WO2010136604A1 - Transfer matrix for transferring a bioactive agent to body tissue - Google Patents

Abstract

The invention relates to a transfer matrix comprising (i) microparticles comprising a bioactive agent and (ii) at least one matrix compound selected from the group of hydrophilic polymers having a weight average molecular mass of at least 10 000 g/mol and amphiphilic macromolecular compounds, for medical use wherein the transfer matrix is to be transferred from an exterior surface of a medical device to an inner surface of a body vessel of a human or another vertebrate animal.

Description

TRANSFER MATRIX FOR TRANSFERRING A BIOACTIVE AGENT TO BODY TISSUE

The invention relates to a transfer matrix comprising a bioactive agent and hydrophilic or amphiphilic substances. The invention further relates to the transfer matrix for medical use. The present invention further relates to the use of the transfer matrix for treating, preventing or ameliorating a medical condition.

US 2006/0020243 relates to a medical device that releases lipophilic drugs for selective therapy of specified diseased tissues or organ parts. The drugs may be present as dry solids or oils on the surface of the device. In another embodiment it is disclosed that the lipophilic drug may be embedded in a readily water-soluble matrix substance. As suitable matrix substances only hydrophilic substances having a relatively low-molecular weight are disclosed. Examples are directed to balloon catheters coated with only the pharmaceutically active agent or the active agent mixed with a low-molecular weight, rapidly dissolving, hydrophilic substance such as Ultravist 300, mannitol, acetylsalicylic acid or glycerine.

A disadvantage of the coating is that - once present at the targeted tissue location - it will be relatively easily washed away by the blood stream. This may cause a premature uptake by the systemic circulation, whereby a considerable amount of the drug will not be able to therapeutically affect the targeted tissue location. It is an object of the present invention to provide an alternative matrix for the transfer of a bioactive agent to a target site, in vivo.

In particular, it is an object to provide a transfer matrix which shows good adhesion to a body tissue or to a naturally present substance attached to body tissue, e.g. intravascular plaque. In particular it is an object to provide a transfer matrix that is suitable to transfer a bioactive agent to body tissue or to a naturally present substance attached to body tissue with good efficiency, more in particular with respect to the percentage of active agent that is transferred to a targeted site (rather than being released systemically) and/or with an advantageous release pattern of the bioactive agent from the transfer matrix to the targeted body tissue or to a naturally present substance attached to body tissue. It is in particular an object of the present invention to provide a transfer matrix that is suitable for treatment of a body vessel with a low risk of blood clotting when transferring the matrix comprising the active agent.

It has now been found that it is possible to provide a bioactive agent in a specific transfer matrix for transferring the active agent to a target site, in vivo, in particular to a target body tissue, or to a natural substance, such as plaque, attached to the body tissue, e.g. intravascular plaque.

Accordingly, the present invention relates to a transfer matrix comprising (i) a bioactive agent and (ii) at least one matrix compound selected from the group of hydrophilic polymers having a weight average molecular mass of at least 10.000 g/mol or selected from the group of amphiphilic macromolecular compounds.

It has surprisingly been found that it is possible to transfer the matrix from a medical device to a target site, in vivo, in particular to a target body tissue, or to a natural substance, such as plaque, attached to said body tissue, within a short period, even within a period that is short enough to allow its use in the treatment of, e.g. arteries from which blood flow can be halted for only a short period of time, e.g. less than 10 min or less than 5 min. For instance, the aorta of a subject can be treated in accordance with the invention. This is in particular surprising, because the prior art typically teaches to use coatings that release easily from the medical device, because the matrices are fluid or in a form that is quickly hydrated or dissolved and thereby readily becomes unstuck from the surface of the device (due to a reduction in attractive forces between the transfer matrix and the surface and/or increase in the attractive forces of the transfer matrix to the target tissue).

In contrast, the transfer matrix in accordance with the present invention is usually solid (under conditions wherein it is employed) or essentially solid and comprises a hydrophilic polymer having a weight average molecular mass of at least 10.000 g/mol or an amphiphilic macromolecular compound with a relatively slow dissolution/hydration rate in a physiological liquid such as aqueous saline, or a body liquid such as blood, plasma, or the like. The term "solid" is used herein for a material that at least substantially retains its dimensions (i.e. does not visibly flow), when exposed to no other forces than gravity (as opposed to a liquid), at a temperature of 25 ⁰C. Non-fluid gels and pastes (Bingham plastic fluids) are examples of essentially solids. The transfer matrix may in particular be a non-gelled amorphous, crystalline or semi-crystalline material. Especially in an embodiment wherein, at least after hydration, the hydrophilic polymer or amphiphilic macromolecular compound forms a hydrogel or solid, it is further advantageous that a transfer matrix according to the present invention is capable of adhering to the target site for a considerable amount of time, which may allow sustained release of the bioactive agent.

Factors such as adhesiveness to the target site, release pattern of the bioactive agent but also the lubricity may further be influenced by the choice of the average molecular weight and/or the molecular weight distribution of the hydrophilic polymer or the amphiphilic macromolecular compound. A higher average molecular weight generally results in a more lubricious material, and a lower average molecular weight generally results in a more adhesive material. The inventors however surprisingly found that a relatively high molecular weight can be used to transfer a bioactive agent, despite an expected reduction in the adhesiveness to body tissue. They further concluded that a hydrophilic polymer having a relatively high (average) molecular weight and/or being an amphiphilic macromolecular compound offers the advantage in that at least a substantial part of the transfer matrix of the present invention may adhere to the targeted body site for a longer time, compared to at least some known matrices. This may be beneficial in that the invention allows introduction of drugs with a different release profile, in particular with a more sustained release. It is also envisaged that in case a topical treatment of a targeted body site (such as an inner wall of a blood vessel to which the transfer matrix is transferred) the presence of a matrix compound having a relatively high (average) molecular weight may allow a more efficient topical release (in)to the targeted site, as less of the active agent may become dissolved in body fluid (such as blood) passing the transferred material before it is absorbed by the targeted body tissue.

It is further concluded that a relatively high (average) molecular weight for the hydrophilic polymer is advantageous in that the transferred matrix tends to cause less disturbance of the flow of body fluid compared to a transfer matrix formed of compound(s) of the same or similar chemical structure, but with a lower (average) molecular weight.

The transfer matrix may be transferred directly to body tissue forming part of the target site, or to a naturally present substance attached to the surface of the body tissue, e.g. plaque in a blood vessel.

For the purpose of the invention, with the term hydrophilic is meant the capacity of a molecular entity, or of a group of molecular entities, to interact with - A -

water. Usually a hydrophilic polymer comprises one or more polar groups. A polar group is any chemical grouping in which the distribution of electrons is uneven, enabling it to take part in an electrostatic interaction, for instance a hydrogen bonding or another dipole-dipole interaction with water. It is contemplated that hydrophilic polymers having a weight average molecular mass of at least 10.000 g/mol or amphiphilic macromolecular compounds hydrate or dissolve relatively slowly in an aqueous system which is extremely important in a physiological environment.

The term polymer is used herein for a molecule comprising two or more (repeating) units derived actually or conceptually form one or more molecules of a lower molecular mass. In particular a polymer may be composed of two or more monomers which may be the same or different.

The term "target-site" is used herein for a part of the body to which transfer of the matrix comprising the bioactive agent is directed. In particular, the target site may be a (part of a) an inner wall of a body cavity, for example a blood vessel, a ureter, a urethra, a cervix, a uterus, a bladder, a prostate lumen or the hollow parts of the digestive tract such as the oesophagus, the stomach, the small intestine, the large intestine or the rectum.

The transfer matrix according to the present invention is particularly suitable for medical use as mentioned above.

