The present invention relates to systems and methods for the intradermal delivery of substances into, or sampling of fluids from, the skin of a mammal and, in particular, systems and methods employing mini needles (herein referred to “intradermal needles” of “ID Needles”) for such purposes.
Intradermal drug delivery is known to be advantageous for a range of different medications and treatments, such as immunization, immune-modulation, gene delivery, aesthetic medicine, dermatology, local anesthesia, allergy, hypersensitivity, cosmetics and diagnostics. Conventionally, intradermal drug delivery is performed by a skilled medical professional using a hypodermic needle positioned bevel-up at a shallow angle relative to the skin surface, also known as the “Mantoux method”. Care is required to achieve the correct depth of penetration to ensure successful injection within the dermal layers rather than subcutaneously or reemerging above the skin. In many cases, it has been reported that this method results in leakage or overly deep delivery that may compromise the diagnostic or therapeutic benefit of such an injection. The bevel-up needle orientation is needed in order to facilitate positive engagement of the needle with the skin surface at such shallow angles and is anyway the standard practice with any acute angle hypodermic needle insertion (including for example for venipuncture into deeper layers). A bevel-down approach has also been suggested, but is not widely in use due to slower injection time and difficulties in technique. The use of conventional hypodermic needles for intradermal delivery is known to be painful, since nerve endings in the dermal layer are typically severed by the relatively large needles used and the length that is usually required for insertion into the skin, safely, without leakage (usually over 0.5 cm length).
Further, it has been hypothesized that intra-epidermal delivery of drugs, such as vaccines, may have a further enhanced biological effect. Despite its promising prospects, this approach has been largely neglected to date since no injection delivery devices are available for such shallow application.
Much interest has been shown in development of drug delivery devices which do not require skilled operation, for example, for self-administration of drugs by patients. One approach is that of a “mini-needle” device with an actuator which selectively deploys or retracts the needle so as to penetrate to a limited depth within the dermal layers. Examples of such a device are commercially available from Becton, Dickinson & Co. (USA) and are described in U.S. Pat. Nos. 6,843,781, 6,776,776, 6,689,118, 6,569,143, 6,569,123 and 6,494,865, and in US Patent Application Publication Nos. 20080045900, 20080033395, 20080015521. The needle canula of such devices typically projects between 1 and 2 millimeters, thereby defining the depth of penetration of the delivery system. Since the already-reduced-length bevel of the needle tip itself has a length of at least about 0.4-0.8 mm, devices based on conventional needle structures of this type (i.e., a hollow metal cylinder with a beveled point) cannot readily be used for sealed fluid delivery to penetration depths less than 1 mm, and most likely are required to be in the length of approximately 1.5 mm.
In order to overcome skin elasticity or otherwise improve penetration, various designs of such limiters have been proposed, as referenced above. Other designs include attaching an adhesive to the skin and penetrating through the adhesive, such as for example in PY et al. (WO2004032989A2); others proposed a stabilizer apparatus, such as for example US 20070118077 to Clarke et al.
One inherent limitation of the proposed configurations listed above is that the insertion depth is at the verge of the subcutaneous space. This is due to the combination of needle size (approximately 1.5 mm) and perpendicular insertion approach. This results in a delivery that is questionably shallow enough to produce the required biological effect, especially if the delivered volume is relatively large (above 0.1 ml). It is thought to be more painful (because it transverses more nerve endings in the dermis), and is supposedly less effective for immunization (which is thought to require targeting of immune potent cells not only in the dermis but also in the epidermis and at the junction between these two layers) than a properly performed intradermal drug delivery. The limiters or adapters proposed in the prior art typically direct a perpendicular insertion angle, and circumscribe or surround the needle in such a manner that the limiter applies a downward force on the tissue into which the needle is inserted, as will be detailed below with reference to
There is therefore a need to provide an intradermal mini-needle interface which will facilitate reliable intradermal liquid delivery at shallow angles, controlled delivery depths, and reduced leakage. It would also be advantageous to provide an intradermal delivery configuration in which a mini-needle would be inserted shallowly into tissue which is not downwardly compressed by contact pressure of a limiter or adapter.
