Classifications

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  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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  • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
  • A61K9/167—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction with an outer layer or coating comprising drug; with chemically bound drugs or non-active substances on their surface
• • A—HUMAN NECESSITIES
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  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
  • A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
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  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
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  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/55—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being also a pharmacologically or therapeutically active agent, i.e. the entire conjugate being a codrug
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  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/554—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being a steroid plant sterol, glycyrrhetic acid, enoxolone or bile acid
• • A—HUMAN NECESSITIES
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  • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
  • A61K47/6921—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere
• • A—HUMAN NECESSITIES
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  • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
  • A61K47/6953—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a fibre, a textile, a slab or a sheet
• • A—HUMAN NECESSITIES
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  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
  • A61K9/0024—Solid, semi-solid or solidifying implants, which are implanted or injected in body tissue
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• • A—HUMAN NECESSITIES
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  • A61K9/0092—Hollow drug-filled fibres, tubes of the core-shell type, coated fibres, coated rods, microtubules or nanotubes
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  • A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
  • A61K9/7007—Drug-containing films, membranes or sheets
• • A—HUMAN NECESSITIES
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  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
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• • A—HUMAN NECESSITIES
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  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J5/00—Normal steroids containing carbon, hydrogen, halogen or oxygen, substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane and substituted in position 21 by only one singly bound oxygen atom, i.e. only one oxygen bound to position 21 by a single bond
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J7/00—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms
  • C07J7/0005—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms not substituted in position 21
  • C07J7/001—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms not substituted in position 21 substituted in position 20 by a keto group
  • C07J7/004—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms not substituted in position 21 substituted in position 20 by a keto group substituted in position 17 alfa
  • C07J7/005—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms not substituted in position 21 substituted in position 20 by a keto group substituted in position 17 alfa substituted in position 16
  • C07J7/0055—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of two carbon atoms not substituted in position 21 substituted in position 20 by a keto group substituted in position 17 alfa substituted in position 16 by a saturated or unsaturated hydrocarbon group
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J9/00—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane
  • C07J9/005—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane containing a carboxylic function directly attached or attached by a chain containing only carbon atoms to the cyclopenta[a]hydrophenanthrene skeleton

Definitions

• Dexamethasone is a useful drug in a variety of medical fields, for example in the treatment of inflammatory diseases or conditions and in reducing inflammation associated with surgery or another therapy.
• the disclosure features prodrug dimers formed from dexamethasone and articles formed from the dimers.
• the articles of the disclosure can be machined, molded, emulsion-processed, electrospun, electrosprayed, blow molded, or extruded to form a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, microparticle (e.g., a microbead), nanoparticle (e.g., a nanobead), or any other type shaped article from which the dexamethasone prodrug dimer is released in a controlled fashion.
• microparticle e.g., a microbead
• nanoparticle e.g., a nanobead
• the disclosure features an article formed from a compound of the disclosure, wherein the article provides controlled release of dexamethasone at 37 °C in 100% bovine serum or at 37 °C in PBS.
• the disclosure features compound described by the formula (I):
• n is an integer from 1 to 6 (e.g., wherein n is 1 , 2, 3, 4, 5, or 6). In some embodiments, n is 1 . In further embodiments, n is 2. In particular embodiments, n is 3. In other embodiments, n is 4. In further embodiments, n is 5. In yet other embodiments, n is 6.
• the disclosure features a pharmaceutical composition including the compound of the previous aspect, and a pharmaceutically acceptable excipient.
• the disclosure features an article including Compound 6 or a compound of formula (I):
• the article provides controlled release of dexamethasone at 37 °C in 100% bovine serum or at 37 °C in PBS; wherein n is an integer from 1 to 6.
• dexamethasone is released from the article through surface erosion.
• the article releases less than 10% of dexamethasone, as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in 100% bovine serum over 5 days; or the surface erosion releases less than 2% of dexamethasone, as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in PBS over 5 days; or the surface erosion releases greater than 20% of dexamethasone, as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in 100% bovine serum over not fewer than 6 days; or the surface erosion releases greater than 5.0% of dexamethasone as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in PBS over not fewer than 6 days; or dexamethasone is released from the article at a rate such that tio is greater than or equal to 1/10 of tso
• the article further includes from 0.1 % to 10% (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• the article is a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, hollow tube, microparticle, nanoparticle, or shaped article.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient.
• the article is in a glassy state.
• the controlled release is provided by any one of: dimensions of the article, composition of the article, crystallinity of the article, surface area of the article, or combinations thereof.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; and (b) heat molding the melt to form the article, wherein n is an integer from 1 to 6 .
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; and (b) injection molding the melt to form the article, wherein n is an integer from 1 to 6.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; and (b) blow molding the melt to form the article, wherein n is an integer from 1 to 6.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features an article including a compound of formula (I):
• step (b) includes solvent casting to form a film or a fiber.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) dissolving the compound to form a solution; and (b) electrospinning or electrospraying the solution to form the article, wherein n is an integer from 1 to 6.
• the article is free of controlled release excipient, free of a
• crystallization inhibiting excipient free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; and (b) electrospinning or electrospraying the melt to form the article, wherein n is an integer from 1 to 6.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; (b) extruding the melt to form the article, wherein n is an integer from 1 to 6.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• n is 1 . In further embodiments, n is 2. In certain embodiments of the articles of the disclosure, n is 3. In other embodiments, n is 4. In further embodiments, n is 5. In yet other embodiments, n is 6.
• the disclosure features an article formed from a compound of the disclosure.
• At least 70% e.g., at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or at least 99%
• at least 90% e.g., at least 91 %, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%
• w/w of the article is the compound of formula (I).
• the compound or dexamethasone is released from the article through surface erosion.
• the surface erosion releases less than 10% (e.g., less than 9%, less than 8%, less than 7%, less than 6%, less than 5%, less than 4%, less than 3%, less than 2%, or less than 1 %) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the article in prodrug form, at 37 °C in 100% bovine serum over 5 days; or the surface erosion releases less than 2% (e.g., less than 1 .8%, less than 1 .5%, less than 1 .2%, less than 1 .0%, or less than 0.5%) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the article in prodrug form, at 37 °C in PBS over 5 days.
• the surface erosion releases greater than 20% (e.g., greater than 22%, 24%, 26%, 28%, or 30%) of dexamethasone (as a percentage of the total dexamethasone present in the article in prodrug form) at 37 °C in 100% bovine serum over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 24% of dexamethasone at 37 °C in 100% bovine serum over 10 days).
• dexamethasone as a percentage of the total dexamethasone present in the article in prodrug form
• the surface erosion releases greater than 5.0% (e.g., greater than 6.0%, 8.0%, 10%, 12%, or 15%) of dexamethasone (as a percentage of the total dexamethasone present in the article in prodrug form) at 37 °C in PBS over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 5% of dexamethasone at 37 °C in PBS over 10 days).
• the dexamethasone can be released from the article at a rate such that tio is greater than or equal to 1 /10 of tso.
• the article further includes from 0.1 % to 10% (e.g., from 0.1 to 5%, from 0.1 to 2%, from 0.5 to 2%, from 1 to 10%) (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• the article may be a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, hollow tube, microparticle (e.g., a microbead), nanoparticle (e.g., a nanobead), or shaped article.
• the article is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the article optionally has a glassy state.
• the disclosure features a fiber formed from a compound of the disclosure. In another aspect, the disclosure features a fiber formed from a compound of formula (I):
• the fiber is prepared by a process including the steps of: (a) dissolving the compound in a solvent to form a solution; and (b) electrospinning, dry spinning, wet spinning, or gel spinning the solution to form the fiber, wherein n is an integer from 1 to 6.
• the fiber is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the fiber optionally has a glassy state.
• the disclosure features a fiber formed from a compound of formula (I):
• the fiber is prepared by a process including the steps of: (a) heating the compound to form a melt; and (b) extruding the melt to form the fiber (i.e., melt spinning), wherein n is an integer from 1 to 6.
• the fiber is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the fiber optionally has a glassy state.
• the disclosure features a fiber formed from a compound of formula (I):
• the fiber is prepared by a process including the steps of: (a) heating the compound to form a melt; and (b) electrospinning the melt to form the fiber, wherein n is an integer from 1 to 6.
• the fiber is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the fiber optionally has a glassy state.
• n is 1 . In further embodiments, n is 2. In particular embodiments of the fibers of the disclosure, n is 3. In another embodiment, n is 4. In further embodiments, n is 5. In yet other embodiments, n is 6.
• At least 70% e.g., at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or at least 99%
• at least 90% e.g., at least 91 %, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%
• w/w of the fiber is the compound of formula (I).
