Cartridge hub with active valve
09597462 ยท 2017-03-21
Assignee
Inventors
Cpc classification
A61M5/20
HUMAN NECESSITIES
A61M2005/2481
HUMAN NECESSITIES
A61M5/2448
HUMAN NECESSITIES
A61M5/345
HUMAN NECESSITIES
F04C2270/0421
MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
A61M5/3294
HUMAN NECESSITIES
A61M5/14244
HUMAN NECESSITIES
A61M2005/3117
HUMAN NECESSITIES
A61M5/19
HUMAN NECESSITIES
A61M2005/2474
HUMAN NECESSITIES
A61M5/14566
HUMAN NECESSITIES
A61M5/16827
HUMAN NECESSITIES
International classification
A61M5/32
HUMAN NECESSITIES
A61M5/20
HUMAN NECESSITIES
A61M5/19
HUMAN NECESSITIES
Abstract
The invention is related to a dispense interface for a drug delivery device for delivering at least two drug agents, wherein the dispense interface is configured to be coupled to a cartridge holder of the drug delivery device, wherein the cartridge holder is configured to hold at least two cartridges, wherein the dispense interface comprises at least two inlet channels, each comprising a fluid inlet opening, wherein each fluid inlet opening is configured to receive fluid from a respective cartridge of the at least two cartridges when the dispense interface is axially coupled to the cartridge holder, an outlet channel comprising a fluid outlet opening, a valve structure configured to be selectively moved into any one of a plurality of positions, wherein in at least one position the valve structure selectively permits or prevents fluid flow from any of the at least two inlet channels to the outlet channel. The invention is further related to a drug delivery device for delivering at least two drug agents comprising a dispense interface of the aforementioned kind.
Claims
1. A dispense interface for a drug delivery device for delivering at least two drug agents, wherein the dispense interface is configured to be axially coupled to a cartridge holder of the drug delivery device, wherein the cartridge holder is configured to hold at least two cartridges, wherein the dispense interface comprises: at least two inlet channels, each comprising a fluid inlet opening configured to receive fluid from a respective cartridge of the at least two cartridges when the dispense interface is axially coupled to the cartridge holder; an outlet channel comprising a fluid outlet opening; and a valve structure configured to be selectively moved into any one of a plurality of positions when the dispense interface is coupled to the cartridge holder, wherein in at least one position the valve structure selectively permits or prevents fluid flow from any of the at least two inlet channels to the outlet channel, wherein the valve structure comprises a coupling structure configured to engage a valve coupling feature of the cartridge holder when the dispense interface is coupled to the cartridge holder, and wherein, when the valve structure is in at least one blocking position of the plurality of positions, the coupling structure is configured to block the engaging of the valve coupling feature of the cartridge holder, thereby preventing coupling of the dispense interface to the cartridge holder.
2. The dispense interface of claim 1, wherein: the valve structure is a rotating valve configured to move into any one of a plurality of positions by a rotating movement.
3. The dispense interface of claim 1, wherein: the valve structure comprises a fluid transfer pathway on a lateral surface of the valve structure, which fluid transfer pathway is configured to permit, in at least one of the plurality of positions, fluid flow from any one inlet channel to the outlet channel and to prevent fluid flow from the other inlet channels to the outlet channel.
4. The dispense interface of claim 3, wherein: the fluid transfer pathway is a groove.
5. The dispense interface of claim 1, wherein: the coupling structure is a notch and the valve coupling feature is a protrusion.
6. The dispense interface of claim 1, wherein: the coupling structure is configured to enable moving the valve structure into any one of the plurality of positions by the cartridge holder when the coupling structure is engaged to the valve coupling feature.
7. The dispense interface of claim 1, comprising: a valve driving construction configured to selectively move the valve structure into any of the plurality of positions.
8. The dispense interface of claim 7, wherein: the valve driving construction comprises an electrical motor configured to move the valve structure.
9. The dispense interface of claim 8, wherein: the valve driving construction comprises at least one electric contact configured to receive electrical signals from the cartridge holder.
10. The dispense interface of claim 9, wherein: the electrical motor is configured to move the valve structure based on the electrical signals received from the cartridge holder.
11. The dispense interface of claim 1, wherein: the valve structure comprises a propelling feature configured to engage a linking arrangement of the cartridge holder; configured to pull the cartridge holder towards the dispense interface when the valve structure is moved into an attachment position of the plurality of positions; and configured to push the cartridge holder away from the dispense interface when the valve structure is moved into a detachment position of the plurality of positions.
