U.S. patent application number 15/623305 was filed with the patent office on 2017-10-05 for method and device for transdermal delivery of parathyroid hormone using a microprojection array.
The applicant listed for this patent is Corium International, Inc.. Invention is credited to Danir Bayramov, Guohua Chen, Parminder Singh, Robert Wade Worsham.
Application Number | 20170281535 15/623305 |
Document ID | / |
Family ID | 44902423 |
Filed Date | 2017-10-05 |
United States Patent
Application |
20170281535 |
Kind Code |
A1 |
Singh; Parminder ; et
al. |
October 5, 2017 |
METHOD AND DEVICE FOR TRANSDERMAL DELIVERY OF PARATHYROID HORMONE
USING A MICROPROJECTION ARRAY
Abstract
A method and a drug delivery system for transdermally
administering parathyroid hormone (PTH) in a pulsatile fashion are
provided, where the drug delivery system comprises an array of
microprojections each comprising PTH.
Inventors: |
Singh; Parminder; (Union
City, CA) ; Bayramov; Danir; (Irvine, CA) ;
Chen; Guohua; (Sunnyvale, CA) ; Worsham; Robert
Wade; (Sutter Creek, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Corium International, Inc. |
Menlo Park |
CA |
US |
|
|
Family ID: |
44902423 |
Appl. No.: |
15/623305 |
Filed: |
June 14, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13101071 |
May 4, 2011 |
9687641 |
|
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15623305 |
|
|
|
|
61331226 |
May 4, 2010 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61K 47/36 20130101;
A61K 47/26 20130101; A61M 2037/0023 20130101; A61K 38/29 20130101;
A61K 47/34 20130101; A61M 37/0015 20130101; A61K 9/0021 20130101;
A61M 2037/0061 20130101; A61K 47/22 20130101; A61P 19/10
20180101 |
International
Class: |
A61K 9/00 20060101
A61K009/00; A61K 38/29 20060101 A61K038/29; A61K 47/34 20060101
A61K047/34; A61K 47/36 20060101 A61K047/36; A61K 47/22 20060101
A61K047/22; A61M 37/00 20060101 A61M037/00; A61K 47/26 20060101
A61K047/26 |
Claims
1. A method of transdermally administering a dose of PTH to a
mammalian subject, comprising: applying to a skin site of a subject
a microprotusion array comprising a plurality of microprotrusions
extending from an approximately planar base, each microprotrusion
comprising an end portion distal to the base and an upper portion
proximal to the base, the end portion comprising a tip of the
microprotrusion, at least the end portion comprising parathyroid
hormone (PTH) in a water-soluble polymer matrix, inserting all or a
portion of the plurality of microprotrusions into the skin, and
maintaining the array on the skin site for about 15 minutes or
less; whereby the method achieves an average time to maximum PTH
plasma concentration (T.sub.max) of about ten minutes or less.
2. The method of claim 1, wherein the PTH is human parathyroid
hormone (1-34).
3. The method of claim 1, wherein after the microprotrusions are
inserted into the skin, at least a portion of the end portions
including the tip of the plurality of microprotrusions detach from
the microprotrusion array.
4. The method of claim 1, wherein the water-soluble polymer matrix
comprises at least one water-soluble polymer and at least one of a
sugar or a sugar alcohol.
5. The method of claim 4, wherein the sugar or sugar alcohol is
selected from sucrose and sorbitol.
6. The method of claim 4, wherein the polymer matrix comprises
about 10-35% dry weight of the at least one sugar or sugar
alcohol.
7. The method of claim 4, wherein the polymer is at least one
dextran polymer.
8. The method of claim 7, wherein the at least one dextran polymer
is selected from Dextran 1, Dextran 10, Dextran 20, Dextran 40,
Dextran 70, and Dextran 75.
9. The method of claim 7, wherein the polymer matrix comprises
about 20-70% dry weight of at the least one dextran polymer.
10. The method of claim 1, wherein the water-soluble matrix further
comprises a buffer selected from the group consisting of histidine
and histidine hydrochloride.
11. The method of claim 1, wherein the base is comprised of a
water-insoluble polymer.
12. The method of claim 11, wherein the upper portion of each
microprotrusion is comprised of the water-insoluble polymer.
13. The method of claim 11, wherein the water-insoluble polymer
comprises a poly(lactic acid-co-glycolic acid).
14. The method of claim 1, whereby the method is effective to
achieve an elimination half-life that is less than about 45
minutes.
15. The method of claim 1, whereby the method is effective to
achieve an elimination half-life that is at least about 20% faster
than the elimination half-life achieved with the same, or lower
dose, of PTH delivered via subcutaneous injection.
16. A microprotrusion array for transdermal administration of a
dose of parathyroid hormone (PTH) to a mammalian subject, said
array comprising a plurality of microprotrusions extending from an
approximately planar base, each microprotrusion comprising an end
portion distal to the base and an upper portion proximal to the
base, at least the end portion comprising parathyroid hormone (PTH)
in a water-soluble polymer matrix, the water-soluble polymer matrix
comprised of: (i) about 7.5-12.8% dry weight PTH; (ii) about 20-70%
dry weight of at least one dextran polymer; and (iii) about 10-35%
dry weight of at least one sugar or sugar alcohol; wherein the
upper portion is comprised of at least one water-insoluble polymer;
wherein said use comprises the transdermal administration of a dose
of PTH to a mammalian subject by: applying the microprotrusion
array to a skin site of the subject; inserting all or a portion of
the plurality of microprotrusions into the skin, and maintaining
the array on the skin site for about 15 minutes or less; whereby
the use achieves an average time to maximum PTH plasma
concentration (T.sub.max) of about ten minutes or less.
17. The microprotrusion array of claim 16, wherein the PTH is human
parathyroid hormone (1-34).
18. The microprotrusion array of claim 16, wherein the at least one
dextran polymer is selected from Dextran 1, Dextran 10, Dextran 20,
Dextran 40, Dextran 70, and Dextran 75.
19. The microprotrusion array of claim 16, wherein the
water-soluble polymer matrix comprises about 35-70% dry weight of
the at least one dextran polymer.
20. The microprotrusion array of claim 16, wherein the at least one
sugar or sugar alcohol is selected from sucrose and sorbitol.
21. The microprotrusion array of claim 16, wherein the base is
comprised of a water-insoluble polymer.
22. The microprotrusion array of claim 16, wherein the array
comprises a total dose of about 10-100 .mu.g PTH.
23. The microprotrusion array of claim 16, wherein the array
comprises a total dose of about 32 .mu.g PTH.
24. The microprotrusion array of claim 16, wherein the array
comprises a total dose of about 64 .mu.g PTH.
25. A kit, comprising: a microprotrusion array comprised of a
plurality of microprotrusions extending from an approximately
planar base, each microprotrusion comprising an end portion distal
to the base and an upper portion proximal to the base, the end
portion of each microprotrusion comprising parathyroid hormone
(PTH) in a water-soluble polymer matrix comprising about 7.5-12.8%
dry weight PTH, about 20-70% dry weight of at least one dextran
polymer, and about 10-35% dry weight of at least one sugar or sugar
alcohol, and the upper portion being comprised of at least one
water-insoluble polymer, said array comprising a therapeutically
effective amount of PTH in the water-soluble polymer matrix, and an
applicator-assembly to which the microprotrusion array is
insertable or affixable; wherein at least the end portion of each
microprotrusion is fabricated to achieve an average time to maximum
PTH plasma concentration (T.sub.max) of about ten minutes or less
when applied to a subject.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 13/101,071, filed May 4, 2011, now U.S. Pat. No. 9,687,641,
which claims the benefit of U.S. Provisional Application No.
61/331,226, filed May 4, 2010, each of which is incorporated by
reference herein.
REFERENCE TO SEQUENCE LISTING, TABLE OR COMPUTER PROGRAM
[0002] A Sequence Listing is being submitted electronically via EFS
in the form of a text file, created Jun. 1, 2017, and named
"0915000692sequencelisting.txt" (825 bytes), the contents of which
are incorporated herein by reference in their entirety.
TECHNICAL FIELD
[0003] This disclosure relates generally to a method and drug
delivery system for transdermally administering parathyroid hormone
(PTH) using an array of microprojections, and related features
thereof.
BACKGROUND
[0004] Human parathyroid hormone (hPTH) is an 84 amino acid protein
that is secreted by the parathyroid gland; PTH is involved in
calcium and phosphorus homeostasis and the control of bone growth
and density. Two forms of recombinant hPTH have been evaluated in
clinical trials, hPTH(1-34) and the full length 84-amino acid,
hPTH(1-84). hPTH (1-34) is an N-terminal fragment of PTH, which,
along with fragment 1-38, retains the full biological activity of
the intact protein.
[0005] A recombinant, rDNA-derived, injectable form of hPTH(1-34)
(teriparatide) was approved in the United States in 2002 for the
treatment of severe osteoporosis and is sold under the tradename
FORTEO.RTM. (Eli Lilly), referred to hereafter as subcutaneously
injected teriparatide. The subcutaneously injected teriparatide is
typically prescribed for women with a history of osteoporotic
fracture, those having multiple risk factors for fracture, or who
have failed or are intolerant of other osteoporosis therapies. In
postmenopausal women, subcutaneously injected teriparatide has been
found to increase bone mineral density and reduce the risk of
vertebral and non-vertebral fractures. Subcutaneously injected
teriparatide has also been described to increase bone mass in men
with primary or hypogonadal osteoporosis who are at a high risk for
fracture. In men with primary or hypogonadal osteoporosis,
subcutaneously injected teriparatide has similarly been reported to
increase bone mineral density. In 2009, subcutaneously injected
teriparatide was also approved for treatment of osteoporosis in men
and women associated with sustained systemic glucocorticoid therapy
at high risk for fracture.
[0006] Bone degenerative diseases such as osteoporosis occur in a
substantial portion of the senior adult population. Osteoporosis
encompasses a heterogeneous group of disorders that represent a
major risk for bone fractures, and a substantial burden on the
health care system. Billions of dollars are spent annually on
medical care for the treatment of osteoporosis. Clinically,
osteoporosis is characterized by diminished bone mass, decreased
bone mineral density (BMD) and bone mineral content (BMC), and loss
of bone architecture resulting in decreased bone strength and
increased risk of bone fracture.
[0007] While a number of antiresorptive agents including
calcitonin, bisphosphonates, estrogen, and selective estrogen
receptor modulators (SERMs) prevent further bone loss, they do not
rebuild bone once it has been lost. This is in contrast to
subcutaneously injected teriparatide, which represents the
first-FDA approved anabolic bone building agent for the treatment
of osteoporosis. PTH or PTH(1-34) is thought to exert its effects
through receptor-mediated activation of two intracellular signaling
pathways via (1) adenylate cyclase and protein kinase A, and (2)
phospholipase C and protein kinase C. PTH(1-34) builds bone mass,
restores bone architecture, and reduces the risk of vertebral and
non-vertebral bone fractures in osteoporotic patients who are at
high risk of fracture (R. Neer, NEJM, 344:1434, 2001).
[0008] As a peptide product, PTH(1-34) requires daily subcutaneous
injections--an administration regime that is less than ideal.
Indeed, most patients have an aversion to self-injection of drugs,
and the need to visit a clinic or doctor's office for
administration is inconvenient and burdensome. Moreover, severely
osteoporotic patients may be unable to self-administer such
injections, such that each of the foregoing factors can contribute
to poor patient compliance.
