WO2024232881A1 - Trodusquemine-coated balloon for targeted treatment of atherosclerosis - Google Patents
Trodusquemine-coated balloon for targeted treatment of atherosclerosis Download PDFInfo
- Publication number
- WO2024232881A1 WO2024232881A1 PCT/US2023/021688 US2023021688W WO2024232881A1 WO 2024232881 A1 WO2024232881 A1 WO 2024232881A1 US 2023021688 W US2023021688 W US 2023021688W WO 2024232881 A1 WO2024232881 A1 WO 2024232881A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- balloon catheter
- acid
- trodusquemine
- aspects
- fatty acid
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
- A61L29/14—Materials characterised by their function or physical properties, e.g. lubricating compositions
- A61L29/16—Biologically active materials, e.g. therapeutic substances
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
- A61L29/08—Materials for coatings
- A61L29/085—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
- A61L2300/22—Lipids, fatty acids, e.g. prostaglandins, oils, fats, waxes
- A61L2300/222—Steroids, e.g. corticosteroids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/422—Anti-atherosclerotic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
- A61L2300/63—Crystals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/105—Balloon catheters with special features or adapted for special applications having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
Definitions
- Atherosclerotic lesions within the vasculature are often treated with angioplastic balloons to attempt to increase the diameter of the blood vessels and allow for blood circulation to attempt to normalize.
- Such physical interventions do not address the underlying cause of the obstruction of the blood vessel.
- Recent therapies have explored introducing drug coatings on the balloon to provide for site-specific delivery of therapeutics that counteract inflammation of the vessel walls.
- plaques that harden and grow to occlude the vessel there is a need for a drug-coated balloon that provides a therapeutic to combat the plaque itself.
- a 1 st aspect of the present disclosure concerns a balloon catheter for delivering a therapeutic agent to a blood vessel, the balloon catheter comprising: an elongate member having a lumen and a distal end; an expandable balloon attached to the distal end of the elongate member and in fluid communication with the lumen; and a coating layer overlying an exterior surface of the balloon, the coating layer comprising trodusquemine or a polymer microparticle containing trodusquemine and an excipient, [0003]
- a 2 nd aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein the excipient comprises a biodegradable polymer chosen from a fatty acid, a fatty acid ester, polylactic acid (PLLA,PDLA,PDLLA), polycaprolactone (PCL), sodium docusate, PLGA, PLGA-b-mPEG, polyglutamic
- a 3 rd aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein trodusquemine is at a concentration density in the coating layer or within the polymer microparticle of from 0.1 pg/mm 2 to 10 pg/mm 2 ,
- a 4 th aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein the coating layer further comprises a hydrophobic material containing trodusquemine embedded therein.
- a 5 th aspect of the present disclosure concerns the balloon catheter of the 4 th aspect, wherein the hydrophobic material comprises a hydrophobic material with a glass transition temperature of 37 °C or lower.
- a 6 th aspect of the present disclosure concerns the balloon catheter of the 5 th aspect, wherein the hydrophobic material is semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, a PEG- fatty acid ester, or a combination thereof.
- the hydrophobic material is semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, a PEG- fatty acid ester, or a combination thereof.
- a 7 th aspect of the present disclosure concerns the balloon catheter of the 4 th aspect, wherein the hydrophobic material is hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petroleum jelly, decanol, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acid, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, a fatty acid triglycerides, a fatty acid alcohol, or a combination thereof.
- the hydrophobic material is hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petroleum jelly, decanol, tridecanol, dodecanol, long chain saturated fatty acids, long
- An 8 th aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein the polymer microparticle comprises poly(lactic-co-glycolic) acid (PLGA) with trodusquemine loaded therein.
- a 9 th aspect of the present disclosure concerns the balloon catheter of the 8 th aspect, wherein trodusquemine is loaded in the polymer microparticle at 30-50 % weight of the polymer microparticle.
- a 10 th aspect of the present disclosure concerns the balloon catheter of the 9 th aspect, wherein the polymer microparticles are of a first size grouping and a second size grouping, wherein the first size grouping has an average size of 10 pm and further wherein the second size grouping has an average size different from the first size grouping.
- An 11 th aspect of the present disclosure concerns the balloon catheter of the 10 th aspect, wherein the second size grouping has an average size of 30 pm, 35 pm, or 40 pm.
- a 12 th aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein trodusquemine is crystalline particles.
- a 13 th aspect of the present disclosure concerns the balloon catheter of the 12 th aspect, wherein the average size of the crystalline particles is of 0.1 pm to 100 pm.
- a 14 th aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein the coating layer further comprises a hydrophilic material chosen from poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(2-Hydroxypropyl) methacrylamide (HPMA), divinyl ether-maleic anhydride (DIVEMA), polyoxazoline, xanthan gum, pectins, chitosan derivatives, dextran, casein sodium, cellulose ethers, sodium carboxy methyl cellulose, hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hyaluronic acid (HA), albumin, or a combination thereof.
- a hydrophilic material chosen from poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(
- a 15 th aspect of the present disclosure concerns the balloon catheter of the 1 st aspect, wherein the coating layer further comprises a therapeutic agent.
- a 16 th aspect of the present disclosure concerns the balloon catheter of the 15 th aspect, wherein the therapeutic agent is chosen from paclitaxel, rapamycin, daunorubicin, 5-fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus (biolimus A9), everolimus, zotarolimus, tacrolimus, sirolimus, dexamethasone, prednisolone, corticosterone, cisplatin, vinblastine, lidocaine, bupivacaine, or a combination thereof.
- the therapeutic agent is chosen from paclitaxel, rapamycin, daunorubicin, 5-fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus (biolimus
- a 17 th aspect of the present disclosure concerns a method for treating an atherosclerotic lesion in a subject comprising introducing the balloon catheter of the 1 st aspect into a blood vessel of the subject; maneuvering the balloon catheter to a atherosclerotic plaque in the blood vessel; and, expanding the expandable balloon.
- FIG. 1 is a schematic of an exemplary aspect of a medical device, particularly a balloon catheter, according to the present disclosure.
- FIG. 2A is a cross-section of some aspect of the distal portion of the balloon catheter of FIG. 1 , taken along line A — A, including a drug coating layer on an exterior surface of a balloon.
- FIG. 2B is a cross-section of some aspect of the distal portion of the balloon catheter of FIG. 1, taken along line A — A, including an intermediate layer between an exterior surface of the balloon and a drug coating layer.
- Trodusquemine refers to a polyamine-steroid or amino sterol originally isolated from the dogfish shark. To date, little is known about its mechanisms of action, although some preliminary studies have identified it will allosterically inhibit protein-tyrosine phosphatase IB (PTP1B). A recent study showed that in mice deficient for both copies of the low density lipoprotein receptor (LDLR) responded favorably with regards to attenuated atherosclerotic plaque formation from both acute and chronic intraperitoneal treatment with trodusquemine (Thompson et al., Clin.
- LDLR low density lipoprotein receptor
- the present disclosure accordingly concerns a coating layer on the exterior surface of a balloon.
- the coating layer may be in directed contact with the exterior surface of the balloon.
- one or more additional layers may overlay the coating layer.
- the coating layer of the present disclosure includes trodusquemine.
- Trodusquemine may be present as an amorphous compound or in a crystalline form.
- trodusquemine may be formulated as a salt to improve solubility in water.
- trodusquemine is a hydrophobic compound.
- trodusquemine is a lipophilic compound.
- Trodusquemine in some aspects, may be able to cross through a lipid deposit, such as a plaque, and reach the cells of the lumen responsible for excretion and deposit of lipids within a blood vessel.
- the coating layer may include microparticles of trodusquemine and a bioabsorbable polymer.
- Microparticles may be prepared the evaporation of a solvent with a bioabsorbable/biodegradable polymer and at least one therapeutic therein.
- the solvent is of dichloromethane (DCM) or ethyl acetate (EtOAc).
- Polymers may include a network of a poly-glycolic acid (PGA) and a poly-L-lactic acid (PLLA).
- bioabsorbable polymers that can be utilized in combination or alone for the microparticles include polycaprolactone (PCL), poly-DL-lactic acid (PDLLA), poly(trimethylene carbonate) (PTMC), poly (ester amine)s (PEA), poly(para-dioxanone) (PPDO), poly-2-hydroxy butyrate (PHB), and co-polymers with various ratios thereof.
- the bioabsorbable polymer may include, either alone or in combination with other bioabsorbable polymers, a polymer combination of lactic acid and glycolic acid, poly-lactic-co-glycolic acid (PLGA).
- PLGA can be of varying percentages of lactic acid and glycolic acid, wherein the higher the amount of lactide units, the longer the polymer can last in situ before degrading. Additional tunable properties with PLGA concern the molecular weight, with higher weights showing increased mechanical strength.
- the polymer microparticle is also loaded or embedded with an antioxidant, such as BHT.
- the coating layer may include a polymer coating, such as a bioabsorbable polymer as set forth herein.
- the density of the trodusquemine or polymer microparticle within the polymer coating is of from about 0.1 to 10 pg/mm 2 .
- the trodusquemine or polymer microparticle is provided on the device in the polymer coating at a density of from about 0.5 to about 5 pg/mm 2 .
- the dose density of the trodusquemine in the coating and/or within each polymer microparticle can vary from about 0.1 to about 10 pg/mm 2 , including about 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5,
- the trodusquemine dose density is of about 0.5 to about 5 pg/mm 2 .
- the concentration density of the trodusquemine in the coating layer or within the polymer microparticle may be from 0.1 pg/mm 2 to 10 pg/mm 2 , from
- 0.1 pg/mm 2 to 8 pg/mm 2 from 0.1 pg/mm 2 to 6 pg/mm 2 , from 0.1 pg/mm 2 to 4 pg/mm 2 , from
- 0.1 pg/mm 2 to 2 pg/mm 2 from 0.1 pg/mm 2 t o 1 pg/mm 2 , from 1 pg/mm 2 to 10 pg/mm 2 , from 1 pg/mm 2 to 8 pg/mm 2 , from 1 pg/mm 2 to 6 pg/mm 2 , from 1 pg/mm 2 to 4 pg/mm 2 , from
- the concentration density of trodusquemine in the coating layer or polymer microparticle may be from 0.5 pg/mm 2 to 5 pg/mm 2 .
- the methods to apply the coating layer include to a medical device may include dip coating, metering coating, spray coating, electrostatic spray coating, roller coating, spin coating, ink-jet printing, 3D printing, or combinations thereof.
- a preferred method is metering coating and spray coating. After the solvent has evaporated, the coating layer is left on the surface.
