WO2010039722A1 - Implantable device for the delivery of risperidone and methods of use thereof - Google Patents
Implantable device for the delivery of risperidone and methods of use thereof Download PDFInfo
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- WO2010039722A1 WO2010039722A1 PCT/US2009/058810 US2009058810W WO2010039722A1 WO 2010039722 A1 WO2010039722 A1 WO 2010039722A1 US 2009058810 W US2009058810 W US 2009058810W WO 2010039722 A1 WO2010039722 A1 WO 2010039722A1
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- polyurethane
- risperidone
- based polymer
- psi
- flex modulus
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- 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
- A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
- A61K9/0092—Hollow drug-filled fibres, tubes of the core-shell type, coated fibres, coated rods, microtubules or nanotubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
- A61K47/34—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
- A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
- A61K47/542—Carboxylic acids, e.g. a fatty acid or an amino acid
-
- 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
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
- A61K9/0024—Solid, semi-solid or solidifying implants, which are implanted or injected in body tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/24—Antidepressants
Definitions
- polyurethane or polyurethane-containing polymers have been used to fabricate a large number of implantable devices, including pacemaker leads, artificial hearts, heart valves, stent coverings, artificial tendons, arteries and veins.
- Formulations for delivery of active agents using polyurethane implantable devices require a liquid medium or carrier for the diffusion of the drug at a zero order rate.
- the active agents and polyurethane coating can be selected based on various physical parameters, and then the release rate of the active from the implantable device can be optimized to a clinically relevant release rate based on clinical and/or in vitro trials.
- One embodiment is directed to a method for delivering a formulation comprising an effective amount of risperidone to a subject, comprising: implanting an implantable device into the subject, wherein the implantable device comprises risperidone or a formulation thereof substantially surrounded by a polyurethane-based polymer.
- the polyurethane-based polymer is formed from one or more polyols, wherein the general polyol structure is selected from the group consisting of
- the values for n and x are integer values of between about 1 and about 1,000,000; of between about 2 and about 500,000; of between about 5 and about 250,000; and of between about 10 and about 100,000.
- the polyol comprises -[0-(CH 2 )J x -O- , wherein the polyurethane-based polymer has an equilibrium water content of between about 5% and about 200%, e.g., of at least about 15%.
- risperidone is released at a zero-order rate of about 149 ⁇ g/day per square centimeter of the surface area of the implantable device.
- the polyol comprises 0-(CH 2 -CH 2 -CH 2 -CH 2 ) X -O- , wherein the polyurethane-base polymer has a flex modulus of between about 1000 and about 92,000 psi, e.g., of about 2,300 psi.
- risperidone is released at a zero-order rate of about 146 ⁇ g/day per square centimeter of the surface area of the implantable device.
- the polyol comprises O-[(CH 2 )6-C ⁇ 3] n -(CH 2 )-O- , wherein the polyurethane-based polymer has a flex modulus of between about 620 and about 92,000 psi, e.g., of about 620 psi.
- risperidone is released at a zero-order rate of about 40 ⁇ g/day per square centimeter of the surface area of the implantable device.
- One embodiment is directed to a drug delivery device for the controlled release of risperidone over an extended period of time to produce local or systemic pharmacological effects, comprising: a) a polyurethane-based polymer formed to define a hollow space; and b) a solid drug formulation comprising a formulation comprising risperidone and optionally one or more pharmaceutically acceptable carriers, wherein the solid drug formulation is contained in the hollow space, and wherein the device provides a desired release rate of risperidone from the device after implantation.
- the drug delivery device is conditioned and primed under conditions chosen to be consistent with the water solubility characteristics of the at least one active agent.
- the pharmaceutically acceptable carrier is stearic acid.
- the polyurethane-based polymer is formed from one or more polyols, wherein the general polyol structure is selected from the group consisting of:
- the polyol comprises -[0-(CH 2 )J x -O- , wherein the polyurethane-based polymer has an equilibrium water content of between about 5% and about 43%, e.g., of at least about 15%.
- risperidone is released at a zero-order rate of about 149 ⁇ g/day per square centimeter of the surface area of the implantable device.
- the polyol comprises 0-(CH 2 -CH 2 -CH 2 -CH 2 ) X -O- , wherein the polyurethane-base polymer has a flex modulus of between about 1000 and about 92,000 psi, e.g., of about 2,300 psi.
- risperidone is released at a zero-order rate of about 146 ⁇ g/day per square centimeter of the surface area of the implantable device.
