antibodies or by recombinant methods that join two antibody fragments containing different antigen binding sites.
• a bispecific antibody used in the present invention has a first antigen binding site that is directed to a therapeutic agent, such as paclitaxel, and a second antigen binding site that is directed to a target antigen.
• the target antigen may be any type of antigen such as an organic compound, inorganic compound, metal complex, receptor, enzyme, antibody, protein, nucleic acid, peptide nucleic acid, DNA 3 RNA, polynucleotide, oligonucleotide, oligosaccharide, lipid, lipoprotein, amino acid, peptide, polypeptide, peptidomimetic, carbohydrate, enzyme cofactor, drug, prodrug, lectin, sugar, glycoprotein, biomolecule, macromolecule, biopolymer, polymer,
• the target antigen may be cell surface components of white blood cells, platelets, endothelial cells, or smooth muscle cells of the arterial wall; or biomolecules released in response to an unstable arterial plaque, such as thrombin or clotting factors.
• binding of the target antigen to the second binding site will decrease the first binding site's affinity for the therapeutic agent such that the therapeutic agent is released from the antibody. This loss of affinity for the therapeutic agent may occur through a conformational change in the antibody structure caused by the binding of the target antigen.
• One of skill in the art could screen bispecific antibodies and select for those having the desired properties.
• the carrier macromolecules may be applied onto a medical device by various means.
• the carrier macromolecules are antibodies 10 which are dispersed within a coating 20 on a portion 30 of a medical device.
• Therapeutic agents 22 are conjugated to antibodies 10 at antigen binding site 13.
• antibodies 10 are embedded in coating 20 in such a manner that antibodies 10 do not diffuse out of coating 20.
• antibodies 10 can be triggered to release therapeutic agent 22.
• therapeutic agent 22 can diffuse out of coating 20 and be eluted into the surrounding fluid or tissue.
• Coating 20 may be any coating used in coating medical devices, such as the polymer coatings used in drug-eluting vascular stents that are known in the art.
• Antibodies 10 may be incorporated into coating 20 by various methods, including those similar to the process of drug coating vascular stents.
• antibodies 10 may be mixed into a solvent containing a polymer and the resultant mixture may be applied onto the medical device by spraying, dipping, roll coating, or the like.
• the carrier macromolecules are antibodies 10 which are dispersed within a coating 20 on a portion 30 of a medical device.
• Therapeutic agents 22 are conjugated to antibodies 10 via covalent links 24.
• the antibody-therapeutic agent complex diffuses out of coating 20 and elutes into the surrounding
• antigen binding site 13 may be directed to a variety of target antigens.
• the carrier macromolecules are antibodies 10 which are tethered to the surface of a coating 20 on a portion 30 of a medical device.
• the Fc portion 18 of antibodies 10 are tethered to coating 20 by covalent linkages, such as those described in U.S. Patent Publication No. 2005/0043787 (Kutryk et al.), which is incorporated by reference herein.
• the carrier macromolecules are bispecific antibodies 12, which are tethered to the surface of a coating 20 on a portion 30 of a medical device.
• the first antigen binding site 14 of bispecific antibody 12 binds to therapeutic agents 22.
• the second antigen binding site 16 of bispecific antibody 12 binds to a cell surface component 42 on a cell 40.
• the binding of cell surface component 42 will cause bispecific antibody 12 to release therapeutic agent 22 (as shown by the arrow).
• the carrier macromolecules may be contained in a porous coating or porous surface on a medical device, such as the porous layers created by the deposition of metallic oxide particles, or the carbonization of polymer coatings.
• the carrier macromolecules may diffuse out of the porous layer or may be permanently embedded in the porous layer.
• the outer diameter of the stent may be coated with an antibody directed to a target antigen on a vascular smooth muscle cell, while the inner diameter of the stent may be coated with an antibody directed to a target antigen on an endothelial cell.
• the antibody on the outer diameter may be conjugated to a different therapeutic agent than the antibody on the inner diameter.