- the coating layer may include crystalline trodusquemine and/or an amorphous trodusquemine of a particular size range or ranges.
- the crystalline and/or amorphous trodusquemine can be embedded within the coating layer.
- the crystalline and/or amorphous trodusquemine is loaded within a polymer microparticle embedded in the coating layer.
- the crystalline and/or amorphous trodusquemine adheres to the surface of the medical device through the evaporation of a solvent.
- the crystalline and/or amorphous trodusquemine microparticle size can vary from about 0.1 pm to about 100 pm, including about 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 60, 70, 80, 90, 99 pm and any size or number therein.
- the particle size is of from about 1 pm to about 20 pm. In other aspects, the particle size of from about 10 pm to about 100 pm. Size selection can be achieved through methods understood in the art, such as by passing through mesh of a pre-determined pore or hole size. The desired particle size can be achieved by dry grind or wet grinding.
- the grinding method may include techniques such as use of a jaw crusher, ultra-centrifugal mill, cyclone mill, cross beater mill, rotor beater mill, cutting mill, knife mill, mortar grinder, disc mill, mixer mill, cryomill, planetary ball mill, drum mill, and/or fine grinding rod mill.
- the particle size may be achieved with use of a ball mill.
- the ground drug particles and polymer mix may be combined with a solvent (or a mixture of solvents) and form a slurry coating solution.
- the methods may also include application of the slurry coating solution to a medical device surface. Such techniques for application may include dip coating, metering coating, spray coating, electrostatic spray coating, roller coating, spin coating, ink-jet printing, and 3D printing.
- the method includes metering coating.
- the drug coating layer includes a hydrophobic material or a hydrophobic material with polymers, polymer compositions and/or therapeutic compositions dispersed therein.
- the therapeutic is embedded therein in an amorphous form, in a crystalline form, embedded within a microparticle embedded in the hydrophobic material, or combinations thereof.
- the hydrophobic layer may include, but is not limited to, hydrophobic polymers and/or hydrophobic small molecules.
- the hydrophobic polymers and/or hydrophobic small molecules are bioabsorbable hydrophobic materials.
- the hydrophobic layer may be a mixture of two or more hydrophobic materials.
- the hydrophobic materials are selected on the basis that they are biodegradable and/or bioabsorbed by the body over time.
- bioabsorbable refers to a compound that can be absorbed by the surrounding or local tissue of a subject and/or degraded and absorbed by the tissue of the subject.
- the hydrophobic layer is easily transferred from the exterior or outer surface of the device, such that the layer transfers to the inner wells of a subject’s vasculature when the medical device is expanded or placed in situ. It will be appreciated that in some aspects, the balloon transfers the entire layer to vessel wall and the majority of drug release and absorption occurs after the transfer.
- the hydrophobic layer retains the embedded polymer microparticles and/or therapeutic agent and releases or elutes the therapeutic from the vessel wall.
- the therapeutic agent is delivered by erosion of polymer microparticles.
- the therapeutic is directly released by erosion and/or degradation of the hydrophobic layer, such as with direct embedding of particular sized crystalline and/or amorphous forms of the therapeutic agent.
- the hydrophobic layer may include, but is not limited to, hydrophobic polymers and/or hydrophobic small molecules that are bioabsorbable hydrophobic materials.
- the hydrophobic layer may be a mixture of two or more hydrophobic materials that are selected on the basis that they are biodegradable and/or bioabsorbed by the body over time.
- bioabsorbable hydrophobic materials may include semi-synthetic glycerides (e.g.
- the bioabsorbable hydrophobic polymer and/or hydrophobic small molecule has a glass transition temperature of 37 °C or lower.
- the hydrophobic layer matrix can become tacky or sticky when the medical device is placed in situ within a human subject.
- the body temperature of the tissue surrounding the device when placed in a subject warms the hydrophobic polymer to above the glass transition temperature, allowing the hydrophobic polymer to become sticky or tacky within the subject.
- the ability of the hydrophobic layer matrix to become tacky allows the coating to adhere or transfer from the outer surface of the medical device to the vessel wall.
- the hydrophobic material is selected from semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, and PEG-fatty acid esters.
- the hydrophobic material is petroleum jelly or petrolatum.
- the present disclosure concerns preparing a coating solution to provide the hydrophobic layer to the surface of the medical device or to a prior coating thereon.
- the methods for coating include dissolving the hydrophobic layer in a solvent that does not dissolve the therapeutic agent or the polymer of the polymer microparticles.
- the methods also include generating a slurry of the solvent with dissolved hydrophobic material and the therapeutic or a slurry of the solvent with dissolved hydrophobic material and the polymer microparticles with the therapeutic agent loaded therein and applying the slurry to the exterior surface or a portion thereof of the medical device or to a coating or portion thereof previous applied to the exterior surface of the medical device.
- the methods further include evaporating the solvent. It will be appreciated that the coating solution can be applied once or more than once. In some aspects, the volume applied and/or the number of applications can control the thickness of the hydrophobic layer.
- the present disclosure concerns a polymer coating of a hydrophilic polymer and the hydrophobic therapeutic agent trodusquemine.
- Hydrophilic polymers may include poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(2-Hydroxypropyl) methacrylamide (HP MA), divinyl ether-maleic anhydride (DIVEMA), polyoxazoline, xanthan gum, pectins, chitosan derivatives, dextran, casein sodium, cellulose ethers, sodium carboxy methyl cellulose, hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hyaluronic acid (HA), albumin, and combinations thereof.
- the hydrophobic coating is prepared by dissolving the polymer in a solvent. Due to the opposing polarity, the trodusquemine and/or polymer microparticles are poorly soluble/insoluble in the solvent. The mixture can be then stirred to provide a slurry and applied to the outer surface of the balloon. As the solvent evaporates, the polymer emerges from the solution, thereby encasing trodusquemine on the surface of the medical device.
- the trodusquemine may be formulated with one or more additional therapeutic agents in the coating layer, either individually within the coating layer, or combined, such as within the same microparticle.
- the additional therapeutic may include one that can produce a desired effect when in situ.
- the additional therapeutic agent can be chosen from paclitaxel, rapamycin, daunorubicin, 5- fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus (biolimus A9), everolimus, sirolimus, zotarolimus, tacrolimus, dexamethasone, prednisolone, corticosterone, cisplatin, vinblastine, lidocaine, bupivacaine, or a combination thereof.
- the coating layer may include one or more excipients.
- Suitable excipients that can be used in some aspects of the present disclosure include, without limitation, organic and inorganic pharmaceutical excipients, natural products and derivatives thereof (such as sugars, vitamins, amino acids, peptides, proteins, and fatty acids), surfactants (anionic, cationic, non-ionic, and ionic), and mixtures thereof.
- organic and inorganic pharmaceutical excipients such as sugars, vitamins, amino acids, peptides, proteins, and fatty acids
- surfactants anionic, cationic, non-ionic, and ionic
- excipients may be useful for purposes of the present disclosure, such as polyglutamic acid, polyacrilic acid, hyaluronic acid, alginate, PVA,PVP, Pluronic (PEO-PPO-PEO), cellulose, CMC, HPC, starch, chitosan, human serum albumin (HSA), phospholipids, fatty acid, fatty acid esters, triglycerides, beeswax, cyclodextrin, polysorbates, polyethylene glycol, polyvinylpyrrolidone (PVP) and aliphatic polyesters.
- PVP polyvinylpyrrolidone
- the excipients may feature a drug affinity part.
- the excipients of the present disclosure may feature a hydrophilic part.
- hydrophilic As is understood in the art, the terms “hydrophilic” and “hydrophobic” are relative terms.
- the excipient is a compound that includes polar or charged hydrophilic moieties as well as non-polar hydrophobic (lipophilic) moieties.
- the hydrophilic part can accelerate diffusion and increase permeation of the therapeutic agent into tissue.
- the hydrophilic part of the excipient may facilitate rapid movement of therapeutic agent off the expandable medical device during deployment at the target site by preventing hydrophobic drug molecules from clumping to each other and to the device, increasing drug solubility in interstitial spaces, and/or accelerating drug passage through polar head groups to the lipid bilayer of cell membranes of target tissues.
- Exemplary excipients for application in the present disclosure may include chemical compounds with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide or ester moieties.
- Hydrophilic chemical compounds with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide or ester moieties having a molecular weight less than 5,000 to 10,000 are preferred in certain aspects.
- molecular weight of the excipient with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide, or ester moieties is preferably less than 1000 to 5,000, or more preferably less than 750 to 1 ,000, or most preferably less than 750.
- the molecular weight of the excipient is less than that of the therapeutic agent to be delivered.
- the one or more excipients may be selected from amino alcohols, alcohols, amines, acids, amides and hydroxyl acids in both cyclo- and linear- aliphatic and aromatic groups.
- Examples include L-ascorbic acid and its salt, D-glucoascorbic acid and its salt, tromethamine, triethanolamine, diethanolamine, meglumine, glucamine, sodium docusate, urea, amine alcohols, glucoheptonic acid, glucomic acid, hydroxyl ketone, hydroxyl lactone, gluconolactone, glucoheptonolactone, glucooctanoic lactone, gulonic acid lactone, mannoic lactone, ribonic acid lactone, lactobionic acid, glucosamine, glutamic acid, benzyl alcohol, benzoic acid, hydroxybenzoic acid, propyl 4-hydroxybenzoate, lysine acetate salt, gentisic acid, lactobionic acid, lactitol, sorbitol, glucitol, sugar phosphates, glucopyranose phosphate, sugar sulphates, sugar alcohols, sinapic acid, van
- Some of the chemical compounds with one or more hydroxyl, amine, carbonyl, carboxyl, amide or ester moieties described herein are very stable under heating, survive an ethylene oxide sterilization process, and/or do not react with the therapeutic agent during sterilization.
- the one or more excipients may be selected from amino acids and salts thereof.
- the excipient may be one or more of alanine, arginine, asparagines, aspartic acid, cysteine, cystine, glutamic acid, glutamine, glycine, histidine, proline, isoleucine, leucine, lysine, methionine, phenylalanine, serine, threonine, tryptophan, tyrosine, valine, and derivatives thereof are.
- low-solubility amino acid refers to amino acid having a solubility in unbuffered water of less than about 4% (40 mg/ml). These include cystine, tyrosine, tryptophan, leucine, isoleucine, phenylalanine, asparagine, aspartic acid, glutamic acid, and methionine.
- Amino acid dimers, sugar-conjugates, and other derivatives may also be considered for excipients.
