The present invention relates generally to a delivery device for delivering a substance to a patient and filtering or removing selected compounds from the substance before delivery to the patient. The delivery device includes an adsorbent material positioned upstream of a delivery member, such as a cannula or catheter, to remove selected compounds from the substance just prior injecting into the patient. The delivery device in one embodiment is suitable for delivering a controlled dosage of an insulin formulation where the device is associated with an adsorbent for removing stabilizing agents and/or selected compounds from the insulin formulation prior to introducing to the patient.
Insulin and other injectable medications are commonly delivered with drug delivery pens, whereby a disposable pen needle hub is attached to the pen to facilitate drug container access and allow fluid egress from the container through the needle into the patient.
Drugs and pharmaceuticals often contain preservatives and stabilizing agents to extend the shelf-life of the drug or pharmaceutical. For example, insulin often contains phenol and/or m-cresol as stabilizers. These stabilizers can often produce side effects, such as irritation, inflammation, scarring and lipohypertrophy at the injection site.
Various pen needle delivery devices are known in the art for dispensing the substance to the patient. The delivery devices often use a disposable needle hub having a cannula or needle extending from a patient end of the hub for inserting into the patient. A non-patient end of the hub is coupled to the pen delivery device for delivering the substance to the patient.
The needle hub assembly is often packaged in a container containing several loose needle hubs. A needle hub is selected from the package and attached to the pen needle delivery device for injecting the patient and then removed to be discarded. The needle hub package includes an outer cover that encloses the needle hub and a removable seal that is peeled from the outer cover to open the cavity so that the needle hub can be removed. The needle hub can have threaded non-patient end that is threaded onto the delivery device. The delivery device with the attached needle hub is then removed from the outer cover. An inner needle shield is attached to the needle hub to cover the cannula until the device is ready for use. The shield is removed to expose the cannula for use to deliver the substance to the patient. After use, the needle hub can be inserted back into the outer cover to enclose the exposed cannula. The pen delivery device separates from the needle hub leaving the needle hub in the outer cover. The prior delivery devices are generally suitable for delivering the insulin directly from a storage container or supply.
Existing pen needle assemblies are disclosed in U.S. Patent Application Publication Nos. 2006/0229562 to Marsh et al. and 2007/0149924 to R. Marsh, the entire contents of both of which are hereby incorporated by reference for this purpose.
Although the prior devices have been suitable for the intended use, there is a continuing need in the industry for improved delivery devices to reduce the irritation and inflammation at the injection site.
The present invention is directed to a delivery device for delivering a drug or pharmaceutical to a patient. The delivery device can be an injection or infusion device having a cannula or catheter for delivering the substance to the patient. The delivery device is particularly suitable for treating insulin formulations shortly before introducing the insulin to the patient.
The delivery device is used in conjunction with a filter and/or adsorbent that is able to remove selected substances or compounds from the medication, drug or pharmaceutical prior to delivering the medication, drug or pharmaceutical to the patient. In one embodiment, the filter or adsorbent is a separate unit that is attached to the delivery device and/or positioned in the flow path of the medication prior to introducing the medication to the patient. In other embodiments, the adsorbent is incorporated into the device where the medication passes through the adsorbent at the time of delivery to the patient.
In one embodiment, a delivery device is able to inject a substance, such as insulin, medication, drug or pharmaceutical into the patient at controlled rates and dosage, which can be over an extended period of several days. Examples of delivery devices include a pen needle, infusion set, patch pump, catheter, or other delivery device suitable for introducing a medication and particularly insulin to a patient in a unit dosage or sustained continuous delivery. The delivery device is configured so that the substance passes through a filter and/or adsorbent to remove selected compounds or materials from the substance just prior to introducing into the patient. In one embodiment, the delivery device includes an injection member, such as a needle, cannula, or catheter, where the adsorbent or filter is oriented upstream of the injection member to filter and treat the insulin, medication, drug or pharmaceutical prior to delivering to the injection member and prior to injecting to the patient.
