This present patent application relates to medical devices and methods of delivering at least two drug agents from separate reservoirs using devices having only a single dose setting mechanism and a single dispense interface. A single delivery procedure initiated by the user causes a non-user settable dose of a second drug agent and a variable set dose of a first drug agent to be delivered to the patient. The drug agents may be available in two or more reservoirs, containers or packages, each containing independent (single drug compound) or pre-mixed (co-formulated multiple drug compounds) drug agents. Specifically, this application concerns a method and system for preventing leakage of a medicament in a medicated module that is used to deliver the non-user settable dose of the second drug agent.
Certain disease states require treatment using one or more different medicaments. Some drug compounds need to be delivered in a specific relationship with each other in order to deliver the optimum therapeutic dose. The presently proposed devices and methods are of particular benefit where combination therapy is desirable, but not possible in a single formulation for reasons such as, but not limited to, stability, compromised therapeutic performance and toxicology.
For example, in some cases it might be beneficial to treat a diabetic with a long acting insulin and with a glucagon-like peptide-1 (GLP-1), which is derived from the transcription product of the proglucagon gene. GLP-1 is found in the body and is secreted by the intestinal L cell as a gut hormone. GLP-1 possesses several physiological properties that make it (and its analogs) a subject of intensive investigation as a potential treatment of diabetes mellitus.
There are a number of potential problems that can arise when delivering two active medicaments or “agents” simultaneously. The two active agents may interact with each other during the long-term, shelf life storage of the formulation. Therefore, it is advantageous to store the active components separately and combine them at the point of delivery, e.g. injection, needle-less injection, pumps, or inhalation. However, the process for combining the two agents needs to be simple and convenient for the user to perform reliably, repeatedly and safely.
A further problem is that the quantities and/or proportions of each active agent making up the combination therapy may need to be varied for each user or at different stages of their therapy. For example one or more active agents may require a titration period to gradually introduce a patient up to a “maintenance” dose. A further example would be if one active agent requires a non-adjustable fixed dose while the other is varied in response to a patient's symptoms or physical condition. This potential problem means that pre-mixed formulations of multiple active agents may not be suitable as these pre-mixed formulations would have a fixed ratio of the active components, which could not be varied by the healthcare professional or user.
Additional problems arise where a multi-drug compound therapy is required, because many users cannot cope with having to use more that one drug delivery system or make the necessary accurate calculation of the required dose combination. This is especially true for users with dexterity or computational difficulties. In some circumstances it is also necessary to perform a priming procedure of the device and/or needle cannulae before dispensing the medicaments. Likewise, in some situations, it may be necessary to bypass one drug compound and to dispense only a single medicament from a separate reservoir.
Accordingly, there exists a need to provide devices and methods for the delivery of two or more medicaments in a single injection or delivery step that is simple for the user to perform. The presently proposed devices and methods overcome the above-mentioned problems by providing separate storage containers for two or more active drug agents that are then only combined and/or delivered to the patient during a single delivery procedure. Setting a dose of one medicament automatically fixes or determines the dose of the second medicament (i.e. non-user settable). The proposed devices and methods also give the opportunity for varying the quantity of one or both medicaments. For example, one fluid quantity can be varied by changing the properties of the injection device (e.g. dialing a user variable dose or changing the device's “fixed” dose). The second fluid quantity can be changed by manufacturing a variety of secondary drug containing packages with each variant containing a different volume and/or concentration of the second active agent. The user or healthcare professional would then select the most appropriate secondary package or series or combination of series of different packages for a particular treatment regime. The proposed medicated module forms a self-contained reservoir in which non-user-settable dose of a medicament may be stored. The proposed medicated module also is designed so as to prevent leakage of the medicament from the medicated module.
These and other advantages will become evident from the following more detailed description of the invention.
The presently proposed devices and methods allow for complex combinations of multiple drug compounds within a single drug delivery system. The presently proposed devices and methods allow the user to set and dispense a multi-drug compound device through one single dose setting mechanism and a single dispense interface. This single dose setter controls the mechanism of the device such that a predefined combination of the individual drug compounds is delivered when a single dose of one of the medicaments is set and dispensed through the single dispense interface.