- the polyol comprises O-[(CH 2 )6-C ⁇ 3] n -(CH 2 )-O- , wherein the polyurethane-based polymer has a flex modulus of between about 620 and about 92,000 psi, e.g., of about 620 psi.
- risperidone is released at a zero-order rate of about 40 ⁇ g/day per square centimeter of the surface area of the implantable device.
- appropriate conditioning and priming parameters can be selected to establish the desired delivery rates of the at least one active agent, wherein the priming parameters are time, temperature, conditioning medium and priming medium.
- FIG. 1 is a side view of an implant with two open ends.
- FIG. 2 is a side view of pre-fabricated end plugs used to plug the implants.
- FIG. 3 is a side view of an implant with one open end.
- FIG. 4 is a graph of the release rate of risperidone from Carbothane ®
- PC-3575A polyurethane implants (Flex Modulus 620 psi) prepared from tubing sections representing the beginning, middle and end of a coil of tubing as part of an assessment of the uniformity of the material within a particular lot. Samples were evaluated weekly for one year. All implants were of equivalent geometry and drug load.
- FIG. 5 is a graph of the release rate of risperidone from Carbothane ®
- PC-3575A polyurethane implants (Flex Modulus 620 psi) as part of an assessment of the effect using saline versus aqueous hydroxypropyl betacellulose solution (15% in phosphate buffered saline) as the elution media. Samples were evaluated weekly for 11 weeks. All implants were of equivalent geometry and drug load. [0013] FIGS.
- FIG. 6A and 6B are graphs comparing the release rates of risperidone from Carbothane ® PC-3595A polyurethane implants (Flex modulus 4500 psi) to Tecophilic ® HP-60D-20 polyurethane implants (EWC, 14.9%) as part of the evaluation of the release of the active from either hydrophilic and hydrophobic polyurethane materials. Samples were evaluated weekly for 22 weeks for the Carbothane ® implant. Samples were evaluated weekly for 15 weeks for the Tecophilic ® implant. All implants were of equivalent geometry and drug load.
- FIG. 1 IB is a graph of the release rate of risperidone from Tecophilic ® HP-60D-20 polyurethane implants (EWC, 14.9%) alone, sampled weekly for 15 weeks.
- FIG. 7 is a graph comparing the release rates of risperidone from
- Tecoflex ® EG-80A polyurethane implants (Flex Modulus 1000 psi) and two grades of Tecophilic ® polyurethane implants, HP-60D-35 and HP-60D-60 (EWC, 23.6% and 30.8%, respectively). All were sampled weekly for 10 weeks. All implants were of equivalent geometry and drug load.
- FIG. 8 is a graph of the release rate of risperidone from Carbothane ®
- FIG. 9 is a graph of the in vivo plasma concentration of risperidone in the beagle dog study described in Example 8.
- the lower plot represents the average plasma concentration achieved in dogs implanted with one Carbothane ® PC-3575A polyurethane implant (Flex Modulus 620 psi).
- the upper plot represents the average plasma concentration achieved in dogs implanted with two Carbothane ® PC-3575A polyurethane implants (Flex Modulus 620 psi).
- FIG. 10 is a graph showing the in vitro release of risperidone from
- FIG. 11 is a graph showing the in vivo release of risperidone from
- Tecoflex ® and Carbothane ® implants as compared to a control.
- the pellets comprising the risperidone formulation had a diameter of 3.5 mm, a length of about 4.5 mm and a weight of 5.4 mg.
- the implant had a reservoir length of about 39-40 mm, a wall thickness of 0.2 mm, and internal diameter of 3.6 mm and an overall length of about 45 mm.
- the present invention is directed to the use of polyurethane-based polymers as drug delivery devices for releasing drugs at controlled rates for an extended period of time to produce local or systemic pharmacological effects.
- the drug delivery device can comprise a cylindrically shaped reservoir surrounded by polyurethane-based polymer that controls the delivery rate of the drug inside the reservoir.
- the reservoir contains a formulation, e.g., a solid formulation, comprising one or more active ingredients and, optionally, pharmaceutically acceptable carriers.
- the carriers are formulated to facilitate the diffusion of the active ingredients through the polymer and to ensure the stability of the drugs inside the reservoir.
- a polyurethane is any polymer consisting of a chain of organic units joined by urethane links.
- Polyurethane polymers are formed by reacting a monomer containing at least two isocyanate functional groups with another monomer containing at least two alcohol groups in the presence of a catalyst.