- hydrophilic molecules may be joined to hydrophobic amino acids, or hydrophobic molecules to hydrophilic amino acids, to make additional excipients useful in aspects of the present disclosure.
- Catecholamines such as dopamine, levodopa, carbidopa, and DOPA, are also useful as excipients.
- the excipient may be of a material that is at a glass transition temperature at 37 °C or higher. As identified herein, providing a material on the medical device that transitions to a sticky or tacky state in situ within the vessel of the subject allows for adhering the coating to the vessel wall.
- Such materials may include hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petrolatum, petroleum jelly, decanol, soft paraffin, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acids, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, fatty acid triglycerides, fatty acid alcohols or combinations thereof.
- the excipients may be liquid additives.
- One or more liquid excipients may be can be used in the medical device coating to improve the integrity of the coating.
- a liquid excipient can improve the compatibility of the therapeutic agent in the coating mixture.
- the liquid excipients used in aspects of the present disclosure is not a solvent.
- the solvents such as ethanol, methanol, dimethylsulfoxide, and acetone, will be evaporated after the coating is dried. In other words, the solvent will not stay in the coating after the coating is dried. In contrast, the liquid excipients in aspects of the present disclosure will stay in the coating after the coating is dried.
- the liquid excipient is liquid or semi-liquid at room temperature and one atmosphere pressure.
- the liquid excipient may form a gel at room temperature.
- the liquid excipient may be a non-ionic surfactant.
- liquid excipients include PEG-fatty acids and esters, PEG-oil transesterification products, polyglyceryl fatty acids and esters, Propylene glycol fatty acid esters, PEG sorbitan fatty acid esters, and PEG alkyl ethers as mentioned above.
- Some examples of a liquid excipient are Tween 80, Tween 81, Tween 20, Tween 40, Tween 60, Solutol HS 15, Cremophor RH40, and Cremophor EL&ELP.
- the excipient may be a surfactant; a chemical compound with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties; or both.
- exemplary surfactants may be chosen from PEG fatty esters, PEG omega-3 fatty esters and alcohols, glycerol fatty esters, sorbitan fatty esters, PEG glyceryl fatty esters, PEG sorbitan fatty esters, sugar fatty esters, PEG sugar esters, Tween 20, Tween 40, Tween 60, p-isononylphenoxypolyglycidol, PEG laurate, PEG oleate, PEG stearate, PEG glyceryl laurate, PEG glyceryl oleate, PEG glyceryl stearate, polyglyceryl laurate, polyglyceryl oleate, polyglyceryl myristate, poly
- one or more of a surfactant or a small water-soluble molecule (the chemical compounds with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties) with the therapeutic agent are in certain cases superior to only utilizing the therapeutic agent and a single excipient.
- the drug coating may have increased stability during transit and rapid drug release when pressed against tissues of the lumen wall at the target site of therapeutic intervention when compared to some formulations comprising the therapeutic agent and only one excipient.
- the miscibility and compatibility of the therapeutic agent with the excipient or the drug coating with the medical device generally, is improved by the presence of the one or more additional excipients.
- a surfactant may allow for improved coating uniformity and integrity.
- the coating layer(s) may include multiple excipients, and one excipient is more hydrophilic than one or more of the other excipients.
- the coating layer multiple excipients, and one excipient has a different structure from that of one or more of the other excipients.
- the coating layer includes multiple excipients.
- Some aspects of the present disclosure may include a mixture of at least two additional excipients, for example, a combination of one or more surfactants and one or more chemical compound with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties.
- therapeutic agents may bind to extremely water-soluble small molecules more poorly than surfactants, which can lead to suboptimal coating uniformity and integrity.
- Some surfactants may adhere so strongly to the therapeutic agents and the surface of the medical device that the therapeutic agent is not able to rapidly release from the surface of the medical device at the target site.
- some water-soluble small molecules adhere so poorly to the medical device that they release therapeutic agents before it reaches the target site, for example, into serum during the transit of a coated balloon catheter to the site targeted for intervention.
- the coating layer may have improved properties over a formulation with only one excipient or no excipient.
- the one or more additional excipients may include an antioxidant.
- An antioxidant is a molecule capable of slowing or preventing the oxidation of other molecules. Oxidation reactions can produce free radicals and/or peroxides, which start chain reactions and may cause degradation of therapeutic agents. Antioxidants terminate these chain reactions by removing free radicals and inhibiting oxidation of the active agent by being oxidized themselves. Antioxidants are used as the one or more additional excipients in certain aspects to prevent or slow the oxidation of the therapeutic agents in the coatings for medical devices. Antioxidants are a type of free radical scavengers.
- the antioxidant may be used alone or in combination with other additional excipients in certain aspects and may prevent degradation of the active therapeutic agent during sterilization or storage prior to use.
- Some representative examples of antioxidants that may be used in the drug coatings of the present disclosure include, without limitation, oligomeric or polymeric proanthocyanidins, polyphenols, polyphosphates, polyazomethine, high sulfate agar oligomers, chitooligosaccharides obtained by partial chitosan hydrolysis, polyfunctional oligomeric thioethers with sterically hindered phenols, hindered amines such as, without limitation, p-phenylene diamine, trimethyl dihydroquinolones, and alkylated diphenyl amines, substituted phenolic compounds with one or more bulky functional groups (hindered phenols) such as tertiary butyl, arylamines, phosphites, hydroxylamines, and benzofuranones.
- aromatic amines such as p-phenylenediamine, diphenylamine, and N,N' di-substituted p- phenylene diamines may be utilized as free radical scavengers.
- BHT butylated hydroxytoluene
- BHA butylated hydroxyanisole
- L-ascorbate L-ascorbate
- Vitamin E herbal rosemary, sage extracts, glutathione, resveratrol, ethoxyquin, rosmanol, isorosmanol, rosmaridiphenol, propyl gallate, gallic acid, caffeic acid, p-coumeric acid, p-hydroxy benzoic acid, astaxanthin, ferulic acid, dehydrozingerone, chlorogenic acid, ellagic acid, propyl paraben, sinapic acid, daidzin, glycitin, genistin, daidzein,
- phosphites examples include di(stearyl)pentaerythritol diphosphite, tris(2,4-di-tert.butyl phenyl)phosphite, dilauryl thiodipropionate and bis(2,4-di-tert.butyl phenyl)pentaerythritol diphosphite.
- hindered phenols include octadecyl-3, 5, di-tert.butyl-4-hydroxy cinnamate, tetrakis-methylene-3-(3',5'-di-tert.butyl-4-hydroxyphenyl)propionate methane 2,5-di-tert- butylhydroquinone, ionol, pyrogallol, retinol, and octadecyl-3-(3,5-di-tert.butyl-4- hydroxyphenyl)propionate.
- An antioxidant may include glutathione, lipoic acid, melatonin, tocopherols, tocotrienols, thiols, Beta- carotene, retinoic acid, cryptoxanthin, 2,6-di-tert- butylphenol, propyl gallate, catechin, catechin gallate, and quercetin.
- Preferable antioxidants are butylated hydroxytoluene (BHT) and butylated hydroxy anisole (BHA).
- the medical device is a balloon catheter.
- a balloon catheter 10 has a proximal end 18 and a distal end 20.
- the balloon catheter 10 may be any suitable catheter for desired use, including conventional balloon catheters known to one of ordinary skill in the art.
- the balloon catheter 10 may be a rapid exchange or over-the-wire catheter.
- the balloon catheter may be a ClearStreamTM Peripheral catheter available from BD Peripheral Intervention.
- the balloon catheter 10 may be made of any suitable biocompatible material.
- the balloon 12 of the balloon catheter may include a polymer material, such as, for example only, polyvinyl chloride (PVC), polyethylene terephthalate (PET), polyethylene, Nylon, PEBAX (i.e. a copolymer of polyether and polyamide), polyurethane, polystyrene (PS), polyethleneterephthalate (PETP), or various other suitable materials as will be apparent to those of ordinary skill in the art.
- PVC polyvinyl chloride
- PET polyethylene terephthalate
- Nylon Nylon
- PEBAX i.e. a copolymer of polyether and polyamide
- PS polystyrene
- PETP polyethleneterephthalate
- the balloon catheter 10 includes an expandable balloon 12 and an elongate member 14.
- the elongate member 14 extends between the proximal end 18 and the distal end 20 of the balloon catheter 10.
- the elongate member 14 has at least one lumen 26a, 26b and a distal end 20.
- the elongate member 14 may be a flexible member which is a tube made of suitable biocompatible material.
- the elongate member 14 may have one lumen or, as shown in FIGS.
- the elongate member 14 may include a guide-wire lumen 26b that extends to the distal end 20 of the balloon catheter 10 from a guide- wire port 15 at the proximal end 18 of the balloon catheter 10.
- the elongate member 14 may also include an inflation lumen 26a that extends from an inflation port 17 of the balloon catheter 10 to the inside of the expandable balloon 12 to enable inflation of the expandable balloon 12. From the elements of FIGS.
- the one or more lumens present in the elongate member 14 may be configured in any manner suited to the intended purposes of the lumens including, for example, introducing inflation media and/or introducing a guide-wire. Many such configurations are well known in the art.
- the expandable balloon 12 is attached to the distal attachment end 22 of the elongate member 14.
- the expandable balloon 12 has an exterior surface 25 and is inflatable.
- the expandable balloon 12 is in fluidic communication with a lumen of the elongate member 14, (for example, with the inflation lumen 26a).
- At least one lumen of the elongate member 14 is configured to receive inflation media and to pass such media to the expandable balloon 12 for its expansion. Examples of inflation media include air, saline, and contrast media.
- the balloon catheter 10 includes a handle assembly such as a hub 16.
- the hub 16 may be attached to the balloon catheter 10 at the proximal end 18 of the balloon catheter 10.
- the hub 16 may connect to and/or receive one or more suitable medical devices, such as a source of inflation media (e.g., air, saline, or contrast media) or a guide wire.
- a source of inflation media e.g., air, saline, or contrast media
- a guide wire may be introduced to the guide-wire port 15 of the hub 16, (for example through the guide-wire lumen 26b).
- the cross section A — A of FIG. 1 may be as depicted according to FIG. 2A, in which the drug coating layer 30 is applied directly onto an exterior surface 25 of the balloon 12.
- the specific compositions of the drug coating layer 30 itself, according to various aspects, will also be described subsequently in greater detail.
- the cross section A — A of FIG. 1 may be as depicted according to FIG. 2B, in which the drug coating layer 30 is applied onto an intermediate layer 40 overlying the exterior surface 25 of the balloon 12.
- the exterior surface 25 may undergo a surface modification.