By defining the therapeutic relationship between the individual drug compounds, the proposed delivery device and delivery methods help ensure that a patient/user receives the optimum therapeutic combination dose from a multi-drug compound device without the inherent risks associated with multiple inputs where the user has to calculate and set the correct dose combination every time they use the device. The medicaments can be fluids, defined herein as liquids or gases or powders that are capable of flowing and that change shape at a steady rate when acted upon by a force tending to change its shape. Alternatively, one or both of the medicaments may be a solid that is carried, solubilized or otherwise dispensed with another fluid medicament.
Applicants' proposed concept is of particular benefit to users with dexterity or computational difficulties as the single input and associated predefined therapeutic profile removes the need for them to calculate their prescribed dose every time they use the device and the single input allows considerably easier setting and dispensing of the combined compounds.
In a preferred embodiment a master drug compound, such as insulin, contained within a multiple dose, user selectable device could be used with a single use, user replaceable, module that contains a single dose of a secondary medicament and the single dispense interface. When connected to the primary device, the secondary compound is activated/delivered on dispense of the primary compound.
Although the present application specifically mentions insulin, insulin analogs or insulin derivatives, and GLP-1 or GLP-1 analogs as two possible drug combinations, other drugs or drug combinations, such as an analgesics, hormones, beta agonists or corticosteroids, or a combination of any of the above-mentioned drugs could be used with our invention.
For the purposes of our invention the term “insulin” shall mean Insulin, insulin analogs, insulin derivatives or mixtures thereof, including human insulin or a human insulin analogs or derivatives. Examples of insulin analogs are, without limitation, Gly(A21), Arg(B31), Arg(B32) human insulin; Lys(B3), Glu(B29) human insulin; Lys(B28), Pro(B29) human insulin; Asp(B28) human insulin; human insulin, wherein proline in position B28 is replaced by Asp, Lys, Leu, Val or Ala and wherein in position B29 Lys may be replaced by Pro; Ala(B26) human insulin; Des(B28-B30) human insulin; Des(B27) human insulin or Des(B30) human insulin. Examples of insulin derivatives are, without limitation, B29-N-myristoyl-des(B30) human insulin; B29-N-palmitoyl-des(B30) human insulin; B29-N-myristoyl human insulin; B29-N-palmitoyl human insulin; B28-N-myristoyl LysB28ProB29 human insulin; B28-N-palmitoyl-LysB28ProB29 human insulin; B30-N-myristoyl-ThrB29LysB30 human insulin; B30-N-palmitoyl-ThrB29LysB30 human insulin; B29-N-(N-palmitoyl-Y-glutamyl)-des(B30) human insulin; B29-N-(N-lithocholyl-Y-glutamyl)-des(B30) human insulin; B29-N-(ω-carboxyheptadecanoyl)-des(B30) human insulin and B29-N-(ω-carboxyhepta-decanoyl) human insulin.
As used herein the term “GLP-1” shall mean GLP-1, GLP-1 analogs, or mixtures thereof, including without limitation, exenatide (Exendin-4(1-39), a peptide of the sequence H-His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile -Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH2), Exendin-3, Liraglutide, or AVE0010 (H-His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-S er-S er-Gly-Ala-Pro-Pro -Ser-Lys-Lys-Lys-Lys-Lys-Lys-NH2).
Examples of beta agonists are, without limitation, salbutamol, levosalbutamol, terbutaline, pirbuterol, procaterol, metaproterenol, fenoterol, bitolterol mesylate, salmeterol, formoterol, bambuterol, clenbuterol, indacaterol.
Hormones are for example hypophysis hormones or hypothalamus hormones or regulatory active peptides and their antagonists, such as Gonadotropine (Follitropin, Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin), Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin, Buserelin, Nafarelin, Goserelin.