The present invention is an intradermal mini-needle interface and associated devices and methods.
According to an embodiment of the present invention there is provided, an intradermal mini-needle interface comprising: (a) a penetration limiter providing a skin contact edge; (b) a hollow hypodermic needle having a beveled penetrating portion protruding forward beyond the skin contact edge by no more than 3 mm, the penetrating portion having a central needle axis; and (c) at least one skin contact surface defining a skin contact plane parallel to, or at a shallow angle to, the needle axis, the skin contact plane intersecting the skin contact edge substantially at a base of the penetrating portion.
According to a further optional embodiment of the present invention, the penetration limiter is asymmetric under rotation about the needle axis.
According to a further optional embodiment of the present invention, the penetration limiter is non-encompassing relative to the needle axis.
According to a further optional embodiment of the present invention, the penetration limiter is provided by a projecting element extending along one side of the hypodermic needle and spaced therefrom by no more than 2 mm.
According to a further optional embodiment of the present invention, there is also provided a fluid inlet in fluid communication with the hypodermic needle, the fluid inlet defining an inlet axis, wherein the skin contact plane is at an oblique angle to the inlet axis.
According to a further optional embodiment of the present invention, the needle axis is non-parallel to the inlet axis.
According to a further optional embodiment of the present invention, the hypodermic needle is deployed substantially parallel to, and adjacent to, the skin contact plane.
According to a further optional embodiment of the present invention, the penetration limiter and the at least one skin contact surface are provided by a unitary block of polymer material.
According to a further optional embodiment of the present invention, the hypodermic needle is part of a needle adapter having an exposed needle of length greater than 3 mm, and wherein the penetration limiter and the at least one skin contact surface are provided by a supplementary adapter configured for receiving the exposed needle.
According to a further optional embodiment of the present invention, the intradermal mini-needle interface is integrated as part of a syringe body.
According to a further optional embodiment of the present invention, there is also provided a fluid inlet in fluid communication with the hypodermic needle, the fluid inlet being configured for removable attachment to a syringe.
According to a further optional embodiment of the present invention, there is also provided a pressure impulse supply arrangement associated with the hypodermic needle and deployed to deliver a high energy fluid jet through the hypodermic needle.
There is also provided according to a further embodiment of the present invention, a method for transferring a liquid through at least one layer of the skin by use of an intradermal mini-needle interface including: (a) a penetration limiter providing a skin contact edge; (b) a hypodermic needle having a beveled penetrating portion protruding forward beyond the skin contact edge by no more than 3 mm, the penetrating portion having a central needle axis; and (c) at least one skin contact surface defining a skin contact plane parallel to, or at a shallow angle to, the needle axis, the skin contact plane intersecting the skin contact edge substantially at a base of the penetrating portion, the method comprising the steps of: (i) penetrating at least one layer of the skin with the hypodermic needle; (ii) bringing the hypodermic needle to a position with its central axis at a shallow angle to the initial local surface of the skin such that the hypodermic needle extends into a portion of the skin which is not overlaid by the penetration limiter; and (iii) transferring a liquid via the hypodermic needle through at least one layer of the skin.
There is also provided according to a further embodiment of the present invention, a method for introducing a liquid through at least one layer of the skin, the method comprising the steps of: (a) penetrating at least one layer of the skin with a hollow needle; (b) maintaining the hollow needle with its central axis at an angle of less than 45 degrees to the initial local surface of the skin; and (c) directing a high energy jet of the liquid along the hollow needle so as to cause directional penetration of the liquid through tissue beyond an end of the hollow needle.
