Medical delivery device having reduced oxygen permeability

Abstract

To provide excellent medical devices.SOLUTION: The present disclosure relates to medical devices such as syringes, auto-injectors, and pens that inhibit oxygen permeation into a fluid chamber. The medical devices include a lubricant (e.g., silicone)-free or a siliconized barrel having an interior surface defining the fluid chamber, an elastomeric stopper, and a plunger rod. In one embodiment, at least a portion of the interior surface of the barrel is reduced to increase the interference fit between the stopper and the barrel. In another embodiment, the stopper may include a plurality of ribs and a valley between each pair of ribs may include a ring member provided in each valley. The ring member includes an oxygen-absorbing material, an oxygen-adsorbing material, or both, to bind any oxygen that permeates into the syringe, the auto-injector, or the pen. In yet another embodiment, the stopper may include a barrier coating including an oxygen barrier material to inhibit or prevent oxygen permeation.SELECTED DRAWING: Figure 7

Description

[Technical field]

[0001] Technical Field FIELD OF THE DISCLOSURE The present disclosure relates to medical delivery devices, and in particular to syringes, auto-injectors and pens, configured to inhibit the permeation of oxygen into fluids or substances contained within the medical delivery device. [Background technology]

[0002] background Medical delivery devices such as syringes, auto-injectors and pens typically include a barrel, a stopper disposed within the barrel, and a plunger rod or actuation mechanism for displacing the stopper. As the pharmaceutical industry seeks new and more convenient drug delivery methods, pre-filled syringes, auto-injectors and pens have emerged as the preferred choice for unit dose drug delivery. Pre-filled syringes minimize drug waste and extend product life while allowing patients to self-administer injectable medications. In particular, pre-filled syringes, auto-injectors and pens eliminate dosing errors and prevent overfilling. Drug instability over time is one of the problems that persists with pre-filled syringes. Drug instability can be due, for example, to interactions between the syringe and the fluid composition contained therein.

[0003] Thus, the design and quality of the pre-filled syringe helps ensure that the fluid composition contained therein remains uncontaminated. Contamination can result, for example, from contact between the fluid composition and any of several different components of the syringe, automatic injector, and pen. For example, the syringe, automatic injector, and pen can include a barrel with a stopper slidably fitted into the barrel, and can have a plunger rod for actuation of the syringe and delivery of the drug. The stopper is generally composed of an elastomer. Traditionally, silicone oil is applied to the stopper and / or barrel to reduce sliding friction between the stopper and barrel and improve the seal therebetween. The silicone oil allows the stopper to slide easily in the barrel when administering a dose, which can ensure that a complete dose is administered.

[0004] The use of silicone in pre-filled syringes, auto-injectors or pens has been of concern in the industry because oils may degrade the drug and / or a certain amount of silicone may be injected with it. The use of silicone in pre-filled syringes, auto-injectors and pens may be of particular concern with biopharmaceuticals because it may cause aggregation of certain proteins.

[0005] Additionally, some fluid compositions in pre-filled syringes, auto-injectors and pens are oxygen sensitive and can oxidize or otherwise be adversely affected by contact with oxygen. Such oxygen sensitivity can cause problems for pre-filled syringes, auto-injectors and pens, typically where small amounts of air can permeate into the syringe during storage. As a result, oxygen-sensitive drugs or drug formulations may require additional excipients, packaging and / or manufacturing steps to enhance stability and prevent degradation. However, these approaches add complexity to the overall structure of the device or drug formulation. Summary of the Invention [Problem to be solved by the invention]

[0006] Therefore, there is a need for silicone-free pre-filled syringes, auto-injectors and pens that are configured to reduce or prevent the transmission of oxygen into the barrel of the syringe, auto-injector or pen. [Means for solving the problem]

[0007] Summary of the Invention The present disclosure relates to a medical delivery device (e.g., syringes, autoinjectors, and pens) that includes a silicone-free barrel having proximal and distal ends and an inner surface that define a fluid chamber for containing at least one therapeutic agent, an elastomeric stopper having an outer surface that forms a fluid-tight seal with the inner surface of the barrel, and a plunger rod or actuation mechanism for displacing the stopper within the barrel. The barrel has a reduced diameter region located at the proximal end of the barrel to enhance an interference fit between the elastomeric stopper and the inner surface of the barrel. The stopper includes at least one rib that is in adjacent contact with the reduced diameter region while the stopper is in an unstressed state. The reduced diameter region has a diameter smaller than the diameter of the remainder of the barrel. The barrel can include a transition section (e.g., a frusticonical or tapered transition section) disposed between the reduced diameter region at the proximal end and the larger diameter region at the distal end to provide a gradual transition therebetween.

[0008] A portion of the interior surface of the barrel may be provided with a coating material to form a region of reduced diameter. At least one rib of the stopper is in contact with the coating material in an unstressed state. In some embodiments, the coating material may include an oxygen absorbing material and an oxygen adsorbing material or a combination of the two. In another embodiment, the coating includes a material with low oxygen permeability. In yet another embodiment, the coating is formed from a material that is compliant and has a low coefficient of friction, which may improve the seal at the proximal end of the medical device while simultaneously reducing release and slippage forces. In an exemplary embodiment, the coating material does not extend more than half the length of the barrel.

[0009] In another embodiment, at least one insert contacts the inner surface of the barrel to form a region of reduced diameter. The insert is formed from or includes a gas barrier to inhibit oxygen permeation into the barrel. The insert can be attached to the inner surface of the barrel (e.g., via an adhesive) or can be integrally formed on the inner surface of the barrel. In one embodiment, the insert is a solid polymer tube bonded to the inner surface of the barrel.

[0010] In further embodiments, the region of reduced diameter includes a laminate having one or more fluoropolymer films attached to the interior surface of the barrel. The laminate may be formed from a single high strength thin film (e.g., PTFE) or multiple high strength thin films. The thin films may have a thickness ranging from about 0.5 μm to about 100 μm. In some embodiments, the laminate may be bonded or otherwise attached to the interior surface of the barrel. In an alternative embodiment, the laminate may be thermoformed onto the interior surface of the barrel.

[0011] In yet another embodiment, the present disclosure relates to a medical device (e.g., syringes, autoinjectors, and pens) including a silicone-free barrel having proximal and distal ends and an inner surface defining a fluid chamber for containing at least one therapeutic agent, an elastomeric stopper having an outer surface forming a fluid-tight seal with the inner surface of the barrel, and a plunger rod or actuation mechanism for displacing the stopper within the barrel. The stopper includes a plurality of ribs and a valley between each pair of ribs. At least one ring member is provided in one or more valleys of the stopper. The ring member may include an oxygen absorbing material and / or an oxygen adsorbing material that binds to and / or otherwise removes oxygen that may permeate into the valley. In some embodiments, each valley of the elastomeric stopper includes at least one ring member. The medical device further includes a coating on a portion of the inner surface of the barrel adjacent the proximal end of the barrel to form a coated region, the coated region forming a region of reduced diameter having a diameter smaller than the diameter of the uncoated region of the barrel.

[0012] In further embodiments, the present disclosure relates to a medical device (e.g., syringes, autoinjectors, and pens) including a silicone-free barrel including proximal and distal ends and an inner surface defining a fluid chamber for containing at least one therapeutic agent, an elastomeric stopper having an outer surface forming a fluid-tight seal with the inner surface, a plunger rod attached to the stopper and mounted within a syringe barrel for moving the stopper distally within the barrel, and a barrier coating over a portion of the stopper. The barrier coating can include an oxygen barrier material. The barrier coating can surround the portion of the stopper that is not exposed to the fluid chamber. In some embodiments, the barrier coating surrounds the entire stopper, so long as the barrier coating is inert to the therapeutic agent contained within the barrel of the syringe. The stopper can include an elastomeric body having a plurality of ribs and valleys between each pair of ribs. A coating can be provided on the ribs and in the valleys between each pair of ribs. In some aspects, the plunger rod further includes a coating.

[0013] These and other embodiments, along with many of their advantages and features, are described in more detail in conjunction with the following description and the accompanying non-limiting figures. [Brief description of the drawings]

[0014] BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings are included to provide a further understanding of the disclosure, and are incorporated in and constitute a part of this specification, illustrate embodiments and, together with the description, serve to explain the principles of the disclosure.

[0015] [Figure 1a] FIG. 1a shows a cross-sectional view of a syringe barrel having a region of reduced diameter, according to some embodiments.

[0016] [Figure 1b] FIG. 1b shows an exploded view of a syringe barrel having a region of reduced diameter, according to some embodiments.

[0017] [Figure 2a-c] 2a-c show process steps for coating the inner surface of a syringe barrel, according to some embodiments.

[0018] [Diagram 3] FIG. 3 shows a cross-sectional view of a syringe barrel having a coating on its inner surface, according to some embodiments.

[0019] [Figure 4] FIG. 4 shows an exploded view of a stopper rib contacting the inner surface of the syringe barrel of FIG. 3, according to some embodiments.

[0020] [Diagram 5] FIG. 5 shows a cross-sectional view of a stopper pressed into a syringe barrel, according to some embodiments.

[0021] [Figure 6] FIG. 6 shows a perspective view of a syringe with a ring member around the valley of the stopper, according to some embodiments.

[0022] [Figure 7] FIG. 7 shows a cross-sectional view of the syringe of FIG. 6, according to some embodiments.

[0023] [Figure 8] FIG. 8 shows a cross-sectional view of a syringe with a coated stopper, according to some embodiments.

[0024] [Figure 9] FIG. 9 shows a cross-sectional view of a syringe with a coated stopper and plunger rod, according to some embodiments.

[0025] [Figure 10] FIG. 10 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates that may be applied, according to some embodiments. [Figure 11] FIG. 11 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates applied, according to some embodiments. [Figure 12] FIG. 12 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates that may be applied, according to some embodiments. [Figure 13] FIG. 13 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates applied, according to some embodiments. [Figure 14] FIG. 14 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates that may be applied, according to some embodiments. [Figure 15] FIG. 15 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates applied, according to some embodiments. [Figure 16] FIG. 16 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates applied, according to some embodiments. [Figure 17] FIG. 17 is a schematic diagram of a cross-sectional side view of a stopper showing various types of laminates that may be applied, according to some embodiments; and

[0026] [Figure 18] FIG. 18 is a schematic cross-sectional view of an automatic injector, according to some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0027] Detailed Description Those skilled in the art will easily understand that the various aspects of the present disclosure can be realized by any number of methods and devices configured to perform the intended functions. It should also be noted that the accompanying drawings referred to herein are not necessarily drawn to scale and may be exaggerated to illustrate the various aspects of the present disclosure, and in that respect, the drawings should not be interpreted as limiting. The terms "silicone" and "silicone oil" may be used interchangeably herein.

[0028] The present disclosure relates to silicone-free or substantially silicone-free medical delivery devices (e.g., syringes, auto-injectors, and pens) used to store and deliver medical fluids. As used herein, the term "substantially free" is intended to denote that the barrel and / or stopper of the syringe has an unquantifiable or trace amount of silicone or other liquid lubricant. The medical delivery device is configured to inhibit or prevent oxygen from penetrating into the barrel of the medical delivery device. The present disclosure provides a stopper suitable for use with a syringe that inhibits or prevents oxygen from entering the barrel and is free or substantially free of silicone or other liquid lubricant that contacts the therapeutic liquid in the medical delivery device. For ease of description, the following disclosure is directed to a syringe, but the description is equally applicable to an auto-injector or pen. Additionally, in alternative embodiments, the barrel can include silicone (or another lubricant), and such embodiments are considered to be within the scope of the present disclosure.

[0029] 1a illustrates a syringe 10 (e.g., a pre-filled syringe) according to one or more embodiments. The syringe 10 includes a barrel 15 that is free or substantially free of silicone and has opposed distal and proximal ends 20 and 25, respectively, and a fluid chamber 30 disposed between the distal and proximal ends 20 and 25. In certain embodiments, the barrel 15 has a hydrophilic inner surface. The distal end 20 of the barrel 15 can include an injection port 35 extending therethrough and in communication with the fluid chamber 30. In some embodiments, the barrel is formed from a glass material, such as, for example, borosilicate glass, that is free of silicone or other lubricants.

[0030] In some embodiments, a cap 40 is disposed at the distal end 20 of the barrel 15. The cap 40 includes a proximal end 45 that is coupled to the distal end 20 or the injection port 35, and a closed distal end 50. The cap 40 inhibits or prevents ambient air from communicating with the fluid chamber 30 via the distal end 20 or the injection port 35. Optionally, a piercing element 55 is also disposed at the distal end 20 of the barrel 15. The piercing element 55, e.g., a needle, includes a distal end 65 and a proximal end 60 that is coupled to the distal end 20 or the injection port 35. As should be understood by one of skill in the art, it is within the scope of this disclosure that in some embodiments, the injection port 35 can include a sharply pointed needle cannula, or a blunt cannula, such as those used in so-called needle-free systems. For purposes of illustration, and not limitation, as shown herein, piercing element 55 is formed as a sharply pointed elongated needle cannula including a proximal end 60, a sharply pointed distal end 65, and a lumen 70 extending between proximal end 60 and distal end 65. The proximal end 60 of the needle cannula can be securely attached to the injection port 35 of the barrel 15.

[0031] In some embodiments, the cap 40 is mounted over the fill port 35 and releasably engages the fill port 35 of the barrel 15. The cap 40 can be formed from a rigid material such as plastic, or from a flexible material such as rubber, or from similar materials or combinations known to those of skill in the art, and it can be configured with appropriately sized sealing elements, etc. Thus, the cap 40 inhibits or prevents ambient air from communicating with the fluid chamber 30 through the fill port 35.

[0032] The proximal end 25 of the barrel 15 can include a flange 80 that is used as a finger holder for pushing and pulling a plunger rod 85 within the barrel 15. The plunger rod 85 has opposed distal and proximal ends 90 and 95 with a stopper 100 attached to the distal end 90. The stopper 100 includes opposed proximal and distal ends 105 and 110. As will be appreciated by those skilled in the art, the stopper 100 can include one or more circumferentially extending annular ribs that form a fluid-tight seal with the barrel 15. In at least one embodiment, the stopper 100 includes two or more ribs 120. In embodiments having multiple ribs, the stopper includes a valley 115 between each pair of adjacent ribs 120.

[0033] The barrel may be formed from a substantially rigid or hard material, such as a glass material (e.g., borosilicate glass), a ceramic material, one or more polymeric materials (e.g., polypropylene, polyethylene and copolymers thereof), a metallic material, or a plastic material (e.g., cyclic olefin polymer (COC) and cyclic olefin copolymer (COP) and combinations thereof). In certain embodiments, the barrel has an inner wall formed from glass (e.g., bare glass without lubricant), resin, plastic, metal, or similar material, and characterized by the absence of lubricants, such as, but not limited to, silicone or silicone oil.

[0034] The stopper 100 may be formed from an elastomeric body 125. The elastomeric body 125 may comprise any elastomer suitable for the application, most particularly rubber constructed from butyl, bromobutyl, chlorobutyl, silicone, nitrile, styrene butadiene, polychloroprene, ethylene propylene diene, fluoroelastomers, or combinations or blends of any of the foregoing. The material of the elastomeric body 125 is selected to provide a low coefficient of friction, compliance, low extractables and leachables, good barrier properties related to extractables and leachables from the elastomeric body 125, and good air and liquid impermeability.

[0035] In some embodiments, the stopper 100 can further include a low friction barrier film surrounding the elastomeric body 125. The barrier film can inhibit leaching of materials from the elastomeric material or extraction of compounds from the drug by the elastomer. The material of the barrier film is selected to provide good barrier properties related to low coefficient of friction, compliance, low extractables and leachables, and extractables and leachables from the elastomeric body 125. For example, the barrier film can include one or more fluoropolymer films, including, but not limited to, polytetrafluoroethylene (PTFE) or expanded polytetrafluoroethylene (ePTFE) films.

[0036] In some embodiments, the stopper 100 may be formed from an elastomeric body 125 and one or more laminate layers 230. The laminate layer 230 may include a single layer of a polymeric barrier layer 240. FIG. 10 illustrates such a stopper 100 including a single layer that includes an elastomeric body 125 and a barrier layer 240.

[0037] Examples of elastomers that can be used to form elastomeric body 125 include any elastomer suitable for the application, most particularly rubbers comprised of butyl, bromobutyl, chlorobutyl, silicone, nitrile, styrene butadiene, polychloroprene, ethylene propylene diene, fluoroelastomers, thermoplastic elastomers (TPEs), thermoplastic vulcanizates (TPVs), materials sold under the trade name VITON®, and combinations and blends thereof. Exemplary elastomeric materials include, but are not limited to, butyl rubber, bromobutyl rubber, chlorobutyl rubber, silicone, nitrile, styrene butadiene, polychloroprene, ethylene propylene diene, fluoroelastomers, and combinations thereof.

