coating for intraluminal expandable catheter that provides contact transfer of drug micro-reservoirs

专利摘要:
A coating for an expandable portion of a catheter comprising a hydrophobic matrix and a dispersed phase is described. The dispersed phase comprises a plurality of micro-reservoirs dispersed in the hydrophobic matrix, wherein the plurality of micro-reservoirs comprises a first active agent and a biodegradable or biodegradable polymer. A coating formulation and a method for forming the coating are also disclosed. Also provided are a catheter comprising the coating on the expandable portion and a method for treating a condition.
公开号:BR112017001032B1
申请号:R112017001032-1
申请日:2015-07-16
公开日:2021-03-09
发明作者:Michael Thomas Ahlering；Ronald Kenichi Yamamoto；Tien Thuy Nguyen；John Edwin Shulze；Jelle Jurjen Zoethout
申请人:M.A. Med Alliance SA；
IPC主号:

专利说明:

INCORPORATION BY REFERENCE TO ANY PRIORITY REQUESTS
[001] Any and all claims for which a claim of foreign or domestic priority is identified in the Order Data Sheet as filed with this claim are incorporated by reference under 37 CFR 1.57. BACKGROUND OF THE INVENTION Field of invention
[002] This disclosure is related to the field of drug administration through expandable catheters. Description of the Related Art
[003] Balloon angioplasty is an established method for the treatment of vascular disease, physically dilating an area of atherosclerosis, stenosis or the reduction in luminal diameter in diseased blood vessels. Angioplasty is typically performed with a catheter that can be advanced into the circulatory system to the diseased area. The catheter has a balloon at the distal end that is inflated to dilate and expand the area of the stenosis. In many cases, such as in the coronary arteries, a stent is also expanded outside the balloon. The stent is left in place after deflation and removal of the balloon to maintain unblocking of the expanded lumen.
[004] In order to achieve the physical enlargement of the vessel, the great forces are exerted on the tissues of the vessel during the filling of the high pressure balloon. Physical dilation results in damage to the vessel, including endothelial interruption, fragmentation of the internal elastic lamina, and dissection of the vessel's middle layer. Injury often extends to the outer adventitia as well. The biological response of the vessel advances through a thrombotic phase during days 0 to 3, which involve the activation and adhesion of platelets and the formation of thrombi. The thrombotic phase is followed by a phase of cell recruitment during days 3 to 8, involving the infiltration of inflammatory cells, macrophages and lymphocytes, at the site of the vessel injury. The release of growth factors and cytokines from inflammatory cells leads to the proliferative phase during day 8 through day 14, in which the smooth muscle cells in latent middle vessel layers are stimulated to proliferate. Subsequently, migration of smooth muscle cells in proliferation of the tunica layer and thrombus in the lumen results in neointimal hyperplasia, a major component of restenosis. Although cell proliferation ceases after 14 days, the continued production of extracellular matrix by smooth muscle cells continues to increase the degree of neoplasia hyperplasia and restenosis. Restenosis effectively reverses the treatment of dilation and potentially creates a serious threat to the patient. Clinical studies in humans have shown that restenosis usually occurs 1 to 3 months after balloon angioplasty and restenosis typically peaks at about 3 months.
[005] Although balloon angioplasty provides an important increase in blood flow in diseased vessels, restenosis is inherent due to the extent of the associated mechanical injury. A strategy for reducing the restenosis response is to release drugs into the vessel in combination with balloon dilation treatment to counteract the inflammatory and healing response. Approaches include coating the balloon with drugs, such as paclitaxel and sirolimus (rapamycin), which limit cell proliferation. During the contact of the balloon to the luminal surface of the vessel, it is believed that the coating facilitates the transfer of the drug to the site of the vessel injury. These methods attempt to provide a drug concentration that is sufficient to reduce restenosis caused by cell proliferation and at the same time is low enough to minimize toxicity to the vessel, which can result in damage or deterioration of the vessel. It is believed that it is desirable to maintain an effective drug concentration for a sufficient time to minimize restenosis.
[006] In practice, the administration of drugs to the tissues of the vessel wall by drug-coated balloons, as described in the art, is limited by the short period of time during which the balloon can be placed in contact with the vessel. Typically, balloon inflation during angioplasty is performed for about 30 to about 120 seconds to limit cardiac ischemia and potential patient complications and discomfort. These periods of balloon inflation and the release of drugs of short duration may be sufficient for the antineoplastic drug paclitaxel, which has demonstrated the inhibition of the formation of neointima in animals after a few minutes of exposure time. However, in order to provide maximum therapeutic effect and minimize the dose of high potential toxicity to the vessel, it would be desirable to provide the administration of drugs to the vessel over an extended period of time, preferably longer than the duration of the inflation of the vessel. balloon. In addition, drugs such as sirolimus and their analogs have both anti-proliferative and anti-inflammatory activity, which can provide benefits in addition to the acute period for restenosis, if administered over an extended period of time.
[007] Many of the drug-coated balloons described in the prior art use high initial levels of active agent and various treatments to create a high initial treatment concentration, but then the concentration drops off quickly. This is undesirable, because most of the active agent in the device is lost in the form of embolic particles possible in the bloodstream, or by diffusion away from the treatment site.
[008] Many of the drug coatings described in the prior art include hydrophilic polymers and excipients, or excipients that are liquid at body temperature. Such hydrophilic coating formulations provide a hydrophilic matrix for the hydrophobic drug particles and can be effective in transferring the drug to the vessel wall. However, such coatings do not provide significant resistance to washing out of the blood or during the maneuver of the balloon to the treatment site, or after the transfer of the drug coating to the surface of the vessel. SUMMARY OF THE INVENTION
[009] Some embodiments provide a coating for an expandable portion of a catheter comprising a hydrophobic matrix and a dispersed phase, wherein the dispersed phase comprises a plurality of micro-reservoirs dispersed in the hydrophobic matrix, wherein the plurality of micro-reservoirs comprises a first active agent mixed with, or dispersed in, a biodegradable or bioerodible polymer. Some embodiments provide a coating, in which the dispersed phase comprises a plurality of micro-reservoirs dispersed in the hydrophobic matrix, in which some of the plurality of micro-reservoirs comprise a first active agent and a biodegradable or bioerodible polymer.
[010] Some embodiments provide a catheter comprising an expandable portion over an elongated body and a liner as described herein over the expandable portion. In some embodiments, the catheter additionally comprises a release layer between the expandable portion and the liner, wherein the release layer is configured to release the liner from the expandable portion. In some embodiments, the catheter additionally comprises a protective layer on the coating that contains the micro-reservoirs.
[011] Some embodiments provide a coating formulation for an expandable portion of a catheter comprising a solid portion and a fluid. The solid portion comprises a plurality of micro-reservoirs and at least one hydrophobic compound. The plurality of micro-reservoirs comprises a first active agent and a biodegradable or bioerodible polymer. The fluid disperses or solubilizes the, at least one hydrophobic compound, and suspends the plurality of micro-reservoirs.
[012] Some embodiments provide a method for coating an expandable portion of a catheter which comprises arranging a coating formulation described herein, on the surface of an expanded expandable portion of a catheter, evaporating the fluid, and collecting the expandable portion. .
[013] Some modalities provide a method for treating or preventing a condition at a treatment site, which comprises advancing a catheter comprising an expandable portion to the treatment site, where the expandable portion is coated with a coating described herein, expanding the expandable portion to allow contact between the liner and tissue at the treatment site, the collapse of the expandable portion, and removal of the catheter. BRIEF DESCRIPTION OF THE DRAWINGS
[014] The characteristics and aspects, and advantages of the modalities of the present invention are described in detail below with reference to the drawings of various modalities, which are intended to illustrate and not to limit the invention. These drawings describe only several modalities according to the description, and should not be considered as limiting its scope.
[015] FIG. 1 illustrates an embodiment of a balloon catheter with a liner over the expandable portion of the catheter.
[016] FIG. 2 depicts an embodiment of a balloon catheter with a release layer between the liner and the expandable portion of the catheter.
[017] FIG. 3 depicts an embodiment of a balloon catheter with a protective layer on the liner.
[018] FIG. 4 is a photomicrograph of the luminal surface of a vessel treated with a balloon catheter modality.
[019] FIG. 5 is a photomicrograph of the luminal surface of a vessel treated with a balloon catheter modality. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[020] To overcome the limitations of the state of the art, the modalities described here provide coatings for an expandable portion of a catheter that has time-release micro-reservoirs of drugs mixed with or dispersed within a coating on a balloon that can be transferred to the luminal surface of the vessel during the 30 to about 120 seconds of inflation time of the balloon. This approach allows for a prolonged and controlled release of drug to the vessel wall over a long period of time, which can be adapted by the design of the micro-reservoirs to the characteristics of a particular drug or the pathology of the diseased vessel. In addition to providing sustained release, the coating described here can also withstand the washing out of blood, which both increases drug transfer efficiency and patient safety from excessive particles. Coating
[021] A coating for an expandable portion of a catheter or catheter system is disclosed here. The catheter is designed for insertion into a living body for the administration of at least one locally active agent. The lining is formulated and constructed for minimal dispersion and solubilization into the bloodstream or body fluid while the catheter is being positioned inside the target vessel or body lumen for treatment, or after transferring the lining of a tissue at the site of treatment, such as the vessel wall or the lumen wall. The liner is configured to transfer to a luminal surface or luminal wall contacted by the liner when the expandable portion is expanded. In some vessels or body lumens, the inner surface of the vessel or body lumen may be diseased and may have an irregular topology such as due to plaques, injuries, or previous intervention. The coating is configured to transfer to the luminal surface including the irregular topology, as described in this patent application through the lumen wall term. In some embodiments, the active agent or drug is transferred to the vessel to prevent or minimize restenosis after balloon angioplasty. In some embodiments, the expandable portion may be a balloon from a balloon catheter.
[022] Referring to Fig. 1, in some embodiments, the liner 12 for an expandable portion 11 of a catheter 10 includes two phases, a hydrophobic matrix 14 and a dispersed phase 13. The dispersed phase 13 is dispersed in the hydrophobic matrix 14 The dispersed phase 13 includes a plurality of micro-reservoirs, and a plurality of micro-reservoirs includes a first active agent and a biodegradable or bioerodible polymer. In some embodiments, the first active agent is mixed with, or dispersed in, the biodegradable or bioerodible polymer. When the coating 12 is transferred to the lumen wall or luminal surface, the transferred coating would include both the hydrophobic matrix 14 and the dispersed phase 13.