According to a further optional embodiment of the present invention, the hollow needle is part of an intradermal mini-needle interface comprising: (a) a penetration limiter providing a skin contact edge; (b) a hypodermic needle having a beveled penetrating portion protruding forward beyond the skin contact edge by no more than 3 mm, the penetrating portion having a central needle axis; and (c) at least one skin contact surface defining a skin contact plane parallel to, or at a shallow angle to, the needle axis, the skin contact plane intersecting the skin contact edge substantially at a base of the penetrating portion.
The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
The present invention is an intradermal mini-needle interface and associated devices and methods.
The principles and operation of devices and methods according to the present invention may be better understood with reference to the drawings and the accompanying description.
Referring now to the drawings, a number of embodiments of the invention can be described generically, using reference numerals which will be maintained throughout the description, as follows. Generally speaking, an intradermal mini-needle interface according to an embodiment of the present invention includes a penetration limiter 16 providing a skin contact edge 16a, and a hollow hypodermic needle 12 having a beveled penetrating portion 12a protruding forward beyond skin contact edge 16a by no more than 3 mm. At least one skin contact surface 18 defines a skin contact plane 19 parallel to, or at a shallow angle to, a central axis 13 of needle 12. Skin contact plane 19 intersects skin contact edge 16a substantially at a base of penetrating portion 12a.
At this stage, it will be immediately apparent that such embodiments of the present invention offer distinct advantages over conventional devices available for intradermal injection, and intradermal fluid sampling. Specifically, the use of a needle with no more than 2 mm protruding beyond the skin contact edge allows reliable intradermal injection without the level of skill required using a conventional exposed hypodermic needle. Provision of skin contact surfaces defining a shallow-angle skin contact plane which intersects the edge of the penetration limiter substantially at the base of the penetration portion of the needle also facilitates correct alignment of the needle for effective intradermal injection. This geometry also helps to ensure that the tip of the needle extends into tissue which is not overlaid by the penetration limiter, thereby allowing delivery of liquid into uncompressed tissue. These and other advantages of the present invention will become clearer from the following description.
While the invention will be exemplified herein primarily in the context of devices and methods for intradermal injection, it should be noted that fluid sampling, for example, for diagnostic purposes such as glucose sensing, also falls within the scope of the present invention. Furthermore, in some cases, a sensor may be incorporated within the needle, or a similarly shaped dedicated sensor element may replace the needle, to perform sensing directly at or near the skin interface.
Before addressing the features of embodiments of the present invention in more detail, it will be useful to define certain terminology as used herein in the description and claims. Firstly, embodiments of the invention are referred to as an “intradermal mini-needle interface.” The phrase “mini-needle interface” is used herein to refer to any device which provides a needle-based interface with the skin for transferring a liquid through at least one layer of the skin in which the maximum perpendicular penetration depth of the needle is limited by a penetration limiter to no more than 5 mm, preferably no more than 3 mm, and most preferably no more than 2 mm. The interface may be integrated as part of liquid delivery device, such as a pre-filled syringe, or may be implemented as an adapter for attachment to another device.
The term “integrated” is used in this context to refer to an interface which is integrally formed or attached to other parts of the device so that it is not readily separable therefrom in a non-destructive manner. An “adapter” on the other hand is an interface which is configured for attachment to another device to provide required functionality. Thus, for example, a device with a luer connector for attachment to a syringe or other liquid supply line is referred to as an adapter. A conventional hypodermic needle integrated with a luer connector for use with a syringe is an example of a “needle adapter” while reference will be made in certain embodiments to a “supplementary adapter” which connects over a needle adapter.
The term “hypodermic needle” is used herein in the description and claims to refer to a hollow cylindrical needle with beveled penetrating tip, typically formed of metal. Such needles are commonly referred to as hypodermic needles, even when employed for intradermal use.
Reference is made to a central needle axis. This refers to the central axis of the cylindrical body of the needle, disregarding the bevel. In the case of a bent needle, the central needle axis is taken to the axis of the needle near its tip.