12. The dispense interface of claim 11, wherein: the propelling feature is a groove and the linking arrangement is a ridge.
13. Drug delivery device for delivering at least two drug agents comprising a dispense interface according to claim 1.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) 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, in which:
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DETAILED DESCRIPTION
(17) Before describing the embodiment, of the invention, an exemplary embodiment of a drug delivery device is explained, which can be used for applying the invention. The drug delivery device illustrated in
(18) The main body 14 contains a micro-processor control unit, an electro-mechanical drive train, and at least two medicament reservoirs. When the end cap or cover 18 is removed from the device 10 (as illustrated in
(19) The drive train may exert a pressure on the bung of each cartridge, respectively, in order to expel the doses of the first and second medicaments. For example, a piston rod may push the bung of a cartridge forward a pre-determined amount for a single dose of medicament. When the cartridge is empty, the piston rod is retracted completely inside the main body 14, so that the empty cartridge can be removed and a new cartridge can be inserted.
(20) A control panel region 60 is provided near the proximal end of the main body 14. Preferably, this control panel region 60 comprises a digital display 80 along with a plurality of human interface elements that can be manipulated by a user to set and inject a combined dose. In this arrangement, the control panel region comprises a first dose setting button 62, a second dose setting button 64 and a third button 66 designated with the symbol OK. In addition, along the most proximal end of the main body, an injection button 74 is also provided (not visible in the perspective view of
(21) The cartridge holder 40 can be removably attached to the main body 14 and may contain at least two cartridge retainers 50 and 52. Each retainer is configured so as to contain one medicament reservoir, such as a glass cartridge. Preferably, each cartridge contains a different medicament.
(22) In addition, at the distal end of the cartridge holder 40, the drug delivery device illustrated in
(23) Once the device is turned on, the digital display 80 shown in
(24) As shown in
(25) As mentioned above when discussing
(26) In
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(28) The needle assembly 400 illustrated in
(29) Similarly, a second or proximal piercing end 406 of the needle assembly 400 protrudes from an opposite side of the circular disc so that it is concentrically surrounded by the sleeve 403. In one needle assembly arrangement, the second or proximal piercing end 406 may be shorter than the sleeve 403 so that this sleeve to some extent protects the pointed end of the back sleeve. The needle cover cap 420 illustrated in
(30) Referring now to
(31) a. a main outer body 210,
(32) b. an first inner body 220,
(33) c. a second inner body 230,
(34) d. a first piercing needle 240,
(35) e. a second piercing needle 250,
(36) f. a valve seal 260, and
(37) g. a septum 270.
(38) The main outer body 210 comprises a main body proximal end 212 and a main body distal end 214. At the proximal end 212 of the outer body 210, a connecting member is configured so as to allow the dispense interface 200 to be attached to the distal end of the cartridge holder 40. Preferably, the connecting member is configured so as to allow the dispense interface 200 to be removably connected the cartridge holder 40. In one preferred interface arrangement, the proximal end of the interface 200 is configured with an upwardly extending wall 218 having at least one recess. For example, as may be seen from
(39) Preferably, the first and the second recesses 217, 219 are positioned within this main outer body wall so as to cooperate with an outwardly protruding member located near the distal end of the cartridge housing 40 of the drug delivery device 10. For example, this outwardly protruding member 48 of the cartridge housing may be seen in
(40) The main outer body 210 and the distal end of the cartridge holder 40 act to form an axially engaging snap lock or snap fit arrangement that could be axially slid onto the distal end of the cartridge housing. In one alternative arrangement, the dispense interface 200 may be provided with a coding feature so as to prevent inadvertent dispense interface cross use. That is, the inner body of the hub could be geometrically configured so as to prevent an inadvertent cross use of one or more dispense interfaces.
(41) A mounting hub is provided at a distal end of the main outer body 210 of the dispense interface 200. Such a mounting hub can be configured to be releasably connected to a needle assembly. As just one example, this connecting means 216 may comprise an outer thread that engages an inner thread provided along an inner wall surface of a needle hub of a needle assembly, such as the needle assembly 400 illustrated in
(42) The dispense interface 200 further comprises a first inner body 220. Certain details of this inner body are illustrated in
(43) In addition, as can be seen in
(44) Preferably, this dispense interface 200 further comprises a valve arrangement. Such a valve arrangement could be constructed so as to prevent cross contamination of the first and second medicaments contained in the first and second reservoirs, respectively. A preferred valve arrangement may also be configured so as to prevent back flow and cross contamination of the first and second medicaments.