According to an embodiment, a medicated module is attachable to a drug delivery device. The medicated module includes a needle, and this needle holds a medicament. The needle includes an engagement needle portion and an output needle portion in fluid communication with each other. The medicated module further includes a first seal and a second seal. A proximal end of the engagement needle portion partially pierces the first seal, and a distal end of the output needle portion partially pierces the second seal.
According to another embodiment, a medicated module includes an engagement needle and an output needle, wherein the engagement needle and the output needle are in fluid communication. Further, the engagement needle and the output needle hold a medicament. The medicated module also includes a first seal and a second seal. A proximal end of the engagement needle partially pierces the first seal, and a distal end of the output needle partially pierces the second seal. Other embodiments include a drug delivery device including such medicated modules.
The medicated module can be designed for use with any drug delivery device with an appropriate compatible interface. However, it may be preferable to design the module in such a way as to limit its use to one exclusive primary drug delivery device (or family of devices) through employment of dedicated or coded features to prevent attachment of a non-appropriate medicated module to a non-matching device. In some situations it may be beneficial to ensure that the medicated module is exclusive to one drug delivery device while also permitting the attachment of a standard drug dispense interface to the device. This would allow the user to deliver a combined therapy when the module is attached, but would also allow delivery of the primary compound independently through a standard drug dispense interface in situations, such as, but not limited to, dose splitting or top-up of the primary compound.
A particular benefit of Applicants' method and system is that the method and system provides a fluid seal to the ends of needles in a medicated module in order to prevent leakage of a medicament in the medicated module. The fluid seals remain sealed until either attachment to a drug delivery device or just prior to injection of the medicament. Beneficially, the fluid seal may also reduce or prevent contamination of the medicament.
In a preferred embodiment, the primary drug delivery device is used more than once and therefore is a multi-use device; however, the drug delivery device may also be a single use disposable device. Such a device may or may not have a replaceable reservoir of the primary drug compound, but our proposed concept is equally applicable to both scenarios. It is also possible to have a suite of different medicated modules for various conditions that could be prescribed as one-off extra medication to patients already using a standard drug delivery device. Should the patient attempt to reuse a previously used medicated module, this module may include a locking needle guard that is activated after a user delivers a dose from the medicated module. Other means of alerting the user may include some (or all) of the following:
Physical prevention of medicated module re-attachment to the primary drug deliver device once the module has been used and removed.
Physical/hydraulic prevention of subsequent liquid flow through the drug dispense interface once it has been used.
Physical locking of the dose setter and/or dose button of the primary drug delivery device.
Visual warnings (e.g. change in color and/or warning text/indicia within an indication window on the module once insertion and/or fluid flow has occurred).
Tactile feedback (presence or absence of tactile features on the outer surface of the module hub following use).
A further proposed feature is that both medicaments are delivered via one injection needle and in one injection step. This offers a convenient benefit to the user in terms of reduced user steps compared to administering two separate injections. This convenience benefit may also result in improved compliance with the prescribed therapy, particularly for users who find injections unpleasant or who have computational or dexterity difficulties.
These as well as other advantages of various aspects of the present invention will become apparent to those of ordinary skill in the art by reading the following detailed description, with appropriate reference to the accompanying drawings.
Exemplary embodiments are described herein with reference to the drawings, in which:
Applicants' proposed concept is a system and method for preventing leakage of a medicament in a medicated module. The proposed concept specifically relates to sealing features of a medicated module, where the medicated module is intended to be used in conjunction with a primary injection device to deliver a fixed dose of a secondary medicament when a user injects a selected dose of a primary medicament.
A medicated module in accordance with embodiments of Applicants' proposed concepts may be attached to a primary drug delivery device, such as drug delivery device 100. Generally, Applicants' proposed arrangement includes a series of movable seals that are used to seal the medicament stored in the medicated module. The medicament is stored in a needle (or in a first and second needle). Ends of the needle (or an end of the first needle and an end of the second needle) partially pierce the seals prior to attachment to a drug delivery device and/or insertion. In this condition of partially pierced seals, fluid-tight seals are provided and maintained in the medicated module. However, movement of the seals eventually removes the fluid-tight seals. For example, a top seal may be moved due to attachment to the primary drug delivery device. This movement causes a needle tip to fully pierce the top seal, thereby allowing fluid communication between the first and second medicament to occur. Further, a bottom seal may be moved prior to or just prior to insertion. This movement removes the bottom seal from the needle tip of the output needle, and the output needle may then be used to subcutaneously inject both the first and second medicament.