The transfer matrix may be transferred such that it adheres directly to body tissue. However, the transfer matrix is also suitable to be transferred to tissue that is fully or partly covered with plaque, which may be a substantially hydrophobic deposition. The transfer matrix according to the present invention may be suitable for the treatment of atherosclerosis, osteomyelitis, osteosarcoma, joint infection, macular degeneration, diabetic eye, diabetes mellitus, psoriasis, ulcers, atherosclerosis, conjunctival administration of the eye, claudication, thrombosis, viral infection, cancer or in the treatment of hernia. The hydrophilic polymers may be natural or synthetic. It can be a blend or a copolymer of a natural and a synthetic polymer. The hydrophilic polymers are for example selected from the group of poly(vinyllactams) such as polyvinylpyrrolidone (PVP); polyvinyl alcohols; polyvinylethers; maleic anhydride based copolymers; polyesters, such as polylactides, polyglycolides, or coplymers thereof, polycaprolactones; or polyvinylamines; polyethyleneimines; polyethyleneoxides; poly(carboxylic acids); polyamides; polyanhydrides; polyphosphazenes; cellulose and cellulose derivatives, in particular carboxymethyl cellulose, methyl cellulose, hydroxyethyl cellulose, and hydroxypropylcellulose; polypeptides, in particular collagens, fibrins, proteins, albumin, and elastin; oligopeptides; polysacharrides, in particular heparin, dextran, chondroitin sulfate, chitosan, hyaluronic acid, alginates, and chitin; oligonucleotides; and polymeric polyelectrolytes.

In a particularly preferred embodiment, the hydrophilic polymer comprises polyvinylpyrrolidone (PVP). PVP has been widely used in medical applications and is readily available in a medical grade quality. The PVP is preferably selected from polyvinylpyrrolidone having a K-value of 15-90, in particular a K-value of 25-30. K-values are commonly used as an indicator for viscosity average molecular weight (M_v), The K-value is e.g. determinable by the Method W1307, and Revision 5/2001 of the Viscotek Y501 automated relative viscometer.

Preferably, the hydrophilic polymer is a non-crosslinked linear or branched polymer. In case it is cross-linked, the degree of cross-linking is preferably low and in particular does not exceed 1 crosslink per 100 monomer units.

The presence of a non-crosslinked hydrophilic polymer is advantageous with respect to providing a high adhesiveness towards the target site but also with respect to facilitating the release of the bioactive agent to the body tissue The preferred average molecular weight of the hydrophilic polymer depends on the type of polymer in question. As indicated above the weight average molecular mass (M_w), is 10.000 g/mol or more. Preferably, M_w is at least 15.000 g/mol, in particular at least 20.000 g/mol, more in particular at least 25.000 g/mol or at least 28.000 g/mol. In particular, good results, with respect to transfer efficacy, have been achieved using a hydrophilic polymer having an M_w of more than 40.000 g/mol.

As used herein the M_w is a value as determinable by light scattering, optionally in combination with size exclusion chromatography

For a good transfer efficiency is has surprisingly been found that the upper limit of the M_w is not particularly critical. For instance, it has been found that a transfer matrix comprising a hydrophilic polymer having an M_w in the range of 1.000.000 to 1.500.000 g/mol can also be transferred efficacy.

The weight average molecular mass of the hydrophilic polymer may be 2.000.000.g/mol or less, 500.000 g/mol or less, 100.000 g/mol or less, 60.000 g/mol or less, or 50.000 g/mol or less. It is noted that, depending on the application, it may desired that the polymer or a degradation product thereof is at least substantially excretable by the body. In case, e.g., a urinary tract is treated with a transfer matrix according to the invention, there is not practical barrier, avoiding the excretion. In case, e.g. the treatment of restenosis, at some point in time, after the transfer matrix has been transferred to the inner wall of a blood vessel (after the active agent has been released), the polymer (or its break down products) may dissolve in the blood. It is then desirable that the dissolved polymer (or its break down products) can pass through the renal glomelurus or other clearance pathways of the body. In particular for PVP and polymers of the same class such as polyvinyl lactams, it is preferred that molecules of said polymer with a molecular weight higher than 60,000 g/mol are essentially absent in the transfer matrix. Preferably less than 0.5 wt. %, in particular less than 0.1 wt. % of such molecules are present based on the total weight of the polymer. In a particularly preferred embodiment at least 99 % of the weight of said polymer is formed by molecules having a molecular weight in the range of 5 000-60 000 g/mol, in the range of 10 000-55 000 g/mol or in the range of 15- 50 000 g/mol.

The matrix compound may also be selected from the group of amphiphilic macromolecular compounds. The amphiphilic macromolecular compound may be present as an alternative to the hydrophilic polymer or it may be present in combination with the hydrophilic polymer. The weight average molecular mass of the amphiphilic macromolecular compound usually is 1000 g/mol or more. In a specific embodiment weight average molecular mass may be 3000 g/mol or more, 5000 g/mol or more, or 10.000 g/mol or more. Regarding a suitable upper limit, the same considerations apply as for the hydrophilic polymer, mentioned above: in particular when it is desired that the compound is excretable via the kidneys, the degradation products should be small enough to allow this.

The amphiphilic macromolecular compound may be selected from a non-ionic compound, a cationic compound, an anionic compound or a zwitter-ionic compound.

In particular suitable are amphiphilic macromolecular compounds selected from the group of polypropyleneoxide-polyethylene oxide block-copolymers, such as poloxamers (e.g. commercially available under the trade name Pluronic, e.g. Pluronic 127F), polysorbate detergents (e.g. commercially available under the trade name Tween, e.g. Tween 80). Other examples of amphiphilic macro molecular compounds are polyoxyethylene alkyl ethers (e.g. macrogol ethers such as cetomacrogol 1000), polyoxyethylene castor oil derivatives, polyoxyethylene stearates, amphilic polysaccharide derivatives (e.g. carboxymethylcellulose, hydroxypropyl celluloses, hydroxypropyl methylcellulose, methylcellulose, hydroxyethylcellulose, hydroxypropylcellulose, hydroxypropylmethyl-cellulose phthalate, 4-(1 , 1 ,3,3- tetramethylbutyl)-phenol polymer with ethylene oxide and formaldehyde (also known as tyloxapol, superione, and triton), poloxamines (e.g., Tetronic 908(R), also known as Poloxamine 908(R), which is a tetrafunctional block copolymer derived from sequential addition of propylene oxide and ethylene oxide to ethylenediamine (BASF Wyandotte Corporation, Parsippany, N.J.));alkyl aryl polyether sulfonate (e.g. Tritons X-200(R), Rohm and Haas.

In the transfer matrix according to the invention, the total concentration of hydrophilic polymer(s) and amphiphilic macromolecular compound(s), is usually 30 wt.% or more based on total dry weight, in particular at least 40 wt. %. Preferably, the total concentration is 50 wt. % or more, based on total dry weight. In a particularly preferred embodiment, the total concentration is at least 60 wt. % or at least 65 wt. %.

As mentioned above the transfer matrix may comprise a hydrophilic polymer, an amphiphilic macromolecular compound or both. The weight to weight ratio of hydrophilic polymer to amphiphilic macromolecular compound may be in the range of 100:0 to 0:100. If both are present, said ratio is usually in the range of 0.1 :99.9 to 99:1 , in particular in the range of 0.4:99.6 to 95:5, more in particular in the range of 1 :99 to 90:10. Preferred ratios depend to some extent on the amphiphilic compound. For instance, an amphiphilic macromolecular compound, in particular a poloxamer, may advantageously be used as the major matrix compound (i.e. the weight to weight ratio of hydrophilic polymer to amphiphilic macromolecular compound being less than 50:50). On the other hand, a minor amount of the amphiphilic macromolecular may be sufficient to provide an advantageous. Thus, the weight to weight ratio of hydrophilic polymer to amphiphilic macromolecular compound 50:50 or more, in particular 75:25 or more.