(45) In one preferred system, dispense interface 200 includes a valve arrangement in the form of a valve seal 260. Such a valve seal 260 may be provided within a cavity 231 defined by the second inner body 230, so as to form a holding chamber 280. Preferably, cavity 231 resides along an upper surface of the second inner body 230. This valve seal comprises an upper surface that defines both a first fluid groove 264 and second fluid groove 266. For example,
(46) Together, the first and second grooves 264, 266 converge towards the non-return valves 262 and 268 respectively, to then provide for an output fluid path or a holding chamber 280. This holding chamber 280 is defined by an inner chamber defined by a distal end of the second inner body both the first and the second non return valves 262, 268 along with a pierceable septum 270. As illustrated, this pierceable septum 270 is positioned between a distal end portion of the second inner body 230 and an inner surface defined by the needle hub of the main outer body 210.
(47) The holding chamber 280 terminates at an outlet port of the interface 200. This outlet port 290 is preferably centrally located in the needle hub of the interface 200 and assists in maintaining the pierceable seal 270 in a stationary position. As such, when a double ended needle assembly is attached to the needle hub of the interface (such as the double ended needle illustrated in
(48) The hub interface 200 further comprises a second inner body 230. As can be seen from
(49) Axially sliding the main outer body 210 over the distal end of the drug delivery device attaches the dispense interface 200 to the multi-use device. In this manner, a fluid communication may be created between the first needle 240 and the second needle 250 with the primary medicament of the first cartridge and the secondary medicament of the second cartridge, respectively.
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(51) When the interface 200 is first mounted over the distal end of the cartridge holder 40, the proximal piercing end 244 of the first piercing needle 240 pierces the septum of the first cartridge 90 and thereby resides in fluid communication with the primary medicament 92 of the first cartridge 90. A distal end of the first piercing needle 240 will also be in fluid communication with a first fluid path groove 264 defined by the valve seal 260.
(52) Similarly, the proximal piercing end 254 of the second piercing needle 250 pierces the septum of the second cartridge 100 and thereby resides in fluid communication with the secondary medicament 102 of the second cartridge 100. A distal end of this second piercing needle 250 will also be in fluid communication with a second fluid path groove 266 defined by the valve seal 260.
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(54) As illustrated in
(55) In one preferred arrangement, the dispense interface is configured so that it attaches to the main body in only one orientation, that is it is fitted only one way round. As such as illustrated in
(56) Referring now to
(57) Further, the dispense interface 402 also comprises a third channel, which is an outlet channel 424 with a fluid outlet opening 426. The fluid outlet opening leads to a needle assembly with an injection needle (not shown).
(58) The dispense interface 402 further comprises a valve structure 420, which is here a rotating valve, arranged along a central longitudinal axis of the dispense interface 402. This valve 420 provides a fluid transfer pathway 428. In one of two open positions, the rotating valve 420 enables a fluid connection between the first inlet channel 404 and the outlet channel 424 or between the second inlet channel 406 and the outlet channel 424. In a closing position, illustrated in
(59) The rotating valve 420 has a coupling structure, which in the present case is a notch 430. The notch 430 protrudes from the dispense interface 402 in a proximal direction of the dispense interface 402, i.e. facing the cartridge holder. This notch 430 is configured for insertion of a valve coupling feature of the cartridge holder, which in general may be a protrusion. In the particular case illustrated, the protrusion is a peg 432 of the chassis or cartridge holder. Notch 430 and peg 432 share the same cross-section. Because of the shape of the cross-section, illustrated in
(60) When the peg 432 is inserted into the notch 430, the operation of the rotating valve 420 can be controlled by the peg 432. Therefore the rotating valve 420 can for example be controlled by further control logic implemented outside the dispense interface 402, for example by the micro-processor control unit of the main body 14.
(61) A typical operation of the dispense interface 402 shall now be described. The cartridge holder with two cartridges 416, 418 is ready to be coupled to the dispense interface 402. The peg 432 of the cartridge holder is oriented identically to the notch 430, thereby enabling the coupling, during which the peg 432 is inserted into the notch 430, thereby engaging the notch 430.
(62) In the initial orientation, shown in
(63) As part of the drug delivery procedure, the primary medicament from the first cartridge 416 is to be injected. To that end, the peg 432 turns the rotating valve 420 in an anti-clockwise direction until the transfer pathway 428 creates a fluid connection between the first inlet channel 404 and the outlet channel 424. Now the bung in the first cartridge 416 advances, thereby discharging the primary medicament from the first cartridge 416 via the fluid outlet 426 to the injection needle. The bung advances in the first cartridge 416 until the desired amount of primary medicament has been injected.
