The present disclosure relates to drug delivery/infusion devices. More particularly, the present disclosure relates to devices mounted to the body for automatically delivering a drug to a patient. Even more particularly, the present disclosure relates devices mounted to the body of a patient, the device including a substrate securely adhered and conformed to the body of the patient such that the risk of dislodgement of the device is minimized.
Delivery of liquid drugs to a patient via injection using a needle or syringe is well-known. More recently, devices that automate the delivery of liquid drugs have been introduced. These devices (which are commonly referred to as “on-body devices” or “on-body injectors”) are mounted or otherwise secured to the body of the patient (e.g., to the arm or abdomen) and remain in place for an extended amount of time (on the order of hours or days), injecting an amount of the drug into the body of the patient at one or more scheduled times. For example, a device may be configured to deliver a drug over the span of 45 minutes, with delivery beginning 27 hours after the device has been activated and applied to a patient (to ensure that the drug is not delivered sooner than 24 hours after a medical procedure or treatment). These devices improve upon manual methods by obviating the need for the patient to inject themselves with the drug (which carries heightened risks of the patient improperly administering the injection or injecting the drug at an inappropriate time) or to return to a medical facility for one or more injections by a technician or medical professional.
One known on-body device 10 is shown in
The internal components of the device 10 include a reservoir 14 that is configured to be filled with a liquid drug to be delivered to the patient. An upper surface of the housing 12 includes a fill indicator 16 that provides a visual indication of the amount of fluid in the reservoir 14. In addition to the fill indicator 16, the upper surface of the housing 12 may include printed information, such as information regarding the drug to be delivered. The upper surface of the housing 12 may be formed of a translucent material, which allows light from a status light 18 (which may be configured as a light-emitting diode) mounted within the housing 12 (
The drug is injected into the reservoir 14 using a (typically pre-filled) syringe 22 via a port 24 incorporated into the bottom or underside of the housing 12 (
A piston or plunger 28 (
When the device 10 has been activated, it is mounted or secured to the body of the patient. The applicator 26 is first removed from the underside of the housing 12 and discarded, followed by a pull tab 30 being manipulated to remove a release film from an adhesive pad 32 (substrate) associated with the underside of the housing 12. The housing 12 is then pressed against the body of the patient, with the adhesive pad 32 (adhesive side of the substrate) facing the body. An adhesive present on the adhesive pad/substrate 32 causes the adhesive pad 32 (and, hence, the housing 12) to adhere to the body. Examples of devices using adhesive pads/substrates are described in U.S. Patent Application Publication 2019/0083702 and International Patent Application Publication WO2018/081234, the contents of which are incorporated by reference herein in their entireties.
Some predetermined time after the device 10 has been activated (which may be on the order of three to five minutes, for example), a distal end portion of a cannula 34 is introduced into the skin of the patient via a cannula window 36 defined in the housing 12 (
As the cannula 34 is not itself configured to pierce the skin, an associated needle 38 is provided within the lumen of the cannula 34, with a sharp or beveled distal end of the needle 38 extending out of a distal end of the cannula 34. A midsection of the needle 38 is mounted within a needle carriage 40, while a proximal end 42 of the cannula 34 is mounted within a cannula carriage 44 that is initially positioned directly adjacent to the needle carriage 40. The needle carriage 40 is pivotally connected to an end of a linkage or crank arm 46, with an opposite end of the linkage 46 being associated with a torsion spring 48. At the designated time (e.g., 3-5 minutes after the device 10 has been activated), the controller causes a lever (not visible) to be released, which allows the spring 48 to recoil, in turn rotating the linkage 46, which rotation causes the needle carriage 40 to move along a linear track 50 from a first position adjacent to the spring 48 (
Continued recoiling of the spring 48 causes further rotation of the linkage 46, which has the effect of moving the needle carriage 40 back toward the spring 48 (i.e., back toward its first position). Rather than moving along with the needle carriage 40, the cannula carriage 44 is held in its second position (
Movement of the needle carriage 40 in a proximal direction away from the cannula carriage 44 causes the needle 38 to partially (but not fully) retract from the cannula 34. In the final condition shown in
As for the mechanism by which the drug is advanced out of the reservoir 14, the device 10 includes a lever 54 mounted to a pivot point 56 (
A first wire or filament 72 extends from the lever 54, around a first pulley 74, and into association with a first electrical contact 76. A second wire or filament 78 extends from the lever 54 in the opposite direction of the first wire 72, around a second pulley 80, and into association with a second electrical contact 82. The wires 72 and 78 (which are commonly referred to as “muscle wires”) are formed of a shape memory alloy (e.g., Nitinol), which causes them to heat up and contract when a current flows through them, while being allowed to stretch when the current is removed and the wire 72, 78 cools. Current is alternately applied to the two wires 72 and 78, causing the one carrying a current to heat up and contract while the other one is allowed to stretch. The wire 72, 78 that contacts will pull on the lever 54, causing it to pivot about the pivot point 56. Thus, alternately applying current to the two wires 72 and 78 will cause the wires 72 and 78 to alternately contact and stretch, which in turn causes the lever 54 to pivot back and forth about the pivot point 56.
