The present invention relates generally to applicators for electrokinetic mass transfer of substances to live tissue and particularly relates to an apparatus for electrokinetically delivering substances, e.g., a medicament, to a treatment site on, in or under the skin of a human patient. In particular, this application is directed to electrokinetic delivery applicators for wide areas of skin to infuse medicament into a wide area treatment site and applicator for treatment sites having high resistances, such as a toenail or fingernail or area of hard skin.
Electrokinetic delivery of medicaments applies medication topically to the skin to reach a treatment site. One type of electrokinetic delivery mechanism is iontophoresis, which is the application of an electric current to the skin to enhance the permeability of the skin and thereby deliver ionic agents, e.g., ions of salts and other drugs, to the treatment site below the surface of the skin. Electrokinetic delivery methods include iontophoretic, transdermal, transmucosal cutaneous, electroosmosis, electroporation, and electromigration, any or all of which are more generally known as electrotransport, electromolecular transport or iontophoretic methods. These techniques are collectively referred to herein as electrokinetic delivery methods.
Electrokinetic delivery methods may be problematic when applied to, for example, large areas of skin, skin with highly variable impedances, or tissues with high intrinsic impedance such as toenails. Large skin treatment areas may be associated with skin conditions such as eczema, psoriasis and acne. To deliver medicament electrokinetically to a large skin treatment site, a relatively large medicament matrix is applied to the skin. A large electrical current is generally needed to electrokinetically drive sufficient medicament from the large area matrix into the skin. The matrix consists of a uniform solid phase within which is dispersed a uniform medicament formulation. Such a matrix is limited to delivering that medicament at one rate governed by the applied current from an electrode in general contact with the entire matrix. There is a need for a medicament matrix that is more responsive to the particular needs of tissues from one site to another beneath the matrix and that is capable of delivering one or more medicaments at various rates or dosages. Further, there is a need for such a matrix able to redistribute medicament particles so that the medicament particles are more evenly distributed throughout the matrix. The present invention fulfills these needs.
The invention relates to an electrokinetic apparatus for applying medicament to a treatment site of a mammalian user, the apparatus including: a segmented active electrode; a medicament matrix having one side abutting the segmented active electrode and another side adapted to contact a surface of skin over the treatment site, wherein the matrix has an associated active medicament management device or system that causes medicament to flow from regions of the matrix having an abundance of medicament to regions depleted of medicament.
The active management device or system may include electrodes to apply electric fields to redistribute the charged medicament particles such that the particles are more evenly distributed in the matrix. For example, electrodes of the active management device may arranged around a peripheral side of the matrix and a varying current applied to the electrodes. The varying electric field applied by these electrodes causes the medicament to move, e.g., diffuse, through the matrix in a direction towards or away from the electrodes.
In a preferred embodiment, the mammalian user is a human.
The foregoing summary, as well as the following detailed description of preferred embodiments of the invention, will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the invention, there are shown in the drawings embodiments which are presently preferred. It should be understood, however, that the invention is not limited to the precise arrangements and instrumentalities of the embodiments shown in the drawings. In the drawings:
The invention relates generally to an electrokinetic apparatus for applying medicament to a treatment site of a mammalian user. In one embodiment, the apparatus includes: a segmented active electrode; a medicament matrix having one side abutting the segmented active electrode and another side adapted to contact a surface of skin over the treatment site, wherein the matrix has an associated active medicament management device or system that causes medicament to flow from regions of the matrix having an abundance of medicament to regions depleted of medicament.
In some embodiments, the active management device or system may include electrodes to apply electric fields to redistribute the charged medicament particles such that the particles are more evenly distributed in the matrix. For example, electrodes of the active management device may arranged around a peripheral side of the matrix and a varying current applied to the electrodes. The varying electric field applied by these electrodes causes the medicament to move, e.g., diffuse, through the matrix in a direction towards or away from the electrodes.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, the preferred methods and materials are described.