[0038] Examples of fluoropolymers that can be used to form the barrier layer 240 include any fluoropolymer suitable for the application, most particularly densified expanded fluoropolymers, such as densified expanded polytetrafluoroethylene (ePTFE). Other suitable fluoropolymers include, but are not limited to, expanded polytetrafluoroethylene (ePTFE), fluorinated ethylene propylene (FEP), polyvinylidene fluoride, polyvinyl fluoride, perfluoropropyl vinyl ether, perfluoroalkoxy polymers, tetrafluoroethylene (TFE), parylene AF-4, parylene VT-4, and copolymers and combinations thereof. Non-fluoropolymers, such as, but not limited to, polyethylene, polypropylene, parylene C, and parylene N, can be used to form the barrier layer 240.

[0039] In one or more embodiments, the barrier layer 240 can include or be formed from one or more of the following materials: ultra-high molecular weight polyethylene, as taught in U.S. Pat. No. 9,732,184 to Sbriglia; polyparaxylylene, as taught in U.S. Patent Publication No. 2016 / 0032069 to Sbriglia; polylactic acid, as taught in U.S. Pat. No. 9,732,184 to Sbriglia et al.; and / or VDF-co-(TFE or TrFE) polymer, as taught in U.S. Pat. No. 9,441,088 to Sbriglia.

[0040] In some embodiments, the barrier layer 240 may include or be formed from an expanded or densified expanded fluoropolymer, preferably expanded polytetrafluoroethylene (ePTFE) or densified expanded polytetrafluoroethylene. Densified ePTFE films may be prepared by methods described in U.S. Patent No. 7,521,010 to Kennedy et al., U.S. Patent No. 6,030,694 to Dolan et al., U.S. Patent No. 5,792,525 to Fuhr et al., or U.S. Patent No. 5,374,473 to Knox et al. Expanded copolymers of PTFE, such as those described in U.S. Patent No. 5,708,044 to Branca, U.S. Patent No. 6,541,589 to Baillie, U.S. Patent No. 7,531,611 to Sabol et al., U.S. Patent No. 8,637,144 to Ford, and U.S. Patent No. 9,139,669 to Xu et al., may be utilized, especially when densified.

[0041] The barrier layer 240 can also include an expanded polymeric material including a functionalized tetrafluoroethylene (TFE) copolymer material having a microstructure characterized by nodes interconnected by fibrils, where the functionalized TFE copolymer material includes a functionalized copolymer of TFE and PSVE (perfluorosulfonyl vinyl ether), or TFE and another suitable functional monomer, such as, but not limited to, vinylidene fluoride (VDF), vinyl acetate, or vinyl alcohol. The functionalized TFE copolymer material can be prepared, for example, according to the methods described in U.S. Pat. No. 9,139,669 to Xu et al. or U.S. Pat. No. 8,658,707 to Xu et al.

[0042] In another embodiment, as shown in Figure 11, the laminate layer 230 can include a composite material including a barrier layer 245 and a porous layer 250. The barrier layer 245 can include a fluoropolymer such as densified expanded fluoropolymer (e.g., densified expanded polytetrafluoroethylene), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), fluorinated ethylene propylene (FEP), polyvinylidene fluoride, polyvinyl fluoride, perfluoropropyl vinyl ether, perfluoroalkoxy polymer, tetrafluoroethylene (TFE), parylene AF-4, parylene VT-4, and copolymers and combinations thereof. Non-fluoropolymers such as polyethylene, polypropylene, parylene C, and parylene N can also be utilized in the barrier layer 245. It should be understood that any of the materials described above with respect to the barrier layer 240 can be used in or as the barrier layer 245. The porous layer 250 may comprise ePTFE (ePTFE as taught in U.S. Pat. No. 6,541,589 to Baille) or other porous expanded (and often fibrillated) fluoropolymers. The laminate layer 230 with the barrier layer 245 and the porous layer 250 may be constructed by coating or otherwise depositing a barrier polymer (e.g., a fluoropolymer) onto the porous layer 250 to create a composite material. One such example of this is depositing a granular or powdered fluoropolymer, such as powdered PTFE, onto the surface of the porous ePTFE layer in a coating process. The ePTFE layer should be constructed to be sufficiently heat stable so that the deposited granular or powdered fluoropolymer can be heat treated to create a barrier layer or bond the deposited barrier layer to the porous ePTFE layer. It should be noted that the porous (e.g., ePTFE) layer may be filled with organic or inorganic materials to provide color, lubricity, or other functional attributes.

[0043] According to some embodiments, the elastomeric material of the elastomeric body 125 can at least partially penetrate the porous layer 250. Figure 12 shows a cross section of a stopper showing the barrier layer 145, the porous layer 250, and the elastomeric body 125. Specifically, Figure 12 shows an area 260 of partial penetration of the elastomeric material of the elastomeric body 125 into the porous layer 250. The penetration of the elastomeric material of the elastomeric body 125 into the porous layer 250 improves the bond between the elastomeric body 125 and the laminate layer 230.

[0044] According to another embodiment, the material of the barrier layer 245 can at least partially penetrate the porous layer 250. FIG. 13 shows a cross section of a stopper showing the barrier layer 245, the porous layer 250, and the elastomeric body 125. Specifically, FIG. 13 shows an area 265 of partial penetration of the material of the barrier layer 245 into the porous layer 250. The penetration of the material of the barrier layer 245 into the porous layer 250 improves the bond between the barrier layer 245 and the porous layer 250. The partial penetration area 265 can also provide support for the barrier layer 245 to impart strength, toughness, compliance, and stability, which can be beneficial in both fabrication processes and applications.

[0045] In some embodiments, the barrier layer 245 can substantially fill the porous layer 250. In another embodiment, the porous layer 250 can be filled to a substantially equal extent with the barrier layer 245 and the elastomer, leaving few open pores in the porous structure. In yet another embodiment, both the barrier layer 245 and the elastomer partially fill the porous layer 250, leaving some open pores between them. Other variations in the penetration of the elastomer and / or the barrier layer 245 will be readily apparent to those skilled in the art. Each has advantages, depending on the particular application, and taking into consideration various desirable properties of the finished device, such as reduced friction, improved barrier properties, and improved sealing. The penetration depth of either the barrier polymer or the elastomer can be controlled by any known means, including time, temperature, pressure, and altering the porosity of the porous material. In one embodiment, the porous material can have a porosity that varies with depth, for example.

[0046] In yet another embodiment, the barrier layer 245 can be formed from a composite fluoropolymer or non-fluoropolymer material having a barrier layer and a tie layer, such as described in U.S. Patent Publication No. 2016 / 0022918 to Gunzel. Note that as used herein, the term "tie layer" can include fluoropolymer and / or non-fluoropolymer materials. The tie layer can include or be formed from ePTFE or other porous expanded fluoropolymer (e.g., ePTFE as taught in U.S. Patent No. 6,541,589 to Baille). Alternatively, the tie layer can be formed from or include a non-fluoropolymer material. Non-limiting examples of non-fluoropolymer materials suitable for use in or as a tie layer include non-fluoropolymer membranes, non-fluoropolymer microporous membranes, nonwoven materials (e.g., spunbond, meltblown fiber materials, electrospun nanofibers), polyvinylidene difluoride (PVDF), nanofibers, polysulfones, polyethersulfones, polyarlysofones, polyetheretherketones (PEEK), polyethylene, polypropylene, and polyimides.

[0047] In a further embodiment, the barrier layer 245 can be made by forming a thin densified composite including a porous ePTFE layer and a thermoplastic barrier layer. In this embodiment, a thermoplastic with a surface with a low coefficient of friction is preferred. Thus, fluoropolymer-based thermoplastics such as FEP, PFA, THV, etc. are applicable. The barrier according to this embodiment can be an FEP / ePTFE laminate obtained by following the method taught in WO 94 / 13469 to Bacino. The barrier can be formed at a process temperature above the softening temperature or even above the melting temperature of the FEP film in the female cavity mold.

[0048] Composites formed from the expanded fluoropolymers (e.g., ePTFE) and fluoropolymer-based thermoplastics (e.g., FEP) described herein allow for the formation of surprisingly thin, strong barrier films. In one embodiment, the ePTFE layer can act as a support during molding to allow for a thin barrier film. The porous ePTFE layer can also act as a reinforcement for the thermoplastic layer to maintain the film strength and integrity of the barrier layer as described above, and the ePTFE porous layer can also act as a tie layer when a portion of the ePTFE remains porous and is directed toward the interior of the mold.

[0049] In another embodiment, the barrier layer 245 can include a composite of a densified ePTFE film and a thin layer of porous ePTFE bonded to the barrier layer film. The densified ePTFE film can be obtained as described in U.S. Patent No. 7,521,010 to Kennedy et al. The ePTFE / densified ePTFE composite can be combined in a manner described in U.S. Patent No. 6,030,694 to Dolan et al. In this embodiment, the composite includes a layer of densified ePTFE film and a layer of porous ePTFE. The porous ePTFE layer is configured to retain most of its porosity upon thermoforming. It is also sufficiently malleable to improve sealing to the syringe barrel wall. To accomplish this, at least a portion of the porous layer can remain sufficiently open after thermoforming and post-compression molding with an elastomer. This open porosity allows for some compressibility that can aid in conformity and sealing of the stopper to a surface.

[0050] In another embodiment, as shown in FIG. 14, the laminate layer 230 comprises a composite having at least three layers: a densified expanded fluoropolymer layer 270, a barrier melt fluoropolymer layer 275, and a porous layer 280. The densified expanded fluoropolymer layer 270 can comprise or be formed from densified ePTFE. The barrier melt fluoropolymer layer 275 can comprise fluoropolymers such as densified expanded fluoropolymer, PTFE, ePTFE, densified ePTFE, fluorinated ethylene propylene (FEP), polyvinylidene fluoride, polyvinyl fluoride, perfluoropropyl vinyl ether, perfluoroalkoxy polymers, and copolymers and combinations thereof. Non-limiting examples of non-fluoropolymers that may be utilized in the barrier melt layer 275 include polyethylene and polypropylene. The porous layer 280 can comprise or be formed from ePTFE or other porous expanded fluoropolymers. The laminate layer 230 having the densified expanded fluoropolymer layer 270, the barrier melt fluoropolymer layer 275 and the porous layer 280 may be constructed by coating or otherwise depositing the densified expanded fluoropolymer onto the porous layer to create a composite material. The densified ePTFE film, the fluoropolymer and the porous layer may be thermoformed to create a preform, which may then be combined with the elastomeric body 125 by injection molding around the elastomeric preform, compression molding, priming and post laminating, or other suitable methods known to those skilled in the art. In one non-limiting embodiment, the laminate layer 230 is formed from a densified fluoropolymer (e.g., densified ePTFE), a thermoplastic adhesive (e.g., FEP) and a porous fluoropolymer (e.g., ePTFE).

[0051] According to some aspects, the elastomeric material of the elastomeric body 125 can at least partially penetrate the porous layer 280, as shown in Figure 15. According to other embodiments, the material of the barrier melt fluoropolymer layer 275 can at least partially penetrate the porous layer 180, as shown in Figure 16. In other embodiments, the material of the barrier melt fluoropolymer layer 275 can at least partially penetrate the densified expanded fluoropolymer layer 270, as shown in Figure 17.

[0052] It is to be understood that the stopper 100 can include either an elastomeric material or a barrier polymer of varying degrees of penetration into a porous material or a densified expanded fluoropolymer layer as shown herein and described in U.S. Patent No. 8,722,178 to Ashmead et al., U.S. Patent Publication No. 2012 / 0251748 to Ashmead et al., and U.S. Patent Publication No. 2016 / 0022918 to Ashmead et al. It is also to be understood that there are many variations of the methods described herein that can be utilized to form the stopper 100 without departing from the scope and / or spirit of the present invention.

[0053] In one embodiment, the elastomeric body 125 of the stopper can have an ePTFE film or densified ePTFE film thereon. High strength oriented films can form very thin barrier films. The barrier film can be made in thicknesses ranging from 0.5 microns to 20 microns. The film is preferentially less than 30 microns. The film can optionally be pre-treated or post-treated by chemical etching, plasma treatment, corona treatment, roughening, or other methods known to those skilled in the art to improve bonding to the elastomeric body. In some embodiments, the film, e.g., ePTFE film or densified ePTFE film, surrounds the entire elastomeric body 125. In other embodiments, the film partially surrounds the elastomeric body 125. For example, the film can surround only the portion of the stopper that is not in contact with the fluid or drug in the syringe.

[0054] In other embodiments, the barrier film can include a composite fluoropolymer film having a barrier layer and a porous layer. The barrier layer can be formed from densified expanded polytetrafluoroethylene, expanded polytetrafluoroethylene, polytetrafluoroethylene (PTFE), fluorinated ethylene propylene (FEP), polyethylene, polypropylene, polyvinylidene fluoride, polyvinyl fluoride, perfluoropropyl vinyl ether, perfluoroalkoxy polymers, and the like. The porous layer can be formed from ePTFE or other porous expanded, advantageously fibrillating fluoropolymer (e.g., ePTFE as taught in U.S. Pat. No. 3,953,566 to Gore). The ePTFE layer can advantageously be filled with organic or inorganic materials to provide color, lubricity, or other functionality. In one non-limiting embodiment, the barrier layer is a three-layer composite including a densified fluoropolymer (e.g., densified ePTFE), a thermoplastic adhesive (e.g., FEP, and a porous fluoropolymer (e.g., ePTFE).

[0055] The stoppers described herein can be used in syringes for storing and delivering fluids, typically for medical applications. In some embodiments, the syringe is pre-filled with a fluid (e.g., a pre-filled syringe). In one embodiment, the syringe contains a fluid to treat diseases such as, but not limited to, eye diseases (e.g., macular degeneration or glaucoma) and diabetes. Advantageously, the syringe is free of lubricants such as silicone or other liquid lubricants. Thus, the barrels in the syringes described herein are free or substantially free of silicone or other liquid lubricants.

[0056] In at least one embodiment, a syringe of the present disclosure includes a barrel including a reduced diameter region located at the proximal end of the barrel to enhance the interference fit between the stopper and the inner surface of the barrel to prevent or inhibit oxygen transmission into the barrel. As shown in Figures 1a and 1b, the barrel 15 has a reduced diameter region 16 that enhances the interference fit between the stopper 100 and the inner surface of the barrel at the reduced diameter region 16. As the interference fit increases, the resistance to oxygen transmission also increases. To increase the interference fit while ensuring an adequate minimum push-in force to facilitate operation, the reduced diameter region 16 is provided in only a portion of the barrel 15, such as adjacent the proximal end 25 of the barrel 15. This allows one or more ribs 120 to be present on the stopper 100 within the reduced diameter region 16 to increase the interference fit to inhibit oxygen transmission prior to use. Slight movement of the stopper 100 during pushing (e.g., distal advancement of the plunger rod 85) can cause one or more ribs 120 to move distally within the barrel 15 beyond the region of reduced diameter 16 and easily move through the barrel 15 to expel the fluid 135.

[0057] 1a also shows fluid 135 being provided to fluid chamber 30 of barrel 15 of syringe 10 (e.g., a pre-filled syringe). For purposes of illustration only, fluid 135 is identified herein as a predetermined dose of a fluid, i.e., a therapeutic, biological, pharmaceutical, or drug, although it should be understood that fluid 135 can be any type of liquid or material capable of being expelled from a syringe, or fluid 135 can be absent from a receiving chamber (e.g., an unfilled syringe).

[0058] 1b shows an exploded view of a syringe according to some embodiments. The barrel 15, the stopper 100 and the plunger rod 85 are three separate and distinct elements that form the syringe 10. One or more of these components work in conjunction to inhibit oxygen transmission into the barrel 15 of the syringe 10 prior to use.

[0059] As discussed herein, there are many ways to form a reduced diameter region, for reducing the inside diameter of the barrel 15 over a portion of its length. In one embodiment, the barrel 15 of the syringe 10 can be manufactured such that a portion of the barrel is reduced in diameter, as shown in FIGS. 1a and 1b. For example, a glass syringe can be heated and molded around a mandrel to set the inside diameter. This heat treatment can be applied to only a portion of the barrel 15 to form the reduced diameter region 16. In another embodiment, the barrel 15 can have a first region of constant diameter and a second region of constant diameter, where the first region has a smaller diameter than the second region. The two regions can be separated by one or more steps (not shown), or there can be a gradual transition between the two regions. In another embodiment, the reduced diameter region 16 can have a tapering barrel 15, for example, having a full conical or conical shape from the reduced diameter region to the larger diameter region. 1a and 1b, the barrel includes a fulcrum conical transition section that connects two regions and provides a gradual transition between them. For example, barrel 15 includes a fulcrum conical taper between a region of reduced diameter and a region of larger diameter adjacent the distal end of the barrel.