One aspect of the delivery device provides a storage container that is able to store a selected volume of the substance prior to use and delivery to the patient. The delivery device is able to removed selected substances and compounds from a dosage amount of the substance before introducing to the patient. The delivery device in one embodiment includes a filter or adsorbent that is a separate unit from the storage container so that the substance being stored in the storage container does not contact the adsorbent until the substance is ready for delivery to the patient.
The delivery device in one embodiment is connected to a filter or adsorbent member to treat the substance as the substance is dispensed from a storage container over an extended period of time of several days and before introducing to the patient. The substance contacts the adsorbent after dispensing from the storage container to remove selected compounds from the substance and before supplying the substance to a delivery member.
In one embodiment, the delivery device includes the adsorbent positioned between the storage container and the injection member. The delivery device can be an infusion set for insulin delivery having a pump or other dispensing mechanism, a storage container for the insulin, and a catheter or cannula for delivering the insulin to the patient. The adsorbent is located in the fluid flow path upstream of the catheter to treat the insulin just before supplying to the catheter and delivering to the patient The absorbent can be positioned as close as possible to the catheter to limit the time between the point in the flow path where the selected compounds are removed from the insulin and the time the insulin is introduced to the patient. Positioning the adsorbent close to the catheter limits the amount of treated insulin remaining in the assembly.
In another embodiment, the delivery device is a pen needle assembly having a cartridge containing the insulin and a dispensing mechanism. A pen needle having a needle hub and a needle is attached to the pen needle assembly for injecting the insulin into the patient. An adsorbent is provided in the flow path between the cartridge and the pen needle to treat the insulin as the insulin is being delivered to the patient.
The delivery device in one embodiment is an insulin delivery device such as an infusion set, pen needle assembly, patch pump, catheter, or other delivery mechanism for delivering insulin to the patient in a controlled dosage. A cartridge containing the adsorbent is connected to the delivery device in the flow path of the substance being delivered to the patient. The cartridge is positioned in the insulin fluid flow path upstream of the cannula or catheter for the delivery device. Alternatively, the cartridge containing the adsorbent can be provided in a pen needle assembly where the insulin dispensed from the cartridge passes through the adsorbent and then to the pen needle before delivering to the patient. In other embodiments, the adsorbent can be incorporated in the cartridge or at the outlet of the cartridge where the insulin passes through the adsorbent as the insulin is dispensed from the cartridge to the pen needle.
The delivery device in another embodiment can be an infusion pump having a supply tube or other fluid connection extending from the pump mechanism to a catheter or cannula for positioning in the patient to deliver the insulin to the patient in a controlled and continuous delivery. A cartridge containing an adsorbent is positioned upstream of the catheter and in close proximity of the catheter or cannula so that the insulin passes through the adsorbent during delivery and infusion to the patient.
In one embodiment, the drug being delivered is an insulin formulation, such as fast acting insulin formulation, containing a stabilizing and/or preserving agent that is present to extend the shelf-life of the insulin. An example of a preservative is a stabilizing phenolic compound, such as phenol, m-cresol, and mixtures thereof. The adsorbent is able to remove at least a portion of the phenol and m-cresol from the insulin solution by passing the insulin formulation through a bed of the adsorbent or a cartridge containing the adsorbent. The absorbent is used in an amount to remove an amount of the phenolic stabilizers sufficient to reduce irritation at the injection site that is normally caused by the presence of the phenolic stabilizing agents in the insulin. The adsorbent is selective to the phenolic stabilizer, and particularly m-cresol, without reducing the effectiveness or potency of the insulin. Reducing the concentration or amount of the phenolic stabilizing agents in the insulin that contacts the tissue at the delivery site improves the absorption of the insulin at the infusion site and reduces inflammation.
In one embodiment, the adsorbent is activated carbon or activated charcoal that is able to adsorb phenol and m-cresol effectively by contacting the insulin solution with the adsorbent without reducing the effectiveness or potency of the insulin solution at the time of delivery to the patient. Acid activated charcoal, such as phosphoric acid treated activated charcoal, is particularly suitable for adsorbing and removing phenol and m-cresol from the insulin formulation without significantly lowering the potency of the insulin. Activated carbon that is chemically activated by phosphoric acid at pH 6.7 is effective in selectively removing phenol and/or m-cresol from insulin.