• the compound or dexamethasone is released from the fiber through surface erosion.
• the surface erosion releases less than 10% (e.g., less than 9%, less than 8%, less than 7%, less than 6%, less than 5%, less than 4%, less than 3%, less than 2%, or less than 1 %) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the fiber in prodrug form, at 37 °C in 100% bovine serum over 5 days; or the surface erosion releases less than 2% (e.g., less than 1 .8%, less than 1 .5%, less than 1 .2%, less than 1 .0%, or less than 0.5%) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the fiber in prodrug form, at 37 °C in PBS over 5 days.
• the surface erosion releases greater than 20% (e.g., greater than 22%, 24%, 26%, 28%, or 30%) of dexamethasone (as a percentage of the total dexamethasone present in the fiber in prodrug form) at 37 °C in 100% bovine serum over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 24% of dexamethasone at 37 °C in 100% bovine serum over 10 days).
• dexamethasone as a percentage of the total dexamethasone present in the fiber in prodrug form
• the surface erosion releases greater than 5.0% (e.g., greater than 6.0%, 8.0%, 10%, 12%, or 15%) of dexamethasone (as a percentage of the total dexamethasone present in the fiber in prodrug form) at 37 °C in PBS over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 5% of dexamethasone at 37 °C in PBS over 10 days).
• dexamethasone as a percentage of the total dexamethasone present in the fiber in prodrug form
• the dexamethasone can be released from the fiber at a rate such that tio is greater than or equal to 1 /10 of tso
• the fiber further includes from 0.1 % to 10% (e.g., from 0.1 to 5%, from 0.1 to 2%, from 0.5 to 2%, from 1 to 10%) (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radioopaque agents, and mixtures thereof.
• the fiber is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the fiber optionally has a glassy state.
• the disclosure features a fiber mesh or woven fabric formed from a fiber of the disclosure.
• the disclosure further features a non-woven fabric formed from a fiber of the disclosure.
• the fiber mesh, woven fabric, and non-woven fabric can be formed from the fibers using methods known in the art.
• the fiber mesh is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the fiber mesh optionally has a glassy state.
• the disclosure features a glassy state composition formed from a compound of the disclosure.
• the disclosure features glassy state composition formed from a compound of formula (I):
• the composition is prepared by a process including the steps of: (a) heating the compound to form a melt; and (b) cooling the melt to form the composition, wherein n is an integer from 1 to 6.
• the glassy state composition is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient.
• n is 1 . In further embodiments, n is 2. In some embodiments of the glassy state compositions of the disclosure, n is 3. In other embodiments, n is 4. In yet other embodiments, n is 5. In yet other embodiments, n is 6.
• At least 70% e.g., at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or at least 99%
• at least 90% e.g., at least 91 %, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%
• w/w of the glassy state composition is the compound of formula (I).
• the compound or dexamethasone is released from the glassy state composition through surface erosion.
• the surface erosion releases less than 10% (e.g., less than 9%, less than 8%, less than 7%, less than 6%, less than 5%, less than 4%, less than 3%, less than 2%, or less than 1 %) of dexamethasone (as a percentage of the total drug, dexamethasone, present in the glassy state composition in prodrug form) at 37 °C in 100% bovine serum over 5 days.
• the surface erosion releases less than 2.0% (e.g., less than 1 .8%, 1 .5%, 1 .2%, 1 .0%, or 0.5%) of dexamethasone (as a percentage of the total drug, dexamethasone, present in the glassy state composition in prodrug form) at 37 °C in PBS over 5 days, 7 days, 10 days, or 14 days (e.g., less than 2% of dexamethasone at 37 °C in PBS over 5 days).
• the surface erosion releases greater than 20% (e.g., greater than 22%, 24%, 26%, 28%, or 30%) of dexamethasone (as a percentage of the total
• dexamethasone present in the glassy state composition in prodrug form at 37 °C in 100% bovine serum over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 24% of dexamethasone at 37 °C in 100% bovine serum over 10 days).
• the surface erosion releases greater than 5.0% (e.g., greater than 6.0%, 8.0%, 10%, 12%, or 15%) of dexamethasone (as a percentage of the total dexamethasone present in the glassy state composition in prodrug form) at 37 °C in PBS over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 5% of dexamethasone at 37 °C in PBS over 10 days).
• the dexamethasone can be released from the glassy state composition at a rate such that tio is greater than or equal to 1/10 of tso
• the glassy state composition further includes from 0.1 % to 10% (e.g., from 0.1 to 5%, from 0.1 to 2%, from 0.5 to 2%, from 1 to 10%) (w/w) of one or more additives, wherein the one or more additives are selected from
• the glassy state composition can be formed by machining, molding, electrospinning, electrospraying, blow molding, fiber spinning (e.g., wet spinning, dry spinning, gel spinning, melt spinning, etc.), or extruding.
• the glassy state composition is a fiber, fiber mesh, woven fabric, non- woven fabric, pellet, cylinder, hollow tube, microparticle (e.g., a microbead), nanoparticle (e.g., a nanobead), or shaped article in the shape of a cylinder, a cube, a sheet, a star, a toroid, a pyramid, a sphere, an irregular polygon, or a regular polygon.
• the glassy state composition is a shaped article in the form of fibers having a mean diameter of from about 0.01 to 1 mm (e.g., 0.05 to 0.3 mm, 0.1 to 0.3 mm, 0.15 to 0.3 mm, 0.2 to 0.3 mm, 0.25 to 0.3 mm, 0.01 to 0.1 mm, 0.01 to 0.2 mm, 0.01 to 0.3 mm, 0.01 to 0.4 mm, 0.01 to 0.5 mm, 0.01 to 0.6 mm, 0.01 to 0.7 mm, 0.01 to 0.8 mm, or 0.01 to 0.9 mm).
• 0.01 to 1 mm e.g., 0.05 to 0.3 mm, 0.1 to 0.3 mm, 0.15 to 0.3 mm, 0.2 to 0.3 mm, 0.25 to 0.3 mm, 0.01 to 0.1 mm, 0.01 to 0.2 mm, 0.01 to 0.3 mm, 0.01 to 0.4 mm, 0.01 to 0.5 mm, 0.01 to 0.6 mm, 0.01
• the glassy state composition is a shaped article in the form of pellets having a mean diameter of from about 0.2 to 5 mm (e.g., from about 0.2 to 1 mm, from about 0.2 to 2 mm, from about 0.3 to 3 mm, from about 1 .5 to 5 mm, from about 2 to 5 mm, from about 2.5 to 5 mm, from about 3 to 5 mm, from about 3.5 to 5 mm, from about 4 to 5 mm, or from about 4.5 to 5 mm).
• a mean diameter of from about 0.2 to 5 mm (e.g., from about 0.2 to 1 mm, from about 0.2 to 2 mm, from about 0.3 to 3 mm, from about 1 .5 to 5 mm, from about 2 to 5 mm, from about 2.5 to 5 mm, from about 3 to 5 mm, from about 3.5 to 5 mm, from about 4 to 5 mm, or from about 4.5 to 5 mm).
• the glassy state composition is a shaped article in the form of cylinders of from about 0.01 to 1 mm in diameter (e.g., about 0.01 to 0.2 mm, about 0.1 to 0.3 mm, about 0.1 to 0.4 mm, about 0.2 to 0.5 mm, about 0.1 to 0.6 mm, about 0.1 to 0.7 mm, about 0.1 to 0.8 mm, or about 0.1 to 0.9 mm) and 0.5 to 20 mm in length (e.g., about to 0.5 to 1 mm, about 0.5 to 2 mm, about 0.5 to 4 mm, about 0.5 to 6 mm, about 0.5 to 8 mm, about 0.5 to 10 mm, about 0.5 to 12 mm, about 0.5 to 14 mm, about 0.5 to 16 mm, or about 0.5 to 18 mm).
• the length of the cylinder is about 0.5 to 10mm, or about 1 to 10 mm.
• the glassy state composition is a shaped article in the form of microparticles having a mean diameter of from about 1 to 1000 pm (e.g., about 10 to 1000 pm, about 100 to 1000 pm, about 200 to 1000 pm, about 500 to 1000 pm, about 700 to 1000 pm, or about 900 to 1000 pm).
• the glassy state composition is a shaped article in the form of nanoparticles having a mean diameter of from about 0.01 to 1 pm (about 0.05 to 1 pm, about 0.1 to 1 pm, about 0.2 to 1 pm, about 0.3 to 1 pm, about 0.4 to 1 pm, about 0.5 to 1 pm, about 0.6 to 1 pm, about 0.7 to 1 pm, about 0.8 to 1 pm, or about 0.9 to 1 pm).
• the glassy state composition is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient.