The transfer matrix further comprises a bioactive agent selected from any agent which is a therapeutic, prophylactic, or diagnostic agent. These agents can have anti-proliferative or antiinflammatory properties or can have other properties such as antineoplastic, antiplatelet, anticoagulant, anti-fibrin, antithrombotic, antimitotic, antibiotic, antiallergic, or antioxidant properties. Moreover, these agents can be cystostatic agents, agents that promote the healing of the endothelium, or agents that promote the attachment, migration and proliferation of endothelial cells while quenching smooth muscle cell proliferation. Examples of suitable therapeutic and prophylactic agents include synthetic inorganic and organic compounds, proteins and peptides, polysaccharides and other sugars, lipids, and DNA and RNA nucleic acid sequences having therapeutic, prophylactic or diagnostic activities. Nucleic acid sequences include genes, antisense molecules, which bind to complementary DNA to inhibit transcription, and ribozymes. Some other examples of bioactive agents include antibodies, receptor ligands, enzymes, adhesion peptides, blood clotting factors, inhibitors or clot dissolving agents, such as streptokinase and tissue plasminogen activator, antigens for immunization, hormones and growth factors, oligonucleotides such as antisense oligonucleotides and ribozymes and retroviral vectors for use in gene therapy.

Examples of anti-proliferative agents include rapamycin and its functional or structural derivatives, 40-0- (2-hydroxy)ethyl-rapamycin (everolimus), and its functional or structural derivatives, paclitaxel and its functional and structural derivatives. Examples of rapamycin derivatives include ABT-578, 40-0-(3- hydroxy)propyl-rapamycin, 40-O-[2-(2-hydroxy)ethoxy]ethyl- rapamycin, and 40-0- tetrazole-rapamycin. Examples of paclitaxel derivatives include docetaxel. Examples of antineoplastics and/or antimitotics include methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, doxorubicin hydrochloride (e.g. Adriamycin® from Pharmacia AND Upjohn, Peapack N. J.), and mitomycin (e.g. Mutamycin® from Bristol-Myers Squibb Co., Stamford, Conn.). Examples of such antiplatelets, anticoagulants, antifibrin, and antithrombins include sodium heparin, low molecular weight heparins, heparinoids, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclin analogues, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein llb/llla platelet membrane receptor antagonist antibody, recombinant hirudin, thrombin inhibitors such as Angiomax (Biogen, Inc., Cambridge, Mass.), calcium channel blockers (such as nifedipine), colchicine, fibroblast growth factor (FGF) antagonists, fish oil (omega 3 -fatty acid), histamine antagonists, lovastatin (an inhibitor of HMG-CoA reductase, a cholesterol lowering drug, brand name Mevacor® from Merck AND Co., Inc., Whitehouse Station, NJ), monoclonal antibodies (such as those specific for Platelet-Derived Growth Factor (PDGF) receptors), nitroprusside, phosphodiesterase inhibitors, prostaglandin inhibitors, suramin, serotonin blockers, steroids, thioprotease inhibitors, triazolopyrimidine (a PDGF antagonist), super oxide dismutases, super oxide dismutase mimetic, 4-amino-2,2,6,6-tetramethylpiperidine-l-oxyl (4-amino-TEMPO), estradiol, anticancer agents, dietary supplements such as various vitamins, and a combination thereof. Examples of anti- inflammatory agents including steroidal and nonsteroidal antiinflammatory agents include biolimus, tacrolimus, dexamethasone, clobetasol, corticosteroids or combinations thereof. Examples of such cytostatic substances include angiopeptin, angiotensin converting enzyme inhibitors such as captopril (e.g. Capoten® and Capozide® from Bristol-Myers Squibb Co., Stamford, Conn.), cilazapril or lisinopril (e.g. Prinivil® and Prinzide® from Merck AND Co., Inc., Whitehouse Station, NJ). An example of an antiallergic agent is permirolast potassium. Other therapeutic substances or agents which may be appropriate include alpha- interferon, pimecrolimus, imatinib mesylate, midostaurin, and genetically engineered epithelial cells. The foregoing substances can also be used in the form of prodrugs or co-drugs thereof. The foregoing substances also include metabolites thereof and/or prodrugs of the metabolites. The foregoing substances are listed by way of example and are not meant to be limiting. Other active agents which are currently available or that may be developed in the future are equally applicable.

The bioactive agent may be present, in the transfer matrix, in a particulate form. Particles are e.g. useful for realising a specific release pattern of the bioactive agent. Thereby, the presence of the bioactive agent in particulate form in combination with the matrix compound(s) as defined herein, especially in combination with one or more amphiphilic macromolecular compounds and/or with one or more hydrophilic polymers having a relatively high molecular weight (as indicated above), offers the possibility to improve the delivery of a bioactive agents specifically to a targeted site. For instance, the efficiency of said delivery may be improved (increased topical uptake of bioactive agent in the targeted site, reduced systemic release) or a different release pattern of bioactive agent, in particular a more sustained release may be realised. Particles have been defined and classified in various different ways depending on their specific structure, size, or composition, see e.g. Encyclopaedia of Controlled drug delivery Vol2 M-Z Index, Chapter: Microencapsulation Wiley Interscience, starting at page 493, see in particular page 495 and 496.

As used in the present invention the term particles includes micro- or nanoscale particles or micelles, which are typically composed of solid or semi-solid materials and which are capable of carrying an bioactive agent. Typically, the average diameter of the particles ranges from 10 nm to 1000 μm, preferably from 10 nm to 500 μm, more preferably from 10 nm to 100 μm. In fact the most preferred average diameter depends on the intended use. Microparticles according to the present invention typically have an average diameter ranging from 1 μm to 1000.μm. In case that the particles are intended for use as an injectable drug delivery system, in particular as an intravascular drug delivery system, an average diameter of up to 10 μm, in particular in the range of 1 to 10 μm, preferably in the range of 1-5 μm may be desired. Nanoparticles according to the present invention typically have an average diameter below 1000 nm, for example ranging from 10 nm-999 nm. Preferably the average diameter is ranging from 20-800 nm, more preferably from 30-500 nm. For intravascular purposes, the average diameter is preferably ranging from 100-300 nm, for intracellular purposes the average diameter is preferably ranging from 10-100 nm. In other applications, other dimensions may be desirable, for instance an average diameter in the range of 10 nm to 500 nm, preferably in the range from 10 nm to 300 nm.

Micelles according to the present invention typically are oriented molecular aggregates, often in a spherical or rod shape for example made of 10 to 100 surface active molecules formed in a solution; the hydrophilic or lipophilic (hydrophobic) parts of the molecule orient according to their favorite interaction with the surrounding solvent which becomes excluded from the interior part of the micelle. The micelles according to the present invention have an average diameter below 300 nm, preferably below 200 nm, more preferably below 100 nm. In particular, the particle diameter as used herein is the Z-average diameter as determinable by a Malvern Zetasizer NanoZS Dynamic lights cattering (Malvern Instrument Inc.), making use of an ASTM certified polymer latex size standard of 60 nm as a control. Z-Average diameters are calculated directly from the correlation function measured and therefore do not depend on the input of physical properties of the particles. In particular, if the particles are too small or non analyzable by light scattering because of their optical properties then scanning electron microscopy (SEM) or transmission electron microscopy (TEM) can be used.

The particle structure may be a substantially homogenous structure, including nano- and/or microparticles or micelles. In particular in case more than one bioactive agent has to be released or in case one or more functionalities are needed, it may be preferred that the particles are provided with a structure comprising an inner core and an outer shell. A core/shell structure enables more multiple mode of action for example in drug delivery of incompatible compounds or in imaging.

In a further embodiment, the particles are imageable by a specific technique. Suitable imaging techniques are MRI, CT, X-ray. The imaging agent can be incorporated inside the particles or coupled onto their surface. Such particles may be useful to visualize how the particles migrate, for instance in the blood or in cells. A suitable imaging agent is for example gadolinium.

