Anti-interleukin antibody preparations for delivery into a lumen of the intestinal tract using a swallowable drug delivery device
Embodiments of the invention provide swallowable devices, preparations and methods for delivering therapeutic agents within the GI tract such as neutralizing proteins (NP) particularly antibodies which neutralize interleukins. Many embodiments provide a swallowable device e.g., a capsule for delivering various agents into the intestinal wall (IW). Embodiments also provide agent preparations that are configured to be contained within the capsule, advanced from the capsule into the IW and degrade to release the agent into the bloodstream to produce a therapeutic effect. The preparation can be operably coupled to delivery means having a first configuration where the preparation is contained in the capsule and a second configuration where the preparation is advanced out of the capsule into the IW. Embodiments of the invention are particularly useful for the delivery of interleukin NP's (INP) for treatment of inflammatory conditions where such INP's are poorly absorbed, tolerated and/or degraded within the GI tract.
1. A method of delivering an anti-interleukin 17 antibody (AI17 antibody) to a patient having a disease or condition associated with interleukin 17, the method comprising:
administering an AI17-antibody in a solid form shaped as a tissue-penetrating member and configured to be orally delivered to the patient's intestinal tract, wherein an amount of AI17-antibody in the solid form is in a range from about 1 to 20 mg;
penetrating the solid form into an intestinal wall of the patient after oral ingestion by application of mechanical force on the tissue-penetrating member such that the tissue-penetrating member is retained in the intestinal wall; and
releasing the AI17-antibody into the patient's blood stream from the solid form in the intestinal wall;
wherein any adverse reaction from said release of the AI17-antibody in the intestinal wall is less than that associated with parenterally injected delivery of the AI17-antibody.
2. A method of delivering an anti-interleukin 17 antibody (AI17 antibody) to a patient, the method comprising:
administering daily an AI17 antibody in a solid form shaped as a tissue-penetrating member and configured to be orally delivered to the patient's intestinal tract, wherein an amount of AI17-antibody in the solid form dose is in a range from about 1 to 20 mg;
penetrating the solid form into an intestinal wall of the patient after oral ingestion by application of mechanical force on the tissue-penetrating member such that the tissue-penetrating member is retained in the intestinal wall; and
releasing the AI17-antibody into the patient's blood stream from the solid form in the intestinal wall of the patient, such that a daily fluctuation in a plasma concentration of the AI17-antibody is between about 0.12 and 0.26%.
3. A method for treating plaque psoriasis in a patient, the method comprising:
administering an anti-interleukin 17 antibody (AI17-antibody) in a solid form shaped as a tissue-penetrating member wherein an amount of AI17-antibody in the solid form is in a range from about 1 to 20 mg;
penetrating the solid form into an intestinal wall of the patient after oral ingestion by application of mechanical force on the tissue-penetrating member such that the tissue-penetrating member is retained in the intestinal wall; and
releasing the AI17-antibody into the blood stream of the patient from the solid form in the intestinal wall;
wherein any adverse reaction from said release of the AI17-antibody in the intestinal wall is less than that associated with parenterally injected delivery of the AI17-antibody.
4. A method for treating psoriatic arthritis in a patient, the method comprising:
administering an anti-interleukin 17 antibody (AI17-antibody) in a solid form shaped as a tissue-penetrating member, wherein an amount of AI17-antibody in the solid form is in a range from about 1 to 20 mg;
penetrating the solid form AI17-antibody into an intestinal wall of the patient after oral ingestion by application of mechanical force on the tissue-penetrating member such that the tissue-penetrating member is retained in the intestinal wall; and
releasing the AI17-antibody into the blood stream of the patient from the solid form in the intestinal wall;
wherein any adverse reaction from said release of the AI17-antibody is less than that associated with parenterally injected delivery of the AI17-antibody.
5. The method of claim 1 , wherein the parenterally injected delivery is an intramuscular or sub-dermal injection.
6. The method of claim 1 , wherein the solid dose AI17-antibody is adapted to be orally delivered in a swallowable capsule, the method further comprising:
swallowing the capsule and having it reach the small intestine; and
penetrating the solid dose AI17-antibody into the wall of the small intestine responsive to a condition in the small intestine.
7. The method of claim 6 , wherein the condition is a pH.
8. The method of claim 7 , wherein the condition is a pH of about 6.5 such that the solid dose AI17-antibody penetrates into the wall of the duodenum or jejunum sections of the small intestine and avoids the ileum section containing the Peyer's patches.
9. The method of claim 1 , wherein the disease or condition comprises a biological effect in the body of the patient that is induced by interleukin 17.
10. The method of claim 9 , wherein the biological effect is selected from one or more of a pro-inflammatory response; Th1 modulation; Th2 modulation; NK modulation; neutrophil modulation; monocyte-macrophage lineage modulation; neutrophil modulation; eosinophil modulation; B cell modulation; cytokine modulation; and chemokine modulation.
11. The method of claim 1 , wherein the adverse reaction is selected from one or more of an injection site reaction, anaphylactic reaction, anaphylactic shock, edema, headache, immunogenic reaction, production of antibodies against the AI17-antibody, and reduced efficacy of the AI1-antibody.
12. The method of claim 1 , wherein an immune response in the patient to the AI17-antibody is reduced as compared to delivery of the AI17-antibody by parenteral injection.
13. The method of claim 12 , wherein the immune response in the patient to the AI17-antibody is reduced by an amount in the range of two to thirty times as compared to an intramuscular or sub-dermal injection.