[0009] While other forms of administration have been suggested,
such as oral delivery to the stomach, transdermal delivery, and
nasopharyngeal absorption, none of these delivery routes has been
proven to be particularly effective and each suffers from certain
drawbacks. Oral delivery results in very low bioavailability of
polypeptide drugs, usually below 1%, due to degradation in the
gastrointestinal tract. Moreover, the epithelial lining of the
gastrointestinal tract is impermeable to most polypeptides.
Nasopharyngeal and passive transdermal delivery avoid the problems
of enzyme degradation, but usually require penetration enhancers in
order to effect systemic absorption. Even with such penetration
enhancers, bioavailability will usually be very low, and the
penetration enhancers can often cause undesirable irritation. In
the case of nasopharyngeal administration, penetration enhancers
can often damage the nasal epithelium and chronic use has been
associated with hyperplasia of the nasal lining.
[0010] It is presently believed that PTH is most effectively
delivered to a patient in a pulsatile fashion to achieve active
bone formation. That is to say, plasma concentrations of PTH should
ideally rise rapidly after administration (rapid onset) and fall
rapidly after a peak has been reached (rapid decline), generally
resulting in a spike in the plasma concentration profile. Thus, a
particularly desirable method of administration of PTH is one that
achieves such a plasma concentration profile.
[0011] For at least these reasons, it would be desirable to provide
an alternative delivery method for parathyroid hormone which is
patient acceptable. Any such method should avoid subcutaneous
injection, limit irritation to the skin and body mucosa, and
provide a desired pulsatile delivery profile as described above,
among having other advantageous features. Such method should
ideally provide for high levels of PTH bioavailability, be amenable
to self-administration by the patient, be minimally invasive, and
ideally provide a pharmacokinetic profile that is similar to, or
preferably improved over, that achieved upon subcutaneous
administration.
BRIEF SUMMARY
[0012] The present disclosure is directed generally to a device and
method of transdermally administering PTH, inclusive of PTH
analogs, fragments, salts, etc., in a pulsatile fashion to a
mammalian subject, where the method results in pharmacokinetics and
a related delivery profile that are surprisingly superior to
subcutaneously administered PTH, particularly with respect to the
rapid pharmacokinetics achieved. Additional advantageous features
achieved by the device and methods of the invention are described
in greater detail herein.
[0013] In a first aspect, provided herein is a method of
transdermally administering PTH in a pulsatile fashion to a
mammalian subject. The method comprises applying to a skin site of
a subject a microprotrusion array comprising a plurality of
microprotrusions extending from an approximately planar base, each
microprotrusion comprising an end portion distal to the base and an
upper portion proximal to the base, at least the end portion
comprising parathyroid hormone (PTH) in a water-soluble polymer
matrix; inserting all or a portion of the plurality of
microprotrusions into the skin, and maintaining the array on the
skin site for 15 minutes or less, whereby at least a portion of the
end portions of the plurality of microprotrusions detach from the
microprotrusion array; and whereby the method achieves an average
time to maximum PTH plasma concentration (T.sub.max) of about ten
minutes or less.
[0014] In one embodiment, the PTH is human parathyroid hormone
(1-34).
[0015] In yet another embodiment, the microprotrusion array
comprises from about 1500 to about 3200 microprotrusions, more
preferably from about 2200 to about 3200 microprotrusions.
[0016] In yet a further embodiment, the microprotrusion array
possesses a diameter ranging from about 8 millimeters to about 14
millimeters.
[0017] In yet an additional embodiment related to any one or more
of the foregoing, the water-soluble matrix comprises dextran and
sorbitol, along with additional optional excipients. For example,
in a further embodiment, the water-soluble matrix further comprises
histidine and histidine hydrochloride.
[0018] In a further embodiment, the microprotrusions themselves
comprise PTH in a water-soluble polymer matrix, rather than having
PTH present as a coating on the microprotrusions. That is, the PTH
is admixed with and/or incorporated into the water-soluble polymer
matrix from which at least the tip portions of each microprojection
is formed.
[0019] In yet another embodiment of the method, the water-insoluble
polymer comprises poly(lactic acid-co-glycolic acid).
[0020] In a further embodiment of the method, the base and the
upper portion of the microprotrusion array comprise the same
water-insoluble polymer.
[0021] In yet another embodiment related to the foregoing, the base
and the upper portion of the microprotrusion array comprise the
same material.
[0022] In a further embodiment, the end portion and the upper
portion of each microprotrusion in the microprotrusion array are
composed of a water-insoluble polymer material that dissolves or
biodegrades after insertion into the skin.
[0023] In another embodiment, the microprotrusion array comprises a
dose of PTH, and at least about 80% of the dose is disposed in the
end portions of the microprotrusions in the array.
[0024] In another embodiment of the method, the array is maintained
on the skin site for no more than about 10 minutes, alternatively
for about 10 minutes or less, alternatively for a time between 1
second and 10 minutes, inclusive, or between 5 seconds, 10 seconds,
15 seconds and 10 minutes.
[0025] In yet another embodiment, the array is maintained on the
skin site for no more than about 5 minutes, alternatively for about
5 minutes or less.
[0026] In yet an additional embodiment, the method is effective to
deliver at least about 55 percent of the total dose of PTH in the
array to the subject. In another embodiment, the method is
effective to deliver at least about 60 percent of the total dose of
PTH in the array to the subject, more preferably at least about 65
percent of the total PTH dose in the array, based on a residual
analysis of the device.
[0027] In yet another embodiment, the microprotrusion array is
applied to the abdomen of the subject.
[0028] In yet a further embodiment, the method achieves an
elimination half-life (t.sub.1/2) of PTH that is at least about
15%, 20%, 22% 25% or 30% lower than the elimination half-life
(t.sub.1/2) of the same dose of PTH administered
subcutaneously.
[0029] In a second aspect, provided herein is a microprojection
array for use in delivering hPTH in accord with the delivery
parameters as described in any one or more of the foregoing
embodiments.
[0030] In yet a third aspect, a kit comprising (i) a
microprotrusion array comprised of a plurality of microprotrusions
extending from an approximately planar base, each microprotrusion
comprising an end portion distal to the base and an upper portion
proximal to the base, the end portion of each microprotrusion
comprising PTH in a water-soluble polymer matrix, said array
comprising a therapeutically effective amount of PTH, and (ii) an
applicator-assembly to which the microprotrusion array is
insertable or affixable or, in another embodiment, (ii) an
applicator to which the microprotrusion array is insertable or
affixable, is provided.
[0031] In one embodiment, the microprotrusion array is provided in
the kit secured to a support or holding member, such as a plunger,
that is insertable into the applicator assembly.
[0032] In another embodiment of the third aspect, the kit further
comprises an applicator assembly comprising a housing in which the
array support member and microprotrusion array can be disposed, and
an energy-storage member that, in one embodiment, is movable
between first and second stable configurations.
[0033] In one or more related embodiments, the kit comprises a
microprotrusion array according to one or more of the array
embodiments described herein.
[0034] In yet another embodiment, the applicator assembly further
comprises fasteners to temporarily connect the housing and the
energy storage member prior to assembly.
[0035] In a more specific embodiment of the kit, the applicator
assembly is packaged in a first package or protective
container.
[0036] In yet another embodiment of the kit, the microprotrusion
array and an array support member are packaged together in a second
package or protective container.
[0037] In a further embodiment, the kit comprises (i) a packaged
applicator assembly and (ii) a packaged microprotrusion array and
array support member that is insertable into the applicator
assembly prior to use.
[0038] Additional embodiments of the present method,
microprojection array, kit, and the like will be apparent from the
following description, drawings, examples, and claims. As can be
appreciated from the foregoing and following description, each and
every feature described herein, and each and every combination of
two or more of such features, is included within the scope of the
present disclosure provided that the features included in such a
combination are not mutually inconsistent. In addition, any feature
or combination of features may be specifically excluded from any
embodiment of the present invention. Additional aspects and
advantages of the present invention are set forth in the following
description and claims, particularly when considered in conjunction
with the accompanying examples and drawings.
[0039] These and other objects and features of the invention will
become more fully apparent when read in conjunction with the
following detailed description.
BRIEF DESCRIPTION OF THE FIGURES
[0040] FIG. 1 demonstrates a fully assembled applicator.
[0041] FIG. 2 is demonstrates an exploded view of the applicator of
FIG. 1.
[0042] FIG. 3 is a plot of hPTH(1-34) plasma concentration (pg/mL)
versus time for an illustrative microprotrusion array-based hPTH
transdermal delivery system in comparison to subcutaneous
administration of hPTH(1-34) as described in detail in Example 11.
Values of maximum plasma concentration and Tmax for the treatments
shown are as follows: (transdermal delivery of hPTH via a
microprotrusion array known under the tradename MicroCor.RTM., 32
.mu.g: Cmax: 180 pg/mL, Tmax: 8.1 mins; MicroCor.RTM. 64 .mu.g:
Cmax: 336 pg/mL, Tmax: 7.4 mins; subcutaneously injected
teriparatide (Forteo.RTM.) 20 .mu.g: Cmax: 85 pg/mL, Tmax: 0.44
mins).
[0043] FIG. 4 demonstrates dose-normalized AUC (area under the
curve) values (pg*min/mL*.mu.g) for an illustrative microprotrusion
array-based hPTH transdermal delivery system in comparison to
subcutaneous administration of hPTH as described in detail in
Example 11.
[0044] FIG. 5 is a graph illustrating mean Cmax (pg/mL) values for
each of the three treatment regimes examined: an illustrative
microprotrusion array-based hPTH transdermal delivery system
(MicroCor.RTM. 32 .mu.g dose and MicroCor.RTM. 64 .mu.g dose) in
comparison to subcutaneous administration (Forteo.RTM., 20 .mu.g
dose) as described in detail in Example 11.
[0045] FIG. 6 is a graph illustrating mean Tmax (minutes) values
for each of the three treatment regimes examined: an illustrative
microprotrusion array-based hPTH transdermal delivery system
(MicroCor.RTM. 32 .mu.g dose and MicroCor.RTM. 64 .mu.g dose) in
comparison to subcutaneous administration (Forteo.RTM., 20 .mu.g
dose) as described in detail in Example 11.
[0046] FIG. 7 is a graph illustrating mean T1/2 (minutes) values
for each of the three treatment regimes examined: an illustrative
microprotrusion array-based hPTH transdermal delivery system
(MicroCor.RTM. 32 .mu.g dose and MicroCor.RTM. 64 .mu.g dose) in
comparison to subcutaneous administration (Forteo.RTM., 20 .mu.g
dose) as described in detail in Example 11.
[0047] FIG. 8 is a graph illustrating normalized plasma
concentration values versus time (hours) for each of the three
treatment regimes examined: an illustrative microprotrusion
array-based hPTH transdermal delivery system (MicroCor.RTM. 32
.mu.g dose-open squares and MicroCor.RTM. 64 .mu.g dose-closed
squares) in comparison to subcutaneous administration (Forteo.RTM.,
20 .mu.g dose, closed circles) as described in detail in Example
11.
[0048] FIGS. 9A-9B depict schematically in cross-section exemplary
microprojection arrays.
DETAILED DESCRIPTION
[0049] Various aspects now will be described more fully
hereinafter. Such aspects may, however, be embodied in many
different forms and should not be construed as limited to the
embodiments set forth herein; rather, these embodiments are
provided so that this disclosure will be thorough and complete, and
will fully convey its scope to those skilled in the art.
[0050] The practice of the present disclosure will employ, unless
otherwise indicated, conventional methods of chemistry,
biochemistry, and pharmacology, within the skill of the art. Such
techniques are explained fully in the literature. See, e.g.; A. L.