[023] In some embodiments, some or a part of the plurality of micro-reservoirs may comprise a first active agent and a biodegradable or bioderodible polymer, and some may contain the biodegradable or bioderodible polymer without the first active agent.
[024] In some embodiments, the hydrophobic matrix 14 may also include a second active agent. The second active agent is present outside the plurality of micro-reservoirs. The second active agent can be the same or different from the first active agent.
[025] In some embodiments, the plurality of micro-reservoirs may also include a third active agent. In some embodiments, the plurality of micro-reservoirs may further include a second biodegradable or bioerodible polymer. In some embodiments, the first and second biodegradable or bioderodible polymer may be the same or different. In some embodiments, the plurality of micro-reservoirs may contain only one type of micro-reservoir.
[026] In some embodiments, the coating 12 includes about 10% to about 75%, about 20% to about 65%, or about 30% to about 55%, by weight, from the plurality of micro-reservoirs. In some embodiments, coating 12 has a surface concentration of about 1 μg / m2 to about 10 μg / m2, from about 2 μg / m2 to about 9 μg / m2, or about 3 μg / m2 at about 8 μg / m2 in the expandable portion of the catheter 10.
[027] The hydrophobic matrix 14 comprises a combination of materials selected for their desired adhesive properties for the luminal surface or wall of the lumen. The preferred hydrophobic matrix 14 includes a combination of hydrophobic compounds that are resistant to dissolution in blood or other body fluid, but provide a uniform distribution of the formulation, including micro-reservoirs, when applied to the surface of the flask. In some embodiments, the hydrophobic matrix 14 includes at least one hydrophobic compound selected from the group consisting of lipids, sterols, phospholipids, fatty acids, fats, surfactants, and their derivatives. Particularly useful formulations are a combination of a sterol and a fatty acid or a phospholipid. Sterol can be a sterol, which uses the body's natural clearance mechanism, such as by forming complexes with serum lipids or aggregates with serum apolipoproteins to provide transport to the liver for metabolic processing. In some embodiments, sterol can be cholesterol. Due to the natural compatibility of cholesterol and fatty acids or phospholipids, such combinations can provide a homogeneous mixture for coating 12 and a resulting homogeneous coating on the surface of the balloon. The coating 12 formed by these combinations is homogeneous without the formation of micelles or liposomes in the hydrophobic matrix 14.
[028] In some embodiments, the hydrophobic matrix 14 includes cholesterol and fatty acid. In some embodiments, the weight ratio of cholesterol to fatty acid is in the range of about 1: 2 to about 3: 1, about 1: 1.5 to about 2.5: 1, or about 1: 1 to about 2: 1. The amounts and proportion of cholesterol and fatty acid are sufficient to allow the transfer of the coating from the expandable portion of a catheter to a wall of the lumen. The cholesterol component of the formulation can comprise cholesterol, chemically modified cholesterol or a cholesterol conjugate. In some embodiments, cholesterol is dimethylaminoethane-carbamoyl cholesterol (DC-cholesterol). To maintain physiological compatibility, preferred fatty acids are the fatty acids that are normally found in cell or serum membranes. In some embodiments, fatty acid is selected from the group consisting of lauric acid, lauroleic acid, tetradeadienoic acid, octanoic acid, myristic acid, myristoleic acid, decenoic acid, decanoic acid, hexadecenoic acid, palmitoleic acid, palmitic acid, linolenic acid, linoleic acid, oleic acid, vaccenic acid, stearic acid, eicosapentaenoic acid, arachidenic acid, Mead acid, arachidic acid, docosahexaenoic acid, docosapentaenoic acid, docosatetraenoic acid, docosenoic acid, tetracosanoic acid, hexacoseneic acid, prisic acid, pranic acid and nervous acid.
[029] In some embodiments, the hydrophobic matrix 14 includes a cholesterol and a phospholipid. In some embodiments, the weight ratio of cholesterol to phospholipid is in the range of about 1: 2 to about 3: 1, about 1: 1.5 to about 2.5: 1, or about 1: 1 to about 2: 1. The amounts and proportion of cholesterol and phospholipid are sufficient to allow the transfer of the coating from the expandable portion of a catheter to a wall of the lumen. The cholesterol component of the formulation can comprise cholesterol, chemically modified cholesterol or a cholesterol conjugate. In some modalities, cholesterol is DC-cholesterol. The preferred phospholipids are phospholipids, usually found in cell or serum membranes. In some embodiments, the phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, or phosphatidylinositol. In some embodiments, the phospholipid comprises an acyl chain length of about 20 to about 34 carbon atoms.
[030] In some embodiments of the invention, the hydrophobic matrix 14 comprises only hydrophobic components, such as lipids, sterols and fatty acids. In other words, in some embodiments, the hydrophobic matrix does not contain hydrophilic polymers or hydrophilic excipients. In some embodiments of the invention, the hydrophobic matrix 14 comprises only hydrophobic components, such as lipids, sterols and fatty acids, and any amphiphilic components are present. Preferably, coating 12 and its components have limited solubility in blood or the like, such as phosphate buffered saline or plasma. The use of cationic cholesterol or a cationic phospholipid in the formulation can provide additional chemical attraction of the hydrophobic matrix 14 to the lumen wall and, potentially, to the surface of the micro-reservoirs to increase the transfer of the coating 12 and the resistance to blood dissolution after the transfer. Suitable cationic forms of cholesterol are modified at position 3 of carbon to attach a tertiary or quaternary branched amine and include DC-cholesterol. Suitable cationic forms of naturally occurring phospholipids include phospholipids and synthetic modifications of phospholipids, such as phosphatidylethanolamine, dioleoylphosphatidylethanolamine (DOPE), and phosphatidylcholine amine derivatives such as ethylphosphatidylcholine.
[031] In some embodiments, the length of the acyl chain and degree of unsaturation of the phospholipid component of the hydrophobic matrix 14 can be used to adapt the physical and chemical properties of the hydrophobic matrix 14. In some modalities, the long chain lengths are selected of acyl to increase the hydrophobicity of the phospholipid for adherence to the lumen wall and to decrease solubility and flushing out due to exposure of the blood flow. The length of the fatty acid acyl chain and the fatty acid portion of phospholipids are described by abbreviated notation with the number of carbon atoms, followed by a colon with the number of carbon-carbon double bonds. In the following description of phospholipids, either the generic or the trivial name, the specific stereo numbering and abbreviated notation is used for the first description of the compound. Acyl chain lengths of 20 to 34 carbon atoms (C20 to C34) are suitable for use as a coating component 12, with acyl chain lengths of 20 to 24 carbon atoms (C20 to C24) particularly preferred. Although the present invention also works with saturated acyl chains, one or more unsaturation sites can provide increased chain flexibility. Examples of preferred phospholipids include dieicosenoyl phosphatidylcholine (1,2-dieicosenoyl-sn-glycero-3-phosphocholine, C20: 1 PC), diaraquidonoyl phosphatidylcholine (1,2-diarachidoil-sn-glycero-3-phosphocoline, C20: 0 PC) , dierucoyl phosphatidylcholine (1,2-dierucoyl-sn-glycero-3-phosphocoline, C22: 1 PC), didocosahexaenoil phosphatidylcholine (1,2-didocosahexaenoil-sn-glycero-3-phosphocoline, C22: 6 PC), henicosenoyl phosphatidylcholine ( 1,2-heneicosenoyl-sn-glycero-3-phosphocholine, C21: 1 PC) and dinervonyl phosphatidylcholine (1,2-dinervonoil-sn-glycero-3-phosphocholine, C24: 1 PC). In some embodiments, the phospholipids have a transition temperature equal to or above room temperature (20 ° C) in such a way that the hydrophobic matrix 14 constitutes a solid during storage.
[032] The plurality of micro-reservoirs comprises an active agent and a polymer. The active agent can be referred to as a first active agent or a third active agent. The active agent is associated with the polymer in order to provide slow or prolonged release of the active agent from the micro-reservoirs. In some embodiments, the active agent is mixed with, or dispersed in, the biodegradable or bioerodible polymer. In some embodiments, the active agent can be encapsulated by the biodegradable or bioerodible polymer. In some embodiments, the plurality of micro-reservoirs may include a first active agent. In some embodiments, the plurality of micro-reservoirs may also include a third active agent. In some embodiments, a second active agent may be present outside a plurality of micro-reservoirs. The second active agent can be included in the hydrophobic matrix portion. Suitable active agent, such as the first, second or third active agent, may include antiproliferative or anti-inflammatory agents, such as paclitaxel, sirolimus (rapamycin) and their chemical or analogous derivatives, which are inhibitors of mTOR, inhibitory RNA, inhibitory DNA , steroids and complement inhibitors. In some embodiments, the active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivatives, paclitaxel analogs, sirolimus analogs, the inhibitory RNA, inhibitory DNA, steroids, and complement inhibitors. In some embodiments, the active agent is about 10% to about 50%, about 15% to about 45%, about 20% to about 40%, or about 25% to about 35% in weight, among the plurality of micro-reservoirs. Micro-reservoirs can include microparticles or microspheres. In some embodiments, polylactic-co-glycolic acid (PLGA) microspheres are well suited for incorporating the active agent for sustained release of up to approximately 50% by weight of the active agent in the microsphere.
[033] In some embodiments, the plurality of micro-reservoirs has an average diameter of about 0.5 microns to about 8 microns, about 2 microns to about 6 microns, or about 3 microns to about 5 microns . In some embodiments, micro-reservoirs are desired to be large enough to provide a sustained release of the active agent, about 1.5 microns or greater in diameter or average cross-sectional size of microparticles of non-uniform size. Smaller micro-reservoir sizes typically have an increased surface area in relation to volume, and reduced diffusional pathway for the active agent that does not provide sufficient prolonged release. The maximum size of the micro-reservoirs is approximately the size of a red blood cell, at about 6 microns to about 8 microns, to prevent capillary embolization due to any micro-reservoirs released into the bloodstream during or after the treatment. In some embodiments, micro-reservoirs do not necessarily have the affinity or adherence to the lumen wall.
[034] The biodegradable or bioderodible polymer can provide controlled and extended release of the active agent. The biodegradable or bioderodible polymer can be referred to as a first biodegradable or bioerodible polymer or a second biodegradable or bioerodible polymer. The polymer acts as a barrier to the diffusion of the drug, thus providing a release profile adapted to the pharmacokinetics of the active agent that acts on the treated vessel. For example, the active agent can be mixed and distributed in a polymer in a solid solution. The polymer can provide controlled release, reducing the diffusion of the active agent or by drug release coupling for biodegradation, dissolution or bioerosion of the polymer. In some embodiments, the biodegradable or bioderodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans, and a combination thereof. In some embodiments, the micro-reservoirs may also be microspheres or microparticles that contain at least one active agent which treats the inflammation or healing response. In some embodiments, the plurality of micro-reservoirs may include a first biodegradable or bioerodible polymer. In some embodiments, the plurality of micro-reservoirs may include a second biodegradable or bioerodible polymer.
[035] After the contact of the coating 12 with the lumen wall of the body, the release kinetics of the active agent is controlled by the release of the active agent from the micro-reservoirs to the surrounding environment, thus making available a sustained elution of agent active to penetrate the vessel wall. To provide significant active agent during the initial high-risk period for restenosis after swelling, it is preferred that the active agent in coating 12 be released continuously with a release kinetics half-life of about 2 weeks to about 6 weeks or more. In some embodiments, the plurality of micro-reservoirs has active agent release kinetics with a half-life of at least 14 days.
