MEDICAL IMPLANT
20220133532 · 2022-05-05
Inventors
- Thomas A. Shepard (Rolesville, NC, US)
- Tyler Pegoraro (Raleigh, NC, US)
- Stuart Williams (Raleigh, NC, US)
- Sanjib Kumar Das (Cary, NC, US)
- Leo Anthony Trevino (Hurdle Mills, NC, US)
- Cheng Li (Durham, NC, US)
Cpc classification
B29L2031/753
PERFORMING OPERATIONS; TRANSPORTING
A61F2250/0067
HUMAN NECESSITIES
B29C33/3842
PERFORMING OPERATIONS; TRANSPORTING
A61K9/0024
HUMAN NECESSITIES
B29K2867/003
PERFORMING OPERATIONS; TRANSPORTING
A61F9/0017
HUMAN NECESSITIES
G03F7/0002
PHYSICS
International classification
A61F9/00
HUMAN NECESSITIES
B29C33/38
PERFORMING OPERATIONS; TRANSPORTING
Abstract
A medical implant is disclosed. The medical implant includes a body having a first end having a first cross-sectional dimension, a second end having a second cross-sectional dimension, and a tapered portion extending between the first end and the second end. The first cross-sectional dimension is larger than the second cross-sectional dimension. In some embodiments, the body comprises multiple layers.
Claims
1. A medical implant comprising: a body including a first end having a first cross-sectional dimension, a second end having a second cross-sectional dimension, and a tapered portion extending between the first end and the second end; wherein the first cross-sectional dimension is larger than the second cross-sectional dimension.
2. The medical implant of claim 1, wherein the tapered portion extends only partially between the first end and the second end.
3. The medical implant of claim 1, wherein the first end and the second end each have a rounded profile.
4. The medical implant of claim 1, wherein a length of the first end of the body to a first end of the tapered portion is in a range of about 5% to about 50% of the total length of the implant.
5. The medical implant of claim 1, wherein a length of the first end of the tapered portion to the second end of the body is in a range of about 950 μm to about 4750 μm.
6. The medical implant of claim 1, wherein the body of the medical implant comprises a single layer.
7. The medical implant of claim 1, wherein the body of the medical implant is made of a mixture of a therapeutic or diagnostic agent and biocompatible polymers.
8. The medical implant of claim 7, wherein the biocompatible polymers inclide terminal esters or acids.
9. The medical implant of claim 1, wherein the body of the medical implant comprises a plurality of layers.
10. The medical implant of claim 9, wherein at least one of the plurality of layers is made of biocompatible polymers, and at least one other of the plurality of layers is made of a mixture of a therapeutic or diagnostic agent and biocompatible polymers.
11. The medical implant of claim 1, wherein the medical implant is formed or manufactured using a particle replication in non-wetting templates (PRINT) method to shape the medical implant.
12. The medical implant of claim 1, wherein the medical implant is inserted using a drug delivery device.
13. The medical implant of claim 1, wherein the body of the medical implant includes a surface modification.
14. A medical implant comprising: a body including a first layer, a second layer, and a third layer, wherein the body further includes a first end having a first cross-sectional dimension and a second end having a second cross-sectional dimension; the body further including a tapered portion extending between the first end and the second end; wherein the first layer and the third layer comprise a first material, and the second layer comprises a second material; and wherein the first cross-sectional dimension is larger than the second cross-sectional dimension.
15. The medical implant of claim 14, wherein the tapered portion extends only partially between the first end and the second end.
16. The medical implant of claim 14, wherein a length of the first end of the body to a first end of the tapered portion is in a range of about 5% to about 50% of the total length of the implant.
17. The medical implant of claim 14, wherein the first material comprises a mixture of PLGAs and the second material comprises a mixture of a therapeutic agent and PLGAs.
18. A drug delivery device configured to insert one or more of the medical implant of claim 14 into an eye of a patient, the drug delivery device comprising a needle configured to retain the medical implant from a time of manufacture until the medical implant is inserted into the eye of the patient.