• the disclosure features a substrate including a coating formed from a compound of the disclosure.
• the disclosure features a substrate including a coating formed from a compound of formula (I):
• the coating is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the coating optionally has a glassy state.
• n is 1 . In further embodiments, n is 2. In certain embodiments of the substrates of the disclosure, n is 3. In other embodiments, n is 4. In still other embodiments, n is 5. In yet other embodiments, n is 6.
• At least 70% e.g., at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or at least 99%
• at least 90% e.g., at least 91 %, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%
• w/w of the coating is the compound of formula (I).
• the compound or dexamethasone is released from the coating through surface erosion.
• the surface erosion releases less than 10% (e.g., less than 9%, less than 8%, less than 7%, less than 6%, less than 5%, less than 4%, less than 3%, less than 2%, or less than 1 %) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the coating in prodrug form, at 37 °C in 100% bovine serum over 5 days; or the surface erosion releases less than 2% (e.g., less than 1 .8%, less than 1 .5%, less than 1 .2%, less than 1 .0%, or less than 0.5%) of dexamethasone, as a percentage of the total drug, dexamethasone, present in the coating in prodrug form, at 37 °C in PBS over 5 days.
• the surface erosion releases greater than 20% (e.g., greater than 22%, 24%, 26%, 28%, or 30%) of dexamethasone (as a percentage of the total dexamethasone present in the coating in prodrug form) at 37 °C in 100% bovine serum over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 24% of dexamethasone at 37 °C in 100% bovine serum over 10 days).
• dexamethasone as a percentage of the total dexamethasone present in the coating in prodrug form
• the surface erosion releases greater than 5.0% (e.g., greater than 6.0%, 8.0%, 10%, 12%, or 15%) of dexamethasone (as a percentage of the total dexamethasone present in the coating in prodrug form) at 37 °C in PBS over not fewer than 6 days, 8 days, 10 days, or 12 days (e.g., greater than 5% of dexamethasone at 37 °C in PBS over 10 days).
• the dexamethasone can be released from the coating at a rate such that tio is greater than or equal to 1/10 of tso
• the coating further includes from 0.1 % to 10% (e.g., from 0.1 to 5%, from 0.1 to 2%, from 0.5 to 2%, from 1 to 10%) (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• the coating is a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, hollow tube, microparticle (e.g., a microbead), nanoparticle (e.g., a nanobead), or other shaped article.
• the coating is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the coating optionally has a glassy state.
• the coating has a glassy state and is formed from a compound of the disclosure.
• the disclosure features a coating having a glassy state formed from a compound of the disclosure.
• the disclosure features an implantable medical device including a substrate of the disclosure, wherein the coating resides on the surface of the implantable medical device.
• the disclosure features a method of forming an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) heating the compound to form a melt; (b) cooling the melt to form a glassy state composition; and (c) heating the glassy state composition to a temperature above the glass transition temperature of the glassy state composition and shaping the glassy state composition to form a shaped article, wherein n is an integer from 1 to 6.
• Step (c) can include extruding, molding, blow molding, heat spinning, electrospinning, or electrospraying the glassy state composition to form the shaped article.
• the method forms an article free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the method forms an article that optionally has a glassy state.
• the disclosure features a method of forming an article including a compound of formula (I):
• the article is formed by a process including the steps of: (a) dissolving the compound in a solvent to form a solution; (b) evaporating the solvent to form a glassy state composition; and (c) heating the glassy state composition to a temperature above the glass transition temperature of the glassy state composition and shaping the glassy state composition to form a shaped article, wherein n is an integer from 1 to 6.
• Step (c) can include extruding, molding, blow molding, heat spinning, electrospinning, or electrospraying the glassy state composition to form the shaped article.
• step (c) includes molding, extruding, blow molding, electrospinning, heat spinning, or electrospraying the glassy state composition to form the shaped article (e.g., a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, microparticle (e.g., a microbead), or nanoparticle (e.g., a nanobead), or another shaped article).
• the shaped article e.g., a fiber, fiber mesh, woven fabric, non-woven fabric, pellet, cylinder, microparticle (e.g., a microbead), or nanoparticle (e.g., a nanobead), or another shaped article).
• microparticles are prepared by melting the compound to form glassy state pellets or other shaped forms, crushing the glassy state articles into rough or irregular- shaped particles, filtering particles through sieves, and heating the particles above the Tg to round them into smoother spherical particles.
• the method produces an article free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the method produces an article that optionally has a glassy state.
• the disclosure features a method of forming an article comprising a compound of formula (I):
• n is an integer from 1 to 6, and wherein the article is formed by a process comprising the steps of: (a) dissolving the compound in a solvent to form a solution; (b) electrospraying the solution to form a glassy state composition; and (c) heating the glassy state composition to a temperature above the glass transition temperature of the glassy state composition and shaping the glassy state composition to form a coating; wherein n is an integer from 1 to 6.
• the method forms an article that is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the method forms an article that optionally has a glassy state.
• the disclosure features a solid crystalline form of Compound 1 having an X-ray powder diffraction (XRPD) pattern including three, four, five, or more angles 2Q (°) of 9.316°, 1 1 .501 °,
• XRPD X-ray powder diffraction
• the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 2Q (°) of 9.316°. In some embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 2Q (°) of 1 1 .501 °. In some embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 2Q (°) of 14.019°. In further embodiments, the solid crystalline form of
• Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 15.982°. In still further embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 17.268°. In other embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 17.685°. In further embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 18.658°.
• the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 20.440°. In some embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 21.782°. In certain embodiments, the solid crystalline form of
• Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 23.472°. In still other embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 29.816°. In particular embodiments, the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak at diffraction angle 20 (°) of 33.150°.
• the solid crystalline form of Compound 1 has an XRPD pattern including at least one peak diffraction angle 20 (°) of 9.316°, 11.501 °, 14.019°, 15.982°, 17.268°, 17.685°, 18.658°, 20.440°, 21.782°, 23.472°, 29.816°, and 33.150°.
• the disclosure features Compound 6.
• the disclosure also includes a pharmaceutical composition comprising Compound 6 and a pharmaceutically acceptable excipient.
• free of controlled release polymer refers to the absence of an amount of a polymeric material of greater than 10 KDa in the articles of the disclosure that is sufficient to delay or slow the release of the dexamethasone prodrug dimer from the article in comparison to the release profile observed for an otherwise identical article containing none of the polymeric material, where the release profile is measured at 37 °C in 100% fetal bovine serum (FBS).
• FBS fetal bovine serum
• the term“free of a crystallization inhibiting excipient,” as used herein, refers to the absence of an amount of an excipient in the articles of the disclosure that is sufficient to reduce the amount of crystalline dexamethasone prodrug dimer in the article in comparison to the amount of crystalline dexamethasone prodrug dimer observed in an otherwise identical article containing none of the excipient.
• the level of crystallinity can be measured using DSC or XRD.
• the articles of the disclosure are free of a crystallization inhibiting excipient that is a polymeric material of greater than 10 KDa.
• the term“free of a mechanical integrity enhancing excipient,” as used herein, refers to the absence of an amount of an excipient in the articles of the disclosure that is sufficient to increase the mechanical integrity of the article in comparison to the mechanical integrity of an otherwise identical article containing none of the excipient.
• the mechanical integrity of an article can be tested using a 3- or 4-point mechanical bend test (ASTM C1684-18) on the formulation with or without the excipient with the article in the shape of a rod either in the dry state (prior to drug release) or after 15-30% drug release.
• the mechanical integrity can be tested using a 3-point mechanical bend test (ASTM D790-17) or 4-point mechanical bend test (ASTM D6272) on the formulation with or without excipient either in the dry state (prior to drug release) or after 15-30% drug release.
• a reduction in mechanical integrity causes the articles to break apart sooner, increasing the total surface area of the quantity of articles, and resulting in a more rapid release profile.
• the articles of the disclosure are free of a mechanical integrity enhancing excipient that is a polymeric material of greater than 10 KDa.
• the term“free of a binding excipient,” as used herein, refers to the absence of an amount of an excipient in the articles of the disclosure that is sufficient to delay or slow the release of the
• dexamethasone prodrug dimer from the article in comparison to the release profile observed for an otherwise identical article containing none of the binding excipient, where the release profile is measured at 37 °C in 100% FBS.
• cylinder refers to the shape of the pharmaceutical compositions of the disclosure that has parallel sides and a circular or oval cross section, or a shaped cross section (e.g., a star shaped cross section).
