ABSTRACT
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.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a Continuation of U.S. application Ser. No. 16/786,906, filed Feb. 10, 2020, now allowed, which is a Divisional of U.S. application Ser. No. 15/623,305, filed Jun. 14, 2017, which is a continuation of U.S. application Ser. No. 13/101,071, filed May 4, 2011, now U.S. Pat. No. 9,687,641, issued Jun. 27, 2017, 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
A Sequence Listing is being submitted electronically via USPTO Patent Center in the form of an XML file, created Jul. 14, 2022, and named â091500-0970_Sequence_Listing.XMLâ (2 kilobytes), the contents of which are incorporated herein by reference in their entirety.
TECHNICAL FIELD
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
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.
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® (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.
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.
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).
As a peptide product, PTH (1-34) requires daily subcutaneous injectionsâan 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.
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.
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.
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
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.
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 max ) of about ten minutes or less.
In one embodiment, the PTH is human parathyroid hormone (1-34).
In yet another embodiment, the microprotrusion array comprises from about 1500 to about 3200 microprotrusions, more preferably from about 2200 to about 3200 microprotrusions.
In yet a further embodiment, the microprotrusion array possesses a diameter ranging from about 8 millimeters to about 14 millimeters.
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.
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.
In yet another embodiment of the method, the water-insoluble polymer comprises poly(lactic acid-co-glycolic acid).
In a further embodiment of the method, the base and the upper portion of the microprotrusion array comprise the same water-insoluble polymer.
In yet another embodiment related to the foregoing, the base and the upper portion of the microprotrusion array comprise the same material.
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.
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.
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.
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.
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.
In yet another embodiment, the microprotrusion array is applied to the abdomen of the subject.
In yet a further embodiment, the method achieves an elimination half-life (t 1/2 ) of PTH that is at least about 15%, 20%, 22% 25% or 30% lower than the elimination half-life (t 1/2 ) of the same dose of PTH administered subcutaneously.
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.
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.
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.
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.
In one or more related embodiments, the kit comprises a microprotrusion array according to one or more of the array embodiments described herein.
In yet another embodiment, the applicator assembly further comprises fasteners to temporarily connect the housing and the energy storage member prior to assembly.
In a more specific embodiment of the kit, the applicator assembly is packaged in a first package or protective container.
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.
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.
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.
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
FIG. 1 demonstrates a fully assembled applicator.
FIG. 2 is demonstrates an exploded view of the applicator of FIG. 1 .
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®, 32 μg: Cmax: 180 μg/mL, Tmax: 8.1 mins; MicroCor® 64 μg: Cmax: 336 μg/mL, Tmax: 7.4 mins; subcutaneously injected teriparatide (Forteo®) 20 μg: Cmax: 85 μg/mL, Tmax: 0.44 mins).
FIG. 4 demonstrates dose-normalized AUC (area under the curve) values (μg*min/mL*μg) for an illustrative microprotrusion array-based hPTH transdermal delivery system in comparison to subcutaneous administration of hPTH as described in detail in Example 11.
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® 32 μg dose and MicroCor® 64 μg dose) in comparison to subcutaneous administration (Forteo®, 20 μg dose) as described in detail in Example 11.
FIG. 6 is a graph il
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a Continuation of U.S. application Ser. No. 16/786,906, filed Feb. 10, 2020, now allowed, which is a Divisional of U.S. application Ser. No. 15/623,305, filed Jun. 14, 2017, which is a continuation of U.S. application Ser. No. 13/101,071, filed May 4, 2011, now U.S. Pat. No. 9,687,641, issued Jun. 27, 2017, 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
A Sequence Listing is being submitted electronically via USPTO Patent Center in the form of an XML file, created Jul. 14, 2022, and named â091500-0970_Sequence_Listing.XMLâ (2 kilobytes), the contents of which are incorporated herein by reference in their entirety.
TECHNICAL FIELD
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
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.
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® (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.
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.
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).
As a peptide product, PTH (1-34) requires daily subcutaneous injectionsâan 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.
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.
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.
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
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.
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 max ) of about ten minutes or less.
In one embodiment, the PTH is human parathyroid hormone (1-34).
In yet another embodiment, the microprotrusion array comprises from about 1500 to about 3200 microprotrusions, more preferably from about 2200 to about 3200 microprotrusions.
In yet a further embodiment, the microprotrusion array possesses a diameter ranging from about 8 millimeters to about 14 millimeters.
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.
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.
In yet another embodiment of the method, the water-insoluble polymer comprises poly(lactic acid-co-glycolic acid).
In a further embodiment of the method, the base and the upper portion of the microprotrusion array comprise the same water-insoluble polymer.
In yet another embodiment related to the foregoing, the base and the upper portion of the microprotrusion array comprise the same material.
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.
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.
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.
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.
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.
In yet another embodiment, the microprotrusion array is applied to the abdomen of the subject.