19. The drug delivery device of claim 18, wherein the medical implant is retained within the needle via a friction fit.
20. A method for manufacturing a medical implant, comprising: forming a medical implant using a particle replication in non-wetting templates (PRINT) method to shape the medical implant, the medical implant comprising body including a first end having a first cross-sectional dimension, a second end having a second cross-sectional dimension, and a tapered portion extending between the first end and the second end, wherein the first cross-sectional dimension is larger than the second cross-sectional dimension; wherein the shape of the medical implant enables the medical implant to be retained within a needle of a drug delivery device via a friction fit; and wherein the medical implant is configured to be inserted into an eye using the drug delivery device.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] Exemplary embodiments are illustrated in the drawings. It is intended that the embodiments and figures disclosed herein are to be considered illustrative rather than restrictive.
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DETAILED DESCRIPTION
[0046] A medical implant for use with a needle-based implant delivery device is disclosed. The medical implant is characterized by a geometrical shape that includes an outer geometry designed to create an interference fit between the inner diameter of the needle or cannula positioned adjacent to a needle and the outer surface area of the implant so that the implant is retained within the needle from the time of manufacture up until the implant is inserted and dosed to a patient's tissue. Retention within the needle is maintained during packaging, shipping, and storage of the loaded implant delivery device.
[0047]
[0048] As shown in
[0049]
[0050] D1 is preferably predetermined and configured to be greater than a nominal inner diameter (ID) of the needle that it will be inserted into and retained therein (see
[0051] Referring again to
[0052] In one embodiment, the medical implant 100 is monolithic, or comprises a single layer, as shown in
[0053] Prostaglandins, and analogs or derivatives thereof, having applications as a therapeutic agent in a pharmaceutical implant composition of the present disclosure include latanoprost, bimatoprost, travoprost, tafluprost, 3-hydroxy-2,2-bis(hydroxymethyl)propyl 7-((1r,2r,3r,5s)-2-((r)-3-(benzo[b]thiophen-2-yl)-3-hydroxypropyl)-3,5 dihydroxycyclopentyl)heptanoate (chemical structure (II)), cloprostenol isopropyl ester, 13,14-dihydrocloprostenol isopropyl ester, latanoprostene bunod, unoprostone, PGF.sub.1α laisopropyl ester, PGF.sub.2α a isopropyl ester, PGF.sub.3α isopropyl ester, fluprostenol, or any combination thereof. In some embodiments, the prostaglandins, and analogs or derivatives thereof, having applications as a therapeutic agent include dukeprost, tiaprost, or both. In some embodiments, the prostaglandins, and analogs or derivatives thereof, having applications as a therapeutic agent include free acids, and pharmaceutically acceptable salts thereof, of the prostaglandins and analogs or derivatives thereof.
[0054] Other therapeutic agents having applications in a pharmaceutical implant composition of the present disclosure for treating an ocular disease or disorder, e.g. glaucoma, include but are not limited to beta blockers, miotics, alpha adrenergic agonists, or carbonic anhydrase inhibitors, and antimetabolites such as 5-fluorouracil or mitomycin C.
[0055] Naturally, a pharmaceutical composition of the present disclosure can comprise a therapeutic agent, or a combination of two or more therapeutic agents, examples of which are discussed above. Moreover, analogs or derivatives, pharmaceutically acceptable salts, zwitterions, solvates, esters, and polymorphs of therapeutic agents, such as those discussed herein, have applications in a pharmaceutical composition of the present invention. As used herein, an “analog” is a compound having a structure similar to that of another compound (its “parent” compound) but differing from it in respect to a certain component. The analog can differ from its parent compound in one or more atoms, functional groups, or substructures, which are replaced with other atoms, groups, or substructures. Likewise, an analog of a parent compound can also be formed from the replacement of particular atoms of the parent compound with radioactive isotopes of those particular atoms. A “derivative” is a compound that can be imagined to arise or actually be synthesized from a parent compound by replacement of one atom with another atom or group of atoms.
[0056] In a pharmaceutical composition of the present disclosure, a therapeutic agent is blended with a biodegradable polymer matrix to form a pharmaceutical composition. The amount of a therapeutic agent used in the pharmaceutical composition depends on several factors such as: bio degradable polymer matrix selection, therapeutic agent selection, desired rate of release in a substantially linear manner, duration of desired rate of release, configuration of pharmaceutical composition, and ocular PK, to name a few.
