The present disclosure is directed to methods and apparatuses for intranasal delivery of a substance to a subject.
Various devices have been developed to provide for the nasal delivery of treatment agents, such as medications or vaccines, to a subject. Aerosol delivery of drugs, vaccines, and other therapeutic, preventative, and diagnostic medical products avoids many of the drawbacks of injection, including need for skilled personnel, risk of blood-borne disease, high cost, patient aversion to injection, and the need to safely dispose of used needles and syringes. However, conventional aerosol delivery devices have significant shortcomings that prevent their widespread use. Such shortcomings include, for example, complicated device construction and operation, high cost of manufacture and use, and external power requirements.
Dry powder inhalers can be an attractive means to administer medications or vaccines since they do not require reconstitution. However, conventional dry powder inhalers have numerous shortcomings that restrict their widespread use and adoption. Accordingly, improvements in dry powder delivery devices are desirable.
Various embodiments of nasal delivery devices and methods of delivering a powder to a nostril of a subject are disclosed herein. In one embodiment, a nasal delivery device includes an air-receiving section that has a first passageway therethrough to allow air to pass through the air-receiving section, a powder-reservoir receiving section sized to receive a powder reservoir, and a powder-delivery section that has a second passageway therethrough to allow aerosolized powder from the powder reservoir to pass through the powder-delivery section. The first passageway can have a first end and a second end, with the first end being further from the powder-reservoir receiving section and the second end being at or near the powder-reservoir receiving area. The second end of the air-receiving section can include a flattened region so that air exiting the air-receiving section has a generally flattened profile.
In some embodiments, the first end of the air-receiving section has a larger cross-sectional area than the second end. The first end of the air-receiving section can have a generally circular cross-sectional area. The flattened region can be at least partly defined by a curved sidewall and the curved sidewall can be configured to generally match a respective sidewall on a powder reservoir.
In some embodiments, the powder-reservoir receiving section can include at least one piercing member that is configured to engage and pierce a frangible cover of a powder reservoir. The piercing member(s) can be sized to extend into the powder reservoir and generally push the frangible cover towards at least one side wall of the powder reservoir. The piecing member(s) can be formed of two piercing members located on opposing sides of the powder-reservoir receiving section. In some embodiments, the powder-reservoir receiving section includes at least one attachment member for coupling a powder reservoir to the powder-reservoir receiving section. The attachment member(s) can include grooves that are sized to engage with a respective lip on the powder reservoir. In some embodiments this coupling is irreversible, providing an auto-disabling feature that prevents reuse of the device.
In some embodiments, an inlet tube can be coupled to the air-receiving section, with the inlet tube having a first end sized to be placed in a mouth of a user to receive air from an exhalation of the user. The inlet tube can include a visual indicator of air passing therethrough. The visual indicator can include an expandable region of the inlet tube, with the expandable region being expandable from a first, flattened configuration to a second, expanded configuration when air passes through the inlet tube. The visual indicator can also include an elongate member fastened to the inlet tube, with the elongate member being configured to change shape when air passes therethrough. The elongate member can be configured to unroll when air passes therethrough.
In some embodiments, the second passageway can have an inlet end and an exit end, with the inlet end being at or adjacent the powder-reservoir receiving section and the exit end being sized to be received in a nasal opening of a user. The inlet end of the second passageway can have a larger cross-sectional area than the flattened region of the second end of the first passageway. In some embodiments, the second passageway can include a recirculation zone, with the recirculation zone having a larger cross-sectional area than the inlet end of the second passageway.
In some embodiments, a hinge member can be provided that extends along at least a portion of the air-receiving section, the powder-reservoir receiving section, and the powder-delivery section, with the hinge member being located to allow the device to move between an open configuration for manufacture and a closed configuration for use.
In some embodiments, a powder reservoir can be configured to be coupled to the powder-reservoir receiving section. The powder reservoir can include one or more alignment markings to facilitate alignment of the powder reservoir when coupling it one or more piercing members on the powder-reservoir receiving section. The powder reservoir can include a treatment agent and, in some cases, an excipient. The excipient can be selected so that a greater portion of excipient lofts before the treatment agent.
In another embodiment, a method of delivering an aerosolized treatment agent to a subject is provided. The method can include attaching a powder reservoir containing a treatment agent to a nasal delivery device, positioning an air inlet end of the device into an air delivery source, positioning an exit end the device at least partially within a nostril of the subject, delivering air through a passageway in the air inlet end to the powder reservoir, the passageway comprising a flattened region so that air exiting the flattened region enters the powder reservoir with a generally flattened profile, and delivering aerosolized treatment agent through the exit end of the device and into the nostril of the subject.