The adsorbent is positioned relative to the delivery or injection device to contact the insulin formulation at the time of or immediately before introducing into the patient. The adsorbent is included in an amount to provide a contact time with the insulin sufficient to remove a desired amount of the phenolic stabilizing agent from the insulin without reducing the effectiveness of the insulin in one embodiment, the adsorbent is located at or near the injection member, such as a catheter or cannula, so that the residence time of the resulting treated insulin downstream of the adsorbent is sufficiently short to minimize degradation, denaturing, or loss of potency of the insulin delivered to the patient. The absorbent removes an amount of the phenolic compounds to reduce or inhibit the inflammation or irritation at the delivery site and improve absorption by the patient.
A method is also provided for delivering the drug, such as an insulin solution, to a patient by providing a delivery device having a storage container or compartment for storing the drug until ready for use. The delivery device includes a dispensing mechanism for dispensing the insulin and an injection member for introducing the insulin to the patient. An adsorbent, such as activated charcoal, is positioned between the storage container and the injection member. The insulin is introduced to the injection member and delivered to the patient from the storage container by passing the insulin through the adsorbent to remove stabilizing agents from the insulin immediately before injection to the patient.
The objects, advantages, and features of the device will become apparent from the following detailed description, which, taken in conjunction with the annexed drawings, discloses exemplary embodiments of the invention.
The above benefits and other advantages of the various embodiments of the present invention will be more apparent from the following detailed description of exemplary embodiments of the present invention and from the accompanying figures, in which:
Throughout the drawings, like reference numbers will be understood to refer to like parts, components, and structures.
The present invention is directed to a delivery device and method of delivering a substance, such as insulin, medication, or a drug to a patient, and removing selected compounds or substances from the insulin, medication or drug prior to delivering to the patient.
The delivery device and method are particularly suitable for use in delivering insulin that contains a stabilizer or preservative where at least a portion of the stabilizer or preservative is removed from the insulin before delivering to the patient. The delivery device for introducing an insulin formulation into the patient is used in association with an adsorbent material that contacts the insulin formulation before introducing to the patient. In one embodiment, a method of reducing or minimizing the irritation and inflammation at the delivery or an injection site is attained by reducing the amount of the stabilizer, such as phenol and/or m-cresol in an insulin formulation before introducing to the patient. The insulin is treated with an adsorbent to remove at least a portion of the phenol and/or m-cresol where the treated insulin is introduced into the patient within a period of time to prevent denaturing or loss of insulin potency.
Reference is made to embodiments of the present invention, which are illustrated in the accompanying drawings, wherein like reference numerals refer to like elements throughout. The embodiments described herein exemplify, but do not limit, the present invention by referring to the drawings. The exemplary embodiments are presented in separate descriptions, although the individual features and construction of these embodiments can be combined in any number of ways to meet the therapeutic needs of the user.
This disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The embodiments herein are capable of being modified, practiced or carried out in various ways. Also, it will be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless limited otherwise, the terms “connected,” “coupled,” and “mounted,” and variations thereof herein are used broadly and encompass direct and indirect connections, couplings, and mountings. In addition, the terms “connected” and “coupled” and variations thereof are not limited to physical or mechanical connections or couplings. Further, terms such as up, down, bottom, and top are relative, and are to aid illustration, but are not limiting. The embodiments are not intended to be mutually exclusive so that the features of one embodiment can be combined with other embodiments as long as they do not contradict each other. Terms of degree, such as “substantially”, “about” and “approximately” are understood by those skilled in the art to refer to reasonable ranges around and including the given value and ranges outside the given value, for example, general tolerances associated with manufacturing, assembly, and use of the embodiments. The term “substantially” when referring to a structure or characteristic includes the characteristic that is mostly or entirely.
The delivery device and method are provided for delivering the substance, such as insulin, drug, pharmaceutical or other substance to a patient by a bolus flow delivery or basal delivery. In one embodiment, the drug is an insulin formulation or solution that is delivered to the patient in a selected and controlled dosage at an injection or infusion site.
