INGESTIBLE DEVICE WITH DELIVERY MEMBER DETACHMENT
20220313967 · 2022-10-06
Inventors
- Morten Revsgaard Frederiksen (Copenhagen K, DK)
- Brian Jensen (Broenshoej, DK)
- Mikkel Oliver Jespersen (Copenhagen N, DK)
- Mette Poulsen (Glostrup, DK)
Cpc classification
A61M5/2033
HUMAN NECESSITIES
A61M5/3202
HUMAN NECESSITIES
A61M5/3287
HUMAN NECESSITIES
A61M5/286
HUMAN NECESSITIES
International classification
A61M31/00
HUMAN NECESSITIES
A61M5/20
HUMAN NECESSITIES
A61M5/28
HUMAN NECESSITIES
Abstract
An ingestible device is disclosed suitable for swallowing into a lumen of a gastrointestinal tract of a patient, the lumen having a lumen wall. The ingestible device (100, 200) comprises: a capsule (110, 120), a delivery member (130) being shaped to penetrate tissue of a lumen wall and having a tissue penetrating end and a trailing end, the delivery member (130) comprising a therapeutic payload, a ram (150) attached relative to the delivery member (130) at the trailing end; and an actuator (140) coupled to the ram (150) and having a first configuration and a second configuration, the delivery member (130) being retained by the ram (150) within the capsule (110, 120) when the actuator (140) is in the first configuration, wherein the delivery member (130) is configured to be advanced from the capsule (110, 120) and into the lumen wall by movement of the actuator (140) from the first configuration to the second configuration such that the delivery member (130) moves along a predefined trajectory. The ram (150) is configured for being tilted relative to the predefined trajectory upon the actuator (140) moving into the second configuration to detach at least a portion of the delivery member (130) from the ram (150) such that the detached portion of the delivery member (130) remains within the lumen wall to release therapeutic payload.
Claims
1. An ingestible device suitable for swallowing into a lumen of a gastrointestinal tract of a patient, the lumen having a lumen wall, the ingestible device comprising: a capsule sized to be ingested by a patient; a delivery member disposable in the capsule, the delivery member being shaped to penetrate tissue of the lumen wall and having a tissue penetrating end and a trailing end opposite the tissue penetrating end, the delivery member comprising a therapeutic payload or being configured to deliver a therapeutic payload from a reservoir; a ram attached relative to the delivery member at the trailing end; and an actuator coupled to the ram and having a first configuration and a second configuration, the delivery member being retained by the ram within the capsule when the actuator is in the first configuration, wherein the delivery member is configured to be advanced from the capsule and into the lumen wall by movement of the actuator from the first configuration to the second configuration such that the delivery member moves along a predefined trajectory, wherein the ram is configured for being tilted relative to the predefined trajectory upon the actuator moving into the second configuration to detach at least a portion of the delivery member from the ram such that the detached portion of the delivery member remains within the lumen wall to release therapeutic payload.
2. The ingestible device as in claim 1, wherein the delivery member is a solid formed entirely from a preparation comprising the therapeutic payload, wherein the delivery member is made from a dissolvable material that dissolves when inserted into tissue of the lumen wall to deliver at least a portion of the therapeutic payload into tissue.
3. The ingestible device as in claim 1, wherein an exterior portion of the delivery member is made from a dissolvable solid material that dissolves when inserted into tissue of the lumen wall.
4. The ingestible device as in claim 3, wherein the exterior portion of the delivery member defines an enclosure, and wherein a preparation comprising the therapeutic payload forms a liquid, gel or powder accommodated within the enclosure.
5. The ingestible device as in claim 3, wherein the delivery member is an injection needle, and wherein the therapeutic payload is provided as a liquid, gel or powder being expellable through the injection needle from a reservoir within the capsule.
6. The ingestible device as in claim 1, wherein the delivery member forms an elongated member that, when the actuator assumes the first configuration, extends along a longitudinal axis, and wherein the predefined trajectory defines an axis coaxial with the longitudinal axis.
7. The ingestible device as in claim 1, wherein the delivery member forms an elongated member that extends along a curve, and wherein the predefined trajectory extends along said curve.
8. The ingestible device as in claim 1, wherein the capsule comprises a stop surface and the ram comprises a counter stop surface configured for engaging the stop surface of the capsule, wherein the stop surface of the capsule and the counter stop surface of the ram are formed to induce a tilting movement of the ram upon the actuator moving into the second configuration.