- the exterior surface 25 has been subjected to a surface modification, such as a fluorine plasma treatment, which decreases a surface free energy of the exterior surface 25 before application of the drug coating layer 30.
- a surface modification such as a fluorine plasma treatment
- Subjecting the exterior surface to a surface modification may decreases the surface free energy of the exterior surface before application of the coating layer and affect the release kinetics of drug in the coating layer from the balloon, the crystallinity of the drug layer, the surface morphology of the coating and particle shape, or the particle size of drug of a therapeutic layer in the coating layer, drug distribution on the surface.
- the balloon catheter 10 includes a drug coating layer 30 applied over an exterior surface 25 of the balloon 12.
- the drug coating layer 30 itself includes a therapeutic agent and an additive.
- the drug coating layer 30 comprises trodusquemine, and one or more additional additives.
- the drug coating layer 30 does not include a polymer.
- the device may include a top layer (not shown) overlying the drug coating layer 30.
- a top coat layer may be advantageous in order to prevent premature drug loss during the device delivery process before deployment at the target site.
- Trodusquemine will be dissolved in a solvent and dip-coated on to the exterior surface of a balloon of a balloon catheter. Evaporation of the solvent leaves a dried drug-coating on the surface.
- the balloons can then be utilized in animal studies to observe the effects in comparison with controls, such as a solvent only coating and/or a non-coated balloon, as well as with positive controls such as a rapamycin or paclitaxel coating at a similar concentration.
- the balloons can be tested when implanted in femoral arteries of porcine model, followed by histological studies on the arteries for lumen area, medial area, neointimal area and the resulting percentage of stenosis. It is expected that trodusquemine will improve the lumen area and reduce the percentage of stenosis in comparison to vehicle and/or solvent only.
- Patents, publications, and applications mentioned in the specification are indicative of the levels of those skilled in the art to which the disclosure pertains. These patents, publications, and applications are incorporated herein by reference to the same extent as if each individual patent, publication, or application was specifically and individually incorporated herein by reference.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Biophysics (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Pulmonology (AREA)
- Child & Adolescent Psychology (AREA)
- Vascular Medicine (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Molecular Biology (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicinal Preparation (AREA)
Abstract
The present disclosure concerns coatings for angioplastic balloons that deliver trodusquemine to the vessel walls during the expansion of the balloon in situ. The hydrophobic nature of the drug combined with the mechanism of action allow for site specific treatment to wear away plaque within the vessel walls. The site specific delivery offers the potential for lower dosing and the choice of trodusquemine provides a further alternative to conventional medications.
Description
Trodusquemine-coated Balloon for Targeted Treatment of Atherosclerosis
BACKGROUND
[0001] Atherosclerotic lesions within the vasculature are often treated with angioplastic balloons to attempt to increase the diameter of the blood vessels and allow for blood circulation to attempt to normalize. However, such physical interventions do not address the underlying cause of the obstruction of the blood vessel. Recent therapies have explored introducing drug coatings on the balloon to provide for site-specific delivery of therapeutics that counteract inflammation of the vessel walls. However, within the lumen itself often reside plaques that harden and grow to occlude the vessel. As such, there is a need for a drug-coated balloon that provides a therapeutic to combat the plaque itself.
SUMMARY
[0002] A 1 st aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns a balloon catheter for delivering a therapeutic agent to a blood vessel, the balloon catheter comprising: an elongate member having a lumen and a distal end; an expandable balloon attached to the distal end of the elongate member and in fluid communication with the lumen; and a coating layer overlying an exterior surface of the balloon, the coating layer comprising trodusquemine or a polymer microparticle containing trodusquemine and an excipient, [0003] A 2nd aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1 st aspect, wherein the excipient comprises a biodegradable polymer chosen from a fatty acid, a fatty acid ester, polylactic acid (PLLA,PDLA,PDLLA), polycaprolactone (PCL), sodium docusate, PLGA, PLGA-b-mPEG, polyglutamic acid, polyacrilic acid, hyaluronic acid, alginate, PVA, PVP, Pluronic (PEO-PPO- PEO), cellulose, CMC, HPC, starch, chitosan, human serum albumin (HSA), phospholipids, fatty acid, fatty acid esters, triglycerides, beeswax, cyclodextrin, Tween 20, Tween 80, TPGS, SLS, butylated hydroxytoluene, vitamin E, vitamin E succinate, tannic acid, polyethylene glycol, N- isopropylacrylamide, and sorbitol esters.
[0004] A 3 rd aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein trodusquemine is at a concentration density in the coating layer or within the polymer microparticle of from 0.1 pg/mm2 to 10 pg/mm2,
[0005] A 4th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein the coating layer further comprises a hydrophobic material containing trodusquemine embedded therein.
[0006] A 5th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 4th aspect, wherein the hydrophobic material comprises a hydrophobic material with a glass transition temperature of 37 °C or lower.
[0007] A 6th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 5th aspect, wherein the hydrophobic material is semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, a PEG- fatty acid ester, or a combination thereof.
[0008] A 7th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 4th aspect, wherein the hydrophobic material is hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petroleum jelly, decanol, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acid, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, a fatty acid triglycerides, a fatty acid alcohol, or a combination thereof.
[0009] An 8th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein the polymer microparticle comprises poly(lactic-co-glycolic) acid (PLGA) with trodusquemine loaded therein. [0010] A 9th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 8th aspect, wherein trodusquemine is loaded in the polymer microparticle at 30-50 % weight of the polymer microparticle.
[0011] A 10th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 9th aspect, wherein the polymer microparticles are of a first size grouping and a second size grouping, wherein the first size grouping has an average size of 10 pm and further wherein the second size grouping has an average size different from the first size grouping.
[0012] An 11th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 10th aspect, wherein the second size grouping has an average size of 30 pm, 35 pm, or 40 pm.
[0013] A 12th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein trodusquemine is crystalline particles.
[0014] A 13 th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 12th aspect, wherein the average size of the crystalline particles is of 0.1 pm to 100 pm.
[0015] A 14th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein the coating layer further comprises a hydrophilic material chosen from poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(2-Hydroxypropyl) methacrylamide (HPMA), divinyl ether-maleic anhydride (DIVEMA), polyoxazoline, xanthan gum, pectins, chitosan derivatives, dextran, casein sodium, cellulose ethers, sodium carboxy methyl cellulose, hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hyaluronic acid (HA), albumin, or a combination thereof.
[0016] A 15th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 1st aspect, wherein the coating layer further comprises a therapeutic agent.
[0017] A 16th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns the balloon catheter of the 15th aspect, wherein the therapeutic agent is chosen from paclitaxel, rapamycin, daunorubicin, 5-fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus (biolimus A9), everolimus, zotarolimus, tacrolimus, sirolimus, dexamethasone, prednisolone, corticosterone, cisplatin, vinblastine, lidocaine, bupivacaine, or a combination thereof.
[0018] A 17th aspect of the present disclosure, either alone or in combination with any other aspect herein, concerns a method for treating an atherosclerotic lesion in a subject comprising introducing the balloon catheter of the 1st aspect into a blood vessel of the subject; maneuvering the balloon catheter to a atherosclerotic plaque in the blood vessel; and, expanding the expandable balloon.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] It is to be understood that both the foregoing general description and the following detailed description describe various aspects and are intended to provide an overview or framework for understanding the nature and character of the claimed subject matter. The accompanying drawings are included to provide a further understanding of the various aspects, and are incorporated into and constitute a part of this specification. The drawings illustrate the various aspects described herein, and together with the description serve to explain the principles and operations of the claimed subject matter.
[0020] FIG. 1 is a schematic of an exemplary aspect of a medical device, particularly a balloon catheter, according to the present disclosure.
[0021] FIG. 2A is a cross-section of some aspect of the distal portion of the balloon catheter of FIG. 1 , taken along line A — A, including a drug coating layer on an exterior surface of a balloon.
[0022] FIG. 2B and is a cross-section of some aspect of the distal portion of the balloon catheter of FIG. 1, taken along line A — A, including an intermediate layer between an exterior surface of the balloon and a drug coating layer.
DESCRIPTION
[0023] The present disclosure concerns trodusquemine as an active agent in a coating on the exterior of a balloon, such as a balloon of a balloon catheter. Trodusquemine refers to a polyamine-steroid or amino sterol originally isolated from the dogfish shark. To date, little is known about its mechanisms of action, although some preliminary studies have identified it will allosterically inhibit protein-tyrosine phosphatase IB (PTP1B). A recent study showed that in mice deficient for both copies of the low density lipoprotein receptor (LDLR) responded favorably with regards to attenuated atherosclerotic plaque formation from both acute and chronic intraperitoneal treatment with trodusquemine (Thompson et al., Clin. Sci (Lond.) 2017: 131(20): 2489-2501). While the protective effect showed promise, to date there was no known study that identified that trodusquemine can provide any effect on established atherosclerotic plaques and improve the overall blood flow in the vasculature on a more long term basis.
[0024] The present disclosure accordingly concerns a coating layer on the exterior surface of a balloon. The coating layer may be in directed contact with the exterior surface of the balloon. There may be one or more intermediate layers between the coating layer and the exterior surface of the balloon. In some aspects, one or more additional layers may overlay the coating layer.
[0025] In aspects, the coating layer of the present disclosure includes trodusquemine. Trodusquemine may be present as an amorphous compound or in a crystalline form. In some aspects, trodusquemine may be formulated as a salt to improve solubility in water. In other aspects, trodusquemine is a hydrophobic compound. In some aspects, trodusquemine is a lipophilic compound. Trodusquemine in some aspects, may be able to cross through a lipid deposit, such as a plaque, and reach the cells of the lumen responsible for excretion and deposit of lipids within a blood vessel.
[0026] In some aspects, the coating layer may include microparticles of trodusquemine and a bioabsorbable polymer. Microparticles may be prepared the evaporation of a solvent with a bioabsorbable/biodegradable polymer and at least one therapeutic therein. In some aspects, the solvent is of dichloromethane (DCM) or ethyl acetate (EtOAc). Polymers may include a network of a poly-glycolic acid (PGA) and a poly-L-lactic acid (PLLA). Other bioabsorbable polymers that can be utilized in combination or alone for the microparticles include polycaprolactone (PCL), poly-DL-lactic acid (PDLLA), poly(trimethylene carbonate) (PTMC), poly (ester amine)s (PEA), poly(para-dioxanone) (PPDO), poly-2-hydroxy butyrate (PHB), and co-polymers with various ratios thereof. In some aspects, the bioabsorbable polymer may include, either alone or in combination with other bioabsorbable polymers, a polymer combination of lactic acid and glycolic acid, poly-lactic-co-glycolic acid (PLGA). Those skilled in the art will appreciate that PLGA can be of varying percentages of lactic acid and glycolic acid, wherein the higher the amount of lactide units, the longer the polymer can last in situ before degrading. Additional tunable properties with PLGA concern the molecular weight, with higher weights showing increased mechanical strength. In some aspects, the polymer microparticle is also loaded or embedded with an antioxidant, such as BHT.
