WO2015032741A1

WO2015032741A1 - Needle insertion and retraction arrangement with manually triggered, spring-loaded drive mechanism

Info

Publication number: WO2015032741A1
Application number: PCT/EP2014/068595
Authority: WO
Inventors: Michael Schabbach; Meinolf WERNER; Olaf Zeckai; Philippe Nzike
Original assignee: Sanofi-Aventis Deutschland Gmbh
Priority date: 2013-09-05
Filing date: 2014-09-02
Publication date: 2015-03-12
Also published as: EP3041529B1; US20160213837A1; HK1223870A1; JP2016530016A; JP6476188B2; US10046111B2; EP3041529A1; DK3041529T3; CN105492040A; CN105492040B; TR201902021T4

Abstract

Disclosed is a needle insertion arrangement (1) with a drive mechanism (9) comprising: a belt (15) frictionally engaging a first roller (10) and a needle retainer (7) with an injection needle (2) fixed to the belt, the first roller being rotatably arranged about an axis (A), a second roller (11) also rotatably arranged about the axis (A), a first spring (13) rotatably biasing the first roller against the second roller, a second spring (14) rotatably biasing the second roller against an arrester (12), the first and the second roller being connected via an internal protrusion (10.2) and arcuate slot (11.2), the two springs (13, 14) biasing the rollers (10, 11) from respective first to respective second angular positions (ΑΡ1₁, AP1₂, AP2₁, AP2₂), and a trigger mechanism (17,20) releasably locking the first and second rollers (10, 11) such that upon pivoting the trigger button (20) in one direction, the first roller drives the belt in one direction to linearly transport the needle retainer towards an extended position, and upon pivoting the trigger button in the other direction, the first roller drives the belt back to retract the needle retainer.

Description

NEEDLE INSERTION AND RETRACTION ARRANGEMENT WITH

MANUALLY TRIGGERED, SPRING-LOADED DRIVE MECHANISM

Technical Field

The invention relates to a drive mechanism for a needle insertion arrangement.

Background of the Invention

Administering an injection is a process which presents a number of risks and challenges for users and healthcare professionals, both mental and physical. During manual insertion of an injection needle into an injection site, e.g. the skin of a patient, it may be difficult to avoid tilting and bending of the needle and the insertion may be slow thus causing pain.

There remains a need for an improved drive mechanism for a needle insertion arrangement.

Summary of the Invention

It is an object of the present invention to provide an improved drive mechanism for a needle insertion arrangement

The object is achieved by a drive mechanism for a needle insertion arrangement according to claim 1 . Exemplary embodiments of the invention are given in the dependent claims.

According to the invention a drive mechanism for a needle insertion arrangement comprises:

- at least one rotatable roller, - at least one spring adapted to bias the roller from a first angular position towards a second angular position,

- a belt adapted to frictionally engage the roller and adapted to be fixed to a needle retainer, and

- a trigger mechanism adapted to releasably lock the roller in the

first angular position.

In an exemplary embodiment the drive mechanism further comprises a needle retainer adapted to retain an injection needle, the needle retainer arranged to be moved between a retracted position and an extended position.

In an exemplary embodiment the drive mechanism further comprises:

- a first roller adapted to frictionally engage the belt and rotatably arranged about an axis,

- a second roller rotatably arranged about the axis,

- a first spring adapted to rotatably bias the first roller against the second roller,

- a second spring adapted to rotatably bias the second roller against an arrester.

In an exemplary embodiment the spring is arranged as a torsion spring.

In an exemplary embodiment the drive mechanism further comprises an arrangement for limiting rotation of the first roller relative the second roller.

In an exemplary embodiment one of the first roller and the second roller comprises an internal protrusion adapted engage an arcuate slot within the other one of the first roller and the second roller.

In an exemplary embodiment the first roller is adapted to maintain the needle retainer in a retracted position when the first roller is in the first angular position and to move the needle retainer from the retracted position into an extended position when the first roller is rotated from the first angular position in a second rotational direction to a second angular position. In an exemplary embodiment the second roller is adapted to rotate the first roller from the second angular position in a first rotational direction to the first angular position through the arrangement for limiting rotation when the second roller is rotated from the first angular position in the first rotational direction to the second angular position thereby moving the needle retainer from the extended position into the retracted position.

In an exemplary embodiment the drive mechanism further comprises two deflection pulleys, wherein the belt is guided over the deflection pulleys, wherein the belt is fixed to the needle retainer between the two deflection pulleys.