[0060] In a further embodiment not shown, the insert contacts the inner surface of the barrel to form a region of reduced diameter. The insert can be a solid conformable material that is adhered or bonded to the inner surface of the barrel 15. Alternatively, the insert can be attached to the inner surface of the barrel 15, for example via an adhesive, to form the region of reduced diameter 16. Alternatively, the insert can be integrally formed on the inner surface of the barrel 15. As used herein, the term "insert" refers to a member that is formed separately from the barrel, for example a tubular member, that is attached or otherwise affixed, for example glued, to the inner surface of the barrel.

[0061] In some embodiments, the barrel 15 can include one or more inserts bonded to the inner surface of the barrel. The inserts can have a variety of diameters and lengths and can be made of glass, ceramic, metal, or polymer, so long as they are compatible with the material forming the barrel 15 and the contents of the syringe 10. For example, the insert can include a polymer tube, such as a fluoropolymer, bonded to the inner surface of the barrel 15. The polymer tube can be heated and expanded to bond to the wall of the inner surface of the barrel 15. In some embodiments, the polymer tube bonded to the inner surface of the barrel 15 is a solid material, preferably a gas barrier to inhibit oxygen transmission. In some embodiments, the polymer tube is heat malleable to provide a seal over a portion of the inner surface of the barrel 15. In some embodiments, the polymer tube has a low enough coefficient of friction to allow the stopper to slide inside the barrel 15.

[0062] In some embodiments, the reduced diameter region 16 can be formed using a laminate that is adhered or bonded to the inner surface of the barrel 15. For example, the laminate can be one or more film layers that are bonded to the inner surface of the barrel 15. The laminate is bonded or otherwise attached to the inner wall of the barrel. In at least one embodiment, the laminate is attached to the inner surface of the barrel 15 using an adhesive. Alternatively, the laminate can be thermoformed onto the inner surface of the barrel 15 as described above.

[0063] In some embodiments, the laminate can be in the form of a single high strength thin film or multiple thin high strength films formed on the interior surface of the barrel 15. The high strength thin film can include any of the materials described herein for coating materials. The thin film can have a thickness ranging from about 0.5 μm to about 100 μm, about 0.5 μm to about 20 μm, or about 10 μm to about 15 μm. In some embodiments, the film is less than about 30 μm, less than about 20 μm, or less than about 10 μm. The film can be pre-treated or post-treated with chemical etching, plasma treatment, corona treatment, roughening, etc. to improve the interference fit with the stopper.

[0064] In another embodiment, the coating material is provided on a portion of the barrel's inner surface to form a coated region, which in turn forms a region of reduced diameter. The coating material 140 can be formed from a liquid coating material 139 applied to a portion of the barrel's inner surface. FIGS. 2a-c show a method of coating the barrel 15 according to one embodiment of the present disclosure. In this method, a portion of the barrel 15 adjacent the proximal end 25 is coated with the liquid coating material 139 to provide a coated region 145. FIG. 2a shows a proximal portion of the barrel 15 of the syringe 10 prior to the coating process. The barrel 15 has a uniform and constant diameter prior to coating. Suitable materials for the coating material 140 include, but are not limited to, fluorinated ethylene propylene, expanded fluorinated ethylene propylene, expanded polytetrafluoroethylene (ePTFE), epoxy resins, acrylics, and combinations thereof.

[0065] As discussed above, FIG. 2a shows the barrel 15 of the syringe 10 prior to being submerged in a coating bath 150 containing liquid coating material 139. In FIG. 2b, the proximal end 25 of the barrel 15 is submerged in the coating bath 150. The barrel 15 is submerged in the coating bath 150 until the liquid coating material 139 adheres to the interior surface of the barrel 15 to form a coated region 145. Any excess liquid coating material 139 may be removed before the liquid coating material 139 solidifies on the interior surface of the barrel 15. Depending on the composition of the coating material 139 used, after removal from the coating bath 150, the liquid coating substance 139 adhered to the interior of the barrel 15 may be dried (such as via air or heat) and UV cured, thermally cured or ambient air cured to form the coating material 140. Alternatively, the liquid coating material 139 may be dried to form the coating material 140. The coating material 140 forms the coated region 145 of the barrel 15 forming a region of reduced diameter.

[0066] Note that Figure 2c shows the exterior surface of the barrel 15 without any liquid coating material 139. After the barrel 15 is lifted out of the coating bath 150, the liquid coating material 139 is removed from the exterior surface of the barrel 15, after which it is allowed to solidify or adhere to the exterior surface. For example, the liquid coating material 139 can be blown off the exterior surface of the barrel 15 with deionized air. After the liquid coating material is blown off the exterior surface of the barrel 15, only the interior surface of the barrel 15 includes the coating material 140. The coating material 140 on the interior surface of the barrel solidifies to form coated area 145.

[0067] In some embodiments, the coating material 140 includes fluorinated ethylene propylene, expanded fluorinated ethylene propylene, epoxy resin, acrylic, and combinations thereof. The coating material 140 can further include an oxygen absorbing or adsorbing material. In some embodiments, the oxygen absorbing material can include ascorbic acid, sodium ascorbate, activated carbon, and combinations thereof. The oxygen adsorbing material can include iron, nickel, tin, copper, zinc, tungsten, cobalt, palladium, platinum, zinc oxide, cerium mixed oxide, zirconium mixed oxide, metal oxides (e.g., zinc oxide and iron oxide), iron hydroxide, iron carbide, ascorbic acid, sodium ascorbate, catechol, phenol, activated carbon, polymeric materials, metal oxides such as titanium oxide, and combinations thereof. The oxygen absorbing or adsorbing material should be compatible with the contents of the syringe. It is understood that the oxygen absorbing and adsorbing materials can be used alone or in combination with each other. It should also be understood that the oxygen absorbing material is not limited to the above materials, but can include any suitable material that captures or retains oxygen on its surface. Likewise, it should also be understood that the oxygen absorbing material is not limited to the above materials, but can include any suitable material that adsorbs or otherwise consumes oxygen. Additional oxygen absorbing or adsorbing materials can include low molecular weight organic compounds, such as phenols, and polymeric materials incorporating resins and catalysts.

[0068]

[0069] In some embodiments, coating material 140 is provided on an area from flange 80 to less than half the length of barrel 15, e.g., half the length, less than half the length, less than a quarter of the length, or less than an eighth of the length. In one aspect, coating material 140 is not in contact with fluid in fluid chamber 30 when coating material 140 may contaminate the fluid. In another aspect, coating material 140 can be in contact with fluid in fluid chamber 30 when coating material 140 does not contaminate the fluid or coating material 140 is inert.

[0070] In another embodiment, during the coating process, the liquid coating material 139 can include a liquid carrier, optionally a solvent, and a coating precursor dissolved, suspended or emulsified therein. The coating precursor is optionally in the form of particles suspended in the liquid carrier. For example, the particle size can be smaller than the thickness of the coating so that the coating is uniform. After application onto the syringe, the liquid carrier is preferably removed, for example, by heating and / or drying, resulting in the formation of a dry coating material on the syringe. The temperature of the liquid coating material can range from about 25° C. to about 350° C. during the application process. Of course, the temperature will depend on the substrate being coated. Metals, ceramics, and glass can withstand high temperatures, while plastic barrels require lower temperatures. In another embodiment, the liquid coating material includes a monomer that can be cured (polymerized), for example, upon application of UV radiation, to form a solid coating composition on the syringe.

[0071] The barrel 15 can be submerged in the coating bath 150 and withdrawn at a rate that facilitates the formation of a uniform, defect-free or substantially defect-free coating of a desired thickness on the barrel 15. For example, the barrel 15 can be coated with a thin film of a thermoplastic resin of coating material 140, which is then dried or cured to form the coated area 145. Optionally, a preformed shape can be pressed against the coating material 140 over a portion of the interior surface of the barrel 15 to approximately conform the interior surface to a desired shape or thickness.

[0072] In some embodiments, the barrel 15 can be dipped into the liquid coating material 139 and then heat treated, cured and / or spin dried. In other embodiments, the coating material can be applied to the syringe by a spray process or brush application of the liquid coating material 139 followed by drying and / or curing, as described above, to form the coated area 145.

[0073] FIG. 2c shows a portion of the coated barrel after removal from the coating bath 150. In the embodiment shown in FIG. 2c, a portion of the proximal end 25 of the barrel 15 is coated to provide a coated region 145. As shown, the barrel 15 of the syringe 10 can have a coated region 145 (formed from the coating material 140) at the proximal end 25 and an uncoated distal end (not shown) adjacent the coated region 145. The coated region 145 (formed from the coating material 140) has a diameter smaller than the diameter of the uncoated region. For example, the diameter of the coated region 145 can be at least about 25 μm smaller, at least 50 μm smaller, or at least 100 μm smaller than the diameter of the uncoated region. The smaller diameter created by the coated region 145 provides a tighter interference fit with the stopper 100 and inhibits oxygen transmission to the fluid chamber 30 of the syringe. The thickness of the coated region 145 can vary depending on many factors, i.e., the number of coats of liquid coating material 139, the viscosity of the coating, and / or the speed of withdrawal during the dipping process. The coating material 140 can be ground, machined, or melted to a desired thickness. For example, the thickness of the coating material 140 (and thus the coated region 145) can range from about 0.5 μm to about 100 μm, from about 0.5 μm to about 20 μm, or from about 10 μm to about 15 μm. In some embodiments, the coating material 140 (and thus the coated region 145) has a thickness of less than about 30 μm, less than about 20 μm, or less than about 10 μm.

[0074] 3 illustrates a syringe 10 in which a portion of the inner surface of the barrel 15 has a coated region 145 formed thereon from a coating material 140 at a proximal end thereof. In one embodiment, at least one or more ribs 120 of the stopper 100 are disposed within the coated region 145 of the barrel 150 in the unstressed state. For example, at least one rib 120, at least two ribs, or at least three (or more) ribs of the stopper 100 are disposed within the coated region 145 formed from the coating material 140 in the unstressed state. In some embodiments, the entire stopper 100 can be disposed within the coated region 145 while in the unstressed state.

[0075] Coating material 140 is disposed in a portion of barrel 15 adjacent proximal end 25 of barrel 15. Coated region 145 has a diameter smaller than the diameter of the uncoated region of the barrel, as described above. As a result, the portion of stopper 100 in coated region 145 is more compressed than the portion of stopper 100 in uncoated region 146.

[0076] In the uncompressed state, the one or more ribs 120 of the stopper 100 are in abutting contact with the coating material 140 at the coated region 145. The one or more ribs 120 have a first contact area while in abutting contact with the coating material 140 at the coated region 145 and a second contact area, smaller than the first contact area, while in contact with the uncoated region 146. By "abutting contact" it is meant that the longitudinal edges of the ribs contact the inner wall formed by the region of reduced diameter, e.g., the coated region, thereby compressing the rib.

[0077] 4 shows an exploded view of one of the ribs 120 of the stopper 100 shown in FIG. 3. In an uncompressed state, the stopper 100 includes at least one rib 120 in abutting contact with the coating material 140 at a coated region 145. The coated region 145 has a smaller diameter than an uncoated region 146 of the barrel 15, thereby increasing the interference fit with the rib 120 of the stopper 100 at the coated region. The first contact area can be at least 1% greater than the second contact area, such as at least 5% greater or at least 10% greater. Due to the reduced diameter of a portion of the inner surface of the barrel 15, the stopper 100 has an increased interference fit with the barrel 15 at the coated region 145. The increased interference fit at the coated region 145 reduces or prevents oxygen permeation into the barrel 15 of the syringe 10. In some embodiments, the coated region 145 has an inner diameter that provides a combination of minimal sliding force and increased interference fit.

[0078] 5 shows the syringe in a depressed state, meaning that the plunger 95 has been pushed distally such that the stopper 100 is no longer in adjacent contact with the coated region 145. That is, in the depressed state, all of the ribs 120 of the stopper 100 are in contact with the uncoated region 146 of the inner surface of the barrel 15. In use, the syringe 10 can administer a fluid 135, e.g., a therapeutic agent, to a patient in need thereof. The method of administering a fluid can begin by loading the fluid chamber 30 with the fluid 135. In some embodiments, the syringe 10 is preloaded with the fluid 135. In the undepressed state, at least one rib 120 of the stopper 100 is in the coated region 145 of the barrel 15. A user can apply a depressing force to plunger rod 85 to move stopper 100 distally within syringe barrel 15 and, as plunger rod 85 is depressed, force fluid 135 through injection port 35 at the distal end of barrel 15. As shown in FIG. 5, the force causes at least one rib 120 to move from coated region 145 to uncoated region 146 in a depressed state.

[0079] Due to the enhanced interference fit of the one or more ribs 120 with the inner surface of the barrel 15 in the coated region 145, the initial force to move the stopper 100 in the coated region 145 can be greater than the force to move the stopper 100 in the uncoated region 146. However, due to the material used to coat the barrel, the stopper 100 moves smoothly in the coated region 145 without the need for the use of a lubricant, such as silicone. For example, the initial force applied to the plunger rod can be greater to move the stopper in the coated region 145 compared to moving the stopper while it is completely within an uncoated region.

[0080] It is also contemplated that in some embodiments, the composition of the coating material used in coated region 145 can have a lower coefficient of friction than the material forming the barrel. Thus, in these embodiments, the initial force can be comparable to, for example, within 5% of the force required to move a stopper on an uncoated region, or even less, despite the reduced diameter of coated region 145.

[0081] In another embodiment, one or more ring members can be provided on the stopper to reduce or inhibit oxygen permeation into the barrel of the syringe. As used herein, the term "ring member" refers to any circumferential member configured to extend transversely around the stopper, including, but not limited to, a torus-shaped member, such as an O-ring, a ring-shaped or tubular member. It is noted that the outer shape, or general volume, of the ring member can be any shape as long as it confines the oxygen absorbing and / or adsorbing material. Furthermore, the shape of the ring member ultimately depends on the shape of the stopper and the barrel. The shape may also depend on the size / depth of the valley in the stopper. In this specification, the ring member is depicted as a circle for ease of explanation.

[0082] As shown in FIGS. 6 and 7, a ring member 160 may be provided in one or more valleys 115 of the stopper 100. In some embodiments, the ring member 160 may contact and wrap tightly around the valleys 115 of the stopper 100. The ring member 160 may include an oxygen absorbing material and / or an oxygen adsorbing material. The oxygen absorbing or adsorbing material binds and / or otherwise removes oxygen that may enter the valleys 115 of the stopper 100 before permeating into the fluid chamber 30, thereby inhibiting contamination of the fluid, e.g., oxygen sensitive drug or composition, contained within the barrel. In some embodiments, the ring member 160 may be glued, attached or otherwise attached to one or more valleys 115 of the stopper 100. As used herein, the term "oxygen sensitive" refers to the ability of a material to be oxidized or otherwise adversely affected by contact with oxygen under ambient conditions. In other embodiments, the ring member 160 may include other materials that adsorb or absorb other gaseous substances that may permeate into the syringe.

[0083] FIG. 7 shows a cross-sectional view of the syringe of FIG. 6. In this embodiment, a ring member 160 is provided in each valley 115 of the stopper 100. The ring member 160 may be formed of an elastic or rigid circular body. When oxygen permeates into the valley 115 between a pair of ribs 120, the oxygen absorbing and / or adsorbing material in the ring member 160 inhibits or prevents the oxygen from contaminating the fluid in the fluid chamber 30. Thus, the oxygen absorbing or adsorbing material absorbs, adsorbs and / or otherwise removes oxygen from the valley of the stopper without significantly affecting the sliding force. Materials suitable for the oxygen absorbing or adsorbing material include, but are not limited to, the materials described above.

[0084] According to some embodiments, ring members including or formed from oxygen absorbing and / or oxygen adsorbing material can be manufactured according to conventional methods, i.e., melt extrusion, coating, etc. For example, the ring members can be melt extruded using a uniformly distributed amount of oxygen absorbing and / or oxygen adsorbing material. In some embodiments, the ring members can be manufactured into the body of the stopper during manufacturing. In some embodiments, the diameter of the ring members is measured and cut to correspond to the circumference of the valleys of the stopper. In other embodiments, a binder can be applied to secure the ring members to each valley.