[036] The release kinetics of the active agent can be adapted by the characteristics of the micro-reservoirs. Two or more types of micro-reservoirs with different active agents or different release kinetics for the same active agent can be formulated into the coating 12, to adapt the treatment effect. In some embodiments, some active agent can be incorporated into the outer coating formulation of the micro-reservoirs to provide a rapid initial release of the active agent to the vessel walls, allowing the micro-reservoirs to provide sufficient active agent to maintain the effective concentration of the active agent tissue over an extended period of time. Since the healing and resolution of inflammation in the region of dilation usually takes 4-12 weeks, it is desirable to have micro-reservoirs and coating 12 to elute the active agent to provide therapeutic levels of tissue for at least about 4 weeks. about 12 weeks after treatment. In certain applications, such as vessels, which are extensively very long ill, maintaining levels of active agent for more than 4 to 12 weeks, it may be desirable to provide additional protection against the effects of less common late restenosis.
[037] The release of the active agent mixed with, or dispersed in, a solid was shown following Higuchi's kinetics with the decrease in the release of the active agent over time. For spherical particles with an active agent dispersed within the polymer, the release kinetics of the active agent also follows a power law of decreasing release speed, a Korsmeyer-Peppas kinetic model, similar to the Higuchi equation. (J. Siepmanna J, Peppas NA, Modeling of active agent release from delivery systems based on hydroxypropyl methylcellulose (HPMC), Advanced Drug Delivery Reviews 48 (2001) 139-157). The kinetics of release of the active agent from such micro-reservoirs is well suited for the treatment of the post-dilation wall vessel. The design and selection of micro-reservoirs with the appropriate release constant provides rapid initial release of the active agent with the extended release active agent, and extended residence of the active agent on the vessel wall over longer periods of time in comparison with state of the art devices. The release rate of the active agent can be adapted by the solubility of the active agent in the micro-reservoir material and by adjusting the micro-porosity of the micro-reservoir. The length of effective administration of the active agent can be adapted by selecting the size of the micro-reservoir, the solubility of the active agent in the micro-reservoir material, and the amount of active agent loaded in the micro-reservoirs. The total amount of active agent to be administered is determined by the amount of micro-reservoirs in the coating formulation and its level of active agent charge. As a result, coating 12 is capable of being formulated to have a concentration of active agent in the range of about 0.3 to about 3 μg per mm2 of expandable portion surface 11. The desired release kinetics of the active agent from of the coating 12 can be provided by a single type of micro-reservoir or, alternatively, by a mixture of micro-reservoirs with different size or release characteristics to provide the desired release profile for the vessel wall.
[038] In some embodiments, the coating 12 also includes a PEG-lipid to increase hemocompatibility. In some embodiments, the coating 12 disclosed herein was designed to be transferred to the luminal surface of the wall or in the lumen of a blood vessel and which remains there to release the drug during the healing period, therefore hemocompatibility of the coating 12 is desired. . In addition to preventing the coating 12 from dissolving into the blood stream before the vessel heals, it is desirable to prevent the initiation of significant coagulation and the attachment of fibrin and platelets to the surface of the coating exposed to blood after transfer. The addition of a PEG-lipid to the cholesterol composition and a phospholipid or fatty acid can be used to provide greater hemocompatibility of the formulation. PEG-grafted polymer surfaces showed improved blood contact characteristics mainly through the reduction of free interfacial energy and the spatial impediment of hydrated PEG chains on the surface. Although it is not intended to be linked to a particular theory of operation, it is believed that a small amount of PEG-lipid conjugate added to the composition can migrate to the surface of the blood interface after transfer, especially for relatively molecular weight PEG-lipids low. PEG chains are thus capable of lowering free interfacial energy on the surface of the blood interface. Since the coating material at the blood or fluid interface is a small part of the total coating, a relatively small amount of PEG-lipid is required.
[039] In some embodiments, PEG-lipid is selected from the group consisting of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) - 350 (DSPE-mPEG350), 1 , 2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-methoxy (polyethylene glycol) -350 (DPPE-mPEG350), 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -350 (DOPE -mPEG350), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DSPE-mPEG550), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-N-methoxy ( polyethylene glycol) -550 (DPPE-mPEG550), and 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -500 (DOPE-mPEG550). In some embodiments, PEG-lipid is from about 1% to about 30% by weight of the hydrophobic matrix 14, which consists of the combination of cholesterol, fatty acid or phospholipid and PEG-lipid. In other embodiments, the PEG-lipid is about 2% to about 25%, about 3% to about 20%, or about 5% to about 10% by weight of the hydrophobic matrix 14. In some embodiments , the amount of PEG-lipid is about 12% or less.
[040] In some embodiments, the coating 12 also includes one or more additives. In some embodiments, the one or more additives are independently selected from penetration enhancers and stabilizers. For example, coating 12 may further include performance enhancing additives, such as penetration enhancers. The penetration enhancer can help diffuse the active agent into the vessel wall and maximize the supply of active agent tissue. Suitable penetration enhancers can include surfactants, cationic excipients and cationic lipids. In some embodiments, the additive can be added to the hydrophobic matrix, the micro-reservoirs, or both. In some embodiments, stabilizers can be added to protect the drug during the sterilization of the balloon catheter system and its subsequent storage before use. Stabilizers can include antioxidants and free radical scavengers. Examples of stabilizers include gallic acid, propylgalate, tocopherols and tocotrienols (vitamin E), butylatodhydroxytoluene, butylatedhydroxyanisole, ascorbic acid, thioglycolic acid, ascorbyl palmitate, and EDTA.
[041] In some embodiments, the coating 12 further comprises a third active agent, in which the third active agent is outside the micro-reservoirs or in the hydrophobic matrix 14. The third active agent can be the same or different from the first or the second active agent, in the plurality of micro-reservoirs. However, since the active agent (s) is contained primarily in the micro-reservoirs and not in direct contact with the hydrophobic matrix 14, the need to solubilize or emulsify the active agent in the hydrophobic matrix 14 itself is obviated. Since the active agent (s) is contained primarily in the micro-reservoirs and not in contact with the hydrophobic matrix 14, in some embodiments, the need to include an amphiphilic component or constituent with an affinity for the active agent in the hydrophobic matrix 14 itself is obviated. The hydrophobic matrix 14 can therefore be optimized for the proper properties of resistance to blood or washing out of body fluids and adhesion to the luminal surface or to the lumen wall for the transfer coating 12. Catheter
[042] Referring to Fig. 2, there is also disclosed here a catheter 10 which includes an expandable portion 11 on an elongated body 17, a coating 12 as described above through the expandable portion 11, and a release layer 15 between the expandable portion 11 and liner 12. In some embodiments, release layer 15 is configured to release liner 12 from expandable portion 11. A release layer 15 that is immiscible with liner 12 is preferred to maintain distinct layers . In some embodiments, the conjugated PEG lipids are used as a release layer 15, as the degree of hydrophilicity and miscibility with the active agent coating 12 can be adapted by selecting the lipid and the length of the PEG chain. In some embodiments, release layer 15 is 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N- (methoxy (polyethylene glycol) -350) (DSPE-mPEG350) or 1,2-diestearoyl-sn-glycero- 3-phosphoethanolamine-N- (methoxy (polyethylene glycol) -550) (DSPE-mPEG550). In some embodiments, the release layer 15 has a surface concentration of about 0.1 μg / mm2 and about 5 μg / mm2, about 0.25 μg / mm2 and about 3 μg / mm2, or about 0.5 μg / mm2 and about 2 μg / mm2.
[043] With reference to Fig. 3, in some embodiments, the catheter 10 further includes a protective layer 16 on the coating 12, such as a top coating. In some embodiments, the protective layer 16 includes a hydrophilic polymer, a carbohydrate, or an amphiphilic polymer. In some embodiments, the protective layer 16 is a glycosaminoglycan or crystallized sugar. Examples of glycosaminoglycans include dextran sulfate, chondroitin sulfate, heparan sulfate, and hyaluronic acid. Examples of crystallized sugars include mannitol, sorbitol, erythritol, and xylitol. The crystalline nature of these sugars provides a hard surface that protects the underlying micro-reservoirs. The thickness of the protective layer 16 can be adjusted in such a way that the protective layer 16 flushes away during the transit time necessary to advance the catheter 10 to the target site. In some embodiments, the protective layer 16 has a surface concentration of about 0.1 μg / mm2 and about 5 μg / mm2, about 0.2 μg / mm2 and about 4 μg / mm2, or about 0.3 μg / mm2 and about 3 μg / mm2.
[044] The expandable portion 11 of catheter 10 can be a balloon, which acts as a substrate for the liner 12. In some embodiments, the balloon can be of a low pressure design using an elastomeric material, such as poly copolymers isoprene, polystyrene, polysiloxane, or polyurethane. In some embodiments, the balloon may also be of a high pressure design using polymers with high tensile strength, such as polyvinyl chloride, polyethylene, polyethylene terephthalate, or nylon. In some embodiments, the expandable portion 11 may be made of nylon 12. The coating 12 may be sufficiently adhered to the expandable portion 11, but is readily transferred to the tissues of the vessel lumen upon contact. In such cases, a release layer can be omitted. In addition, “Nylon 12” has sufficient strength such that the balloon can still act as a post-dilation balloon (if necessary) from a subsequent procedure after transferring the coating 12.
[045] In some embodiments, the expandable portion 11 below the liner 12 can be used to expand the target vessel. In some embodiments, the vessel may be provided with another balloon catheter 10, prior to treatment with the coated balloon of the present embodiments. Coating formulation
[046] A coating formulation for an expandable portion 11 of a catheter 10 is also described herein. The formulation includes a solid portion and a fluid. The solid portion includes a plurality of micro-reservoirs and at least one hydrophobic compound. The fluid acts to disperse or solubilize the at least one hydrophobic compound. In some embodiments, the fluid can disperse some hydrophobic compounds and others to solubilize hydrophobic compounds. The micro-reservoirs are dispersed and suspended in the resulting mixing fluid to form the coating formulation. The fluid mixture is formulated to form a homogeneous mixture of hydrophobic compounds that do not separate during drying to result in a uniform and shaped coating of the hydrophobic matrix 14. The coating formulation is characterized by the weight of the solid portion, which refers to all volatile components not in the coating formulation, but excludes the fluid that subsequently evaporates during coating drying.