• the antibody on the outer diameter may be conjugated with an antiproliferative drug, such as pacHtaxel, while the antibody on the inner diameter may be conjugated to a growth factor, such as vascular endothelial growth factor (VEGF), or an antithrombotic drug such as heparin.
• an antiproliferative drug such as pacHtaxel
• a growth factor such as vascular endothelial growth factor (VEGF)
• VEGF vascular endothelial growth factor
• heparin an antithrombotic drug
• the end portions of a vascular stent may be coated with an antibody having high affinity for a therapeutic agent, while the central portions of the stent are coated with antibodies having lower affinity for the same therapeutic agent, in this embodiment, higher dosages of therapeutic agent would be released from the central portion of the stent compared to the ends of the stent where lower dosages are sufficient.
• any of the aforementioned embodiments may also be combined with free therapeutic agents which are not conjugated to a carrier macromolecule.
• a polymer-coated vascular stent may have therapeutic agents that are not conjugated to carrier macromolecules dispersed within the coating and different therapeutic agents that are conjugated to carrier macromolecules either dispersed within the coating or affixed onto the surface of the coating.
• carrier macromolecules that can be used in the present invention include receptors, nuclear proteins, transcription regulators, enzymes, or cell-surface adhesion proteins.
• the therapeutic agent conjugated to the carrier macromolecule may be any pharmaceutically acceptable agent such as a non-genetic therapeutic agent, a biomolecule, a small molecule, or cells.
• non-genetic therapeutic agents include anti-thrombogenic agents such heparin, heparin derivatives, prostaglandin (including micellar prostaglandin El), urokinase, and PPack (dextrophenylalanine proline arginine chloromethylketone); anti-proliferative agents such as enoxaparin, angiopeptin, sirolimus (rapamycin), tacrolimus, everolimus, zotarolimus, monoclonal antibodies capable of blocking smooth muscle cell proliferation, hirudin, and acetylsalicylic acid; anti-inflammatory agents such as dexamethasone.
• anti-thrombogenic agents such as heparin, heparin derivatives, prostaglandin (including micellar prostaglandin El), urokinase, and PPack (dextrophenylalanine proline arginine chloromethylketone)
• anti-proliferative agents such as enoxaparin, angiopept
• anti-neoplastic/anti-proliferative/anti-mitotic agents such as paclitaxel, epothilone, cladribine, 5-fluorouracil, methotrexate, doxorubicin, daunorubicin, cyclosporine, cisplatin, vinblastine, vincristine, epothilones, endostatin, trapidil, halofuginone, and angiostatin; anti-cancer agents such as antisense inhibitors of c-myc oncogene; antimicrobial agents such as triclosan, cephalosporins, aminoglycosides, nitrofurantoin, silver ions, compounds, or salts; biofilm
• biomolecules include peptides, polypeptides and proteins; * oligonucleotides; nucleic acids such as double or single stranded DNA (including naked and cDNA), RNA, antisense nucleic acids such as antisense DNA and RNA, small interfering RNA (siRNA), and ribozymes; genes; carbohydrates; angiogenic factors including growth factors; cell cycle inhibitors; and anti-restenosis agents. Nucleic acids may be incorporated into delivery systems such as, for example, vectors (including viral vectors), plasmids or liposomes.
• Non-limiting examples of proteins include serca-2 protein, monocyte chemoattractant proteins (MCP-I) and bone morphogenic proteins ("BMP's"), such as, for example, BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 (VGR-I), BMP-7 (OP-I), BMP-8, BMP-9, BMP-IO, BMP-Il, BMP-12, BMP-13, BMP-14, BMP-15.
• Preferred BMP's are any of BMP-2, BMP-3, BMP-4, BMP-5, BMP-6, and BMP-7. These BMPs can be provided as homodimers, heterodimers, or combinations thereof, alone or together with other molecules.