At the designated time (e.g., 27 hours after the device 10 has been activated), the controller provides commands that cause current to be alternately applied to the muscle wires 72 and 78, which causes the lever 54 to alternately pivot about the pivot point 56 in opposite first and second directions. Pivotal movement of the lever 54 in the first direction will cause the first arm 58 of the lever 54 to engage and rotate the first gear 60 an incremental amount, while pivotal movement of the lever 54 in the second direction will cause the second arm 62 of the lever 54 to engage and rotate the second gear 64 an incremental amount (in the same direction in which the first gear 60 is rotated by the first arm 58). Both gears 60 and 64 are associated with a common shaft 84 (which is shown in
After the drug has been delivered (e.g., over the course of a 45-minute session), the controller alerts the patient via a visual cue from the status light 18 and/or an audible cue from the buzzer that drug delivery is complete. Subsequently, the patient removes the device 10 from their skin and discards the device 10.
While devices of the type described above have proven adequate, there is room for improvement. For example, it would be desirable that the substrate that carries the device and allows the device to be mounted on the skin of a patient remains reliably affixed to the patient's skin and does not become dislodged or allow for leaks from the device. In that regard, it would be desirable that the substrate conform to the curved surface of the body and stretch and deform, as necessary, during normal body movements of the wearer. It would also be desirable to be able to adjust the size of the substrate to the particular patient. In that regard, it would be desirable to provide an on-body drug-delivery device that includes a substrate of the type described herein that may also be adjustable in size.
There are several aspects of the present subject matter which may be embodied separately or together in the devices and systems described and claimed below. These aspects may be employed alone or in combination with other aspects of the subject matter described herein, and the description of these aspects together is not intended to preclude the use of these aspects separately or the claiming of such aspects separately or in different combinations as set forth in the claims appended hereto.
In a first aspect, an on-body drug delivery device includes a housing having a cover and a bottom wall. The device includes a substrate that comprises a sheet of flexible material having a top surface and a bottom surface. The housing is carried by the substrate, the sheet including one or more cut-outs and/or one or more perforations in the sheet.
In a more particular aspect, the substrate has a top surface and a bottom surface. The bottom surface may include a layer of adhesive.
In another more particular aspect, the on-body drug delivery device includes a substrate including both cut-outs and perforations. In another more particular aspect, the substrate includes only cut-outs or only perforations.
In accordance with another aspect, the substrate includes an outer edge defining a perimeter around the housing. The one or more cut-outs and/or one or more perforations are on the perimeter of the substrate.
The embodiments disclosed herein are for the purpose of providing a description of the present subject matter, and it is understood that the subject matter may be embodied in various other forms and combinations not shown in detail. Therefore, specific designs and features disclosed herein are not to be interpreted as limiting the subject matter as defined in the accompanying claims.
In keeping with the present disclosure, and with reference to
Housing 90 is affixed to and carried by a substrate 100 which may be affixed or adhered to the patient's body. As shown in
Substrate 100 is preferably made of a flexible, resilient material that can be stretched (as will be described in greater detail below.) Substrate 100 may further include upper and lower bacteria impermeable liners as described in US Patent Application Publication US 2019/0083702, the contents of which are incorporated herein by reference. The exposed surface of peripheral edge may likewise include and be covered by a bacterial impermeable liner.
The flexible, resilient material of substrate 100 may be any such material that can be safely applied and adhered to the skin of the patient. Typically, substrate 100 is made of non-woven, fibrous material. Examples of suitable materials include polyethylene, polyvinyl chloride, polyurethane, polyethylene terephthalate, polypropylene, viscose/rayon, thermoplastic elastomer and the like.
As discussed above, infusion device is to be worn by the patient and must be removably affixed or adhered to the skin of the patient. In one embodiment, substrate 100 may include or be otherwise provided with an adhesive on bottom surface 104. The adhesive is such that the substrate remains adhered to the patient's body and cannot be easily dislodged or separated from the patient's skin. In that regard, the adhesive should be waterproof and/or resistant to degradation by perspiration. In addition, adhesive substrate should tightly conform to the skin of the patient to keep the needle of the device from dislodging. At the same time, the adhesive is not permanent and, when necessary, can be removed routinely by a medical professional in an “out-patient” procedure or even by the patient. Examples of suitable adhesives useful with the substrates include any medical-grade or skin contact adhesives such as, but not limited to, acrylic or acrylate compositions, synthetic rubber, hydrocolloid, silicone and the like.