Reference is made to one or more skin contact surfaces which define a “skin contact plane.” The skin contact plane corresponds to the plane of a flat surface against which the skin contact surfaces would sit in close contact, ignoring any obstruction due to the needle tip. The individual skin contact surfaces do not necessarily have flat surfaces aligned with the plane. In the particular example of a single flat skin contact surface, the skin contact plane is coincident with the skin contact surface.
Reference is made herein to a “shallow angle”. The term “shallow angle” is used herein to refer to a direction which forms a sharp angle with the relevant reference plane, i.e., no more than 45 degrees, and most preferably, has an inclination of no more than 25 degrees thereto.
The penetration limiter of certain embodiments is referred to as being asymmetric under rotation. In this context, a shape is considered to be asymmetric under rotation if it is variant under all rotations other than multiples of 360 degrees.
Finally with regard to terminology, in certain embodiments, the needle is described as being parallel to and adjacent to the skin contact surface. In this context, “adjacent” is used to refer to a structure in which there is not a significant step felt between the level of the needle and the level of the skin contact surface. In quantitative terms, where described as adjacent, the closest side of the needle typically lies within about 2 needle diameters above or below the contact surface.
Turning now to
In the case illustrated here, interface 10 is an adapter having a fluid inlet 11, in fluid communication with needle 12, and configured for removable attachment to a syringe or other standard delivery or sampling device. In the case illustrated here, inlet 11 is a standard luer connector with a central inlet axis 11a.
Penetration limiter 16 here is asymmetric under rotation about the needle axis, having an overall profile similar to that illustrated schematically in
Skin contact plane 19 is implemented here at an oblique, and preferably shallow, angle relative to inlet axis 11a. Needle axis 13 is here also non-parallel to inlet axis 11a. According to a particularly preferred feature of this embodiment, needle 12 is deployed substantially parallel to, and adjacent to, skin contact plane 19.
In this and various other preferred embodiments of the present invention, penetration limiter 16 and skin contact surface(s) 18 are advantageously provided by features of a unitary block of polymer material. The entire interface 10 is thus formed essentially from only two components, the polymer block and needle 12, which may be assembled and attached by various known methods, including but not limited to, application of adhesive or thermal welding of the polymer material. During assembly, the off-axis orientation of needle 12 relative to inlet 11 facilitates provision of a small step 21 against which needle 12 abuts to accurately define a fully inserted position of needle 12 for precise and reliable assembly. In certain cases, the needle may be introduced already during injection molding of the polymer block, with suitable precautions taken to ensure that it does not become blocked, as is know in the art.
Needles 12 suitable for implementing this and other embodiments of an interface according to the present invention are typically of outer diameter between about 100 and about 650 microns, and more preferably between about 200 and 400 microns. A short bevel is preferably used. The overall length of needle 12 is chosen according to the structure of the block of the interface, and may vary considerably. The exposed portion of the needle, corresponding to penetrating portion 12a, is preferably no more than 3 mm, and more preferably within the range of 1-2 mm.
Turning now to
Parenthetically, it should be noted here that the use of open-sided channel 14 here also changes the geometry of penetration limiter 16, resulting in a form which is non-encompassing relative to the needle axis. In other words, penetrating portion 12a of needle 12 is located at an extremity of the surface of penetration limiter 16 rather than being surrounded by material of the penetration limiter.
Turning now to
Turning now to
Parenthetically, interface 40 also exemplifies an implementation in which both the needle axis and the skin contact plane are substantially parallel to the inlet axis. In practice, a small deviation is preferably provided between the needle axis and the skin contact plane in order to ensure that the rear end of the needle is sufficiently deep within the block of the adapter to facilitate a leak-free seal to the internal channel connecting with the inlet.
Turning now to
In the implementation illustrated here, forward projection 16b is generated by providing an obtuse angle α at the intersection of forward penetration limiting surface 16 and skin contact surface 18. In the example shown, an internal angle of about 135 degrees was chosen.