As used herein, each of the following terms has the meaning associated with it in this section.
The articles “a” and “an” are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article. By way of example, “an element” means one element or more than one element.
A “medicament,” as used herein, refers to any type of substance or agent that is commonly considered a drug, or a candidate for use as a drug, as well as combinations and mixtures of the above.
A “disease” is a state of health of an animal wherein the animal cannot maintain homeostasis, and wherein if the disease is not ameliorated then the animal's health continues to deteriorate. In preferred embodiment's the animal is a mammal. In more preferred embodiments, the animal is a human.
In contrast, a “disorder” in an animal is a state of health in which the animal is able to maintain homeostasis, but in which the animal's state of health is less favorable than it would be in the absence of the disorder. Left untreated, a disorder does not necessarily cause a further decrease in the animal's state of health. In preferred embodiment's the animal is a mammal. In more preferred embodiments, the animal is a human.
A disease or disorder is “alleviated” if the severity of a symptom of the disease or disorder, the frequency with which such a symptom is experienced by a patient, or both, are reduced.
An “effective amount” or “therapeutically effective amount” of a medicament is that amount of medicament which is sufficient to provide a beneficial effect to the subject to which the medicament is administered.
As used herein, the term “pharmaceutically-acceptable carrier” means a chemical composition with which a medicament can be combined and which, following the combination, can be used to administer the appropriate medicament to a subject.
A “prophylactic” treatment is a treatment administered to a subject who does not exhibit signs of a disease or exhibits only early signs of the disease for the purpose of decreasing the risk of developing pathology associated with the disease.
A “therapeutic” treatment is a treatment administered to a subject who exhibits signs of pathology, for the purpose of diminishing or eliminating those signs.
Throughout this disclosure, various aspects of this invention can be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual and partial numbers within that range, for example, 1, 2, 3, 4, 5, 5.5 and 6. This applies regardless of the breadth of the range.
The ETS control unit 12 can be housed in a handheld device having an actuator switch to provide a manual trigger of the application of medicament by electrokinetic delivery. The ETS control unit may comprise a power system (such as, for example, a battery), a microcontroller for monitoring certain conditions (such as, for example, whether a valid cartridge is inserted in the device) and for controlling the application of current to the active electrode, and conductive circuits connecting the power system, microcontroller, actuator switch, active electrode and counter electrode. The ETS control unit, when actuated, applies current to each of the plurality of electrode segments of the active electrode. The current applied to the electrode segments may be, for example, on the order of 660 microAmps (uA). A current path includes the power connector 14, active electrode 18, medicament matrix 20 which is applied to the skin of a patient, the patient, a counter electrode 21 that is applied to the patient, and the ETS control unit. In preferred embodiments the patient is a mammal. In more preferred embodiments, the patient is a human.
The active electrode power connector 14 may include a plurality of contact pins 22 (such as, for example, 2 or 3 or 4 or 5 or more pins), each having a current limiting device, such as a current limiting diodes (CLD) 24. The diodes are arranged in electrical series with the contact pins. A conductive bus 26 provides a common connection between each pin 22 and diode 24 arrangements and the ETS control unit. The diodes each limit the current to a respective one of the contact pins 22 to, for example, 132 uA or about one fifth the total current applied by the entire electrode segments. The diodes may be selected to limit the current to each of the contact pins to a predetermined level, such as a current level determined by the total current applied to all electrodes divided by the number of contact pins 22.