[0057] For example, overall therapeutic agent content of a pharmaceutical composition of the present disclosure may comprise approximately about 0.1 to approximately 60.0 weight percent of the total pharmaceutical composition. In some embodiments, the therapeutic agent comprises from about 1% to about 90%, or about 1% to about 80%, or about 1% to about 70%, or about 1% to about 60%, or about 1% to about 50%, or about 1% to about 40%, or about 1% to about 30%, or about 1% to about 20%, or about 1% to about 10%, or about 10% to about 50%, or about 10% to about 40%, or about 10% to about 30%, or about 10% to about 25%, or about 10% to about 23%, or about 10% to about 20%, or about 15% to about 35%, or about 15% to about 30%, or about 15% to about 25%. All these percentages are in weight percentage. In a particular embodiment, dexamethasone comprises approximately 20.0 weight percent of the pharmaceutical composition.
[0058] A pharmaceutical composition of the present disclosure is prepared by dissolving a polymer matrix and therapeutic agent in a suitable solvent to create a homogeneous solution. For example, acetone, alcohol (e.g., methyl alcohol or ethyl alcohol), acetonitrile, tetrahydrofuran, chloroform, and ethyl acetate may be used as solvents. Other solvents known in the art are also contemplated. The solvent is then allowed to evaporate, leaving behind a homogeneous film. The solution can be aseptically filtered prior to evaporation of the solvent.
[0059] Additional implant formulation examples can be found in U.S. Pat. No. 10,624,904, which is fully incorporated by reference herein in its entirety.
[0060] In another embodiment, the medical implant 100 may be comprised of a plurality of layers. In one example, as shown in
[0061] Although the medical implant 100 is shown as having three layers, it should be understood that in other embodiments, the implant may comprise any number of layers.
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[0063] In another embodiment, multiple medical implants 100 can be inserted into a single delivery device DD, as shown in
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[0065] A number of possible devices can be configured and used to deliver the implants of the present application. For example,
[0066] The housing 1 can also have a cut-out located at the distal end portion that will slidably accept lock 3 having an anvil stop surface and a retaining detent that can be configured to engage a portion of the housing 1 to prevent premature or unintended disengagement from a locked position. Lock 3 is configured to have two positions, a locked position and an unlocked position.
[0067] Other examples of delivery devices include, but are not limited to, the devices shown and described in U.S. Pat. Pub. No. 2019/0374380, U.S. Pat. Nos. D592,746, 9,039,761, and 10,258,503.
[0068] One possible method of manufacturing or forming the medical implant 100 is a particle replication in non-wetting templates (PRINT) method and technology to obtain the shaped medical implants 100 of this disclosure. The geometric shape of the medical implant 100 can be easily changed during the manufacturing process by changing the geometry of the mold tooling features used to form the implants using PRINT technology.
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[0071] Further details of the PRINT method and technology are described in detail in U.S. Pat. Nos. 7,976,759, 8,439,666, 8,662,878, 8,944,804, 8,945,441, 9,314,548, 9,340,001, 9,545,737, and 9,662,809, all of which are incorporated by reference herein in their entireties.
[0072] Further methods to fabricate the tapered prism or trapezoidal prism or wedge style prism shaped implant of the present disclosure include die-formed extrusion, filament extrusion, injection molding, compression molding and stamp molding. These methods can produce an implant having a portion of the prism length with a larger diagonal dimension than the inner diameter (ID) of the delivery needle and a portion of the prism length with a smaller diagonal than the ID of the delivery needle. The design of a two-dimensional (2-D) form can serve as one possible starting point for different manufacturing techniques. A 2-D form defines the perimeter of the target shape, and another processing step can then be used to control the undefined third dimension which can be referred to as the z-dimension or z-axis. Still other manufacturing techniques can utilize a three-dimensional design e.g., 3-D Printing, Layer by Layer manufacturing, or additive (lamination) manufacturing. Still more manufacturing techniques can combine a coating or additive manufacturing process and 2-D form manufacturing techniques to create an implant with a portion of the length of the shape having a diagonal or diameter larger than the ID of the delivery needle and a portion of the length of the shape that has a diagonal or diameter smaller than the ID of the delivery needle.
[0073] The initial step of creating a 2-D shape is to fabricate a die, or tool, to form the implant matrix material. This can be accomplished by machining or etching metal, ceramic, silicon, or other known tool making materials. These materials can hold their shape when processed.