[0085] In some embodiments, to further inhibit oxygen transmission, a stopper 100 including a ring member can be provided within a syringe barrel that includes a coated region as described above. The coated region is on a portion of the interior surface of the barrel adjacent the proximal end of the barrel. The coated region forms a region of reduced diameter having a diameter smaller than the diameter of the uncoated region of the barrel. In this embodiment, the coated region mechanically improves the interference fit between the syringe barrel and the stopper, while the ring member chemically absorbs and / or adsorbs oxygen that may otherwise permeate into the syringe barrel.

[0086] FIG. 8 illustrates another embodiment in which the stopper includes a barrier coating 170 surrounding a portion of the stopper 100. In an exemplary embodiment, the barrier coating 170 includes or is formed from an oxygen barrier material that inhibits or prevents oxygen transmission into the barrel without significantly affecting the sliding force, i.e., the force that moves the stopper distally within the barrel, the stopper 100 or contaminating fluids within the fluid chamber 30. In some aspects, the oxygen barrier material minimizes friction between the stopper and the inner surface of the barrel when the plunger rod is displaced within the barrel during dispensing of the fluid composition. For example, the coefficient of friction of the barrier coating 170 can be less than the coefficient of friction of the stopper material, thereby allowing the stopper 100 to move smoothly within the barrel 15. The oxygen barrier material can be selected from the oxygen barrier materials described above. Additionally, the oxygen barrier material can be selected according to its compatibility with the contents of the syringe.

[0087] In at least one embodiment, the barrier coating 170 surrounds the portion of the stopper 100 that is not exposed to the fluid chamber 30. As discussed herein, the stopper 100 comprises an elastomeric body having a plurality of ribs 120 and a valley 115 between each pair of adjacent ribs 120. As shown in FIG. 8, the barrier coating 170 is provided on the ribs 120 that are not in contact with the fluid chamber 30 and the valley 115 between each pair of ribs 120. Thus, the barrier coating 170 may not be provided on the distal fluid contacting surface of the stopper 100. However, in aspects where the fluid composition in the fluid chamber 30 is not adversely affected by contact with the barrier coating 170 (e.g., the barrier coating 170 is inert to the fluid in the barrel or to the therapeutic agent), it is contemplated that the barrier coating 170 may also cover the distal surface of the stopper 100 (e.g., the entire stopper 100).

[0088] In some embodiments, the oxygen barrier material is selected from perfluorosulfonic acid, hydrocarbon ionomers, sulfonated polyimides, polyvinyl alcohol, and combinations thereof. Other non-limiting examples of oxygen barrier materials include high density polyethylene (HDPE), low density polyethylene (LDPE), ethylene / vinyl alcohol copolymer (EVOH), polypropylene (PP), polyethylene terephthalate (PET), polyethylene naphthalate (PEN), polyamide (PA), polyvinyl alcohol (PVOH), polyvinyl chloride (PVC), polyvinylidene chloride (PVDC), polychlorotrifluoroethylene (PCTFE), vinylidene, chloride / methyl acrylate copolymer, polyamide, polyester, metallized films, aluminum foil, oxide-coated films, and combinations thereof. Metal foils (e.g., aluminum) or SiOx compounds can be used to provide very low permeability to oxygen. Metallized films can include sputter coating or other application of a metal layer, such as aluminum.

[0089] Embodiments of the oxygen barrier material may also, or alternatively, exist in the form of a multilayer film. The multilayer film (e.g., 2, 3, 4, 5 or 6 layer film) may include one or more of the aforementioned oxygen barrier materials and may also include additional layers of non-barrier materials, such as PET, polyethylene (PE) and / or coated (e.g., clay, wax, plastic, etc.) or uncoated paper. Suitable multilayer films include, but are not limited to, PVC / EVOH, PET / EVOH, PET / EVOH / PE, PET / EVOH / PET, PE / EVOH / PE, PVC / PCTFE / EVOH, paper / aluminum (Alu) / PE, PET / Alu / PE, paper / PE / foil / PE, paper / PET / Alu, clay coated paper / PE / foil / LDPE, paper / LDPE / foil / ethylene-ethyl acrylate and related films thereof. The layers can be bonded together using an adhesive (e.g., a polyolefin blend (a mixture of poly(α-olefins) or a polyamide resin). In some embodiments, the barrier coating 170 includes an oxygen barrier material as a multi-layer film. For example, the barrier coating 170 can include a laminate that is adhered or bonded to the stopper 100.

[0090] In other embodiments, the barrier coating 170 can further include an oxygen absorbing or adsorbing material. Suitable oxygen absorbing or adsorbing materials include, but are not limited to, those materials described above.

[0091] 9 shows a cross-sectional view of a syringe according to another embodiment. In this embodiment, both the plunger rod 85 and the stopper 100 include a barrier coating 170 that includes an oxygen barrier material that inhibits or prevents oxygen from entering the fluid chamber. For example, the portion of the plunger rod 85 attached to the stopper 100 can be disposed within the barrel 15 of the syringe. In one embodiment, the portion of the plunger rod 85 within the barrel 15 can also include a barrier coating 170 to help prevent oxygen from entering the syringe. The barrier coating 170 on the plunger rod 85 can act as an initial barrier to inhibit oxygen transmission before it reaches the stopper 100.

[0092] In some embodiments, the syringe may include any combination of the above embodiments. For example, it is contemplated that the barrel may include a coating on a portion of the interior surface of the barrel to form a region of reduced diameter. The stopper may include one or more ring members including an oxygen absorbing or adsorbing material, and the stopper may include an oxygen barrier material. In this manner, the coating mechanically improves the interference fit between the syringe barrel and the stopper, while the ring members chemically absorb or adsorb oxygen that may permeate into the syringe barrel, and the oxygen barrier material on the surface of the stopper prevents oxygen ingress.

[0093] The method of coating the stopper with an oxygen barrier material can include immersing a portion of the stopper in a suitable solution containing the oxygen barrier material and / or oxygen absorbing or adsorbing material described above. In some embodiments, the portion of the stopper that contacts the fluid in the syringe is not immersed in the solution, i.e., it remains inert. The stopper can be removed from the solution and allowed to dry or harden completely. For example, in one embodiment, a clean stopper can be partially immersed in the solution until the solution adheres to the stopper, then removed from the solution and the excess solution on the stopper can be blown off with deionized air. The stopper can then be dried in an atmosphere at about 25°C for about 1 hour.

[0094] In some embodiments, the syringe can include any combination of the above embodiments. For example, the barrel can include a coating on a portion of the interior surface of the barrel to form a region of reduced diameter, the stopper can include one or more ring members that include an oxygen absorbing or adsorbing material, and the stopper could include an oxygen barrier material. In this manner, the coating mechanically improves the interference fit between the syringe barrel and the stopper, while the ring members chemically absorb or adsorb oxygen that may permeate into the syringe barrel, and the oxygen barrier material on the surface of the stopper prevents oxygen ingress.

[0095] FIG. 18 illustrates an automatic injector 300 according to some embodiments. The automatic injector 300 includes a barrel 301, an injection member 303 for injecting a medical fluid, and a stopper 304. The stopper 304 can be integral with or attached to a plunger rod 305. The inner surface 303 of the barrel 301 can be lubricant-free. It is within the scope of the present invention that the stopper 304 can include ribs and / or stoppers as shown and described with respect to FIGS. 10-17, or can be a ribless stopper. The automatic injector 300 can include a variable actuation force applied to the stopper 304.

[0096] In another aspect, the syringes and auto-injectors or pens detailed herein may be used in combination with different therapeutic compounds, such as, for example, but not limited to, drugs and biologics, including antibodies, antisense, RNA interference, gene therapy, primary and embryonic stem cells, vaccines, and combinations thereof. For example, the embodiments described herein may be utilized in combination with any or all of the following:

[0097] Cell therapy employs cells that are primarily derived from the endoderm (e.g., exocrine epithelial cells and hormone-secreting cells), cells that are primarily derived from the ectoderm (e.g., keratinized epithelial cells, moist stratified barrier epithelial cells, sensory transducer cells, autonomic nerve cells, sensory organs and peripheral neuron support cells, central nervous system nerve cells and glial cells, lens cells), cells that are primarily derived from the mesoderm (e.g., metabolic and storage cells, barrier function cells (lung, intestine, exocrine glands and urogenital tract), extracellular matrix cells, contractile cells, blood cells and immune cells, germ cells, nurse cells, interstitial cells), or combinations thereof. Cells that are genetically, chemically, or physically altered or modified are also contemplated within the scope of the present invention.

[0098] Exocrine epithelial cells include, but are not limited to, salivary gland mucous cells, salivary gland #1, von Ebner gland cells of the tongue, mammary gland cells, lacrimal gland cells, canal gland cells of the ear, eccrine gland dark cells, eccrine gland clear cells, apocrine gland cells, cilia gland cells of the eyelid, sebaceous gland cells, Hohmann gland cells of the nose, Brunner gland cells of the duodenum, seminal vesicle cells, prostate cells, bulbourethral gland cells, Bartholin's gland cells, urethral gland cells, endometrial cells, isolated goblet cells of the respiratory and gastrointestinal tract, and gastric mucosa cells. , gastric gland zymogen cells, gastric gland acid secreting cells, pancreatic acinar cells, Paneth cells of the small intestine, type II pneumocytes of the lungs, and Clara cells of the lungs; hormone-secreting cells include, but are not limited to, anterior pituitary cells, intermediate pituitary cells, large neurosecretory neuron cells, cells of the digestive and respiratory tracts, thyroid cells, parathyroid cells, adrenal cortical cells, Leydig cells of the testes which secrete testosterone, inner theca cells of the ovarian follicles which secrete estrogen, and ovarian cells which secrete progesterone. Luteal cells of secreting ruptured follicles, juxtaglomerular cells, renal macula densa cells, renal circumpolar cells, renal mesangial cells, pancreatic islet cells, and keratinizing epithelial cells include, but are not limited to, epidermal keratinocytes, epidermal basal cells, fingernail and toenail keratinocytes, nail bed basal cells, medullary hair stem cells, cortical hair stem cells, cuticle hair stem cells, cuticle root sheath cells, root sheath cells of Huxley's layer, root sheath cells of Henle's layer, outer root sheath cells, hair Mother cells include moist stratified barrier epithelial cells, including but not limited to, surface epithelial cells of the stratified squamous and basal cells of the epithelium of the cornea, tongue, oral cavity, esophagus, anal canal, distal urethra and vagina, urethral epithelial cells, and sensory transducer cells include but are not limited to, inner hair cells of the organ of Corti, outer hair cells of the organ of Corti, basal cells of the olfactory epithelium, cold sensory primary sensory neurons, heat sensory primary sensory neurons, Merkel cells of the epidermis, olfactory receptor nerves,Examples of the primary sensory neurons include pain primary sensory neurons, photoreceptor cells of the retina of the eye, proprioceptive primary sensory neurons, tactile primary sensory neurons, type I carotid body cells, type II carotid body cells, type I hair cells of the vestibular system of the ear, type II hair cells of the vestibular system of the ear, and type I taste bud cells. Examples of the autonomic nerve cells include, but are not limited to, cholinergic nerve cells, adrenergic nerve cells, and peptidergic nerve cells. Examples of the sensory organ and peripheral neuron supporting cells include, but are not limited to, Examples of neurons and glial cells in the central nervous system include, but are not limited to, astrocytes, neuronal cells, oligodendrocytes, and spindle neurons. Examples of lens cells include, but are not limited to, anterior lens epithelial cells, crystalline lens fiber cells; metabolic and storage cells include, but are not limited to, adipocytes, hepatic adipocytes; barrier function cells include, but are not limited to, renal parietal cells, renal glomerular epithelial cells, renal proximal tubule brush border cells, thin segment cells of the loop of Henle, renal distal tubule cells, renal collecting duct cells, chief cells, interstitial cells, type I alveolar epithelial cells, pancreatic duct cells, smooth muscle duct cells, chief cells, interstitial cells, duct cells, intestinal brush border cells, exocrine ductal cells, Duct cells, gallbladder epithelial cells, non-ciliated cells of the efferent duct of the testis, epididymal principal cells, and epididymal basal cells are included, and extracellular matrix cells include, but are not limited to, ameloblasts, semilunar epithelial cells of the vestibular system of the ear, interdental epithelial cells of the organ of Corti, loose connective tissue fibroblasts, septal fibroblasts, tendon fibroblasts, bone marrow reticular connective tissue fibroblasts, other non-epithelial fibroblasts, pericytes, nucleus pulposus cells of the intervertebral disc, cementoblasts, odontoblasts, hyaline chondrocytes, fibrochondrocytes, elastic chondrocytes, osteoblasts,Examples of cells that may be used include bone precursor cells, vitreous cells of the vitreous body of the eye, perilymphatic space stellate cells of the ear, hepatic stellate cells, and pancreatic stellate cells; contractile cells include, but are not limited to, skeletal muscle cells, satellite cells, cardiac muscle cells, smooth muscle cells, myoepithelial cells of the iris, and myoepithelial cells of the exocrine glands; blood and immune cells include, but are not limited to, erythrocytes, megakaryocytes, monocytes, connective tissue macrophages, epithelial Langerhans cells, osteoclasts, dendritic cells, microglia, neutrophil granulocytes, eosinophilic granulocytes, basophilic granulocytes, hybridoma cells, mast cells, hepatocytes, and hepatocytes. Examples of such cells include, but are not limited to, T cells, suppressor T cells, cytotoxic T cells, natural killer T cells, B cells, natural killer cells, reticulocytes, stem cells and precursors involved in the blood and immune systems; germ cells include, but are not limited to, oogonia / oocytes, sperm cells, spermatocytes, spermatogonia, spermatozoa; nurse cells include, but are not limited to, ovarian follicular cells, Sertoli cells, thymic epithelial cells; and stromal cells include, but are not limited to, kidney stromal cells, and combinations thereof.