9. The ingestible device as in claim 1, wherein the capsule comprises a stop surface and the ram comprises a counter stop surface configured for engaging the stop surface of the capsule, wherein at least one of the stop surface and the counter stop surface comprises an eccentrically disposed protrusion, wherein the other of the stop surface and the counter stop surface is formed as a substantially planar surface, and wherein the protrusion and the planar surface induce a tilting movement of the ram upon the actuator moving into the second configuration.
10. The ingestible device as in claim 1, wherein the ram comprises an interface portion and wherein the trailing end of the delivery member attaches relative to the interface portion of the ram.
11. The ingestible device as in claim 10, wherein the trailing end of the delivery member attaches relative to the interface portion of the ram by structure of an adhesive.
12. The ingestible device as in claim 10, wherein the trailing end of the delivery member attaches relative to the interface portion of the ram by structure of one of a friction fit and a press fit.
13. The ingestible device as in claim 10, wherein the ram is configured upon firing to move the ram from a first position to a second position so that a major portion of the delivery member is inserted in tissue at a target location within the lumen wall, and wherein at least a portion of the delivery member is configured for detachment relative to the interface portion of the ram when the ram assumes the second position due to said tilting of the ram.
14. The ingestible device as in claim 1, wherein the actuator comprises a drive spring, such as a compression spring, the spring being strained or configured for being strained for powering the ram.
15. The ingestible device as in any of claim 1, wherein the ingestible device is configured as a self-righting capsule device, wherein when the self-righting capsule device is at least partially supported by the tissue of the lumen wall, the self-righting capsule device orients in a direction to allow the delivery member to be inserted into the lumen wall to deliver at least a portion of the therapeutic payload into the tissue.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0045] In the following embodiments of the invention will be described with reference to the drawings, wherein
[0046]
[0047]
[0048]
[0049]
[0050]
[0051]
[0052] In the figures like structures are mainly identified by like reference numerals.
DESCRIPTION OF EXEMPLARY EMBODIMENTS
[0053] When in the following terms such as “upper” and “lower”, “right” and “left”, “horizontal” and “vertical” or similar relative expressions are used, these only refer to the appended figures and not necessarily to an actual situation of use. The shown figures are schematic representations for which reason the configuration of the different structures as well as their relative dimensions are intended to serve illustrative purposes only. When the term member or element is used for a given component it generally indicates that in the described embodiment the component is a unitary component, however, the same member or element may alternatively comprise a number of sub-components just as two or more of the described components could be provided as unitary components, e.g. manufactured as a single injection moulded part. The terms “assembly” and “subassembly” do not imply that the described components necessarily can be assembled to provide a unitary or functional assembly or subassembly during a given assembly procedure but is merely used to describe components grouped together as being functionally more closely related.
[0054] With reference to
[0055] The ingestible self-righting capsule device 100 comprises a first portion 100A having an average density, a second portion 100B having an average density different from the average density of the first portion 100A. The capsule device 100 accommodates a payload portion 130 for carrying an agent for release internally of a subject user that ingests the article. In the shown embodiment, the average density of capsule device prior to deployment is larger than that of gastrointestinal fluid, enabling the capsule device to sink to the bottom of the stomach lumen. The outer shape of the self-righting article is a gomboc shape, i.e. a gomboc-type shape that, when placed on a surface in any orientation other than a single stable orientation of the shape, then the shape will tend to reorient to its single stable orientation.
[0056] The capsule device shown includes an upper (proximal) capsule part 110 which mates and attaches to a lower (distal) capsule part 120. The upper capsule part 110 and the lower capsule part 120 together forms the capsule of the device. The capsule defines an interior hollow which accommodates the payload portion 130, a ram 150 which holds and drives forward the payload portion 130, and a firing and propulsion mechanism including an actuator configured to fire and drive forward the ram with the payload for drug delivery. The payload portion 130 is oriented along a firing axis and configured for movement along the firing axis. In the shown embodiment, the upper and lower capsule parts 110, 120 form rotation symmetric parts which are symmetric around the firing axis. In the drawings, the device is oriented with the firing axis pointing vertically, and with the payload portion 130 pointing vertically downwards towards an exit hole 124 arranged centrally in the lower capsule part 120, the exit hole allowing the payload portion 130 to be transported through exit hole and moved outside the capsule device 100. The lower part 120 includes a tissue engaging surface 123 which is formed as a substantially flat lower outer surface surrounding the exit hole 124.