Turning now to
In the embodiment of
An alternative embodiment of the drug delivery/infusion device 10 is shown in
A further alternative of drug delivery/infusion device 10 is shown in
Adhesive substrates of the type described above improve the comfort level for the patient user and reduce the likelihood of dislodgement of the delivery device 10 by conforming and better securing the device to the patient's body. Providing cut-outs and/or perforations allows the substrate to better stretch and deform than a solid sheet and allow the adhesive substrate to be adjusted on a patient-by-patient basis. Moreover, cut-outs and perforations also allow the substrate to be expanded (by stretching) or reduced (by tearing) in size in accordance with the needs of the patient user.
The methods and devices described herein may be used to deliver any suitable fluid medication to a subject. In an exemplary embodiment, the methods and devices described herein are used to deliver pegfilgrastim to a subject, though other exemplary medications include (without limitation) one or more of the following: adalimumab, rituximab, risankizumab, etanercept, trastuzumab, ado-trastuzumab emtansine, trastuzumab deruxtecan, bevacizumab, infliximab, pegfilgrastim, filgrastim, tocilizumab, golimumab, interferon beta-1a, ranibizumab, denosumab, pembrolizumab, nivolumab, aflibercept, eculizumab, ocrelizumab, pertuzumab, secukinumab, omalizumab, ustekinumab, vedolizumab, daratumumab, dupilumab, atezolizumab, natalizumab, bortezomib, ipilimumab, durvalumab, emicizumab, palivizumab, guselkumab, mepolizumab, panitumumab, ramucirumab, belimumab, abatacept, certolizumab pegol, ixekizumab, romiplostim, benralizumab, evolocumab, canakinumab, obinutuzumab, cetuximab, erenumab, blinatumomab, romosozumab, mirikizumab, inotuzumab, sacituzumab govitecan, enfortumab vedotin, brentuximab vedotin.
It will be understood that the embodiments and examples described above are illustrative of some of the applications of the principles of the present subject matter. Numerous modifications may be made by those skilled in the art without departing from the spirit and scope of the claimed subject matter, including those combinations of features that are individually disclosed or claimed herein. For these reasons, the scope hereof is not limited to the above description but is as set forth in the following claims, and it is understood that claims may be directed to the features hereof, including as combinations of features that are individually disclosed or claimed herein.
Number | Name | Date | Kind |
---|---|---|---|
4072149 | Tischlinger | Feb 1978 | A |
4234104 | Apuzzo, Jr. et al. | Nov 1980 | A |
4970502 | Kunikane et al. | Nov 1990 | A |
6620134 | Trombley, III et al. | Sep 2003 | B1 |
8285328 | Caffey et al. | Oct 2012 | B2 |
9452255 | Tieck et al. | Sep 2016 | B2 |
20020169439 | Flaherty | Nov 2002 | A1 |
20030088238 | Poulsen et al. | May 2003 | A1 |
20030167036 | Flaherty | Sep 2003 | A1 |
20040068230 | Estes et al. | Apr 2004 | A1 |
20040116866 | Gorman | Jun 2004 | A1 |
20040199123 | Nielsen | Oct 2004 | A1 |
20060111671 | Klippenstein | May 2006 | A1 |
20070290012 | Jackman | Dec 2007 | A1 |
20080091139 | Srinivasan et al. | Apr 2008 | A1 |
20090131860 | Nielsen | May 2009 | A1 |
20100130931 | Yodfat et al. | May 2010 | A1 |
20110178461 | Chong et al. | Jul 2011 | A1 |
20110196304 | Kramer et al. | Aug 2011 | A1 |
20120010594 | Holt et al. | Jan 2012 | A1 |
20130006213 | Arnitz et al. | Jan 2013 | A1 |
20150374919 | Gibson | Dec 2015 | A1 |
20160020798 | Chen | Jan 2016 | A1 |