[0099] Examples of antibodies, antisense, RNA interference or gene therapy directed against protein targets or genes include Ataxia Telangiectasia Mutated Protein (ATT). Examples of ion channels include, but are not limited to, ligand-gated ion channels, voltage-gated ion channels, and growth factors include, but are not limited to, nerve growth factor (NGF), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), c-fos-inducible growth factor (FIGF), platelet-activating factor (PAF), transforming growth factor beta (TGF-β), bone morphogenetic protein (BMP), activin, inhibin, fibroblast growth factor (FGF), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), glial Examples of G protein-coupled receptors include, but are not limited to, adenosine receptor family, adrenergic receptor family, angiotensin II receptor family, and the like. receptor, apelin receptor, vasopressin receptor family, brain-specific angiogenesis inhibitor family, bradykinin receptor family, bombesin receptor family, complement component 3a receptor 1, complement component 5a receptor 1, calcitonin receptor family, calcitonin receptor-like family, calcium-sensing receptor, cholecystokinin A receptor (CCK1), cholecystokinin B receptor (CCK2), chemokine (CC motif) receptor family, sphingosine-1-phosphate receptor family, succinate receptor,Cholinergic receptor family, Chemokine-like receptor family, Cannabinoid receptor family, Corticotropin-releasing hormone receptor family, Prostaglandin D2 receptor, Chemokine C-X3-C receptor family, Chemokine (CXC motif) receptor family, Burkitt's lymphoma receptor, Chemokine (CXC motif) receptor family, Cysteinyl leukotriene receptor 2 (CYSLT2), Chemokine receptor (FY), Dopamine receptor family, G protein-coupled receptor 183 (GPR183), Lysophosphatidic acid Receptor family, endothelin receptor family, coagulation factor II (clotting) receptor family, free fatty acid receptor family, formyl peptide receptor family, follicle stimulating hormone receptor (FSHR), gamma-aminobutyric acid (GABA)B receptor, galanin receptor family, glucagon receptor, growth hormone releasing hormone receptor (GHRH), ghrelin receptor (ghrelin), growth hormone secretagogue receptor 1b (GHSR1b), gastric inhibitory polypeptide receptor (GIP), glucagon-like peptide receptor family, gonadotropin releasing hormone receptor (GnRH), pyroglutamylated RF-amide peptide receptor (QRFPR), G protein-coupled bile acid receptor 1 (GPBA), hydroxycarboxylic acid receptor family, lysophosphatidic acid receptor 4 (LPA4) lysophosphatidic acid receptor 5 (GPR92), G protein-coupled receptor 79 pseudogene (GPR79), hydroxycarboxylic acid receptor 1 (HCA1), G protein-coupled receptors (C5L2, FFA4, FFA5, FFA6, FFA7, FFA8, FFA9, FFA10, FFA11, FFA12, FFA13, FFA14, FFA15, FFA16, FFA17, FFA18, FFA19, FFA20, FFA21, FFA22, FFA23, FFA24, FFA25, FFA30, FFA31, FFA32, FFA33, FFA34, FFA35, FFA36, FFA37, FFA38, FFA39, FFA40, FFA41, FFA42, FFA43, FFA44, FFA45, FFA46, FFA47, FFA48, FFA49, FFA49, FFA49, FFA48, FFA49, FFA41, FFA42, FFA43, FFA44, FFA45, FFA46, FFA47, FFA48, FFA49 ... 135, GPR139, GPR141, GPR142, GPR143, GPR146, GPR148, GPR149, GPR15, GPR150, GPR151, GPR152, GPR157, GPR161, GPR162, GPR17, GPR171, GPR173, GPR 176, GPR18, GPR182, GPR20, GPR22, GPR25, GPR26, GPR27, GPR3, GPR31, GPR32, GPR35, GPR37L1, GPR39, GPR4, GPR45, GPR50, GPR52, GPR55, GPR6, GPR61,GPR65, GPR75, GPR78, GPR83, GPR84, GPR85, GPR88, GPR97, TM7SF1), metabotropic glutamate receptor family, gastrin releasing peptide receptor (BB2), orexin receptor family, histamine receptor family, 5-hydroxytryptamine receptor family, KISS1-derived peptide receptor (kisspeptin), leucine-rich repeat-containing G protein-coupled receptor family, luteinizing hormone / chorionic gonadotropin receptor (LH), leukotriene B4 receptor (BLT1), adenylate synaptonemal receptor (ASR) ... Clathase-activating polypeptide 1 receptor 1 (mPAC1), motilin receptor, melanocortin receptor family, melanin-concentrating hormone receptor 1 (MCH1), neuropeptide Y1 receptor (Y1), neuropeptide Y2 receptor (NPY2R), opioid receptor family, oxytocin receptor (OT), P2Y purinergic receptor 12 (mP2Y12), P2Y purinergic receptor 6 (P2Y6), pancreatic polypeptide receptor family, platelet-activating factor receptor family, prostaglandin E receptor family, prostanoid IP1 receptor (IP1), MAS-related G PR member family, rhodopsin (rhodopsin), relaxin family peptide receptor family, somatostatin receptor family, tachykinin receptor family, melatonin receptor family, urotensin receptor family, vasoactive intestinal peptide receptor 1 (mVPAC1), neuromedin B receptor (BB1), neuromedin U receptor 1 (NMU1), neuropeptide B / W receptor family, neuropeptide FF receptor 1 (NPFF1), neuropeptide S receptor 1 (NPS receptor), neuropeptide Y receptor family, neurotensin receptor 1 (NTS1), opsin 5 (OPN5), opioid receptor-like receptor (NOP), oxoeicosanoid (OXE) receptor 1 (OXE), oxoglutarate (α-ketoglutarate) receptor 1 (OXGR1), purinergic receptor family, pyrimidinergic receptor family, prolactin-releasing hormone receptor (PRRP), prokineticin receptor family, platelet-activating receptor (PAF), prostaglandin F receptor family, prostaglandin I2 (prostacyclin) receptor family, parathyroid hormone receptor family,Examples of protein kinases include, but are not limited to, AP2-related kinase, human ABL, human ALK1, human ALK2, human ALK3, human ALK4, human ALK5, human ALK6, human ALK7, human ALK8, human ALK9, human ALK10, human ALK11, human ALK12, human ALK13, human ALK24, human ALK3, human ALK4, human ALK5, human ALK6, human ALK7, human ALK8, human ALK9, human ALK14, human ALK15, human ALK16, human ALK17, human ALK18, human ALK19, human ALK25, human ALK19, human ALK26, human ALK3, human ALK19, human ALK27, human ALK3, human ALK4, human ALK5, human ALK19, human ALK19, human ALK27, human ALK3, human ALK3, human ALK4, human ALK5, human ALK6, human ALK7, human ALK8, human ALK9, human ALK14, human ALK15, human ALK16, human ALK17, human ALK18, human ALK19, human ALK19, human ALK19, human ALK19, human ALK19, human ALK24 ... Proto-oncogene 1 non-receptor tyrosine protein kinase family, c-abl oncogene 1 receptor tyrosine kinase family, v-abl Abelson murine leukemia viral oncogene homolog 2, activin A receptor family, bc1 complex homolog chaperone-ABC1 activity (S. pombe) (ADCK3), aarF domain-containing kinase 4 (ADCK4), v-akt murine thymoma viral oncogene homolog family, anaplastic lymphoma receptor tyrosine kinase family, protein kinase A family, protein kinase B family, an Kirin repeat and kinase domain containing 1 (ANKK1), NUAK family-SNF1-like kinase, mitogen-activated protein kinase family Aurora kinase A (AURKA), Aurora kinase B (AURKB), Aurora kinase C (AURKC), AXL receptor tyrosine kinase (AXL), BMP2-inducible kinase (BIKE), B lymphocyte tyrosine kinase (BLK), bone morphogenetic protein receptor family, BMX nonreceptor tyrosine kinase (BMX), v-raf murine sarcoma viral oncogene homolog B1 (BRAF) , protein tyrosine kinase 6 (BRK), BR serine / threonine kinase family, Bruton's agammaglobulinemia tyrosine kinase (BTK), calcium / calmodulin-dependent protein kinase family, cyclin-dependent kinase family, cyclin-dependent kinase-like family, CHK1 checkpoint homolog (S. pombe) (CHEK1), CHK2 checkpoint homolog (S. pombe) (CHEK2), insulin receptor isoform A (INSR), insulin receptor isoform B (INSR),rho-interacting serine / threonine kinase (CIT), v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog (KIT), CDC-like kinase family hepatocyte growth factor receptor (MET), proto-oncogene tyrosine-protein kinase receptor, colony-stimulating factor family receptor, c-src tyrosine kinase (CSK), casein kinase family, megakaryocyte-associated tyrosine kinase (CTK), death-associated protein kinase family, doublecortin-like kinase family, discoidin Main receptor tyrosine kinase, myotonic dystrophy protein kinase (DMPK), dual specificity tyrosine-(Y)-phosphorylation-regulated kinase family, epidermal growth factor receptor family, eukaryotic translation initiation factor 2-alpha kinase 1 (EIF2AK1), EPH receptor family, ephrin type A receptor family, ephrin type B receptor family, v-erb-b2 erythroblastic leukemia viral oncogene homolog family, mitogen-activated protein kinase family, endoplasmic reticulum-nuclear signaling 1 (ERN1), PTK2 protein tyrosine kinase FAK, fer (fps / fes-related) tyrosine kinase (FER), feline sarcoma oncogene (FES), fibroblast growth factor receptor family, Gardner-Rasheed feline sarcoma viral (v-fgr) oncogene homolog (FGR), fms-related tyrosine kinase family, Fms-related tyrosine kinase family, fyn-related kinase (FRK), SRC-related FYN oncogene, cyclin G-associated kinase (GAK), eukaryotic translation initiation factor 2α kinase, growth hormone receptor, G protein-coupled receptor kinase 1 (GRK1), G protein-coupled receptor kinase family, glycogen synthase kinase family, germ cell-associated 2 (hapsin) (HASPIN), hematopoietic cell kinase (HCK), homeodomain-interacting protein kinase family, mitogen-activated protein kinase kinase kinase kinase family, hormone-upregulated Neu-related kinase (HUNK), enterocyte (MAK-like) kinase (ICK), insulin-like growth factor 1 receptor (IGF1R), conserved helix-loop-helix ubiquitous kinase (IKK-α),Inhibitor of kappa light polypeptide gene transcription factor of B cells-kinase beta family, insulin receptor (INSR), insulin receptor-related receptor (INSRR), interleukin-1 receptor-related kinase family, IL2-inducible T-cell kinase (ITK), Janus kinase family, kinase insert domain receptor, v-Kit Hardy-Zuckerman, Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog, lymphocyte-specific protein tyrosine kinase (LCK), LIM domain kinase family, serine / threonine kinase family, leucine-rich repeat kinase family, v-yes-1 Yamaguchi sarcoma viral oncogene homolog (LYN), male germline-associated kinase (MAK), MAP / microtubule affinity-regulating kinase family, microtubule-associated serine / threonine kinase family, maternal embryonic leucine zipper kinase, c-mer proto-oncogene tyrosine kinase Met proto-oncogene (hepatocyte growth factor receptor), MAP kinase interacting serine / threonine kinase family, myosin light chain kinase family, mixed lineage kinase domain-like protein isoform, CDC42-binding protein kinase family, serine / threonine kinase family, macrophage-stimulating 1 receptor (c-met-related tyrosine kinase) (MST1R), mechanistic target of rapamycin (serine / threonine kinase) (MTOR), musculo-skeletal receptor tyrosine kinase (MUSK), myosin light chain kinase family family, NIMA (not in mitosis gene a)-related kinase family, serine / threonine-protein kinase NIM1 (NIM1), nemo-like kinase (NLK), oxidative stress responsive 1 (OSR1), p21 protein (Cdc42 / Rac)-activated kinase family, PAS domain-containing serine / threonine kinase, platelet-derived growth factor receptor family, 3-phosphoinositide-dependent protein kinase-1 (PDPK1), calcium-dependent protein kinase 1, phosphorylase kinase gamma family, phosphatidylinositol 4,5-bisphosphate 3 kinase, phosphoinositide-3 kinase family, phosphatidylinositol 4 kinase family, phosphoinositide kinase, FYVE finger-containing, Pim-1 oncogene (PIM1), pim-2 oncogene (PIM2), pim-3 oncogene (PIM3), phosphatidylinositol-4-phosphate 5 kinase family, phosphatidylinositol-5-phosphate 4 kinase family protein kinase, membrane-associated tyrosine / threonine 1 (PKMYT1), protein kinase N family,Polo-like kinase family, protein kinase C family, protein kinase D family, cGMP-dependent protein kinase family, eukaryotic translation initiation factor 2-alpha kinase 2 (PRKR), X-linked protein kinase (PRKX), prolactin receptor (PRLR), PRP4·pre-mRNA processing factor 4 homolog B (yeast) (PRP4), PTK2B protein tyrosine kinase 2beta (PTK2B), SIK family kinase 3 (QSK), v-raf-1 murine leukemia viral oncogene homolog 1 (RAF1), neurotrophic tyrosine kinase ze receptor type family, receptor (TNFRSF) interacting serine-threonine kinase family, dual serine / threonine and tyrosine protein kinase (RIPK5), Rho-related coiled-coil-containing protein kinase family, c-ros oncogene 1 receptor tyrosine kinase (ROS1), ribosomal protein S6 kinase family, SH3-binding domain kinase 1 (SBK1), serum / glucocorticoid-regulated kinase family, uncharacterized putative serine / threonine protein kinase (Sugen kinase 110) (SgK11) 0), salt-inducible kinase family, SNF-related kinase (SNRK), src-related kinase, SFRS protein kinase family, spleen tyrosine kinase (SYK), TAO kinase family, TANK-binding kinase 1 (TBK1), tec protein tyrosine kinase (TEC), testis-specific kinase 1 (TESK1), transforming growth factor, beta receptor family, tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (TIE1), TEK tyrosine kinase, endothelial (TIE2), angiopoietin-1 receptor (Tie2), t ousled-like kinase family, TRAF2 and NCK interacting kinase (TNIK), non-receptor tyrosine kinase family, TNNI3 interacting kinase (TNNI3K), transient receptor potential cation channel, testis-specific serine kinase family, TTK protein kinase (TTK), TXK tyrosine kinase (TXK), tyrosine kinase 2 (TYK2), TYRO3 protein tyrosine kinase (TYRO3), unc-51-like kinase family, phosphatidylinositol 3-kinase, vaccinia-related kinase 2 (VRK2),Examples of nuclear hormone receptors include, but are not limited to, androgen receptor (AR), estrogen-related receptor alpha (ESRRA), estrogen receptor 1 (ESR1), nuclear receptor subfamily 1 group H member 4 (NR1H4), nuclear receptor subfamily 1 group H member 4 (NR1H5), nuclear receptor subfamily 1 group H member 4 (NR1H6), nuclear receptor subfamily 1 group H member 4 (NR1H7), nuclear receptor subfamily 1 group H member 4 (NR1H8), nuclear receptor subfamily 1 group H member 4 (NR1H9), nuclear receptor subfamily 1 group H member 4 (NR1H10), nuclear receptor subfamily 1 group H member 4 (NR1H11), nuclear receptor subfamily 1 group H member 4 (NR1H12), nuclear receptor subfamily 1 group H member 4 (NR1H14), nuclear receptor subfamily 1 group H member 4 (NR1H15), nuclear receptor subfamily 1 group H member 4 (NR1H16), nuclear receptor subfamily 1 group H member 4 (NR1H17), nuclear receptor subfamily 1 group H member 4 (NR1H18), nuclear receptor subfamily 1 group H member 4 (NR1H19 ... nuclear receptor subfamily 3 group C member 1 (glucocorticoid receptor) (NR3C1), nuclear receptor subfamily 1 group H member 3 (liver X receptor α) (NR1H3), nuclear receptor subfamily 1 group H member 2 (liver X receptor β) (NR1H2), nuclear receptor subfamily 1 group H member 2 (liver X receptor β) (NR1H2), nuclear receptor subfamily 3 group C member 2 (electrolyte corticoid receptor) (NR3C2), peroxisome proliferator-activated receptor α (PPARA), peroxisome proliferator-activated receptor γ (PP ARG), peroxisome proliferator-activated receptor delta (PPARD), progesterone receptor alpha (PGR), progesterone receptor beta (PGR), retinoic acid receptor alpha (RARA), retinoic acid receptor beta (RARB), retinoid X receptor alpha (RXRA), retinoid X receptor gamma (RXRG), thyroid hormone receptor alpha (THRA), thyroid hormone receptor beta (THRB), retinoic acid-related orphan receptor, liver X receptor, farnesoid X receptor, vitamin D receptor, pregnane X receptor, constitutive androstane receptor, hepatocyte nuclear factor 4, Examples of epigenetic targets include, but are not limited to, ATPase family AAA domain containing protein 2 (ATAD2A), ATPase family AAA domain containing 2B (ATAD2B), ATPase family AAA domain containing 2B (ATAD2B), zinc finger domain adjacent bromodomain 1A (BAZ1A), zinc finger domain adjacent bromodomain 1B (BAZ1B),Zinc finger domain adjacent bromodomain 2A (BAZ2A), zinc finger domain adjacent bromodomain 2A (BAZ2A), zinc finger domain adjacent bromodomain 2B (BAZ2B), bromodomain-containing protein 1 (BRD1), bromodomain-containing protein 2 first bromodomain (BRD2), bromodomain-containing protein 2 first and second bromodomains (BRD2), bromodomain-containing protein 2 isoform 1 bromodomain 2 (BRD2(2)), bromodomain-containing protein 3 bromodomain 1 (B RD3(1)), bromodomain-containing protein 3 first bromodomain (BRD3), bromodomain-containing protein 3 first and second bromodomain (BRD3), bromodomain-containing protein 3 bromodomain 2 (BRD3(2)), bromodomain-containing protein 4 first bromodomain (BRD4), bromodomain-containing protein 4 isoform long bromodomains 1 and 2 (BRD4(1-2)), bromodomain-containing protein 4 isoform long bromodomain 2 (BRD4(2)), bromodomain-containing protein 4 isoform short (BRD4 (full-length-short isoform)), bromodomain-containing protein 7 (BRD7), bromodomain-containing 8 bromodomain 1 (BRD8(1)), bromodomain-containing 8 bromodomain 2 (BRD8(2)), bromodomain-containing protein 9 isoform 1 (BRD9), bromodomain-containing testis-specific first bromodomain (BRDT), bromodomain-containing testis-specific first and second bromodomains (BRDT), bromodomain testis-specific protein isoform b bromodomain 2 (BR DT(2)), bromodomain and PHD finger containing 1 (BRPF1), bromodomain and PHD finger containing 3 (BRPF3), bromodomain and PHD finger containing 3 (BRPF3), bromodomain and WD repeat containing 3 second bromodomain (BRWD3(2)), cat eye syndrome critical region protein 2 (CECR2), CREB binding protein (CREBBP), E1A binding protein p300 (EP300), EP300 (EP300), nucleosome remodeling factor subunit BPTF isoform 1 (FALZ),Nucleosome remodeling factor subunit BPT (FALZ), euchromatin histone lysine N-methyltransferase 2 (EHMT2), histone acetyltransferase KAT2A (GCN5L2), euchromatin histone lysine N-methyltransferase 1 (EHMT1), histone lysine N-methyltransferase MLL (MLL), polybromo1 first bromodomain (PB1(1)), polybromo1 second bromodomain (PB1(2)), polybromo1 bromodomain 2 (PBRM1(2)), polybromo1 bromodomain main 5 (PBRM1(5)), histone acetyltransferase KAT2B (PCAF), PH interacting protein first bromodomain (PHIP(1)), PH interacting protein second bromodomain (PHIP(2)), protein kinase C binding protein 1 (PRKCBP1), protein arginine N-methyltransferase 3 (PRMT3), SWI / SNF-related matrix-associated actin-dependent regulator of chromatin subfamily a member 2 (SMARCA2), and SWI / SN of chromatin subfamily a member 4. F-related matrix-associated actin-dependent regulatory factor (SMARCA4), nuclear structural protein SP110 (SP110), nuclear structural protein SP140 (SP140), transcription initiation factor TFIID subunit 1 (TAF1(1-2)), TAF1·RNA polymerase II-TATA box-binding protein (TBP)-associated factor-250 kDa-bromodomain 2 (TAF1(2)), transcription initiation factor TFIID subunit 1-like first bromodomain (TAF1L(1)), transcription initiation factor TFIID subunit 1-like second bromodomain (TAF 1L(2)), tripartite motif-containing 24 (TRIM24(bromo)), tripartite motif-containing 24 (TRIM24(PHD-bromo)), E3 ubiquitin protein ligase TRIM33 (TRIM33), tripartite motif-containing 33 (TRIM33(PHD-bromo)), WD repeat 9 first bromodomain (WDR9(1)), and WD repeat 9 second bromodomain (WDR9(2)). Membrane transport proteins include, but are not limited to, the ATP-binding cassette (ABC) superfamily, the solute carrier (SLC) superfamily,Multidrug resistance protein 1 (P-glycoprotein), organic anion transporter 1, and proteins such as EAAT3, EAAC1, EAAT1, GLUT1, GLUT2, GLUT9, GLUT10, rBAT, AE1, NBC1, KNBC, CHED2, BTR1, NABC1, CDPD, SGLT1, SGLT2, NIS, CHT1, NET, DAT, GLYT2, CRTR, , B0AT1, SIT1, XT3, y+LAT1, BAT1, NHERF1, NHE6, ASBT, DMT1, DCT1, NRAMP2, NKCC2, NCC, KCC3, NACT, MCT1, MCT8, MCT12, SLD, VGLUT3, THTR1, THTR2, PIT 2, GLVR2, OCTN2, URAT1, NCKX1, NCKX5, CIC, PiC, ANT1, ORNT1, AGC1, ARALAR, Citrin, STLN2, aralar2, TPC, MUP1, MCPHA, CACT, GC1, PHC, DTD, CLD, DRA, P These include DS, Prestin, TAT1, FATP4, ENT3, ZnT2, ZnT10, AT1, NPT2A, NPT2B, HHRH, CST, CDG2F, UGAT, UGTL, UGALT, UGT1, UGT2, FUCT1, CDG2C, NST, PAT2, G6PT1, SPX4, ZIP4, LIV4, ZIP13, LZT-Hs9, FPN1, MTP1, IREG1, RHAG, AIM1, PCFT, FLVCR1, FLVCR2, RFT1, RFT2, RFT3, OATP1B1, OATP1B3, and OATP2A1. Examples of signal transduction include, but are not limited to, heat shock proteins, microtubule stabilizing proteins, oncoprotein 18, stathmin, kinesin 8 and kinesin 14 families, Kip3, Kif18A, and proteases include, but are not limited to, the ADAM (disintegrin and metalloprotease) family. Other molecular targets of signal transduction include, but are not limited to, cell division cycle gene 25 homolog A (CDC25A), forkhead box O3, kappa light chain polypeptide gene of B cell inhibitory factor (B cell inhibitory factor). Nuclear factor of transcription activator, alpha (NFKBIA), nuclear factor (erythroid-derived 2)-like 2 (NFE2L2), natriuretic peptide receptor A (NPR1), tumor necrosis factor receptor superfamily, member 11a (TNFRSF11A), v-rel reticuloendotheliosis viral oncogene homolog A (avian) (RELA), sterol regulatory element-binding transcription factor 2 (SREBF2), CREB-regulated transcriptional coactivator 1 (CRTC1), CREB-regulated transcriptional coactivator 2 (CRTC2), X-box binding protein 1 (XBP1), catenin (cadherin-related protein),β1(CTNNB1) and combinations thereof.