• a mean diameter of the cylinder can range from about 0.01 to 1 mm diameter, e.g., about 0.01 to 0.2 mm, about 0.1 to 0.3 mm, about 0.1 to 0.4 mm, about 0.2 to 0.5 mm, about 0.1 to 0.6 mm, about 0.1 to 0.7 mm, about 0.1 to 0.8 mm, or about 0.1 to 0.9 mm.
• a mean length of the cylinder can range from about 0.05 to 20 mm, e.g., about 0.05 to 1 mm, about 0.5 to 2 mm, about 0.5 to 4 mm, about 0.5 to 6 mm, about 0.5 to 8 mm, about 0.5 to 10 mm, about 0.5 to 12 mm, about 0.5 to 14 mm, about 0.5 to 16 mm, or about 0.5 to 18 mm.
• the mean diameter of the cylinder is in the range of about 0.01 to 1 mm and the mean length of the cylinder is about 0.1 mm to 4.0 mm.
• the mean length of the cylinder is about 0.5 to 10 mm, or about 1 to 10 mm.
• a mean diameter of the fiber can range from about 0.01 to 1 mm, e.g., 0.05 to 0.3 mm, 0.1 to 0.3 mm, 0.15 to 0.3 mm, 0.2 to 0.3 mm, 0.25 to 0.3 mm, 0.01 to 0.1 mm, 0.01 to 0.2 mm, 0.01 to 0.3 mm, 0.01 to 0.4 mm, 0.01 to 0.5 mm, 0.01 to 0.6 mm, 0.01 to 0.7 mm, 0.01 to 0.8 mm, or 0.01 to 0.9 mm.
• a mean length of the fiber can range from about 20 to 20,000 mm, e.g.
• fiber mesh refers to a web or a net in having many attached or woven fibers.
• the fiber mesh can have aligned and unaligned morphologies.
• glassy state refers to an amorphous solid including greater than 70%, 80%, 90%, 95%, 98%, or 99% (w/w) of one or more dexamethasone prodrug dimers of the disclosure and exhibiting a glass transition temperature in the range of from 38 to 150 °C.
• the level of crystallinity is low, ranging from 0-15%, e.g., 0-1 %, 0-3%, 0-5%, 0- 7%, 0-9%, 0-10%, or 0-13%.
• Glass formulations of the disclosure can be formed using heat processing or solvent processing one or more dexamethasone prodrug dimers.
• microparticle refers to the shape of the pharmaceutical compositions of the disclosure, which can be regularly or irregularly shaped.
• a mean diameter of the microparticle can range from about 1 to 1000 pm, e.g., about 10 to 1000 pm, about 100 to 1000 pm, about 200 to 1000 pm, about 500 to 1000 pm, about 700 to 1000 pm, or about 900 to 1000 pm.
• a microbead is a microparticle that is spherical.
• nanoparticle refers to the shape of the pharmaceutical compositions of the disclosure, which can be regularly or irregularly shaped.
• a mean diameter of the nanoparticle can range from about 0.01 to 1 pm, e.g., about 0.05 to 1 pm, about 0.1 to 1 pm, about 0.2 to 1 pm, about 0.3 to 1 pm, about 0.4 to 1 pm, about 0.5 to 1 pm, about 0.6 to 1 pm, about 0.7 to 1 pm, about 0.8 to 1 pm, or about 0.9 to 1 pm.
• a“nanobead” refers to a nanoparticle that is spherical.
• non-woven fabric refers to a web structure bonded together by entangling fibers.
• pellet refers to the shape of the pharmaceutical compositions of the disclosure that is rounded, spherical, or cylindrical, or a combination thereof.
• a mean diameter of the pellet can range from about 0.2 to 5 mm, e.g., from about 0.2 to 1 mm, from about 0.2 to 2 mm, from about 0.3 to 3 mm, from about 1 .5 to 5 mm, from about 2 to 5 mm, from about 2.5 to 5 mm, from about 3 to 5 mm, from about 3.5 to 5 mm, from about 4 to 5 mm, or from about 4.5 to 5 mm.
• surface erosion refers to a process of a gradual disintegration of the pharmaceutical compositions of the disclosure and release of a free drug from the dexamethasone prodrug dimer.
• Surface erosion can be tailored to achieve desired drug release rates.
• the rate of surface erosion and release of a given drug from a dexamethasone prodrug dimer may also depend on the quantity of the loaded dexamethasone prodrug dimer as a percent of the final dexamethasone prodrug dimer formulation, article size, solubility of dexamethasone prodrug dimer (e.g., through selection of appropriate linker), and/or surface area of the article.
• surface erosion mechanism of drug release allows drug delivery articles to be tailored with specific physical features (dimensions, diameters, surface areas, total mass, etc.) to achieve desired drug release rates, and drug release may be designed to be initiated within minutes or hours, and may continue to occur over days, weeks, months, or years.
• tso is the time at which 50% of the releasable drug has been released from an article of the disclosure.
• Time tio is, correspondingly, the time at which 10% of the releasable drug has been released from an article of the disclosure.
• tio 1/5 of tso.
• tio is much less than 1/5 of tso.
• tio can be equal to or greater than 1/10 of tso.
• Drug release from an article or compound of the disclosure can be measured at 37 °C in 100% bovine serum, or at 37 °C in PBS, as described in Example 1 .
• woven fabric refers to pharmaceutical compositions that resemble materials that are formed by weaving of fibers.
• Figs. 1A-1 F are a series of images and graphs showing Compound 1 (dexamethasone-triethylene glycol-dexamethasone, Dex-TEG-Dex) (Fig. 1 A) formed into pellets (Fig. 1 B) in the glassy state. Results of testing by differential scanning calorimetry (DSC) (Fig. 1 C) and X-ray powder diffraction (XRPD) (Fig. 1 D) are shown, and drug release over time was determined (Fig. 1 E). Fig. 1 F shows representative images of the pellets over time.
• DSC differential scanning calorimetry
• XRPD X-ray powder diffraction
• Figs. 2A-2E are a series of images showing Compound 1 processed into heat-molded pellets (Fig. 2A), extruded cylinders (Figs. 2B and 2C), glass droplets (Fig. 2D), and fibers (Fig. 2E).
• Figs. 3A-3K are a series of images and graphs showing Compound 1 coated onto titanium (Fig. 3A) and poly(styrene-block-isobutylene-block-styrene) (SIBS) surfaces (Fig. 3B), as well as non-woven fibrous meshes aligned (Fig. 3C) and unaligned (Fig. 3D) morphologies and DSC (Fig. 3E) and XRPD data (Fig. 3F).
• Compound 1 was processed into fibers (Fig. 3G), nanoparticles (Fig. 3H), microparticles (Figs. 3I and 3J). Microparticles were analyzed by DSC (Fig. 3K).
• Fig. 4 is a graph showing drug release of pellets of Compound 1 in 100% FBS over time.
• Fig. 5 is a graph showing representative fracture force.
• Figs. 6A and 6B are a series of graphs showing purity of Compound 1 pre- and post-ethylene oxide gas sterilization (Fig. 6A) and drug release (Fig. 6B).
• Figs. 7A-7F are a series of images and graphs showing Compound 1 formed into heat extruded cylinders (Figs. 7A-7D), purity of extrudate over time (Fig. 7E), and coating formed from Compound 1 (Fig. 7F).
• Figs. 8A-8C are a series of an image and a graph showing Compound 3 (Fig. 8A)
• Figs. 9A-9E are a series of images and a graph showing Compound 6 (Fig. 9A) (dexamethasone- hexane-dexamethasone, Dex-HEX-Dex) processed into heat-molded pellets (Fig. 9B), fibers (Fig. 9C), extruded cylinders (Fig. 9D), and drug release (Fig. 9E).
• Figs. 10A-10D are a series of images and a graph showing Compound 7 (Fig. 10A)
• Figs. 11 A and 11 B are a series of images showing nano- and microparticles formed from
• Fig. 12 is a graph showing dexamethasone release from heat-molded pellets of Compound 1 and Compound 6 in 100% FBS.
• Figs. 13A-13D are a series of image showing Compound 4 (Fig. 13A) (dexamethasone- heptaethylene glycol-dexamethasone, Dex-EG7-Dex) processed into heat-molded pellets (Fig. 13B) and extruded cylinders (Fig. 13C), the extruded cylinders after two weeks in PBS at 37 °C (Fig. 13D).
• Figs. 14A-14D are a series of image showing Compound 5 (Fig. 14A) (dexamethasone- nonaethylene glycol-dexamethasone, Dex-EG9-Dex) processed into heat-molded pellets (Fig. 14B) and extruded cylinders (Fig. 14C), and the extruded cylinders after two weeks in PBS at 37 °C (Fig. 14D).
• Figs. 16A and 16B are a series of images and graphs showing drug release from heat-molded pellets formed from Compound 4 (Fig. 16A) and Compound 5 (Fig. 16B).