20160038689 | Lee | Feb 2016 | A1 |
20160082182 | Gregory et al. | Mar 2016 | A1 |
20160175515 | McCullough | Jun 2016 | A1 |
20160199574 | Ring et al. | Jul 2016 | A1 |
20160220798 | Netzel et al. | Aug 2016 | A1 |
20160296704 | Gibson | Oct 2016 | A1 |
20160354555 | Gibson et al. | Dec 2016 | A1 |
20160374707 | Akagane | Dec 2016 | A1 |
20170119969 | McCullough et al. | May 2017 | A1 |
20170124284 | McCullough et al. | May 2017 | A1 |
20170147787 | Albrecht et al. | May 2017 | A1 |
20170182253 | Folk et al. | Jun 2017 | A1 |
20170312454 | Chattaraj et al. | Nov 2017 | A1 |
20170340837 | Nazzaro et al. | Nov 2017 | A1 |
20170361015 | McCullough | Dec 2017 | A1 |
20170368260 | McCullough et al. | Dec 2017 | A1 |
20180021508 | Destefano et al. | Jan 2018 | A1 |
20180028747 | Hanson et al. | Feb 2018 | A1 |
20180036476 | McCullough et al. | Feb 2018 | A1 |
20180085517 | Laurence et al. | Mar 2018 | A1 |
20180193557 | Johnson et al. | Jul 2018 | A1 |
20180256823 | Nazzaro et al. | Sep 2018 | A1 |
20180272059 | Marbet et al. | Sep 2018 | A1 |
20180304014 | Knudsen et al. | Oct 2018 | A1 |
20190009019 | Shor et al. | Jan 2019 | A1 |
20190022306 | Gibson et al. | Jan 2019 | A1 |
20190050375 | Fitzgibbon et al. | Feb 2019 | A1 |
20190060562 | Olivas et al. | Feb 2019 | A1 |
20190083702 | Nekouzadeh et al. | Mar 2019 | A1 |
20190134296 | Barbedette et al. | May 2019 | A1 |
20190143043 | Coles et al. | May 2019 | A1 |
20190143047 | Jazayeri et al. | May 2019 | A1 |
20190151544 | Stonecipher | May 2019 | A1 |
20190167899 | Cabiri | Jun 2019 | A1 |
20190167908 | Fitzgibbon et al. | Jun 2019 | A1 |
20190192766 | Stonecipher | Jun 2019 | A1 |
20190247579 | Damestani | Aug 2019 | A1 |
20190275241 | Ring et al. | Sep 2019 | A1 |
20190328965 | Moberg | Oct 2019 | A1 |
20190365986 | Coiner et al. | Dec 2019 | A1 |
20190374707 | Damestani et al. | Dec 2019 | A1 |
20190381238 | Stonecipher et al. | Dec 2019 | A1 |
20200023122 | McCullough et al. | Jan 2020 | A1 |
20200164145 | Chang et al. | May 2020 | A1 |
20200164155 | Mojarrad et al. | May 2020 | A1 |
20200179609 | Tan-Malecki et al. | Jun 2020 | A1 |
20200197628 | McCullough et al. | Jun 2020 | A1 |
20200206429 | Hering et al. | Jul 2020 | A1 |
20200230313 | Mojarrad et al. | Jul 2020 | A1 |
20200238004 | McCullough | Jul 2020 | A1 |
20200254172 | Forster et al. | Aug 2020 | A1 |
20200254185 | Bar-el et al. | Aug 2020 | A1 |
20200261643 | Boyaval | Aug 2020 | A1 |
20200261648 | Groszmann et al. | Aug 2020 | A1 |
20200261657 | Gibson et al. | Aug 2020 | A1 |
20200289745 | Harris et al. | Sep 2020 | A1 |
20200297927 | Conrath et al. | Sep 2020 | A1 |
20200315918 | Naygauz | Oct 2020 | A1 |
20200322793 | Yang | Oct 2020 | A1 |
20200338271 | Harris et al. | Oct 2020 | A1 |
20210228799 | Streit et al. | Jul 2021 | A1 |
Number | Date | Country |
---|---|---|
2242034 | Oct 2010 | EP |
2018081234 | May 2018 | WO |
2018183039 | Oct 2018 | WO |
2018226565 | Dec 2018 | WO |
2019018169 | Jan 2019 | WO |
2019022950 | Jan 2019 | WO |
2019022951 | Jan 2019 | WO |
2019032101 | Feb 2019 | WO |
2019143753 | Jul 2019 | WO |
Entry |
---|
RightCare CGM Adhesive Universal Overpatches; Amazon available for sale May 6, 2020. https://www.amazon.com/Adhesive-Universal-Covered-Synthetic-Extreme/dp/B083QMYXQ7/ref=sr_1_27?keywords=overpatch&qid=163080153&sr=8-27&th=1 (Year: 2020). |
Omnipod Grip Shield Designed by Deck My Diabetes; Amazon. Available for sale Dec. 14, 2020 https://www.amazon.com/Deck-My-Diabetes-Flexible-Additional/dp/B08QL3TVZB/ref=sr_1_6?keywords=insulin+pump+overlay&qid=1639074568&sr=8-6 (Year: 2020). |