Lehninger, Biochemistry (Worth Publishers, Inc., current addition);
Morrison and Boyd, Organic Chemistry (Allyn and Bacon, Inc.,
current addition); J. March, Advanced Organic Chemistry (McGraw
Hill, current addition); Remington: The Science and Practice of
Pharmacy, A. Gennaro, Ed., 20.sup.th Ed.; Goodman & Gilman The
Pharmacological Basis of Therapeutics, J. Griffith Hardman, L. L.
Limbird, A. Gilman, 10.sup.th Ed.
[0051] Where a range of values is provided, it is intended that
each intervening value between the upper and lower limit of that
range and any other stated or intervening value in that stated
range is encompassed within the disclosure. For example, if a range
of 1 .mu.m to 8 .mu.m is stated, it is intended that 2 .mu.m, 3
.mu.m, 4 .mu.m, 5 .mu.m, 6 .mu.m, and 7 .mu.m are also explicitly
disclosed, as well as the range of values greater than or equal to
1 .mu.m and the range of values less than or equal to 8 .mu.m.
Definitions
[0052] It must be noted that, as used in this specification, the
singular forms "a," "an," and "the" include plural referents unless
the context clearly dictates otherwise. Thus, for example,
reference to a "polymer" includes a single polymer as well as two
or more of the same or different polymers, reference to an
"excipient" includes a single excipient as well as two or more of
the same or different excipients, and the like.
[0053] In describing and claiming the present invention, the
following terminology will be used in accordance with the
definitions described below.
[0054] "Pulsatile delivery" or delivery in a pulsatile fashion
refers to a rapid rise in blood plasma concentration of drug such
as PTH after administration, followed by a rapid decline of blood
plasma concentration of drug following attainment of Cmax (i.e.,
generally characterized by a "spike" in the concentration
profile).
[0055] "Transdermal" refers to the delivery of an agent such as PTH
into and/or through the skin for local or systemic therapy.
[0056] Reference to a "PTH", or a PTH-agent or to "hPTH(1-34)", as
used herein, is meant to include, without limitation, hPTH(1-34),
hPTH salts, teriparatide, and the like, including recombinant
hPTH(1-34), synthetic hPTH(1-34), and simple known derivatives of
hPTH(1-34), such as hPTH(1-34) amide. Examples of hPTH salts
include, without limitation, salts having counter-ions such as
acetate, propionate, butyrate, pentanoate, hexanoate, heptanoate,
levulinate, chloride, bromide, citrate, succinate, maleate,
glycolate, gluconate, glucuronate, 3-hydroxyisobutyrate,
tricarballylicate, malonate, adipate, citraconate, glutarate,
itaconate, mesaconate, citramalate, dimethylolpropinate, tiglicate,
glycerate, methacrylate, isocrotonate, beta-hydroxibutyrate,
crotonate, angelate, hydracrylate, ascorbate, aspartate, glutamate,
2-hydroxyisobutyrate, lactate, malate, pyruvate, fumarate,
tartarate, nitrate, phosphate, benzene, sulfonate, methane
sulfonate, sulfate and sulfonate. A PTH-agent as described herein
is meant to include any and all forms thereof, including free base
and acid forms, charged or uncharged forms, stereoisomers, chiral
forms, and the like.
[0057] The terms "microprotrusion", "microprojection" or
"microneedle" are used herein to refer to elements adapted to
penetrate or pierce the stratum corneum or other biological
membranes. For example, illustrative microprotrusions or
microprojections may include, in addition to those provided herein,
microblades as described in U.S. Pat. No. 6,219,574 and Canadian
Patent Application No. 2,226,718, edged microneedles as described
in U.S. Pat. No. 6,652,478, and microprotrusions as described in US
Patent Publication No. US 2008/0269685.
[0058] "Substantially" or "essentially" means nearly totally or
completely, for instance, 95% or greater of some given
quantity.
[0059] "Optional" or "optionally" means that the subsequently
described circumstance may or may not occur, so that the
description includes instances where the circumstance occurs and
instances where it does not.
[0060] A material that is "water-soluble" such as the polymer
matrix described herein, is dissolvable at physiological pH, such
that the material dissolves into or within the skin.
Overview
[0061] As described above, provided herein is a method and drug
delivery system for transdermally administering parathyroid hormone
(PTH) using an array of microprojections. The method and related
drug delivery system provides several unexpected advantages over
subcutaneous administration, in particular with the pharmacokinetic
profile achieved, especially its rapid on-set to Cmax and
subsequent rapid elimination rate, thus permitting a pulsed
delivery profile. The method, exemplary microprojection arrays, and
related features will now be described in greater detail below.
MicroProjection Array
[0062] General features of a microprojection array for use in the
instant method are described in detail in U.S. Patent Publication
No. US 2008/0269685, the entire content of which is explicitly
incorporated herein by reference, and described more fully below.
See, in particular, FIGS. 3, 4, 5A, 5B, 5C and 6.
[0063] In reference to the microprojections themselves, in general,
the microprojections have a height of at least about 100 .mu.m, or
at least about 150 .mu.m, or at least about 200 .mu.m, or at least
about 250 .mu.m, or at least about 300 .mu.m. In general, the
microprojections have a height of no more than about 1 mm, no more
than about 500 .mu.m, no more than about 300 .mu.m, or in some
cases no more than about 200 .mu.m or 150 .mu.m. The
microprojections may have an aspect ratio (height to diameter at
base) of at least 10:1, preferably at least about 5:1, more
preferably at least about 3:1, or at least about 2:1, or at least
about 1:1. An illustrative shape for the microprojections is a cone
with a polygonal bottom, for example, being hexagonal or
rhombus-shaped. Additional microprojection shapes include those
provided, for example, in U.S. Patent Publication No. 2004/0087992.
While the array itself may possess any of a number of shapes, the
array is generally sized to possess a diameter of from about 5
millimeters to about 25 millimeters, or from about 7 to about 20
millimeters, or from about 8 to about 14 millimeters. Exemplary
diameters include 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,
18, 19, 20, 21, 22, 23, 24, and 25 millimeters.
[0064] The microprojections may in some cases have a shape which
becomes thicker towards the base, for example microprojections
which have roughly the appearance of a funnel, or more generally
where the diameter of the microprojection grows in a faster than
linear fashion with respect to distance to the microprojection's
distal end. Such a shape may, for example, facilitate drug loading.
Where microprojections are thicker towards the base, a portion of
the microprojection adjacent to the base, which may be referred to
herein as a "backing portion" or `foundation` or as an "upper
portion" may be designed not to penetrate the skin.
[0065] Generally, the number of microprotrusions in the array is
preferably at least about 100, at least about 500, at least about
1000, at least about 1400, at least about 1600, or at least about
2000. For example, the number of microprotrusions in the array may
range from about 1000 to about 4000, or from about 2000 to about
4000, or from about 2000 to about 3500, or from about 2200 to about
3200. The area density of microprotrusions, given their small size,
may not be particularly high, but for example the number of
microprotrusions per cm.sup.2 may be at least about 50, at least
about 250, at least about 500, at least about 750, at least about
1000, or at least about 1500. An illustrative microprotrusion array
is described herein in Examples 9-11.
[0066] Examples of forming various microprotrusion arrays having
different configurations are provided in Examples 1-7. Generally,
an array is prepared by (a) providing a mold with cavities
corresponding to the negative of the microprotrusions, (b) filling
the mold with a casting solution comprising a biocompatible
material such as a biocompatible polymer and a solvent, (c)
removing the solvent, and (d) demolding the resulting array from
the mold. The solution preferably contains an active ingredient
such as PTH. In one or more embodiments, the microprojections
themselves comprise PTH in a water-soluble polymer matrix, as
opposed to having the PTH present as a coating on a microprojection
or microneedle made of a different, biocompatible material such as
a metal.
[0067] The molds can be made using a variety of methods and
materials. Materials for forming a mold include ceramic materials,
silicone rubbers, polyurethanes, and waxes. An exemplary silicone
rubber system is the Sylgard.RTM. system from Dow Corning (Midland,
Mich.), for example Sylgard.RTM. 184. Nusil MED 6215, 6210 is an
alternative system available from NuSil Technology (Carpinteria,
Calif.).
[0068] The molds can be prepared by any of a number of methods
including casting the liquid mold material over a master
microneedle array and allowing the material to dry and solidify by
curing the liquid mold material over a master microneedle array so
it solidifies, such curing being affected by temperature or other
means, by heating the mold material until it melts, followed by
casting the melted liquid over microarray, and allowing the
material to cool and solidify, or by pressing the master
microneedle array into the mold material. The molds can also be
made by plating metal (such as nickel, copper or gold) onto a
master microneedle array.
[0069] The solution which is cast preferably comprises one or more
polymers in a solvent and an active ingredient (i.e., PTH). The
polymers should be biocompatible, in some cases, biodegradable. By
this term is meant that a polymer will degrade under expected
conditions of in vivo use (e.g., insertion into skin), irrespective
of the mechanism of biodegradation. Exemplary mechanisms of
biodegradation include disintegration, dispersion, dissolution,
erosion, hydrolysis, and enzymatic degradation. One preferred
mechanism of biodegradation is dissolution, where the polymer is
water-soluble.
[0070] Biocompatible, biodegradable, or bioerodible polymers for
use in the instant microprojection arrays include poly(lactic acid)
(PLA), poly(glycolic acid) (PGA), poly(lactic acid-co-glycolic
acid)s (PLGAs), polyanhydrides, polyorthoesters, polyetheresters,
polycaprolactones (PCL), polyesteramides, poly(butyric acid),
poly(valeric acid), polyvinylpyrrolidone (PVP), polyvinyl alcohol
(PVA), polyethylene glycol (PEG), block copolymers of PEG-PLA,
PEG-PLA-PEG, PLA-PEG-PLA, PEG-PLGA, PEG-PLGA-PEG, PLGA-PEG-PLGA,
PEG-PCL, PEG-PCL-PEG, PCL-PEG-PCL, copolymers of ethylene
glycol-propylene glycol-ethylene glycol (PEG-PPG-PEG, trade name of
Pluronic.RTM. or Poloxamer.RTM.), dextran, hetastarch, tetrastarch,
pentastarch, hydroxyethyl starches, cellulose, hydroxypropyl
cellulose (HPC), sodium carboxymethyl cellulose (Na CMC),
thermosensitive HPMC (hydroxypropyl methyl cellulose),
polyphosphazene, hydroxyethyl cellulose (HEC), other
polysaccharides, polyalcohols, gelatin, alginate, chitosan,
hyaluronic acid and its derivatives, collagen and its derivatives,
polyurethanes, and copolymers and blends of these polymers. A
preferred hydroxyethyl starch has a degree of substitution of in
the range of 0-0.9.
[0071] The biodegradability or dissolvability of the
microprojection array may be facilitated by the inclusion of
sugars. Exemplary sugars include dextrose, fructose, galactose,
maltose, maltulose, iso-maltulose, mannose, lactose, lactulose,
sucrose, and trehalose. Sugar alcohols, for example lactitol,
maltitol, sorbitol, and mannitol, may also be employed.
Cyclodextrins can also be used advantageously in microneedle
arrays, for example .alpha., .beta., and .gamma. cyclodextrins, for
example hydroxypropy1-.beta.-cyclodextrin and
methyl-.beta.-cyclodextrin. Sugars and sugar alcohols may also be
helpful in stabilization of peptides and proteins and in modifying
the mechanical properties of the microprojections by exhibiting a
plasticizing-like effect.
[0072] An exemplary polymer effective for forming a casting
solution to fill in the tips or end portion of the microprojections
is the polysaccharide, dextran (e.g., Dextran 1, Dextran 10,
Dextran 20, Dextran 40, Dextran 70, Dextran 75, and mixtures
thereof), optionally combined with the sugar alcohol, sorbitol.