In an exemplary embodiment the trigger mechanism comprises:

- at least one external recess arranged in the roller,

- at least one trigger hook with a protrusion adapted to engage the at least one external recess for locking the roller in the first angular position.

In an exemplary embodiment the drive mechanism further comprises:

- a trigger button,

- an engagement surface on the trigger hook adapted to be engaged by the trigger button upon operation.

In an exemplary embodiment the at least one trigger hook and/or the trigger button are/is adapted to be tilted about a respective axis. In an exemplary embodiment the trigger button is adapted to engage one of the trigger hooks thereby disengaging the respective protrusion from the external recess, when the trigger button is tilted in one of the rotational directions, wherein the trigger button is adapted to engage the other one of the trigger hooks thereby disengaging the respective protrusion from the external recess, when the trigger button is tilted in the other one of the rotational directions.

The drive mechanism may be applied in an insertion arrangement for moving an injection needle between a retracted position and an extended position, comprising a disposable unit, comprising a needle base, to which the needle is fixed, and the drive mechanism, wherein the needle retainer is adapted to retain the needle base.

The insertion arrangement has only limited space requirements thus allowing for low profile injection devices with a high wearing comfort. The insertion arrangement achieves high speed needle movements and exact needle guidance thus reducing pain for the patients when inserting and retracting the needle and increasing consumer acceptance and satisfaction. The low part count of the insertion arrangement allows for an increased mechanical robustness and low manufacturing costs. The insertion arrangement is a fault-tolerant system. In the insertion arrangement a single button is used for triggering both needle insertion and needle retraction.

Further scope of applicability of the present invention will become apparent from the detailed description given hereinafter. However, it should be understood that the detailed description and specific examples, while indicating exemplary embodiments of the invention, are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from this detailed description. Brief Description of the Drawings

The present invention will become more fully understood from the detailed description given hereinbelow and the accompanying drawings which are given by way of illustration only, and thus, are not limitive of the present invention, and wherein:

Figure 1 is a schematic perspective view of an exemplary embodiment of an insertion arrangement for inserting an injection needle into an injection site, the insertion arrangement comprising a drive mechanism

Figure 2 is another schematic perspective view of the insertion arrangement,

Figures 3A to 3D are different schematic exploded perspective views of rollers of the drive mechanism, Figure 4 is a schematic side view of the insertion arrangement in an initial position with a needle in a retracted position, Figure 5 is a schematic side view of the insertion arrangement during

operation of a trigger button,

Figure 6 is a schematic side view of the insertion arrangement with the needle in an extended position and after release of the trigger button,

Figure 7 is a schematic side view of the insertion arrangement with the needle in the extended position and during operation of the trigger button, and Figure 8 is a schematic side view of the insertion arrangement with the needle in the retracted position and after release of the trigger button.

Corresponding parts are marked with the same reference symbols in all figures.

Detailed Description

Figure 1 is a schematic perspective view of an exemplary embodiment of an insertion arrangement 1 for automatically or semi-automatically inserting an injection needle 2 into an injection site. Figure 2 is another related perspective view. The arrangement 1 may be applied in medicament pumps, e.g. insulin pumps which may be permanently worn on the body.

The injection needle 2 is part of a disposable unit 3, further comprising a tube 4 for establishing a fluid communication of the needle 2 with a drug container (not illustrated) and comprising a needle base 6, to which the injection needle 2 may be fixed for mechanically connecting the needle 2 to a drive mechanism 9 of an injection unit (not illustrated). The needle base 6 is inserted in a forked needle retainer 7 which is arranged to be moved up and down in a linear guide 8. This linear movement corresponds to insertion of the needle 2 into the injection site, e.g. subcutaneous body tissue and removal from the injection site, respectively.

A drive mechanism 9 for the needle 2 comprises three rollers 10, 1 1 , 12 arranged on a common axis A. Figures 3A to 3D are schematic exploded perspective views of the rollers 10, 1 1 , 12. A first roller 10 is engaged through a first torsion spring 13 to a second roller 1 1 which is in turn engaged through a second torsion spring 14 to a third roller 12. The third roller 12 is rotationally fixed and serves as an arrester for the second torsion spring 14. In an exemplary embodiment the third roller 12 could be replaced by a different arrester with an arbitrary shape. The first roller 10 and the second roller 1 1 are rotatably arranged about the axis A. The first roller 10 and the second roller 1 1 comprise respective external recesses 10.1 , 1 1 .1 which may be used for rotationally locking the first roller 10 and/or the second roller 1 1 in respective first angular positions. The first roller 10 furthermore comprises an internal protrusion 10.2 adapted to be engaged in an arcuate slot 1 1 .2 within the second roller 1 1 for limiting the rotation of the first roller 10 relative the second roller 1 1 . In an alternative embodiment the internal protrusion could be arranged on the second roller 1 1 and the arcuate slot in the first roller 10.