[0074] For die extrusion, a 2-D projection of the X and Y planar design would be etched to make the die opening shape as exemplified in
[0075] For filament extrusion the matrix material could be mixed using an extruder as described above for die extrusion. A filament die of a diameter that is larger than the ID of the target needle cannula would be attached to the end of the extruder barrel.
[0076] For an injection molding process to form the implant of the present disclosure, the rigid mold would have a cavity feature that projected the 2-D planar view of the intended implant geometry. The mold and the individual cavities could be machined, or 3-D printed, to produce the final shape. The cavities would have a tapered profile to produce a cylindrical or prism shape having one end of the cylinder or prism smaller than the ID of the delivery needle and one end of the cylinder or prism larger than the ID of the delivery needle.
[0077] When injection molding is used to fabricate the implants of the present disclosure, any number of cavities per injection molding dies can be used. The sprue and runner configuration of the injection molding die would be designed to have channel diameter reduction based on proximity to the terminal cavities. The terminal connection can be placed so that the flashing from the removal of the individual part would not alter the side profile of the implant. An example of the connection placement that would not alter the side profile would be at the top tip end or bottom tip end of the implant, see
[0078] For compression or stamp molding, the rigid mold or die is designed to have a cavity matching the 2-D planar projection of the desired implant. The rigid material is etched or machined to produce an array of features of a consistent depth with a repeating planar X and Y axis design having one end of the prism of a larger diagonal than the ID of the delivery needle and one end of the prism tapered to a smaller diagonal than the ID of the delivery needle (see
[0079] For 3-D printing or Layer-by-Layer manufacturing, the construction of the implant utilizes precise spatial deposition of the matrix material. The precise spatial deposition of matrix material is typically achieved through robotics, automation, and computer assisted drawings. A computer assisted drawing would be generated of an implant. The implant design would incorporate one end of the implant having a maximum diagonal or diameter larger than the ID of the delivery needle and one end of the implant having a maximum diagonal or diameter smaller than the ID of the delivery needle. The manufacturing technique for creating the implant using filament dispensing stylus would involve a dispensing tip with a diameter smaller than the smallest implant design feature. For a similar technique as in layer-by-layer manufacturing, the z-dimension resolution of the layer features must be less than the target thickness of the implant. The minimum resolution criteria enable the creation of the interference zones and non-interference zones along the implant's length.
[0080] Regardless of the method used to fabricate the implants of the present disclosure, there are post-processing modifications that are possible using the previously mentioned manufacturing modalities to create a section of the implant with one or more interference features. The initial size of the implant generated by the initial fabrication procedure would be smaller than the target cannula ID. Applying a material that has the capacity to increase in size in the presence of a specific media (e.g., hydrogels that increase in volume in the presence of water) onto the end of an implant loaded in a needle cannula. The selective addition of the second material would create the two distinct portions of the implant design where one portion of the prism length has a larger diagonal than the ID of the delivery needle. A manufacturer would fabricate the implant with a sub-needle ID diameter or diagonal using any of the techniques mentioned above. A section of the implant length would be coated with a swelling media through various techniques e.g., submersion, spray-drying, slot die coating, or vapor deposition. The swelling media can be applied as a liquid and dried or cross-linked to form a solid coating.
[0081] The implant shape can be described using six parameters, namely, overall length, thickness, interference width, slip width, interference length, and slip length. These six implant design parameters impact the drug product performance through three key responses. In
[0082] The overall length and thickness parameters have a positive correlation with the three responses mentioned above. As the overall length or thickness increases, the amount of implant surface that can be in contact with the delivery needle wall or inner surface also increases. The interference width parameter correlates positively with the resistance to loading. As the interference width increases the implant diagonal increases, and the resistance during loading increases as a result. The implant's resistance to movement within the delivery needle and the implant's resistance to ejection increases with interference width until the implant's diagonal matches the ID of the delivery needle. At interference widths where the implant diagonal is above the ID of the delivery needle, there is no practical difference in the implant's retention performance or the resistance to ejection. Due to the shearing of material from the edges of the implant as the implant is loaded into the delivery needle, the implant's diagonal does not change once it is in the delivery needle. Once inside the delivery needle, the implant's resistance to movement and the implant's resistance to ejection do not change because the implant's diagonal has been reduced to match the ID of the delivery needle.