The insulin formulation is typically a solution containing a preservative and stabilizing agent to extend the shelf-life of the insulin solution until ready for use. The stabilizing agent in one embodiment is phenol, m-cresol and mixtures thereof. The majority of Type 1 diabetics manage the condition by multiple daily injections of insulin. The daily injections result in side effects including irritation, inflammation, scarring, and lipohypertrophy and the accumulation of subcutaneous fat at the insulin injection site or infusion site. The presence of phenol and m-cresol in insulin formulation is effective as a bacteriostat and for stabilizing the insulin formulation. However, the presence of the phenol and m-cresol in the insulin with repeating or sustained injection at an injection site or infusion site can cause inflammation and irritation to the patient and can reduce insulin absorption at the site.
The phenolic excipients m-cresol and phenol present in insulin analog formulations as a bacteriostatic and stabilizing factor are cytotoxic in an in vitro system and contribute to adverse tissue reactions when delivered locally at formulation concentrations. The adverse tissue reactions result in increased pro-inflammatory cytokine levels and altered subcutaneous insulin pharmacokinetics. The deleterious reactions are dose-dependent so that as more excipient is delivered, such as in insulin infusion devices, pharmacokinetics are increasingly altered relative to initial values. Test data suggests that excipient-induced models of inflammation negatively affect the route of insulin administration and absorption. This can lead to issues of inadequate adherence.
One feature of the delivery device and method is to remove the phenolic excipients selectively from insulin formulations without interfering with the effectiveness of the insulin upon delivery to the patient. Experiments using activated charcoal as a adsorbent show the effective removal of the phenol and m-cresol from insulin formulation while maintaining the effluent insulin at formulation concentrations. The resulting treated insulin having a reduced concentration of the phenolic excipient is delivered to the patient within a period of time where substantially no denaturing or loss of potency of the insulin occurs. In one embodiment, the adsorbent is selected to remove only the phenolic excipients.
An adsorbent is used with the delivery device for removing at least a portion of the stabilizing agents, and particularly for removing at least a portion of the phenolic stabilizing agents from an insulin formulation prior to introducing to the patient. The adsorbent in one embodiment is provided in a chamber, container, or cartridge connected to or positioned in the flow path of the insulin formulation as the formulation is being supplied to the delivery or injection device. In other embodiments, the adsorbent is incorporated within the delivery device and positioned where the insulin formulation contacts the adsorbent as the insulin formulation is being delivered to the patient.
In one embodiment, the adsorbent is activated charcoal that can be in a granular, extruded, or powder form to provide a contact surface area for the insulin that is sufficient to remove an selected amount of the phenolic stabilizers to inhibit inflammation at the delivery site without denaturing or loss of potency of the insulin at the time of delivery to the patient. In the present description of the device, the terms activated charcoal and activated carbon are used interchangeably. Acid treated activated charcoal, such as phosphoric acid activated carbon, is particularly suitable for removing phenol and m-cresol from insulin formulations. In one embodiment, the activated charcoal is a chemically active carbon obtained by treatment with phosphoric acid. The activation can be by phosphoric acid at pH 6.7. Commercially available phosphoric acid treated activated charcoal can be used for the removal of phenol and m-cresol from insulin formulations. An example of a commercially available acid treated activated charcoal is available under the trade name CN5-20 by Cabot Corporation. The activated charcoal has a surface area to provide sufficient contact with the insulin to remove an amount of the phenolic compounds sufficient to minimize irritation and inflammation at the injection site.
The activated charcoal can be obtained from a variety of carbon sources including, for example, wood, coconut shell, olive pits, peat, lignite, coal or other suitable carbon source. The activation in one embodiment is by chemical activation with phosphoric acid to provide the beneficial porosity, pore volume, surface area, surface chemistry, and pore size distribution. The activated charcoal typically has a surface area of greater than 1,000 m2/g. The activated charcoal can have a pore volume of about 0.26-1.16 cm3/g, and generally about 0.40-0.70 cm3/g. In other embodiments, the activated charcoal can have a surface area of 1500 m2/g or greater. In further embodiments, the activated charcoal can have surface area of greater than 2300 m2/g and in some circumstances a surface area of greater than 3,000 m2/g depending on the method of activation.