Applicants' proposed concept is a sealing means (e.g., sealing features) for a medicated module that can attach to a drug delivery device. In accordance with an embodiment of Applicants' proposed concept, a medicated module includes a needle that holds medicament. The needle includes an engagement needle portion and an output needle portion, and the engagement needle portion and output needle portion are in fluid communication with each other. The medicated module also includes a first seal and a second seal. Prior to attaching the medicated module to a drug delivery device, a proximal end of the engagement needle portion partially pierces the first seal, and a distal end of the output needle partially pierces the second seal. The seals provide fluid-tight seals that seal the medicament in the needle. In another embodiment, rather than having a single needle that holds medicament, a medicated module may include two needles (i.e., an engagement needle and an output needle) that are in fluid communication with one another and that hold the medicament.
The medicated module 200 also includes an attachment means 214 and a needle cover 216. Attachment means 214 is configured to attachment to a corresponding attachment means of a drug delivery device, such as the attachment means 109 at the distal end 132 of device 100. This needle cover 216 may have a connection feature (e.g., a snap-fit feature) that allows the cover to be removably attached to the body of the medicated module. Further, the seal 206 is preferably located in the needle cover. In a preferred embodiment, the seal 206 is located at a bottom base at the distal end 224 of the needle cover.
Further, the size (e.g., width and length) and shape of the seals may vary. The size of a seal is preferably large enough so as to provide an adequate liquid-tight seal when a needle end partially pierces the seal. As an example, a seal may be 5 mm×5 mm square. Larger seals are possible, such as 1 m×5 mm or 1 cm×1 cm. Other sizes and shapes are possible as well.
The seals 204, 206 provide a fluid tight engagement for needle 202 until the seals are moved such that the needle no longer partially pierces the seals. The seals may move during the attachment process or prior to the dose delivery (i.e., injection) process. Specifically, the top seal may be moved and fully pierced during attachment of the medicated module to the drug delivery device. Further, the bottom seal may be moved at some point in time prior to injection. In the example of
Returning to the example of
During attachment, the distal end 312 of the cartridge holder contacts the top surface of seal 204 and forces the top seal 204 axially downward in direction 314. Forcing the top seal in direction 314 causes the piercing tip 218 of the engagement needle 210 to fully pierce the top seal. Subsequent to piercing the top seal 204, the piercing tip 218 of the engagement needle 210 pierces the septum 316 of the drug cartridge 304. This action creates fluid communication between the medicament 208 of the medicated module and the primary medicament 306 of the primary device.
Beneficially, piercing the top seal in this manner helps minimize the risk of leakage. Further, piercing the top seal in this manner helps reduce the risk that air is introduced to the system during needle attachment.
As mentioned above, lower seal 206 is preferably contained in the needle cover 216. The needle cover 216 may be removed by the user prior to use (i.e., injection). After removal of the needle cover 216 by the user, the open end 220 of the output needle portion 212 is exposed. The primary medicament 306 and medicament 208 may then be subcutaneously injected. Preferably, the top seal is secured in the bottom of the base of the needle cover, so the bottom seal stays in the needle cover when the cover is removed. The seal may be secured in the needle cover using, for example, adhesive and/or glue.
An alternative embodiment in accordance with Applicants' proposed concept is shown in
Medicated module 400 includes a first needle 406 (i.e., the engagement needle) and a second needle 408 (i.e., the output needle). The engagement needle 406 and the output needle 408 are in fluid communication with one another and hold a medicament 410. In this example, a reservoir 412 is located between and in fluid communication with the engagement needle 406 and the output needle 408. Reservoir 412 may beneficially allow for storage of a large volume of the secondary medicament 410.