[047] Micro-reservoirs include an active agent and a polymer. The active agent can be referred to as a first active agent or a third active agent, as described herein. The polymer can be a biodegradable or bioerodible polymer or a second biodegradable or bioderodible polymer described herein. In some embodiments, the active agent is mixed with, or dispersed in, the biodegradable or bioderodible polymer described herein. In some embodiments, the formulation may include more than one type of micro-reservoir. For example, the plurality of micro-reservoirs can include a first active agent and a biodegradable or bioerodible polymer. In some embodiments, the plurality of micro-reservoirs may also include a second active agent. In some embodiments, the plurality of micro-reservoirs may also include a second biodegradable or bioerodible polymer.
[048] Micro-reservoirs can be manufactured by any of the known means for the manufacture of particles, including spray drying, coacervation, micro-molding, and grinding. All of these processes start by dissolving the active agent and the polymer together in a suitable solvent, such as acetonitrile or dichloromethane, then removing the solvent in a controlled manner that creates uniform particles. The particles can also be shaped by mechanical means. The processes that produce particles with size distributions with coefficients of variation of 10% or less are particularly useful for providing more consistent active agent release rates. Methods for producing microspheres of uniform size are described by forming an emulsion of the microsphere material and extruding the emulsion through a substrate with controlled size holes, as described in US 7,972,543 and US 8,100,348. Alternatively, microspheres can be produced by polymer spray drying solutions as described in US 6,560,897 and US 20080206349.
[049] The fluid in the coating formulation may comprise water, organic solvent, perfluorinated hydrocarbon fluids, or a mixture of such liquids. In some embodiments, the fluid is selected from the group consisting of pentane, hexane, heptane, heptane and a mixture of fluorocarbons, alcohol and a mixture of fluorocarbons, and alcohol and a mixture of water. Fluids that readily solubilize the active agent or polymer from the micro-reservoirs are not preferred since they can extract the active agent from the micro-reservoirs. Such non-preferred fluids include acetic acid, acetonitrile, acetone, ethyl formate, cyclohexanone, DMSO and chloroform. Optionally, the liquid / liquid mixture can be selected to saturate at the desired level of extracted active agent. The additional active agent that is the same as that of the micro-reservoirs can be added to the fluid in advance to pre-saturate the solution, thereby reducing the extraction from the micro-reservoirs during coating processing.
[050] In some embodiments, at least one hydrophobic compound is selected from the group consisting of lipids, sterols, phospholipids, fats, fatty acids and surfactants, and their derivatives. In some embodiments, the at least one hydrophobic compound comprises a cholesterol and a fatty acid, as described herein. In other embodiments, the at least one hydrophobic compound comprises a cholesterol and a phospholipid, as described herein. In some embodiments, the formulation can also include a PEG-lipid, as described herein. In some embodiments, the formulation may also include additives such as penetration enhancers and stabilizers.
[051] In some embodiments, the solid portion also includes a third active agent outside the plurality of micro-reservoirs. In other words, the coating formulation can lead to a hydrophobic matrix 14, which further comprises the third active agent. The active agent outside the micro-reservoirs can be the same or different from the active agent (s) in the micro-reservoirs. In some embodiments, the solid portion may further comprise a PEG-lipid. In some embodiments, the solid portion may also further comprise an additive described herein.
[052] In some embodiments, the concentration of the solid portion by weight percent of the coating formulation is approximately 1% to approximately 90%. In some embodiments, the solids content of the coating formulation has a concentration of about 2% to about 80% by weight, about 3% to about 70% by weight, or about 4% to about 60% % by weight. In some embodiments for spray coating, the solid portion of the coating formulation has a concentration of about 2% to about 7% by weight. The solid portion of the coating formulation comprises about 10% to about 75%, about 20% to about 65%, or about 30% to about 55%, by weight, among the plurality of micro-reservoirs .
[053] The coating composition can be produced by forming a mixture of at least two hydrophobic compounds and a plurality of micro-reservoirs, as described herein. The plurality of micro-reservoirs comprises a first active agent and a biodegradable or bioerodible polymer. The at least two hydrophobic compounds comprise a cholesterol and a phospholipid or a cholesterol and a fatty acid, wherein at least two hydrophobic compounds are present in sufficient quantities and proportions to transfer the lining of an expandable portion of a catheter to a wall of the catheter. lumen, such as a vessel wall. In some embodiments, the mixture further includes a PEG-lipid, as described above. Coating Method
[054] A method for coating an expandable portion 11 of a catheter 10 is also described here. The steps include, eliminating a formulation described here on the surface of an expanded expandable portion 11 of a catheter 10, evaporating the fluid constituents of the coating formulation, and collapsing the expandable portion 11. Eliminating a formulation on the surface of an expanded expandable portion 11 includes eliminating the formulation on the surface of an expanded expandable portion 11. In some embodiments, the formulation may be arranged in or on the expanded expandable portion 11 by spray coating, dip coating, roller coating, electrostatic deposition, printing, pipetting, or dispensing.
[055] The coating formulation is prepared by mixing the coating components in a fluid, as disclosed herein. In some embodiments, micro-reservoirs are dispersed in the fluid formulation. Once completely mixed, the coating formulation can be applied to the surface of the expandable expanded portion 11, such as a balloon and allowed to dry to form coating 12. Application of the coating formulation can be repeated as needed to deposit the desired amount of coating 12, generally in the range of about 5 mg to about 9 mg of coating 12 mm2 per surface of the flask. The liner 12 is left to dry, and the flask deflated and folded to allow introduction into the vascular system. In some embodiments, the release layer has already been placed on the surface of the expandable expanded portion 11, and the coating formulation can be applied over the existing and dried release layer to form coating 12. As such, the release layer is between the surface of the expanded expandable portion 11 and the liner 12.
[056] In some embodiments, the method may further comprise a release layer on the surface of an expanded expandable portion 11. As such, the coating formulation would be arranged on the release layer, while the release layer is arranged on the surface of the expanded expandable layer 11. The release layer is described above. Method for treating or preventing a condition
[057] A method for treating or preventing a condition at a treatment site is also described here. The method involves the steps of advancing a catheter 10, which comprises an expandable portion 11 to the treatment site, expanding the expandable portion 11 to allow contact between the coating and a tissue at the treatment site, the collapse of the expandable portion 11, and removing the catheter 10. The expandable portion 11 is coated with a coating described herein. In some embodiments, contact between the fabric and the liner results in a transfer of at least a portion of a liner over the expandable portion 11 to the expandable portion of the treatment site 11 and the liner for a period of from about 30 to about 120 seconds.
[058] A catheter 10 with the expandable portion 11, such as a coated balloon catheter is used here to demonstrate the concept of releasing an active agent or a combination of active agents into a vessel. The coated balloon catheter is introduced into a vessel with the expandable portion 11 folded to provide a small cross-section profile and to facilitate percutaneous insertion of catheter 10, for example, the well-known Seldinger technique. After the expandable portion 11 of catheter 10 is advanced into the diseased area of the vessel for treatment, the balloon is inflated, and the lining comes in firm contact with the vessel lumen. The coating is formulated to have an affinity for the luminal surface of the tissue, resulting in the adhesion of a coating layer on the vessel lumen. The expandable portion 11 can be inflated or expanded for a period of 30 seconds to 2 minutes, to promote adherence and to provide the initial penetration of the active agent into the vessel wall. The expandable portion 11 can be deflated, and inflation repeated as desired for the treatment of managing the time period and risks of vascular occlusion or tissue ischemia. The coating is adhesive transferred to the vessel light, after the balloon is filled and a firm surface contact of the balloon to the luminal surface of the vessel. The adhesion of the coating to the vessel surface, thus transporting the micro-reservoirs and transferring them to the vessel surface.
[059] In some embodiments, the condition is selected from the group consisting of atherosclerosis, stenosis or the reduction in luminal diameter in diseased blood vessels, restenosis, and in-stent restenosis. In some embodiments, an additional release layer as described herein is placed between the expandable portion 11 and the liner.
[060] Although the present description is directed to the treatment of restenosis related to the dilation of the blood vessel balloon, the invention can be used to administer medications to other lumens and hollow structures of the body, such as the structures of the respiratory system, system gastrointestinal, urinary system, reproductive system and lymphatic system. The device can be coated with an inflatable balloon or other inflatable device. Alternatively, the coating delivery device of the present invention can be a non-inflatable device or any other type of expandable device that is used for the treatment of a living body. EXAMPLES Example 1
[061] Micro-Reservoirs Containing Medicines (microspheres) manufactured by coacervation of polylactic-co-glycolic acid copolymer incorporating sirolimus (rapamycin)
[062] Microsphere sample 1: 50% DL-lactide / 50% glycolide copolymer, average diameter of 3.1 μm, SD 0.44 μm, 39% by weight of sirolimus
[063] Microsphere sample 2: 75% DL-lactide / 25% glycolide copolymer, average diameter of 3.2 μm, SD 0.76 μm, 40% by weight of sirolimus
[064] Microsphere Sample 3: 50% DL-lactide / 50% glycolide copolymer, average diameter of 2.7 μm, SD 0.8 μm, 45% by weight of sirolimus
[065] Microsphere Sample 4: 75% DL-lactide / 25% glycolide copolymer, mean diameter of 3.3 μm, SD 1.2 μm, 46% by weight of sirolimus
[066] Microsphere sample 5: 75% DL-lactide / 25% glycolide copolymer, mean diameter of 4.1 μm, SD 0.61 μm, 25% by weight of sirolimus
[067] Microsphere Sample 6: 75% DL-lactide / 25% glycolide copolymer, average diameter of 3.78 μm, SD 0.44 μm, 28.8% by weight of sirolimus
[068] Microsphere sample 7: 75% DL-lactide / 25% glycolide copolymer, average diameter of 3.8 μm, SD 0.34 μm, 27.7% by weight of sirolimus
[069] Microsphere Sample 8: 75% DL-lactide / 25% glycolide copolymer, average diameter of 3.79 μm, SD 0.39 μm, 29.4% by weight of sirolimus
[070] The drug content of these micro-reservoirs was verified by the method of quantification by HPLC. Typically, micro-reservoirs (1 to 5 mg) were weighed and dissolved in 1 ml of acetonitrile, stirred gently at room temperature for several hours or at 37 ° C for 1 hour, and diluted 50 to 200 times with acetonitrile. The absorbance at 278 nm was monitored, and the content was determined from linear calibration curves. Example 2: sustained release of drugs from micro-reservoirs under physiological conditions
[071] The micro-reservoirs of Example 1 were tested for sustained drug release. Micro-reservoir samples weighing 2 to 5 mg were placed in 1.6 ml Eppendorf tubes with 1.2 ml of phosphate buffered saline (PBS) to simulate a physiological environment. After an initial wash to remove any drug not incorporated in the micro-reservoirs, the tubes were incubated at 37 ° C with gentle shaking at 250 rpm. The PBS was sampled at time intervals and the drug released was quantified by reverse phase HPLC using a C18 column.
[072] The micro-reservoirs were tested for drug elution over 5 hours. The resulting drug release was fit for the Korsmeyer-Peppas kinetic equation for drug release from a polymer with dispersed drug. The results of the Korsmeyer-Peppas model are listed in Table 1.Table 1. 5-hour Korsmeer-Peppas Modeling of Drug Release