[0073] A particularly preferred formulation for filling the end
portion or tip of the microprojections comprises hPTH(1-34),
dextran, and sorbitol. In a preferred embodiment, the PTH is
provided in a water-soluble matrix. The water-soluble matrix
comprises dextran, sorbitol, and PTH counter-ion, if contained in
the PTH source material. Additional components may include buffers
such as histidine and histidine hydrochloride.
[0074] The polymers used may possess a variety and range of
molecular weights. The polymers may, for example, have molecular
weights of at least about 1 KD, at least about 5 kD, at least about
10 kD, at least about 20 kD, at least about 22 kD, at least about
30 kD, at least about 50 kD, or at least about 100 kD.
[0075] Exemplary solvents for casting include water, alcohols (for
example, C.sub.2 to C.sub.8 alcohols such as propanol and butanol),
and alcohol esters, or mixtures of these. Such solvents are
typically useful for casting components which themselves are
water-soluble. Other solvents include esters, ethers, ketones,
nitriles, lactones, amides, hydrocarbons and their derivatives as
well as mixtures thereof.
[0076] The mold itself, or portions of it, may be treated to
improve wetting using any of a number of well-known surface
treatments, such as surfactant coating, salt coating,
radiofrequency treatment, plasma treatment and the like.
[0077] During solvent removal, the volume of the cast solution will
naturally diminish. With an appropriate choice of solvents, it is
possible for the distal ends of the microprojections--those
furthest from the base--to become finer as a result of solvent
removal. Illustrative tip diameters include those of less than
about 10 .mu.m, or less than about 5 .mu.m, less than 2 .mu.m, less
than about 1.5 .mu.m, or even less than about 1 .mu.m.
[0078] The microprotrusion array may be prepared to contain, in
addition to PTH, any of a number of different polymers and other
additives. Generally, the array comprises an approximately planar
base and a plurality of microprotrusions attached thereto. The
array typically further contains a plurality (meaning 2 or more) of
layers arranged roughly parallel to the plane of the base, where at
least two of the plurality of layers comprise different polymers.
One layer of the plurality of layers comprises PTH. Optionally, at
least one layer of the array or the array housing adheres to human
skin.
[0079] Various embodiments include the following. For example,
compared to the overall volume of the microprojection array, the
microprojections themselves may possess a higher amount of PTH. In
certain instances, the end portion of the microprojection comprises
a higher amount of PTH than the upper portion and/or the base. When
the PTH is cast in a water-soluble, dissolvable matrix, the tips or
end portions of the microprojections will dissolve more rapidly
than other portions of the array, making delivery of drug
particularly efficient. Furthermore, in certain treatment
protocols, the array may be left on the skin for only a short
period of time during which essentially only the microprojections
can dissolve to a substantial extent. The desirability of placing a
higher amount of active such as PTH in the projections themselves
is particularly high when the active is costly. An array
configuration that is effective to achieve a high amount of active
in the tips or end portions of the microprojections themselves is
to load or place a first drug-containing polymer layer in the tips
or end portion of the microprojections (or in a substantial portion
of the microprojections), and a second polymer layer which includes
the upper portion of base or a substantial proportion of the base,
but is absent drug (PTH).
[0080] FIGS. 9A-9B depict schematically in cross-section two
exemplary microprojection arrays suitable for use in the methods
described herein. In the first microprojection array shown in FIG.
9A, microprojection array 50 comprises a base 58 and a plurality of
microprojections, such as representative microprojection 56. The
microprojection array comprises two layers, a first layer 52 and a
second layer 54 (shaded). The microprojections, taken in this
embodiment to be the portions of the array that extend from the
planar surface defined by the proximal skin contacting side of
first layer 52, are composed of the material from which first layer
52 is manufactured. In this embodiment, second layer 54 and first
layer 52 collectively define the base of the microprojection array,
the base having a planar surface from which the microprojections
extend. The microprojections extending from layer 52 are comprised
of the material from which layer 52 is fabricated. That is, the
microprojections are fabricated from a first material and all or a
portion of the base is fabricated from the same material. In
another embodiment, the microprojections are fabricated from a
first material and a portion of the base is fabricated from a
different material.
[0081] In another embodiment of a microprojection array 60 depicted
in FIG. 9B, there are also a plurality of microprojections, such as
microprojection 66 which is representative. Each microprojection in
the array has an end portion or distal tip 62 that contacts and
penetrates (upon application of force) the stratum corneum, and an
upper portion proximal to a planar base 64. In this embodiment, the
base member and the upper portion of each microprotrusion is
comprised of a first material, indicated by the shading in the
drawing. The end portion of each microprotrusion is fabricated from
a different material. In one embodiment, the material from which
the base and upper portions are fabricated is a water-insoluble
polymer, and the end portion of each microprotrusion is fabricated
from a second or different material that is a water-soluble or
dissolvable material. The PTH can be incorporated into only the end
portion of each microprotrusion (i.e., "drug-in-tip" as described
in some examples) or can be incorporated into the end portion and
the upper portion of each microprotrusion. Of course, PTH can also
be incorporated into the base, but is normally not for cost of
goods and/or safety reasons. In another embodiment, the first
material forming the base and upper portion of each
microprotrusion, and the material forming the end portion of each
microprotrusion are the same polymer material, preferably a
dissolvable or biodegradable water soluble polymer, and differ only
in that the material forming the end portions contains an active
agent such as PTH and the material forming the base and upper
portions contain no active agent or a different active agent than
the end portions. In one embodiment, at least about 80% of the dose
of PTH in the microprotrusion array is confined to the end portion
(tip) of each microprotrusion, wherein the "tip" intends that
portion of a microprotrusion that is intended to penetrate the
stratum corneum. In other embodiments, at least about 85% and at
least about 90% or 95% or 98% of the dose of PTH in the
microprotrusion array is confined to the end portion (tip) of each
microprotrusion.
[0082] In one embodiment, to prepare a PTH-containing microarray as
provided herein, the solution comprising PTH is cast so that it
fills the cavities of a mold. This solution is then dried. A
further solution with a lower or zero concentration of active,
constituting a second layer, is then cast over the solution or
layer comprising the PTH. The polymers used in the first layer are
preferably not soluble in the solvent used for the second layer.
The second layer preferably uses a different polymer or polymers
from the ones used in the first layer. This procedure may produce
an array having two layers, and in which the microprojections are
enriched in active. In such an array, the active would not be
expected to substantially diffuse into the second layer.
[0083] The second layer may comprise any of a number of polymers
such as cellulose acetate butyrate, cellulose acetate, cellulose
acetate propionate, ethyl cellulose, nitrocellulose, hydroxypropyl
methyl cellulose phthalate, polystyrene, polyacrylates (such as
acrylate/octylacrylamide copolymers, Dermacryl.RTM. 97),
polymethacrylates (such as Eudragit.RTM. E, RL, RS, L100, S100,
L100-55), or poly(hydroxyl alkanoates). Preferably the second layer
comprises a biocompatible, biodegradable polymer(s) such as PLA,
PGA, PLGA, polycaprolactone and copolymers thereof. A particularly
preferred polymer is the water-insoluble polymer, PLGA.
[0084] Preferably, where the first layer is cast in an aqueous
solvent, the second layer comprising the upper portion of the
microprojection, and in certain instances, the base, is cast in an
organic solvent. Preferred solvents for preparing and casting the
second layer include alcohols, for example isopropyl alcohol and
ethanol, and esters, for example ethyl acetate, heptane, or propyl
acetate, or other solvents such as acetonitrile, dimethylsulfone
(DMSO), N-methylpyrrolidone (NMP), or glycofurol.
[0085] As described above, the microprojections of the array
preferably detach from the array following insertion into the skin.
In one embodiment, only a tip portion of each microprojection
detaches from the microarray. In one embodiment, detachment of all
of a microprojection or of only a portion of each microprojection
is achieved by degradation or dissolution of the material from
which that microprojection or that portion of the microprojection
is manufactured. Advantages related to this feature include the
elimination of sharp disposal requirements, elimination of needle
stick injury, and the like.
[0086] Detachable microprojections may be prepared using a number
of approaches. A layered approach, for example, may be used in
which the array is composed of multiple layers, and a layer
comprising the attachment areas of the microprojections to the
array is more readily degradable or dissolvable than the other
layers, such that upon activation, the drug-containing tip of the
microprojection is detached from the upper portion of the
microprojection or from the base, depending upon the specific
configuration. For example, the layer comprising the attachment
areas may be more rapidly hydrated than the other layers.
[0087] The array may also comprise a polymer or polymer blend
having bioadhesive properties which within a certain range of
moisture will have higher adhesive strength the greater the
moisture. In one embodiment, the multilayer array is one in which
the layer or layers in which the microneedles principally lie
possess bioadhesive characteristics.
[0088] Exemplary polymers with bioadhesive characteristics include
suitably plasticized polyvinyl alcohol and polyvinylpyrrolidone. An
extensive discussion of a class of bioadhesive polymer blends is
found in U.S. Pat. No. 6,576,712 and U.S. Published Patent
Applications Nos. 2003/0170308 and 2005/0215727, which are
incorporated by reference for their teaching of bioadhesive polymer
blends and adhesion testing. Preferable bioadhesive polymers are
those which possess hydrogen-bonded crosslinks between strands of
the primary polymers. These crosslinks may comprise a comparatively
small molecule which forms hydrogen bonds to two primary polymer
strands. It is believed that certain sugars may act as a small
molecule crosslinker in this manner with particular primary
polymers such as polyvinyl alcohol, dextran and tetrastarch.
[0089] The microprojection arrays may also include one or more
additives or measures to retard or diminish microorganism growth.
For example, the microprojection arrays may be packaged in a
sealed, low oxygen environment to retard aerobic microorganisms and
eventually destroy their viability. The arrays may also be packaged
in a low moisture environment to dehydrate microorganisms.
Alternatively, a pharmaceutically acceptable antibacterial agent
may be included in the formulation or the packaging. Examples of
such agents are benzalkonium chloride, benzyl alcohol,
chlorbutanol, meta cresol, esters of hydroxyl benzoic acid, phenol,
thimerosal, and silver or silver salts. As a further alternative, a
surfactant or detergent can be added to the casting formulations to
disrupt the cell membrane of potential microorganisms;
alternatively, a desiccant may be added to the packaging.
[0090] Antioxidants may also be added to the formulation, for
example, to protect the PTH from oxidation. Exemplary antioxidants
include methionine, cysteine, D-alpha tocopherol acetate, DL-alpha
tocopherol, ascorbyl palmitate, ascorbic acid, butylated
hydroxyanisole, butylated hydroxyquinone, butylhydroxyanisole,
hydroxycomarin, butylated hydroxytoluene, cephalin, ethyl gallate,
propyl gallate, octyl gallate, lauryl gallate,
propylhydroxybenzoate, trihydroxybutyrophenone, dimethylphenol,
ditertbutylphenol, vitamin E, lecithin, and ethanolamine. Chelating
agents, e.g. ethylenediaminetetraacetic acid (EDTA), may also be
added to the formulation to protect PTH from oxidation.
Formulations
[0091] PTH-containing formulations used to prepare the instant
microprotrusion arrays are described generally above. The
drug-containing formulation, sometimes referred to herein as the
drug-in-tip or DIT formulation, contains an amount of PTH
sufficient to provide a therapeutically effective amount in the
final microprojection array product. Generally, the amount of PTH
ranges from about 10-500 .mu.g per dosage unit, or from about
10-250 .mu.g per dosage unit, or from about 10-100 .mu.g per dosage
unit.