[0057] Regarding suitable materials for the capsule parts for the embodiment shown in
[0058] In the shown embodiment, due to the density distribution of the entire capsule device 100, and due to the outside shape of the device, the capsule device 100 will tend to orient itself with the firing axis substantially perpendicular to the surface (e.g., a surface substantially orthogonal to the force of gravity, a surface of a tissue such as the wall of the gastrointestinal tract). Hence, the capsule device tends to orient relative to the direction of gravity so that the tissue engaging surface 123 faces vertically downward.
[0059] The interior of the upper capsule part 110 includes a sleeve shaped ram guiding structure 115 which extends concentrically with the firing axis from the upper part of the upper capsule part 110 towards a ram stop surface 128 defined by an inner bottom surface formed in the lower capsule part 120, i.e. a proximally facing stop surface. Further, in the shown embodiment, a second sleeve shaped structure 114 extends concentrically with the firing axis and radially inside the ram guiding structure 115 from the upper capsule part 110 and downwards along the firing axis. The second sleeve shaped structure 114 serves as a retainer structure for retaining the ram 150 against the drive force emanating from a strained drive spring 140 arranged within the capsule, i.e. the drive spring serves as an actuator for driving forward the ram from a first position to a second position. In the shown embodiment, the retainer structure has a radially inwards protruding retainer portion 113 arranged at the lower end of the retainer structure. In the shown embodiment, the retainer portion 113 is provided as two opposed radially inwards protruding arc-shaped protrusions.
[0060] In the first embodiment shown in
[0061] The ram 150 comprises an upper retaining part 151 and a lower interface part 155 configured for holding the trailing end of the payload portion 130 in place. In the shown embodiment, the interface part includes a downward open bore that receives the trailing end of the payload portion 130 in a way so that the payload portion 130 is firmly attached within the bore. The lower interface part 155 further defines an annular outer flange having a diameter slightly smaller than the diameter of the ram guiding structure 115. In the shown embodiment, the ram 150 is movable, while being guided for axial movement by the ram guiding structure 115, from a pre-firing configuration shown in
[0062] With regard to the above-mentioned drive spring 140, in capsule device 100, a helical compression spring is arranged coaxially with the firing axis. The proximal end of drive spring 140 is seated against a spring seat of upper capsule part 110, i.e. located radially between the ram guiding structure 115 and the retainer structure. The distal end of drive spring 140 is seated against a spring seat formed by a proximal surface of the flange defined by the lower interface part 155 of the ram 150. As part of assembling the capsule device 100 the drive spring 140 has been energized by axially compressing the drive spring 140 between the two spring seats. Hence, the ram is initially under load from drive spring, such as in the order of 10-30 N. Alternatives to using a compression spring for generating the drive force, other spring configurations may be used to energize the capsule device 100, such as a torsion spring, a leaf spring, a constant-force spring or similar. In further alternatives, a gas spring or a gas generator may be used.
[0063] The upper retaining part 151 of the ram 150 includes deflectable latches provided in the form of two deflectable arms 152 which extend in distal direction from the upper end of the ram towards the exit opening 124, each arm being resiliently deflectable in the radial inwards direction. The end of each deflectable arm 152 includes a blocking portion 153 protruding radially outwards from the resilient arm. In the pre-firing configuration shown in
[0064] In the pre-firing configuration a dissolvable pellet 160 is arranged between the two deflectable arms 152 so that radial opposing surfaces of the pellet 160 engage a radially inwards facing support surface of the two deflectable arms 152. In the shown embodiment, the pellet 160 is arranged in a compartment inside the upper capsule part 110, and a proximally arranged upper opening in upper capsule part 110 facilitates fluid exposure to the dissolvable pellet when the capsule device is submerged in a fluid. In the pre-firing configuration shown in
[0065] In the shown embodiment, the interface between the retainer portions 113 and the blocking portions 153 is sloped by approximately 30° so that the deflectable arms will slide inwards when the dissolvable pellet is dissolved. The angle determines the shear forces on the pellet and to which degree the deflectable arms will tend to slide inwards when subjected to the load force. In connection with the acceleration length of the ram when fired, the optimal angle is 0°, but it requires a much higher spring force to activate such configuration. For the sloped portions, in other embodiments, angles other than 30° may be used.
[0066]
[0067] In situation of intended use, the payload portion 130 is inserted into tissue of the lumen wall where it will anchor generally in a direction along the firing axis. However, at the end of the drive stroke, and due to the tilting action of the ram 150, a bending torque is applied onto payload portion 130 tending to break or otherwise release the connection between payload 130 and ram 150. This effect is introduced to enable the payload portion 130 to become forcedly separated from the ram 150 to prevent that payload portion 130 becomes withdrawn from the tissue after it has been properly lodged within the tissue.