[073] Short-term administration results demonstrate typical Korsmeyer-Peppas drug release constants for the drug dispersed in a spherical polymer particle with probably a small contribution from polymer erosion or degradation to microsphere samples 1, 2, and 3.
[074] Study of prolonged drug release: The microspheres were tested for drug elution over 7 days, using the methods described for the test over 5 hours. The resulting drug release is shown in Table 2.Table 2. 7-Day Drug Release Test

[075] The release rates from the 7-day administration results were fitted with the Higuchi equation: Q = A [D (2C - Cs) Cs t] 1/2 Q = Kh (t) 1/2 where Q is the amount of drug released at time t per unit area A, C is the initial drug concentration, Cs is the solubility of the drug in the polymeric media and D is the diffusion coefficient for the drug in the microsphere polymer. In the generalized equation, Kh is the Higuchi constant incorporating the zone coefficients, diffusion coefficient and drug concentration.
[076] The Higuchi equation was used to determine the release half-life of the micro-reservoirs and also to estimate the half-life as a function of the size of the microspheres. The resulting release half-lives are shown in Table 3.Table 3. Drug release half-life from Higuchi modeling


[077] The results demonstrate that the drug administration half-life from the micro-reservoirs can be adapted by the formulation and size of the micro-reservoirs. For an administration half-life of at least 14 days, a microsphere size of 1.5 microns in diameter or greater is estimated necessary.
[078] The extended release check: Microsphere Sample 4 was tested for drug release over 8 weeks, using the methods previously described. Due to the relatively long time intervals between harvest, compared to previous release experiments, micro-reservoirs cannot have released under immersion conditions at later time points, potentially decreasing the effective release rate. The resulting drug release is shown in Table 4.Table 4. Extended drug release test for 56 days