The adsorbent is present in an amount to provide a contact time with the insulin formulation that is sufficient to remove a desired amount of the phenol, m-cresol or other stabilizing agents contained in the insulin formulation to reduce irritation and inflammation at the injection site without denaturing and without reducing the potency of the insulin. The adsorbent is located in the flow path of the insulin formulation as close to the injection member or delivery site as reasonably possible to limit degradation of the insulin formulation before introducing to the patient.
The amount of activated charcoal in the assembly complements the dosage, and flow rate of the insulin depending on the delivery by basal flow or bolus flow delivery to provide the desired rate of adsorption of the phenolic stabilizers. In one embodiment, the amount of the adsorbent provides removal of about 95% of the m-cresol after 4 days and about 60% after 7 days at a basal flow rate.
In the embodiment shown, the adsorbent can be enclosed in a container or cartridge that is separate from the delivery or injection device. In other embodiments, the adsorbent can be enclosed in a chamber within or as a component of the delivery device or in a supply container or cartridge that treats the insulin formulation as the formulation is dispensed from the supply container.
In one embodiment the delivery device is a pen needle delivery device 10, as shown in
In standard pen needle devices the dosing and delivery mechanisms are found within the outer sleeve 12 and is riot described in greater detail here as they are understood by those knowledgeable of the art. A medicament cartridge is typically attached to a standard pen injector housing by known attachment mechanism. The distal movement of a plunger or stopper within the medicament cartridge causes medication to be forced into the reservoir housing. The medicament cartridge is sealed by a septum and punctured by a septum penetrating needle cannula located within a reservoir or housing. Reservoir housing is preferably screwed onto the medicament cartridge although other attachment mechanism can be used. The pen needle delivery device can be a standard pen delivery device known in the industry so that the pen needle delivery device is not shown in detail. The pen needle assembly 18 as shown in
In the embodiment shown, the pen needle delivery device 10 is provided with an adsorbent, such as activated charcoal, to treat the insulin before delivery to the patient. In one embodiment, a filter cartridge 30 is provided in or on the outlet of the pen needle delivery device as shown in
As shown in
In one embodiment, the cartridge is transparent or has a viewing portion or window having sufficient transparency to enable the user to observe the contents of the cartridge before and after use. The transparent portion of the cartridge is located in a position that the user is able to visualize fibrillation or changes in the insulin caused be denaturing after the stabilizing agents are adsorbed and removed by the adsorbent.
The cartridge 30 has a volume of the adsorbent to contact a dosage of the insulin formulation and remove a selected amount of the phenol, m-cresol or other stabilizing agent from the insulin formulation before introducing to the patient. The cartridge 30 typically has a volume of the activated charcoal to remove an amount of phenol and/or m-cresol from the insulin formulation at typical flow rates of the pen needle delivery assembly 10 to inhibit inflammation and irritation at the injection site. In other embodiments, the adsorbent is contained in a chamber of the cartridge positioned within the sleeve 12 of the pen needle delivery device where the insulin formulation from the cartridge passes through the adsorbent as the insulin is supplied to the pen needle 18.
In the embodiment shown, the cartridge 30 is positioned relative to the pen needle to minimize the time before the treated insulin with the reduced phenol and/or m-cresol concentration is introduced to the patient to minimize the loss of insulin potency by degradation or denaturing of the insulin.
The cartridge 30 in the embodiment of
In the embodiment of
In the embodiment shown, the catheter adapter 44 includes winged extensions 54 that project outwardly from the body of the catheter adapter 44. The winged extensions 54 include an adhesive for attaching the catheter adapter to the patient to maintain a desired position of the catheter adapter following catheterization.