[0100] Well-known biologics include, but are not limited to, Abbosynagis, Abegrin, Actemra, tacatuzumab (AFP-Cide), Antova, Arzerra, Aurexis, Avastin, Benlysta, Bexxar, Blontress, Mepolizumab (Bosatr ia), alemtuzumab (Campath), labetuzumab (CEACide), CEA-Scan, Cimzia, Cyramza, Ektomab, cetuximab (Erbitux), biciromab (FibriScint), obinutuzumab (Gazyva), Herceptin, clivatuzumab tetraxetan (hPAM4-Cide), votumumab (HumaSPECT), zanolimumab (HuMax-CD4), Zalutum Mab (HuMax-EGFr), adalimumab (Humira), fontolizumab (HuZAF), altumomab pentetate (Hybri-ceaker), canakinumab (Ilaris), igovomab (Indimacis-125), Kadcyla, alemtuzumab (Lemtrada), LeukArrest, suresomab (LeukoScan), ranibizumab (Lucentis), Lymphomun, Lymphoscan ( LymphoScan, belimumab (LymphoStat-B), rituximab (MabThera), efungumab (Mycograb), gemtuzumab ozogamicin (Mylotarg), imciromab (Myoscint), technetium fanolesomab (NeutroSpec), motavizumab (Numax), Nuvion, pertuzumab (Omnitarg), Opdivo, muromonab-CD3 (OrthocloneOKT3), oregovomab (OvaRex), panorex, denosumab (Prolia), capromab pendetide (Prostascint), efalizumab (Raptiva), infliximab (Remicade), catumaxomab (Removab), lencarex, abciximab (ReoPro), ertumaxomab (Rexomun), rituximab (Rituxan), tocilizumab (RoActemra), 99mTc-besilesomab (Scintimun), golimumab (Simponi), basiliximab (S imulect), eculizumab (Soliris), ustekinumab (Stelara), palivizumab (Synagis), tactres (Tactress), nimotuzumab (Theracim), pemtumomab (Theragyn), nimotuzumab (Theraloc), natalizumab (Tysabri), panitumumab (Vectibix), nofetumomab (Verluma), omalizumab (Xolair), ipilimumab (Yervoy), daclizumab (Zenapax), and ibritumomab tiuxetan (Zevalin), or combinations thereof.

[0101] Known monoclonal antibodies include, but are not limited to, 3F8, 8H9, abagovomab, abciximab, avituzumab, abrilumab, actoxumab, adalimumab, adecatumumab, aducanumab, afacevicumab, afelimomab, afutuzumab, alacizumab pegol, ALD518, ALD403, alemtuzumab, alirocumab, altumomab pentetate, amatuximab, AMG334, anatumomab mafenatox, anetumab ravtansine, aniformumab, anrukinzumab, apolizumab, arcitumomab, ascrib mbakumab, acelizumab, atezolizumab, atinumab, atlizumab, atolimumab, avelumab, bapineuzumab, basiliximab, bavituximab, bectumomab, begelomab, belimumab, benralizumab, bertilimumab, besilesomab, bevacizumab, bezlotoxumab, biciromab, bimagrumab, bimekizumab, bivatuzumab mertansine, bleselumab, blinatumomab, brontuzumab, brosozumab, bococizumab, brazikumab, brentuximab vedotin, briakinumab, brodalumab, brolucizumab, bronchix Tuzumab, burosumab, cabilalizumab, canakinumab, cantuzumab mertansine, cantuzumab avtansine, caplacizumab, capromab pendetide, carlumab, carotuximab, catumaxomab, cBR96-doxorubicin immunoconjugate, cedelizumab, sergituzumab amnaleukin, certolizumab pegol, cetuximab, sitatuzumab bogatox, cixutumumab, clazakizumab, clenoliximab, clivatuzumab tetraxetan, codrituzumab, cortuximab avtansine, conatumumab, concizumab, CR6261, crene Zumab, Clotedumab, Dacetuzumab, Daclizumab, Darotuzumab, Dapirorizumab pegol, Daratumumab, Dectrekumab, Demcizumab, Denintuzumab mafodotin, Denosumab, Depatuxizumab mafodotin, Delrotuximab biotin, Detumomab, Dinutuximab, Ziridabumab, Domaglozumab, Dorlimomab aritox, Drozitumab, Durigotumab, Dupilumab, Durvalumab, Dusigitumab, Eclomeximab, Eculizumab, Edobacomab, Edrecolomab, Efalizumab, Efangumab,Eldelumab, Elgemtumab, Elotuzumab, Ercilimomab, Emactuzumab, Emivetuzumab, Emicizumab, Enavatuzumab, Enfortumab vedotin, Enlimomab pegol, Enoblituzumab, Enokizumab, Enoticumab, Encituximab, Epitumomab situxetan, Epratuzumab, Erenumab, Erlizumab, Ertumaxomab, Etaracizumab, Etrolizumab, Ebinacumab, Evolocumab, Exibirumab, Fanolesomab, Faralimomab, Faretuzumab, Fasinumab, FBTA05, Felvizumab, Fezakinumab , fibatuzumab, ficlatuzumab, figitumumab, filibumab, framvotumab, fretikumab, fontolizumab, foralumab, foravirumab, fresolimumab, furanumab, futuximab, galcanezumab, galiximab, ganitumab, gantenerumab, gavilimomab, gemtuzumab ozogamicin, gevokizumab, girentuximab, glenbatumumab vedotin, golimumab, gomilikimab, guselkumab, ibalizumab, ibritumomab tiuxetan, icrucumab, idarucizumab, igovomab, IMA-638, IMAB3 62, Imalumab, Imicilomab, Imgatuzumab, Inclacumab, Indatuximab vedotin, Inebilizumab, Infliximab, Inolimomab, Inotuzumab ozogamicin, Intetumumab, Ipilimumab, Iratumumab, Isatuximab, Itolizumab, Ixekizumab, Keliximab, Labetuzumab, Lambrolizumab, Lampalizumab, Lanadelumab, Landgrotumab, Laprituximab emtansine, LBR-101 / PF0442g7429, Lebrikizumab, Remaresomab, Lendarizumab, Len Zilumab, lerdelimumab, lexatumumab, ribivirumab, rifastuzumab vedotin, ligelizumab, rilotumab satetraxetan, lintuzumab, lirilumab, roderucizumab, loxivetumab, lorvotuzumab mertansine, lucatumumab, lurizumab pegol, rumiliximab, lumuletuzumab, LY2951742, mapatumumab, marjetuximab, maslimomab, matuzumab, mavrilimumab, mepolizumab, metelimuab, milatuzumab, minretumomab, mirvetuximab soravtansine, mitumomab, mogamulizumab, monalizumab,Morolimumab, Motavizumab, Moxetumomab pseudotox, Muromonab-CD3, Nacolomab butafenatox, Namilumab, Naptumomab estafenatox, Naratuximab emtansine, Narutuzumab, Natalizumab, Nabicixizumab, Nabivumab, Nebacumab, Necitumumab, Nemolizumab, Nerelimomab, Nesbacumab, Nimotuzumab, Nivolumab, Nofetumomab merpentane, Oviltoxaximab, Obinutuzumab, Ocaratuzumab, Ocrelizumab, Odulimomab, Ofatumumab, Olaratumab, Olokizumab, Omalizumab, Onartuzumab, Ontuxizumab, Opicinumab, Oportuzumab monatox, Oregovomab, Olticumab, Otelixizumab, Otlertuzumab, Oxelumab, Ozanezumab, Ozoralizumab, Pazibaximab, Palivizumab, Pamrevlumab, Panitumumab, Pancomab, Panobacumab, Palsatuzumab, Pascolizumab, Pasotuxizumab, Pateclizumab, Patritumab, Pembrolizumab, Pemtumomab, Perakizumab, Pertuzumab, Pexelizumab, Pidilizumab, Pinatuzumab vedotin, Pintumomab, Plakmab, Prozalizumab Mab, pogalizumab, polatuzumab vedotin, ponezumab, prezarizumab, priliximab, pritoxaximab, pritumumab, PRO140, kirisumab, racotumomab, radletumab, rafivirumab, ralpancizumab, ramucirumab, ranibizumab, raxibacumab, refanezumab, regavirumab, reslizumab, rilotumumab, rinukumab, risankizumab, rituximab, rivavazumab pegol, lobatumumab, loredumab, romosozumab, rontalizumab, rovalpituzumab tesirin, rovelizumab, ruplizumab, sacituzumab gobi Tecan, samalizumab, sapelizumab, sarilumab, satumomab pendetide, secukinumab, seribantumab, setoxaximab, sevilumab, SGN-CD19A, SGN-CD33A, sibrotuzumab, sifalimumab, siltuximab, simtuzumab, siplizumab, sirukumab, sofituzumab vedotin, solanezumab, solitomab, sonepcizumab, sontuzumab, stamulumab, sulesomab, subizumab, tabalumab, tacatuzumab tetraxetan, tadocizumab, talizumab, tamtubetumab, tanezumab, taplitumomab paptox,Talextumab, tefibazumab, terimomab alitox, tenatumomab, teneliximab, teplizumab, teprotumumab, tesidolumab, tetulomab, tezepelumab, TGN1412, ticilimumab, tigatuzumab, tildrakizumab, timolumab, tisotumab vedotin, TNX-650, tocilizumab, toralizumab, tosatoxumab, tositumomab, tobetumab, tralokinumab, trastuzumab, trastuzumab emtansine, TRBS07, tregalizumab, tremelimumab, trevoglumab, tucotuzumab celmoleukin, tuvilumab , ublituximab, urocupulumab, urelumab, urtoxazumab, ustekinumab, utomilumab, vadastuximab butarilin, bundletuzumab vedotin, vanticutuzumab, vanucizumab, bapaliximab, varlilumab, batelizumab, vedolizumab, veltuzumab, beparimomab, besencumab, visilizumab, bovalilizumab, volociximab, borsetuzumab mafodotin, votumumab, xentuzumab, zalutumumab, zanolimumab, zatuximab, diralimumab, and zolimomab alitox, or combinations thereof.

[0102] Vaccines developed for viral diseases include, but are not limited to, Hepatitis A vaccine, Hepatitis B vaccine, Hepatitis E vaccine, HPV vaccine, influenza vaccine, Japanese encephalitis vaccine, MMR vaccine, MMRV vaccine, polio vaccine, rabies vaccine, rotavirus vaccine, chickenpox vaccine, shingles vaccine, smallpox vaccine, yellow fever vaccine, adenovirus vaccine, Coxsackievirus B vaccine, cytomegalovirus vaccine, human dengue vaccine, human Eastern Equine Encephalitis Virus vaccine, Ebola vaccine, Enterovirus 71 vaccine, Epstein-Barr vaccine, Hepatitis C vaccine, HIV vaccine, human HTLV-1 T-lymphotropic leukemia vaccine, Marburg virus disease vaccine, Norovirus vaccine, human respiratory syncytial virus vaccine, severe acute respiratory syndrome (SARS) vaccine, and human West Nile virus vaccine. Vaccines developed for bacterial diseases include, but are not limited to, anthrax vaccine, DPT vaccine, and Q fever vaccine. , Hib vaccine, tuberculosis (BCG) vaccine, meningococcal vaccine, typhoid vaccine, pneumococcal conjugate vaccine, pneumococcal polysaccharide vaccine, cholera vaccine, dental caries vaccine, ehrlichiosis vaccine, leprosy vaccine, Lyme disease vaccine, Staphylococcus aureus vaccine, Streptococcus pyogenes vaccine, syphilis vaccine, tularemia vaccine, and Yersinia pestis vaccine; and vaccines developed for parasitic diseases include, but are not limited to, malaria vaccine, schistosomiasis vaccine, Chagas disease vaccine, hookworm vaccine, and Examples of vaccines developed for non-communicable diseases include, but are not limited to, Alzheimer's disease amyloid protein vaccine, breast cancer vaccine, ovarian cancer vaccine, prostate cancer vaccine, and talimogene laherparepvec (T-VEC). Examples of vaccines developed for non-communicable diseases include, but are not limited to, trade names: ACAM2000, ActHIB, Adacel, Afluria, AFLURIA QUADRIVALENT, Agriflu, BCG.Vaccines include Vaccine, BEXSERO, Biothrax, Boostrix, Cervarix, Comvax, DAPTACEL, DECAVAC, Engerix-B, FLUAD, Fluarix, Fluarix Quadrivalent, Flublok, Flucelvax, Flucelvax Quadrivalent, FluLaval, FluMist, FluMist Quadrivalent, Fluvirin, Fluzone Quadrivalent, Fluzone, Fluzone High-Dose and Fluzone Intradermal, Gardasil, Gardasil 9, Havrix, Hiberix, Imovax, Infanrix, IPOL, Ixiaro, JE-Vax, KINRIX, Menactra, MenHibrix, Menomune-A / C / Y / W-135, Menveo, M-M-R II, M-M-Vax, Pediarix, PedvaxHIB, Pentacel, Pneumovax 23, Poliovax, Prevnar, Prevnar 13, ProQuad, Quadracel, Quadrivalent, RabAvert, Recombivax HB, ROTARIX, RotaTeq, TENIVAC, TICE BCG, Tripedia, TRUMENBA, Twinrix, TYPHIM Vi, VAQTA, Varivax, Vaxchora, Vivotif, YF-Vax, Zostavax and combinations thereof.