The bioactive agent may be more or less homogeneously dispersed within the particles or within a part thereof, notably within the particle core or at/near the surface (e.g. in the shell, in case of a core-shell structure)

Suitable methods of preparing particles comprising a bioactive agent are known in the art. In one embodiment, the particles at least essentially consist of bioactive agent. It is also possible to provide particles comprising one or more additional compounds, in particular one or more polymers, which may for instance have the function of carrier material or encapsulating material. In particular, the particles may further comprise a polymer selected from the group of poly(lactides) (PLA); poly(glycolides) (PGA); co-oligomers or copolymers of poly(lactides) and poly(glycolides) (PLGA); poly(anhydrides); poly(trimethylenecarbonates); poly(orthoesters); poly(dioxanones); poly(ε-caprolactones) (PCL); poly(urethanes); polythioesters; polyanhydrides; poly(hydroxy acids); polycarbonates; polyaminocarbonates; polyphosphazenes; poly(propylene)fumarates; polyesteramides based on amino acids; polyoxaesters; poly(maleic acids); polyacetals; polyketals; polypeptides; polyhydroxyalkanoates; carbohydrates, in particular polysaccharides, fibrin, chitin, chitosan, starch, polysucrose, hyaluronic acid, dextran, heparan sulfate, chondroitin sulfate, heparin, alginate, and similar derivatives thereof; and proteins, in particular gelatin, collagen, albumin, ovalbumin, co-oligomers thereof, copolymers thereof, or blends thereof.

A suitable way to prepare particles with a controlled release pattern is for instance described in WO 98/22093. Suitable polymers mentioned in this publication are crosslinkable water-soluble dextrans, derivatized dextrans, starches, starch derivatives, cellulose, polyvinylpyrrolidone, proteins and derivatized proteins

Particularly favourable are particles, comprising a crosslinked polymer, which polymer is composed of a crosslinkable compound represented by the formula

Formula I wherein

X is a residue of a multifunctional radically polymerisable compound (having at least a functionality equal to n); each Y independently is optionally present, and - if present - each Y independently represents a moiety selected from the group of O, S and NR₀; - each R₀ is independently chosen from the group of hydrogen and substituted and unsubstituted, aliphatic, cycloaliphatic and aromatic hydrocarbon groups which groups optionally contain one or more moieties selected from the group of ester moieties, ether moieties, thioester moieties, thioether moieties, carbamate moieties, thiocarbamate moieties, amide moieties and other moieties comprising one or more heteroatoms, in particular one or more heteroatoms selected from S,

O, P and N, each R₀ in particular independently being chosen from the group of hydrogen and substituted and unsubstituted alkyl groups, which alkyl groups optionally contain one or more heteroatoms, in particular one or more heteroatoms selected from P, S, O and N; - each Z is independently chosen from O and S; each R₁ is independently chosen from the group of substituted and unsubstituted, aliphatic, cycloaliphatic and aromatic hydrocarbon groups which groups optionally contain one or more moieties selected from the group of ester moieties, ether moieties, thioester moieties, thioether moieties, carbamate moieties, thiocarbamate moieties, amide moieties and other moieties comprising one or more heteroatoms, in particular one or more heteroatoms selected from S, O, P and N.; each R₂ is independently chosen from hydrogen and substituted and unsubstituted, aliphatic, cycloaliphatic and aromatic hydrocarbon groups which groups optionally contain one or more moieties selected from the group of ester moieties, ether moieties, thioester moieties, thioether moieties, carbamate moieties, thiocarbamate moieties, amide moieties and other moieties comprising one or more heteroatoms, in particular one or more heteroatoms selected from S, O, P and N, each R₀ in particular independently being chosen from the group of hydrogen and substituted and unsubstituted alkyl groups, which alkyl groups optionally contain one or more heteroatoms, in particular one or more heteroatoms selected from P, S, O and N; and n is at least 2, each R₃ is chosen from hydrogen, -COOCH₃, -COOC₂H₅, -COOC₃H₇, - COOC₄H₉-R. Such particles and the preparation thereof are described in more detail in WO2007/107358.

In the transfer matrix according to the present invention, the particles comprising the bioactive agent are usually dispersed in the matrix compound.

The bioactive agent, optionally present in the form of particles, may be distributed homogenously or in homogenously throughout the transfer matrix (on a macroscopic or microscopic level). In particular the distribution throughout the transfer matrix from a first side of the transfer matrix (the side nearest the transfer device, at least during transfer) to a second side (the side farthest from the surface of the device, i.e. the surface engaging the target site at least during transfer) may be homogenous or inhomogenous as shown in Fig. 4/5.

In particular, in case of a spherical, ellipsoid or tube-shaped transfer matrix the distribution may be homogenous or inhomogenous in the radial direction. An inhomogenous distribution may for instance be a gradual or stepwise increase in concentration of a bioactive agent from a first side to a second side, in particular such increase in a radial direction. It may for instance be advantageous to provide the bioactive agent in a relatively high concentration near the surface of the matrix that is to engage the target site and a relatively low concentration near the surface of the transfer matrix that after transfer may be exposed to body fluid that may erode the matrix while a substantial part of the bioactive agent has not been released to the target tissue.

The part of the particles formed by bioactive agent respectively by carrier material or encapsulating material may be chosen within wide limits. Preferred concentrations inter alia depend on factors such as desired release pattern after transfer, desired dosage and the like. Usually the weight percentage as a percentage of a total weight of the particles of bioactive agent is in the range of 1 -1 OO wt. %. In a preferred embodiment said weight percentage is at least 20 wt. %, at least 40 wt. %, at least 50 wt. %, 90 wt. % or less or 75 wt. % or less, based on the total weight of the particles.

Likewise, the weight to weight carrier or encapsulating material to ratio bioactive agent may be chosen within wide limits, depending on desired properties. Usually, said ratio is in the range of 0:100 to 99:1. In a preferred embodiment, said ratio may be at least 10:90, at least 25:75, 90:10 or less, or 75:25 or less.

In addition, the particles may comprise one or more additives, e.g. to modify a surface property in order to improve dispersibility in the transfer matrix. In particular a surfactant may be present. Suitable surfactants in particular include amphipilic macromolecular compounds, such as those mentioned herein elsewhere when describing the matrix compounds.

In some embodiments, the transfer matrix may further include a biobeneficial material. The biobeneficial material can be polymeric or non-polymeric. The biobeneficial material is preferably substantially non-toxic, non-antigenic and non- immunogenic. A biobeneficial material is one that enhances the biocompatibility of a medical device by being non- fouling, hemocompatible, actively non-thrombogenic, or anti- inflammatory, all without depending on the release of a bioactive agent. Representative biobeneficial materials include, but are not limited to, polyphosphazenes, phosphoryl choline, choline, poly(aspirin), polymers and copolymers of hydroxyl bearing monomers such as hydroxyethyl methacrylate (HEMA), hydroxypropyl methacrylate (HPMA), hydroxypropylmethacrylamide, poly (ethylene glycol) acrylate (PEGA), PEG methacrylate, 2-methacryloyloxyethylphosphorylcholine (MPC), carboxylic acid bearing monomers such as methacrylic acid (MA), acrylic acid (AA), alkoxymethacrylate, alkoxyacrylate, and 3-trimethylsilylpropyl methacrylate (TMSPMA), poly(styrene-isoprene-styrene)-PEG (SIS-PEG), polystyrene-PEG, polyisobutylene-PEG, polycaprolactone-PEG (PCL-PEG), PLA-PEG, poly(methyl methacrylate )-PEG (PMMA-PEG), polydimethylsiloxane-co-PEG (PDMS-PEG), poly(vinylidene fluoride)-PEG (PVDF-PEG), biomolecules such as fibrin, fibrinogen, cellulose, starch, collagen, dextran, dextrin, hyaluronic acid, fragments and derivatives of hyaluronic acid, heparin, fragments and derivatives of heparin, glycosamino glycan (GAG), GAG derivatives, polysaccharide, elastin, chitosan, alginate, silicones, PolyActive™, or combinations thereof. The term PolyActive™ refers to a block copolymer having flexible poly( ethylene glycol) and poly(butylene terephthalate) blocks (PEGT/PBT). PolyActive™ is intended to include AB, ABA, BAB copolymers having such segments of PEG and PBT (e.g., poly(ethylene glycol)-block- poly(butyleneterephthalate)-block polyethylene glycol) (PEG- PBT-PEG).