[0083] The interference length parameter correlates positively for all three responses. Greater interference length increases the resistance to loading, retention, and ejection based on the same rationale as the overall length and thickness. The slip width parameter impacts the loading resistance. The incorporation of the slip section or tapered design creates a lead-in to make implant loading easier. The slip width should not be so small that the mechanical strength is compromised during routine manufacturing processes including loading and ejection. The implant is preferably designed to withstand pushing another implant within the delivery needle or being pushed by a pusher wire for loading or ejection. However, if slip width is large or too similar to the delivery needle ID, then the resistance to loading increases and mechanical failure of the implant during loading may occur. The slip width cannot exceed the ID of the delivery needle. In other words, the slip length parameter impacts the resistance to loading of the implant and is negatively correlated. A properly predetermined slip width parameter should make the process of loading the implant into the needle cannula easier because resistance to loading decreases as the slip length increases. As the implant is loaded, the slip section of the implant centers the implant in relation to the delivery needle opening because the slope of the tapered prism forces the implant to orient and move parallel to the delivery needle cannula the further the implant travels into the delivery needle. Smaller slip lengths have the same impact on the three responses as larger interference lengths. Smaller slip lengths increase the resistance to loading, movement within the delivery needle, and ejection from the delivery needle.
[0084] Determination of implant retention force within a needle cannula can be obtained by measuring the force required to eject the implants from the lumen of the delivery needle, e.g., a 27G needle. Using a narrow-gauge stainless-steel pusher rod operatively associated with a Mark-10 Model M5-10 Force Gauge, or similar force gauge, and a load cell, will provide an indication of the pusher wire force necessary to eject the implant from the inside of the needle cannula.
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TABLE-US-00001 Needle Gauge: 27 G Ultra-thin wall needle Sample Group: A B C D E F1 F2 Manufacturing Injection Injection Injection PRINT PRINT PRINT PRINT Process: mold mold mold Implant Cylinder Cylinder Cylinder Wedge Shaped Wedge Shaped Rectangular Rectangular Geometry: Prism Prism Polymer Used: PEA PEA PEA PLGA PEA PEA PEA Drug Present: Yes Yes Yes No Yes Yes Yes Nominal 280D × 280D × 280D × 210D × 210D × 220D × 220D × Dimension (μm): 1500L 1500L 3000L 225/200W × 222/200W × 220W × 220W × 2275L 2350L 2925L 4500L Interference 0 0 0 481 489 2925 4500 Length (μm): Measured Retention 265 270 270 316 338 341 345 Dimension (μm): Nominal Needle 311 311 311 311 311 311 311 ID (μm): Ret Dim/Needle 0.85 0.87 0.87 1.02 1.09 1.10 1.11 ID: Retention Force (N) 0.000 0.060 0.002 0.060 0.100 1.000 1.000 0.002 0.000 0.012 0.090 0.158 0.010 0.000 0.026 0.030 0.072 0.012 0.042 0.024 0.040 0.058 0.004 0.108 0.004 0.170 0.260 0.010 0.006 0.010 0.080 0.002 0.000 0.006 0.050 0.006 0.004 0.000 0.080 0.000 0.012 0.000 0.008 0.000 0.004 0.000 0.000 0.018 0.024 0.022 0.066
[0086] The test results show that the implant 100 of the present application (wedge shape) had the best retention force (over 0.350 lb) out of the seven different designs tested. The retention forces of the designs with uniform diameters were either too low (cylinder) and disengaged too easily, or too high (rectangular prism) and did not fit into the lumen of the needle.
[0087] In operation, the medical implant 100 is used in conjunction with a drug delivery device, such as a needle 200, to inject (insert) the medical implant 100 into a patient's tissue. In one example embodiment, the medical implant 100 is an intraocular lens implant configured to be injected into the posterior chamber of a patient's eye. First, the needle of the delivery device is inserted through the sclera of the posterior chamber. The implant(s) are then mechanically delivered into the posterior chamber by the forward motion of a pusher wire in the lumen of the needle, as shown in
[0088] Another aspect of the implants of the present disclosure is the ability to impart a surface modification (see
[0089] While a number of exemplary aspects and embodiments have been discussed above, those of skill in the art will recognize that still further modifications, permutations, additions and sub-combinations thereof of the features of the disclosed embodiments are still possible.