- Polyurethane formulations cover a wide range of stiffness, hardness, and densities.
- Polyurethanes are in the class of compounds called "reaction polymers,” which include epoxies, unsaturated polyesters and phenolics.
- Polyurethanes are produced by the polyaddition reaction of a polyisocyanate with a polyalcohol (polyol) in the presence of a catalyst and other additives.
- the reaction product is a polymer containing the urethane linkage, -RNHCOOR'-.
- Isocyanates react with any molecule that contains an active hydrogen. Importantly, isocyanates react with water to form a urea linkage and carbon dioxide gas; they also react with polyetheramines to form polyureas.
- Polyurethanes are produced commercially by reacting a liquid isocyanate with a liquid blend of polyols, catalyst, and other additives. These two components are referred to as a polyurethane system, or simply a system.
- the isocyanate is commonly referred to in North America as the “A-side” or just the “iso,” and represents the rigid backbone (or “hard segment") of the system.
- the blend of polyols and other additives is commonly referred to as the "B-side” or as the "poly,” and represents the functional section (or “soft segment") of the system.
- Resin blend additives can include chain extenders, cross linkers, surfactants, flame retardants, blowing agents, pigments and fillers.
- the "soft segments” represent the section of the polymer that imparts the characteristics that determine the diffusivity of an active pharmaceutical ingredient (API) through that polymer.
- the elastomeric properties of these materials are derived from the phase separation of the hard and soft copolymer segments of the polymer, such that the urethane hard segment domains serve as cross-links between the amorphous polyether (or polyester) soft segment domains.
- This phase separation occurs because the mainly non-polar, low-melting soft segments are incompatible with the polar, high-melting hard segments.
- the soft segments which are formed from high molecular weight polyols, are mobile and are normally present in coiled formation, while the hard segments, which are formed from the isocyanate and chain extenders, are stiff and immobile.
- the hard segments are covalently coupled to the soft segments, they inhibit plastic flow of the polymer chains, thus creating elastomeric resiliency.
- a portion of the soft segments are stressed by uncoiling, and the hard segments become aligned in the stress direction. This reorientation of the hard segments and consequent powerful hydrogen-bonding contributes to high tensile strength, elongation, and tear resistance values.
- the polymerization reaction is catalyzed by tertiary amines, such as, for example, dimethylcyclohexylamine, and organometallic compounds, such as, for example, dibutyltin dilaurate or bismuth octanoate.
- catalysts can be chosen based on whether they favor the urethane (gel) reaction, such as, for example, l,4-diazabicyclo[2.2.2]octane (also called DABCO or TEDA), or the urea (blow) reaction, such as bis-(2-dimethylaminoethyl)ether, or specifically drive the isocyanate trimerization reaction, such as potassium octoate.
- gel such as, for example, l,4-diazabicyclo[2.2.2]octane (also called DABCO or TEDA)
- urea (blow) reaction such as bis-(2-dimethylaminoethyl)ether
- isocyanate trimerization reaction such as potassium octoate.
- Polyurethan ⁇ polymer formed by reacting a diisocyanate with a polyol
- Isocyanates with two or more functional groups are required for the formation of polyurethane polymers.
- aromatic isocyanates account for the vast majority of global diisocyanate production.
- Aliphatic and cycloaliphatic isocyanates are also important building blocks for polyurethane materials, but in much smaller volumes. There are a number of reasons for this.
- First, the aromatically- linked isocyanate group is much more reactive than the aliphatic one.
- aromatic isocyanates are more economical to use. Aliphatic isocyanates are used only if special properties are required for the final product. Light stable coatings and elastomers, for example, can only be obtained with aliphatic isocyanates. Aliphatic isocyanates also are favored in the production of polyurethane biomaterials due to their inherent stability and elastic properties.
- aliphatic and cycloaliphatic isocyanates include, for example, 1 ,6-hexamethylene diisocyanate (HDI), l-isocyanato-3-isocyanatomethyl- 3,5,5-trimethyl-cyclohexane (isophorone diisocyanate, IPDI), and 4,4'-diisocyanato dicyclohexylmethane (H12MDI). They are used to produce light stable, non-yellowing polyurethane coatings and elastomers. Hl 2MDI prepolymers are used to produce high performance coatings and elastomers with optical clarity and hydrolysis resistance.