• molecules capable of inducing an upstream or downstream effect of a BMP can be provided.
• Such molecules include any of the "hedghog" proteins, or the DNA's encoding them.
• genes include survival genes that protect against cell death, such as anti- apoptotic Bcl-2 family factors and Akt kinase; serca 2 gene; and combinations thereof.
• Non- limiting examples of angiogenic factors include acidic and basic fibroblast growth factors, vascular endothelial growth factor, epidermal growth factor, transforming growth factors ⁇ and ⁇ , platelet-derived endothelial growth factor, platelet-derived growth factor, tumor necrosis factor ⁇ , hepatocyte growth factor, and insulin-like growth factor.
• a non-limiting example of a cell cycle inhibitor is a cathespin D (CD) inhibitor.
• Non-limiting examples of anti-restenosis agents include pl5, pl6, pl8, pl9, p21, p27, p53, p57, Rb, nFkB and E2F decoys, thymidine kinase and combinations thereof and other agents useful for interfering with cell proliferation.
• Exemplary small molecules include hormones, nucleotides, amino acids, sugars, and lipids and compounds have a molecular weight of less than 10OkD.
• Exemplary cells include stem cells, progenitor cells, endothelial cells, adult cardiomyocytes, and smooth muscle cells.
• Cells can be of human origin (autologous or allogenic) or from an animal source (xenogenic), or genetically engineered.
• Non-limiting examples of cells include side population (SP) cells, lineage negative (Lin ⁇ ) cells including Lin” CD34", Lin ⁇ CD34 + , Lin'cKit + , mesenchymal stem cells including -mesenchymal stem cells with 5-aza, cord blood cells, cardiac or other tissue derived stem cells, whole bone marrow, bone marrow mononuclear cells, endothelial progenitor cells, skeletal myoblasts or satellite cells, muscle derived cells, go cells, endothelial cells, adult cardiomyocytes, fibroblasts, smooth muscle cells, adult cardiac fibroblasts + 5-aza, genetically modified cells, tissue engineered grafts, MyoD scar fibroblasts, pacing cells, embryonic stem cell clones, embryonic stem cells, fetal or neonatal cells, immunologically masked cells, and teratoma derived cells.
• SP side population
• Lin ⁇ lineage negative cells
• Lin ⁇ CD34 + Lin'cKit +
• any of the therapeutic agents may be combined to the extent such combination is biologically compatible.
• 10035 The foregoing description and examples have been set forth merely to illustrate the invention and are not intended to be limiting. Each of the disclosed aspects and embodiments of the present invention may be considered individually or in combination with other aspects, embodiments, and variations of the invention. In addition, unless otherwise specified, none of the steps of the methods of the present invention, are confined to any particular order of performance. Modifications of the disclosed embodiments incorporating the spirit and substance of the invention may occur to persons skilled in the art and such modifications are within the scope of the present invention. Furthermore, all references cited herein are incorporated by reference in their entirety.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• General Health & Medical Sciences (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Epidemiology (AREA)
• Animal Behavior & Ethology (AREA)
• Chemical & Material Sciences (AREA)
• Medicinal Chemistry (AREA)
• Transplantation (AREA)
• Heart & Thoracic Surgery (AREA)
• Dermatology (AREA)
• Surgery (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Vascular Medicine (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Molecular Biology (AREA)
• Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
• Materials For Medical Uses (AREA)
• Prostheses (AREA)

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• 2006
  • 2006-05-18 US US11/435,690 patent/US7572625B2/en not_active Expired - Fee Related
• 2007
  • 2007-05-02 EP EP07776624.4A patent/EP2035052B1/en not_active Not-in-force
  • 2007-05-02 CA CA002652233A patent/CA2652233A1/en not_active Abandoned
  • 2007-05-02 JP JP2009510962A patent/JP2009537218A/ja active Pending
  • 2007-05-02 WO PCT/US2007/010646 patent/WO2007136516A2/en not_active Ceased

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