• Fig. 17 is a graph showing cumulative drug release from a coating of Compound 1 (Dex-TEG- Dex) from titanium and poly(styrene-block-isobutylene-block-styrene) (SIBS) over time.
• Compound 1 Dex-TEG- Dex
• SIBS poly(styrene-block-isobutylene-block-styrene)
• sustained drug release delivery systems While the clinical importance of sustained drug release delivery systems to maintain therapeutic concentration of drugs for extended periods of time (e.g., days to weeks, to months or even years) has been well acknowledged for decades, there has been a limited number of successfully commercialized products on the market to date. It is recognized in this disclosure that to develop successful sustained drug delivery systems, technical difficulties must be overcome ranging from drug degradation during formulation process; lack of controlled release, including unwanted burst or incomplete release associated with diffusion or bulk erosion mechanisms of drug release; low encapsulation efficiency; and formulation complexity.
• dexamethasone prodrug dimers that can be in a crystalline or amorphous form and have unique properties that allow them to be processed as viscous fluids from a melt or solution, in order yield shaped articles where most of the material is in a glassy state.
• the shaped articles may be held together by secondary (e.g., non-crystalline) interactions and have the ability to release their prodrug/drug elements from these shaped forms upon surface mediated
• This disclosure may alter the need for a carrier matrix to provide shape and form to a drug delivery depot or device, and therefore, may mitigate the issues of phase separation of drug from the matrix, and incompatible processing conditions between the formulations’ components. Further, such materials can minimize inflammatory responses because the drugs/prodrugs undergoing surface erosion from the shaped article can be released in the biological environment in a non-particulate (e.g., non-crystalline) form and can have inherent anti-inflammatory activity from the drugs being released from the prodrug shaped form.
• a non-particulate e.g., non-crystalline
• the compounds of the disclosure can be designed for the controlled and sustained release of dexamethasone from the dexamethasone prodrug dimer used to make the shaped article.
• Articles formed from the compounds of the disclosure can yield sustained and uniform release of the
• dexamethasone prodrugs without exhibiting any burst release (e.g., tio can be equal to or greater than 1/10 of tso) and without reliance upon degradable matrices, which can cause undesirable local side effects (such as inflammation).
• the high drug loading that can be present in the articles of the disclosure are suitable for producing locally effective concentrations of a dexamethasone for periods of days to weeks to months or even years.
• n is an integer from 1 to 6.
• the compound is Compound 1
• the compound is Compound 2:
• the compound is Compound 3:
• the pharmaceutical compositions of the disclosure can include an article in the form of fibers, fiber meshes, woven fabrics, non-woven fabrics, pellets, cylinders, hollow tubes, microparticles (e.g., microbeads), nanoparticle (e.g., nanobeads), or other shaped articles.
• the pharmaceutical composition of the disclosure has a non-circular shape that affects, e.g., increases, the surface area (e.g., extruded through star-shaped dye).
• Suitable pharmaceutical compositions for use with this disclosure can be small regularly or irregularly shaped particles, which can be solid, porous, or hollow.
• compositions of the present disclosure can have the advantages of providing a controllable surface area, being easily injected, not requiring removal after completion of drug release, and allow for tailoring drug release rates required for a given indication.
• microparticles e.g., microbeads
• nanoparticles e.g., nanobeads
• other shaped articles can have the advantages of providing a controllable surface area, being easily injected, not requiring removal after completion of drug release, and allow for tailoring drug release rates required for a given indication.
• drug release rate and interaction with cells are strongly dependent on the size distribution of the pharmaceutical composition form.
• Articles of the disclosure can be formed using any number of the methods, for example, heat processing or solvent processing of the dexamethasone prodrug dimer of formula (I).
• Heat processing can include heat molding, injection molding, extrusion, 3D printing, melt electrospinning, fiber spinning, fiber extrusion, and/or blow molding.
• Solvent processing may include coating, micro printing, emulsion processing dot printing, micropatterning, fiber spinning, solvent blow molding, electrospraying, and electrospinning.
• the pharmaceutical compositions of the disclosure are dissolved in a solvent (e.g., acetone) at concentrations ranging from, e.g., 10-30% w/v, and are electrosprayed to form micro- and nanobeads.
• a solvent e.g., acetone
• the solutions can be loaded into a syringe and can be injected at a particular rate, e.g., 0.5 mL/h, onto a stationary collection plate. Between the needle and collecting surface, a potential difference of, e.g., 18 kV, can be maintained. Exemplary concentration of 10% w/v is used to obtain nanoparticles. In other embodiments, a concentration of 30% w/v is used to obtain microbeads.
• a solvent e.g., acetone
• the pharmaceutical compositions of the disclosure e.g., fibrous meshes with aligned and unaligned morphologies are prepared by electrospinning.
• the pharmaceutical compositions of the disclosure are dissolved in a solvent (e.g., THF, or 1 :1 ratio of DCM/THF).
• the solutions may be injected from a syringe at a particular rate, e.g., 0.5 mL/h, onto a cylindrical mandrel rotating at a particular rotational speed, e.g., 1150 rpm, to obtain aligned fibers, or onto a stationary collector surface to obtain unaligned fibers.
• fibers are prepared either from the melt at elevated temperatures, the glassy state intermediate, or from solution by dissolving the pharmaceutical compositions of the disclosure in a solvent (e.g., DCM, THF, or chloroform).
• a solvent e.g., DCM, THF, or chloroform.
• the viscous melt, intermediate, or solution can be fed through a spinneret and fibers may be formed upon cooling (melt or heat spinning) or following solvent evaporation with warm air as the compound exits the spinneret (dry spinning).
• Wet spinning and gel spinning performed according to methods known in the art, may also be used to produce the fibers of the disclosure.
• Heat spinning describes a process that is essentially the same as the melt spinning process, but performed with the glassy state intermediate and heated above the glass transition temperature (Tg) to get the viscous fluid to extrude/spin instead of the melt.
• Tg glass transition temperature
• tweezers may be dipped into melted material or concentrated solutions and retracted slowly in order to pull fibers. The rate of pulling and distance pulled may be varied to yield fibers and columnar structures of different thickness.
• micro-particles or nano-particles made from the pharmaceutical composition can be formed using an emulsion process.
• the pharmaceutical composition may be dissolved in an organic solvent (e.g., DCM, THF, etc.) and a surfactant (e.g., SDS, PVA, etc.) may be added to the solution/mixture at a low percentage (e.g., 1 %).
• a surfactant e.g., SDS, PVA, etc.
• the resulting mixture may be stirred for the appropriate time at room temperature to form an emulsion.
• the emulsion may be subsequently added to Milli-Q water under stirring for an appropriate time (e.g., 1 h) to remove residual solvent.
• the resulting micro- or nano-particles may be collected by centrifugation and dried to obtain the desired form.
• injectable cylinders made from the pharmaceutical composition may be formed by heat extrusion.
• the pharmaceutical composition may be loaded into a hot melt extruder, heated to a temperature above the melting point (for crystalline compositions) or glass transition temperature (for pre-melted or amorphous compositions), and extruded using a light compressive force to push the material through the nozzle and a light tensile force to pull the material out of the extruder.
• the extrudate may be cut to the desired length for appropriate drug dosing for the indication of interest.
• a milling process may be used to reduce the size of an article of the disclosure to form sized particles, e.g., beads, in the micrometer (microbeads) to nanometer size range (nanobeads).
• the milling process may be performed using a mill or other suitable apparatus. Dry and wet milling processes such as jet milling, cryo-milling, ball milling, media milling, sonication, and homogenization are known and can be used in methods described herein.
• a suspension of the material to be used as the core is agitated with or without excipients to reduce particle size.
• Dry milling is a process wherein the material to be used as the article core is mixed with milling media with or without excipients to reduce particle size.
• a suspension of the material to be used as the core is mixed with milling media with or without excipients under cooled temperatures.
• subsequent heating of the milled microparticle above the Tg is needed to achieve a spherical shape, or particles with non-spherical shapes can be used as milled.
• the dexamethasone prodrug dimer has a limited window (e.g., short timeframe of seconds to minutes) of thermal stability, whereby the purity of the dimer is minimally affected at elevated temperatures.
• it is beneficial to make an intermediate glassy state form e.g., film, pellet, micro-particles, or other shaped article. This can be accomplished by heat or solvent processing to remove or reduce the crystallinity of the material to form a glassy state composition.
• the glassy state composition is subsequently heat processed at a lower temperature (e.g., processing just above the glass transition temperature (Tg), and below the melt temperature (Tm)). This can provide a longer timeframe for heat processing the glassy state material into the final shaped article, while reducing the impact of processing conditions on the purity of the dexamethasone prodrug dimer in the article.