- HDI 1 ,6-hexamethylene diisocyanate
- IPDI isophorone diisocyanate
- H12MDI 4,4'-diisocyanato dicyclohexylmethane
- Tecoflex®, Tecophilic® and Carbothane® polyurethanes are all produced from Hl 2MDI prepolymers.
- Polyols are higher molecular weight materials manufactured from an initiator and monomeric building blocks, and, where incorporated into polyurethane systems, represent the "soft segments" of the polymer. They are most easily classified as polyether polyols, which are made by the reaction of epoxides (oxiranes) with an active hydrogen containing starter compounds, or polyester polyols, which are made by the polycondensation of multifunctional carboxylic acids and hydroxyl compounds.
- Tecoflex® polyurethanes, Tecogel® polyurethanes and Tecophilic® polyurethanes are cycloaliphatic polymers and are of the types produced from polyether-based polyols.
- Tecoflex® polyurethanes the general structure of the polyol segment is represented as,
- x represents a increase in flexibility (decreased “Flex Modulus”; "FM”), yielding FM ranging from about 1000 - 92,000 psi. From the standpoint of drug release from these materials, the release of a relatively hydrophobic API decreases as the FM increases.
- the values for x are integer values of between about 1 and about 1,000,000; of between about 2 and about 500,000; of between about 5 and about 250,000; and of between about 10 and about 100,000. In still other embodiments, x may range from about 2-500, about 2-100, about 5-50, and 10-30.
- n and x represent variations in hydrophilicity, and yield equilibrium water contents (%EWC) ranging from about 5% - 200%.
- the values for n and x are integer values of between about 1 and about 1,000,000; of between about 2 and about 500,000; of between about 5 and about 250,000; and of between about 10 and about 100,000.
- n and x may have the same or different values, with those values ranging from about 2-500, about 2-100, about 5-50, and 10-30. From the standpoint of drug release from these materials, the release of a relatively hydrophilic API increases as the %EWC increases.
- Specialty polyols include, for example, polycarbonate polyols, polycaprolactone polyols, polybutadiene polyols, and polysulfide polyols.
- Carbothane® polyurethanes are cycloaliphatic polymers and are of the types produced from polycarbonate-based polyols. The general structure of the polyol segment is represented as,
- n represents a increase in flexibility (decreased FM), yielding FM ranging from about 620 - 92,000 psi.
- the values for n are integer values of between about 1 and about 1,000,000; of between about 2 and about 500,000; of between about 5 and about 250,000; and of between about 10 and about 100,000.
- n may range from about 2-500, about 2-100, about 5-50, and 10-30. From the standpoint of drug release from these materials, the release of a relatively hydrophobic API will decrease as the FM increases.
- Chain extenders and cross linkers are low molecular weight hydroxyl- and amine-terminated compounds that play an important role in the polymer morphology of polyurethane fibers, elastomers, adhesives and certain integral skin and microcellular foams.
- chain extenders include, for example, ethylene glycol, 1 ,4-butanediol (1,4-BDO or BDO), 1,6-hexanediol, cyclohexane dimethanol and hydroquinone bis(2-hydroxyethyl) ether (HQEE). All of these glycols form polyurethanes that phase separate well, form well-defined hard segment domains, and are melt processable.
- thermoplastic polyurethanes are all suitable for thermoplastic polyurethanes with the exception of ethylene glycol, since its derived bis-phenyl urethane undergoes unfavorable degradation at high hard segment levels.
- Tecophilic®, Tecoflex® and Carbothane® polyurethanes all incorporate the use of 1 ,4-butanediol as the chain extender.
- the current invention provides a drug delivery device that can achieve the following objectives: a controlled-release rate (e.g., zero-order release rate) to maximize therapeutic effects and minimize unwanted side effects, an easy way to retrieve the device if it is necessary to end the treatment, an increase in bioavailability with less variation in absorption and no first pass metabolism.
- a controlled-release rate e.g., zero-order release rate
- the release rate of the drug is governed by the Fick's Law of Diffusion as applied to a cylindrically shaped reservoir device (cartridge).
- the following equation describes the relationship between different parameters: dM _ 2 ⁇ h p AC where: dM/dt : drug release rate; h : length of filled portion of device;
- ⁇ C concentration gradient across the reservoir wall
- r o /r j ratio of outside to inside radii of device
- p permeability coefficient of the polymer used.
- the permeability coefficient is primarily regulated by the hydrophilicity or hydrophobicity of the polymer, the structure of the polymer, and the interaction of drug and the polymer.