As shown in
As shown in
Another embodiment as shown in
A fluid supply tube 62 is connected to a removable fluid coupling 64 for connecting to the base 58 to supply the insulin formulation to the catheter. A cartridge 66 is connected to the supply tube 62 so that the insulin formulation passes through the cartridge before delivering to the infusion set 56. The cartridge 66 has an inlet 68 that receives the insulin formulation from a supply and pump mechanism, and an outlet 70 for directing the treated insulin formulation to the catheter.
The cartridge 66 contains an amount of the adsorbent, such as activated charcoal, to contact the insulin formulation and remove at least a portion of the phenol, m-cresol or other stabilizing agents from the insulin formulation before discharging through the outlet 70 of the cartridge. The cartridge 66 can be a single component that can be connected to supply tube 62 by couplings so that the cartridge 66 can be removed when the adsorbent reaches the end of its useful life. A replacement cartridge can then be connected to the supply tube 62 for continued delivery of a treated insulin to the patient.
In a further embodiment shown in
As shown in
The passage 83 includes a porous membrane, screen, or filter 91 and the open bottom end includes a porous membrane, screen, or filter 93 to form the cavity 85 and retain the adsorbent 87 within the cavity 85. The porous membranes have pore size to retain the adsorbent in the cavity while allowing sufficient insulin flow through the cartridge to the catheter of the infusion set.
The activated charcoal as an adsorbent has been found to be effective in filtering and removing phenol from insulin lispro, such as sold under the tradename Humalog over a 7 day period. The activated charcoal has also been found to be effective in removing phenol and m-cresol from insulin aspart, such as sold under the tradename Novolog. No aggregation or fibrillation of insulin was observed for either of these formulations during or after contact with the activated charcoal over a 7 day.
The activated adsorbent is particularly suitable for treating insulin in an infusion device such as the infusion devices of
In the embodiment shown, the patch pump 100 includes a cartridge 112 connected to the fluid supply tube from the reservoir 104 so that the insulin from the reservoir passes through the cartridge 112 before catheter. In the embodiment shown, cartridge 112 is constructed in a manner similar to the embodiment of
The effectiveness of the activated charcoal for removing phenol and m-cresol from insulin formulations was tested using a known infusion formulation. The insulin formulation obtained under the tradename Humalog containing m-cresol as a stabilizer was passed through a bed of 15 mg of acid-treated activated charcoal for a period of 7 days. The acid-treated activated charcoal was obtained under the tradename CN5-20 from Cabot Corporation. The insulin formulation was passed through the activated charcoal at a rate corresponding to a basal flow delivery of insulin and a bolus flow delivery of insulin. As shown in the table of
Example 2 was performed in a similar manner as in Example 1 except for the use of 2.5 mg of the acid-treated activated charcoal with a similar insulin volume. As shown in the basal flow of the table in
In this example, the insulin formulation was obtained under the tradename Novolog and tested with 15 mg of acid-treated activated charcoal by the tradename CN5-20. The activated charcoal was shown to effectively remover m-cresol and phenol from the insulin formulation as shown in the table in
The activated charcoal is found to be effective in removing phenol and m-cresol from insulin formulations immediately before introducing to the patient. The activated charcoal is effective in removing the phenol and m-cresol from insulin formulations at typical flow rates of infusion devices that provide a controlled and/or continuous insulin delivery without loss of insulin potency. The reduced content of the phenol and m-cresol from the insulin formulation reduces the irritation and inflammation at the injection site and improves adsorption of insulin at the injection site over a prolonged period of time.
The foregoing embodiments and advantages are merely exemplary and are not to be construed as limiting the scope of the present invention. The description of an exemplary embodiment of the present invention is intended to be illustrative, and not to limit the scope of the present invention. Various modifications, alternatives, and variations will be apparent to those of ordinary skill in the art, and are intended to fall within the scope of the invention. It is particularly noted that the features of different embodiments and claims may be combined with each other as long as they do not contradict each other. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the appended claims and their equivalents.
This application claims priority to U.S. Provisional Patent Application No. 62/663,605, filed on Apr. 27, 2018, which is incorporated by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/US2019/028248 | 4/19/2019 | WO | 00 |
Number | Date | Country | |
---|---|---|---|
62663605 | Apr 2018 | US |