• the pharmaceutical compositions of the disclosure provide optimal delivery of dexamethasone they release the dexamethasone from an article of the disclosure in a controlled manner, for example, by surface erosion.
• the surface erosion mechanism of drug release may allow the shaped article to maintain its physical form (e.g. shape/geometry of the article), while gradually decreasing in size as the surface erodes (e.g., like a bar of soap), rather than bulk erosion that is characteristic of some polymer- based drug release vehicles (e.g. polylactic/glycolic acid). This may inhibit burst release and reduce the formation of inflammatory particulates (e.g., no crystalline particulates are formed when drug is released in the manner described herein).
• the drug can be controlled to be delivered over a desired period of time.
• a slower and steadier rate of delivery may in turn result in a reduction in the frequency with which the pharmaceutical composition must be administered to a subject, and improve the safety profile of the drug.
• Drug release can also be tailored to avoid side effects of slower and longer release of the drug by engineering the article to provide steady release over a comparatively shorter period of time.
• the rate of release of a given drug from a dexamethasone prodrug dimer may also depend on the quantity of the loaded drug dimer as a percent of the final drug dimer formulation, e.g., by using a pharmaceutical excipient that acts as a bulking agent. Another factor that can affect the release rate of a drug from, for example a microbead, is the microbead size.
• drug release is tailored based on the solubility of dexamethasone prodrug dimer (e.g., through selection of appropriate linker) that will influence the rate of surface erosion (e.g., dissolution/degradation) from the article.
• drug release is affected by changes in surface area of the formulation, e.g., by changing the diameter of the microbeads.
• dissolution, degradation, diffusion, and controlled release may be varied over wide ranges.
• release may be designed to be initiated over minutes to hours, and may extend over the course of days, weeks, months, or years.
• the dexamethasone prodrug dimers of the disclosure are used as a drug delivery device (or, e.g., a drug depot) with a minimal need for additives. This may achieve a local, sustained release and a local biological effect, while minimizing a systemic response.
• the additives when present, are in small amounts and do not affect the physical or bulk properties. In some embodiments, when present, the additives do not alter the drug release properties from the pharmaceutical composition but rather act to improve processing of the prodrug dimer into the shaped article.
• the pharmaceutical compositions contain additives such as a plasticizer (e.g., to reduce thermal transition temperatures), an antioxidant (e.g., to increase stability during heat processing), a binder (e.g., to add flexibility to the fibers), a bulking agent (e.g., to reduce total drug content), a lubricant, a radio-opaque agent, or mixtures thereof.
• the additives may be present at 30% (w/w), e.g., 20% (w/w), 10% (w/w), 7% (w/w), 5% (w/w), 3% (w/w), 1 % (w/w), 0.5% (w/w), or 0.1 % (w/w).
• plasticizers are polyols, e.g., glycerol, ethylene glycol, diethylene glycol, triethylene glycol, tetraethylene glycol, polyethylene glycol, propylene glycol, triacetin, sorbitol, mannitol, xylitol, fatty acids, monosaccharides (e.g., glucose, mannose, fructose, sucrose), ethanolamine, urea,
• polyols e.g., glycerol, ethylene glycol, diethylene glycol, triethylene glycol, tetraethylene glycol, polyethylene glycol, propylene glycol, triacetin, sorbitol, mannitol, xylitol, fatty acids, monosaccharides (e.g., glucose, mannose, fructose, sucrose), ethanolamine, urea,
• polyols e.g., glycerol, ethylene glycol, diethylene glycol
• binders and bulking agents can be, e.g., polywinylpyrrolidone (PVP), starch paste, pregelatinized starch, hydroxypropyl methyl cellulose (HPMC), carboxymethyl cellulose (CMC), or polyethylene glycol (PEG) 6000.
• PVP polywinylpyrrolidone
• HPMC hydroxypropyl methyl cellulose
• CMC carboxymethyl cellulose
• PEG polyethylene glycol
• Methods involving treating a subject may include preventing a disease, disorder or condition from occurring in the subject which may be predisposed to the disease, disorder and/or condition but has not yet been diagnosed as having it; inhibiting the disease, disorder or condition, e.g., impeding its progress; and relieving the disease, disorder, or condition, e.g., causing regression of the disease, disorder and/or condition.
• Treating the disease or condition includes ameliorating at least one symptom of the particular disease or condition, even if the underlying pathophysiology is not affected (e.g., such treating the pain of a subject by administration of an agent even though such agent does not treat the cause of the pain).
• compositions containing the dexamethasone prodrug dimers described herein may be administered to a subject via any route known in the art. These include, but are not limited to, oral, sublingual, nasal, intradermal, subcutaneous, intramuscular, rectal, vaginal, intravenous, intraarterial, intracisternally, intraperitoneal, intravitreal, periocular, topical (as by powders, creams, ointments, or drops), buccal and inhalational administration.
• the articles of the disclosure are administered parenterally as injections (intravenous, intramuscular, or subcutaneous), or locally as injections (intraocularly or into a joint space).
• the formulations are admixed under sterile conditions with a pharmaceutically acceptable carrier or suspension or resuspension agents (e.g., for micro- and nanoparticles) and any needed preservatives or buffers as may be required.
• the articles of the disclosure described herein including a dexamethasone prodrug dimer may be administered to a subject to be delivered in an amount sufficient to deliver to a subject a therapeutically effective amount of an incorporated pharmaceutical agent as part of prophylactic or therapeutic treatment, or as a part of adjunctive therapy to avoid side-effects of another drug or therapy.
• an effective amount of a pharmaceutical agent or component refers to the amount necessary to elicit the desired biological response.
• the desired concentration of pharmaceutical agent in the article of the disclosure will depend on numerous factors, including, but not limited to, absorption, inactivation, and excretion rates of the drug as well as the delivery rate of the compound from the subject compositions, the desired biological endpoint, the agent to be delivered, the target tissue, etc.
• dosage values may also vary with the severity of the condition to be alleviated. It is to be further understood that for any particular subject, specific dosage regimens should be adjusted over time according to the individual need and the professional judgment of the person administering or supervising the administration of the compositions. Typically, dosing will be determined using techniques known to one skilled in the art.
• concentration and/or amount of any pharmaceutical agent to be administered to a subject may be readily determined by one of ordinary skill in the art. Known methods are also available to assay local tissue concentrations, diffusion rates from dexamethasone prodrug dimers and local blood flow before and after administration of the therapeutic formulation.
• a sterile formulation is essentially free of pathogenic microorganisms, such as bacteria, microbes, fungi, viruses, spores, yeasts, molds, and others generally associated with infections.
• articles of the disclosure may be subject to an aseptic process and/or other sterilization process.
• An aseptic process typically involves sterilizing the components of a formulation, final formulation, and/or container closure of a drug product through a process such as heat, gamma irradiation, ethylene oxide, or filtration and then combining in a sterile environment. In some cases, an aseptic process is preferred. In other embodiments, terminal sterilization is preferred. Treatment methods
• the formulations of the disclosure may be used in the fields of ophthalmology, oncology, laryngology, endocrinology and metabolic diseases, rheumatology, urology, neurology, cardiology, dental medicine, dermatology, otology, post-surgical medicine, and orthopedics.
• the articles of the disclosure may be used prevent, treat or manage diseases or conditions at the back of the eye, such as at the retina, macula, choroid, sclera and/or uvea.
• the articles of the disclosure are used as injectable drug delivery devices for ophthalmology (e.g., intravitreal injection, coating on a minimally invasive glaucoma surgery (MIGS) devices, or implant in blebs).
• MIGS minimally invasive glaucoma surgery
• a medication is placed directly into the space in the back of the eye called the vitreous cavity, which is filled with a jelly-like fluid called the vitreous humor gel.
• Intravitreal injections may be used to treat retinal diseases such as diabetic retinopathy, macular degeneration, macular edema, uveitis, and retinal vein occlusion.
• the articles of the disclosure may be used to treat, prevent, or manage an ocular condition, i.e., a disease, ailment, or condition that affects or involves the eye or one or more of the parts or regions of the eye.
• an ocular condition i.e., a disease, ailment, or condition that affects or involves the eye or one or more of the parts or regions of the eye.
• the articles of the disclosure may be used to treat, prevent, or manage an ocular condition at the front of the eye of a subject.
• a front of the eye ocular condition includes a disease, ailment or condition, such as for example, post-surgical inflammation;
• articles of the disclosure may be used to treat, prevent, or manage an ocular condition at the back of the eye of a subject.