Furthermore, the internal protrusion 10.2 and the arcuate slot 1 1 .2 could be replaced by a different arrangement for limiting the rotation of the first roller 10 relative the second roller 1 1 .

Referring again to figures 1 and 2, the first roller 10 is frictionally engaged by a belt 15 which is guided over two deflection pulleys 16. Between the two deflection pulleys 16 the belt is fixed to the needle retainer 7. If the first roller 10 is rotated, the belt 15 is advanced thereby moving the needle retainer 7 and hence the needle 2. A direction of this movement depends on a rotational direction of the first roller 10. A trigger mechanism 17 is arranged to engage the external recess 10.1 of the first roller 10 and lock it in the first angular position AP1 1 and/or to engage the external recess 1 1 .1 of the second roller 1 1 and lock it in the first angular position API ₂. In an exemplary embodiment the trigger mechanism 17 comprises a first trigger hook 18 with a protrusion 18.1 for engaging the external recess 10.1 of the first roller 10, a second trigger hook 19 with a protrusion 19.1 for engaging the external recess 1 1 .1 of the second roller 1 1 and a trigger button 20 for operating the trigger hooks 18, 19. Each trigger hook 18, 19 further comprises an engagement surface 18.2, 18.3, e.g. in the shape of a spring wire, adapted to be engaged by the trigger button 20 upon operation. In the illustrated exemplary embodiment the trigger hooks 18, 19 and the trigger button 20 are arranged to be tilted about respective axes 18.3, 19.3, 20.1 . When the trigger button 20 is tilted in one rotational direction it engages one of the trigger hooks 18, 19 thereby disengaging the respective protrusion 18.1 , 19.1 from the external recess 10.1 , 1 1 .1 . When the trigger button 20 is tilted in another, opposite, rotational direction it engages the other one of the trigger hooks 19, 18 thereby disengaging the respective protrusion 19.1 , 18.1 from the external recess 1 1 .1 , 10.1 . A spring (not illustrated) may be arranged for biasing the trigger button towards a central position CP where neither the first trigger hook 18 nor the second trigger hook 19 is engaged.

In an alternative embodiment the trigger mechanism 17 could be arranged to linearly move a protrusion in and out of the external recess 10.1 . The torsion springs 13, 14 serve for providing the energy required to move the needle retainer 7. In order to prepare the drive mechanism 9 for an injection the second roller 1 1 is rotated thus charging the torsion springs 13, 14. A cocking arrangement (not illustrated) may be arranged to facilitate rotating the second roller 1 1 . A sequence of operation of the insertion arrangement 1 is as follows:

Figure 4 is a schematic side view of the insertion arrangement 1 in an initial position. The disposable unit 3 with the needle base 6, the needle 2 and the tube 4 has been inserted in the forked needle retainer 7. The first roller 10 is in the first angular position AP1 1 thus maintaining the needle retainer 7 in a retracted position RP through the belt 15. The two torsion springs 13, 14 are cocked. The protrusions 18.1 , 19.1 of the trigger mechanism 17 engage the external recesses 10.1 , 1 1 .1 of the first roller 10 and the second roller 1 1 thus preventing the torsion springs 13, 14 from relaxing and rotating the first and/or second roller 10, 1 1 . The trigger button 20 is in the central position CP neither engaging the first trigger hook 18 nor the second trigger hook 19.

Figure 5 is a schematic side view of the insertion arrangement 1 during operation of the trigger button 20. Starting from the central position CP the trigger button 20 has been tilted about its axis 20.1 in the first rotational direction R1 thus displacing the engagement surface 18.1 of the first trigger hook 18 which is hence tilted about its axis 18.3 in the second rotational direction R2. Thus, the protrusion 18.1 of the first trigger hook 18 disengages the external recess 10.1 of the first roller 10 allowing the first torsion spring 13 to relax and rotate the first roller 10 from the first angular position AP1 i in the second rotational direction R2 to a second angular position AP2i, which may for example be 120 ° offset from the first angular position AP1 i . In the second angular position AP2i the internal protrusion 10.2 of the first roller 10 abuts against an end of the arcuate slot 11 .2 of the second roller 1 1 , which is in the first angular position AP1₂. The rotation of the first roller 10 conveys the belt 15 and hence moves the needle retainer 7 with the needle 2 from the retracted position RP into the extended position EP in order to rapidly insert the needle 2 into an injection site. A needle insertion depth, e.g. in the subcutaneous body tissue, may be determined by the needle retainer 7 abutting a stop (not illustrated) on the linear guide 8 or by the needle retainer 7 abutting one of the deflection pulleys 16.