In addition to the matrix compound and the bioactive agent optionally present in the form of particles, the transfer matrix may comprise one or more additional ingredients selected from the group of antioxidants, lubricants or wetting agents other than water.

During storage and before use, the transfer matrix on the support is usually present in a dry form or may contain only a minor amount of water. In particular the water content may be in the range of 0.1-10 wt. % based on the weight of the transfer matrix. In more particular, the water content is less than 5 wt. %, more in particular less than 2 wt. %.

In principle, shortly before use, the transfer matrix may be wetted with water or an aqueous liquid to increase lubricity of the transfer matrix such that it can be introduced into a body vessel with less friction. Thus, matrix compound in the transfer matrix may swell and, e.g., form a hydrogel comprising a considerable amount of water. The water concentration in such a gel is in generally more than 10 wt. % based on the total weight of the transfer matrix, e.g. 25-99 wt. %.

However, a transfer matrix according tot the invention may advantageously be used without needing to wet the material prior to use.

When wetted, for example by a body fluid (in situ) or with another aqueous liquid, e.g. a physiological saline solution (prior to application to the body ), the matrix layer may swell. This swelling may have several effects. In particular, the adherence of the transfer matrix to the transfer device may become weaker than the adherence in the situation wherein the matrix layer was not swollen (i.e. dry). This may contribute to an easier and/or more effective transfer. Further, the active agent in the transfer matrix may become more mobile in the matrix (due to an increased plasticity of the transfer matrix. This may facilitate pressing the particles through the matrix in the direction of the target site as a consequence of the expanding during transfer, possibly to the extent that the particles are pressed out of the transfer material into body tissue (or at least into naturally present body material, for instance plaque in a blood vessel).

The transfer of the transfer matrix usually takes place with the aid of a medical device. Such a medical device in general comprises an expandable support, of which a surface is arranged to engage the target site during transfer. On said surface the transfer matrix is present as shown in Figure 1/5.

The medical device comprising the transferable matrix as described herein can be used to treat, prevent, or ameliorate a medical condition such as atherosclerosis, thrombosis, restenosis, hemorrhage, vascular dissection or perforation, vascular aneurysm, vulnerable plaque, chronic total occlusion, claudication, anastomotic proliferation (for vein and artificial grafts), bile duct obstruction, urethra obstruction, tumor obstruction, and combinations thereof. The medical device may in particular be a device that can be expanded intraluminally, wherein the matrix is usually present on the outer surface, at least during transfer. A preferred example of a medical device for use in accordance with the invention is a balloon catheter. Balloon catheters are known in the art, and commercially available.

When the device is expanded intraluminally, the device will press against the wall of the lumen. In addition, body fluid surrounding the device may cause swelling of the transfer matrix. The pressing and the swelling may have several effects. It is contemplated that particles comprising bioactive agent that are squeezed out of the transfer matrix, will be forced into the wall of the lumen. The transfer matrix will adhere to the wall of the lumen and it will release from the expandable support or from an optionally present primer layer on the expandable support. A transfer matrix intended to be transferred to a blood vessel or another duct, preferably has a tubular shape.

The transfer matrix according to the present invention is usually applied to a support. If desired, the surface of the support can be pre-treated in order to improve adherence of the matrix compound, for instance a chemical and/or physical pre-treatment. Suitable pre-treatments are known in the art for specific combinations of materials for the surface of the support and matrix compound. Examples of pre- treatments include plasma treatment, corona treatment, gamma irradiation, light irradiation, chemical washing, polarising and oxidation.

The surface of the support on which the transfer matrix is provided is preferably a polymeric material. In particular, at least said surface of the support may comprise a polymer selected from the group of polyesters, PET, PTFE, latexes, parylenes polyvinylchlorides, silicon polymers, polyamides poly-urethanes, including copolymers of such polymers, for instance a copolymer of a polyamide and a polyether (e.g. Pebax™), a copolyester thermoplastic elastomer, e.g. Arnitel®, or a silicone- urethane. In particular a polyamide is very suitable for a balloon catheter, more in particular nylon-12.

The present invention further relates to a layered structure comprising the transfer matrix according to the invention. In addition to the transfer matrix, at least one other layer is present. In a specific embodiment, the surface of the transfer matrix may comprise a further layer that is essentially free of bioactive agent (apart from active agent that may diffuse into said layer). Such layer may be composed of the same or a different matrix compound as present in the transfer matrix. In an embodiment, the layered structure further comprises a primer layer as shown in Fig. 3/5. A primer layer is in particular useful to improve the adherence of the transfer matrix to the transfer device, which improves resistance against scratching or rubbing off the matrix, for instance when the device is inserted and directed to the correct position. Thus, the risk of premature release of the matrix is reduced.

A suitable material for the primer layer can be based on materials known in the art to act as a primer for the matrix of choice. In particular, a primer layer may comprise a network of at least one polymer selected from the group of polyether's and polythioesters, including copolymers thereof and optionally a hydrophilic polymer entangled in the network. The entangled polymers help to adhere the matrix to the primer, without binding it too strongly to adversely affect the transfer effictivity or the transfer rate. It is also possible to use a lubricious coating material, such as known per se for catheters that are to be inserted intraluminal^ as a primer layer. Such lubricious coating material may in particular comprise a polymer selected from the group consisting of polylactams, polyalkylene oxides, poly vinyl alcohols, polyacrylates, polyhydroxyalkylates, polymethacrylates, polyhydroxymethacrylat.es, and polyacrylamides. PVP is particularly suitable. Compared to the transfer layer, this material may have a similar or higher molecular weight. The weight average molecular weight of such polymer is usually in the range of 20 000 to 10 000 000 g/mol, preferably 250 000 g/mol to 3 000 000 g/mol, more preferably 360 000 to 1 500 000 g/mol. A relatively high molecular weight is considered advantageous with respect to providing lubricity and/or avoiding the transfer of a large portion of the primer layer with the matrix The polymer for the primer layer may be crosslinked or non-cross linked A particularly suitable material and method for providing a primer layer in a layered structure of the invention and method for preparing a primer layer or a lubricious coating is described in WO 06/056482 or WO 07/065720 of which the contents with respect to these materials and methods are incorporated herein by reference.

The primer layer may be chemically or physically bound to the support. Interaction between primer layer and transfer matrix is typically less strong than between support and primer, at least under the circumstances that exist during transfer. For example the interaction between primer layer and transfer matrix may be such that it is low, e.g., at a temperature of about 30-37 ⁰C (dependent on the target tissue) and/or in the presence of an aqueous liquid, e.g. blood or extracellular fluid. The material for the primer layer is usually chosen such that when primer layer and/or transfer matrix are in contact with water or an aqueous fluid, such as an aqueous body fluid (e.g. blood), the transfer matrix releases from the primer layer, although in principle it is possible that the primer layer is released with the transfer matrix. For a fast release it is preferred that the primer layer and the matrix are not chemically bound or that they are bound by a chemical bond that is not stable in water or a body fluid.