[0027] In some aspects, the coating layer may include a polymer coating, such as a bioabsorbable polymer as set forth herein. In some aspects, the density of the trodusquemine or polymer microparticle within the polymer coating is of from about 0.1 to 10 pg/mm2. In certain aspects, the trodusquemine or polymer microparticle is provided on the device in the polymer coating at a density of from about 0.5 to about 5 pg/mm2. In some aspects, the dose density of the
trodusquemine in the coating and/or within each polymer microparticle can vary from about 0.1 to about 10 pg/mm2, including about 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5,
1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8., 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7,
3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9,
6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9, 8.0, 8.1,
8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9.0, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, and 9.9 pg/mm2. In some aspects, the trodusquemine dose density is of about 0.5 to about 5 pg/mm2.
[0028] In some aspects, the concentration density of the trodusquemine in the coating layer or within the polymer microparticle may be from 0.1 pg/mm2 to 10 pg/mm2, from
0.1 pg/mm2 to 8 pg/mm2, from 0.1 pg/mm2 to 6 pg/mm2, from 0.1 pg/mm2 to 4 pg/mm2, from
0.1 pg/mm2 to 2 pg/mm2, from 0.1 pg/mm2 t o 1 pg/mm2, from 1 pg/mm2 to 10 pg/mm2, from 1 pg/mm2 to 8 pg/mm2, from 1 pg/mm2 to 6 pg/mm2, from 1 pg/mm2 to 4 pg/mm2, from
1 pg/mm2 to 2 pg/mm2, from 2 pg/mm2 to 10 pg/mm2, from 2 pg/mm2 to 8 pg/mm2, from
2 pg/mm2 to 6 pg/mm2, from 2 pg/mm2 to 4 pg/mm2, from 4 pg/mm2 to 10 pg/mm2, from
4 pg/mm2 to 8 pg/mm2, from 4 pg/mm2 to 6 pg/mm2, from 6 pg/mm2 to 10 pg/mm2, from
6 pg/mm2 to 8 pg/mm2, or from 8 pg/mm2 t ) 10 pg/mm2. In some aspects, the concentration density of trodusquemine in the coating layer or polymer microparticle may be from 0.5 pg/mm2 to 5 pg/mm2.
[0029] The methods to apply the coating layer include to a medical device may include dip coating, metering coating, spray coating, electrostatic spray coating, roller coating, spin coating, ink-jet printing, 3D printing, or combinations thereof. A preferred method is metering coating and spray coating. After the solvent has evaporated, the coating layer is left on the surface.
[0030] In some aspects, the coating layer may include crystalline trodusquemine and/or an amorphous trodusquemine of a particular size range or ranges. In some aspects, the crystalline and/or amorphous trodusquemine can be embedded within the coating layer. In other aspects, the crystalline and/or amorphous trodusquemine is loaded within a polymer microparticle embedded in the coating layer. In further aspects, the crystalline and/or amorphous trodusquemine adheres to the surface of the medical device through the evaporation of a solvent. In some aspects, the crystalline and/or amorphous trodusquemine microparticle size can vary from about 0.1 pm to about 100 pm, including about 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 60, 70, 80, 90, 99 pm and any size or number therein. In some aspects, the particle size is of from about 1 pm to about 20 pm. In other aspects, the particle size of from about 10 pm to
about 100 pm. Size selection can be achieved through methods understood in the art, such as by passing through mesh of a pre-determined pore or hole size. The desired particle size can be achieved by dry grind or wet grinding. The grinding method may include techniques such as use of a jaw crusher, ultra-centrifugal mill, cyclone mill, cross beater mill, rotor beater mill, cutting mill, knife mill, mortar grinder, disc mill, mixer mill, cryomill, planetary ball mill, drum mill, and/or fine grinding rod mill. In some aspects, the particle size may be achieved with use of a ball mill. The ground drug particles and polymer mix may be combined with a solvent (or a mixture of solvents) and form a slurry coating solution. The methods may also include application of the slurry coating solution to a medical device surface. Such techniques for application may include dip coating, metering coating, spray coating, electrostatic spray coating, roller coating, spin coating, ink-jet printing, and 3D printing. In certain aspects, the method includes metering coating.
[0031] In some aspects, the drug coating layer includes a hydrophobic material or a hydrophobic material with polymers, polymer compositions and/or therapeutic compositions dispersed therein. In some aspects, the therapeutic is embedded therein in an amorphous form, in a crystalline form, embedded within a microparticle embedded in the hydrophobic material, or combinations thereof. In some aspects, the hydrophobic layer may include, but is not limited to, hydrophobic polymers and/or hydrophobic small molecules. In some aspects, the hydrophobic polymers and/or hydrophobic small molecules are bioabsorbable hydrophobic materials. In some aspects, the hydrophobic layer may be a mixture of two or more hydrophobic materials. In certain aspects, the hydrophobic materials are selected on the basis that they are biodegradable and/or bioabsorbed by the body over time. As used herein, “bioabsorbable” refers to a compound that can be absorbed by the surrounding or local tissue of a subject and/or degraded and absorbed by the tissue of the subject. In some aspects, the hydrophobic layer is easily transferred from the exterior or outer surface of the device, such that the layer transfers to the inner wells of a subject’s vasculature when the medical device is expanded or placed in situ. It will be appreciated that in some aspects, the balloon transfers the entire layer to vessel wall and the majority of drug release and absorption occurs after the transfer. Accordingly, in some aspects, the hydrophobic layer retains the embedded polymer microparticles and/or therapeutic agent and releases or elutes the therapeutic from the vessel wall. In some aspects, the therapeutic agent is delivered by erosion of polymer microparticles. In other aspects, the therapeutic is directly released by erosion and/or degradation of the hydrophobic layer, such as with direct embedding of particular sized crystalline and/or amorphous forms of the therapeutic agent.
[0032] In some aspects, the hydrophobic layer may include, but is not limited to, hydrophobic polymers and/or hydrophobic small molecules that are bioabsorbable hydrophobic materials. In some aspects, the hydrophobic layer may be a mixture of two or more hydrophobic materials that are selected on the basis that they are biodegradable and/or bioabsorbed by the body over time. By way of example and not limitation, examples of bioabsorbable hydrophobic materials may include semi-synthetic glycerides (e.g. Suppocire AIML, AML, BML, BS2, BS2X, NBL, NAIS 10, CS2X), lecithin, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, mineral oil, cetyl alcohol, petrolatum, petroleum jelly, decanol, soft paraffin, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acids, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, fatty acid triglycerides, fatty acid alcohols, PEG- fatty acid esters (with hydrophilic-lipophilic balance (HLB) below 13), PEG-surfactants with an HLB below 13, or combinations thereof.
[0033] In some aspects, the bioabsorbable hydrophobic polymer and/or hydrophobic small molecule has a glass transition temperature of 37 °C or lower. By providing a hydrophobic material in the hydrophobic layer matrix with a glass transition temperature that is below body temperature, the hydrophobic layer matrix can become tacky or sticky when the medical device is placed in situ within a human subject. In some aspects, the body temperature of the tissue surrounding the device when placed in a subject warms the hydrophobic polymer to above the glass transition temperature, allowing the hydrophobic polymer to become sticky or tacky within the subject. The ability of the hydrophobic layer matrix to become tacky allows the coating to adhere or transfer from the outer surface of the medical device to the vessel wall. In some aspects, embedding a therapeutic within such a hydrophobic layer matrix restricts exposure to water or the hemic environment or the aqueous environment of the blood and as a result, release may be impeded and/or prolonged. In some aspects, prolonging the time course of releasing a therapeutic agent can prevent or reduce incidences of restenosis. In some aspects, the hydrophobic material is selected from semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, and PEG-fatty acid esters. In certain aspects, the hydrophobic material is petroleum jelly or petrolatum.
[0034] In some aspects, the present disclosure concerns preparing a coating solution to provide the hydrophobic layer to the surface of the medical device or to a prior coating thereon. In some aspects, the methods for coating include dissolving the hydrophobic layer in a solvent that does not dissolve the therapeutic agent or the polymer of the polymer microparticles. The methods also include generating a slurry of the solvent with dissolved hydrophobic material and the therapeutic or a slurry of the solvent with dissolved hydrophobic material and the polymer microparticles with the therapeutic agent loaded therein and applying the slurry to the exterior surface or a portion thereof of the medical device or to a coating or portion thereof previous applied to the exterior surface of the medical device. The methods further include evaporating the solvent. It will be appreciated that the coating solution can be applied once or more than once. In some aspects, the volume applied and/or the number of applications can control the thickness of the hydrophobic layer.
[0035] In some aspects, the present disclosure concerns a polymer coating of a hydrophilic polymer and the hydrophobic therapeutic agent trodusquemine. Hydrophilic polymers may include poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(2-Hydroxypropyl) methacrylamide (HP MA), divinyl ether-maleic anhydride (DIVEMA), polyoxazoline, xanthan gum, pectins, chitosan derivatives, dextran, casein sodium, cellulose ethers, sodium carboxy methyl cellulose, hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hyaluronic acid (HA), albumin, and combinations thereof. In some aspects, the hydrophobic coating is prepared by dissolving the polymer in a solvent. Due to the opposing polarity, the trodusquemine and/or polymer microparticles are poorly soluble/insoluble in the solvent. The mixture can be then stirred to provide a slurry and applied to the outer surface of the balloon. As the solvent evaporates, the polymer emerges from the solution, thereby encasing trodusquemine on the surface of the medical device.
[0036] In aspects, the trodusquemine may be formulated with one or more additional therapeutic agents in the coating layer, either individually within the coating layer, or combined, such as within the same microparticle. In some aspects, the additional therapeutic may include one that can produce a desired effect when in situ. By way of example, and not as a limitation, the additional therapeutic agent can be chosen from paclitaxel, rapamycin, daunorubicin, 5- fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus
(biolimus A9), everolimus, sirolimus, zotarolimus, tacrolimus, dexamethasone, prednisolone, corticosterone, cisplatin, vinblastine, lidocaine, bupivacaine, or a combination thereof.