(64) Once the injection of the primary medicament is complete, the peg 432 turns the rotating valve 420 further still in an anti-clockwise direction until the transfer pathway 428 creates a fluid connection between the second inlet channel 406 and the outlet channel 424.
(65) Then the bung in the second cartridge 418 advances, discharging the secondary medicament from the second cartridge 418 via the fluid outlet 426 to the injection needle.
(66) Once the injection of the secondary medicament is complete, the peg 432 turns the rotating valve 420 to a position in which the orientation of the notch 430 is not identical to the orientation of the notch 430 in the initial state, i.e. different from the orientation shown in
(67) Alternatively to moving the peg 432 to a position in which the orientation of the notch 430 is not identical to the initial state only after injection, the peg 432 can be moved to such a position already directly after attachment of the dispense interface to the chassis or cartridge holder. After each injection, the peg 432 then moves the notch 430 to this position again.
(68) After the dispense interface is removed, the peg 432 moves back into the initial position for attachment of a new dispense interface.
(69) Removal of the used dispense interface may be detected by a sensor or switch in the cartridge holder, the chassis of the drug delivery device, or even in the peg 432. The sensor or switch may be triggered by a corresponding mechanical structure (e.g. a wall or a surface) of the dispense interface.
(70) Thus, when the dispense interface 402 is removed from the cartridge holder or chassis of the drug delivery device and a re-coupling of the used dispense interface 402 is attempted, the coupling of the used dispense interface 402 to the cartridge holder or chassis will not succeed because the notch 430 of the used dispense interface 402 will not be able to engage the peg 432 with a different alignment. As the peg 432 has moved back into the initial position, only a new, unused cartridge hub can be attached. Thereby reuse of the dispense interface 402 is prevented.
(71) Attaching and removing the dispense interface to the drug delivery device may therefore comprise the following steps, provided that the peg 432 of the drug delivery device is in the initial position for attachment of a new dispense interface: detecting attachment of a new dispense interface, for example by a switch or sensor; optionally, locking the dispense interface to the chassis or cartridge holder; operating the valve in the cartridge holder through the peg 432, i.e. opening or closing one or more fluid paths in the valve; moving the valve to a closed position (i.e. a position in which all fluid paths are closed) different from the initial position; detecting removal of the dispense interface, for example by the switch or sensor; and moving/turning the peg 432 back into the initial position for attachment of a new dispense interface.
(72) Alternatively, attaching and removing the dispense interface to the drug delivery device may comprise the following steps. Here, the valve is moved to a different position directly after attachment of the dispense interface: detecting attachment of a new dispense interface, for example by a switch or sensor; optionally, locking the dispense interface to the chassis or cartridge holder; moving the valve to a closed position different from the initial position by rotation of peg 432; operating the valve in the cartridge holder through the peg 432, i.e. opening or closing one or more fluid paths in the valve; moving the valve to the closed position different from the initial position (this may be the same closed position as in the step above); detecting removal of the dispense interface, for example by the switch or sensor; and moving/turning the peg 432 back into the initial position for attachment of a new dispense interface.
(73) The step of detecting removal of the dispense interface may comprise detection of an eject button or switch that may be operated by a user. After the detection of the eject button press, the dispense interface may be unlocked, if it was previously locked to the device.
(74) The term drug or medicament, as used herein, means a pharmaceutical formulation containing at least one pharmaceutically active compound,
(75) wherein in one embodiment the pharmaceutically active compound has a molecular weight up to 1500 Da and/or is a peptide, a proteine, a polysaccharide, a vaccine, a DNA, a RNA, an enzyme, an antibody or a fragment thereof, a hormone or an oligonucleotide, or a mixture of the above-mentioned pharmaceutically active compound,
(76) wherein in a further embodiment the pharmaceutically active compound is useful for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy, thromboembolism disorders such as deep vein or pulmonary thromboembolism, acute coronary syndrome (ACS), angina, myocardial infarction, cancer, macular degeneration, inflammation, hay fever, atherosclerosis and/or rheumatoid arthritis,
(77) wherein in a further embodiment the pharmaceutically active compound comprises at least one peptide for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy,
(78) wherein in a further embodiment the pharmaceutically active compound comprises at least one human insulin or a human insulin analogue or derivative, glucagon-like peptide (GLP-1) or an analogue or derivative thereof, or exedin-3 or exedin-4 or an analogue or derivative of exedin-3 or exedin-4.