The transfer matrix according to the present invention may be prepared by dissolving or dispersing hydrophilic polymer or an amphiphilic compound, bioactive agent and optionally one or more other ingredients in a suitable liquid, e.g. water. The resultant mixture may then be applied to the medical device, which may already comprise a primer layer or any other layer. I

If desired, a protective layer and/or transfer enhancing layer may be applied over the transfer matrix, as shown in Fig. 2/5 or 5/5. The protective layer is usually provided at a surface of the transfer matrix that may make contact with the body of a patient during treatment, in particular during positioning the transfer matrix to a target side. The protective layer is useful to protect the transfer matrix against being rubbed off from the delivery device or being damaged in another way. Usually, and in particular during transfer, the transfer matrix is situated between an outer surface of the transfer device (the surface engaging the target site), and if present the primer layer, on the one side and the protective layer on the other.

In a particularly advantageous layer embodiment, a layered structure according to the invention comprises a transfer enhancement layer, which may be the same as the protective layer or different from the protective layer. If present, he transfer enhancement layer, is usually a layer intended to make direct contact with the target site to which the matrix is to be transferred. In view thereof the transfer enhancement layer preferably is hydrophilic if the tissue is hydrophilic, and hydrophobic if the tissue is hydrophobic (e.g. in case of a blood vessel of which substantial parts is covered with lipid plaque). In an advantageous embodiment, the protective layer comprises a compound selected from the group of HDL-cholesterol, polyunsaturated fatty acids, in particular ω-3 polyunsaturated fatty acids. In between applying different layers, a drying step may be carried out or a drying step may be carried out after the last layer has been applied.

In a specific method the support is dipped into a liquid mixture for forming a layer of interest, such as a liquid for forming the matrix, said liquid for example comprises the hydrophilic polymer and bioactive agent. After dipping the layer may be dried. Thereafter, this procedure of dipping and drying may be repeated at least one more time to provide another layer of interest. This method is in particular suitable for applying a transfer matrix comprising a layered structure wherein different layers comprise a different bioactive agent and/or the same bioactive agent in a different concentration.

The present invention further relates to a method for prophylactic or therapeutic medical treatment of a human or other anima. In particular such method may comprise a prophylactic or a therapeutic treatment of a disorder selected from the group of cardiovascular diseases and disorders occurring as a consequence of the treatment of a cardiovascular disease. Preferred examples of such disorders are selected from the group of atherosclerosis, stenosis, stent thrombosis and other forms of thrombosis.

A medical use according to the invention may in particular comprise inserting into a body vessel of the human or other animal a transfer matrix comprising bioactive agent as defined herein on an expandable medical device; thereafter expanding the device and transferring the transfer matrix comprising the bioactive agent from the device to the body vessel; and retreating the device from which the transfer matrix has been transferred from the human or animal body.

In case the device comprises a primer material, the transfer matrix is preferably transferred to the body vessel, whilst the primer at least substantially remains on the expandable device.

Transfer of the transfer matrix to a target site may be based on known technology, in particular known technology for inserting and expanding similar devices, e.g. in case of a transfer via a catheter balloon, the insertion, positioning and expanding of the device may be done by a manner known in the art

In the scope of the present invention it may be advantageous to 'over- expand' the expandable transfer device. With over-expanding is meant that the transfer device is expanded to a diameter exceeding the diameter the body vessel to which the transfer matrix is to be transferred had before expanding the transfer device, or wherein the force applied to expand the transfer device at least exceeds the force necessary to expand the device (material that is to be transferred) to a diameter equal to the inner diameter of the vessel to which the transfer matrix is to be transferred.

Further, the invention is directed to a method for preparing a transfer matrix according to the invention on a transfer device, comprising providing an expandable medical device; thereafter Optionally providing a surface of the medical device with a primer layer; thereafter applying matrix compound and bioactive agent directly to a surface of the medical device if no primer layer is present, or if a primer layer is present to the primer layer, the matrix compound and bioactive agent forming the transfer matrix and thereafter,

Optionally applying a protective layer to the transfer matrix

The invention will now be illustrated by the following examples without being limited thereto.

EXAMPLES

Example 1 :

The pure drug particle preparation: Preparation of 12um Rapamvcin microparticle suspension DSX.I:

The rapamycin as obtained, from Oscar Tropzsch (purity >99.7%), was added to water (1gram per ml) and glass beads (diameter = 3 mm) without any additives the mixture was homogenized during 1 hour under 360 rpm. After homogenizing the mixture was dried and with regular microscopy the particle size was determined at 12μm.

Preparation of 6.4 um Rapamvcin microparticle suspension DSX.II:

The rapamycin as obtained, from Oscar Tropizsch (purity >99.7%), was added to water (0.5082gram rapamycin per 20.2307g water) and glass beads (diameter = 3 mm) with 0.215 g Orothan 731 K. 1 hour was milled were after the glass beads were washed with 5 ml of extra water. This resulted in d (0.5) of 6.4 μm, the concentration is 0.020164 g rapamycin / ml.

Preparation of nanoparticles:

Preparation of drug solution (DS) compositions:

For the preparation of the DS1 solutions, first rapamycin was weighed and thereafter 1.000 ml of solvent was added and homogenized for 15 minutes on a shacking bench.

For the DS2 solutions first a stock of surfactant - solvent was made, 2.4800 - 2.5200 grams of surfactant was weighed and 500.000 ml of solvent was added. Fast dissolution was obtained via a shacking bench, the formed foam was removed by an ultra sonic bath in the degassing mode. Then 1.0 - 250.0 mg of rapamycin was weighed, therafter 1.000 ml of surfactant - solvent was added and homogenized for 15 minutes on a shacking bench.

Recepies of the surfactant solution (SS):

For the SS1 solutions first a stock of surfactant - milli Q is made: 2.4800 - 2.5200 grams of surfactant was weighed and 500.000 ml of milli Q was added. A fast dissolution was obtained via a shacking bench, the formed foam was removed by an ultra sonic bath in the degassing mode.

The drug solution (0.1000-1.000 ml) - surfactant combinations (1.000-15.00 ml) (DS):

To prepare the rapamycin nanoparticle suspension typically 1.000 ml of drug suspension (DS) was added to 10.00 ml of surfactant solution. The addition, by pressing as fast as possible, was done with an eppendorf pipette. Directly after addition the nanoparticle suspension was swirled and stored at 4⁰C. The particle diameter (z- average) is determined by Dynamic light scattering.

Example 2: PLGA-PTE synthesis

Synthesis PLGA 10k diene

The degradable oligomer poly(lactide-co-glycolide)10000di(4- pentenoate) was synthesized via poly(lactide-co-glycolide)10000diol. Thereto, 38.69 g (265.80 mmol) of dl-lactide, 10.39 g (88.69 mmol) of glycolide and 0.5316 g (5.00 mmol) of diethyleneglycol were added and melted at 150 ⁰C. 500 μl of a hexane solution containing 15 mg of tindioctoate was added. The reaction was allowed to proceed for 24 h upon which the reaction mixture was cooled to room temperature to obtain the product. Yield: 98% as a slight yellow solid.

Next, poly(lactide-co-glycolide)10000diol (49 g, 49 mmol) was dissolved in THF (300 ml), triethylamine (1.22 g, 12 mmol) was added and the reaction mixture was cooled to 0 ⁰C upon which pentenoylchloride (1.26 g, 11 mmol) was added and the temperature was maintained at 0 ⁰C for 1 h. The mixture was left to stir at room temperature. Next, the reaction mixture was stirred for 20 min at 0 ⁰C to precipitate the triethylamine hydrochloride salts formed during the reaction. The mixture was filtered and concentrated in vacuo. The residue was redissolved in chloroform and extracted with saturated aqueous NaCI solution and distilled water. The organic layer was dried over Na₂SO₄ and the solvent was removed under vacuum. Yield 81% as an off-white solid.

GPC results for PLGA 10k diene

Svnthesis PLGA PTE (AIBN route)

PLGAdiene and DTAA (di-thio-addipic acid) were weighed into a 50 ml round bottom flask. The dry solvent was added and the mixture was stirred until both compounds were dissolved. Subsequently the thermal initiator was added under stirring and the solution was heated to 80 ⁰C.