Figure 6 is a schematic side view of the insertion arrangement 1 with the needle 2 in the extended position EP and after release of the trigger button 20. The trigger button 20 has returned to its central position CP. The first trigger hook 18 cannot return to its prior position as the external recess 10.1 of the first roller 10 is no longer aligned with the protrusion 18.1. The second trigger hook 19 remains engaged to the second roller 1 1 thus preventing the second torsion spring 14 from relaxing and rotating the second roller 1 1 .

Figure 7 is a schematic side view of the insertion arrangement 1 with the needle 2 in the extended position EP and during another operation of the trigger button 20. Starting from the central position CP the trigger button 20 has been tilted about its axis 20.1 in the second rotational direction R2 thus displacing the engagement surface 19.1 of the second trigger hook 19 which is hence tilted about its axis 19.3 in the first rotational direction R1 . Thus, the protrusion 19.1 of the second trigger hook 19 disengages the external recess 1 1 .1 of the second roller 1 1 allowing the second torsion spring 14 to relax and rotate the second roller 1 1 from the first angular position API ₂ in the first rotational direction R1 to a second angular position AP2₂, which may for example be 120 ⁰ offset from the first angular position AP1₂. Due to the internal protrusion 10.2 of the first roller 10 being abutted against an end of the arcuate slot 1 1 .2 of the second roller 1 1 the rotation of the second roller 11 causes rotation of the first roller 10 from its second angular position AP2i in the first rotational direction R1 to the first angular position AP1 i . This rotation conveys the belt 15 and hence moves the needle retainer 7 with the needle 2 from the extended position EP into the retracted position RP in order to retract the needle 2 from the injection site. The rotation of the first roller 10 back into the first angular position AP1 also aligns the external recess 10.1 of the first roller 10 with the protrusion 18.1 of the first trigger hook 18 allowing the protrusion 18.1 to enter the external recess 10.1 and lock the first roller 10 in position. Figure 8 is a schematic side view of the insertion arrangement 1 with the needle 2 in the retracted position RP and after release of the trigger button 20. The trigger button 20 has returned to its central position CP. The first second trigger hook 19 cannot return to its prior position as the external recess 1 1.1 of the second roller 1 1 is no longer aligned with the protrusion 19.1 . The first trigger hook 18 remains engaged to the first roller 10 thus preventing the first torsion spring 13 from relaxing and rotating the first roller 10. Both torsion springs 13, 14 are relaxed.

Another injection can only be performed after the two torsion springs 13, 14 have been re-cocked by rotating the second roller 1 1 back into its first angular position API ₂ in the second rotational direction R2. The second torsion spring 14 is cocked by the rotation as the third roller 12 is fixed in rotation against the axis A. The first torsion spring 13 is cocked by the rotation of the second roller 1 1 as it is engaged to the first roller 10 which is fixed in rotation by the protrusion 18.1 of the first trigger hook 18 engaging the external recess 10.1 of the first roller 10. The rotation of the second roller 1 1 back into the first angular position AP1₂ aligns the external recess 1 1.1 of the second roller 1 1 with the protrusion 19.1 of the second trigger hook 19 allowing the protrusion 19.1 to enter the external recess 1 1 .1 and lock the second roller 1 1 in position. The insertion arrangement 1 would thus arrive in the initial state illustrated in figure 4. A velocity profile of the needle 2 during movement between the retracted position RP and the extended position EP and vice versa can be modified by varying the diameter of the first roller 10. A fast movement of the needle 2 into the retracted position RP and the extended position EP is facilitated by the elasticity of the belt 15 and possible

transmission-slip between the first roller 10 and the belt 15. The term "drug" or "medicament", as used herein, means a pharmaceutical

formulation containing at least one pharmaceutically active compound, wherein in one embodiment the pharmaceutically active compound has a molecular weight up to 1500 Da and/or is a peptide, a proteine, a polysaccharide, a vaccine, a DNA, a RNA, an enzyme, an antibody or a fragment thereof, a hormone or an