(79) Insulin analogues are for example 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 and Des(B30) human insulin.
(80) Insulin derivates are for example 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-(-carboxyheptadecanoyl)-des(B30) human insulin and B29-N-(-carboxyhepta-decanoyl) human insulin.
(81) Exendin-4 for example means 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.
(82) Exendin-4 derivatives are for example selected from the following list of compounds:
(83) H-(Lys)4-des Pro36, des Pro37 Exendin-4(1-39)-NH2,
(84) H-(Lys)5-des Pro36, des Pro37 Exendin-4(1-39)-NH2,
(85) des Pro36 [Asp28] Exendin-4(1-39),
(86) des Pro36 [IsoAsp28] Exendin-4(1-39),
(87) des Pro36 [Met(O)14, Asp28] Exendin-4(1-39),
(88) des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39),
(89) des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39),
(90) des Pro36 [Trp(O2)25, IsoAsp28] Exendin-4(1-39),
(91) des Pro36 [Met(O)14 Trp(O2)25, Asp28] Exendin-4(1-39),
(92) des Pro36 [Met(O)14 Trp(O2)25, IsoAsp28] Exendin-4(1-39); or
(93) des Pro36 [Asp28] Exendin-4(1-39),
(94) des Pro36 [IsoAsp28] Exendin-4(1-39),
(95) des Pro36 [Met(O)14, Asp28] Exendin-4(1-39),
(96) des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39),
(97) des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39),
(98) des Pro36 [Trp(O2)25, IsoAsp28] Exendin-4(1-39),
(99) des Pro36 [Met(O)14 Trp(O2)25, Asp28] Exendin-4(1-39),
(100) des Pro36 [Met(O)14 Trp(O2)25, IsoAsp28] Exendin-4(1-39),
(101) wherein the group -Lys6-NH2 may be bound to the C-terminus of the Exendin-4 derivative;
(102) or an Exendin-4 derivative of the sequence
(103) H-(Lys)6-des Pro36 [Asp28] Exendin-4(1-39)-Lys6-NH2,
(104) des Asp28 Pro36, Pro37, Pro38Exendin-4(1-39)-NH2,
(105) H-(Lys)6-des Pro36, Pro38 [Asp28] Exendin-4(1-39)-NH2,
(106) H-Asn-(Glu)5des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-NH2,
(107) des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(108) H-(Lys)6-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(109) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(110) H-(Lys)6-des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39)-Lys6-NH2,
(111) H-des Asp28 Pro36, Pro37, Pro38 [Trp(O2)25] Exendin-4(1-39)-NH2,
(112) H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-NH2,
(113) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-NH2,
(114) des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(115) H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(116) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(117) H-(Lys)6-des Pro36 [Met(O)14, Asp28] Exendin-4(1-39)-Lys6-NH2,
(118) des Met(O)14 Asp28 Pro36, Pro37, Pro38 Exendin-4(1-39)-NH2,
(119) H-(Lys)6-desPro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2,
(120) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2,
(121) des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(122) H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(123) H-Asn-(Glu)5 des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(124) H-Lys6-des Pro36 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-Lys6-NH2,
(125) H-des Asp28 Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25] Exendin-4(1-39)-NH2,
(126) H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2,
(127) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-NH2,
(128) des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2,
(129) H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(S1-39)-(Lys)6-NH2,
(130) H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2;
(131) or a pharmaceutically acceptable salt or solvate of any one of the aforementioned Exedin-4 derivative.
(132) Hormones are for example hypophysis hormones or hypothalamus hormones or regulatory active peptides and their antagonists as listed in Rote Liste, ed. 2008, Chapter 50, such as Gonadotropine (Follitropin, Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin), Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin, Buserelin, Nafarelin, Goserelin.
(133) A polysaccharide is for example a glucosaminoglycane, a hyaluronic acid, a heparin, a low molecular weight heparin or an ultra low molecular weight heparin or a derivative thereof, or a sulphated, e.g. a poly-sulphated form of the above-mentioned polysaccharides, and/or a pharmaceutically acceptable salt thereof. An example of a pharmaceutically acceptable salt of a poly-sulphated low molecular weight heparin is enoxaparin sodium.