In yet a further embodiment, the method achieves an elimination half-life (t 1/2 ) of PTH that is at least about 15%, 20%, 22% 25% or 30% lower than the elimination half-life (t 1/2 ) of the same dose of PTH administered subcutaneously.
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.
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.
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.
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.
In one or more related embodiments, the kit comprises a microprotrusion array according to one or more of the array embodiments described herein.
In yet another embodiment, the applicator assembly further comprises fasteners to temporarily connect the housing and the energy storage member prior to assembly.
In a more specific embodiment of the kit, the applicator assembly is packaged in a first package or protective container.
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.
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.
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.
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
FIG. 1 demonstrates a fully assembled applicator.
FIG. 2 is demonstrates an exploded view of the applicator of FIG. 1 .
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®, 32 μg: Cmax: 180 μg/mL, Tmax: 8.1 mins; MicroCor® 64 μg: Cmax: 336 μg/mL, Tmax: 7.4 mins; subcutaneously injected teriparatide (Forteo®) 20 μg: Cmax: 85 μg/mL, Tmax: 0.44 mins).
FIG. 4 demonstrates dose-normalized AUC (area under the curve) values (μg*min/mL*μg) for an illustrative microprotrusion array-based hPTH transdermal delivery system in comparison to subcutaneous administration of hPTH as described in detail in Example 11.
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® 32 μg dose and MicroCor® 64 μg dose) in comparison to subcutaneous administration (Forteo®, 20 μg dose) as described in detail in Example 11.
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® 32 μg dose and MicroCor® 64 μg dose) in comparison to subcutaneous administration (Forteo®, 20 μg dose) as described in detail in Example 11.
FIG. 7 is a graph illustrating mean T½ (minutes) values for each of the three treatment regimes examined: an illustrative microprotrusion array-based hPTH transdermal delivery system (MicroCor® 32 μg dose and MicroCor® 64 μg dose) in comparison to subcutaneous administration (Forteo®, 20 μg dose) as described in detail in Example 11.
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® 32 μg doseâopen squares and MicroCor® 64 μg doseâclosed squares) in comparison to subcutaneous administration (Forteo®, 20 μg dose, closed circles) as described in detail in Example 11.
FIGS. 9 A- 9 B depict schematically in cross-section exemplary microprojection arrays.
DETAILED DESCRIPTION
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.
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., 20th Ed.; Goodman & Gilman The Pharmacological Basis of Therapeutics , J. Griffith Hardman, L. L. Limbird, A. Gilman, 10th Ed.
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 μm to 8 μm is stated, it is intended that 2 μm, 3 μm, 4 μm, 5 μm, 6 μm, and 7 μm are also explicitly disclosed, as well as the range of values greater than or equal to 1 μm and the range of values less than or equal to 8 μm.
Definitions
It must be noted that, as used in this specification, the singular forms âa,â âan,â and âtheâ include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to a âpolymerâ includes a single polymer as well as two or more of the same or different polymers, reference to an âexcipientâ includes a single excipient as well as two or more of the same or different excipients, and the like.
In describing and claiming the present invention, the following terminology will be used in accordance with the definitions described below.
âPulsatile deliveryâ 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 âspikeâ in the concentration profile).
âTransdermalâ refers to the delivery of an agent such as PTH into and/or through the skin for local or systemic therapy.
Reference to a âPTHâ, or a PTH-agent or to âhPTH (1-34)â, 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.
The terms âmicroprotrusionâ, âmicroprojectionâ or âmicroneedleâ 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.
âSubstantiallyâ or âessentiallyâ means nearly totally or completely, for instance, 95% or greater of some given quantity.
âOptionalâ or âoptionallyâ 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.
A material that is âwater-solubleâ such as the polymer matrix described herein, is dissolvable at physiological pH, such that the material dissolves into or within the skin.
Overview
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
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 , 5 A, 5 B, 5 C and 6 .
In reference to the microprojections themselves, in general, the microprojections have a height of at least about 100 μm, or at least about 150 μm, or at least about 200 μm, or at least about 250 μm, or at least about 300 μm. In general, the microprojections have a height of no more than about 1 mm, no more than about 500 μm, no more than about 300 μm, or in some cases no more than about 200 μm or 150 μm. 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.
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 âbacking portionâ or âfoundationâ or as an âupper portionâ may be designed not to penetrate the skin.
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 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.
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.
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® system from Dow Corning (Midland, MI), for example Sylgard® 184. Nusil MED 6215, 6210 is an alternative system available from NuSil Technology (Carpinteria, CA).
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.
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.
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® or Poloxamer®), 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.
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 α, β, and γ cyclodextrins, for example hydroxypropyl-β-cyclodextrin and methyl-β-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.
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.
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 dexran, sorbitol, and PTH counter-ion, if contained in the PTH source material. Additional components may include buffers such as histidine and histidine hydrochloride.
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.
Exemplary solvents for casting include water, alcohols (for example, C 2 to C 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.
