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(12) United States Patent (10) Patent No.: US 6,913,760 B2 Carr Et Al

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(12) United States Patent (10) Patent No.: US 6,913,760 B2 Carr Et Al USOO691376OB2 (12) United States Patent (10) Patent No.: US 6,913,760 B2 Carr et al. (45) Date of Patent: Jul. 5, 2005 54) DRUG DELIVERY COMPOSITION B ennett, et al.,1. "A peripheral mononeuropathyhv iin rat pro (75) I nVentOS. DanielDaniel B.S. CCar CheStnut Hill,HI MA duces disorders of pain Sensation like those Seen in man', (US); Andrzej W.s Lipkowski,s Warsaw Pain,ain, 33(1)33(1): 87-107,s 1988. (PL); Donald L. Wise, Belmont, MA Carr, et al., “Spinal tube of analgesia: Opiods and future (US); Vasif Hasirci, Ankara (TR) options”, Neural Blockade in Clinical Anesthesia and Man (73) Assignee: New England Medical Hospitals, Inc., agement of Pain, Cousins and Bridenbaugh, eds., 915-983, Boston, MA (US) 1998. (*) Notice: Subject to any disclaimer, the term of this Chary, et al., The dose response relationship of controle patent is extended or adjusted under 35 d-release codeine (codeine contin) in chronic cancer pain', U.S.C. 154(b) by 0 days. Journal of Pain and Symptom Management, 9(6): 363-371, 1994. (21) Appl. No.: 10/213,584 Cooper, et al., “Patient-controlled extradural analgesia to (22) Filed: Aug. 6, 2002 compare bupivacaine, fentanyl and bupivacaine with fenta (65) Prior Publication Data nyl in the treatment of postoperative pain', British Journal of Anaesthesia, 70: 503–507, 1993. US 2003/0170288 A1 Sep. 11, 2003 Curley, et al., “Prolonged regional nerve blockade', Anes Related U.S. Application Data thesiology, 84(6): 1401-1410, 1996. (60) Provisional application No. 60/310,434, filed on Aug. 6, 2001. Dahm, et al., "Six years of continuous infusion of opioid and (51) Int. CI.7 A61E 13/00; A61E 2/00; bupivacaine in the treatment of refractory pain due to O 1 - O - - - - - - - - - - - - - - - - - - - - - - - - - - - A61K9/1 4 intrapelvic extrusion of bone cement after total hip arthro (52) U.S. Cl. ....................... 424/422. 424/423. 424/426 plasty, Regional Anesthesia and Pain Medicine, 23(3): 424/428; 424/484; 424/485; 424/486 315-319, 1998. (58) Field of Search ................................. 424/422, 423, 424/426, 428, 484-486 (Continued) (56) References Cited Primary Examiner Alton Pryor U.S. PATENT DOCUMENTS (74) Attorney, Agent, or Firm Mintz, Levin, Cohn, Ferris, 5,543,156 A 8/1996 Roorda et al. .............. 424/484 Glovsky and Popeo, P.C.; Ingrid A. Beattie, Esq. 5,834,010 A 11/1998 Quan et al. ................. 424/448 6,605,294 B2 * 8/2003 Sawhney .................... 424/426 (57) ABSTRACT 2003/0068371 A1 4/2003 Oshacket al. ............. 424/465 The invention provides a drug delivery compositions and OTHER PUBLICATIONS methods for treating pain. A drug delivery composition Curley et al., Prolonged Regional Nerve Blockade, Jun. contains a polymer and at least two drugs. Sucha as an 1996, Anesthesiology, vol. 84 pp. 1401-1410.* analgesic agent and an anesthetic agent. Ahmedzai, S., "Current Strategies for pain control', Annals of Oncology, 8: 21-24, 1997. 