[0037] In some aspects, the coating layer may include one or more excipients. Suitable excipients that can be used in some aspects of the present disclosure include, without limitation, organic and inorganic pharmaceutical excipients, natural products and derivatives thereof (such as sugars, vitamins, amino acids, peptides, proteins, and fatty acids), surfactants (anionic, cationic, non-ionic, and ionic), and mixtures thereof. The following list of excipients useful in the present disclosure is provided for exemplary purposes only and is not intended to be comprehensive. Many other excipients may be useful for purposes of the present disclosure, such as polyglutamic acid, polyacrilic acid, hyaluronic acid, alginate, PVA,PVP, Pluronic (PEO-PPO-PEO), cellulose, CMC, HPC, starch, chitosan, human serum albumin (HSA), phospholipids, fatty acid, fatty acid esters, triglycerides, beeswax, cyclodextrin, polysorbates, polyethylene glycol, polyvinylpyrrolidone (PVP) and aliphatic polyesters.
[0038] In some aspects, the excipients may feature a drug affinity part. The excipients of the present disclosure may feature a hydrophilic part. As is understood in the art, the terms “hydrophilic” and “hydrophobic” are relative terms. To function as an excipient in some aspects of the present disclosure, the excipient is a compound that includes polar or charged hydrophilic moieties as well as non-polar hydrophobic (lipophilic) moieties. The hydrophilic part can accelerate diffusion and increase permeation of the therapeutic agent into tissue. The hydrophilic part of the excipient may facilitate rapid movement of therapeutic agent off the expandable medical device during deployment at the target site by preventing hydrophobic drug molecules from clumping to each other and to the device, increasing drug solubility in interstitial spaces, and/or accelerating drug passage through polar head groups to the lipid bilayer of cell membranes of target tissues.
[0039] Exemplary excipients for application in the present disclosure may include chemical compounds with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide or ester moieties. Hydrophilic chemical compounds with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide or ester moieties having a molecular weight less than 5,000 to 10,000 are preferred in certain aspects. In other aspects, molecular weight of the excipient with one or more hydroxyl, amino, carbonyl, carboxyl, acid, amide, or ester moieties is preferably less than 1000 to 5,000, or more preferably less than 750 to 1 ,000, or most preferably less than 750. In these aspects, the molecular weight of the excipient is less than that of the therapeutic agent to be delivered.
[0040] In some aspects, the one or more excipients may be selected from amino alcohols, alcohols, amines, acids, amides and hydroxyl acids in both cyclo- and linear- aliphatic and aromatic groups. Examples include L-ascorbic acid and its salt, D-glucoascorbic acid and its salt, tromethamine, triethanolamine, diethanolamine, meglumine, glucamine, sodium docusate, urea, amine alcohols, glucoheptonic acid, glucomic acid, hydroxyl ketone, hydroxyl lactone, gluconolactone, glucoheptonolactone, glucooctanoic lactone, gulonic acid lactone, mannoic lactone, ribonic acid lactone, lactobionic acid, glucosamine, glutamic acid, benzyl alcohol, benzoic acid, hydroxybenzoic acid, propyl 4-hydroxybenzoate, lysine acetate salt, gentisic acid, lactobionic acid, lactitol, sorbitol, glucitol, sugar phosphates, glucopyranose phosphate, sugar sulphates, sugar alcohols, sinapic acid, vanillic acid, vanillin, methyl paraben, propyl paraben, xylitol, 2-ethoxyethanol, sugars, galactose, glucose, ribose, mannose, xylose, sucrose, lactose, maltose, arabinose, lyxose, fructose, cyclodextrin, (2-hydroxypropyl)-cyclodextrin, acetaminophen, ibuprofen, retinoic acid, lysine acetate, gentisic acid, catechin, catechin gallate, tiletamine, ketamine, propofol, lactic acids, acetic acid, salts of any organic acid and amine described above, polyglycidol, glycerol, multiglycerols, galactitol, di(ethylene glycol), tri(ethylene glycol), tetra(ethylene glycol), penta( ethylene glycol), di(propylene glycol), tri(propylene glycol), tetra(propylene glycol, and penta(propylene glycol), and combinations thereof. Some of the chemical compounds with one or more hydroxyl, amine, carbonyl, carboxyl, amide or ester moieties described herein are very stable under heating, survive an ethylene oxide sterilization process, and/or do not react with the therapeutic agent during sterilization.
[0041] In some aspects, the one or more excipients may be selected from amino acids and salts thereof. For example, the excipient may be one or more of alanine, arginine, asparagines, aspartic acid, cysteine, cystine, glutamic acid, glutamine, glycine, histidine, proline, isoleucine, leucine, lysine, methionine, phenylalanine, serine, threonine, tryptophan, tyrosine, valine, and derivatives thereof are. Certain amino acids, in their zwitterionic form and/or in a salt form with a monovalent or multivalent ion, have polar groups, relatively high octanol-water partition coefficients, and are useful in some facets of the present disclosure. In the context of the present disclosure “low-solubility amino acid” refers to amino acid having a solubility in unbuffered water of less than about 4% (40 mg/ml). These include cystine, tyrosine, tryptophan, leucine, isoleucine, phenylalanine, asparagine, aspartic acid, glutamic acid, and methionine.
[0042] Amino acid dimers, sugar-conjugates, and other derivatives may also be considered for excipients. Through simple reactions well known in the art hydrophilic molecules
may be joined to hydrophobic amino acids, or hydrophobic molecules to hydrophilic amino acids, to make additional excipients useful in aspects of the present disclosure. Catecholamines, such as dopamine, levodopa, carbidopa, and DOPA, are also useful as excipients.
[0043] In some aspects, the excipient may be of a material that is at a glass transition temperature at 37 °C or higher. As identified herein, providing a material on the medical device that transitions to a sticky or tacky state in situ within the vessel of the subject allows for adhering the coating to the vessel wall. Such materials may include hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petrolatum, petroleum jelly, decanol, soft paraffin, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acids, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, fatty acid triglycerides, fatty acid alcohols or combinations thereof.
[0044] In some aspects, the excipients may be liquid additives. One or more liquid excipients may be can be used in the medical device coating to improve the integrity of the coating. Without being bound by theory, a liquid excipient can improve the compatibility of the therapeutic agent in the coating mixture. The liquid excipients used in aspects of the present disclosure is not a solvent. The solvents such as ethanol, methanol, dimethylsulfoxide, and acetone, will be evaporated after the coating is dried. In other words, the solvent will not stay in the coating after the coating is dried. In contrast, the liquid excipients in aspects of the present disclosure will stay in the coating after the coating is dried. The liquid excipient is liquid or semi-liquid at room temperature and one atmosphere pressure. The liquid excipient may form a gel at room temperature. In some aspects, the liquid excipient may be a non-ionic surfactant. Examples of liquid excipients include PEG-fatty acids and esters, PEG-oil transesterification products, polyglyceryl fatty acids and esters, Propylene glycol fatty acid esters, PEG sorbitan fatty acid esters, and PEG alkyl ethers as mentioned above. Some examples of a liquid excipient are Tween 80, Tween 81, Tween 20, Tween 40, Tween 60, Solutol HS 15, Cremophor RH40, and Cremophor EL&ELP.
[0045] In some aspects, the excipient may be a surfactant; a chemical compound with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties; or both. Exemplary surfactants may be chosen from PEG fatty esters, PEG omega-3 fatty esters and alcohols, glycerol fatty esters, sorbitan fatty esters, PEG glyceryl fatty esters, PEG sorbitan fatty esters, sugar fatty esters, PEG sugar esters, Tween 20, Tween 40, Tween 60, p-isononylphenoxypolyglycidol, PEG
laurate, PEG oleate, PEG stearate, PEG glyceryl laurate, PEG glyceryl oleate, PEG glyceryl stearate, polyglyceryl laurate, polyglyceryl oleate, polyglyceryl myristate, polyglyceryl palmitate, polyglyceryl-6 laurate, polyglyceryl-6 oleate, polyglyceryl-6 myristate, polyglyceryl-6 palmitate, polyglyceryl- 10 laurate, polyglyceryl- 10 oleate, polyglyceryl- 10 myristate, polyglyceryl- 10 palmitate , PEG sorbitan monolaurate, PEG sorbitan monolaurate, PEG sorbitan monooleate, PEG sorbitan stearate, PEG oleyl ether, PEG laurayl ether, Tween 20, Tween 40, Tween 60, Tween 80, octoxynol, monoxynol, tyloxapol, sucrose monopalmitate, sucrose monolaurate, decanoyl-N- methylglucamide, n-decyl - p -D-glucopyranoside, n-decyl - -D-maltopyranoside, n-dodecyl - P -D-glucopyranoside, n-dodecyl - p -D-maltoside, heptanoyl-N-methylglucamide, n-heptyl- p - D-glucopyranoside, n-heptyl - p -D-thioglucoside, n-hexyl - p -D-glucopyranoside, nonanoyl-N- methylglucamide, n-nonyl - p -D-glucopyranoside, octanoyl-N-methylglucamide, n-octyl- p -D- glucopyranoside, octyl - p -D-thioglucopyranoside and their derivatives. In some aspects, the excipients may include one of sodium docusate sorbitol, urea, BHT, BHA, PEG-sorbitan monolaureate, petrolatum, methyl stearate or a combination thereof.
[0046] In some aspects, one or more of a surfactant or a small water-soluble molecule (the chemical compounds with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties) with the therapeutic agent are in certain cases superior to only utilizing the therapeutic agent and a single excipient. By incorporating the one or more additional excipients, the drug coating may have increased stability during transit and rapid drug release when pressed against tissues of the lumen wall at the target site of therapeutic intervention when compared to some formulations comprising the therapeutic agent and only one excipient. Furthermore, the miscibility and compatibility of the therapeutic agent with the excipient or the drug coating with the medical device, generally, is improved by the presence of the one or more additional excipients. For example, a surfactant may allow for improved coating uniformity and integrity.
[0047] In some aspects, the coating layer(s) may include multiple excipients, and one excipient is more hydrophilic than one or more of the other excipients. In another embodiment, the coating layer multiple excipients, and one excipient has a different structure from that of one or more of the other excipients. In yet another aspect, the coating layer includes multiple excipients. Some aspects of the present disclosure may include a mixture of at least two additional excipients, for example, a combination of one or more surfactants and one or more chemical compound with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties. For example, therapeutic agents may bind to extremely water-soluble small molecules more poorly
than surfactants, which can lead to suboptimal coating uniformity and integrity. Some surfactants may adhere so strongly to the therapeutic agents and the surface of the medical device that the therapeutic agent is not able to rapidly release from the surface of the medical device at the target site. On the other hand, some water-soluble small molecules (with one or more hydroxyl, amine, carbonyl, carboxyl, amides or ester moieties) adhere so poorly to the medical device that they release therapeutic agents before it reaches the target site, for example, into serum during the transit of a coated balloon catheter to the site targeted for intervention. By incorporating a mixture of multiple excipients, the coating layer may have improved properties over a formulation with only one excipient or no excipient.