- the device e.g., a cylindrically shaped device
- the device can be manufactured through precision extrusion or precision molding process for thermoplastic polyurethane polymers, and reaction injection molding or spin casting process for thermosetting polyurethane polymers.
- the cartridge can be made with either one end closed or both ends open.
- the open end can be plugged with, for example, pre -manufactured end plug(s) to ensure a smooth end and a solid seal, or, in the case of thermoplastic polyurethanes, by using heat-sealing techniques known to those skilled in the art.
- the solid actives and carriers can be compressed into pellet form to maximize the loading of the actives.
- radiopaque material can be incorporated into the delivery device by inserting it into the reservoir or by making it into end plug to be used to seal the cartridge.
- the cartridges are sealed on both ends with the filled reservoir, they are optionally conditioned and primed for an appropriate period of time to ensure a constant delivery rate.
- the conditioning of the drug delivery devices involves the loading of the actives (drug) into the polyurethane-based polymer that surrounds the reservoir.
- the priming is done to stop the loading of the drug into the polyurethane-based polymer and thus prevent loss of the active before the actual use of the implant.
- the conditions used for the conditioning and priming step depend on the active, the temperature and the medium in which they are carried out. The conditions for the conditioning and priming may be the same in some instances.
- the conditioning and priming step in the process of the preparation of the drug delivery devices is done to obtain a determined rate of release of a specific drug.
- the conditioning and priming step of the implant containing a hydrophilic drug can be carried out in an aqueous medium, e.g., in a saline solution.
- the conditioning and priming step of a drug delivery device comprising a hydrophobic drug is usually carried out in a hydrophobic medium such as, for example, an oil-based medium.
- the conditioning and priming steps can be carried out by controlling three specific factors, namely the temperature, the medium and the period of time.
- a person skilled in the art would understand that the conditioning and priming step of the drug delivery device is affected by the medium in which the device is placed.
- a hydrophilic drug can be conditioned and primed, for example, in an aqueous solution, e.g., in a saline solution.
- the temperature used to condition and prime the drug delivery device can vary across a wide range of temperatures, e.g., about 37 0 C.
- the time period used for the conditioning and priming of the drug delivery devices can vary from about a single day to several weeks depending on the release rate desired for the specific implant or drug.
- the desired release rate is determined by one of skill in the art with respect to the particular active agent used in the pellet formulation.
- conditioning and priming the implants are to optimize the rate of release of the drug contained within the implant. As such, a shorter time period spent on the conditioning and the priming of a drug delivery device results in a lower rate of release of the drug compared to a similar drug delivery device that has undergone a longer conditioning and priming step.
- the temperature in the conditioning and priming step will also affect the rate of release in that a lower temperature results in a lower rate of release of the drug contained in the drug delivery device when compared to a similar drug delivery device that has undergone a treatment at a higher temperature.
- the sodium chloride content of the solution determines what type of rate of release will be obtained for the drug delivery device. More specifically, a lower content of sodium chloride results in a higher rate of release of drug when compared to a drug delivery device that has undergone a conditioning and priming step where the sodium chloride content was higher.
- the conditioning and priming medium is a hydrophobic medium, more specifically an oil-based medium.
- the delivery of risperidone can be useful, for example, to treat schizophrenia, manic states, bipolar disorder, irritability, autism, obsessive-compulsive disorder, severe treatment-resistant depression with or without psychotic features, Tourette syndrome, disruptive behavior disorders in children; and eating disorders.
- Risperidone belongs to a class of anti-psychotic drugs known as "atypical neuroleptics". It is a strong dopamine antagonist. It has a high affinity for D2 dopaminergic receptors.
- 5-HT serotonin receptor subtypes
- 5-HT2C linked to weight gain
- 5-HT2A linked to its antipsychotic action and relief of some of the extrapyramidal side effects experienced with the "typical neuroleptics" through action at 5-HT IA.
- 5-HT IA the "typical neuroleptics" through action at 5-HT IA.
- Effective levels of risperidone in the blood are known and established and can range, for example, about 0.1 to about 10 ng/ml, from about 0.5 to about 8 ng/ml or about 1.0 to about 5 ng/ml range.
- One of skill in the art would be able to tailor risperidone release by altering a variety of implant factors.
- different classes of polyurethanes lead to different release rates of risperidone.
- the EWC and/or flex modulus of the polyurethane can be varied to achieve different risperidone release rates.