oligonucleotide, or a mixture of the above-mentioned pharmaceutically active compound, wherein in a further embodiment the pharmaceutically active compound is useful for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy, thromboembolism disorders such as deep vein or pulmonary thromboembolism, acute coronary syndrome (ACS), angina, myocardial infarction, cancer, macular degeneration, inflammation, hay fever,

atherosclerosis and/or rheumatoid arthritis, wherein in a further embodiment the pharmaceutically active compound comprises at least one peptide for the treatment and/or prophylaxis of diabetes mellitus or

complications associated with diabetes mellitus such as diabetic retinopathy, wherein in a further embodiment the pharmaceutically active compound comprises at least one human insulin or a human insulin analogue or derivative, glucagon-like peptide (GLP-1 ) or an analogue or derivative thereof, or exendin-3 or exendin-4 or an analogue or derivative of exendin-3 or exendin-4. Insulin analogues are for example Gly(A21 ), Arg(B31 ), Arg(B32) human insulin; Lys(B3), Glu(B29) human insulin; Lys(B28), Pro(B29) human insulin; Asp(B28) human insulin; human insulin, wherein proline in position B28 is replaced by Asp, Lys, Leu, Val or Ala and wherein in position B29 Lys may be replaced by Pro; Ala(B26) human insulin;

Des(B28-B30) human insulin; Des(B27) human insulin and Des(B30) human insulin.

Insulin derivates are for example B29-N-myristoyl-des(B30) human insulin; B29-N- palmitoyl-des(B30) human insulin; B29-N-myristoyl human insulin; B29-N-palmitoyl human insulin; B28-N-myristoyl LysB28ProB29 human insulin; B28-N-palmitoyl- LysB28ProB29 human insulin; B30-N-myristoyl-ThrB29LysB30 human insulin; B30-N- palmitoyl- ThrB29LysB30 human insulin; B29-N-(N-palmitoyl-Y-glutamyl)-des(B30) human insulin; B29-N-(N-lithocholyl-Y-glutamyl)-des(B30) human insulin; Β29-Ν-(ω- carboxyheptadecanoyl)-des(B30) human insulin and B29-N-(ω-carboxyheptadecanoyl) human insulin.

Exendin-4 for example means Exendin-4(1 -39), a peptide of the sequence H-His-Gly-

Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe- lle-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH2. Exendin-4 derivatives are for example selected from the following list of compounds:

H-(Lys)4-des Pro36, des Pro37 Exendin-4(1 -39)-NH2,

H-(Lys)5-des Pro36, des Pro37 Exendin-4(1 -39)-NH2,

des Pro36 Exendin-4(1 -39),

des Pro36 [Asp28] Exendin-4(1 -39),

des Pro36 [lsoAsp28] Exendin-4(1 -39),

des Pro36 [Met(0)14, Asp28] Exendin-4(1 -39),

des Pro36 [Met(0)14, lsoAsp28] Exendin-4(1 -39),

des Pro36 [Trp(02)25, Asp28] Exendin-4(1 -39),

des Pro36 [Trp(02)25, lsoAsp28] Exendin-4(1 -39),

des Pro36 [Met(0)14 Trp(02)25, Asp28] Exendin-4(1 -39),

des Pro36 [Met(0)14 Trp(02)25, lsoAsp28] Exendin-4(1 -39); or des Pro36 [Asp28] Exendin-4(1 -39),

des Pro36 [lsoAsp28] Exendin-4(1 -39),

des Pro36 [Met(0)14, Asp28] Exendin-4(1 -39),

des Pro36 [Met(0)14, lsoAsp28] Exendin-4(1 -39),

des Pro36 [Trp(02)25, Asp28] Exendin-4(1 -39),

des Pro36 [Trp(02)25, lsoAsp28] Exendin-4(1 -39),

des Pro36 [Met(0)14 Trp(02)25, Asp28] Exendin-4(1 -39),

des Pro36 [Met(0)14 Trp(02)25, lsoAsp28] Exendin-4(1 -39),

wherein the group -Lys6-NH2 may be bound to the C-terminus of the Exendin-4 derivative; or an Exendin-4 derivative of the sequence

des Pro36 Exendin-4(1 -39)-Lys6-NH2 (AVE0010),

H-(Lys)6-des Pro36 [Asp28] Exendin-4(1 -39)-Lys6-NH2,

des Asp28 Pro36, Pro37, Pro38Exendin-4(1 -39)-NH2,

H-(Lys)6-des Pro36, Pro38 [Asp28] Exendin-4(1 -39)-NH2,

H-Asn-(Glu)5des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1 -39)-NH2,

des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1 -39)-(Lys)6-NH2,

H-(Lys)6-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1 -39)-(Lys)6-NH2,

H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1 -39)-(Lys)6-NH2,

H-(Lys)6-des Pro36 [Trp(02)25, Asp28] Exendin-4(1 -39)-Lys6-NH2,

H-des Asp28 Pro36, Pro37, Pro38 [Trp(02)25] Exendin-4(1 -39)-NH2,

H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(02)25, Asp28] Exendin-4(1-39)-NH2,