[0048] In some aspects, the one or more additional excipients may include an antioxidant. An antioxidant is a molecule capable of slowing or preventing the oxidation of other molecules. Oxidation reactions can produce free radicals and/or peroxides, which start chain reactions and may cause degradation of therapeutic agents. Antioxidants terminate these chain reactions by removing free radicals and inhibiting oxidation of the active agent by being oxidized themselves. Antioxidants are used as the one or more additional excipients in certain aspects to prevent or slow the oxidation of the therapeutic agents in the coatings for medical devices. Antioxidants are a type of free radical scavengers. The antioxidant may be used alone or in combination with other additional excipients in certain aspects and may prevent degradation of the active therapeutic agent during sterilization or storage prior to use. Some representative examples of antioxidants that may be used in the drug coatings of the present disclosure include, without limitation, oligomeric or polymeric proanthocyanidins, polyphenols, polyphosphates, polyazomethine, high sulfate agar oligomers, chitooligosaccharides obtained by partial chitosan hydrolysis, polyfunctional oligomeric thioethers with sterically hindered phenols, hindered amines such as, without limitation, p-phenylene diamine, trimethyl dihydroquinolones, and alkylated diphenyl amines, substituted phenolic compounds with one or more bulky functional groups (hindered phenols) such as tertiary butyl, arylamines, phosphites, hydroxylamines, and benzofuranones. Also, aromatic amines such as p-phenylenediamine, diphenylamine, and N,N' di-substituted p- phenylene diamines may be utilized as free radical scavengers. Other examples include, without limitation, butylated hydroxytoluene ("BHT"), butylated hydroxyanisole ("BHA"), L-ascorbate (Vitamin C), Vitamin E, herbal rosemary, sage extracts, glutathione, resveratrol, ethoxyquin, rosmanol, isorosmanol, rosmaridiphenol, propyl gallate, gallic acid, caffeic acid, p-coumeric acid, p-hydroxy benzoic acid, astaxanthin, ferulic acid, dehydrozingerone, chlorogenic acid, ellagic
acid, propyl paraben, sinapic acid, daidzin, glycitin, genistin, daidzein, glycitein, genistein, isoflavones, and tertbutylhydroquinone. Examples of some phosphites include di(stearyl)pentaerythritol diphosphite, tris(2,4-di-tert.butyl phenyl)phosphite, dilauryl thiodipropionate and bis(2,4-di-tert.butyl phenyl)pentaerythritol diphosphite. Some examples, without limitation, of hindered phenols include octadecyl-3, 5, di-tert.butyl-4-hydroxy cinnamate, tetrakis-methylene-3-(3',5'-di-tert.butyl-4-hydroxyphenyl)propionate methane 2,5-di-tert- butylhydroquinone, ionol, pyrogallol, retinol, and octadecyl-3-(3,5-di-tert.butyl-4- hydroxyphenyl)propionate. An antioxidant may include glutathione, lipoic acid, melatonin, tocopherols, tocotrienols, thiols, Beta- carotene, retinoic acid, cryptoxanthin, 2,6-di-tert- butylphenol, propyl gallate, catechin, catechin gallate, and quercetin. Preferable antioxidants are butylated hydroxytoluene (BHT) and butylated hydroxy anisole (BHA).
Balloon Catheters
[0049] In some aspects, the medical device is a balloon catheter. Referring to the exemplary drawing of FIG. 1, a balloon catheter 10 has a proximal end 18 and a distal end 20. The balloon catheter 10 may be any suitable catheter for desired use, including conventional balloon catheters known to one of ordinary skill in the art. For example, the balloon catheter 10 may be a rapid exchange or over-the-wire catheter. In some specific examples, the balloon catheter may be a ClearStream™ Peripheral catheter available from BD Peripheral Intervention. The balloon catheter 10 may be made of any suitable biocompatible material. The balloon 12 of the balloon catheter may include a polymer material, such as, for example only, polyvinyl chloride (PVC), polyethylene terephthalate (PET), polyethylene, Nylon, PEBAX (i.e. a copolymer of polyether and polyamide), polyurethane, polystyrene (PS), polyethleneterephthalate (PETP), or various other suitable materials as will be apparent to those of ordinary skill in the art.
[0050] Various aspects of the balloon catheter 10 of FIG. 1 are illustrated through the cross sections along line A — A of FIG. 1 in FIGS. 2A and 2B. Referring jointly to FIGS. 1, 2A, and 2B, the balloon catheter 10 includes an expandable balloon 12 and an elongate member 14. The elongate member 14 extends between the proximal end 18 and the distal end 20 of the balloon catheter 10. The elongate member 14 has at least one lumen 26a, 26b and a distal end 20. The elongate member 14 may be a flexible member which is a tube made of suitable biocompatible material. The elongate member 14 may have one lumen or, as shown in FIGS. 1, 2A, and 2B, more than one lumen 26a, 26b therein. For example, the elongate member 14 may include a guide-wire lumen 26b that extends to the distal end 20 of the balloon catheter 10 from a guide-
wire port 15 at the proximal end 18 of the balloon catheter 10. The elongate member 14 may also include an inflation lumen 26a that extends from an inflation port 17 of the balloon catheter 10 to the inside of the expandable balloon 12 to enable inflation of the expandable balloon 12. From the elements of FIGS. 1, 2 A, and 2B, even though the inflation lumen 26a and the guide-wire lumen 26b are shown as side-by-side lumens, it should be understood that the one or more lumens present in the elongate member 14 may be configured in any manner suited to the intended purposes of the lumens including, for example, introducing inflation media and/or introducing a guide-wire. Many such configurations are well known in the art.
[0051] The expandable balloon 12 is attached to the distal attachment end 22 of the elongate member 14. The expandable balloon 12 has an exterior surface 25 and is inflatable. The expandable balloon 12 is in fluidic communication with a lumen of the elongate member 14, (for example, with the inflation lumen 26a). At least one lumen of the elongate member 14 is configured to receive inflation media and to pass such media to the expandable balloon 12 for its expansion. Examples of inflation media include air, saline, and contrast media.
[0052] Still referring to FIG. 1, in one aspect, the balloon catheter 10 includes a handle assembly such as a hub 16. The hub 16 may be attached to the balloon catheter 10 at the proximal end 18 of the balloon catheter 10. The hub 16 may connect to and/or receive one or more suitable medical devices, such as a source of inflation media (e.g., air, saline, or contrast media) or a guide wire. For example, a source of inflation media (not shown) may connect to the inflation port 17 of the hub 16 (for example, through the inflation lumen 26a), and a guide wire (not shown) may be introduced to the guide-wire port 15 of the hub 16, (for example through the guide-wire lumen 26b).
[0053] In some examples, the cross section A — A of FIG. 1 may be as depicted according to FIG. 2A, in which the drug coating layer 30 is applied directly onto an exterior surface 25 of the balloon 12. The specific compositions of the drug coating layer 30 itself, according to various aspects, will also be described subsequently in greater detail. In other examples, the cross section A — A of FIG. 1 may be as depicted according to FIG. 2B, in which the drug coating layer 30 is applied onto an intermediate layer 40 overlying the exterior surface 25 of the balloon 12. In some aspects, the exterior surface 25 may undergo a surface modification. In some aspects where the exterior surface 25 is a modified exterior surface, the exterior surface 25 has been subjected to a surface modification, such as a fluorine plasma treatment, which decreases a surface free energy of the exterior surface 25 before application of the drug coating layer 30. Subjecting the exterior
surface to a surface modification may decreases the surface free energy of the exterior surface before application of the coating layer and affect the release kinetics of drug in the coating layer from the balloon, the crystallinity of the drug layer, the surface morphology of the coating and particle shape, or the particle size of drug of a therapeutic layer in the coating layer, drug distribution on the surface.
[0054] In aspects in which the cross section A — A of FIG. 1 is as depicted according to FIG. 2A, the balloon catheter 10 includes a drug coating layer 30 applied over an exterior surface 25 of the balloon 12. The drug coating layer 30 itself includes a therapeutic agent and an additive. In one particular aspect, the drug coating layer 30 comprises trodusquemine, and one or more additional additives. In further aspects, the drug coating layer 30 does not include a polymer.
[0055] In other aspects, two or more therapeutic agents are used in combination in the drug coating layer. In other aspects, the device may include a top layer (not shown) overlying the drug coating layer 30. In some aspects, a top coat layer may be advantageous in order to prevent premature drug loss during the device delivery process before deployment at the target site.
EXAMPLES
[0056] Trodusquemine will be dissolved in a solvent and dip-coated on to the exterior surface of a balloon of a balloon catheter. Evaporation of the solvent leaves a dried drug-coating on the surface. The balloons can then be utilized in animal studies to observe the effects in comparison with controls, such as a solvent only coating and/or a non-coated balloon, as well as with positive controls such as a rapamycin or paclitaxel coating at a similar concentration. For example, the balloons can be tested when implanted in femoral arteries of porcine model, followed by histological studies on the arteries for lumen area, medial area, neointimal area and the resulting percentage of stenosis. It is expected that trodusquemine will improve the lumen area and reduce the percentage of stenosis in comparison to vehicle and/or solvent only.
[0057] While particular aspects have been illustrated and described herein, it should be understood that various other changes and modifications may be made without departing from the spirit and scope of the claimed subject matter. Moreover, although various aspects of the claimed subject matter have been described herein, such aspects need not be utilized in combination. It is therefore intended that the appended claims cover all such changes and modifications that are within the scope of the claimed subject matter.
[0058] It is appreciated that all reagents are obtainable by sources known in the art unless otherwise specified.
[0059] It is also to be understood that this disclosure is not limited to the specific aspects and methods described herein, as specific components and/or conditions may, of course, vary. Furthermore, the terminology used herein is used only for the purpose of describing particular aspects of the present disclosure and is not intended to be limiting in any way. It will be also understood that, although the terms “first,” “second,” “third” etc. may be used herein to describe various elements, components, regions, layers, and/or sections, these elements, components, regions, layers, and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer, or section from another element, component, region, layer, or section. Thus, “a first element,” “component,” “region,” “layer,” or “section” discussed below could be termed a second (or other) element, component, region, layer, or section without departing from the teachings herein. Similarly, as used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms, including “at least one,” unless the content clearly indicates otherwise. “Or” means “and/or.” As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. It will be further understood that the terms “comprises” and/or “comprising,” or “includes” and/or “including” when used in this specification, specify the presence of stated features, regions, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components, and/or groups thereof. The term “or a combination thereof’ means a combination including at least one of the foregoing elements.