• a posterior ocular condition can include a disease, ailment, or condition, such as intraocular melanoma; acute macular neuroretinopathy; Behcet’s disease; choroidal neovascularization; uveitis; diabetic uveitis; histoplasmosis; infections, such as fungal or viral-caused infections; macular degeneration, such as acute macular degeneration, non-exudative age related macular degeneration and exudative age related macular degeneration; edema, such as macular edema (e.g., cystoid macular edema (CME) and diabetic macular edema (DME)); multifocal choroiditis; ocular trauma which affects a posterior ocular site or location; ocular tumors; retinal disorders, such as central retinal vein occlusion, diabetic retinopathy (including proliferative diabetic retinopathy), proliferative vitreoretinopathy (PVR
• the articles of the disclosure may be used to treat, prevent, or manage dry eye in a subject.
• the articles of the disclosure may be used to treat, prevent, or manage inflammation in the eye of a subject. Inflammation is associated with a variety of ocular disorders. Inflammation may also result from a number of ophthalmic surgical procedures, including cataract surgery.
• the pharmaceutical agent that is delivered into the eye by the articles of the disclosure and/or methods described herein may be a corticosteroid.
• the dexamethasone prodrug dimers of the disclosure are used as adjunctive therapy to reduce inflammation and fibrosis associated with devices (e.g., minimally invasive glaucoma surgery (MIGS) devices).
• MIGS minimally invasive glaucoma surgery
• articles of the disclosure may be used to treat, prevent, or manage age-related macular degeneration (AMD) in a subject.
• AMD age-related macular degeneration
• the articles of the disclosure are used for the treatment of osteoarthritis (OA).
• OA osteoarthritis
• IA intraarticular
• Steroids may be used to reduce inflammation in tendons and ligaments in osteoarthritic joints.
• IA steroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.
• Dexamethasone can be used in the treatment of OA.
• microspheres of the disclosure composed of the dexamethasone prodrug dimers are injected into a knee joint for the treatment of OA.
• the articles of the disclosure are used in conjunction with a surgical procedure.
• an article of the disclosure can be implanted at a surgical site to reduce the risk of inflammation treated by the surgical procedure, or can be used as an adjunctive to reduce the risk of infection.
• Compounds 1 -8 can be used in the compositions, methods, and articles of the disclosure.
• Example 1 Compound 1 (dexamethasone-triethylene glycol-dexamethasone) can be synthesized, processed into pellets in the glassy state by heat molding, and release drug through surface erosion from an intact pellet
• Dexamethasone (1 mol equivalent) was suspended in dichloromethane on an ice bath and triethylamine (2 mol equivalent) and triethylene glycol bis(chloroformate) (0.6 mol equivalent) were added to the mixture. The ice bath was allowed to warm to room temperature and the reaction was stirred overnight. The solvent was removed and the solid residue was purified by column chromatography. Product was recrystallized twice from acetonitrile to give Compound 1 (Fig. 1 A) as an off-white crystalline solid.
• Compound 1 was formed into pellets in the glassy state by heat molding (Fig. 1 B). Crystalline powder was melted at 185°C and pellets were formed from 1 mm x 1 mm cylindrical molds. The starting powder and heat-processed pellets were tested by differential scanning calorimetry (DSC; Fig. 1 C) and X- ray powder diffraction (XRPD; Fig. 1 D) to confirm heat-processing converted Compound 1 from the crystalline state to the glassy state.
• DSC differential scanning calorimetry
• XRPD X- ray powder diffraction
• Heat-molded pellets from Compound 1 were then placed in 20 ml_ glass vials and 2 ml_ of release buffer (either 100% phosphate buffered saline (PBS), 1 % fetal bovine serum (FBS) in PBS, or 100% FBS) was added. Samples were incubated at 37 °C on a shaker rotating at 1 15 rpm. After 1 day, 3 days, 7 days, and subsequently in alternating 3 and 4 day intervals (i.e., 1 , 3, 7, 10, 14 days etc.), release buffer was sampled directly (PBS) or syringe filtered, proteins were precipitated with acetonitrile, and drug release products were extracted.
• release buffer either 100% phosphate buffered saline (PBS), 1 % fetal bovine serum (FBS) in PBS, or 100% FBS
• Samples were incubated at 37 °C on a shaker rotating at 1 15 rpm. After 1 day, 3 days, 7 days, and
• Example 2 Compound 1 (Dex-TEG-Dex) can be processed into different forms in the glassy state by multiple processing methods from the melt state
• FIG. 2A Heat- molded pellets
• Fig. 2B Extruded cylinders
• Fig. 2C shows an extruded cylinder with a 23G diameter nozzle, cut, and loaded into a 23G needle.
• Glass droplets Fig.
• Fibers of Compound 1 were prepared by heat extrusion at 185°C using a small diameter nozzle (e.g. 30-32G) combined with a tensile force to pull the extrudate out of the nozzle. Fibers were also prepared by melting Compound 1 from a powder at 185 °C and by pulling the melted material at different rates to yield fibers of different diameters (Fig. 2E).
• Example 3 Compound 1 (Dex-TEG-Dex) can be processed into different forms in the glassy state by multiple processing methods from the solution state
• Compound 1 was processed into different forms in the glassy state, including coatings, non- woven fibrous meshes, fibers, and micro- and nano-particles, from the solution state using organic solvents.
• Compound 1 was coated onto titanium (Fig. 3A) and poly(styrene-block-isobutylene-block- styrene) (SIBS) surfaces (Fig. 3B) from acetone by drop coating and can be coated using other common techniques (e.g., dip-coating, spray coating, electrospraying, etc.).
• Non-woven fibrous meshes with aligned (Fig. 3C) and unaligned (Fig. 3D) morphologies were prepared by electrospinning.
• Compound 1 was dissolved in tetrahydrofuran (THF) and was
• Fibers were prepared by dissolving Compound 1 in dichloromethane (DCM), THF, or chloroform and by pulling Compound 1 from the solution. The rate of pulling and distance pulled were varied to yield fibers and columnar structures of different thickness. Electrosprayed micro- and nano-particles were prepared by dissolving Compound 1 in acetone. A concentration of 10% w/v was used to electrospray Compound 1 into nanoparticles (Fig. 3H), while a concentration of 30% w/v was used to electrospray Compound 1 into microparticles (Fig. 3I).
• Micro-particles of Compound 1 were prepared by emulsion from DCM using sodium dodecyl sulfate (Fig. 3J). The microparticles were analyzed by DSC (Fig. 3K) to confirm they were in the glassy state. Different preparation conditions (solvents, concentrations, surfactants, surfactant concentrations, mixing conditions, etc.) resulted in different particle sizes and distributions.
• Example 4 Drug release properties from heat-molded pellets of Compound 1 (Dex-TEG-Dex) can be adjusted by changing the physical properties of the pellets due to surface erosion mechanism of drug release
• Compound 1 was heat-molded into pellets with ⁇ 1 mm and ⁇ 0.35 mm diameters using the conditions described in Example 1 and 2 above to get pellets with different masses of Compound 1 and different surface areas. Details of the samples are summarized in Table 2, below. Drug release from the different samples was carried out in 100% FBS as described in Example 1 over a 7 day period. The change in drug release expected from different surface areas due to the surface erosion mechanism of drug release is exemplified in Fig. 4 as a plot of surface area vs. the average drug released per day taken from the linear release curves.
• Example 5 Mechanical testing of extruded cylinders of Compound 1 (Dex-TEG-Dex) using a 3 point bend test (ASTM C1684-18)
• Heat-molded pellets from Compound 1 were sterilized by ethylene oxide (ETO) gas at a temperature of 55 °C.
• ETO ethylene oxide
• Pre- and post-ETO sterilized pellets were analyzed by HPLC to demonstrate no changes in pellet (Compound 1) purity (Fig. 6A) and drug release (Fig. 6B) to demonstrate no changes in release properties due to the ETO sterilization process.
• Drug release was carried out in either 1 % FBS in PBS or 100% FBS as described in Example 1.
• Example 7 Processing Compound 1 (Dex-TEG-Dex) into an intermediate glassy state to manufacture the final article
• Compound 1 (Dex-TEG-Dex) was formed into heat extruded cylinders directly from the crystalline powder by heating above the melting point (185°C), as shown in Figs. 7A and 7B, using the methods described above in Example 2.
• Compound 1 was also formed into heat extruded cylinders by forming an intermediate glassy state form from the melt followed by heat extrusion above the glass transition temperature (150°C) as shown in Figs. 7C and 7D. Purity of the extrudate over time is shown in Fig. 7E and demonstrates longer extrusion run times using the intermediate glassy state before Compound 1 drops in purity when compared to extrusion from the melt state.