[0068] At this point the capsule device 100 has delivered the intended dose and will release relative to the deposited payload portion 130 which rests inside the tissue wall. Subsequently, the remaining parts of the capsule device will travel out through the digestive system of the user and be disposed of.
[0069] If the payload 130 where still fixedly connected to ram 150, and thus also to the remaining parts of the capsule device 100, the likelihood that payload portion would become retracted from the tissue by movements of the capsule device relative to the target location would be high.
[0070] In the shown embodiment, the tilting motion of ram 150 upon reaching the end destination is obtained by forming an eccentrically arranged protrusion 158 on the distally facing surface of interface part 155 of ram 150. As proximally facing ram stop surface 128 defined by the inner bottom surface formed in the lower capsule part 120 is planar, and oriented orthogonally to the firing axis, a tilting effect is obtained as ram 150 meets the ram stop surface 128. As will be discussed further below, the tilting effect may be obtained by a variety of alternative geometrical designs. Also, as shown in connection with
[0071] For the dissolvable member discussed above, i.e. the dissolvable pellet 160 forming a dissolvable firing member, different forms and compositions may be used. Non-limiting examples include injection moulded Isomalt pellets, compressed granulate Isomalt pellets, compressed pellets made from a granulate composition of Citrate/NaHCO3, or compressed pellets made from a granulate composition of Isomalt/Citrate/NaHCO3. A non-limiting exemplary size of a dissolvable pellet is a pellet which at the time of manufacturing measures Ø1×3 mm.
[0072] In the shown example of ram 150 the upper retaining part 151 is formed as a chamber wherein the dissolvable pellet 160 is received within the chamber having a tight fit. In the shown embodiment, the central upper part of capsule device 100 includes a single opening for introducing stomach fluid within the capsule. In other embodiments, the capsule may include other design of fluid inlet openings such as multiple openings distributed around the capsule. In some designs, the payload portion 130 is accommodated in a chamber that is fluidly sealed from the chamber of the dissolvable pellet. Also, the exit hole 124 may include a seal preventing moisture from entering the payload portion chamber prior to firing of the capsule device 100.
[0073] Turning now to
[0074] Design no. 1 includes a ram 150 having a central pin 156.I extending from lower interface part 155 of the ram 150. Payload portion 130 is correspondingly formed with a central opening configured for receiving central pin 156.I.
[0075] Design no. 11 includes a ram 150 having a central conical protrusion 156.II extending from lower interface part 155 of the ram 150. Payload portion 130 is correspondingly formed with a central conical depression configured for mating with and receiving conical protrusion 156.II.
[0076] Design no. III includes a ram 150 having a central conical depression 156.III at the distal facing surface of lower interface part 155 of ram 150. Payload portion 130 is correspondingly formed with a central conical protrusion configured for mating with and receiving conical protrusion 156.III.
[0077] The above described four different variants of interfaces between the payload portion 130 and the ram 150 are only exemplary and other configurations may be used instead. The detachable attachment between the payload portion and the ram may be obtained by using a friction or press fit. Alternatively, an adhesive may be used at the interface, such as sucrose. Still alternatively, the attachment may be obtained by initially wetting the payload portion and utilizing inherent stiction between the ram and the payload portion. In situation of use, upon the ram reaching its final destination, detachment may occur at the interface between the payload portion and the ram. In other embodiments, a desired detachment may be obtained by detaching a major portion of the payload portion from the remaining payload portion being still adhered or fastened to the ram. In some embodiments, the payload portion includes a weakened point which determines the point of separation. In still further embodiments, as discussed further below, the ram and the payload portion may be formed as a unitary component all made of a composition containing API, and wherein the intended payload portion to be pushed out from capsule device is separated from the ram portion.
[0078]
[0079] In
[0080] Design no. II also includes an upwardly extending retaining structure 113 wherein a major portion of the ram is suspended. In this embodiment, the ram includes proximally extending delectable arms having blocking elements on the proximal ends of the deflectable arms 152, and wherein the proximal ends of the arms are designed to flex radially inwards when a centrally located dissolvable firing member 160 is sufficiently dissolved.
[0081] The figure depicting design no. III shows a related configuration but wherein the ram only includes a single deflectable arm. In this design a non-deflectable structure is arranged on the side of the dissolvable firing member 160 on the side facing away from the single deflectable arm. The non-deflectable structure continuously supports the dissolvable firing member 160 on one side thereof whereas the opposing side makes room for the single deflectable latch arm to move radially inwards and pass the retainer portion 113.