(134) Antibodies are globular plasma proteins (150 kDa) that are also known as immunoglobulins which share a basic structure. As they have sugar chains added to amino acid residues, they are glycoproteins. The basic functional unit of each antibody is an immunoglobulin (Ig) monomer (containing only one Ig unit); secreted antibodies can also be dimeric with two Ig units as with IgA, tetrameric with four Ig units like teleost fish IgM, or pentameric with five Ig units, like mammalian IgM.
(135) The Ig monomer is a Y-shaped molecule that consists of four polypeptide chains; two identical heavy chains and two identical light chains connected by disulfide bonds between cysteine residues. Each heavy chain is about 440 amino acids long; each light chain is about 220 amino acids long. Heavy and light chains each contain intrachain disulfide bonds which stabilize their folding. Each chain is composed of structural domains called Ig domains. These domains contain about 70-110 amino acids and are classified into different categories (for example, variable or V, and constant or C) according to their size and function. They have a characteristic immunoglobulin fold in which two 0 sheets create a sandwich shape, held together by interactions between conserved cysteines and other charged amino acids.
(136) There are five types of mammalian Ig heavy chain denoted by , , , , and . The type of heavy chain present defines the isotype of antibody; these chains are found in IgA, IgD, IgE, IgG, and IgM antibodies, respectively.
(137) Distinct heavy chains differ in size and composition; and contain approximately 450 amino acids and approximately 500 amino acids, while and have approximately 550 amino acids. Each heavy chain has two regions, the constant region (CH) and the variable region (VH). In one species, the constant region is essentially identical in all antibodies of the same isotype, but differs in antibodies of different isotypes. Heavy chains , and have a constant region composed of three tandem Ig domains, and a hinge region for added flexibility; heavy chains and have a constant region composed of four immunoglobulin domains. The variable region of the heavy chain differs in antibodies produced by different B cells, but is the same for all antibodies produced by a single B cell or B cell clone. The variable region of each heavy chain is approximately 110 amino acids long and is composed of a single Ig domain.
(138) In mammals, there are two types of immunoglobulin light chain denoted by and . A light chain has two successive domains: one constant domain (CL) and one variable domain (VL). The approximate length of a light chain is 211 to 217 amino acids. Each antibody contains two light chains that are always identical; only one type of light chain, or , is present per antibody in mammals.
(139) Although the general structure of all antibodies is very similar, the unique property of a given antibody is determined by the variable (V) regions, as detailed above. More specifically, variable loops, three each the light (VL) and three on the heavy (VH) chain, are responsible for binding to the antigen, i.e. for its antigen specificity. These loops are referred to as the Complementarity Determining Regions (CDRs). Because CDRs from both VH and VL domains contribute to the antigen-binding site, it is the combination of the heavy and the light chains, and not either alone, that determines the final antigen specificity.
(140) An antibody fragment contains at least one antigen binding fragment as defined above, and exhibits essentially the same function and specificity as the complete antibody of which the fragment is derived from. Limited proteolytic digestion with papain cleaves the Ig prototype into three fragments. Two identical amino terminal fragments, each containing one entire L chain and about half an H chain, are the antigen binding fragments (Fab). The third fragment, similar in size but containing the carboxyl terminal half of both heavy chains with their interchain disulfide bond, is the crystalizable fragment (Fc). The Fc contains carbohydrates, complement-binding, and FcR-binding sites. Limited pepsin digestion yields a single F(ab)2 fragment containing both Fab pieces and the hinge region, including the HH interchain disulfide bond. F(ab)2 is divalent for antigen binding. The disulfide bond of F(ab)2 may be cleaved in order to obtain Fab. Moreover, the variable regions of the heavy and light chains can be fused together to form a single chain variable fragment (scFv).
(141) Pharmaceutically acceptable salts are for example acid addition salts and basic salts. Acid addition salts are e.g. HCl or HBr salts. Basic salts are e.g. salts having a cation selected from alkali or alkaline, e.g. Na+, or K+, or Ca2+, or an ammonium ion N+(R1)(R2)(R3)(R4), wherein R1 to R4 independently of each other mean: hydrogen, an optionally substituted C1 C6-alkyl group, an optionally substituted C2-C6-alkenyl group, an optionally substituted C6-C10-aryl group, or an optionally substituted C6-C10-heteroaryl group. Further examples of pharmaceutically acceptable salts are described in Remington's Pharmaceutical Sciences 17. ed. Alfonso R. Gennaro (Ed.), Mark Publishing Company, Easton, Pa., U.S.A., 1985 and in Encyclopedia of Pharmaceutical Technology.
(142) Pharmaceutically acceptable solvates are for example hydrates.