H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(02)25, Asp28] Exendin-4(1-39)-NH2, des Pro36, Pro37, Pro38 [Trp(02)25, Asp28] Exendin-4(1 -39)-(Lys)6-NH2,

H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(02)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(02)25, Asp28] Exendin-4(1 -39)-(Lys)6-NH2, H-(Lys)6-des Pro36 [Met(0)14, Asp28] Exendin-4(1 -39)-Lys6-NH2,

des Met(0)14 Asp28 Pro36, Pro37, Pro38 Exendin-4(1 -39)-NH2,

H-(Lys)6-desPro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-NH2,

H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-NH2, des Pro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-(Lys)6-NH2,

H-(Lys)6-des Pro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-(Lys)6-NH2, H-Asn-(Glu)5 des Pro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-(Lys)6-NH2, H-Lys6-des Pro36 [Met(0)14, Trp(02)25, Asp28] Exendin-4(1 -39)-Lys6-NH2,

H-des Asp28 Pro36, Pro37, Pro38 [Met(0)14, Trp(02)25] Exendin-4(1-39)-NH2,

H-(Lys)6-des Pro36, Pro37, Pro38 [Met(0)14, Asp28] Exendin-4(1 -39)-NH2,

H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(0)14, Trp(02)25, Asp28] Exendin-4(1 -39)- NH2,

des Pro36, Pro37, Pro38 [Met(0)14, Trp(02)25, Asp28] Exendin-4(1 -39)-(Lys)6-NH2, H-(Lys)6-des Pro36, Pro37, Pro38 [Met(0)14, Trp(02)25, Asp28] Exendin-4(S1 -39)- (Lys)6-NH2,

H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(0)14, Trp(02)25, Asp28] Exendin-4(1 -39)- (Lys)6-NH2; or a pharmaceutically acceptable salt or solvate of any one of the afore-mentioned Exendin-4 derivative.

Hormones are for example hypophysis hormones or hypothalamus hormones or regulatory active peptides and their antagonists as listed in Rote Liste, ed. 2008, Chapter 50, such as Gonadotropine (Follitropin, Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin), Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin, Buserelin, Nafarelin, Goserelin.

A polysaccharide is for example a glucosaminoglycane, a hyaluronic acid, a heparin, a low molecular weight heparin or an ultra low molecular weight heparin or a derivative thereof, or a sulphated, e.g. a poly-sulphated form of the above-mentioned

polysaccharides, and/or a pharmaceutically acceptable salt thereof. An example of a pharmaceutically acceptable salt of a poly-sulphated low molecular weight heparin is enoxaparin sodium.

Antibodies are globular plasma proteins (-150 kDa) that are also known as

immunoglobulins which share a basic structure. As they have sugar chains added to amino acid residues, they are glycoproteins. The basic functional unit of each antibody is an immunoglobulin (Ig) monomer (containing only one Ig unit); secreted antibodies can also be dimeric with two Ig units as with IgA, tetrameric with four Ig units like teleost fish IgM, or pentameric with five Ig units, like mammalian IgM.

The Ig monomer is a "Y"-shaped molecule that consists of four polypeptide chains; two identical heavy chains and two identical light chains connected by disulfide bonds between cysteine residues. Each heavy chain is about 440 amino acids long; each light chain is about 220 amino acids long. Heavy and light chains each contain intrachain disulfide bonds which stabilize their folding. Each chain is composed of structural domains called Ig domains. These domains contain about 70-1 10 amino acids and are classified into different categories (for example, variable or V, and constant or C) according to their size and function. They have a characteristic immunoglobulin fold in which two β sheets create a "sandwich" shape, held together by interactions between conserved cysteines and other charged amino acids.

There are five types of mammalian Ig heavy chain denoted by α, δ, ε, γ, and μ. The type of heavy chain present defines the isotype of antibody; these chains are found in IgA, IgD, IgE, IgG, and IgM antibodies, respectively.