After approximately 12 h of keeping the temperature at 80 ⁰C a sample was taken to monitor the increase in molecular weight by GPC.

Synthesis PLGA-PTE (UV-route)

Formulation was brought onto a glass plate and applied using a doctor blade (200 μm). The sample was then polymerized using a D-bulb (15 J/cm²) under nitrogen atmosphere. The resulting polymer was dried overnight in vacuum oven and analyzed by SEC. SEC (polystyrene standards): Mn = 18382, Mw = 33460, PDI = 1.82 Example 3: Drug/polymer nanoparticle preparation

Materials

The drug - polymer solution compositions

The surfactant solution recipes:

Example 4: Table of formulations of the transfer matrix:

Formulation ID1 :

The transfer matrix composition 1 :

Total Solids only

Rapamycin: 0.45% 4.98%

PVP; Kolidon K 90 F: 8.17% 90.87%

Benzophenone: 0.05% 0.61% lrgacure 2959: 0.01 % 0.13 % Tween 80: 0.03% 0 .38 % PEGDAA: 0.27% 3 .04 % Ethanol: 91.01%

Formulation ID2:

The transfer matrix composition 2:

Total Solids only - Rapamycin (12 μm; DSX.I): 0.45% 4.98%

PVP; Kolidon K 90 F: 8.18% 90.87%

Benzophenone: 0.05% 0.61% lrgacure 2959: 0.01 % 0.13%

Tween 80: 0.03% 0.38% - PEGDAA: 0.27% 3.04%

Water: 91.00%

Formulation ID3:

The transfer matrix composition 3.1 (high RAPA content):

Total Solids only

Rapamycin (12 μm; DSX.I): 0.04% 0.54% PVP; Kolidon K 90 F: 8.25% 99.05% Tween 80: 0.03% 0.41 % - Water: 91.67%

The transfer matrix composition 3.2 (low RAPA content):

Total Solids only

Rapamycin (12 μm; DSX.I): 0.02% 0.27% PVP; Kolidon K 90 F: 8.25% 99.32% Tween 80: 0.03% 0.41 % Water: 91.69% Formulation ID4:

The primer composition: Total Solids only PTGL (ml_DI-HEA)₂: 5.00% 98.07% lrgacure 2959 0.10% 1.93% Ethanol (96%) 94.90% -

The transfer matrix composition 4: Total Solids only Rapamycin (12 μm; DSX.I): 0.04% 0.54% PVP; Kolidon K 90 F: 8.25% 99.05% Tween 80: 0.03% 0.41% Water: 91.67%

Formulation ID5:

The transfer matrix composition 5.1 :

Total Solids only

Rapamycin (12 μm; DSX.I): 0.47% 6.12% PVP; Kolidon LK 80: 7.18% 93.08% Tween 80: 0.06% 0.80% Water: 92.28%

The transfer matrix composition 5.2:

Total Solids only - Rapamycin (12 μm; DSX.I): 0.48% 4.86% PVP; Kolidon LK 60: 9.30% 94.25% Tween 80: 0.09% 0.89% Water: 90.13% The transfer matrix composition 5.3:

Total Solids only

Rapamycin (12 μm; DSX.I): 0.49% 5.92% PVP; Kolidon 30: 7.64% 93.27% Tween 80: 0.07% 0.81 % Water: 91.81%

Formulation ID6:

The transfer matrix composition 6:

Total Solids only

Rapamycin (6.4 μm; DSX.II): 2.64% 12.60% PVP; Kolidon K 90 F: 18.29% 87.40% Water: 79.08%

Formulation ID7:

Nanoparticle suspension (NS7.1 ): Drug solution (DS1.II.7):

Rapamycin: 302.7 mg

Ethanol (100%): 3.000 ml

Surfactant solutionθ.5% (SS1.1.7):

Pluronic 127F: 2.5082 g - H₂O (MiIIi Q): 500.000 ml

From the drug solution 1.000 ml was added to 10.00 ml surfactant solution to create the nanoparticles. Nanoparticles obtained: z-average = 166.8 nm; PdI = 0.016.

The transfer matrix composition 7.1 :

Total Solids only

Rapamycin (NS7.1 ): 0.86% 9.99% PVP; Kolidon K 90 F: 7.78% 90.01 % Water: 91.35% The transfer matrix composition 7.2:

Total Solids only

Rapamycin (6.4 μm; DSX.II): 3.31 % 30.00%

PVP; Kolidon 30: 7.73% 70.00%

Water: 88.96%

The transfer matrix composition 7.3:

Total Solids only - Rapamycin (6.4 μm; DSX.II): 10.46% 60.00% PVP; Kolidon 30: 6.97% 40.00% Water: 82.56%

Formulation ID8: Nanoparticle suspension (NS8.1 ): Drug solution (DS1.1.8.1 ): Rapamycin: 25.0 mg Acetone (100%): 1.000 ml

Surfactant solution 0.5% (SS1.I.8.1 ): Pluronic 127F: 2.5055 g H₂O (MiIIi Q): 500.000ml

From the drug solution 1.000 ml was added to 10.00 ml surfactant solution to create the nanoparticles. To the 11.000 ml nanoparticle suspension 1 1.0 mg PVP Kolidon 30 was added. Nanoparticles obtained: z-average = 231.2; PdI = 0.005.

The transfer matrix composition 8.1 :

Total Solids only

Rapamycin (NS8.1 ): 0.23% 29.11 % PVP; Kolidon 30: 0.10% 12.66% Pluronic 127 F 0.46% 58.23% Water: 99.21%

Nanoparticle suspension NS8.2: Drug solution (DPS1.8.2): - Rapamycin: 12.5 mg

PLGA-PTE (UV TK 20K): 12.5 mg Acetone (100%): 1.000 m

Surfactant solution 0.5% (SS1.I.8.2): - Pluronic 127F: 2.5055 g H₂O (MiIIi Q): 500.000ml

From the drug solution 1.000 ml was added to 10.00 ml surfactant solution to create the nanoparticles. To the 11.000 ml nanoparticle suspension 1 1.0 mg PVP Kolidon 30 was added. Nanoparticles obtained: z-average = 79.48 nm; PdI = 0.073.

The transfer matrix composition 8.2:

Total Solids only

Rapamycin (NS8.2): 0.1 1 % 14.10% PLGA-PTE (UV TK 20K): 0.11 % 14.10% PVP; Kolidon 30: 0.46% 12.82% Pluronic 127 F 0.10% 58.97% Water: 99.22%

For suspension 8.2 three different coating application techniques were used: a. For these balloons multiple dips (75) were used in order to reach a >200 μg RAPA concentration per balloon. b. For these balloons a factor of approximately 7 dips (10 actual dips) less was used c. For these balloons multiple dips (75) were also used but the drying of the formulation onto the balloon was at 75⁰C instead of maximum 5O⁰C with all other experiments.

Formulation ID9: Nanoparticle suspension NS9: Drug solution (DS1.II.9): - Rapamycin: 25.1 mg

Ethanol (100%): 1.000 ml

Surfactant solution 0.5% (SS1.II.9):

Tween 80: 2.5055 g - H₂O (MiIIi Q): 500.000ml

From the drug solution 1.000 ml was added to 10.00 ml surfactant solution to create the nanoparticles. To the 11.000 ml nanoparticle suspension 1 1.7 mg PVP Kolidon 30 was added. Nanoparticles obtained: z-average = 516.5 nm; PdI = 0.220.