[0060] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. It will be further understood that terms such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and the present disclosure, and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.
[0061] Reference is made in detail to exemplary compositions, aspects and methods of the present disclosure, which constitute the best modes of practicing the disclosure presently known to the inventors. The Figures are not necessarily to scale. However, it is to be understood that the disclosed aspects are merely exemplary of the disclosure that may be embodied in various and
alternative forms. Therefore, specific details disclosed herein are not to be interpreted as limiting, but merely as a representative basis for any aspect of the disclosure and/or as a representative basis for teaching one skilled in the art to variously employ the present disclosure.
[0062] Patents, publications, and applications mentioned in the specification are indicative of the levels of those skilled in the art to which the disclosure pertains. These patents, publications, and applications are incorporated herein by reference to the same extent as if each individual patent, publication, or application was specifically and individually incorporated herein by reference.
[0063] The foregoing description is illustrative of particular embodiments of the disclosure, but is not meant to be a limitation upon the practice thereof. The following claims, including all equivalents thereof, are intended to define the scope of the disclosure.
Claims
1. A balloon catheter for delivering a therapeutic agent to a blood vessel, the balloon catheter comprising: an elongate member having a lumen and a distal end; an expandable balloon attached to the distal end of the elongate member and in fluid communication with the lumen; and a coating layer overlying an exterior surface of the expandable balloon, the coating layer comprising trodusquemine or a polymer microparticle containing trodusquemine and an excipient.
2. The balloon catheter of claim 1 , wherein the excipient comprises a biodegradable polymer chosen from a fatty acid, a fatty acid ester, polylactic acid (PLLA,PDLA,PDLLA), polycaprolactone (PCL), sodium docusate, PLGA, PLGA-b-mPEG, polyglutamic acid, polyacrilic acid, hyaluronic acid, alginate, PVA, PVP, Pluronic (PEO-PPO-PEO), cellulose, CMC, HPC, starch, chitosan, human serum albumin (HSA), phospholipids, fatty acid, fatty acid esters, triglycerides, beeswax, cyclodextrin, Tween 20, Tween 80, TPGS, SLS, butylated hydroxytoluene, vitamin E, vitamin E succinate, tannic acid, polyethylene glycol, N- isopropylacrylamide, and sorbitol esters.
3. The balloon catheter of claim 1, wherein trodusquemine is at a concentration density in the coating layer or within the polymer microparticle of from 0.1 pg/mm2 to 10 pg/mm2,
4. The balloon catheter of claim 1 , wherein the coating layer further comprises a hydrophobic material containing trodusquemine embedded therein.
5. The balloon catheter of claim 4, wherein the hydrophobic material comprises a hydrophobic material with a glass transition temperature of 37 °C or lower.
6. The balloon catheter of claim 5, wherein the hydrophobic material is semi-synthetic glycerides, methyl stearate, hydrogenated coconut oil, coconut oil, cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, hard fats, petroleum jelly/petrolatum, a PEG-fatty acid ester, or a combination thereof.
7. The balloon catheter of claim 4, wherein the hydrophobic material is hydrogenated coconut oil, coconut oil, mineral oil, cetyl alcohol, petroleum jelly, decanol, tridecanol, dodecanol, long chain saturated fatty acids, long chain unsaturated fatty acid, fatty acid esters, fatty acid ethers, witepsol, solid lipids, methyl stearate, triglycerides, glyceryl monostearate, glyceryl palmitostearate, stearic acid, palmitic acid, decanoic acid, behenic acid, beeswax, carnauba wax, paraffin, a fatty acid triglycerides, a fatty acid alcohol, or a combination thereof.
8. The balloon catheter of claim 1, wherein the polymer microparticle comprises poly(lactic- co-glycolic) acid (PLGA) with trodusquemine loaded therein.
9. The balloon catheter of claim 8, wherein trodusquemine is loaded in the polymer microparticle at 30-50 % weight of the polymer microparticle.
10. The balloon catheter of claim 9, wherein the polymer microparticles are of a first size grouping and a second size grouping, wherein the first size grouping has an average size of 10 pm and further wherein the second size grouping has an average size different from the first size grouping.
11. The balloon catheter of claim 10, wherein the second size grouping has an average size of 30 pm, 35 pm, or 40 pm.
12. The balloon catheter of claim 1, wherein trodusquemine is crystalline particles.
13. The balloon catheter of claim 12, wherein the average size of the crystalline particles is of 0.1 pm to 100 pm.
14. The balloon catheter of claim 1, wherein the coating layer further comprises a hydrophilic material chosen from poly(ethylene glycol), polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacrylamides, N-(2-Hydroxypropyl) methacrylamide (HPMA), divinyl ether-maleic anhydride (DIVEMA), polyoxazoline, xanthan gum, pectins, chitosan derivatives, dextran, casein sodium, cellulose ethers, sodium carboxy methyl cellulose, hydroxypropylmethyl cellulose (HPMC), hydroxypropyl cellulose (HPC), hydroxyethyl cellulose (HEC), hyaluronic acid (HA), albumin, or a combination thereof.
15. The balloon catheter of claim 1, wherein the coating layer further comprises a therapeutic agent.
16. The balloon catheter of claim 15, wherein the therapeutic agent is chosen from paclitaxel, rapamycin, daunorubicin, 5 -fluorouracil, doxorubicin, sunitinib, sorafenib, irinotecan, bevasizumab, cetuxamab, biolimus (biolimus A9), everolimus, sirolimus, zotarolimus, tacrolimus, dexamethasone, prednisolone, corticosterone, cisplatin, vinblastine, lidocaine, bupivacaine, or a combination thereof.
17. A method for treating an atherosclerotic lesion in a subject comprising introducing the balloon catheter of claim 1 into a blood vessel of the subject; maneuvering the balloon catheter to a atherosclerotic plaque in the blood vessel; and, expanding the expandable balloon.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/US2023/021688 WO2024232881A1 (en) | 2023-05-10 | 2023-05-10 | Trodusquemine-coated balloon for targeted treatment of atherosclerosis |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/US2023/021688 WO2024232881A1 (en) | 2023-05-10 | 2023-05-10 | Trodusquemine-coated balloon for targeted treatment of atherosclerosis |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2024232881A1 true WO2024232881A1 (en) | 2024-11-14 |
Family
ID=86688590
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/US2023/021688 Pending WO2024232881A1 (en) | 2023-05-10 | 2023-05-10 | Trodusquemine-coated balloon for targeted treatment of atherosclerosis |
Country Status (1)
| Country | Link |
|---|---|
| WO (1) | WO2024232881A1 (en) |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20150196690A1 (en) * | 2009-12-11 | 2015-07-16 | Abbott Cardiovascular Systems Inc. | Coatings with tunable molecular architecture for drug-coated balloon |
| WO2023059318A1 (en) * | 2021-10-05 | 2023-04-13 | Bard Peripheral Vascular, Inc. | Drug coatings for medical devices |
-
2023
- 2023-05-10 WO PCT/US2023/021688 patent/WO2024232881A1/en active Pending
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20150196690A1 (en) * | 2009-12-11 | 2015-07-16 | Abbott Cardiovascular Systems Inc. | Coatings with tunable molecular architecture for drug-coated balloon |
| WO2023059318A1 (en) * | 2021-10-05 | 2023-04-13 | Bard Peripheral Vascular, Inc. | Drug coatings for medical devices |
Non-Patent Citations (2)
| Title |
|---|
| THOMPSON DAWN ET AL: "Pharmacological inhibition of protein tyrosine phosphatase 1B protects against atherosclerotic plaque formation in the LDLR-/- mouse model of atherosclerosis", CLINICAL SCIENCE., vol. 131, no. 20, 29 September 2017 (2017-09-29), GB, pages 2489 - 2501, XP093100696, ISSN: 0143-5221, Retrieved from the Internet <URL:https://portlandpress.com/clinsci/article-pdf/131/20/2489/448278/cs-2017-1066.pdf> [retrieved on 20231113], DOI: 10.1042/CS20171066 * |
| THOMPSON ET AL., CLIN. SCI (LOND., vol. 131, no. 20, 2017, pages 2489 - 2501 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US10912932B2 (en) | Drug releasing coatings for balloon catheters | |
| CN102883753B (en) | Drug Release Coatings for Medical Devices | |
| CA2955639C (en) | Coating for intraluminal expandable catheter providing contact transfer of drug micro-reservoirs | |
| CN113226389B (en) | Medical device with drug eluting coating on modified device surface | |
| ES2871499T3 (en) | Medical device with drug elution coating and interlayer | |
| CN113939324A (en) | Medical devices having drug eluting coatings on modified device surfaces | |
| CN104857573A (en) | Drug releasing coating for medical device | |
| CN112867514A (en) | Coating of intraluminal expandable catheters providing contact transfer of drug microreservoirs | |
| US20240382656A1 (en) | Drug Coatings for Medical Devices | |
| US20250041489A1 (en) | A Drug Coating Formulation for a Sirolimus Coated Balloon Catheter | |
| JP7335920B2 (en) | Drug release coating for medical devices | |
| WO2024232881A1 (en) | Trodusquemine-coated balloon for targeted treatment of atherosclerosis | |
| WO2024263155A1 (en) | Protective coverings for drug coated balloons | |
| WO2024191445A1 (en) | Therapeutic bio-absorbable polymeric scaffold with drug-loaded micro-needles for drug delivery | |
| WO2024242668A1 (en) | Protective coverings for drug coated balloons | |
| WO2025136359A1 (en) | Endobronchial drug coated balloon | |
| US20240325108A1 (en) | Drug-refillable, biocompatible, and biodegradable tissue markers and methods of making and using the same | |
| US11975161B2 (en) | Drug releasing coatings for balloon catheters | |
| JP2025528176A (en) | Drug-coated medical devices and manufacturing methods | |
| HK1242231B (en) | Coating for intraluminal expandable catheter providing contact transfer of drug micro-reservoirs | |
| HK1242231A1 (en) | Coating for intraluminal expandable catheter providing contact transfer of drug micro-reservoirs |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| 121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 23728525 Country of ref document: EP Kind code of ref document: A1 |