[079] The results verify the prolonged release of drugs from the micro-reservoirs. Micro-reservoirs can be adapted or selected with a half-life to provide drug during the dilated vessel's curing period. Example 3: Micro-reservoir formulations in the cholesterol and fatty acid coating formulation with PEG-lipid
[080] The coating formulation was prepared with 107 mg of stearic acid, 105 mg of cholesterol and 50 mg of DPPE-mPEG350 mixed with 14 ml of heptane and heated to 60 ° C in such a way that a clear solution was obtained . The solution was then mixed vigorously for 30 seconds and allowed to cool. Then, 200 mg of microspheres loaded with sample # 6 Sirolimus were added, and the formulation was placed in an ultrasound bath for 4 minutes to disperse and suspend the microspheres. [Formulation 1023E]
[081] The coating formulation was prepared with 58 mg of erucic acid, 43 mg of DC-cholesterol, and 6.25 mg of DOPE-mPEG350 mixed with 7 ml of heptane and heated to 60 ° C such that a solution clear was obtained. The solution was then mixed vigorously for 30 seconds and allowed to cool. Then, 100 mg of microspheres loaded with sample # 8 Sirolimus were added, and the formulation was placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0424A]
[082] The coating formulation was prepared with 25 mg of nervous acid, 75 mg of DC-cholesterol, and 6.25 mg of DOPE-mPEG350 mixed with 7 ml of heptane and heated to 60 ° C in such a way that a solution clear was obtained. The solution was then mixed vigorously for 30 seconds and allowed to cool. Then, 97 mg of microspheres loaded with sample # 8 Sirolimus was added, and the formulation was placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0422E] Example 4: Additive formulation of micro-reservoirs in the formulation of cholesterol, fatty acid, PEG-lipid coating and stabilization
[083] The coating formulation was prepared with 77 mg of stearic acid, 40 mg of cholesterol, 50 mg of DPPE-mPEG350, and 58 mg of alpha-tocopherol mixed with 7 ml of heptane and heated to 60 ° C until obtaining a clear solution. The solution was mixed vigorously for 1 minute and allowed to cool to room temperature. Then, 100 mg of microspheres loaded with Sirolimus from sample # 5 were added. The formulation was placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 1009 A] Example 5: Formulation of micro-reservoirs in the formulation of cholesterol and phospholipid coating
[084] The coating formulation was prepared with 43 mg of cholesterol and 42 mg of L-alpha-phosphatidylcholine mixed with 7 ml of heptane and heated to 60 ° C. The solution was mixed vigorously for 30 seconds and then allowed to cool to room temperature. Then, 100 mg of microspheres loaded with sample # 5 Sirolimus were added to the flask which was then placed in an ultrasonic bath for 8 minutes to disperse and suspend the microspheres. [Formulation 0311 A] Example 6: Formulation of micro-reservoirs in the formulation of cholesterol and acyl phospholipid long chain coating, with and without PEG-lipid
[085] The coating formulation was prepared with 51 mg of DC-cholesterol, 6.25 mg of DOPE-mPEG350 and 51 mg of phosphatidyl-dierucoyl (DEPC) mixed with 7 ml of heptane and heated to 60 ° C. The solution was mixed vigorously for 30 seconds and then allowed to cool to room temperature. Then, 100 mg of microspheres loaded with sample # 7 Sirolimus were added to the flask which was then placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0410A]
[086] The coating formulation was prepared with 20 mg of DC-cholesterol, 26 mg of cholesterol, 6.25 mg of DOPE-mPEG350 and 75 mg of dinervonyl phosphatidylcholine (DNPC) mixed with 7 ml of heptane and heated to 60 ° Ç. The formulation had a weight ratio of DNPC to DC-cholesterol of 1.6: 1. The solution was allowed to cool to room temperature. Then, 97 mg of microspheres loaded with sample # Sirolimus were added to the flask which was then vigorously mixed for 30 seconds and then placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0421A]
[087] The coating formulation was prepared with 28 mg of DC-cholesterol, 26 mg of cholesterol, 6.25 mg of DOPE-mPEG350 and 50 mg of dinervonyl phosphatidylcholine (DNPC) mixed with 7 ml of heptane and heated to 60 ° Ç. The solution was mixed vigorously for 30 seconds and then allowed to cool to room temperature. Then, 97 mg of microspheres loaded with sample # 7 Sirolimus were added to the flask which was then placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0421B]
[088] The coating formulation was prepared with 50 mg of DC-cholesterol and 50 mg of dinervonyl phosphatidylcholine (DNPC) mixed with 7 ml of heptane and heated to 60 ° C. The formulation had a 1: 1 ratio of DNPC to DC-cholesterol by weight. The solution was mixed vigorously for 30 seconds and then allowed to cool to room temperature. Then, 100 mg of microspheres loaded with sample # 7 Sirolimus were added to the flask which was then placed in an ultrasound bath for 4 minutes to disperse and suspend the microspheres. [Formulation 1205 A]
[089] The coating formulation was prepared with 49 mg DC-cholesterol, 6.25 mg DOPE-mPEG350 and 50 mg dinervonyl phosphatidylcholine (DNPC) mixed with 7 ml heptane and heated to 60 ° C. The formulation had a 1: 1 weight ratio of DNPC to DC-cholesterol. The solution was mixed vigorously for 30 seconds and then allowed to cool to room temperature. Then, 100 mg of microspheres loaded with sample # 7 Sirolimus were added to the flask which was then placed in an ultrasound bath for 2 minutes to disperse and suspend the microspheres. [Formulation 1209A]
[090] The coating formulation was prepared with 76 mg of DC-cholesterol, 6.25 mg of DOPE-mPEG350 and 25 mg dinervonyl phosphatidylcholine (DNPC) mixed with 7 ml of heptane and heated to 60 ° C. The formulation had a 1: 3 weight ratio of DNPC to DC-cholesterol. The solution was allowed to cool to room temperature. Then, 100.7 mg of microspheres loaded with sample # 8 Sirolimus were added to the flask, mixed vigorously for 30 seconds and then placed in an ultrasound bath for 5 minutes to disperse and suspend the microspheres. [Formulation 0513A] Example 7: Formulation of micro-reservoirs in the formulation of DC-cholesterol coating with different PEG-lipid content
[091] The coating formulation was prepared with 12.5 mg of DOPE-mPEG350, 44 mg of DC-cholesterol and 44 mg of dinervonoil phosphatidylcholine (DNPC) mixed with 7 ml of heptane heated to 60 ° C. The clear solution was allowed to cool to room temperature, then 97 mg of microspheres loaded with sample # 8 microsphere Sirolimus were added. The formulation was then placed in an ultrasound bath and sonicated for 5 minutes to disperse and suspend the microspheres. [Formulation 0422A]
[092] The coating formulation was prepared with 25 mg of DOPE-mPEG350, 37.5 mg of DC-cholesterol and 37.5 mg of dinervonoil phosphatidylcholine (DNPC) mixed with 7 ml of heptane heated to 60 ° C. The clear solution was allowed to cool to room temperature and then 97 mg of microspheres loaded with Sirolimus from microsphere sample # 8 were added. The formulation was then placed in an ultrasound bath and sonicated for 5 minutes to disperse and suspend the microspheres. [Formulation 0422B] Example 8: Coating with additional drug
[093] The coating formulation was prepared with 72.9 mg of DC-cholesterol in 7 ml of heptane and heated to 60 ° C until the DC-cholesterol was solubilized to produce a clear solution. To the solution, 15.5 mg of sirolimus was added and mixed vigorously for 30 seconds. The solution was heated for 40 minutes, vortexed 10 seconds every 10 minutes and sonicated for 5 minutes while cooling to room temperature. To the solution, 50 mg of DNPC was added. When at room temperature, the solution was filtered through a 0.2 micron PTFE filter to remove large particles of drug. The solution was left overnight with no particles formed observed overnight. The solution was tested, and the sirolimus content was found to be 0.96 mg per ml. To the solution, 98 mg of microspheres loaded with Sirolimus from sample # 8 of microspheres were added, mixed vigorously for 30 seconds and sonicated for 8 minutes to disperse and suspend the microspheres. The resulting coating formulation contained 0.71% by weight of sirolimus which 19.1% of the drug was in the DC-cholesterol and hydrophobic DNPC matrix with the remainder in the microspheres. [Formulation 0512A]
[094] The weight percentage compositions of the coating formulations described in Examples 3, 4, 5, 6, 7 and 8 are shown in Table 5.Table 5. Weight percentage compositions of the coating formulations


Example 9: Application of catheter balloon coating formulation
[095] The stearic acid coating formulation of Example 3 (Formulation 1023E) was sprayed onto the surface of the 5.0 mm long x 20 mm diameter nylon balloon of angioplasty balloons. Seven ml of the coating formulation was loaded into a 25 ml gas-tight syringe with an integrated magnetic stir bar system. The formulation was continuously agitated during spraying to keep the drug micro-reservoirs well suspended. A syringe pump delivers the coating formulation at a rate of 0.11 mL / min through a 120 KHz ultrasound nozzle and is activated with 5.5 watts of power [Sonotek DES1000]. To verify the process parameters, a cylinder with a length of 5.0 mm in diameter x 20 mm from the balloon material was cut, weighed and placed in relation to the same balloon size. This piece of material from the flask was then coated and weighed to verify about 2.2 mg of total coating was applied, which corresponds to 7 μg / mm2 of coating density. Of this 7 μg / mm2 of the formulation of Example 3, stearic acid constituted about 1.6 μg / mm2, cholesterol composed of 1.6 μg / mm2, DPPE-mPEG350 0.8 μg / mm2 and sirolimus microspheres loaded from the microsphere sample # 5 at 3 μg / mm2 resulting in a drug density of 0.87 μg / mm2. Once the weights of the piece confirmed that the objective weight had been reached, the filled balloons were coated. A 5.0 mm diameter x 20 mm long balloon was inflated, positioned under the spray and then rotated constantly while moving back and forth 5 times. The flask was then removed and left to dry. The process was repeated until 6 balloons were coated. This same process was repeated to spray the coating formulation of Example 6 (Formulation 0513A) into 3.0 mm diameter x 20 mm balloon lengths. The target weight of the coating piece for a 3.0 mm x 20 mm diameter balloon length with the formulation of Example 6 (Formulation 0513A) was 1.4 mg until it reached a coating density of 7.6 μg / mm2. From this 7.6 μg / mm2, dinervonoil phosphatidylcholine comprised 0.9 μg / mm2, DC-cholesterol 2.7 μg / mm2, DOPE-mPEG350 0.23 μg / mm2, and the microspheres loaded with sample # 5 comprised 3 , 7 μg / mm2, resulting in a drug density of 1.08 μg / mm2.
[096] The coating formulations of Examples 4, 5, 6, 7 and 8 were also sprayed onto the surface of the 20 mm long balloons in the spray form of the formulation of Example 3 described above. The coating weights and resulting coating densities are shown in Table 6.Table 6. Coating of balloon catheters


[097] For coated flasks with the formulation of Example 4, each flask was sprayed with an additional top coating formulation (1010D) consisting of 1 mg of cholesterol and cholesterol-PEG600 coating to cover the micro-reservoir layer. To make this top coat, 23 mg of cholesterol-PEG600 and 224 mg of cholesterol were dissolved in 7 ml of isopropanol. The target coating weight of 1 mg in a 5.0 mm diameter x 20 mm flask corresponds to 3.2 μg / mm2 of total top coating composed of 0.3 μg / mm2 of cholesterol-PEG600 and 2 , 9 μg / mm2 of cholesterol. Example 10: adhesion of coatings to the luminal surface of vessels
[098] Ex-vivo porcine arteries were washed with 37 ° C Ringer's lactate solution at 50 mL / min pulsatile flow (approximately 72 BPM) for 5 minutes. The balloons coated with the formulation of Example 3 were inflated in the lumen of the porcine arteries ex vivo to an approximately 1: 1.2 super stretch to transfer the drug-containing coating to the vessel lumen. The solution that passed through the arteries before and after inflation (pre and post embedded), the balloon used for the arteries, and the section of the artery contacting the inflated balloon were subsequently analyzed for the drug after 5 minutes of post-inflation flow. The vessels treated with formulations 1205A and 1209A were stained for a total of 60 minutes, to assess the prolonged stability of the transferred coating. The amount of drug measured from all sources in the assay was totaled and compared to the predicted drug content of the flask based on the weight of the coating. The proportion of drug transferred to the artery based on the estimated drug content of the flask by coating weight was used as a measure of transfer efficiency.Table 7. Stearic Acid - Cholesterol Formulation [Formulation 1023E]

Table 8. Formulation of erucic acid - DC-cholesterol [Formulation 0424A]
Table 9. Nervonic Acid Formulation - DC-cholesterol [Formulation 0422E]


[099] Flasks coated with the formulation of Example 4 were also tested in ex vivo porcine arteries. Table 10. Stearic acid formulation - Cholesterol-alpha-tocopherol [Formulation 1009A / 1010D]