Turning now to
Turning now to
As best seen in
As seen in
Turning now to
Specifically, penetration limiter 16 is provided by the front surface of a needle leader structure 88 including flattened portions on either side of the needle and a top bridging element for support. Skin contact surfaces 18 are provided by the underside of the needle leader structure 88 as well as by a lower bridging element 86 and stepped lower ribs 82. These surfaces in combination define a shallow angle skin contact plane relative to the needle axis, providing functionality similar to the other embodiments discussed above. The ribs also provide press-fitting of a protective cap 84, as in the previous embodiment.
In addition to providing mechanical support, the upper and lower bridging elements define a recess 87 around the needle, thereby facilitating bonding of the needle and hub through a single-drop bonding procedure. The rear part of needle 12 runs through a closed channel 89 to connect with the inlet 11.
Turning now to
Turning now to
Embodiments of the interface of the present invention have been illustrated thus far with reference to adapter implementations suitable for attachment to a syringe or other standard device for liquid delivery or sampling. It should be noted however that the interface of the present invention is not limited to this adapter modality, and can be implemented in a wide range of other forms. By way of non-limiting examples,
Turning first to
Turning now to
Jet injectors have been known in the art for many years (for example US Patent Application Pub. No. US 2004/0220524 A1 of Antares Pharma), but are typically designed to be used in a perpendicular approach and thus are able to deliver the medicament only to the deep subcutaneous or the intramuscular compartments.
The disclosed lateral jet injection method sprays a jet laterally into the dermal compartment and therefore can be regarded as a distinctive route of administration. It differs from the ordinary perpendicular jet injection as it targets shallower tissue (ID instead of IM/SC), and it differs from ordinary ID injection as it disposed in the skin as a dispersed spray rather than as a bleb reservoir.
It is a particularly preferred feature of certain implementations of the present invention that the high pressure flow is delivered only after mechanical penetration by penetrating portion 12a, thereby ensuring that the material of the jet successfully penetrates beneath the stratum corneum. In the absence of such initial mechanical penetration, it is believed that use of a shallow angle jet would result in a significant proportion of the material in the jet being deflected outwards by the stratum corneum and lost, reducing efficiency and rendering results of the procedure unpredictable. Pre-penetration of the stratum corneum also allows lower jet pressures to be used to achieve a given desired degree of penetration.
The lateral intradermal jet injection route is assumed to have benefits of enhancing the pharmacokinetics parameters of certain drugs and treatments. One example is a possible improved absorption of insulin as the spray is dispersed over large areas of the papillary dermis. Another example is a possibly improved immune response in vaccines as the jet transverse through regions rich in langerhance cells.
Another benefit of Intradermal Jet Injection concerns the reduced injection time (fraction of second) compared to regular intradermal injection (about 5-10 seconds).
An exemplary device for performing the lateral jet injection technique according to the present invention is shown in
Turning now to
In the case of an infusion set, the insertion process preferably includes additional steps as illustrated in
Turning now to
Finally, turning to
Interface 170 provides its penetration limiter through a projecting element 172 which extends along one side of hypodermic needle 12 and defines a maximum depth of forward penetration b no greater than 3 mm, as in the previous examples. Unlike the previous examples, the projecting element 172 is spaced from the needle along part of the length of the needle. Specifically, projecting element 172 has an edge 174 facing, but spaced from, the needle by a spacing a no greater than 2 mm, and more preferably, between about 0.5 mm and about 1.5 mm. This arrangement allows extended penetration of the needle within the layers of the skin as illustrated in
Notwithstanding the description of
It will be appreciated that the above descriptions are intended only to serve as examples, and that many other embodiments are possible within the scope of the present invention as defined in the appended claims.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB09/55493 | 12/3/2009 | WO | 00 | 6/6/2011 |
Number | Date | Country | |
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61119747 | Dec 2008 | US |