- one of skill in the art could vary the size of the implant to increase or decrease the surface area of the implant, thereby varying the release rate of risperidone from the implant.
- Such alterations lead to release rates in the physiologically-relevant range, e.g., of about 0.001 to about 15 mg/day, from about 0.1 to about 15 mg/day, from about 1 to about 12.5 mg/day, from about 7.5 to about 12.5 mg/day or at about 12.5 mg/day.
- Release rate from implants can also be varied, for example, by adjusting the amount and nature of excipients contained in the risperidone formulation.
- Implants that achieve physiological release rates of risperidone can vary in size, depending on, for example, the nature of the polyurethane used.
- a cylindrical implant for example, can have a range of internal diameters from about 1 mm to about
- An implant can range in length from about, for example,
- the current invention focuses on the application of polyurethane-based polymers, thermoplastics or thermosets, to the creation of implantable drug devices to deliver biologically active compounds at controlled rates for prolonged period of time.
- Polyurethane polymers can be made into, for example, cylindrical hollow tubes with one or two open ends through extrusion, (reaction) injection molding, compression molding, or spin-casting (see e.g., U.S. Pat. Nos. 5,266,325 and 5,292,515), depending on the type of polyurethane used.
- Thermoplastic polyurethane can be processed through extrusion, injection molding or compression molding.
- Thermoset polyurethane can be processed through reaction injection molding, compression molding, or spin-casting.
- the dimensions of the cylindrical hollow tube should be as precise as possible.
- Polyurethane-based polymers are synthesized from multi-functional polyols, isocyanates and chain extenders. The characteristics of each polyurethane can be attributed to its structure.
- Thermoplastic polyurethanes are made of macrodiols, diisocyanates, and difunctional chain extenders (e.g., U.S. Pat. Nos. 4,523,005 and 5,254,662).
- Macrodiols make up the soft domains.
- Diisocyanates and chain extenders make up the hard domains.
- the hard domains serve as physical crosslinking sites for the polymers.
- Varying the ratio of these two domains can alter the physical characteristics of the polyurethanes, e.g., the flex modulus.
- Thermoset polyurethanes can be made of multifunctional (greater than difunctional) polyols and/or isocyanates and/or chain extenders (e.g., U.S. Pat. Nos. 4,386,039 and 4,131,604).
- Thermoset polyurethanes can also be made by introducing unsaturated bonds in the polymer chains and appropriate crosslinkers and/or initiators to do the chemical crosslinking (e.g., U.S. Pat. No. 4,751,133). By controlling the amounts of crosslinking sites and how they are distributed, the release rates of the actives can be controlled.
- Different functional groups can be introduced into the polyurethane polymer chains through the modification of the backbones of polyols depending on the properties desired.
- hydrophilic pendant groups such as ionic, carboxyl, ether, and hydroxyl groups are incorporated into the polyols to increase the hydrophilicity of the polymer (e.g., U.S. Pat. Nos. 4,743,673 and 5,354,835).
- hydrophobic pendant groups such as alkyl, siloxane groups are incorporated into the polyols to increase the hydrophobicity of the polymer (e.g., U.S. Pat. No. 6,313,254).
- the release rates of the actives can also be controlled by the hydrophilicity/hydrophobicity of the polyurethane polymers.
- thermoplastic polyurethanes precision extrusion and injection molding are the preferred choices to produce two open-end hollow tubes (FIG. 1) with consistent physical dimensions.
- the reservoir can be loaded freely with appropriate formulations containing actives and carriers or filled with pre-fabricated pellets to maximize the loading of the actives.
- One open end needs to be sealed first before the loading of the formulation into the hollow tube.
- two prefabricated end plugs FIG. 2 can be used.
- the sealing step can be accomplished through the application of heat or solvent or any other means to seal the ends, preferably permanently.
- thermoset polyurethanes precision reaction injection molding or spin casting is the preferred choice depending on the curing mechanism. Reaction injection molding is used if the curing mechanism is carried out through heat and spin casting is used if the curing mechanism is carried out through light and/or heat. Hollow tubes with one open end (FIG. 3), for example, can be made by spin casting. Hollow tubes with two open ends, for example, can be made by reaction injection molding. The reservoir can be loaded in the same way as the thermoplastic polyurethanes. [0060] To seal an open end, an appropriate light-initiated and/or heat-initiated thermoset polyurethane formulation can be used to fill the open end, and this is cured with light and/or heat.