Distinct heavy chains differ in size and composition; a and γ contain approximately 450 amino acids and δ approximately 500 amino acids, while μ and ε have approximately 550 amino acids. Each heavy chain has two regions, the constant region (CH) and the variable region (V_H). In one species, the constant region is essentially identical in all antibodies of the same isotype, but differs in antibodies of different isotypes. Heavy chains γ, a and δ have a constant region composed of three tandem Ig domains, and a hinge region for added flexibility; heavy chains μ and ε have a constant region composed of four immunoglobulin domains. The variable region of the heavy chain differs in antibodies produced by different B cells, but is the same for all antibodies produced by a single B cell or B cell clone. The variable region of each heavy chain is approximately 1 10 amino acids long and is composed of a single Ig domain. In mammals, there are two types of immunoglobulin light chain denoted by λ and κ. A light chain has two successive domains: one constant domain (CL) and one variable domain (VL). The approximate length of a light chain is 21 1 to 217 amino acids. Each antibody contains two light chains that are always identical; only one type of light chain, K or λ, is present per antibody in mammals.

Although the general structure of all antibodies is very similar, the unique property of a given antibody is determined by the variable (V) regions, as detailed above. More specifically, variable loops, three each the light (VL) and three on the heavy (VH) chain, are responsible for binding to the antigen, i.e. for its antigen specificity. These loops are referred to as the Complementarity Determining Regions (CDRs). Because CDRs from both VH and VL domains contribute to the antigen-binding site, it is the combination of the heavy and the light chains, and not either alone, that determines the final antigen specificity. An "antibody fragment" contains at least one antigen binding fragment as defined above, and exhibits essentially the same function and specificity as the complete antibody of which the fragment is derived from. Limited proteolytic digestion with papain cleaves the Ig prototype into three fragments. Two identical amino terminal fragments, each containing one entire L chain and about half an H chain, are the antigen binding fragments (Fab). The third fragment, similar in size but containing the carboxyl terminal half of both heavy chains with their interchain disulfide bond, is the crystalizable fragment (Fc). The Fc contains carbohydrates, complement-binding, and FcR-binding sites. Limited pepsin digestion yields a single F(ab')2 fragment containing both Fab pieces and the hinge region, including the H-H interchain disulfide bond. F(ab')2 is divalent for antigen binding. The disulfide bond of F(ab')2 may be cleaved in order to obtain Fab'. Moreover, the variable regions of the heavy and light chains can be fused together to form a single chain variable fragment (scFv). Pharmaceutically acceptable salts are for example acid addition salts and basic salts. Acid addition salts are e.g. HCI or HBr salts. Basic salts are e.g. salts having a cation selected from alkali or alkaline, e.g. Na+, or K+, or Ca2+, or an ammonium ion

N+(R1 )(R2)(R3)(R4), wherein R1 to R4 independently of each other mean: hydrogen, an optionally substituted C1 -C6-alkyl group, an optionally substituted C2-C6-alkenyl group, an optionally substituted C6-C10-aryl group, or an optionally substituted C6-C10- heteroaryl group. Further examples of pharmaceutically acceptable salts are described in "Remington's Pharmaceutical Sciences" 17. ed. Alfonso R. Gennaro (Ed.), Mark Publishing Company, Easton, Pa., U.S.A., 1985 and in Encyclopedia of Pharmaceutical Technology.

Pharmaceutically acceptable solvates are for example hydrates.

Those of skill in the art will understand that modifications (additions and/or removals) of various components of the apparatuses, methods and/or systems and embodiments described herein may be made without departing from the full scope and spirit of the present invention, which encompass such modifications and any and all equivalents thereof. List of References

1 insertion arrangement

2 injection needle

3 disposable unit

4 tube

5

6 needle base

7 needle retainer

8 linear guide

9 drive mechanism

10 first roller

10.1 external recess

10.2 internal protrusion

1 1 second roller

1 1 .1 external recess

1 1 .2 arcuate slot

12 third roller

13 first torsion spring

14 second torsion spring

15 belt

16 deflection pulley

17 trigger mechanism

18 first trigger hook

18.1 protrusion

18.2 engagement surface

18.3 axis

19 second trigger hook

19.1 protrusion

19.2 engagement surface

19.3 axis

20 trigger button 20.1 axis

A axis

AP1 i first angular position

AP2i second angular position

AP1₂ first angular position

AP2₂ second angular position

CP central position

R1 first rotational direction

R2 second rotational direction

Claims

1 . Drive mechanism (9) for a needle insertion arrangement (1 ), the drive mechanism (9) comprising:

- a first roller (10) adapted to frictionally engage a belt (15) and rotatably arranged about an axis (A),