The transfer matrix composition 9:

Total Solids only

Rapamycin (NS9): 0.23% 28.75% - PVP; Kolidon 30: 0.11 % 13.75%

Tween 80 0.46% 57.50%

Water: 99.20% Formulation ID10:

Nanoparticle suspension NSI Oa, b, c:

Drug solution (DPS1.10):

Rapamycin: 51.2 mg - PLGA-PTE 3 x 1 OK AIBN: 51.1 mg

Acetone (100%): 4.000 ml

Surfactant solution 0.5% (SS1.II.10):

Tween 80: 2.5055 g - H₂O (MiIIi Q): 500.000ml

From the drug solution 1.000 ml was added to 10.00 ml surfactant solution to create the nanoparticles. Nanoparticles obtained: z-average =204.2 nm; PdI =0.444. a. To 1/3 (3.500 ml) of the nanoparticle suspension no PVP Kolidon 30 was added. (NS10.a) b. To 1/3 (3.500 ml) of the nanoparticle suspension 5.5 mg PVP Kolidon 30 was added. (NS10.b) c. To 1/3 (3.500 ml) of the nanoparticle suspension 1 1.0 mg PVP Kolidon 30 was added. (NS10.C)

The transfer matrix composition 10. a:

Total Solids only

Rapamycin (NS10.a): 0.12% 17.14% - PLGA-PTE 3 x 10K AIBN: 0.12% 17.14% Pluronic 127 F 0.46% 65.71 % Water: 99.3%

The transfer matrix composition 10.b:

Total Solids only

Rapamycin (NS10.b): 0.12% 16.00%

PLGA-PTE 3 x 10K AIBN: 0.12% 16.00%

PVP; Kolidon 30: 0.05% 6.67%

Pluronic 127 F 0.46% 61.33% - Water: 99.25% The transfer matrix composition 10.c:

Total Solids only

Rapamycin (NS10.C): 0.12% 15.00% - PLGA-PTE 3 x 10K AIBN: 0.12% 15.00% PVP; Kolidon 30: 0.10% 12.50% Pluronic 127 F 0.046% 57.50% Water: 99.20% _

Example 5: Ex-vivo test set up

Cut a piece of 50 mm long out of porcine artery with diameter 3.0 mm, this artery is subsequently washed in 10 ml of warm (37⁰C) Phosphor Buffer Saline (PBS).

%-RAPA in Saline (wet).

Put the coated balloon in PBS for 1 minute. The PBS will be analyzed via a

HPLC analyses on RAPA content (=%-RAPA in saline (wet)).

%-RAPA in saline (tissue). Put the artery in 10ml of PBS and insert the artery in the 50mm long artery, performed submerged in PBS. Then inflate the balloon with 13 atm (200psi) for 1 minute. Release pressure and take out balloon. The PBS will be analyzed via a HPLC analyses on RAPA content (=%-RAPA in saline (Tissue)). %-RAPA remaining on balloon. After inflation and deflation within the artery the balloon is put into 2 ml of acetonitrile (Ad ) and vortexed for 3 minutes. From Ad 0.5ml is analyzed via a HPLC on RAPA content (Ad RAPA). This procedure is repeated with 2 ml of acetonitrile (Ac2). From Ad 0.5ml is analyzed via a HPLC on RAPA content (Ac2 RAPA). The total of RAPA remaining on the balloon is determined by adding the RAPA concentrations of both extractions (%-RAPA on balloon = [RAPA Ad] +

[RAPA Ac2]).

%-RAPA in saline (wash); washing step introduced from example 6 to the end: Use pipet to wash all tissues with 10 ml buffered Saline (1 mL each time), all fractions are collected and mixed. Analyze the PBS 10ml washing solution via a HPLC on RAPA content (= %-RAPA in saline (wash)). %-tissue transfer.

The artery used for the transfer experiment is cut open and cut into pieces, subsequently 1 ml of acetonitrile is added and homogenized for 30 seconds. The homogenized artery in acetonitrile is transferred to a centrifuge tube and centrifuged for 15 minutes at 10000 rpm. The supernatant is submitted for a

HPLC analyses which results in the %+tissue transfer. Amount of RAPA on balloon:

= %-RAPA in saline (wet)

+ %-RAPA in saline (tissue) + %-RAPA in saline (wash)

+ %-RAPA remaining on balloon

+ %-tissue transfer.

Balloon application, multiple dips, formulation concentration dependant, in the formulation were used and after each dip the balloon was dried with 5O⁰C air.

Results: Performance data of ex vivo experiments

Ul

Claims

1. A transfer matrix comprising (i) a bioactive agent and (ii) at least one matrix compound selected from the group of hydrophilic polymers having a weight average molecular mass of at least 10 000 g/mol or from the group of amphiphilic macromolecular compounds.

2. A transfer matrix according to claim 1 wherein the hydrophilic polymer or the amphiphilic macromolecular compound is degradable or excretable.

3. A transfer matrix according to any one of the claims 1-2 whereby the hydrophilic polymer is selected from the group of polylactam, polyvinylpyrrolidone, polyvinyl alcohol, polyvinylether, polyesteramide, polylactide, polyglycolide, or polylactide-glycolide copolymers or polycaprolactone.

4. A transfer matrix according to any one of the claims 1 -3 whereby the amphiphilic macromolecular compound is selected from the group of polysorbates, poloxamers, polyoxyethylene alkyl ethers, polyoxyethylene stearates, amphilic polysaccharide derivatives or poloxamines.

5. A transfer matrix according to any one of the claims 1-4, which further comprises a protective layer and/or a primer layer.

6. A transfer matrix according to claim 5 wherein the protective layer comprises a compound selected from the group of cholesterol or polyunsaturated fatty acids.

7. A transfer matrix according to claim 5 wherein the primer layer comprises a compound selected from the group of polyethers, polythioesters or polythioethers.

8. A transfer matrix according to any one of the claims 1-7 wherein the bioactive agent is selected from the group of paclitaxel, docetaxel, estradiol, 17-beta- estradiol, nitric oxide donors, super oxide dismutases, super oxide dismutase mimics, 4-amino-2,2,6,6-tetramethylpiperidine-l-oxyl (4-amino- TEMPO), tacrolimus, dexamethasone, rapamycin, rapamycin derivatives, 40-0-(2- hydroxy)ethyl-rapamycin (everolimus), 40-0-(3-hydroxy)propyl-rapamycin, 40- 0-[2-(2- hydroxy)ethoxy]ethyl-rapamycin, and 40-0-tetrazole-rapamycin, 40- epi-(NI-tetrazolyl)- rapamycin (ABT-578), gamma-hiridun, clobetasol, mometasone, pimecrolimus, imatinib mesylate, or midostaurin, or prodrugs, co-drugs, or combinations of these.

9. A transfer matrix according to any of the preceding claims, wherein the bioactive agent is present in the form of a particle.

10 A transfer matrix according to claim 9 wherein the particle is a micro-, nano- particle or micelle.

11. A transfer matrix according to any one of the claims 9 or 10 wherein the particles further comprise a polymer selected from the group of polyesteramide based on aminoacids, polylactide, polyglycolide, poly(anhydrides), poly(trimethylenecarbonates), poly(orthoesters), poly(dioxanones), poly(ε-caprolactones), poly(urethanes), polythioesters, polyanhydrides, poly(hydroxy acids), polycarbonates, polyaminocarbonates, polyphosphazenes, poly(propylene)fumarates, polyesteramides, polyoxaesters, poly(maleic acids), polyacetals, polyketals, polypeptides, polyhydroxyalkanoates, polysaccharides, carbohydrates, proteins, and polyelectrolytes.

12. A transfer matrix according to any one of the claims 9-11 , wherein the particles are distributed inhomogeneously through the matrix compound.

13. A transfer matrix according to any one of the claims 1 -12 wherein the transfer matrix is to be transferred from an exterior surface of a medical device to an inner surface of the body of a human or vertebrate animal.

14. A transfer matrix according to claim 13 wherein the transfer matrix is to be transferred using a medical device that is to be expanded intraluminally.

15. Transfer matrix according to any one of the preceding claims for medical use.

16. Transfer matrix according to any one of the preceding claims for the preparation of a medicament for treating vascular diseases or circular disturbances.