[0092] The PTH is contained in a water-soluble polymer matrix.
Preferably, the matrix comprises one or more water-soluble
polymers. One preferred water-soluble polymer is a polysaccharide,
such as the exemplary polysaccharide, dextran. The dextran
preferably possesses a molecular weight ranging from about 1 to
about 150 kilodaltons, or from about 40 to about 100 kilodaltons.
Representative dextrans possess each of the following molecular
weights: 1 kilodaltons, 10 kilodaltons, 20 kilodaltons, 40
kilodaltons, 70 kilodaltons, and 75 kilodaltons. Generally, dextran
is present in the final end portion of the microprojections in an
amount greater than that of any of the other components. Typically,
the amount of polysaccharide, such as dextran 70, ranges from about
1 percent by weight to about 90 percent by weight, more preferably
from about 20 percent by weight to about 70 percent by weight,
still more preferably from about 35 percent by weight to about 70
percent by weight, of the DIT formulation, based upon dry weight
(i.e., the layer after solvent removal). The amount of PTH
contained in the layer will of course vary, based upon the amount
of PTH to be administered per dosage unit. Generally, the amount
contained in the final end portion ranges from about 1 percent by
dry weight to about 50 percent by dry weight, more preferably from
about 5 percent by dry weight to about 25 percent by dry weight,
still more preferably from about 7.5 percent by dry weight to about
10 percent by dry weight. The other major component of the DIT
layer is the sugar alcohol, sorbitol. Sorbitol is typically present
in an amount less than dextran. Illustrative ranges of sorbitol
content are from about 1 percent by weight to about 50 percent by
weight, or from about 10 percent by weight to about 35 percent by
weight, of the formulation. Thus, the main components forming the
water-soluble polymer matrix are PTH, dextran, and sorbitol.
Additional lesser components include the buffers histidine and
histidine hydrochloride, as well as any PTH counterions, if
applicable.
[0093] Generally, the casting solutions or precursor solutions to
the final DIT layer are prepared to have a total solids content
ranging from about 1% solids to about 50% solids, or from 15%
solids to about 45% solids, where representative solids contents
include 5, 10, 15, 20, 25, 30, 35, 40, 45 and 50% solids.
[0094] The upper portion or layer of the microprojections and base
typically comprise at least one water-insoluble polymer and are
substantially absent PTH, to provide an array having
microprojections that are PTH-enriched in comparison to the upper
portion and base portions of the array. One preferred type of
water-insoluble polymer is PLGA, and in particular, poly(lactic
acid-co-glycolic acid), having a lactide to glycolide ratio of
75/25. Materials having other DL-lactide to glycolide ratios may
also be used, such as 50:50, 65:35, 85:15, or PLA by itself.
Preferably, the PLGA is ester-terminated. Such polymers are
available from Durect (Cupertino, Calif.).
[0095] Description of an exemplary PTH formulation as described
above is provided in Example 9.
Transdermal Delivery Device
[0096] In one or more embodiments, the microprojection array forms
part of a final transdermal delivery system or product. The product
typically comprises the microprotrusion array according to any one
or more of the embodiments provided herein, and an array support
member (also referred to herein as a microprojection-holding
member). The array support member (or microprojection-holding
member) is typically affixed or affixable to the base of the
microprotrusion array at the surface opposite the microprotrusions.
One such exemplary microprojection-holding member is a plunger as
described in Example 10.
[0097] The product may further comprise an applicator assembly that
comprises a housing and an energy storage member effective to
activate the device. See, e.g., FIGS. 1 and 2, along with Example
10.
[0098] As described above, such an applicator suitable for use is
illustrated in FIGS. 1 and 2, where an applicator 180 is shown
fully assembled in FIG. 1 and in exploded view in FIG. 2. An outer
housing 182 is dimensioned to contain an energy-storage member 183
and a microprojection-holding member 184 which holds a
microprojection array (not shown in the figures). In storage and
prior to use, microprojection-holding member 184 is held in place
by two platforms in housing 182, such as platform 196, against
which a projection member, such as members 185, 187 in member 184,
engages. When it is desired to activate the device, a user twists
member 184 (e.g., with thumb and forefingers gripping projection
members 185, 187) so that it is no longer over the platforms and
restrained by them. When that twisting occurs, energy-storage
member 183 moves downward pressing the microprojection-holding
member in a downward direction to contact the microprojection array
against the skin.
[0099] The applicator of FIGS. 1 and 2 is further provided with an
optional set of components for adapting to skin, in this case an
adapter 190, a snap ring 186, and an extender 188. In addition,
FIG. 1 shows an optional adhesive 192 and an optional release liner
194. An optional safety feature to prevent inadvertent or
accidental actuation of the applicator can also be provided. In one
embodiment, a pin 197 is removably inserted through a cavity in
microprojection holding member 184 prior to use. The applicator may
be simplified and adapted to reduce the number of parts. To enable
the applicator for actuation, a user pulls pin 197 from its
retaining position as shown in FIG. 1 to permit a user to activate
the applicator by the twisting motion described above. Various
configurations, components, and embodiments of a microprojection
array-based transdermal delivery system suitable for administering
PTH according to the methods provided herein are described in
co-owned U.S. Provisional Patent Application No. 60/331,175, filed
on May 4, 2010, the entire content of which is expressly
incorporated herein by reference. It will be appreciated that the
applicator described herein is merely exemplary, and that any
applicator that achieves penetration of the microprojections into
the skin of a user is contemplated for use in the claimed
methods.
[0100] Product components may optionally be provided as part of a
kit, e.g., for assembly prior to actuation and use, or
alternatively, in assembled form. See, e.g., FIG. 1. For example,
one such kit may contain a microprojection array along with an
array support member, where the array support member is affixable
or affixed to the base of the microprotrusion array at the surface
opposite the microprotrusions.
[0101] The kit may optionally further comprise an applicator
assembly comprising a housing in which the array support member and
microprotrusion array can be disposed, combined with an energy
storage member that is movable between first and second
configurations (e.g., a resting position and a position in which
the microprojection-holding member is extended in a downward
direction to contact the microprojection array against the skin as
described above). In one particular embodiment, the energy storage
member is a spring. Optionally, the applicator assembly comprises
fasteners to temporarily hold together the housing and the energy
storage member.
[0102] The kit may also comprise various components of the final
product as described above to be assembled prior to use, where any
of the individual or combinations of components may be provided in
primary packaging, and optionally further contained in secondary
packaging.
Pharmacokinetics
[0103] The microprojection array described herein was used to
administer transdermally hPTH(1-34) to healthy human subjects. As a
comparator, hPTH(1-34) was also administered subcutaneously to a
healthy group of human subjects. Details of this study are provided
in Example 11, and the resulting data are presented in FIGS. 3-8
and in Table 1, now to be described.
[0104] In this study, a microprojection array was prepared as
detailed in Example 9 and inserted into an applicator-array
assembly to form a transdermal delivery system, as described in
Example 10. The system described in Examples 9 and 10 is referred
to herein, and in the drawings, as "MicroCor.RTM. hPTH(1-34)" or
more simply, "MicroCor.RTM.". The delivery system was designed to
deliver a systemic dose of hPTH (1-34) across the stratum corneum
barrier layer of the skin upon activation of the applicator to
deploy an array of microstructures causing the array of
microstructures to penetrate the stratum corneum. In this study,
two dose levels were administered via the transdermal delivery
system, 32 .mu.g hPTH(1-34) and 64 .mu.g hPTH(1-34) (32 .mu.g
hPTH(1-34).times.2). Subjects received these doses by applying the
transdermal microneedle delivery system MicroCor.RTM. device
containing the indicated amount of hPTH in the distal tips of the
microneedles in the array to an abdominal site, and leaving the
device in place for five (5) minutes. The comparator treatment (the
commercial hPTH product known as Forteo.RTM.) was subcutaneously
administered via injection into the abdominal wall at a dose of 20
.mu.g. Blood samples were drawn at designated times and analyzed
for hPTH concentration. The pharmacokinetic data is summarized in
FIGS. 3-8 and in Table 1.
[0105] FIG. 3 is a plot of average hPTH(1-34) plasma concentration
(pg/mL) versus time, in hours, for subjects treated hPTH
administered via the transdermal microneedle delivery system (under
the tradename MicroCor.RTM.) at a dose of 32 .mu.g (open squares)
and 64 .mu.g (open diamonds) or via subcutaneous injection
(Forteo.RTM.) at a dose of 20 .mu.g (open triangles).
Administration of PTH from the microprojection delivery system
wherein the PTH was contained within a dissolvable polymer matrix
from which the microprojections, or at least the tips of each
microprojection, was fabricated, achieved a rapid onset to maximum
plasma concentration. Specifically, and with reference to FIGS.
5-6, for the 32 .mu.g dose, a maximum plasma concentration (180
pg/mL) was reached in about 8 minutes, and for the 64 .mu.g dose, a
maximum plasma concentration (336 pg/mL) was reached in 7.4 minutes
after application of the system to the skin. Subcutaneous injection
of a 20 .mu.g dose of PTH, in contrast, achieved its maximum
concentration (85 pg/mL) 26 minutes post injection.
[0106] Accordingly, in one embodiment, a method for administering
PTH to a human subject is provided, by contacting the skin of the
subject with a microprotrusion array containing a dose of PTH and
causing all or a portion, preferably a majority, of the
microprotrusions to penetrate the stratum corneum. Entry of the
microprotrusions into the skin achieves delivery of the PTH to the
subject, wherein the time to maximum plasma concentration (Tmax) is
less than about 20 minutes, more preferably Tmax is achieved in
about 15 minutes or less, more preferably in less than about 12
minutes, still more preferably in less than about 10 minutes, more
preferably in less than about 9 minutes.
[0107] With continuing reference to FIG. 3 and additionally to FIG.
7, it can also be seen that administration of PTH from the
microprojection delivery system described herein, in addition to a
rapid (e.g., about 10 minutes or less) onset to maximum plasma
concentration, a rapid elimination rate is also achieved. The
elimination half life (T.sub.1/2), calculated in accord with
standard equations and methods in the art and generally reflective
of the time for the plasma concentration to fall to half of its
original value, was 37 minutes for the 32 .mu.g dose of hPTH
administered via the transdermal microneedle delivery system. The
elimination half life was 52 minutes for the 20 .mu.g dose of hPTH
administered via subcutaneous injection.
[0108] Accordingly, in one embodiment, a method for administering
PTH to a human subject is provided, by contacting the skin of the
subject with a microprotrusion array containing a dose of PTH and
causing all or a portion, preferably a majority, of the
microprotrusions to penetrate the stratum corneum. Entry of the
microprotrusions into the skin achieves delivery of the PTH to the
subject, wherein the elimination half life of PTH is less than
about 45 minutes, and more preferably is 40 minutes or less. In one
embodiment, the PTH when administered via the microneedle delivery
system described herein, wherein PTH is contained in a
water-soluble polymer matrix in at least the tip portions of each
microprojection in an array, provides a time to maximum plasma
concentration (Tmax) of less than about 20 minutes, more in about
15 minutes, 12 minutes, 10 minutes or 9 minutes or less, and an
elimination half life of less than about 45 minutes, and more
preferably 44, 43, 42, 41 or 40 minutes or less.
[0109] In another embodiment, PTH administered in accord with the
microprotrusion array described herein provides a maximum plasma
concentration of greater than about 100 pg/mL, more preferably of
125, 130, 135, 140, 145, 150, 155, 160, 165, 170, or 175 pg/mL, for
a dose of 32 .mu.g PTH, in less than about 20 minutes, about 15
minutes, about 12 minutes, about 10 minutes or about 9 minutes, and
an elimination half life of less than about 45 minutes, and more
preferably 44, 43, 42, 41 or 40 minutes or less.