In some embodiments, the air delivery source comprises exhaled air and the air inlet end of the device is positioned in the subject's mouth. In other embodiments, the air delivery source can comprise an external source, such as a squeeze bulb or other types of air sources (manual or powered).
In some embodiments, the act of attaching the powder reservoir to the device can include attaching a lip of the powder reservoir to one or more grooves on the device. The act of attaching the powder reservoir to the device further can include piercing a frangible cover of the powder reservoir with at least one piercing member that extends from the device.
At least one piercing member can extend into the powder reservoir and push the frangible cover towards at least one side wall of the powder reservoir.
In some embodiments, the method can include providing a visual indication when air is delivered through a passageway in the air inlet end to the powder reservoir. The act of providing a visual indication can include expanding a region of the air inlet end from a first, flattened configuration to a second, expanded configuration when air passes through the air inlet end. The act of providing a visual indication can include changing a shape of an elongate member fastened to the air inlet end when air passes therethrough. In some embodiments, the elongate member unrolls to change shape.
In some embodiments, before attaching the powder reservoir, the method comprises folding the device about a hinge member and attaching opposing surfaces on the device to one another. The attachment of opposing surfaces can include ultrasonic welding of opposing surfaces. The attachment of opposing surfaces can also include snap fitting opposing surfaces together. The attachment of opposing surfaces can also include bonding opposing surfaces together by an adhesive.
In another embodiment, a device can include a reservoir containing a treatment agent and an excipient, with the reservoir comprising a pair of opposing sidewalls that are generally curved toward one another to facilitate air flow across an inside surface of each sidewall, a sealing member for sealing the treatment agent and the excipient inside the reservoir, and an attachment member extending from the reservoir to facilitate coupling of the reservoir to a powder-reservoir receiving section of a nasal delivery device.
In some embodiments, the sealing member can include a frangible member. The frangible sealing member may be a metallic foil, polymer film, combination foil/film material, or other similar type of material. The sealing member can include one or more alignment markings to facilitate alignment of the powder reservoir when coupling the powder-reservoir receiving section. In some embodiments, the excipient can be selected so that a greater portion of excipient lofts before the treatment agent when exposed to an air flow. The excipient can also be positioned in the reservoir relative to the treatment agent so that a greater portion of excipient lofts before the treatment agent when exposed to an air flow.
The foregoing and other objects, features, and advantages of the invention will become more apparent from the following detailed description, which proceeds with reference to the accompanying figures.
The following description is exemplary in nature and is not intended to limit the scope, applicability, or configuration of the invention in any way. Various changes to the described embodiment may be made in the function and arrangement of the elements described herein without departing from the scope of the invention.
As used in this application and in the claims, the singular forms “a,” “an,” and “the” include the plural forms unless the context clearly dictates otherwise. Additionally, the term “includes” means “comprises.” Further, the terms “coupled” and “associated” generally mean electrically, electromagnetically, and/or physically (e.g., mechanically or chemically) coupled or linked and does not exclude the presence of intermediate elements between the coupled or associated items absent specific contrary language.
As used herein, the term “frangible” means capable of being broken and/or removed to allow access to materials behind or under the “frangible” member. Accordingly, a “frangible” cover on a container can be, for example, punctured or cut to obtain access to materials within the container or, alternatively, entirely or partly removed to obtain access to the materials.
Treatment agents, as used herein, comprise agents that can be administered to living organisms for an effect in the treated organism. Such agents include live and killed organisms for vaccination, immunogens, immune activators or suppressors, chemotherapeutics, pharmaceuticals, nucleic acids, insulin, hormones, antibodies and fragments thereof, receptors, proteins, carbohydrates, fats, nutrients, anesthetics, narcotics, and pain relievers.
Exemplary methods of the present disclosure comprise delivery of treatment agents such as vaccine compositions. The present disclosure contemplates the use of any vaccine composition or other treatment agents that can be delivered via the disclosed devices and/or disclosed methods of administration. Particularly preferred vaccination compositions are those for measles, mumps and rubella. Such compositions may comprise measles vaccine, mumps vaccine, rubella vaccine and combinations and mixtures such as measles and mumps, rubella and mumps, measles and rubella, and measles, mumps and rubella. Other particularly preferred vaccine compositions are those for influenza. Such compositions may comprise live virus vaccines, inactivated virus vaccines, and virus-like particle vaccines. The vaccines further comprise pharmaceutical or formulation components such as those known in the art, including, but not limited to, diluents, compounding agents, surfactants, and agents to maintain sterility.