• Example 8 Formation of pellets, fibers, and/or cylinders in the glassy state from Compounds 3, 6, and 7 and drug release from intact glassy-state pellets
• Compounds 3, 6, and 7 were processed into heat molded pellets ( ⁇ 1 mm x ⁇ 1 mm), fibers from the melt state, and/or heat extruded cylinders from the melt or intermediate glassy state as described in Examples 1 , 2, and 7 above using the appropriate temperature for each compound (i.e., above the Tm or Tg as required). Processing Compounds 3, 6, and 7 into the articles converted crystalline compounds into the glassy state and was confirmed for heat molded pellets by DSC. Drug release from heat molded pellets was carried out in PBS and/or 100% FBS, as described in Example 1 , for different time periods.
• Example 9 Nano- and micro-particle formation in the glassy state from Compound 6 (Dex-HEX- Dex) provides sustained release of drug
• Electrospraying and emulsions were used to make nano- and microparticles from Compound 6 (Figs. 11A and 11 B) using conditions similar to that described for Compound 1 in Example 3 above.
• Different preparation conditions for example solvents, concentrations, surfactants, surfactant concentrations, mixing conditions, etc., resulted in different particle sizes and distributions.
• DSC was used to confirm the particles were in the glassy state.
• Example 10 Methods to adjust release of drug from glassy state articles
• the release of drug from glassy state articles can be controlled in various ways for example by changing the environment the article is placed or by adjusting the physical properties of the article to take advantage of the surface erosion mechanism of drug release.
• other properties such as compound structure via a change in linker can be adjusted to engineer the article to obtain the desired drug release properties for the application of interest.
• Dexamethasone release from heat molded pellets ( ⁇ 1 mm x 1 mm) of Compound 1 (Dex-TEG-Dex) and Compound 6 (Dex-Hex-Dex) in 100% FBS as shown in Fig. 12 exemplifies how linker affects the drug release rates.
• Example 11 Compounds 4 (Dex-EG7-Dex), 5 (Dex-EG9-Dex), and 8 (Dex-PEG300-Dex) can be formed into heat molded pellets and extruded cylinders in the glassy state but undergo physical (e.g., shape) and drug release changes over time in release medium at 37 °C
• Example 12 Drug release from Compound 1 (Dex-TEG-Dex) coated on different surfaces
• Compound 1 was coated onto titanium and SIBS as described in Example 3 above. Drug release from the coated material was carried out in PBS as described in Example 1 above. Cumulative drug release was calculated and plotted as a percentage of the total drug in each coated surface released over time (Fig. 17).
• Each of compounds 1 -8 differ in modest changes to the linker covalently tethering two dexamethasone radicals into a dimer. All of the compounds were observed to be capable of being processed into articles (e.g., glassy amorphous solids). However, articles formed from different compounds were observed to exhibit dramatically different stability (under physiologically relevant conditions) and dramatically different dexamethasone release profiles.
• Figs. 13D, 14D, and 15D articles formed from Compounds 4, 5, and 8 (i.e., the compounds with the longer PEG linkers) appear to undergo a change in physical form (geometric shape) in an aqueous environment at 37 °C, while articles formed from Compounds 1 , 3, 6, and 7 do not.
• Figs. 13D, 14D, and 15D Compounds 4, 5, and 8 form into spherical droplets after two weeks in PBS.
• Fig. 1 F shows pellets formed from Compound 1 maintaining their shape over extended periods of time, and similar stability was observed for compounds 3, 6, and 7 in PBS.
• dexamethasone release profiles were also observed to exhibit dramatically different dexamethasone release profiles.
• the dexamethasone release profiles from articles formed from compounds 1 , 3, 6, and 7 were observed to be generally linear over the course of 12 weeks or more (see, e.g., Figs. 1 E, 8C, 9E, and 10D).
• the dexamethasone release profiles from articles formed from compounds 4 and 5 were observed to be non-linear (see Figs. 16A and 16B).
• dexamethasone release profiles from heat molded pellets ( ⁇ 1 mm x 1 mm) of Compound 1 (Dex-TEG-Dex) and Compound 6 (Dex-Hex-Dex) in 100% FBS as shown in Fig. 12 exemplifies how linker affects the drug release rates.
• the difference in these release profiles show that articles formed from Compound 1 might be preferred for use where dexamethasone release is only needed for 1 or 2 months, while articles formed from Compound 6 might be preferred for use where dexamethasone release is needed for 6 months or more.
• Compounds 9-1 1 can be prepared by using methods analogous to those described herein.
• the compounds can be processed as described herein to produce articles capable of producing an extended release profile following implantation into a subject, and can be used in the methods, compositions, and articles of the disclosure.
• n is an integer from 1 to 6.
• a pharmaceutical composition comprising the compound of any one of items 2-5, and a pharmaceutically acceptable excipient.
• the article provides controlled release of dexamethasone at 37 °C in 100% bovine serum or at 37 °C in PBS; wherein n is an integer from 1 to 6.
• dexamethasone present in the article in prodrug form at 37 °C in 100% bovine serum over not fewer than 6 days; or the surface erosion releases greater than 5.0% of dexamethasone as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in PBS over not fewer than 6 days; or dexamethasone is released from the article at a rate such that tio is greater than or equal to 1/10 of tso.
• the article further comprises from 0.1 % to 10% (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• n is an integer from 1 to 6.
• n is an integer from 1 to 6.
• n is an integer from 1 to 6.
• step (b) comprises solvent casting to form a film or a fiber.
• n is an integer from 1 to 6.
• n is an integer from 1 to 6.
• n is an integer from 1 to 6.
• dexamethasone as a percentage of the total drug, dexamethasone, present in the article in prodrug form, at 37 °C in PBS over 5 days; or the surface erosion releases greater than 20% of dexamethasone, as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in 100% bovine serum over not fewer than 6 days; or the surface erosion releases greater than 5.0% of dexamethasone as a percentage of the total dexamethasone present in the article in prodrug form, at 37 °C in PBS over not fewer than 6 days; or dexamethasone is released from the article at a rate such that tio is greater than or equal to 1/10 of tso.
• the fiber is prepared by a process comprising the steps of:
• the fiber is prepared by a process comprising the steps of:
• n is an integer from 1 to 6.
• the fiber is prepared by a process comprising the steps of:
• n is an integer from 1 to 6.
• composition is prepared by a process comprising the steps of:
• n is an integer from 1 to 6.
• the glassy state composition of any one of items 48-52, wherein at least 70% (w/w) of the glassy state composition is Compound 6 or the compound of formula (I).
• the glassy state composition of any one of items 48-53, wherein at least 90% (w/w) of the glassy state composition is Compound 6 or the compound of formula (I).
• the glassy state composition of item 55 wherein the surface erosion releases less than 10% of dexamethasone, as a percentage of the total drug, dexamethasone, present in the glassy state composition in prodrug form, at 37 °C in 100% bovine serum over 5 days; or the surface erosion releases less than 2% of dexamethasone, as a percentage of the total drug, dexamethasone, present in the glassy state composition in prodrug form, at 37 °C in PBS over 5 days; or the surface erosion releases greater than 20% of dexamethasone, as a percentage of the total dexamethasone present in the glassy state composition in prodrug form, at 37 °C in 100% bovine serum over not fewer than 6 days; or the surface erosion releases greater than 5.0% of dexamethasone as a percentage of the total dexamethasone present in the glassy state composition in prodrug form, at 37 °C in PBS over not fewer than 6 days; or dexamethasone is
• glassy state composition of item 59 wherein the glassy state composition is a shaped article in the form of:
• a substrate comprising a coating formed from the compound of any one of items 2-5 and 95.
• a substrate comprising a coating formed from Compound 6 or a compound of formula (I):
• n is an integer from 1 to 6.
• the coating further comprises from 0.1 % to 10% (w/w) of one or more additives, wherein the one or more additives are selected from plasticizers, antioxidants, binders, lubricants, radio-opaque agents, and mixtures thereof.
• the coating is free of controlled release excipient, free of a crystallization inhibiting excipient, free of a mechanical integrity enhancing excipient, and/or free of a binding excipient; or the coating optionally has a glassy state.
• An implantable medical device comprising the substrate of any one of items 62-73, wherein the coating resides on the surface of the implantable medical device.
• step (c) comprises extruding, molding, blow molding, heat spinning, melt spinning, electrospinning or electrospraying the glassy state composition to form the shaped article.
• step (c) comprises extruding, molding, blow molding, heat spinning, melt spinning, electrospinning or electrospraying the glassy state composition to form the shaped article.
• n is an integer from 1 to 6.
• XRPD X-ray powder diffraction
• a pharmaceutical composition comprising Compound 6 and a pharmaceutically acceptable excipient.

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• 2019
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