[0110] In another embodiment, a method for administering PTH to a
human subject is provided, by contacting the skin of the subject
with a microprotrusion array containing a dose of PTH and causing
all or a portion, preferably a majority, of the microprotrusions to
penetrate the stratum corneum. Entry of the microprotrusions into
the skin achieves delivery of the PTH to the subject, wherein the
time to maximum plasma concentration (Tmax) is 50% lower (shorter),
more preferably 55%, 60%, 65% or 70% less than the time to maximum
plasma concentration achieved with the same, or lower dose, of PTH
delivered via subcutaneous injection. In another embodiment, the
method of PTH administration via a transdermal microneedle array in
accord with that described herein provides delivery of PTH to the
subject such that the elimination half life is at least about 15%,
20%, 22% or 25% faster than the elimination half life achieved with
the same, or lower dose, of PTH delivered via subcutaneous
injection.
[0111] Dose-normalized area under the curve values in pg*min/mL*pg
were calculated from the plasma concentration data, and are
presented in FIG. 4. The AUC values for the exemplary
microprotrusion array-based hPTH transdermal delivery system was
approximately 48% lower than the AUC value for hPTH administered
subcutaneously via injection. The lower AUC of the drug when
administered via microneedles transdermally is indicative of the
fast elimination half life, and supportive of this method of
delivery being able to achieve the desirable pulsatile delivery
profile, wherein a pulse of drug is provided to the system with a
rapid onset to maximum blood concentration and a fast elimination
half-life of drug.
TABLE-US-00001 TABLE 1 Pharmacokinetic Results Parameter MicroCor
.RTM. 32 .mu.g MicroCor .RTM. 64 .mu.g Forteo .RTM. AUC/Dose 220 (n
= 15) 229 (n = 16) 429 (n = 16) (pg*min/mL*.mu.g) C.sub.max (pg/mL)
180 (n = 16) 336 (n = 16) 85 (n = 16) T.sub.max (minutes) 8.1 (n =
16) 7.4 (n = 16) 26.2 (n = 16) Elimination 37.1 (n = 16) 52 (n =
16) 52 (n = 16) Half-Life, T.sub.1/2 (minutes)
[0112] As can be seem from the data summarized in Table 1, relative
to subcutaneously injected PTH, delivery transdermally via an array
of microprojections exhibits rapid pharmacokinetic properties such
as a shorter T.sub.max, a higher C.sub.max, and a shorter
elimination half life, T.sub.1/2. Absorption of hPTH (1-34)
occurred more rapidly with the microprojection transdermal delivery
relative to the subcutaneous delivery (Forteo.RTM.), as illustrated
by the higher dose-normalized C.sub.max value and the smaller
T.sub.max values for both microprojection transdermal delivery
(MicroCor.RTM.) treatments.
[0113] FIG. 8 presents the pharmacokinetic data from the study of
Example 11 in a different way, to illustrate the pulsatile delivery
profile achieved with the microneedle array delivery system
described herein. In FIG. 8, the plasma concentration value at each
time point was normalized by the maximum concentration value
achieved by each of the three treatment regimens: 32 microgram and
64 microgram doses of PTH delivered by the microprotrusion array
and the 20 microgram dose delivered via subcutaneous injection. The
Cmax normalized plasma concentration data is plotted against time,
in hours. The time to achieve Cmax of well under 30 minutes when
PTH is delivered transdermally from the microneedle array compared
to the time to reach Cmax of greater than 30 minutes when
administered subcutaneously is evident. The faster elimination of
the drug after reaching Cmax when delivered transdermally from the
microneedle array is also readily seen when the data is presented
as shown in FIG. 8, by comparing the slopes of the lines during the
elimination phase--i.e., at a time after Cmax.
[0114] In summary, relative to subcutaneous administration, the
exemplary microprojection array-based PTH products described herein
exhibit rapid pharmacokinetic properties. Such properties (relative
to subcutaneous injection) include a shorter Tmax, a higher Cmax,
and a shorter elimination half life, T.sub.1/2. Ideally,
administration using a microprojection array-based PTH product is
effective to achieve a Tmax value that is at least about 2 times
less, or at least about 3 times less, or at least about 4, or 5, or
6, or 7 times or more less than that achieved by SC administration
of the same PTH moiety, preferably based upon normalized Cmax
values. Absorption of hPTH (1-34) occurs more rapidly when
delivered with the microprojection array-based delivery system when
compared to delivery via subcutaneous injection (i.e., hPTH product
Forteo.RTM.), as illustrated by the higher dose-normalized
C.sub.max values and the faster T.sub.max values for both the high
and low dose microprojection array-based treatments. The
elimination half-life based upon microprojection array-based PTH
treatment was also less than with subcutaneously administered PTH
(Forteo.RTM.). Moreover, microprojection array-based treatment is
more effective in achieving the desired pulsatile delivery profile
of PTH (i.e., rapid on set and rapid offset after reaching Cmax),
as can be seen in FIGS. 3 and 8.
[0115] The transdermal microprojection array delivery systems were
analyzed after use, to assess residual PTH content in the
microprojection array. Analysis for residual PTH in the arrays
following application to a subject for delivery of the drug,
revealed that, on average, about 85% of drug was delivered from the
microprojection array device (i.e., 85% drug delivery efficiency,
data not shown). Accordingly, in one embodiment, the method
includes providing for use in the method a microprojection array
capable of delivery at least about 55%, or at least about 60%, or
at least about 65%, or at least about 70%, or at least about 75%,
or at least about 80%, or at least about 85% of the total PTH dose
in the array when applied to the skin of the patient for the
desired amount of time. In the studies conducted above, the
microarray was in contact with the skin for 5 minutes, however it
will be appreciated that the microprojection array-delivery system
can be applied to a skin site for times other than the 5 minutes
utilized in the present study. In one embodiment, the system is
maintained on the skin for no more than 15 minutes, or for no more
than 10 minutes, or even for no more than 5 minutes. That is to
say, the microprojection array is maintained on the skin for no
more than about 15 minutes, or 14 minutes, or 13 minutes, or 12
minutes, or 11 minutes, or 10 minutes, or 9 minutes, or 8 minutes,
or 7 minutes, or 6 minutes or even 5 minutes. Although any of a
number of skin sites may be used for application of PTH such as the
thigh, arm, etc., one preferred skin site is the abdomen.
[0116] A skilled artisan will also appreciate that delivery
efficiency based on residual analysis of the microprojection array
post-use is but one measure to characterize the device. The
microprojection array can also be characterized by the percentage
of total dose delivered by the microprojection array, determined
for example based on pharmacokinetic parameters and the total
amount of drug loaded into the microprojection array. This value
may differ from a residual analysis since some of the drug
delivered may be degraded by enzymes in the skin or not reach
systemic circulation for other reasons. In one embodiment, the
method for administering PTH to a human subject comprises
contacting the skin of the subject with a microprotrusion array
containing a dose of PTH and causing all or a portion, preferably a
majority, of the microprotrusions to penetrate the stratum corneum.
The microprotrusions in the array are left in contact with the skin
for a period of time. Application of the device to the skin in
accord with the method delivers at least about 40%, 45%, 50%, 55%
or 60% of the total PTH dose in the microprotrusion array into
systemic circulation of the subject. In another approach, the
delivery efficiency of the microprojection array is determined
based on comparing the pharmacokinetic parameters, and in
particular AUC, to pharmacokinetic parameters achieved from a
subcutaneously injected dose of PTH.
Methods of Use
[0117] The methods, kits, microprojection arrays and related
devices described herein may be used for treating any condition
receptive to treatment with PTH. For instance, the PTH-containing
microprojection arrays may be used to deliver PTH for treatment of
osteoporosis, osteopenia, periodontal disease, and in particular,
periodontal disease associated with alveolar bone loss. The
PTH-containing microprojection arrays are also contemplated for use
in healing bone fractures, improving bone fracture healing rates
and for reducing risk of fracture in at risk persons.
[0118] More particularly, the methods, kits, microprojection arrays
and related devices described herein may be used for (i) treating
postmenopausal women with osteoporosis at high risk for fracture,
(ii) increasing bone mass in men with primary or hypogonadal
osteoporosis at high risk for fracture, (iii) treatment of
osteoporosis in men and women with osteoporosis associated with
sustained glucocorticoid therapy at high risk for fracture, and
(iv) treatment of osteoporotic patients who have failed or are
intolerant of other available osteoporosis therapies.
[0119] It is to be understood that while the invention has been
described in conjunction with the preferred specific embodiments
thereof, the foregoing description is intended to illustrate and
not limit the scope of the invention. Other aspects, advantages,
and modifications within the scope of the invention will be
apparent to those skilled in the art to which the invention
pertains.
[0120] All patents, patent applications, and publications mentioned
herein are hereby incorporated by reference in their entireties.
However, where a patent, patent application, or publication
containing express definitions is incorporated by reference, those
express definitions should be understood to apply to the
incorporated patent, patent application, or publication in which
they are found, and not necessarily to the text of this
application, in particular the claims of this application, in which
instance, the definitions provided herein are meant to
supercede.
[0121] The following examples are put forth so as to provide those
of ordinary skill in the art with a complete disclosure and
description of how to implement the invention, and are not intended
to limit the scope of what the inventors regard as their invention.
Efforts have been made to ensure accuracy with respect to numbers
(e.g., amounts, temperature, etc.) but some errors and deviations
should be accounted for. Unless indicated otherwise, parts are
parts by weight, temperature is in .degree. C. and pressure is at
or near atmospheric.
Example 1
General Process for Array Casting
[0122] A clean mold is placed in a mold folder. The mold is then
placed in a Petri dish and a small amount of formulation, for
example, 200 .mu.L, is placed on the mold. An illustrative
formulation such as those described herein is applied. The
formulation is spread manually over the mold using a transfer
pipette with a trimmed tip. The formulation is then vortexed, for
example, for five seconds, using a commercial vibrating instrument.
The mold containing formulation is placed in a pressure vessel
under 1 atm for about 1 minute. Pressure is released, and the mold
placed in an incubator at 32.degree. C., for about 1 hr. The array
is then demolded, for example, using double-sided adhesive tape,
and optionally attached to a backing.
Example 2
General Process for Casting Two-Layer Arrays
[0123] Following the drying step of Example 1, an additional layer
is cast on the mold using similar procedures. An exemplary
composition, e.g., containing 754 of 20 wt % Eudragit.RTM. EPO in a
3:1 mixture of ethanol and isopropyl alcohol is cast onto the mold.
The additional layer may be spread out, for example, using a glass
slide. The mold containing the additional layer is placed in a
pressure vessel and pressurized at 1 atm for 2 minutes. The
pressure is released and the mold is allowed to dry in the pressure
vessel for an additional five minutes, without disturbing. The mold
is again dried in the incubator for 1 hr at 32.degree. C., and then
demolded.
Example 3
Casting Two-Layer Arrays
[0124] A microprojection array with two layers is typically
prepared by the following steps.