[0103] Examples of injectable drugs include, but are not limited to, Ablavar (gadofosveset trisodium injection), Abarelix Depot, Botulinum Toxin A injection (Dysport), ABT-263, ABT-869, ABX-EFG, Accretropin (somatropin injection), Acetadote (acetylcysteine ​​injection), Acetazolamide injection Injection), Acetylcysteine ​​Injection (Acetadote), Actemra (Tocilizumab Injection), Acthrel (Corticolerin Oubain Triflutate for Injection), Actummune, Activase, Acyclovir for Injection (Zovirax Injection),

[0137] , Adacel, Adalimumab, Adenoscan (Adenosine Injection), Adenosine Injection (Adenoscan), Adrenaclick, AdreView (Iobenguane 1123 Injection, for intravenous administration), A fluria, Ak-Fluor (fluorescein injection), Aldurazyme (laronidase), alglucerase injection (Ceredase), Alkeran injection (melphalan Hcl injection), allopurinol sodium for injection (Aloprim), Aloprim (allopurinol sodium for injection), alprostadil, Alsuma (sumatriptan injection), ALTU-238, amino acid injection, Aminosyn, Apidra, Apremilast, alprostadil dual chamber system for injection (Caverject Impulse), AMG009, AMG076, AMG102, AMG108, AMG114, AMG162, AMG220, AMG221, AMG222, AMG223, AMG317, AMG379, AMG386, AMG403, AMG477, AMG479, AMG517, AMG531, AMG557, AMG623, AMG655, AMG706, AMG714, AMG745, AMG785, AMG811, AMG827, AMG837, AMG853, AMG951, Amiodarone HCl Injection, Amobarbital Sodium Injection, Amytal SodiumSodium (amobarbital sodium injection), Anakinra, Anti-Abeta, Anti-Beta7, Anti-Beta20, Anti-CD4, Anti-CD20, Anti-CD40, Anti-IFNα, Anti-IL13, Anti-OX40L, Anti-oxLDS, Anti-NGF, Anti-NRP1, Arixtra, Amphadase (hyaluronidase injection), Ammonul (sodium phenylacetate and sodium benzoate injection), Anaprox, Anzemet injection (dolasetron mesylate injection), Apidra (insulin glulisine [rDNA derived] injection), Apomab, Aranesp (darbepoetin α), Argatroban (argatroban injection), Arginine hydrochloride injection (R-Gene 10, Aristocort, Aristospan, Arsenic Acid Injection (Trisenox), Articane HCl and Epinephrine Injection (Septocaine), Arzerra (Ofatumumab Injection), Asclera (Polidocanol Injection), Ataluren, Ataluren-DMD, Atenolol Injection (Tenormin Intravenous Injection), Atracurium Besylate Injection, Avastin, Azactam Injection, Azithromycin (Zithromax Injection), Aztreonam Injection, Baclofen Injection (Lioresal Intrathecal), Bacteriostatic Water, Baclofen Injection (Lioresal Intrathecal), Bal in Oil Ampules (dimercarprol injection), BayHepB, BayTet, Benadryl, bendamustine hydrochloride injection (Treanda), benztropine mesylate injection (Cogentin), betamethasone injectable suspension (Celestone Soluspan), Bexxar, Bicillin CR900 / 300 (Penicillin G Benzathine and Penicillin G Procaine Injection), Blenoxane (Bleomycin Sulfate Injection), Bleomycin Sulfate Injection (Blenoxane), Boniva Injection (Ibandronate Sodium Injection), Botox Cosmetic (OnabotulinumtoxinA for Injection), BR3-FC, Bravelle (Urofollitropin Injection), Bretylium (Bretylium Tosylate Injection), Brevital Sodium (Methohexital Sodium for Injection), Brethine, Briobacept, BTT-1023, Bupivacaine HCl, Byetta, Ca-DTPA (Calcium Pentetate Trisodium Injection), Cabazitaxel Injection (Jevtana), Caffeine Alkaloid (Caffeine and Sodium Benzoate Injection), Calcijex Injection (Calcitriol), Calcitriol (Calcijex Injection), Calcium Chloride (Calcium Chloride Injection 10%), Calcium Disodium Versenate (Calcium Disodium Edetate Injection), Campath (Artemtuzumab), Camptosar Injection (Irinotecan Hydrochloride), Canakinumab Injection (Ilaris), Capastat Sulfate (Capreomycin for Injection), Capreomycin for Injection (Capastat Sulfate), Cardiolite (Technetium Tc99 Sestamibi Prep Kit for Injection), Carticel, Cathflo, Cefazolin, Dextrose for Injection (Cefazolin Injection), Cefepime Hydrochloride, Cefotaxime, Ceftriaxone, Cerezyme, Carnitor Injection, Caverject, Celestone Soluspan, Celsior, Cerebyx (Fosphenytoin Sodium Injection), Ceredase (Alglucerase Injection), Ceretec (Technetium Tc99m Examethazime Injection), Certolizumab, CF-101, Chloramphenicol Sodium Succinate (Chloramphenicol Sodium Succinate Injection), Chloramphenicol Sodium Succinate InjectionSuccinate), Cholestagel (Colesevelam Hydrochloride), Choriogonadotropin Alpha Injection (Ovidrel), Cimzia, Cisplatin (Cisplatin Injection), Clolar (Clofarabine Injection), Clomiphine Citrate, Clonidine Injection (Duraclon), Cogentin (Benzotropine Mesylate Injection), Colitimethate Injection (Coly-Mycin M), Coly-Mycin M (Colistimethate Injection), Compath, Conivaptan Hydrochloride Injection (Vaprisol), Conjugated Estrogens for Injection (Premarin Injection), Copaxone, Corticorelin Oubain Triflutate for Injection (Acthrel), Corvert (Ibutilide Fumarate Injection), Cubicin (Daptomycin Injection), CF-101, Cyanokit (Hydroxocobalamin for Injection), Cytarabine Liposomal Injection (DepoCyt), Cyanocobalamin, Cytovene (ganciclovir), DHE 45, Dacetuzumab, Dacogen (Decitabine Injection), Dalteparin, Dantrium IV (Dantrolene Sodium for Injection), Dantrolene Sodium for Injection (Dantrium IV), Daptomycin Injection (Cubicin), Darbepoietin Alfa, DDAVP Injection (Desmopressin Acetate Injection), Decavax, Decitabine Injection (Dacogen), Dehydrated Alcohol (Absolute Alcohol Injection), Denosumab Injection (Prolia), Delatestryl, Delestrogen, Delteparin Sodium, Depacon (Sodium Valproate Injection), Depo Medrol (Methylprednisolone Acetate Injectable Suspension), DepoCyt (Cytarabine Liposomal Injection), DepoDur (Morphine Sulfate XR Liposomal Injection), Desmopressin Acetate Injection (DDAVP Injection), Depo-Estradiol, Depo-Provera 104 mg / ml, Depo-Provera 150 mg / ml, Depo-Testosterone, Dexrazoxane for Injection, Intravenous Injection Only (Totect), Dextrose / Electrolytes, Dextroseand Sodium Chloride Injection (0.9% Sodium Chloride Solution in 5% Dextrose), Dextrose, Diazepam Injection, Digoxin Injection (Lanoxin Injection), Dilaudid-HP (Hydromorphone Hydrochloride Injection), Dimercaprol Injection (Bal in Oil Ampules), Diphenhydramine Injection (Benadryl Injection), Dipyridamole Injection, DMOAD, Docetaxel for Injection (Taxotere), Dolasetron Mesylate Injection (Anzemet Injection), Doribax (Doripenem for Injection), Doripenem for Injection (Doribax), Doxercalciferol Injection (Hectorol Injection), Doxil (Doxorubicin Hydrochloride Liposome Injection), Doxorubicin Hydrochloride Liposome Injection (Doxil), Duraclon (Clonidine Injection), Duramorph (Morphine Injection), Dysport (Abobotulinum Toxin A Injection), Ecallantide Injection (Kalbitor), EC-N aprosyn (naproxen), edetate calcium disodium injection (calcium disodium versenate), Edex (alprostadil for injection), Engerix, edrophonium injection (Enlon), eliglustat tartrate, Eloxatin (oxaliplatin injection), Emend injection (fosaprepitant dimeglumine injection), Enalaprilat injection (enalaprilat injection), Enlon (edrophonium injection), enoxaparin sodium injection (Lovenox), Eovist (gadoxetate disodium injection), Enbrel (etanercept), Enoxaparin, Epicel, Epinepherine, Epipen, EpipenJr., Epratuzumab, Erbitux, Ertapenem Injection (Invanz), Erythropoieten, Essential Amino Acid Injection (Nephramine), Estradiol Cypionate, Estradiol Valerate, Etanercept, Exenatide Injection (Byetta), Evlotra, Fabrazyme (Adalusidase beta), Famotidine Injection, FDG (Fludeoxyglucose F18 Injection), Feraheme (Ferumoxytol Injection), Feridex IV (Ferumoxides Injectable Solution), Fertinex, Ferumoxides Injectable Solution (Feridex IV), Ferumoxytol Injection (Feraheme), Flagyl Injection (Metronidazole Injection), Fluarix, Fludara (Fludarabine Phosphate), Fludeoxyglucose F18 Injection (FDG), Fluorescein Injection (Ak-Fluor), Follistim AQ Cartridge (Follitropin beta injection), Follitropin alpha injection (Gonal-f RFF), Follitropin beta injection (Follistim AQ Cartridge), Folotyn (pralatrexate solution for intravenous injection), Fondaparinux, Forteo (Teriparatide (rDNA derived) injection), Fostamatinib, Fosaprepitant dimeglumine injection (Emend injection), Foscarnet sodium injection (Foscavir), Foscavir (Foscarnet sodium injection), Fosphenytoin sodium injection (Cerebyx), Fospropofol disodium injection (Lusedra), Fragmin, Fuzeon (enfuvirtide), GA10 1, Gadobenate dimeglumine injection (Multihance), Gadofosveset trisodium injection (Ablavar), Gadoteridol injection (ProHance), Gadoversetamide injection (OptiMARK), Gadoxetate disodium injection (Eovist), Ganirelix (Ganirelix acetate injection), Gardasil, GC1008, GDFD, Gemtuzumab ozogamicin for injection (Mylotarg), Genotropin, Gentamicin injection, GENZ-112638, Golimumab injection (Simponi injection), Gonal-fRFF (Follitropin alfa injection), Granisetron hydrochloride (Kytril injection), Gentamicin sulfate, Glatiramer acetate, Glucagen, Glucagon, HAE1, Haldol (Haloperidol injection), Havrix, Hectorol injection (Doxercalciferol injection), Hedgehog signaling pathway inhibitors, Heparin, Herceptin, hG-CSF, Humalog, Human growth hormone, Humatrope, HuMax, Humegon, Humira, Humulin, Ibandronate sodium injection (Boniva injection), Ibuprofen lysine injection (NeoProfen), Ibutilide fumarate injection (Corvert), Idamycin PFS (Idarubicin hydrochloride injection), Idarubicin hydrochloride injection (Idamycin PFS), Ilaris (Canakinumab injection), Injectable imipenem and cilastatin (Primaxin IV), Imitrex, Incobotulinumtoxin A for Injection (Xeomin), Increlex (Mecasermin [rDNA-derived] Injection), Indocin IV (Indomethacin Injection), Indomethacin Injection (Indocin IV), Infanrix, Innohep, Insulin, Insulin Aspart [rDNA-derived] Injection (NovoLog), Insulin Glargine [rDNA-derived] Injection (Lantus), Insulin Glulisine [rDNA-derived] Injection (Apidra), Interferon alpha-2b, Recombinant for Injection (Intron A), Intron A (Interferon alpha-2b, Recombinant for Injection), Invanz (Ertapenem Injection), Invega Sustenna (paliperidone palmitate extended-release injectable suspension), Invirase (saquinavir mesylate), iobenguane 1123 injection for intravenous administration (AdreView), iopromide injection (Ultravist), ioversol injection (Optiray injection), Iplex (mecasermin rinfavert [rDNA-derived] injection), Iprivask, irinotecan hydrochloride (Camptosar injection), Ferric oxide injection (Venofer), Istodax (romidepsin for injection), Itraconazole injection (Sporanox injection), Jevtana (cabazitaxel injection), Jonexa, Kalbitor (ecallantide injection), KCL in D5NS (potassium chloride and sodium chloride in 5% dextrose injection), KCL in D5W, KCL in NS, Kenalog 10 Injection (Triamcinolone Acetonide Injectable Suspension), Kepivance (Palifermin), Keppra Injection (Levetiracetam), Keratinocyte, KFG, Kinase Inhibitors, Kineret (Anakinra), Kinlytic (Urokinase Injection), Kinrix, Klonopin (Clonazepam), Kytril Injection (Granisetron Hydrochloride), Lacosamide Tablets and Injection (Vimpat), Lactated Ringer's Solution, Lanoxin Injection (Digoxin Injection), Lansoprazole for Injection (Prevacid IV), Lantus, Leucovorin Calcium (Leucovorin Calcium Injection), Lente (L), Leptin, Levemir, Leukine Sargramostim, Leuprolide Acetate, Levothyroxine, Levetiracetam (Keppra Injection), Lovenox, Levocarnitine Injection (Carnitor Injection), Lexiscan (Regadenoson Injection), Lioresal Intrathecal (Baclofen Injection), Liraglutide [rDNA] Injection (Victoza), Lovenox (Enoxaparin Sodium Injection), Lucentis (Ranibizumab Injection), Lumizyme, Lupron (Leuprolide Acetate Injection), Lusedra (Fospropofol Disodium Injection), Maci, Magnesium Sulfate (Magnesium Sulfate Injection), Mannitol Injection (Mannitol IV), Marcaine (Bupivacaine Hydrochloride and Epinephrine Injection), Maxipime (Cefepime Hydrochloride for Injection), MDP for Technetium InjectionMulti-Dose Kit (Technetium Tc99m Medronate Injection), Mecasermin [rDNA-derived] Injection (Increlex), Mecasermin Linfavert [rDNA-derived] Injection (Iplex), Melphalan Hydrochloride Injection (Alkeran Injection), Methotrexate, Menactra, Menopur (Menotropins Injection), Menotropins for Injection (Repronex), Methohexital Sodium for Injection (Brevital Sodium), Methyldoparin Hydrochloride Injection, Solution (Methyldoparin Hydrochloride), Methylene Blue (Methylene Blue Injection), Methylprednisolone Acetate Injectable Suspension (Depo Medrol), MetMab, Metoclopramide Injection (Reglan Injection), Metrodin (Urofollitropin for Injection), Metronidazole Injection (Flagyl Injection), Miacalcin, Midazolam (Midazolam Injection), Mimpara (Cinacalcet), Minocin Injection (Minocycline Injection), Minocycline Injection (Minocin Injection), Mipomersen, Mitoxantrone for Injection Concentrate (Novantrone), Morphine Injection (Duramorph), Morphine Sulfate XR Liposomal Injection (DepoDur), Morrhuate Sodium (Sodium Morrhuate Injection), Motesanib, Mozobil (Plerixafor Injection), Multihance (Gadobenate Dimeglumine Injection), Combined Electrolytes and Dextrose Injection, Combined Electrolytes Injection, Mylotarg (Gemtuzumab Ozogamicin for Injection), Myozyme (Alglucosidase Alfa), Nafcillin Injection (Nafcillin Sodium), Nafcillin Sodium (Nafcillin Injection), Naltrexone XR Injection (Vivitrol), Naprosyn (Naproxen), NeoProfen (Ibuprofen Lysine Injection), Nandrol Decanoate, NeostigmineMethylsulfate (Neostigmine Methylsulfate Injection), NEO-GAA, NeoTect (Technetium Tc99m Depreotide Injection), Nephramine (Essential Amino Acid Injection), Neulasta (Pegfilgrastim), Neupogen (Filgrastim), Novolin, Novolog, NeoRecormon, Neutrexin (Trimetrexate Glucuronate Injection), NPH(N), Nexterone (Amiodarone Hydrochloride Injection), Norditropin (Somatropin Injection), Normal Saline (Sodium Chloride Injection), Novantrone (Mitoxantrone for Injection Concentrate), Novolin 70 / 30 Innolet (70% NPH, Human Isophane Insulin Suspension and 30% Standard Human Insulin Injection), NovoLog (Insulin Aspart [rDNA-derived] Injection), Nplate (Romiplostim), Nutropin (Somatropin for Injection (rDNA-derived)), Nutropin AQ, Nutropin Depot (Somatropin for Injection (rDNA-derived)), Octreotide Acetate Injection (Sandostatin LAR), Ocrelizumab, Ofatumumab Injection (Arzerra), Olanzapine Extended-Release Injectable Suspension (Zyprexa Relprevv), Omnitarg, Omnitrope (Somatropin [rDNA-derived] Injection), Ondansetron Hydrochloride Injection (Zofran Injection), OptiMARK (Gadoversetamide Injection), Optiray Injection (Ioversol Injection), Orencia, Osmitrol Injection in Aviva Container (Mannitol Injection in Aviva Plastic Container 250), Osmitrol Injection in Viaflex (Mannitol Injection in Viaflex Plastic Container 250), Osteoprotegrin, Ovidrel (Chorigonadotropin alpha Injection), Oxacillin (Oxacillin for Injection), Oxaliplatin Injection (Eloxatin), Oxytocin Injection (Pitocin), Paliperidone Palmitate Sustained-Release Injectable Suspension (InvegaSustenna), Pamidronate Disodium Injection, Panitumumab Injection for Intravenous Use (Vectibix), Papaverine Hydrochloride Injection (Papaverine Injection), Papaverine Hydrochloride Injection Parathyroid Hormone, Paricalcitol Injection, in Push-up Vials (Zemplar Injection), PARP Inhibitors, Pediarix, PEGlntron, Peginterferon, Pegfilgrastim, Penicillin G Benzathine and Penicillin G Procaine, Pentetate Calcium Trisodium Injection (Ca-DTPA), Pentetate Zinc Trisodium Injection (Zn-DTPA), Pepcid Injection (Famotidine Injection), Pergonal, Pertuzumab, Phentolamine Mesylate (Phentolamine Mesylate for Injection), Physostigmine Salicylate (Physostigmine Salicylate (Injection)), Piperacillin-Tazobactam Injection (Zosyn), Pitocin (Oxytocin Injection), Plasma-Lyte 148 (Combined Electrolyte Injection), Plasma-Lyte 56 and Dextrose (Combined Electrolyte and Dextrose Injection in 250 Viaflex Plastic Containers), PlasmaLyte, Plerixafor Injection (Mozobil), Polidocanol Injection (Asclera), Potassium Chloride, Pralatrexate Solution for Intravenous Injection (Folotyn), Pramlintide Acetate Injection (Symlin), Premarin Injection (Conjugated Estrogens for Injection), Technetium Tc99 Sestamibi Prep Kit for Injection (Cardiolite), Prevacid IV (Lansoprazole for Injection), Primaxin IV (Imipenem and Cilastatin for Injection), Prochymal, Procrit, Progesterone, ProHance (Gadoteridol Injection), Prolia (Denosumab Injection), Promethazine HCl Injection, Propranolol Hydrochloride Injection, Quinidine Gluconate Injection, Quinidine Injection, R-Gene10 (arginine hydrochloride injection), ranibizumab injection (Lucentis), ranitidine hydrochloride injection (Zantac injection), Raptiva, Reclast (zoledronic acid injection), Recombivarix HB, regadenoson injection (Lexiscan), Reglan injection (metoclopramide injection), Remicade, Renagel, Renvela (sevelamer carbonate), Repronex (menotropins for injection), Retrovir IV (Zidovudine Injection), rhApo2L / TRAIL, Ringer's Solution and 5% Dextrose Injection (Ringer's in Dextrose), Ringer's Injection, Rituxan, Rituximab, Rocephin (Ceftriaxone), Rocuronium Bromide Injection (Zemuron), Roferon-A (Interferon alpha-2a), Romazicon (Flumazenil), Romidepsin for Injection (Istodax), Saizen (Somatropin Injection), Sandostatin LAR (Octreotide Acetate Injection), Sclerostin Ab, Sensipar (Cinacalcet), Sensorcaine (Bupivacaine Hydrochloride Injection), Septocaine (Articane HCl and Epinephrine Injection), Serostim LQ (Somatropin (rDNA-derived) Injection), Simponi Injection (Golimumab Injection), Sodium Acetate (Sodium Acetate Injection), Sodium Bicarbonate (Sodium Bicarbonate 5% Injection), Sodium Lactate (Sodium Lactate Injection, with AVIVA), Sodium Phenylacetate and Sodium Benzoate Injection (Ammonul), Somatropin for Injection (rDNA-derived) (Nutropin), Sporanox Injection (Itraconazole Injection), Stelara Injection (Ustekinumab), Stemgen, Sufenta (Sufentanil Citrate Injection), Sufentanil Citrate Injection (Sufenta), Sumavel, Sumatriptan Injection (Alsuma), Symlin, Symlin Pen, Systemic Hedgehog Antagonists, Synvisc-One (Hylan GF 20Single intra-articular injection), Tarceva, Taxotere (docetaxel injection), Technetium Tc99m, telavancin injection (Vibativ), temsirolimus injection (Torisel), Tenormin IV Injection (Atenolol Injection), Teriparatide (rDNA-derived) Injection (Forteo), Testosterone Cypionate, Testosterone Enanthate, Testosterone Propionate, Tev-Tropin (Somatropin, rDNA-derived, for Injection), tgAAC94, Thallium Chloride, Theophylline, Thiotepa (Thymoglobulin (Rabbit)), Thyrogen (Thyrotropin Alfa for Injection), Ticarcillin Disodium and Potassium Clavulanate Galaxy (Timentin Injection), Tigan Injection (Trimethobenzamide Hydrochloride Injectable), Timentin Injection (Ticarcillin Disodium and Potassium Clavulanate Galaxy), TNKase, Tobramycin Injection, Tocilizumab Injection (Actemra), Torisel (Temsirolimus) Injection), Totect (Dexrazoxane for Injection, Intravenous Injection Only), Trastuzumab-DM1, Travasol (Amino Acids (Injection)), Treanda (Bendamustine Hydrochloride Injection), Trelstar (Triptorelin Pamoate for Injectable Suspension), Triamcinolone Acetonide, Triamcinolone Diacetate, Triamcinolone Hexacetonide Injectable Suspension (Aristospan Injection 20 mg), Triesence (Triamcinolone Acetonide Injectable Suspension), Trimethobenzamide Hydrochloride Injectable (Tigan Injection), Trimetrexate Glucuronide Injection (Neutrexin), Triptorelin Pamoate for Injectable Suspension (Trelstar), Twinject, Trivaris (Triamcinolone Acetonide Injectable Suspension), Trisenox (Arsenic Trioxide Injection), Twinrix, Typhoid Vi, Ultravist (iopromide injection), injectable urofollitropin (Metrodin), urokinase injection (Kinlytic), ustekinumab (Stelara injection), Ultralente(U), Valium (diazepam), Sodium Valproate Injection (Depacon), Valtropin (Somatropin Injection), Vancomycin Hydrochloride (Vancomycin Hydrochloride Injection), Vancomycin Hydrochloride Injection, Vaprisol (Conivaptan Hydrochloride Injection), VAQTA, Vasovist (Gadofosveset Trisodium Injection for Intravenous Use), Vectibix (Panitumumab Injection for Intravenous Use), Venofer (Sugar-Containing Iron Oxide Injection), Verteporfin Injection (Visudyne), Vibativ (Telavancin for Injection), Victoza (Liraglutide [rDNA] Injection), Vimpat (Lacosamide Tablets and Injection), Vinblastine Sulfate (Vinblastine Sulfate Injection), Vincasar PFS (Vincristine Sulfate Injection), Victoza, Vincristine Sulfate (Vincristine Sulfate Injection), Visudyne (Verteporfin Injection), Vitamin B-12, Vivitrol (Naltrexone XR Injection), Voluven (Hydroxyethyl Starch Injection in Sodium Chloride), Xeloda, Xenical (orlistat), Xeomin (Incobotulinumtoxin A for injection), Xolair, Zantac Injection (Ranitidine Hydrochloride Injection), Zemplar Injection (Paricalcitol Injection in flip-top vials), Zemuron (Rocuronium Bromide Injection), Zenapax (Daclizumab), Zevalin, Zidovudine Injection (Retrovir IV), Zithromax Injection (azithromycin), Zn-DTPA (zinc trisodium pentetate injection), Zofran Injection (ondansetron hydrochloride injection), Zingo, Zoledronic Acid for Injection (Zometa), Zoledronic Acid Injection (Reclast), Zometa (Zoledronic Acid for Injection), These include Zosyn (piperacillin-tazobactam injection), Zyprexa Relprevv (olanzapine extended-release injectable suspension), and combinations thereof.