[0100] The balloons coated with the formulation of Example 5 were also tested in ex-vivo porcine arteries. Table 11. Formulation of L-alpha-Phosphatidylcholine -Colesterol [Formulation 0311A]


[0101] Flasks coated with the formulation of Example 6 were also tested in ex vivo porcine arteries. Table 12. DEPC formulation - DC-Cholesterol [Formulation 0410A]
Table 13. Formulation of DNPC - DC-Cholesterol [Formulation 0421A]

Table 14. DNPC formulation - DC-Cholesterol-Cholesterol [Formulation 0421B]
Table 15. DNPC formulation - DC-cholesterol (without PEG-Lipid) [Formulation 1205A]

Table.16. DNPC formulation - DC-cholesterol (PEGLipid) [Formulation 1209 A]
Table 17. DNPC formulation - DC-cholesterol (PEG-Lipid) [Formulation 0513A]


[0102] The luminal surface of the artery after insufflation of the balloon coated with Formulation 1209A and after one hour of post-fluid fluid inflation was seen under dark field microscopy. FIG. 4 is a photomicrograph of the luminal surface at 200X magnification, showing the adhered material. FIG. 5 is a photomicrograph of the surface at 1000X magnification showing the material adhering to be a layer of spherical micro-reservoirs surrounded by coating material. Example 11: Adhesion of coatings to the Luminal surface of the formulation vessel with varying PEG-lipid content
[0103] The samples of Example 7 were tested for transfer and wash resistance of the coating using the methods of Example 10. The results were tabulated to compare coatings with DNPC and DC-cholesterol in equal weight proportions with varying amounts of DOPE -mPEG350. [Formulations 1205A, 1209A, 0422A, 0422B] Table 18. Transfer and wash resistance for various coating formulations


[0104] The results demonstrate a significant transfer of drug coating to the vessel lumen. Loss of drug coating during pre-flushing was increased for coating formulation with 25% PEG-lipids. Example 12: Adhesion of coating with additional sirolimus to the luminal surface of vessels
[0105] The formulation of Example 8 was tested for transfer and wash resistance to washing using the methods of Example 10.Table 19. Formulation of DNPC-DC Cholesterol with Additional Drug [Formulation 0512A]


[0106] The results demonstrate significant drug transfer to the vessel lumen from an additional coating with drug added to the phospholipid and cholesterol components of the coating formulation. Example 13: The release of the drug in a treated vessel in vivo
[0107] To prepare the balloon catheters coated with drug micro-reservoir containing the formulation, 100 mg of DNPC, 103 mg of DC-cholesterol and 12.5 mg of DOPE-mPEG350 were mixed in 14 ml of heptane. The mixture was heated to 60 ° C to dissolve the solid components and cooled to room temperature. Then 195 mg of sample # 6 of microspheres were added and the microspheres were suspended to suspend. balloon catheters with 3.0 mm long x 20 mm diameter balloons were coated with the formulation using the methods described in Example 9. The coated balloon catheters were allowed to dry. An average of 1.28 mg ± 0.12 mg of dry coating was applied to the flasks, resulting in a coating density of 6.80 μg / mm2 and a drug density of 1.06 μg / mm2. The balloons were deflated and folded to a pre-implant configuration with a smaller cross section, and wrapped in a sleeve to retain the folded configuration. The balloon catheters were packaged and sterilized by ionizing radiation with a minimum dose of 25 kilogray.
[0108] The rabbit's iliofermoral artery was used to assess the in vivo transfer of the drug's coating to an arterial vessel. The iliofermoral artery segment for treatment was first stripped of the endothelium to reproduce tissue damage after angioplasty. Dissection was performed on the common carotid artery, and a 5F balloon cuneiform catheter was inserted into the artery and directed under fluoroscopic guidance to the femoral artery treatment site. Contrast agent was injected through the catheter, and angiograms of iliofemoral arteries recorded. The balloon cuniform catheter was exchanged for a standard 3.0 mm diameter x 8 mm angioplasty balloon catheter under fluoroscopic guidance, inflated, and removed proximally in its inflated state, approximately at the level of the iliac bifurcation to bare the section of the artery. The angioplasty balloon catheter was replaced with a drug-coated balloon catheter. The catheter was advanced to the vessel segment, stripped and inflated for 120 seconds. The balloon was deflated and removed. The right and left iliac arteries of each animal were treated.
[0109] A total of eleven animals were treated. One animal (2 treated iliac arteries) was sacrificed one hour after treatment and the vessel segments were recovered for microscopic examination. Another animal (2 treated iliac arteries) was euthanized 24 hours after treatment, and segments of vessels recovered for microscopic examination. Three animals (6 iliac arteries) were recovered at each time point of 1 hour, 7 days and 28 days. Blood samples were taken from these animals before surgery, at 0.5, 1, 4 hours after treatment and at the time of sacrifice. The vessel segments were recovered and analyzed for drug content by HPLC / MS quantification.
[0110] Assay of blood samples showed an accelerated decline of the drug in circulating blood, with a concentration of 4.75 ng / mL in 30 minutes, 2.63 ng / mL at 1 hour and 0.82 ng / mL in 4 hours. The blood drug concentration collected at the time of sacrifice for the 7 day and 28 day time points was below the detection limit for the quantification assay. Blood levels were adjusted to an exponential decay curve with a half-life of 0.77 hours, indicating rapid dilution and clearance of the drug from the bloodstream.
[0111] Scanning electron microscopy and light microscopy of tissue samples collected 1 hour and 24 hours after treatment demonstrated a layer of material on the lumen surface of the vessel with spherical drug micro-reservoirs observed within the layer. Irregular areas of fibrin were observed on the luminal surface, but no large deposits of fibrin indicative of blood incompatibility were observed to be associated with the lining.
[0112] Assay of treated vessel segments demonstrated tissue drug levels of 261 μg / g ± 116.5 μg / g in 1 hour after treatment, 43.8 μg / g ± 34.2 μg / g in 7 days after treatment and 21.5 μg / g ± 17.3 μg / g at 28 days after treatment. The results indicate the adhesion of the coating containing drug micro-reservoirs to the luminal surface of an artery with the sustained presence of medication associated with the tissues of the treated vessel over 28 days. The associated drug tissue levels demonstrated a rapid initial decline that took between 7 and 28 days. The associated drug tissue levels after 7 and 28 days were adjusted to an exponential decay, indicating a half-life of about 20.4 days. Additional modalities
[0113] Although the present invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond those specifically described for other alternative embodiments and / or uses of the present invention and obvious and equivalent modifications thereof. In addition, it is contemplated that various aspects and characteristics of the described invention can be practiced separately, combined together, or replaced by one another, and that a wide variety of combinations and sub-combinations of the characteristics and aspects can be made and still fall into. the scope of the invention. In addition, the disclosure here of any special characteristic, aspect, method, property, characteristic, quality, attribute, component, or the like, in connection with a modality can be used in all other modalities presented here. Thus, it is intended that the scope of the present invention disclosed herein should not be limited by the particular disclosed modalities described above, but should be determined only by a fair reading of the claims.
[0114] Conditional language, such as, among others, "could", "can", or "can", unless specifically stated otherwise, or otherwise understood within the context as used, is generally the intention to convey that certain modalities include, while other modalities do not include certain characteristics or elements. Thus, such a conditional language is not generally intended to imply that characteristics or elements are in no way necessary for one or more modalities. Synthesis of Modalities
[0115] A coating for an expandable portion of a catheter comprising a hydrophobic matrix and a dispersed phase comprising a plurality of micro-reservoirs dispersed in the hydrophobic matrix, wherein the plurality of micro-reservoirs comprises a first active agent and a biodegradable polymer or bioerodible. The coating is configured to transfer to a wall of the lumen when the expandable portion is expanded.
[0116] In coating modalities as described above, the first active agent is mixed with, or dispersed in, the biodegradable or bioerodible polymer.
[0117] In embodiments the coating as described above, the biodegradable or bioderodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans, and combination of them.
[0118] In embodiments the coating as described above, the hydrophobic matrix comprises at least one hydrophobic compound selected from the group consisting of lipids, sterols, phospholipids, fatty acids, fats, surfactants, and their derivatives.
[0119] In some embodiments of the coating described above, in which the hydrophobic matrix comprises a cholesterol and a fatty acid. In some embodiments, the weight ratio of fatty acid cholesterol is in the range of about 1: 2 to about 3: 1.
[0120] In embodiments the coating as described above, the fatty acid is selected from the group consisting of lauric acid, lauroleic acid, tetradeadienoic acid, octanoic acid, myristic acid, myristoleic acid, decenoic acid, decanoic acid, hexadecenoic acid, palmitoleic acid, palmitic acid, linolenic acid, linoleic acid, oleic acid, vaccenic acid, stearic acid, eicosapentaenoic acid, arachidonic acid, Mead acid, arachidic acid, docosahexaenoic acid, docosapentaenoic acid, docosatetraenoic acid, docosacosenoic acid, tetra acid , hexacosenoic acid, pristanic acid, phycanic acid and nervous acid.
[0121] In other embodiments the coating described above, wherein the hydrophobic matrix comprises a cholesterol and a phospholipid. In some embodiments, the weight ratio of cholesterol to phospholipid is in the range of about 1: 2 to about 3: 1.
[0122] In some embodiments, the phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, and phosphatidylinositol.
[0123] In some embodiments, the phospholipid is a cationic phospholipid. In some embodiments, the cationic phospholipid is phosphatidylethanolamine, dioleoylphosphatidylethanolamine (DOPE), or an amine derivative of phosphatidylcholine.
[0124] In some embodiments, the phospholipid comprises an acyl chain length of about 20 to about 34 carbon atoms. In some embodiments, the phospholipid is selected from the group consisting of dieicosenoyl phosphatidylcholine (1,2-dieicosenoyl-sn-glycero-3-phosphocholine, C20: 1 PC), diaracidonoyl phosphatidylcholine (1,2-diaracidoil-sn-glycerine -3-phosphocholine, C20: 0 PC), dierucoyl phosphatidylcholine (1,2-dierucoyl-sn-glycero-3-phosphocholine, C22: 1 PC), didocosahexaenoyl phosphatidylcholine (1,2-didocosahexaenoil-sn-glycerine-3-phosphocoline , C22: 6 PC), henicosenoyl phosphatidylcholine (1,2-henicosenoyl-sn-glycero-3-phosphocholine, C21: 1 PC) and dinarvonyl phosphatidylcholine (1,2-dinarvonoil-sn-glycero-3-phosphocholine, C24: 1 PRAÇA).
[0125] In embodiments the coating as described above, the cholesterol is DC-cholesterol.
[0126] In embodiments the coating as described above, the plurality of micro-reservoirs is from about 10% to about 75% by weight of the coating.
[0127] In coating modalities as described above, the plurality of micro-reservoirs has an average diameter of about 1.5 microns to about 8 microns. In some embodiments, the plurality of micro-reservoirs has an average diameter of about 2 microns to about 6 microns. In some embodiments, the plurality of micro-reservoirs has an average diameter of about 3 microns to about 5 microns.
[0128] In coating modalities as described above, the plurality of micro-reservoirs has an active ingredient release kinetics with a half-life of at least 14 days.
[0129] In embodiments the coating as described above, the first biodegradable or bioderodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans , and combination thereof.
[0130] In embodiments the coating as described above, the first active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivatives, paclitaxel analogs, sirolimus analogs, the inhibitory RNA, DNA inhibitor, steroids, and complement inhibitors.
[0131] In embodiments the coating as described above, the first active agent is from about 10% to about 50%, by weight, among the plurality of micro-reservoirs.
[0132] In embodiments the coating as described above, the coating further comprises a second active agent outside the plurality of micro-reservoirs. In some embodiments, the second active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivative, paclitaxel analogs, sirolimus analogs, the inhibitory RNA, DNA inhibitor, steroids, and complement inhibitors . In some embodiments, the second active agent is the same as the first active agent.
[0133] In embodiments the coating as described above, the hydrophobic matrix further comprises a PEG-lipid. In some embodiments, PEG-lipid is selected from the group consisting of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) - 350 (DSPE-mPEG350), 1,2- dipalmitoyl-sn-glycero-3-phosphoethanolamine-methoxy (polyethylene glycol) -350 (DPPE-mPEG350), 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -350 (DOPE-mPEG350) , 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DSPE-mPEG550), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DPPE-mPEG550), and 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -500 (DOPE-mPEG550). In some embodiments, PEG-lipid is from about 1% to about 30% by weight of the hydrophobic matrix. In some embodiments, the PEG-lipid is about 12% or less by weight of the hydrophobic matrix.
[0134] In embodiments the coating as described above, the coating further comprises one or more additives selected independently of penetration enhancers and stabilizers.
[0135] In coating modalities as described above, where the coating has a surface concentration of about 1 μg / mm2 and about 10 μg / mm2.
[0136] A catheter comprising an expandable portion on an elongated body, and any embodiment of the coating described above on the expandable portion. In some embodiments, the catheter additionally comprises a release layer between the expandable portion and the liner, wherein the release layer is configured to release the liner from the expandable portion. In some embodiments, the release layer comprises DSPE-mPEG350 or DSPE-mPEG500. In some embodiments, the release layer has a surface concentration of about 0.1 μg / mm2 and about μg / mm2.
[0137] In catheter modalities, as described above, the catheter additionally comprises a protective layer on the coating. In some embodiments, the protective layer comprises a hydrophilic polymer, a carbohydrate, or an amphiphilic polymer. In some embodiments, the protective coating is a glycosaminoglycan or crystallized sugar. In some embodiments, the protective coating has a surface concentration of about 0.1 μg / mm2 and about 5 μg / mm2.
[0138] A coating formulation for an expandable portion of a catheter comprising a portion of solid and a fluid. The solid portion comprises a plurality of micro-reservoirs and at least one hydrophobic compound, wherein the plurality of micro-reservoirs comprises a first active agent and a biodegradable or bioerodible polymer. In some embodiments, the first active agent is mixed with, or dispersed in, the biodegradable or bioerodible polymer.
[0139] In some embodiments, the first active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivatives, paclitaxel analogs, sirolimus analogs, the inhibitory RNA, DNA inhibitor, steroids, and inhibitors of complement. In some embodiments, the biodegradable or bioderodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans, and a combination thereof.
[0140] In some embodiments of the coating formulation described above, the fluid is selected from the group consisting of pentane, hexane, heptane, heptane and fluorocarbon mixture, alcohol and fluorocarbon mixture, and alcohol and water mixture.
[0141] In some embodiments of the coating formulation described above, wherein the solid portion further comprises a second active agent outside the plurality of micro-reservoirs. In some embodiments, the second active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivatives, paclitaxel analogs, sirolimus analogs, inhibitory RNA, inhibitory DNA, steroids, and complement inhibitors.
[0142] In some embodiments of the coating formulation described above, in which at least one hydrophobic compound is selected from the group consisting of lipids, sterols, phospholipids, fatty acids, fats, surfactants, and their derivatives.
[0143] In some embodiments of the coating formulation described above, wherein the at least one hydrophobic compound comprises a cholesterol and a fatty acid. In some embodiments, the weight ratio of fatty acid cholesterol is in the range of about 1: 2 to about 3: 1. In some embodiments, the fatty acid is selected from the group consisting of lauric acid, the acid lauroleic, tetradeadienoic acid, octanoic acid, myristic acid, myristoleic acid, decenoic acid, decanoic acid, hexadecenoic acid, palmitoleic acid, palmitic acid, linolenic acid, linoleic acid, oleic acid, vaccic acid, stearic acid, eicosapentaenoic acid, arachidonic acid, Mead acid, arachidic acid, docosahexaenoic acid, docosapentaenoic acid, docosatetraenoic acid, docosenoic acid, tetracosanoic acid, hexacosenoic acid, pristanic acid, phytic acid and nervous acid.
[0144] In some embodiments of the coating formulation described above, wherein the at least one hydrophobic compound comprises a cholesterol and a phospholipid. In some embodiments, the weight to cholesterol to phospholipid ratio is in the range of about 1: 2 to about 3: 1. In some embodiments, the phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, and phosphatidylinositol.
[0145] In some embodiments, the phospholipid is a cationic phospholipid. In some embodiments, the cationic phospholipid is phosphatidylethanolamine, dioleoylphosphatidylethanolamine (DOPE), or phosphatidylcholine amine derivatives.
[0146] In some embodiments, the phospholipid comprises an acyl chain length of about 20 to about 34 carbon atoms. In some embodiments, the phospholipid is selected from the group consisting of phosphatidylcholine (1,2-dieicosenoyl-sn-glycero-3-phosphocholine, C20: 1 PC), diaracidonoyl phosphatidylcholine (1,2-diaracidoil-sn-glycero- 3-phosphocholine, C20: 0 PC), dierucoyl phosphatidylcholine (1,2-dierucoyl-sn-glycero-3-phosphocholine, C22: 1 PC), didocosahexaenoyl phosphatidylcholine (1,2-didocosahexaenoil-sn-glycerine-3-phosphocoline, C22: 6 PC), henicosenoyl phosphatidylcholine (1,2-henicosenoyl-sn-glycero-3-phosphocholine, C21: 1 PC) and dinarvonyl phosphatidylcholine (1,2-dinarvonoil-sn-glycero-3-phosphocoline, C24: 1 PC ).
[0147] In some embodiments of the coating formulation described above, the cholesterol is DC-cholesterol.
[0148] In some embodiments of the coating formulation described above, the solid portion further comprises a PEG-lipid, and / or an additive. In some embodiments, PEG-lipid is selected from the group consisting of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -350 (DSPE-mPEG350), 1,2- dipalmitoyl-sn-glycero-3-phosphoethanolamine-methoxy (polyethylene glycol) -350 (DPPE-mPEG350), 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -350 (DOPE-mPEG350 ), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DSPE-mPEG550), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DPPE-mPEG550), and 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -500 (DOPE-mPEG550).
[0149] In some embodiments of the coating formulation described above, the plurality of micro-reservoirs is from about 10% to about 75% by weight of the solid part.
[0150] In some embodiments of the coating formulation described above, the solid part is about 2 to about 7% by weight of the coating formulation.
[0151] A method for coating an expandable portion of a catheter which comprises arranging a coating formulation of any of the above described methods on the surface of an expanded expandable portion of a catheter, evaporating the fluid, and collecting the expandable portion. In some embodiments, the elimination of the coating formulation comprises spray coating, dip coating, roller coating, electrostatic deposition, printing, pipetting, or dispensing.
[0152] In some embodiments of the method described above, the method further comprises a release layer over the expandable release portion. In some embodiments, the release layer comprises DSPE-mPEG350 or DSPE-mPEG500.
[0153] A method for the treatment or prevention of a condition at a treatment site, which comprises advancing a catheter comprising an expandable portion to the treatment site, wherein the expandable portion is coated with a coating of any modalities described above, the expansion of the expandable portion to allow contact between the lining and a tissue at the treatment site, the collapse of the expandable portion, and removal of the catheter.
[0154] In modalities of the method described above, the contact between the tissue and the coating results in a transfer of at least a portion of a coating over the expandable portion to the treatment site. In some embodiments, the method further comprises maintaining contact between the lining and the fabric for a period of about 30 to about 120 seconds.
[0155] In modalities of any of the methods described above, the condition is selected from the group consisting of atherosclerosis, stenosis or the reduction in luminal diameter in diseased blood vessels, restenosis, restenosis in-stent, and combinations thereof.
[0156] In embodiments of any of the methods described above, in which an additional release layer is disposed between the expandable portion and the liner.