[0125] STEP 1. CASTING A SOLUTION COMPRISING AN ACTIVE AGENT,
POLYMER, AND POSSIBLY OTHER COMPONENTS IN A MOLD. The clean mold is
placed in a mold holder. A small amount of formulation, for
example, 75 .mu.L, as a droplet on the mold, is dispensed by
placing a cover slip on top of the droplet to help spread the
liquid onto the entire surface of the mold. An exemplary wet
formulation contains, for example, 15% human parathyroid hormone
1-34 fragment (hPTH1-34), 65% dextran 70 and 20% sorbitol, in a
histidine buffer solvent with a total solids content of 30% as
applied to the mold. The loaded mold (i.e., containing drug
formulation) is placed in a pressure vessel under about 50 psi for
about 30 seconds. Pressure is then removed. The excess formulation
is wiped with a silicone or metal wiper with the interference
between wiper edge and surface of mold about 1-10 mils. The mold is
placed in an incubator at a temperature of 32.degree. C., for about
half an hour. After incubating, the dry formulation contains 5%
human parathyroid hormone 1-34 fragment (hPTH1-34), 21% dextran 70
and 7% sorbitol, with histidine and histidine hydrochloride also
present.
[0126] STEP 2. CASTING AN ADDITIONAL LAYER ON TOP OF THE FIRST
LAYER IN THE MOLD. The mold with drug-containing layer cast is
removed from the drying oven, and any residue of dry formulation
left on the base of the mold is removed by tape strip using a 3M
1516 single-sided adhesive. Approximately 150 .mu.L of "backing" or
upper layer/base solution containing poly(lactic acid-co-glycolic
acid) (PLGA) with an L/G ratio of 75/25 in acetonitrile is placed
on the mold (atop the first drug-containing formulation). A thin
film is cast using a wiper with the clearance between edge of the
wipe and the surface of the mold about 10-20 mil. The mold is then
placed into a pressure vessel under 10-30 psi with controlled
venting for about 5 min. The mold is further dried at room
temperature for about 30 min. The array may then be demolded, for
example using double-sided adhesive tape, and optionally attached
to a polyethylene terephthalate film as backing.
Example 4
Solvent-Cast Microprojection Arrays Containing hPTH(1-34)
[0127] Microprojection arrays were prepared according to the
general procedures described above. The following table provides
the relative amounts of water-soluble matrix components and active
agent, along with the percent solids content of the resulting
exemplary casting solutions.
TABLE-US-00002 TABLE 4-1 hPTH Solids in Polymer Sugar (1-34)
casting solution Ex. # Type Wt % Type Wt % Wt % Wt % B1 PVA 52.6
Sucrose 26.3 21.1 22.8 B2 PVA 46.2 Sucrose 23.1 30.7 26 B3 Dextran
70 67.5 Sorbitol 14 18.5 33 B4 Dextran 70 64.9 Sorbitol 19.5 15.6
30.8 B5 Dextran 40 67.5 Sorbitol 14 18.5 33 B6 Dextran 40 64.9
Sorbitol 19.5 15.6 30.8 B7 Tetrastarch 67.5 Sorbitol 14 18.5 33 B8
Tetrastarch 64.9 Sorbitol 19.5 15.6 30.8 B9* Dextran 70 64.8
Sorbitol 19.3 15.5 31.2 *ca. 0.4 wt % of methionine was added to
the formulation as an antioxidant agent.
[0128] Based on the above, it can be seen that a wide variety of
formulations can be prepared for use in forming a microprojection
arrays for delivery of hPTH through the skin.
Example 5
Polymeric Solutions for Casting "Backing" or Upper Layers of
Microneedle Arrays
[0129] For arrays comprising an upper microprotrusion portion or
layer proximal to the base of the array and placed atop the water
soluble polymer/h PTH tip layer), different polymer formulations
were used. The backing layer (which in this embodiment comprises
the upper portion of the microprotrusion proximal to the base and
the base itself) comprises one or more water-insoluble polymers.
The polymer solutions were typically prepared by dissolving the
polymers in a solvent or solvent mixture at room temperature with a
polymer concentration ranging from about 15-30% by weight.
[0130] The details of the illustrative polymer solutions used for
casting the backing layer of the microneedle arrays are summarized
in the table below.
TABLE-US-00003 TABLE 5-1 Polymer Solvent Ex. # Type Wt % Type Wt %
Cl Eudragit EPO 100 20 Ethanol/IPA 80 C2 Eudragit EPO 100 30
Ethanol/IPA 3/1 70 C3 Eudragit EPG 20 Ethanol/IPA 3/1 80 100/PVP
(1:1) C4 PLGA (75/25) 10 Ethyl acetate 90 C5 PLGA (75/25) 15 Ethyl
acetate 85 C6 PLGA (75/25) 15 Acetonitrile 85 C7 PLGA (75/25) 20
Acetonitrile 80 C8 PLGA (75/25) 30 Acetonitrile 70 C9 PLGA (65/35)
20 Acetonitrile 80 C10 PLA 20 Acetonitrile 80 C11 Polycaprolactone
20 Acetonitrile 80
[0131] In the table above, the following abbreviations are used:
Polyvinylpyrrolidone (PVP); poly(lactic acid-co-glycolic acid)
(PLGA) (L/G ratio 75/25, 65/35); poly(lactic acid) (PLA); and
isopropyl alcohol (IPA).
Example 6
Casting Microneedle Arrays with Three Layers
[0132] A microneedle array with three layers is prepared as
follows.
[0133] 1) Casting a non-drug containing tip layer (end portion
distal to base) in the mold. The clean mold is placed in a mold
holder. A small amount (200 .mu.L) of formulation solution absent
drug is dispensed as a droplet on the mold. One such exemplary
formulation contains, for example, 23% dextran 70, 10% sorbitol in
histidine buffer solvent, such that the formulation has, e.g., a
30% solids content as applied. The mold comprising formulation is
placed in a pressure vessel under ca. 50 psi for about 30 seconds.
Pressure is then released. Any excess formulation is wiped with a
silicone or metal wiper with the interference between wiper edge
and surface of the mold at about 1-10 mils. The mold is placed in
an incubator at a temperature of 32.degree. C., for about half an
hour.
[0134] 2) Casting drug containing layer in the mold. After step 1)
above, a small amount of formulation, for example, 75 .mu.L, is
dispensed as a droplet on the mold. A cover slip is placed on top
of the droplet to aid in spreading the liquid onto the entire
surface of the mold. One such illustrative formulation may contain,
for example, on a dry weigh basis 5% wt human parathyroid hormone
1-34 fragment (hPTH(1-34)), 21% wt dextran 70, 7% wt sorbitol. The
wet casting formulation utilizes histidine buffer as the solvent,
such that the formulation has, for example, a 30% solids content as
applied. The mold containing is then placed in a pressure vessel
under ca. 50 psi for about 30 seconds. Pressure is then released.
The excess formulation is wiped with a silicone or metal wiper with
the interference between wiper edge and surface of mold about 1-10
mils. The mold is placed in an incubator at a temperature of
32.degree. C., for about half an hour.
[0135] 3) Casting the backing layer on top of the drug-containing
layer. After step 2) above, about 150 .mu.L of backing solution
(upper layer portion) comprising poly(lactic acid-co-glycolic acid)
(PLGA) with a L/G ratio of 75/25 in acetonitrile is placed on the
mold (on top of the drug-containing layer). A thin film is cast
using a wiper with the clearance between edge of the wipe and
surface of the mold about 10-20 mil. The mold is then placed into a
pressure vessel under 10-30 psi with controlled venting for about 5
min. The mold is further dried at room temperature for about 30
min. The array is then demolded, for example using double-sided
adhesive tape, and optionally attached to a polyethylene
terephthalate film as backing.
Example 7
Casting Arrays for Sustained Release of Drug Substance from the
Array
[0136] A microneedle array for sustained release of drug substance
from the array is prepared in the following steps.
[0137] 1) Casting a drug-containing layer for sustained release of
drug substance. A clean mold is placed in a mold holder. A small
amount (e.g., 75 .mu.L) of aqueous solution containing, e.g.,
hPTH(1-34), components for a polymeric matrix such as polyethylene
glycol-co-poly(lactic acid-co-glycolic acid) (PEG-PLGA) copolymer,
and excipients such as sucrose or sorbitol, is dispensed into the
mold. The polymeric matrix is generally amphiphilic in nature,
where the hydrophobic segment(s) of the polymer are effective to
control the release of drug substance. Exemplary formulations of
this type are described in the table below. The liquid formulation
is spread manually on the surface of the mold with a glass cover
slip. The formulation-loaded mold is placed in a pressure vessel
under ca. 50 psi for about 30 seconds. Pressure is then released.
Excess formulation is wiped with a silicone or metal wiper with the
interference between wiper edge and surface of the mold about 1-10
mils. The mold is placed in an incubator at room temperature for
about half an hour.
[0138] The following table provides the details of representative
aqueous solutions used to form this type of microneedle array
comprising drug substance hPTH, a polymeric matrix, and
excipients.
TABLE-US-00004 TABLE 7-1 hPTH Solids in Polymer Excipients (1-34)
casting solution Ex. # Type Wt % Type Wt % Wt % Wt % D1 PEG-PLGA 50
Sucrose 35 15 10 (50/50(65/35)) D2 PEG-PLGA 45 Sucrose 40 15 10
(50/50(65/35)) D3 PEG-PLGA 45 Sucrose 40 15 20 (50/50(65/35)) D4
PEG-PLGA 55 Sucrose 35 10 10 (50/30(65/35)) D5 PEG-PLGA 55 Sucrose
35 10 10 (50/30(65/35)) D6 PEG-PLGA 55 Sorbitol 35 10 10
(50/30(65/35)) D7 PEG-PLGA 45 Sorbitol 40 15 10 (50/50(65/35)) D8
Pluronic F68 50 Sucrose 35 15 25 D9 Pluronic F127 50 Sucrose 35 15
15 D10 Pluronic F68 50 Sorbitol 35 15 25 D11 Pluronic F127 50
Sorbitol 35 15 15
[0139] In the table above, PEG-PLGA denotes a blend of polyethylene
glycol and poly(lactic acid-co-glycolic acid).
[0140] 2) Casting a dissolvable layer on top of the drug-containing
layer in the mold. After step 1) above, a small amount of
formulation, for example, 25 .mu.L, is placed as a droplet on the
mold, and a cover slip is placed on top of the droplet to spread
the liquid onto the entire surface of the mold. For example, an
illustrative wet formulation contains 70% Dextran 70, and 30%
sorbitol, in histidine buffer solvent, such that the formulation
contains, for example, 30% solids content as applied. The
drug-polymer matrix loaded mold is placed in a pressure vessel
under ca. 50 psi for about 30 seconds. Pressure is then released.
Excess formulation is wiped with a silicone or metal wiper with the
interference between wiper edge and the surface of the mold about
1-8 mils. The mold is placed in an incubator at a temperature of
32.degree. C., for about half an hour.
[0141] 3) Casting a backing layer on top of the dissolvable layer
in the mold. Following step 2) above, approximately 150 .mu.L of
backing solution (upper portion layer) containing poly(lactic
acid-co-glycolic acid) (PLGA) with a L/G ratio of 75/25 in
acetonitrile is placed on the mold (on top of the dissolvable
layer) and a thin film is cast using a wiper with the clearance
between edge of the wipe and surface of mold about 10-20 mil. The
mold is then placed into a pressure vessel under 10-30 psi with
controlled venting for about 5 min. The mold is further dried at
room temperature for about 30 min. The array is demolded, for
example using double-sided adhesive tape, and optionally attached
to a polyethylene terephthalate film as backing.
Example 8
hPTH(1-34) Stability in Dry Films Made with Microneedle Casting
Formulations
[0142] Dry films of microneedle casting formulations were prepared
using process conditions similar to those for casting microneedle
arrays to evaluate the stability of hPTH (1-34 fragment) in the
dried form. About 200 .mu.L of liquid formulation was placed in an
Eppendorf tube. The formulation was spread into a thin film in the
inside wall of the tube, then dried at 32.degree. C. for 30 min,
and then further dried under vacuum at room temperature overnight.