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.
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 microprojectionsâthose furthest from the baseâto become finer as a result of solvent removal. Illustrative tip diameters include those of less than about 10 μm, or less than about 5 μm, less than 2 μm, less than about 1.5 μm, or even less than about 1 μm.
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.
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).
FIGS. 9 A- 9 B 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. 9 A , 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.
In another embodiment of a microprojection array 60 depicted in FIG. 9 B , 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., âdrug-in-tipâ 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 âtipâ 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.
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.
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® 97), polymethacrylates (such as Eudragit® 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.
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.
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.
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.
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.
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.
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.
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
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 μg per dosage unit, or from about 10-250 μg per dosage unit, or from about 10-100 μg per dosage unit.
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.
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.
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, CA).
Description of an exemplary PTH formulation as described above is provided in Example 9.
Transdermal Delivery Device
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.
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.
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.
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.
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.
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.
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
Th
CLAIMS
Claims ( 14 )
It is claimed:
1. 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 of the plurality of microprotrusions comprising an end portion distal to the planar base and an upper portion proximal to the planar base,
wherein at least the end portion of each microprotrusion of the plurality of microprotrusions comprises a portion of the dose of the PTH in a water-soluble polymer matrix, the water-soluble polymer matrix comprising:
(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; and
wherein the upper portion of each microprotrusion of the plurality of microprotrusions comprises at least one water-insoluble polymer.
2. The microprotrusion array of claim 1 , wherein the PTH is human parathyroid hormone (1-34).
3. The microprotrusion array of claim 1 , wherein the at least one dextran polymer is selected from Dextran 1, Dextran 10, Dextran 20, Dextran 40, Dextran 70 and Dextran 75.
4. The microprotrusion array of claim 1 , wherein the water-soluble polymer matrix comprises about 35-70% dry weight of the at least one dextran polymer.
5. The microprotrusion array of claim 1 , wherein the at least one sugar or sugar alcohol is selected from sucrose and sorbitol.
6. The microprotrusion array of claim 1 , wherein the base is comprised of a water-insoluble polymer.
7. The microprotrusion array of claim 1 , wherein the water-insoluble polymer comprises a poly(lactic acid-co-glycolic acid).
8. The microprotrusion array of claim 1 , wherein the dose of PTH includes about 10-100 μg PTH.
9. The microprotrusion array of claim 1 , wherein the dose of PTH includes about 32 μg PTH.
10. The microprotrusion array of claim 1 , wherein the dose of PTH includes about 64 μg PTH.
11. The microprotrusion array of claim 1 , wherein at least a portion of the end portion of each microprotrusion of the plurality of microprotrusions including a tip of that microprotrusion is configured to detach from that microprotrusion after the plurality of microprotrusions have been inserted into a skin of the mammalian subject.
12. The microprotrusion array of claim 1 , wherein the plurality of microprotrusions are configured to:
(a) penetrate a skin of the mammalian subject when the microprotrusion array is applied to a skin site of the mammalian subject,
(b) administer transdermally the dose of the PTH to the mammalian subject after the microprotrusion array has been applied to the skin site for about 15 minutes or less, and
(c) achieve an average time to maximum PTH plasma concentration (Tmax) of about ten minutes or less.
13. A kit, comprising:
a microprotrusion array comprised of a plurality of microprotrusions extending from an approximately planar base, each microprotrusion of the plurality of microprotrusions comprising an end portion distal to the planar base and an upper portion proximal to the planar base,
the end portion of each microprotrusion of the plurality of microprotrusions comprising parathyroid hormone (PTH) in a water-soluble polymer matrix comprising:
(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, and
the upper portion of each microprotrusion of the plurality of microprotrusions being comprised of at least one water-insoluble polymer,
said microprotrusion 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 of the plurality of microprotrusions is fabricated to achieve an average time to maximum PTH plasma concentration (Tmax) of about ten minutes or less when the microprotrusion array is applied to a subject.
14. A method of transdermally administering a dose of parathyroid hormone (PTH) to a mammalian subject, comprising:
applying, to a skin site of the mammalian subject, a microprotrusion array comprising a plurality of microprotrusions extending from an approximately planar base, each microprotrusion of the plurality of microprotrusions comprising an end portion distal to the planar base and an upper portion proximal to the planar base, the end portion of each microprotrusion of the plurality of microprotrusions comprising a tip of that microprotrusion, at least the end portion of each microprotrusion of the plurality of microprotrusions comprising parathyroid hormone (PTH) in a water-soluble polymer matrix;
inserting all or a portion of the plurality of microprotrusions into the skin site; and
maintaining the microprotrusion array on the skin site for about 15 minutes or less to achieve a maximum PTH plasma concentration (Tmax) in an average time of about ten minutes or less.
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Method and device for transdermal delivery of parathyroid hormone using a microprojection array
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Method and device for transdermal delivery of parathyroid hormone using a microprojection array
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