- a pre-fabricated end plug for example, can also be used to seal the open end by applying an appropriate light-initiated and/or heat-initiated thermoset polyurethane formulation on to the interface between the pre-fabricated end plug and the open end, and curing it with the light and/or heat or any other means to seal the ends, preferably permanently.
- the final process involves the conditioning and priming of the implants to achieve the delivery rates required for the actives.
- the appropriate conditioning and priming media is chosen. Water-based media are preferred for hydrophilic actives, and oil-based media are preferred for hydrophobic actives.
- Tecophilic® polyurethane polymer tubes are supplied by Thermedics.
- Tecophilic® polyurethane is a family of aliphatic polyether-based thermoplastic polyurethane that can be formulated to different equilibrium water contents (EWC) of up to 150% of the weight of dry resin. Extrusion grade formulations are designed to provide maximum physical properties of thermo formed tubing or other components. An exemplary tube and end cap structures are depicted in FIGS. 1-3. [0064] The physical data for the polymers is provided below as made available by Thermedics Polymer Product (tests conducted as outlined by American Society for Testing and Materials (ASTM), Table 1).
- Tables 2A-C show release rates of risperidone from three different classes of polyurethane compounds (Tecophilic®, Tecoflex® and Carbothane®). The release rates have been normalized to surface area of the implant, thereby adjusting for slight differences in the size of the various implantable devices.
- Risperidone is considered to be hydrophobic (not very water-soluble), as indicated by the Log P value; for the purposes of the data provided, a Log P value of greater than about 2.0 is considered to be not readily soluble in aqueous solution.
- the polyurethanes were selected to have varying affinities for water soluble active agents and varying flexibility (as indicated by the variation in flex modulus).
- the polyurethane exhibits physical properties suitable for the risperidone formulation to be delivered.
- Polyurethanes are available or can be prepared, for example, with a range of EWCs or flex moduli (Table 2).
- Tables 2A-C show normalized release rates for various active ingredients from polyurethane compounds.
- Tables 2D-F show the non-normalized release rates for the same active ingredients, together with implant composition.
- the solubility of an active agent in an aqueous environment can be measured and predicted based on its partition coefficient (defined as the ratio of concentration of compound in aqueous phase to the concentration in an immiscible solvent).
- the partition coefficient (P) is a measure of how well a substance partitions between a lipid (oil) and water.
- the measure of solubility based on P is often given as Log P.
- solubility is determined by Log P and melting point (which is affected by the size and structure of the compounds). Typically, the lower the Log P value, the more soluble the compound is in water. It is possible, however, to have compounds with high Log P values that are still soluble on account of, for example, their low melting point. It is similarly possible to have a low Log P compound with a high melting point, which is very insoluble.
- the flex modulus for a given polyurethane is the ratio of stress to strain.
- the elution rate of an active agent from a polyurethane compound can vary on a variety of factors including, for example, the relative hydrophobicity/hydrophilicity of the polyurethane (as indicated, for example, by logP), the relative "stiffness" of the polyurethane (as indicated, for example, by the flex modulus), and/or the molecular weight of the active agent to be released.
- FIGS. 5-10 are graphs showing elution profiles of risperidone from various implantable devices over varying periods of time.
- 3575A polyurethane implants (F. M. 620 psi) prepared from tubing sections representing the beginning, middle and end of a coil of tubing as part of an assessment of the uniformity of the material within a particular lot (FIG. 5). Samples were evaluated weekly for one year. All implants were of equivalent geometry and drug load.
- 3575A polyurethane implants F. M. 620 psi
- F. M. 620 psi polyurethane implants
- 3575A polyurethane implants (F.M. 620 psi) that served as in vitro controls for implants used in the beagle dog study described in Example 4.
- the in vitro elution study of these implants was initiated on the date of implantation of the subject implants as part of an assessment of in vivo-in vitro correlation.
- Example 4 Evaluation of polyurethane subcutaneous implant devices containing risperidone in beagle dogs
- the implants initially contained about 80 mg of risperidone and are designed to deliver approximately 130 meg/day for 3 months.
- the test article was stored at between 2-8 0 C before use.
- the animals were as follows:
- Each animal was anesthetized by general anesthesia via pentobarbital sodium at the dose of 30 mg/kg for device implantation. The drug was released at a steady rate for several months. Half the animals received one implant (group 1) and the others received two implants (group 2). A 5 cm2 area of the shoulder was shaved and 2 mL of marcaine infused under the skin to numb the area. A small incision was made on the shoulder and the device was slid under the skin. The small incision was closed and the animal was allowed to recover and return to his run. Over the next five to seven days, the implantation site was be monitored for signs of infection or reaction. The skin staples were removed when the skin has healed sufficiently.