权利要求:
Claims (65)
[0001]
1. Catheter characterized by the fact that it comprises: an expandable portion in an elongated body; and a coating on an outer surface of the expandable portion, wherein the coating comprises: a hydrophobic matrix, wherein the hydrophobic matrix comprises a cholesterol and a fatty acid or a cholesterol and a phospholipid; and a dispersed phase comprising a plurality of micro-reservoirs dispersed in the hydrophobic matrix, wherein the plurality of micro-reservoirs comprises a first active agent and a biodegradable or bioerodible polymer.
[0002]
2. Catheter, according to claim 1, characterized by the fact that the first active agent is intermixed with, or dispersed in, the biodegradable or bioerodible polymer.
[0003]
3. Catheter, according to claim 1 or 2, characterized by the fact that the biodegradable or bioerodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans, and combination thereof.
[0004]
4. A catheter according to any one of claims 1 to 3, characterized in that the hydrophobic matrix comprises a cholesterol and a fatty acid.
[0005]
5. Catheter, according to claim 4, characterized by the fact that the weight ratio of cholesterol to fatty acid is in the range of 1: 2 to 3: 1.
[0006]
6. Catheter according to claim 4 or 5, characterized by the fact that the fatty acid is selected from the group consisting of lauric acid, lauroleic acid, tetradeadienic acid, octanoic acid, myristic acid, myristoleic acid, decenoic acid , decanoic acid, hexadecenoic acid, palmitoleic acid, palmitic acid, linolenic acid, linoleic acid, oleic acid, vaccic acid, stearic acid, eicosapentaenoic acid, arachidonic acid, hydromel acid, arachidic acid, docosahexaenoic acid, docosapentaenoic acid, docosapentaenoic acid, docosapentaenoic acid, docosapentaenoic acid, docosapentaenoic acid docosenóico, tetracosanoico acid, hexacosenoic acid, pristanic acid, phytanic acid and nervous acid.
[0007]
A catheter according to any one of claims 1 to 3, characterized in that the hydrophobic matrix comprises a cholesterol and a phospholipid.
[0008]
8. A catheter, according to claim 7, characterized by the fact that the weight ratio of cholesterol to phospholipid is in the range of 1: 2 to 3: 1.
[0009]
9. Catheter according to claim 7 or 8, characterized by the fact that the phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, and phosphatidylinositol.
[0010]
10. Catheter according to claim 7 or 8, characterized by the fact that the phospholipid is a cationic phospholipid.
[0011]
11. Catheter according to claim 10, characterized by the fact that the cationic phospholipid is phosphatidylethanolamine, dioleoylphosphatidylethanolamine (DOPE), or a phosphatidylcholine amine derivative.
[0012]
12. The catheter according to claim 7 or 8, characterized by the fact that the phospholipid comprises an acyl chain length of 20 to 34 carbons.
[0013]
13. The catheter according to claim 12, characterized by the fact that the phospholipid is selected from the group consisting of dieicosenoyl phosphatidylcholine (1,2-dieicosenoyl-sn-glycero-3-phosphocholine, C20: 1 PC), diaraquidonoyl phosphatidylcholine (1,2-diaraquidoyl-sn-glycero-3-phosphocholine, C20: 0 PC), dierucoyl phosphatidylcholine (1,2-dierucoyl-sn-glycero-3-phosphocholine, C22: 1 PC), didocosahexaenoyl phosphatidylcholine (1 , 2-didocosahexaenoil-sn-glycero-3-phosphocholine, C22: 6 PC), henicosenoyl phosphatidylcholine (1,2-heneicosenoyl-sn-glycero-3-phosphocholine, C21: 1 PC) and dinervonyl phosphatidylcholine (1, 2-dinervonoil -sn-glycero-3-phosphocholine, C24: 1 PC).
[0014]
14. The catheter according to any one of claims 4 to 13, characterized by the fact that the cholesterol is Cholesterol DC.
[0015]
Catheter according to any one of claims 1 to 14, characterized in that the coating comprises from 10% to 75% by weight of the plurality of micro-reservoirs.
[0016]
16. The catheter according to any one of claims 1 to 15, characterized by the fact that the plurality of micro-reservoirs has an average diameter of 1.5 microns to 8 microns.
[0017]
17. The catheter according to claim 16, characterized by the fact that the plurality of micro-reservoirs has an average diameter of 2 microns to 6 microns.
[0018]
18. The catheter according to claim 16, characterized by the fact that the plurality of micro-reservoirs has an average diameter of 3 microns to 5 microns.
[0019]
19. The catheter according to any one of claims 1 to 18, characterized by the fact that the plurality of micro-reservoirs has an active ingredient release kinetics with a half-life of at least 14 days.
[0020]
20. Catheter according to any one of claims 1 to 19, characterized by the fact that the first active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivative, paclitaxel analogs, analogs sirolimus, inhibitory RNA, inhibitory DNA, steroids, and complement inhibitors.
[0021]
21. A catheter according to any one of claims 1 to 20, characterized by the fact that the first active agent is 10% to 50% by weight of the plurality of micro-reservoirs.
[0022]
22. A catheter according to any one of claims 1 to 21, characterized in that the coating further comprises a second active agent outside the plurality of micro-reservoirs.
[0023]
23. The catheter according to claim 22, characterized by the fact that the second active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivative, paclitaxel analogs, sirolimus analogs, RNA inhibitory, inhibitory DNA, steroids, and complement inhibitors.
[0024]
24. A catheter according to claim 22 or 23, characterized by the fact that the second active agent is the same as the first active agent.
[0025]
25. A catheter according to any one of claims 1 to 24, characterized in that the hydrophobic matrix further comprises a PEG-lipid.
[0026]
26.Catheter according to claim 25, characterized by the fact that the PEG-lipid is selected from the group consisting of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -350 (DSPE- mPEG350), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-methoxy (polyethylene glycol) -350 (DPPE-mPEG350), 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N -methoxy (polyethylene glycol) -350 (DOPE-mPEG350), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DSPE-mPEG550), 1,2-dipalmitoil-sn -glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DPPE-mPEG550), el, 2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -500 (DOPE-mPEG550) .
[0027]
27. The catheter according to claim 25 or 26, characterized by the fact that the PEG-lipid is from 1% to 30% by weight of the hydrophobic matrix.
[0028]
28. The catheter according to claim 25 or 25, characterized by the fact that the PEG-lipid is 12% or less by weight of the hydrophobic matrix.
[0029]
29. A catheter according to any one of claims 1 to 27, characterized by the fact that it further comprises one or more additives selected independently of penetration enhancers and stabilizers.
[0030]
Catheter according to any one of claims 1 to 29, characterized in that the coating has a surface concentration of 1 μg / mm2 to 10 μg / mm2.
[0031]
31. A catheter according to any one of claims 1 to 30, characterized by the fact that it further comprises a release layer between the expandable portion and the coating, wherein the release layer is configured to release the coating from the portion expandable.
[0032]
32. The catheter according to claim 31, characterized by the fact that the release layer comprises DSPE-mPEG350 or DSPE-mPEG500.
[0033]
33. The catheter according to claim 31 or 32, characterized by the fact that the release layer has a surface concentration of 0.1 μg / mm2 to 5 μg / mm2.
[0034]
34. A catheter according to any one of claims 1 to 33, characterized in that it further comprises a protective coating on the coating.
[0035]
35. A catheter according to claim 34, characterized in that the protective coating comprises a hydrophilic polymer, a carbohydrate, or an amphiphilic polymer.
[0036]
36. A catheter according to claim 34 or 35, characterized in that the protective coating is a glycosaminoglycan or crystallized sugar.
[0037]
37. A catheter according to any one of claims 34 to 36, characterized by the fact that the protective coating has a surface concentration of 0.1 μg / mm2 to 5 μg / mm2.
[0038]
38. Coating formulation for an expandable portion of a catheter characterized by the fact that it comprises: a solid portion comprising: a plurality of micro-reservoirs, wherein the plurality of micro-reservoirs comprises a first active agent and a biodegradable or bioerodible polymer ; at least one hydrophobic compound, wherein the at least one hydrophobic compound comprises a cholesterol and a fatty acid or a cholesterol and a phospholipid; and a fluid.
[0039]
39. Coating formulation according to claim 38, characterized by the fact that the first active agent is mixed with, or dispersed in, the biodegradable or bioerodible polymer.
[0040]
40. Coating formulation according to claim 38 or 39, characterized by the fact that the biodegradable or bioerodible polymer is selected from the group consisting of polylactic acid, polyglycolic acid and its copolymers, polydioxanone, polycaprolactone, polyphosphazene, collagen, gelatin, chitosan, glycosaminoglycans, and combination thereof.
[0041]
41. Coating formulation according to any one of claims 38 to 40, characterized in that the fluid is selected from the group consisting of pentane, hexane, heptane, heptane and mixture of fluorocarbon, alcohol and mixture of fluorocarbon , and the mixture of alcohol and water.
[0042]
42. The coating formulation according to any one of claims 38 to 41, characterized in that the solid portion further comprises a second active agent outside the plurality of micro-reservoirs.
[0043]
43. Coating formulation according to claim 42, characterized by the fact that the second active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivative, paclitaxel analogs, sirolimus analogs , Inhibitory RNA, inhibitory DNA, steroids, and complement inhibitors.
[0044]
44. Coating formulation according to any one of claims 38 to 43, characterized by the fact that the first active agent is selected from the group consisting of paclitaxel, sirolimus, paclitaxel derivative, sirolimus derivative, paclitaxel analogs , sirolimus analogues, inhibitory RNA, inhibitory DNA, steroids, and complement inhibitors.
[0045]
45.Cover formulation according to any one of claims 38 to 44, characterized by the fact that at least one hydrophobic compound is selected from the group consisting of sterols, lipids, phospholipids, fats, fatty acids, surfactants, and its derivatives.
[0046]
46. Coating formulation according to any one of claims 38 to 45, characterized in that the at least one hydrophobic compound comprises a cholesterol and a fatty acid.
[0047]
47. Coating formulation according to claim 46, characterized by the fact that the weight ratio of cholesterol to fatty acid is in the range of 1: 2 to 3: 1.
[0048]
48. Coating formulation according to claim 46 or 47, characterized by the fact that the fatty acid is selected from the group consisting of lauric acid, lauroleic acid, tetradeadienic acid, octanoic acid, myristic acid, myristoleic acid, decenoic acid, decanoic acid, hexadecenoic acid, palmitoleic acid, palmitic acid, linolenic acid, linoleic acid, oleic acid, vaccenic acid, stearic acid, eicosapentaenoic acid, arachidonic acid, hydromel acid, arachidic acid, docosahexaenoic acid, docosapentaenoic acid, docosapentaenoic acid, docosapentaenoic acid docosenoic acid, tetracosanoic acid, hexacosenoic acid, pristanic acid, phytanic acid and nervous acid.
[0049]
49. Coating formulation according to any one of claims 38 to 45, characterized in that the at least one hydrophobic compound comprises a cholesterol and a phospholipid.
[0050]
50. Coating formulation according to claim 49, characterized by the fact that the weight ratio of cholesterol to phospholipid is in the range of 1: 2 to 3: 1.
[0051]
51. Coating formulation according to claim 49 or 50, characterized in that the phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, and phosphatidylinositol.
[0052]
52. Coating formulation according to claim 49 or 50, characterized by the fact that the phospholipid is a cationic phospholipid.
[0053]
53. Coating formulation according to claim 52, characterized by the fact that the cationic phospholipid is phosphatidylethanolamine, dioleoylphosphatidylethanolamine (DOPE), or an amine derivative of phosphatidylcholine.
[0054]
54. Coating formulation according to claim 49 or 50, characterized in that the phospholipid comprises an acyl chain length of 20 to 34 carbons.
[0055]
55. Coating formulation according to claim 54, characterized by the fact that the phospholipid is selected from the group consisting of dieicosenoyl phosphatidylcholine (1,2-dieicosenoyl-sn-glycero-3-phosphocholine, C20: 1 PC ), diaraquidonoyl phosphatidylcholine (1,2-diarachidoil-sn-glycero-3-phosphocholine, C20: 0 PC), dierucoyl phosphatidylcholine (1,2-dierucoyl-sn-glycero-3-phosphocholine, C22: 1 PC), didocosahexaenoil phosphatidylcholine (1,2-didocosahexaenoil-sn-glycero-3-phosphocholine, C22: 6 PC), henicosenoyl phosphatidylcholine (1,2-heneicosenoyl-sn-glycero-3-phosphocholine, C21: 1 PC) and dinervonyl phosphatidylcholine (l, 2 -dinervonoil-sn-glycero-3-phosphocholine, C24: 1 PC).
[0056]
56. Coating formulation according to any one of claims 46 to 55, characterized by the fact that the cholesterol is Cholesterol DC.
[0057]
57. Coating formulation according to any one of claims 38 to 56, characterized in that the solid portion further comprising a PEG-lipid, and / or an additive.
[0058]
58. Coating formulation according to claim 57, characterized by the fact that PEG-lipid is selected from the group consisting of 1,2-diestearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) ) -350 (DSPE-mPEG350), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-methoxy (polyethylene glycol) -350 (DPPE-mPEG350), 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine- N-methoxy (polyethylene glycol) -350 (DOPE-mPEG350), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DSPE-mPEG550), 1,2-dipalmitoyl- sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -550 (DPPE-mPEG550), el, 2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol) -500 (DOPE-mPEG550 ).
[0059]
59. The coating formulation according to any one of claims 38 to 58, characterized by the fact that the plurality of micro-reservoirs is 10% to 75% by weight of the solid part.
[0060]
60. Coating formulation according to any one of claims 38 to 59, characterized in that the solid part is 2 to 7% by weight of the coating formulation.
[0061]
61. Method for coating an expandable portion of a catheter, characterized in that it comprises: arranging a coating formulation as defined in any one of claims 38 to 60 along a surface of an expanded expandable portion of a catheter; evaporation of the fluid; and collapse of the expandable portion.
[0062]
62. The method of claim 61, characterized in that the elimination of the coating formulation comprises spray coating, dip coating, roller coating, electrostatic deposition, printing, pipetting or distribution.
[0063]
63. The method of claim 61 or 62, characterized by the fact that a release layer is arranged on the surface of the expandable portion.
[0064]
64. Method according to claim 63, characterized by the fact that the coating formulation is disposed on the release layer.
[0065]
65. The method of claim 63 or 64, characterized by the fact that the release layer comprises DSPE-mPEG350 or DSPE-mPEG500.

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法律状态:
2019-08-27| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

---

2020-09-01| B06A| Notification to applicant to reply to the report for non-patentability or inadequacy of the application [chapter 6.1 patent gazette]|

---

2020-11-10| B25G| Requested change of headquarter approved|Owner name: M.A. MED ALLIANCE SA (CH) |

---

2021-01-12| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

---

2021-03-09| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 16/07/2015, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

---

US14/335,823|2014-07-18|

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US14/335,823|US9492594B2|2014-07-18|2014-07-18|Coating for intraluminal expandable catheter providing contact transfer of drug micro-reservoirs|

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PCT/US2015/040812|WO2016011298A1|2014-07-18|2015-07-16|Coating for intraluminal expandable catheter providing contact transfer of drug micro-reservoirs|

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