28 Claims, 6 Drawing Sheets -o- placebo (empty rods) 00 -- HM (220 grad) ra- BP (220 girod) 9. -- HM + BP (half rod) -o- Biphalin (110 girody 80 70 60 S 43 i 30 20 10 US 6,913,760 B2 Page 2 OTHER PUBLICATIONS Moulin, et al., “Comparison of continuous Subcuateneous Dietz, et al., “Bupivacaine preferentially blocks ventral root and intravenous hydromorphone infusions for management axons in rats”, Anesthesiology, 88: 172-180, 1997. of cancer pain”, The Lancet, 337: 465–468, 1991. Fletcher, et al., “Antinociceptive effect of bupivacaine Parker, et al., “Epidural patient-controlled analgesia: influ encapsulated in Poly(D.L)-Lactide -co-glycotide micro ence of bupivacaine and hydromorphone basal infusion on Spheres in the acute inflammatory pain model of carragee pain control after cesarean delivery', Anesthesia and Anal nin-injected rats”, Anesthesia and Analgesia, B4(1) 90-94, gesia, 75(5): 740–746, 1992. 1997. Payne, R., "Factor influencing quality of life in cancer Grant, et al., “Prolonged analgesia with bupivacaine in a patients: the role of transdermal fentanyl in the management mouse model”, Regional Anesthesia, 19(4): 264-269, 1994. of pain”, Seminars in Oncology, 25(3): 47-53, 1998. Hagen, et al., “Comparative clinical efficacy and Safety of a Renck, et al., "Slow release formulations of local anesthetics novel controlled release oxycodone formulation and con and opioids”, Current in Anesthesiology, 9:399-403, 1996. trolled-release hydromorphone in treatment of cancer pain', Rhodes, et al., “Hydromorphone Polymer Implant”, Journal Cancer, 79(7): 1428–1437, 1997. of Substance Abuse Treatment, Journal of Substance Abuse Hanks, G.W., “Cancer pain and the importance of its con Treatment, 14(6): 535-542, 1997. trol”, Anti-Cancer Drugs, 6(3): 14-17, 1995. Singh, et al., “Effects of ketorolac verSuS bupivacaine co-ad Hanks, et al., “Opioid responsiveness”, Acta Anaesthesio ministration during patient-controlled hydromorphone epi logica Scandinavica, 41: 154-158, 1997. dural analgesia after thoracotomy procedures', Anesthesia Hargreaves, et al., “A new and Sensitive method for mea and Analgesia, 84(3), 564-569, 1997. Suring thermal nociception in cutaneous intrathecal hyper Soberg, et al., “Nueropathologic findings after long-term algesia”, Pain, 32: 77-88, 1988. intrathecal infusion of morphine and bupivacaine for pain Hays, et al., “Comperative clinical efficacy and Safety of treatment in cancer patients”, Anesthesiology, 76(2): immediate relese and controlled release hydromorphone for 173–186, 1992. chronic severe cancer pain”. Cancer, 74(6): 1808-1816, Suri, et al., “Pharmacokinetic-pharmacodynamic relation 1994. ships for analgesics”, International Journal of Clinical Phar Lafont, et al., “Use of liposome-associated bupivacaine in a macology and Therapeutics, 35(8):307-323, 1997. cancer pain syndrome", Anaesthesia, 51(5):578-579, 1996. Vainio, et al., “Opioid treatment for radiating cancer pain: Lawfor, et al., “Dose radio between morphine and hydro oral administration VS. epidural techniques”, Acta Anesthe morphane in patients with cancer pain: a retrospective siologica Scandinavica, 32: 179-185, 1988. study”, Pain, 72(1–2): 79–85, 1997. Van Dongan, et al., “Neurological impairment during long Le Corre, et al., “In vitro controlled release kinetics of local term intrathecal infusion of bupivacaine in cancer patients: anesthetics from poly(D.L-lactide) and poly(lactide-c- a sign of spinal cord compression”, Pain, 69(1-2): 205-209, O-glycolide) microSpheres”, Journal of Microencapsulation, 1997. 