- FIG. 9 is a graph of the in vivo plasma concentration of risperidone in the beagle dog study.
- the lower plot represents the average plasma concentration achieved in dogs implanted with one Carbothane® PC-3575A polyurethane implant (F. M. 620 psi).
- the upper plot represents the average plasma concentration achieved in dogs implanted with two Carbothane® PC-3575A polyurethane implants (F. M. 620 psi).
- Example 5 Evaluation of polyurethane subcutaneous implant devices containing risperidone in beagle dogs
- Example 4 Expanding on the data presented in Example 4, this study determines the blood levels of risperidone from one or two larger implants and the duration of time the implants release the drug. Polyurethane-based implantable devices comprising a pellet comprising risperidone were implanted into beagles to determine release rates of risperidone in vivo. The results of the larger implant data are summarized in FIG. 10 (in vitro elution profile) and FIG. 11 (elution in beagle dogs).
- the pellets comprising the risperidone formulation used for this study had a diameter of 3.5 mm, a length of about 4.5 mm and a weight of 5.4 mg.
- the implant had a reservoir length of about 39-40 mm, a wall thickness of 0.2 mm, and internal diameter of 3.6 mm and an overall length of about 45 mm. initially contained about 80 mg of risperidone and are designed to deliver approximately 130 meg/day for 3 months.
Abstract
Description
Claims
Priority Applications (11)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP09737241.1A EP2344124B1 (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof |
BRPI0919465A BRPI0919465A2 (en) | 2008-09-30 | 2009-09-29 | implantable device for risperidone release and methods of use of risperidone |
KR1020117007924A KR101707791B1 (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone |
JP2011529360A JP2012504146A (en) | 2008-09-30 | 2009-09-29 | Implantable device for delivery of risperidone and method of use thereof |
RU2011117331/15A RU2510266C2 (en) | 2008-09-30 | 2009-09-29 | Implanted risperidone delivery system and methods for using it |
MX2011003301A MX2011003301A (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof. |
CN2009801421147A CN102202646A (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof |
CA2739181A CA2739181C (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof |
AU2009298637A AU2009298637B2 (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof |
UAA201105431A UA103635C2 (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and method of use thereof |
IL211952A IL211952A (en) | 2008-09-30 | 2011-03-27 | Implantable device for the delivery of risperidone and methods of use thereof |
Applications Claiming Priority (4)
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PCT/US2009/058810 WO2010039722A1 (en) | 2008-09-30 | 2009-09-29 | Implantable device for the delivery of risperidone and methods of use thereof |
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US (2) | US9078900B2 (en) |
EP (1) | EP2344124B1 (en) |
JP (2) | JP2012504146A (en) |
KR (1) | KR101707791B1 (en) |
CN (1) | CN102202646A (en) |
AU (1) | AU2009298637B2 (en) |
BR (1) | BRPI0919465A2 (en) |
CA (1) | CA2739181C (en) |
IL (1) | IL211952A (en) |
MX (1) | MX2011003301A (en) |
RU (1) | RU2510266C2 (en) |
WO (1) | WO2010039722A1 (en) |
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US20160030337A1 (en) | 2016-02-04 |
US20100080835A1 (en) | 2010-04-01 |
AU2009298637A1 (en) | 2010-04-08 |
JP5977324B2 (en) | 2016-08-24 |
CN102202646A (en) | 2011-09-28 |
JP2015083581A (en) | 2015-04-30 |
IL211952A0 (en) | 2011-06-30 |
EP2344124B1 (en) | 2017-02-22 |
RU2011117331A (en) | 2012-11-10 |
MX2011003301A (en) | 2011-06-09 |
CA2739181C (en) | 2017-03-14 |
US9078900B2 (en) | 2015-07-14 |
JP2012504146A (en) | 2012-02-16 |
KR20120008018A (en) | 2012-01-25 |
BRPI0919465A2 (en) | 2015-12-01 |
CA2739181A1 (en) | 2010-04-08 |
RU2510266C2 (en) | 2014-03-27 |
KR101707791B1 (en) | 2017-02-17 |
EP2344124A1 (en) | 2011-07-20 |
IL211952A (en) | 2015-11-30 |
AU2009298637B2 (en) | 2015-08-13 |
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