Although the operations of exemplary embodiments of the disclosed method may be described in a particular, sequential order for convenient presentation, it should be understood that disclosed embodiments can encompass an order of operations other than the particular, sequential order disclosed. For example, operations described sequentially may in some cases be rearranged or performed concurrently. Further, descriptions and disclosures provided in association with one particular embodiment are not limited to that embodiment, and may be applied to any embodiment disclosed.
Moreover, for the sake of simplicity, the attached figures may not show the various ways (readily discernible, based on this disclosure, by one of ordinary skill in the art) in which the disclosed system, method, and apparatus can be used in combination with other systems, methods, and apparatuses. Additionally, the description sometimes uses terms such as “produce” and “provide” to describe the disclosed method. These terms are high-level abstractions of the actual operations that can be performed. The actual operations that correspond to these terms can vary depending on the particular implementation and are, based on this disclosure, readily discernible by one of ordinary skill in the art.
The embodiments described herein relate to dry powder inhalers for nasal administration of drugs, vaccines, and other therapeutic, preventative, and diagnostic medical products. In some embodiments, the powder is placed in an inhaler device from which it is lofted into the airstream of the patient by the patient's own expiratory flow for conveyance into the naris. Such nasal dry powder inhalers provide numerous advantages over conventional aerosol delivery systems, such as a nebulizer-liquid vaccine system, including, for example, their simpler construction and operation, low cost, and no need for external power. In addition, dry powder vaccines and medications can have some advantages as the delivery agent over other delivery media, such as less stringent cold chain requirements.
Powder reservoir 18 can have a sealing member 20 that must be pierced or opened before powder within powder reservoir 18 can be delivered to a location outside of powder reservoir 18. Although
As shown in
As piercing members 24 extend into powder reservoir 18, sealing member 20 is pushed back against the walls of the inside of powder reservoir 18 as shown in
In one embodiment, inlet tube 32 can be configured to receive exhaled air from a user to aerosolize the powder and deliver the aerosolized powder through powder delivery section 16. Powder delivery section 16 can be tapered at a nasal insertion area 17 (e.g., a nasal prong tip) to allow comfortable insertion in a wide range of nasal orifice sizes. In addition, as shown in
When configured for oral exhalation of a user, inlet tube 32 can have a first end 34 sized to receive a mouth of a user and a second end 36 configured to be coupled to air receiving section 12. Second end 36 can be coupled to air receiving section 12 in any known manner, including, for example, by a friction fit such as by sliding a slightly larger diameter of second end 36 over an outer surface of air receiving section 12 (or vice versa). One or more protrusions can be provided on surfaces of the air receiving section 12 and/or inlet tube 32 to secure the two elements together.
Referring again to
Flattened region 40 can be configured so that it permits exhaled air to pass therethrough, but restricts the delivery of inhaled air in the opposite direction. For example, flattened region 40 can comprise a compliant material with a relatively thin wall that opens easily (e.g., like a balloon) when air is blown into the flattened region. However, when subjected to suction, the compliant flattened region 40 will collapse, thereby restricting inhalation by the user and delivery of powder from powder reservoir 18 into the oral cavity of the user.
Other types of devices to restrict oral inhalation of the powder can be provided. For example,
In addition, during exhalation of the user, inlet tube 32 can provide a visual indication of the act of exhaling. For example, flattened region 40 can be configured to visually expand during user exhalation, thereby providing a visual indication that the user has exhaled into inlet tube causing delivery of aerosolized powder to the user's nasal orifice. The visual expansion of flattened region 40 can comprise, for example, a significant visual expansion of the cross-sectional area of flattened region 40, such as by expanding the cross-sectional area to double the original size or greater when a exhalation is delivered by a user that is sufficient to aerosolize the powder in powder reservoir 18 and deliver it through powder delivery section 16.
As shown in
In operation, elongate member 139 can also act as a visual indicator of air flow within the inlet tube. As shown in
In some embodiments, device 10 can be configured to direct air into the powder reservoir in a substantially flat pattern. For example, as shown in
Accordingly, the geometry of flow channel 48 can facilitate effective entraining of a dose of dry powder (containing medication, vaccines, etc.) into an airflow, while breaking apart agglomerations of powder into their constituent particles, without significantly increasing fluid resistance through the device.