14(2): 243-255, 1997. Vercauteren, et al., “Addition of bupivacaine to Sulfentanil Lee-Son, et al., “Stereoselective Inhibition of Neuronal in patient controlled epidural analgesia after lower limb Sodium Channels by Local Anesthetics', Anesthesiology, Surgery in young adults”, Regional Anesthesia and Pain 77(2): 324-335, 1992. Medicine, 23(2): 182-188, 1998. Lesser, et al., “In Vitro and in Vivo Studies of Subcutaneous Vigano, et al., “Individualized use of methadone and opioid hydromorphone implants designed for the treatment of can rotation in the comprehensive management of cancer pain cer pain”, Pain, 65(2-3): 265-272, 1996. associated with poor prognostic indicators’, Pain, 67(1): Malinovsky, et al., “Neurotoxicological assestment after 115-119, 1996. intracisternal injection of liposomal bupivacaine in rabbits', Wu, et al., “The efficacy of intrathecal coadministration of Anesthesia and Analgesia, 85(6): 1331-1336, 1997. morphine and bupivacaine for labor analgesia’, Acta Ana Malinovsky, et al., “Motor and blood pressure effects of esthesiologica Scandinavica, 35: 209-216, 1997. epidural Sustained release bupivacaine from polymer micro Okuda, et al., “Prolonged antinociceptive effect of poly Spheres: A dose-response Study in rabbits', Anesthesia and (DL-lactic acid)-fentanyl composites after their intrathecal Analgesia, 81(3): 519–524, 1995. injection in rats” (in Japanese), Masui-Japanese Journal of Masters, et al., “Sustained local anesthetic release from Anesthesiology, 48(2): 141-145, 1999, with Abstract in bioerodible polymer matrices: a potential for prolonged English. regional analgesia”, Pharmaceutical Research, 10(10): 1527-1532, 1993. * cited by examiner U.S. Patent Jul. 5, 2005 Sheet 1 of 6 US 6,913,760 B2 -O- placebo (empty rods) 100 -O- HM (220 g/rod) r-A- BP (220 g/rod) 90 -- HM + BP (half rod) - C - Biphalin (110 uglrod) 80 7O 6O SO 40 3O 10 U.S. Patent Jul. 5, 2005 Sheet 2 of 6 US 6,913,760 B2 left side 1OO -O- placebo (empty rods) -O- HM (220 g/rod) 90 - A - BP (220 pg/rod) 8O -- HM + BP (half rod) -o- Biphalin (110 g/rod) 70 6O 50 4O 3O 20 1O time U.S. Patent Jul. 5, 2005 Sheet 3 of 6 US 6,913,760 B2 fight side 1OO -O-- placebo (empty rods) -O- HM (220 g/rod) -A - BP (220 girod) -- HM + BP (half rod) Biphalin (110 g/rod) 4.5 OO s 3 O U.S. Patent Jul. 5, 2005 Sheet 5 of 6 US 6,913,760 B2 left side right side 3OO 275 - 250 225 200 175 150 -- O 125 - D 100 75 50 25 -25 Placebo HM BP HM + BP Biphalin p < 0.05 versus placebo group on the left and right side Sg. 2. U.S. Patent Jul. 5, 2005 Sheet 6 of 6 US 6,913,760 B2 p < 0.05 Control group 1O N HM group BP group -15 - Sexs HM + BP group single dose double dose in the experiment with double dose (t-test): p < 0.05 control group vs HM, BP and HM + BP group x p < 0.05 HM + BP group vs HM group and BP group ^ p < 0.05 HM group vs BP group is 4 US 6,913,760 B2 1 2 DRUG DELIVERY COMPOSITION The device is administered topically (e.g., on or into dermal tissue Such as skin), locally (e.g., implanted or This application claims priority to provisional applica injected directly around a nerve Supplying a painful area in tion U.S.
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