SYSTEMS FOR ENTERIC DELIVERY OF THERAPEUTIC AGENTS
Described herein are systems for the enteric delivery of therapeutic agents, and methods of administering a therapeutic agent to a patient by orally administering an enteric delivery system. The enteric deliver system includes one or more carrier members comprising a carrier polymer and a therapeutic agent, and the system is configurable in a compacted configuration and an expanded configuration, and is sized to maintain contact with the intestinal wall of the small intestine by applying an outwardly directed pressure to the intestinal wall and transport at least a portion of the therapeutic agent across the enteric mucosa of the small intestine.
1 . A system for enteric delivery of a therapeutic drug, comprising:
one or more carrier members comprising a carrier polymer and a therapeutic agent,
the system configurable in a compacted configuration and an expanded configuration, wherein the system is configured to (1) expand from the compacted configuration to the expanded configuration within the small intestine, or (2) expand from the compacted configuration to the expanded configuration within the stomach and pass through the pylorus without substantial release of the therapeutic agent until reaching the small intestine;
wherein the system is sized to maintain contact with the intestinal wall of the small intestine by applying an outwardly directed pressure to the intestinal wall and transport at least a portion of the therapeutic agent across the enteric mucosa of the small intestine; and
wherein at least a portion of the system loses structural integrity after a period of time within the small intestine to release the outwardly directed pressure.
2 . The system of claim 1 , wherein the system is configured to expand from the compacted configuration to the expanded configuration within the small intestine.
3 . The system of claim 1 , wherein the system is configured to expand from the compacted configuration to the expanded configuration within the stomach and pass through the pylorus without substantial release of the therapeutic agent until reaching the small intestine.
4 . The system of any one of claims 1 - 3 , wherein the one or more carrier members comprise a coating comprising the therapeutic agent.
5 . The system of claim 4 , wherein the coating further comprises a permeability enhancing agent.
6 . The system of any one of claims 1 - 3 , wherein the therapeutic agent is loaded into the carrier polymer.
7 . The system of claim 6 , wherein a permeability enhancing agent is loaded into the carrier polymer.
8 . The system of claim 5 or 7 , wherein the permeability enhancing agent is a muco-adhesive agent or a muco-permeating agent.
9 . The system of claim 8 , wherein the permeability enhancing agent is a fatty acid, a bile salt, chitosan, a thiolated polymer, or a cell penetrating peptide.
10 . The system of any one of claims 1 - 9 , wherein the outwardly directed pressure is released after about 1 hour to about 72 hours after the system enters the small intestine.
11 . The system of any one of claims 1 - 10 , wherein release of the outwardly directed pressure allows for passage of the carrier members through the small intestine.
12 . The system of any one of claim 1 - 11 , wherein the system is configured to transport the therapeutic agent across the enteric mucosa for about 1 hour to about 72 hours.
13 . The system of any one of claims 1 - 12 , wherein the system is sized to maintain contact with the intestinal wall of the duodenum by applying an outwardly directed pressure to the intestinal wall of the duodenum and transport at least a portion of the therapeutic agent across the enteric mucosa of the duodenum.
14 . The system of any one of claims 1 - 13 , wherein the one or more carrier members comprise a hollow core.
15 . The system of any one of claims 1 - 14 , wherein the one or more carrier members comprise a solid core.
16 . The system of any one of claims 1 - 15 , wherein the one or more carrier members are configured to lose structural integrity after a period of time within the small intestine to release the outwardly directed pressure.
17 . The system of claim 16 , wherein the one or more carrier members are configured to lose structural integrity through erosion, degradation, or softening of the one or more carrier members.
18 . The system of any one of claims 1 - 16 , wherein the one or more carrier members are arranged in a ring shape.
19 . The system of any one of claims 1 - 18 , further comprising one or more linkers that join the one or more carrier members to form a ring shape, the one or more linkers comprising a polymer configured to lose structural integrity after a period of time in the small intestine.