14. The method of claim 1 , wherein an incidence of allergic reaction to the AI17-antibody is reduced as compared to delivery of the AI17-antibody by parenteral injection.
15. The method of claim 14 , wherein the incidence of allergic reaction to the AI17-antibody is reduced by an amount in the range of about two to thirty times as compared to an intramuscular or sub-dermal injection.
16. The method of claim 1 , wherein the AI17-antibody is released into the mesenteric vasculature so as to flow into the portal vein and bind to interleukin 17 in the liver before substantially binding to interleukin 17 at other locations in the body.
17. The method of claim 1 , wherein the solid dose AI17-antibody is inserted into a section of the intestinal wall before that containing Peyer's patches such that any immune response to the AI17-antibody caused by the Peyer patches is minimized.
18. The method of claim 17 , wherein the solid form AI17-antibody is inserted into a duodenum or jejunum wall portion of the small intestine.
19. The method of claim 1 , wherein the AI17-antibody released into the blood stream from the solid form AI17-antibody reaches a Cmax in a shorter time period than a time period to achieve a Cmax for an extravascularly injected dose of AI17-antibody.
20. The method of claim 19 , wherein a tmax for the AI17-antibody released from the solid form AI17-antibody is less than about 50% of a tmax for the extravascularly injected dose of AI17-antibody.
21. The method of claim 1 , wherein the solid form AI17-antibody is provided daily so that a steady state daily fluctuation in a plasma concentration of the AI17-antibody is significantly less than that for the parenteral injection.
22. The method of claim 1 , wherein the solid form of the AI17-antibody provides a steady daily fluctuation in plasma concentration of the AI17-antibody between about 0.12 and 0.26%.
23. The method of claim 21 , wherein the steady daily fluctuation in plasma concentration of the AI17-antibody is between about 171 and 216 times less than that associated with parenterally injected delivery of the AI17-antibody.
24. The method of claim 1 , wherein the AI17-antibody is secukinumab, brodalumab, or ixekizumab.
25. The method of claim 1 , wherein the disease or condition is plaque psoriasis.
26. The method of claim 1 , wherein the disease or condition is psoriatic arthritis.
27. The method of claim 1 , wherein the disease or condition is ankylosing spondylitis.
28. The method of claim 1 , wherein the disease or condition is rheumatoid arthritis.
29. The method of claim 1 , wherein the disease or condition is Crohn's Disease.
30. The method of claim 1 , wherein the disease or condition is inflammatory bowel disease.
31. The method of claim 2 , wherein the patient has a disease selected from the group consisting of plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis, Crohn's disease, and inflammatory bowel disease.
32. The method of claim 2 , wherein the steady daily fluctuation in plasma concentration of the AI17-antibody is between about 171 and 216 times less than that associated with parenterally injected delivery of the AI17-antibody.
33. The method of claim 2 , wherein the adverse reaction is selected from one or more of an injection site reaction, anaphylactic reaction, anaphylactic shock, edema, headache, immunogenic reaction, production of antibodies against the AI17-antibody, and reduced efficacy of the AI1-antibody.
34. The method of claim 3 , wherein the AI17-antibody is secukinumab, brodalumab, or ixekizumab.
35. The method of claim 3 , wherein the AI17-antibody is brodalumab.
36. The method of claim 3 , wherein the AI17-antibody is ixekizumab.
37. The method of claim 3 , wherein an immune response in the patient to the AI17-antibody is reduced as compared to delivery of the AI17-antibody by parenteral injection.
38. The method of claim 37 , wherein the immune response in the patient to the AI17-antibody is reduced by an amount in the range of about two to thirty times as compared delivery of the AI17-antibody by parenteral injection.
39. The method of claim 37 , wherein the incidence of allergic reaction to the AI17-antibody is reduced by an amount in the range of two to thirty times compared delivery of the AI17-antibody by parenteral injection.
40. The method of claim 4 , wherein the AI17-antibody is secukinumab, brodalumab, or ixekizumab.
41. The method of claim 4 , wherein the AI17-antibody is brodalumab.
42. The method of claim 4 , wherein the AI17-antibody is ixekizumab.
43. The method of claim 4 , wherein the AI17-antibody is released into the mesenteric vasculature so as to flow into the portal vein and bind to interleukin 17 in the liver before substantially binding to interleukin 17 at other locations in the body.
44. A method of delivering an anti-interleukin 17 antibody (AI17 antibody) to a patient, the method comprising:
administering an AI17-antibody in a solid form shaped as a tissue-penetrating member and configured to be orally delivered to the patient's intestinal tract wherein an amount of AI17-antibody in the form is in a range from about 1 to 20 mg:
penetrating the solid form AI17-antibody into the patient's intestinal wall or surrounding tissue after oral ingestion by application of mechanical force on the tissue-penetrating member such that the tissue penetrating member is retained in the intestinal wall or surrounding tissue; and
releasing the AI17-antibody from the retained solid form AI17 into mesenteric vasculature surrounding the intestinal wall such that the released AI17-antibody flows into the patient's portal vein and into the patient's liver where a substantial amount of the AI17-antibody binds to interleukin 17 present in the liver before binding to said interleukin 17 present at non-liver sites in the body.
45. The method of claim 2 , wherein the AI17-antibody is secukinumab, brodalumab, or ixekizumab.
46. The method of claim 44 , wherein the AI17-antibody is secukinumab, brodalumab, or ixekizumab.