Similar to the embodiment of
As depicted in
After attaching the medicated module 400 to drug delivery device 402, a user may inject a dose. During insertion of the output needle 408 into the user, the act of insertion forces needle guard 404 axially in direction 424. This relative motion causes the output needle 408 to fully pierce the lower seal 416 immediately prior to piercing the skin of the user. After fully piercing lower seal 416, the output needle travels through opening 426 in order to pierce a user's skin.
This needle-guard arrangement of
The medicated module may also include a biasing member 428. This biasing member 428 is operably connected to the needle guard 404. The biasing member may serve to keep the needle guard around the needle when a user is not applying an axially directed force on the needle guard. Further, after injection, the biasing member acts to return the needle guard to its pre-injection position surrounding the needle.
Should a user attempt to reuse a previously used a medicated module having the proposed sealing means may include a feature or features that prevent re-attachment to a drug delivery device.
It should be understood that Applicants' proposed sealing features may be used in an medicated module where the drug is essentially contained within a cavity formed between a tip of an engagement needle (i.e., the needle that pierces the septum of a drug cartridge when the medicated module is attached to a drug delivery device) and a tip of an outlet needle (i.e., the needle that is inserted into the patient).
Applicants' proposed concept beneficially provides a sealing means to seal medicament in a medicated module. The sealing means beneficially prevents leakage and reduces or minimizes contamination. Further, the sealing means requires few components and provides an effective and inexpensive means to secure medicament in a medicated module.
In the above described embodiments, the medicament in the medicated module may be either in a powdered solid state, any fluid state contained within the needle and/or reservoir, or coated to the inside surface of the needle. The greater concentration of the solid form of the medicament has the benefit of occupying a smaller volume than the liquid having lower concentration. This in turn reduces the ullage of the medicated module. The device would be used in the same manner as the preferred embodiment with the medicament in the medicated module being dissolved by the primary medicament during dispense.
The connection or attachment between the medicated module of the above descried embodiments may contain additional features (not shown), such as connectors, stops, splines, ribs, grooves, and the like design features, that ensure that specific medicated module are attachable only to matching drug delivery devices. Such additional features would prevent the insertion of a non-appropriate medicated module to a non-matching injection device.
The shape of the medicated module may be a cylindrical body or any other geometric shape suitable for defining a fluid reservoir or for containing discrete self-contained reservoir of the medicament in the medicated module and for attaching one or more needle cannula. The medicated module can be manufactured from glass or other drug contact suitable material. The integrated output needle can be any needle cannula suitable for subcutaneous or intramuscular injection. Preferably the medicated module is provided by a drug manufacturer as a stand-alone and separate device that is sealed to preserve sterility. The sterile seal of the module is preferably designed to be opened automatically, e.g. by cutting, tearing or peeling, when the medicated module is advanced or attached to the drug delivery device by the user.
The medicated module of Applicants' concept could be designed to operate in conjunction with a multiple use injection device, preferably a pen-type multi-dose injection device, similar to what is illustrated in
A typical injection device contains a cartridge or other reservoir of medication. This cartridge is typically cylindrical in shape and is usually manufactured in glass. The cartridge is sealed at one end with a rubber bung and at the other end by a rubber septum. The injection pen is designed to deliver multiple injections. The delivery mechanism is typically powered by a manual action of the user, however, the injection mechanism may also be powered by other means such as a spring, compressed gas or electrical energy.
Exemplary embodiments of the present invention have been described. Those skilled in the art will understand, however, that changes and modifications may be made to these embodiments without departing from the true scope and spirit of the present invention, which is defined by the claims.
Number | Date | Country | Kind |
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10189773.4 | Nov 2010 | EP | regional |
The present application is a U.S. National Phase Application pursuant to 35 U.S.C. §371 of International Application No PCT/EP2011/069092 filed Oct. 31, 2011, which claims priority to European Patent Application No. 10189773.4 filed Nov. 3, 2010. The entire disclosure contents of these applications are herewith incorporated by reference into the present application.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP2011/069092 | 10/31/2011 | WO | 00 | 4/26/2013 |