The current limiting device 24 is preferably a simple, miniature current limiting device for each of the partition and/or sub-divided segments of the active electrode. The diodes 24 are one example of a current limiting device such as, by way of non-limiting examples, the generic current limiting diodes 1N5283 through 1N5314 and the CCLM0130 manufactured by Central Semiconductor Corporation. Other electronic circuit components that limit the current to each contact pin may be suitable. There are several types of current limiting diodes (CLD), such as a current regulator diode, constant current diode, and CLDs. Current regulating diodes regulate the current flowing through them to a maximum level and if current exceeds its current regulation point, it drops its terminal voltage. A constant current diode is similar to a junction field effect transistor (JFET) whose gate terminal is shorted to source. A constant current diode can automatically limit a current through a laser driver CLD over a wide range of power supply voltages. A laser driver CLD is a type of CLD that works on the principle of a quantum process whereby light is emitted due to transition of electrons from high-level to low-level energy states. CLDs are employed to ensure that excessive current does not flow to any one of the active electrodes. The CLD is preferably arranged in the housing of the device (rather than in the cartridge), so that the CLD may be reused and is not discarded with the cartridge.
Current may be distributed equally to each segment of the active electrode 18 in proportion to the number of electrodes and/or the size of the matrix corresponding to the corresponding electrode segment. The current is distributed, for example, by the bus 26 and the current limiting device 24 with each pogo pin 22. Because of the current limiting devices 22, the current flow through each segment 36 of the active electrode 18 is preferably limited and not excessive due to a small skin area or other condition that might lead to current concentration. The maximum current density applied to the matrix by each active electrode segment is generally equal to the current applied by the pogo pin 22 applied to the electrode segment divided by the area of the electrode segment.
The pins 22 may be spring biased (such as, for example, pogo pins), such that the pins are biased downward and can be deflected upwards, as shown by a double-headed arrow in
The cartridge 16 may have a generally cylindrical shape with an annular plastic wall 28 that defines a cylindrical recess 30 to receive the medicament matrix 20. The recess 30 may have an open face 32 which is applied to the surface of the skin or toenail to press the medicament matrix against the skin or nail. The cartridge may alternatively be embodied as an array of cartridges that are applied to various locations on the skin or nail.
The active electrode 18 may be mounted on a surface 34 (
If the skin contact area 40 is smaller than the matrix face 42, the current may become concentrated on the small skin contact area 40 as is illustrated by the arrows in
Within the loop of each pair of segmented electrodes 1138, current flows from the active (positive) to the counter (negative) electrode through a medicament matrix, the treatment site and the body of the mammalian user. The current magnitude in each current loop is limited to a value controlled by the CLD 1140 irrespective of the nail and tissue impedance. Although a high DC voltage is generated within each loop, this voltage is self regulating and it will drop entirely across the CLD 1140, nail plate and the toe. Each current loop for each electrode pair maintains a pre-set current which is galvanic-isolated in so far as the coils are isolated. Because a sufficient amount of energy is transferred to the secondary side of the flyback transformer 1136 to obtain a sufficient high DC voltage, the full current allowed by each current diode is maintained. The treatment site, such as a nail or toe, are effectively a short-circuit down stream from the current diode operating in the “limiting” mode.
The applicator panel is connected to a power source and computer controller 118 that may be mounted on the applicator panel or attached by electrical wires 120 to an electrode layer 122 on a side of the medicament layer opposite to the skin. Electrical current through the wires 120 from the power supply and controller to an electrical distribution circuit 124 that directs current to and from individual electrodes 126. The electrical power may be delivered through separate electric current channels to each electrode 126 such that the amount of current applied to each electrode may be separately controlled by the controller 18 or other circuits associated with the distribution circuit 124.
Each electrode 126 may include an active and neutral electrical terminal. There is a neutral electrode that is unique and local to each active electrode. The current path between the active and neutral electrical terminals of each electrode passes through the medicament layer and the treatment site. Accordingly, electrical power passing through each electrode causes medicament in the medicament layer to be delivered to the treatment site as the current in the power passes between the active and neutral terminals of the electrode.