The dry films inside the Eppendorf tube were packaged in a polyfoil
bag and stored at different temperatures for different durations.
The purity of the hPTH(1-34) was analyzed by both reverse phase
HPLC (rp-HPLC) and size exclusion HPLC (sec-HPLC). The details of
the formulations are indicated in Table 8-1 below.
[0143] The following table provides details of the formulations
used to form dry films containing hPTH as the active agent.
TABLE-US-00005 TABLE 8-1 hPTH Solids in Polymer Sugar (1-34)
casting solution Ex. # Type Wt % Type Wt % Wt % Wt % F1 PVA 52.6
Sucrose 26.3 21.1 22.8 F2 Dextran 70 64.9 Sorbitol 19.5 15.6 30.8
F3 Tetrastarch 64.9 Sorbitol 19.5 15.6 30.8 F4* Dextran 70 64.1
Sorbitol 19.4 15.4 31.2 *ca. 0.4 wt % of methionine is added to the
formulation as an antioxidant agent.
[0144] Table 8-2 below illustrates the chemical purity as
determined by rp-HPLC of the hPTH(1-34) in different formulations
as a function of storage time at three different temperatures.
Table 8-3 below illustrates the monomer content as determined by
sec-HPLC of the hPTH(1-34) in different formulations as a function
of storage time at three different temperatures. It appears that
hPTH(1-34) is stable during storage for up to one month at even
elevated temperature in all the formulations examined. (Formulation
F3 was not sampled at the 1 week time point at room temperature or
40.degree. C.)
TABLE-US-00006 TABLE 8-2 F1 F2 F3 F4 5.degree. C. t = 0 100.0 100.0
100.0 100.0 t = 1 week 99.77 99.87 99.78 100.00 t = 2 week 99.76
99.71 99.65 99.74 t = 1 month 99.78 99.69 99.66 99.73 t = 13 months
98.87 100.0 100.0 100.0 25.degree. C. t = 0 100.0 100.0 100.0 100.0
t = 1 week 99.75 100.0 100.0 t = 2 week 99.72 99.63 99.49 99.70 t =
1 month 99.72 99.59 99.52 99.67 t = 3 months 99.76 99.72 99.09
99.88 t = 13 months 100.0 98.62 99.11 98.58 40.degree. C. t = 0
100.0 100.0 100.00 100.00 t = 1 week 99.72 99.79 99.88 t = 1 month
99.56 99.14 98.64 99.39
TABLE-US-00007 TABLE 8-3 F1 F2 F3 F4 5.degree. C. t = 0 100.00
100.00 100.00 100.00 t = 1 week 99.77 99.87 99.78 100.00 t = 2 week
99.76 99.71 99.65 99.74 t = 1 month 99.78 99.69 99.66 99.73
25.degree. C. (room temp.) t = 0 100.00 100.00 100.00 100.00 t = 1
week 99.75 100.00 100.00 t = 2 week 99.72 99.63 99.49 99.70 t = 1
month 99.72 99.59 99.52 99.67 t = 3 months 99.70 99.67 99.52 99.77
40.degree. C. t = 0 100.00 100.00 100.00 100.00 t = 1 week 99.72
99.79 99.88 t = 1 month 99.56 99.14 98.84 99.39
Example 9
Preparation of a 2-Layer Microprojection Array Containing Human
Parathyroid Hormone (hpth(1-34))
[0145] A microprojection array containing a therapeutically
effective amount of hPTH(1-34) (32 .mu.g) was prepared for use in a
Phase I clinical study as follows.
[0146] First, in describing generally the features of the
microprojection array, the microprotrusions of the array can be
characterized generally as comprising a DIT (drug-in-tip) layer and
a "backing" layer. The DIT layer includes hPTH(1-34) in a
water-soluble matrix. The sequence of hPTH(1-34) used was:
TABLE-US-00008 (SEQ ID NO: 1)
H-Ser-Val-Ser-Glu-Ile-Gln-Leu-Met-His-Asn-Leu-Gly-
Lys-His-Leu-Asn-Ser-Met-Glu-Arg-Val-Glu-Trp-Leu-
Arg-Lys-Lys-Leu-Gln-Asp-Val-His-Asn-Phe-OH
[0147] The tip of the microprojections is also referred to herein
as the layer at the bottom-most portion of the tips or
microprotrusions (i.e., proximal to the skin when placed upon the
skin), also referred to herein as the "end portion" that is distal
to the base of the array). The "backing" layer as referred to in
certain of these examples, encompasses both the upper portion of
the microprotrusions proximal to the base of the array as well as
the base itself, where the base is the portion of the array that
supports the tips. The backing layer comprises a biocompatible,
non-water soluble matrix. In the instant array device, the material
in the upper portion of the microprotrusions is the same as the
base material itself, so that the non-water soluble matrix
formulation is applied as a single layer to fill the mold atop the
DIT layer.
[0148] The DIT layer of the microstructure array dissolves into the
skin and contains the components provided in Table 9-1. Acetate was
the counter-ion in the hPTH(1-34) drug substance.
TABLE-US-00009 TABLE 9-1 Composition of Drug-in-Tip Layer of
hPTH(1-34) TDS % w/w (of the Chemical Name Quantity Range
microstructure Trade Name of Ingredient (.mu.g/unit) (.mu.g/unit)
array) hPTH (1-34) human Parathyroid hormone (1-34) 32.0 25.6-38.4
12.8 Dextran 70 Dextran, 70,000 Dalton molecular weight 160.0
128.0-192.0 58.6 Sorbitol, N.F. Sorbitol 54.9 64.0-96.0 21.9
Histidine L-histidine 0.14 0.11-0.17 0.1 Histidine HCl L-histidine
hydrochloride 0.73 0.58-0.88 0.3 NA Acetate 2.5 2.0-3.0 1.0 Total
250.27 100.0
[0149] The backing portion or layer of the array was composed of
poly(DL-lactide-co-glycolide), 75:25, ester terminated (Tradename:
LACTEL.RTM.).
[0150] The ingredients forming the tip portion of the formulation
(i.e., the DIT formulation) were dissolved in water, cast, and
dried in a silicone mold containing microstructure cavities to form
the drug-in-tips (DIT) structures. The water insoluble,
biocompatible polymer, poly(DL-lactide-co-glycolide), 75:25, was
dissolved in acetonitrile to provide the backing formulation which
was then coated on top of the DIT layer in the silicone mold, and
then dried. The solvent was removed from the backing (upper portion
proximal to the base, and base) during processing and was limited
to a level below the amounts recommended in ICH residual solvent
guidelines.
Example 10
Preparation of a Delivery Device Containing a Microprojection Array
Containing Human Parathyroid Hormone (hpth(1-34))
[0151] A delivery system, also referred to as an applicator-array
assembly, comprising a microprojection array prepared in accord
with Example 9 and an applicator as described with reference to
FIGS. 1-2, was assembled as follows. A microprojection holding
member with a microprojection array (Example 9) was prepared and
packaged, and separately an applicator assembly (i.e., an
applicator as in FIGS. 1-2 absent the microprojection-holding
member) was packaged. The two separate packages were provided in a
single boxed unit to each clinical site, for assembly of the
applicator-array assembly prior to use on a patient (see Example 11
below for clinical data).
[0152] The microprojection array contained was 11 millimeters in
diameter with approximately 2700 microprojections arranged in a
hexagonal pattern. The microprojection array was mounted on the
microprojection-holding member (element 184 of FIG. 2) using an
adhesive laminate. The microprojection-holding
member/microprojection array was packaged inside a protective
container and pouched in a dry nitrogen environment.
[0153] The applicator assembly comprised of an outer housing
(element 182 of FIG. 2) with a skin contact adhesive and a release
liner (elements 192, 194, respectively, of FIG. 2), an energy
storage member (in this case, a metal wave spring), and elements to
hold these items together. This applicatory assembly was packaged
inside a protective container and pouched.
[0154] Prior to use of the system, the microprojection-holding
member/microprojection array was inserted into the applicator
assembly, and the system was activated by compressing the spring
and then twisting the microprojection-holding member to lock and
hold the compressed spring in place in the applicator. To initiate
delivery of the hPTH dose, the user twists the
microprojection-holding member to unlock or unseat it from the
outer cover, thus causing the spring to release its stored energy
causing accelerated movement of the microprojection-holding member
and attached microprojection array into contact with the skin. Upon
contact with the skin, the microstructures penetrate past the
stratum corneum, and the hPTH dissolves into the skin rapidly.
Following actuation of the spring and delivery of hPTH, the system
is removed and discarded.
Example 11
In-Vivo Study: Administration of Human Parathyroid Hormone,
hpth(1-34), Via a Microprojection Array Device in Healthy Human
Subjects
[0155] An open label, single dose, sequence randomized, 3-way
cross-over study was carried out in sixteen healthy female
volunteers to determine the pharmacokinetics (along with additional
secondary endpoints) of 32 .mu.g hPTH(1-34) and 64 .mu.g hPTH(1-34)
(32 .mu.g hPTH(1-34).times.2) delivered using the TDS
("MicroCor.RTM.") described in Examples 9 and 10 relative to
subcutaneously administered (SC) FORTEO.RTM. (teriparatide), 20
.mu.g. The system described in Examples 9 and 10 is referred to in
this example generally as "MicroCor.RTM. hPTH(1-34)" or for
simplicity herein, "MicroCor.RTM.".
[0156] Subjects received a single dose of 32 .mu.g hPTH(1-34) or 64
.mu.g hPTH(1-34) (32 .mu.g.times.2) by applying the MicroCor.RTM.
device to an abdominal site for 5 minutes. Treatment with the
commercial hPTH product known as Forteo.RTM. was accomplished by
administration as a subcutaneous injection into the abdominal wall.
Treatments were separated by a 48-hour washout period. The plasma
sampling schedule was as follows: pre-treatment, 5, 10, 15, 20, 25,
30, 40, 50, 60, 75, 90, 120, 180, 240, 300, 360 minutes, and 24
hours post-treatment. Vital signs were monitored pre-treatment, and
at 15 and 30 minutes, and 1, 2, 3, 4, 5, 6, 8, 10, 12, and 24 hours
post-treatment. Adverse advents were monitored throughout the
study. Additional assessments included (i) measurement of anti-PTH
antibodies prior to first treatment and 2 weeks following last
treatment, (ii) measurement of serum calcium, phosphorous, albumin,
and protein at pre-treatment, and 1, 2, 3, 4, 5, 6, and 24 hours
post-treatment, as well as (iii) adhesion of the MicroCor.RTM.
system.
[0157] Administration of hPTH transdermally via the microarray
(MicroCor.RTM. treatments) demonstrated good skin tolerability.
Skin effects were transient and well-tolerated, with mild to
moderate erythema observed. In terms of general safety, all
treatment regimes were well-tolerated. No significant adverse
events nor unexpected adverse events occurred. In fact, there was
no difference in the overall treatment-related adverse events
between the MicroCor.RTM. and the Forteo.RTM.-based treatments. No
significant changes were observed in serum calcium, and no anti-PTH
antibodies were detected, again further demonstrating the overall
safety of MicroCor.RTM.-based treatment in human subjects. Data is
presented in FIGS. 3-8 and Table 1, above.
Sequence CWU 1
1
1134PRTHomo sapiens 1Ser Val Ser Glu Ile Gln Leu Met His Asn Leu
Gly Lys His Leu Asn 1 5 10 15 Ser Met Glu Arg Val Glu Trp Leu Arg
Lys Lys Leu Gln Asp Val His 20 25 30 Asn Phe
* * * * *