- a second roller (1 1 ) rotatably arranged about the axis (A),

- a first spring (13) adapted to rotatably bias the first roller (10) against the second roller (1 1 ) from a first angular position (AP1 1 ) towards a second angular position (AP2i),

- a second spring (14) adapted to rotatably bias the second roller (1 1 ) against an arrester (12) from a first angular position (AP1₂) towards a second angular position (AP2₂)

- a belt (15) adapted to frictionally engage the first roller (10) and adapted to be fixed to a needle retainer (7), and

- a trigger mechanism (17) adapted to releasably lock the roller (10, 1 1 , 12) in the first angular position (AP1 i, AP1₂).

2. Drive mechanism (9) according to claim 1 , comprising a needle retainer (7) adapted to retain an injection needle (2), the needle retainer arranged to be moved between a retracted position (RP) and an extended position (EP).

3. Drive mechanism (9) according to one of the preceding claims, wherein the spring (13, 14) is arranged as a torsion spring.

4. Drive mechanism (9) according to one of the claims 1 to 3, further comprising an arrangement (10.2, 1 1 .2) for limiting rotation of the first roller (10) relative the second roller (1 1 ).

5. Drive mechanism (9) according to claim 4, wherein one of the first roller (10) and the second roller (1 1 ) comprises an internal protrusion (10.2) adapted engage an arcuate slot (1 1 .2) within the other one of the first roller (10) and the second roller (1 1 ).

6. Drive mechanism (9) according to one of the claims 1 to 5, wherein the first roller (10) is adapted to maintain the needle retainer (7) in a retracted position (RP) when the first roller (10) is in the first angular position (AP1 ₁) and to move the needle retainer (7) from the retracted position (RP) into an extended position (EP) when the first roller (10) is rotated from the first angular position (AP1₁) in a second rotational direction (R2) to a second angular position (AP2i).

7. Drive mechanism (9) according to claim 6, wherein the second roller (1 1 ) is adapted to rotate the first roller (10) from the second angular position (AP2i) in a first rotational direction (R1 ) to the first angular position (AP1 i) through the arrangement (10.2, 1 1 .2) for limiting rotation when the second roller (1 1 ) is rotated from the first angular position (API ₂) in the first rotational direction (R1 ) to the second angular position (AP2₂) thereby moving the needle retainer (7) from the extended position (EP) into the retracted position (RP).

8. Drive mechanism (9) according to one of the claims 2 to 7, further comprising two deflection pulleys (16), wherein the belt (15) is guided over the deflection pulleys (16), wherein the belt (15) is fixed to the needle retainer (7) between the two deflection pulleys (16).

9. Drive mechanism (9) according to one of the preceding claims, wherein the trigger mechanism (17) comprises:

- at least one external recess (10.1 , 1 1.1 ) arranged in the roller (10, 1 1 ),

- at least one trigger hook (18, 19) with a protrusion (18.1 , 19.1 ) adapted to engage the at least one external recess (10.1 , 1 1 .1 ) for locking the roller (10, 1 1 ) in the first angular position (AP1 1 , AP1₂).

10. Drive mechanism (9) according to claim 9, further comprising:

- a trigger button (20), - an engagement surface (18.2, 19.2) on the trigger hook (18, 19) adapted to be engaged by the trigger button (20) upon operation.

1 1 . Drive mechanism (9) according to one of the claims 9 or 10, wherein the at least one trigger hook (18, 19) and/or the trigger button (20) are/is adapted to be tilted about a respective axis (18.3, 19.3, 20.1 ).

12. Drive mechanism (9) according to claim 1 1 , wherein the trigger button (20) is adapted to engage one of the trigger hooks (18, 19) thereby disengaging the respective protrusion (18.1 , 19.1 ) from the external recess (10.1 , 1 1 .1 ), when the trigger button

(20) is tilted in one of the rotational directions (R1 , R2), wherein the trigger button (20) is adapted to engage the other one of the trigger hooks (18, 19) thereby disengaging the respective protrusion (18.1 , 19.1 ) from the external recess (10.1 , 1 1 .1 ), when the trigger button (20) is tilted in the other one of the rotational directions (R1 , R2).

13. Insertion arrangement (1 ) for moving an injection needle (2) between a retracted position (RP) and an extended position (EP), comprising a disposable unit (3), comprising a needle base (6), to which the needle (2) is fixed, and a drive mechanism (9) according to one of the preceding claims, wherein the needle retainer (7) is adapted to retain the needle base (6).