The power supply may include batteries contained in a housing with the controller or may include an adapter that plugs into a conventional electrical current supply, such as an electrical wall socket. The housing 119 for the power supply and controller portion may be releasably coupled to the applicator panel 100, wherein the connection includes the wires 120 for providing electrical power and control signals between the housing and the applicator panel. The housing may also include user interface devices, such as one or more control switches 121 and a liquid crystal (LCD) display. The one or more control switches 121 allows the user to input data and control signals into the controller, such as a medicament delivery signal or a code from a drug prescription order to indicate to the controller an amount, delivery rate and composition of medicament to be delivered to the patient. The display 117 may show to the user data generated by the controller identifying the medicament to be dispensed, application instructions, such as a location on the body to which the applicator panel is to be applied and a time period that the applicator panel is to remain on the body.
Medicament stored in the cells 128 in the medicament layer 112 of the applicator panel 100 is delivered to the skin by applying electrical current through wires and electrodes (represented by dotted lines in
Transdermal iontophoresis is an electrokinetic process whereby charged and uncharged molecules (actives) are transferred from an electrically conductive source through the stratum-corneum and into a skin target. Mass transfer of an active across the skin is proportional to current, time, and concentration of the active in the source. Under normal circumstances a virtually infinite supply of active is available for iontophoretic delivery to the skin. Certain applications of transdermal iontophoresis use finite amounts of high-value active medicament molecules loaded into thin films of the medicament matrix. These high-value medicament molecules are preferably delivered by transdermal iontophoresis with minimal waste. The need to minimize waste is especially true for iontophoresis medicament delivery systems utilizing microneedle arrays and/or multichannel electrode designs for controlling delivery to selected skin sites. Iontophoresis applicators having multichannel electrodes and/or microneedle arrays tend to have medicament matrices, e.g., thin films, in which regions form in the matrix that have depleted of active molecules. When causing the flux rate to diminish and delivered dose to drop. In various embodiments, the invention described herein provides a means for relocating actives within the source to ensure homogeneous concentration and therefore constant delivery rate of a finite amount of active with minimal waste.
The medicament matrix may be included as the medicament layer 112 of a multi-channel iontophoretic wide-area applicator panel 100, as shown in
During medicament delivery, the control system 119 may activate certain electrodes and not activate other electrodes, or the current through some electrodes may be greater than at other electrodes. One exemplary control schedule is shown in
As described herein, the present invention provides a method of replenishing depleted areas of medicament in a medicament matrix during treatment. Medicament is moved from areas of high concentration to areas of low concentration by the application of an electric field in the plane of the medicament matrix. Charged medicament within the reservoir is driven in a direction away from the pole of like charge toward the pole of opposite charge. The movement of drug in the reservoir does not happen instantly and varies based upon the molecular structure of the reservoir material itself; the composition of the medicament and the direction and level of the applied field. The applied field's direction (polarity) may be rotated in order to facilitate a consistent redistribution of medicament over the entire surface by, for example, appropriately placing electrodes around the periphery of the reservoir and rotating the angel of application of the electric field. Alternatively, just two plated areas (e.g. diffusion plates) can be placed on each end of the medicament matrix and a varying electric filed can be applied. By switching the polarity back and forth, diffusion of medicament can be caused in a manner similar to the shaking of a container to effectuate diffusion of the contents therein.
The disclosures of each and every patent, patent application, and publication cited herein are hereby incorporated herein by reference in their entirety.
While the invention has been disclosed with reference to specific embodiments, it is apparent that other embodiments and variations of this invention may be devised by others skilled in the art without departing from the true spirit and scope of the invention. The appended claims are intended to be construed to include all such embodiments and equivalent variations.
The present application is a 35 U.S.C. §371 national phase application from, and claiming priority to, International Patent Application No. PCT/US2010/021083, filed on Jan. 14, 2010, which is entitled to priority under 35 U.S.C. §119(e) to U.S. Provisional Application No. 61/144,590, filed on Jan. 14, 2009, the entire disclosures of which are incorporated by reference herein as if each is being set forth herein in its entirety.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US10/21083 | 1/14/2010 | WO | 00 | 2/29/2012 |
Number | Date | Country | |
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61144590 | Jan 2009 | US |