One or more expansion zones can be provided at powder delivery section 16. For example, as shown in
In some embodiments, the delivery device can be formed with a folding body as shown in
As shown in
Alternatively, or in addition, one or more physical features can be provided to secure sections 370, 372 to one another. For example, as shown in
By forming the device with a living hinge as described above, the device can be manufactured using a single tool and at a relatively low cost. In addition, relatively complex three-dimensional geometries, such as those shown in
As disclosed herein, the combination of the delivery device and the powder reservoir facilitate the deposition of medication deep into the biologically active nasal mucosae—not just on the biologically inactive epithelial tissues exterior to the nasal valve. In some embodiments, the delivery of powder in this manner can be further improved by causing an initial part of the powder dose to be delivered into the naris to coat the surfaces of the exterior nose and the nasal valve. This coating can at least partially cover the mucous layer, thereby inhibiting further capture of powder by these surfaces and enabling the bulk of the powder dose to pass through the nasal valve to desired target tissues deeper in the nasal tract.
To facilitate the delivery of powder to desired target tissues, in some embodiments, the medication can be mixed with sufficient excipient so that the excipient provides a coating function, resulting in a reduced portion of treatment agent that adheres to the nasal valve or other non-target surfaces.
The powder can be layered in the cup so excipient is preferentially lofted at the beginning of the dose to provide the coating, and the treatment agent lofts out of the cup at the end of the dose. For example, the excipient can be located in the powder reservoir at the exit area of the powder reservoir.
To further facilitate the lofting of the excipient before the medication (or other treatment agent), the excipient material can be selected so that it tends to loft before the medication. For example, if low density spray dried particles of excipient are included, these will tend to rise to the surface in the powder reservoir due to gravitational settling. Also, because of their low density and large cross-sectional area, they will loft before denser particles.
In some embodiments, an excipient material can be selected with hydrophilic porous interior, but low surface energy exteriors. Such particles will be more likely to stick to the moist nasal valve, but be less likely to capture particles of medication.
In contrast to conventional systems, the systems disclosed herein can be manufactured relatively inexpensively making them well-suited for use with single-dose disposable use as is generally preferred for vaccination. In addition, to restrict re-use of single-use disposable delivery devices, in some embodiments the powder reservoir can be configured to attach to the powder-reservoir receiving area in an irreversible fashion. For example, lips on the powder reservoir can be sized to lock with the grooves so that the powder reservoir cannot be removed from the device. This auto-disabling feature can prevent reuse of the device, which can be particularly useful in certain applications in which cross-contamination between patients is undesirable (e.g., vaccine delivery applications).
Although the devices described herein are generally intended for single-use disposable application, depending on the particular nasal delivery application, in some embodiments, the delivery devices can be cleaned and/or sterilized for reuse with a different powder reservoir 18.
In addition, conventional systems generally permit delivery of medication only to the lower respiratory tract via oral inspiration, while the disclosed systems can effectively deliver active ingredients to the nasal tract. Delivery of dry powders to the nasal cavity provides an attractive alternative to delivery to the deep lung and lower respiratory tract. Surfaces of the nasal cavity posterior to the nasal valve have significant immunologically-active tissues for the action of vaccines, and the nasal cavity provides sites where medications can be effectively transmitted to the brain.
For some dry powder medications or vaccines, delivery should be restricted to the nasal cavity, i.e., negligible powder should be inspired below the larynx into the lower respiratory tract. The dry powder devices disclosed herein can be powered by the patient's exhalation. Also, the exhalation can not only provide the air flow for delivery of the powder, it can also prevent inspiration of powder into the lower respiratory tract. Because the powder delivery is automatically timed to occur during exhalation in this situation, the exhalation flow prevents inspiration of powder into the lower respiratory tract. When combined with a means to prevent accidental oral inspiration of powder as described herein, the dry powder devices disclosed herein are well suited for use by children and others with limited ability to properly time powder delivery within the breath cycle.
In view of the many possible embodiments to which the principles of the disclosed invention may be applied, it should be recognized that the illustrated embodiments are only preferred examples of the invention and should not be taken as limiting the scope of the invention. Rather, the scope of the invention is defined by the following claims. We therefore claim as our invention all that comes within the scope and spirit of these claims.
This application claims the benefit of the earlier filing date of United States Provisional Application No. 61/665,778, filed on Jun. 28, 2012, which is incorporated herein by reference.
This invention was made by an agency of the United States Government or under a contract with an agency of the United States Government. The name of the U.S. Government agency is: the Department of Health and Human Services.
Filing Document | Filing Date | Country | Kind |
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PCT/US2013/047399 | 6/24/2013 | WO | 00 |
Number | Date | Country | |
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61665778 | Jun 2012 | US |