20 . The system of claim 19 , wherein the therapeutic drug is within a coating on or in an outer portion of the ring shape, but not on or in an inner portion of the ring shape.
21 . The system of any one of any one of claims 1 - 17 , wherein the system further comprises an elastomeric central member attached to a plurality of arms radiating outwardly from the central member when the system is in an extended configuration, the arms comprising one or more carrier members.
22 . The system of claim 21 , wherein the therapeutic drug of the system is preferentially disposed on or within distal ends of the arms relative to the elastomeric central member.
23 . The system of claim 22 , wherein the elastomeric central member comprises a polymer configured to lose structural integrity after a period of time in the small intestine.
24 . The system of claim 23 , wherein the elastomeric central member is configured to lose structural integrity through erosion, degradation, or softening of the elastomeric central member.
25 . The system of any one of claims 21 - 24 , wherein the elastomeric central member is joined to the arms through one or more linkers comprising a polymer configured to lose structural integrity after a period of time in the small intestine.
26 . The system of claim 19 , 20 , or 25 , wherein the system loses structural integrity through erosion, degradation, or softening of the one or more linkers.
27 . The system of any one of claims 1 - 26 , wherein the carrier members have a circular, elliptical, or teardrop cross section.
28 . The system of any one of claims 1 - 27 , wherein the therapeutic agent is a polypeptide or a polynucleotide.
29 . The system of claim 28 , wherein the therapeutic agent is a polypeptide comprising 10 or more amino acids.
30 . The system of claim 28 , wherein the therapeutic agent is a polynucleotide comprising 10 or more nucleotides.
31 . The system of any one of claims 1 - 30 , wherein the small intestine is a small intestine of a human.
32 . The system of any one of claims 1 - 31 , wherein the system is coated with a protective coating.
33 . The system of claim 32 , wherein the protective coating is an enteric coating.
34 . The system of claim 32 or 33 , wherein the system is further coated with a reverse-enteric coating.
35 . A therapeutic dosage form comprising a capsule encapsulating the system of any one of claims 1 - 34 .
36 . The therapeutic dosage form of claim 35 , wherein the capsule is an enteric capsule.
37 . A method of administering a therapeutic agent to a patient, comprising:
orally administering to the patient an enteric delivery system in a compacted configuration, the enteric delivery system comprising one or more carrier members comprising a carrier polymer and the therapeutic agent;
expanding the enteric delivery system to an expanded configuration;
applying, using the expanded enteric delivery system, outwardly directed pressure to the intestinal wall of the small intestine of the patient; and
releasing the therapeutic agent from enteric delivery system to transport the therapeutic agent across the enteric mucosa of the small intestine.
38 . The method of claim 37 , wherein the enteric delivery system is expanded within the small intestine.
39 . The method of claim 37 or 38 , wherein the enteric delivery system expands in the duodenum of the patient.
40 . The method of claim 37 , wherein the enteric delivery system is expanded within the stomach of the patient and passes through the pylorus of the patient into the small intestine without substantial release of the therapeutic agent until the system enters the small intestine.
41 . The method of any one of claims 37 - 40 , wherein at least a portion of the system loses structural integrity after a period of time within the small intestine to release the outwardly directed pressure.
42 . The method of claim 41 , wherein the outwardly directed pressure is released after about 1 to about 72 hours after the system enters the small intestine.
43 . The method of claim 41 or 42 , wherein release of the outwardly directed pressure allows the enteric delivery system to pass through the small intestine.
44 . The method of any one of claims 37 - 43 wherein the therapeutic agent is a polypeptide or a polynucleotide.
45 . The method of claim 44 , wherein the therapeutic agent is a polypeptide comprising 10 or more amino acids.
46 . The method of claim 44 , wherein the therapeutic agent is a polynucleotide comprising 10 or more nucleotides.
47 . The method of any one of claims 37 - 46 , wherein the enteric delivery system is the system according to any one of claims 1 - 34 .
48 . The method of any one of claims 37 - 46 , wherein the patient is a human.