[0082] Finally, design no. IV schematically shows an example wherein the deflectable latch and the retainer portions have swapped places. In this design the ram includes an upper retaining portion 151′ with retainer portions 153′ which are designed not to exhibit any flexure during firing of the actuation mechanism. The retaining structure (associated with either the upper capsule part or the lower capsule part) instead includes two deflectable latches in the form of distally extending deflectable latch arms 112′, each having a blocking portion 153′ at its most distal end. Each deflectable arm 112′ is configured to engage a respective dissolvable firing member 160′. Said respective dissolvable firing members 160′ may thus be provided as a common ring-shaped member or be provided as a plurality of separate members arranged in a ring-configuration around the firing axis. As noted above, in some embodiments, the payload may act as a ram by itself to be partly or fully disconnected from the remainder of the capsule device. Such API based ram may include retainer portions which are designed not to exhibit any flexure during firing of the actuation mechanism where the retainer portions are allowed to pass cooperating deflectable latches associated with the housing of the capsule, e.g. the upper or lower capsule parts.
[0083]
[0084] With reference to
[0085] With regard to the self-righting ability and the firing principle, the second embodiment capsule device 200 generally corresponds to the overall design of the first embodiment 100, but the way the ram is moved from the first position to the second position is different. In the shown second embodiment, the ram 150 is movable, while being guided for movement by a system of track and track followers, from a pre-firing configuration shown in
[0086] The interior of the upper capsule part 110 again includes a sleeve shaped ram guiding structure 115 which extends concentrically with the firing axis from the upper part of the upper capsule part 110 towards the lower capsule part 120. Further, in the second embodiment, a second sleeve shaped structure 114 extends concentrically with the firing axis and radially inside the ram guiding structure 115 from the upper capsule part 110 and downwards along the firing axis. The second sleeve shaped structure again serves as a retainer structure for retaining the ram 150 against the drive force emanating from strained drive spring 140 arranged within the capsule, i.e. the drive spring serves as an actuator for driving forward the ram from a first position to a second position. In addition, in this embodiment, the second sleeve shaped structure 114 serves as an additional guide for guiding the ram during its movement from the first position to the second position. A first pair of opposed guiding tracks 115.I are formed in the ram guiding structure 115 whereas a second pair of opposed guiding tracks 114.I are formed in the second sleeve shaped structure 114. Each pair of opposed first and second guiding tracks includes a relatively long axially extending segment which extends in parallel with the firing axis and includes a relatively short angled segment being inclined with respect to the firing axis.
[0087] The ram 150 again comprises an upper retaining part 151 and a lower interface part 155 configured for holding the trailing end of the payload portion 130 in place. The lower interface part 155 defines an annular outer flange having a diameter slightly smaller than the diameter of the ram guiding structure 115. In the shown embodiment, the said guiding tracks and cooperating track followers define the movement of the ram 150 as it moves from the pre-firing configuration shown in
[0088] In the second embodiment capsule device 200, the flange of lower interface part 155 has two opposed track followers, each track follower being provided as a guide pin 155.I arranged to be guided by a respective one of the first pair of opposed guiding tracks 115.I. In addition, the upper retaining part 151 of the ram has two opposed track followers, each track follower being provided as a guide pin 151.I arranged to be guided by a respective one of the second pair of opposed guiding tracks 114.I.
[0089] When the capsule device is in the initial pre-firing configuration, cf.
[0090] Shortly before the ram reaches the end of stroke position, i.e. shortly before the ram assumes the position shown in
[0091] Similarly to what has been noted previously, the condition schematically shown in
[0092] A further alternative tilting mechanism is schematically shown in
[0093] As indicated in
[0094] Shortly before the ram reaches the end of stroke position, i.e. shortly before the ram assumes the position shown in
[0095] Although the above description of exemplary embodiments mainly concern ingestible capsules for delivery in the stomach, the present deployment principle generally finds utility in capsule devices for lumen insertion in general, wherein a capsule device is positioned into a body lumen for deployment of a delivery member. Non-limiting examples of capsule devices may include capsule devices for intestinal delivery of a drug by delivery into the tissue wall of an intestinal lumen, such as a lumen of the small intestines or a lumen of the large intestines. Drug delivery may be performed using a delivery member, such as a needle, or via microneedles which is/are inserted into the tissue wall, such as wherein a microneedle array is becoming detached relative to a ram.
[0096] In the above description of exemplary embodiments, the different structures and means providing the described functionality for the different components have been described to a degree to which the concept of the present invention will be apparent to the skilled reader. The detailed construction and specification for the different components are considered the object of a normal design procedure performed by the skilled person along the lines set out in the present specification.