[0104] Although the present invention has been described in detail, modifications within the spirit and scope of the present invention will be readily apparent to those skilled in the art. It should be understood that the aspects and various features of the present invention and parts of the various embodiments and recited above and / or in the appended claims may be combined or exchanged in whole or in part. In the above description of various embodiments, an embodiment referring to another embodiment may be appropriately combined with other embodiments as would be understood by one skilled in the art. (Aspect) (Aspect 1) a lubricant-free barrel having a proximal end, a distal end and an interior surface defining a fluid chamber for containing at least one therapeutic agent; an elastomeric stopper having an outer surface that forms a fluid-tight seal with an inner surface of the barrel; a plunger rod connected to the elastomeric stopper; 1. A medical delivery device comprising: the barrel having a region of reduced diameter located at least at its proximal end to enhance the interference fit between the elastomeric stopper and the interior surface of the barrel; and A medical delivery device, wherein the elastomeric stopper includes at least one rib that abuts within an area of ​​reduced diameter while the elastomeric stopper is in an uncompressed state. (Aspect 2) The medical delivery device of embodiment 1, wherein the barrel includes a reduced diameter region, a larger diameter region disposed at a distal end of the barrel, and a transition section disposed therebetween for providing a gradual transition between the reduced diameter region and the larger diameter region. (Aspect 3) The medical delivery device of any one of claims 1 to 2, wherein two or more ribs are in adjacent contact with the region of reduced diameter while the elastomeric stopper is in an uncompressed state. (Aspect 4) The medical delivery device of any one of aspects 1 to 3, wherein a coating material is provided over a portion of the inner surface of the barrel to form the region of reduced diameter. (Aspect 5) 5. The medical delivery device of embodiment 4, wherein the coating material comprises at least one member selected from the group consisting of fluorinated ethylene propylene, expanded fluorinated ethylene propylene, epoxy resin, and acrylic. (Aspect 6) 5. The medical delivery device of embodiment 4, wherein at least one rib is in contact with the coating material when the syringe is in an unrepressed state. (Aspect 7) 5. The medical delivery device of embodiment 4, wherein the coating material further comprises an oxygen absorbing material, an oxygen adsorbing material, or a combination thereof. (Aspect 8) The medical delivery device of any one of the preceding embodiments, wherein the elastomeric stopper is at least partially covered with an expanded polytetrafluoroethylene membrane or a densified expanded polytetrafluoroethylene membrane. (Aspect 9) The medical delivery device of any one of aspects 1 to 8, wherein at least one insert contacts the inner surface of the barrel to form a region of reduced diameter, and the at least one insert is a gas barrier that inhibits oxygen permeation into the barrel. (Aspect 10) 10. The medical delivery device of embodiment 9, wherein the insert is attached to the inner surface of the barrel via an adhesive. (Aspect 11) The medical delivery device of claim 9 or claim 10, wherein the insert is integrally formed on an inner surface of the barrel. (Aspect 12) 12. The medical delivery device of any one of claims 9-11, wherein the insert comprises a solid polymer tube bonded to an inner surface of the barrel. (Aspect 13) 13. The medical delivery device of any one of claims 9 to 12, wherein the insert comprises a laminate comprising one or more fluoropolymer membranes attached to an inner surface of the barrel. (Aspect 14) 14. The medical delivery device according to any one of aspects 1 to 13, wherein the at least one therapeutic agent is selected from DNA targeted receptor genes or DNA fragments of target genes of the group consisting of genetic coagulation factors, cytokines, epigenetic protein families, growth factors, hormones, peptides, signaling molecules, vaccines and combinations thereof. (Aspect 15) 15. The medical delivery device according to any one of aspects 1 to 14, wherein the at least one therapeutic agent is selected from a mutation in a DNA targeted receptor gene or a DNA fragment of a target gene. (Aspect 16) 16. The medical delivery device according to any one of aspects 1 to 15, wherein the therapeutic agent is Factor VII. (Aspect 17) 17. The medical delivery device according to any one of embodiments 1 to 16, for use in treating an eye disease. (Aspect 18) 18. The medical delivery device according to any one of the preceding aspects, wherein the medical delivery device is a syringe, an automatic injector, or a pen. (Aspect 19) a lubricant-free barrel having a proximal end, a distal end and an interior surface defining a fluid chamber for containing at least one therapeutic agent; an elastomeric stopper having an outer surface that forms a fluid-tight seal with an inner surface of the barrel, the elastomeric stopper including a plurality of ribs, each pair of ribs having a valley therebetween; at least one ring member disposed within the at least one valley; Including, A medical delivery device, wherein the at least one ring member comprises an oxygen absorbing material, an oxygen adsorbing material, or a combination thereof. (Aspect 20) 20. The medical delivery device of embodiment 19, wherein the two or more valleys comprise the at least one ring member. (Aspect 21) The medical delivery device of claim 19 or claim 20, further comprising a coating material disposed on a portion of the inner surface of the barrel adjacent the proximal end of the barrel, forming a region of reduced diameter to enhance the interference fit between the elastomeric stopper and the inner surface of the barrel. (Aspect 22) 22. The medical delivery device according to any one of aspects 19 to 21, wherein the at least one therapeutic agent is selected from DNA targeted receptor genes or DNA fragments of target genes of the group consisting of genetic coagulation factors, cytokines, epigenetic protein families, growth factors, hormones, peptides, signaling molecules, vaccines and combinations thereof. (Aspect 23) 23. The medical delivery device according to any one of aspects 19 to 22, wherein the therapeutic agent is selected from a mutation in a DNA targeted receptor gene or a DNA fragment of a target gene. (Aspect 24) 24. The medical delivery device according to any one of aspects 19 to 23, wherein the therapeutic agent is Factor VII. (Aspect 25) The medical delivery device according to any one of embodiments 19 to 24, for use in treating an eye disease. (Aspect 26) 26. The medical delivery device of any one of aspects 19 to 25, wherein the medical delivery device is a syringe, an autoinjector, or a pen. (Aspect 27) a silicone-free barrel having a proximal end, a distal end and an interior surface defining a fluid chamber for containing at least one therapeutic agent; an elastomeric stopper having an outer surface that forms a fluid-tight seal with said inner surface; a plunger rod attached to the stopper and mounted within the barrel for moving the stopper distally within the barrel; a barrier coating disposed on at least a portion of the elastomeric stopper, the barrier coating comprising an oxygen barrier material; and 13. A medical delivery device comprising: (Aspect 28) 28. The medical delivery device of embodiment 27, wherein the barrier coating surrounds a portion of the elastomeric stopper that is not exposed to the fluid chamber. (Aspect 29) The medical delivery device of embodiment 27 or embodiment 28, wherein the barrier coating entirely surrounds the elastomeric stopper. (Aspect 30) 30. The medical delivery device of any one of aspects 27 to 29, wherein the barrier coating is disposed on the plunger rod. (Aspect 31) 31. The medical delivery device of any one of aspects 27-30, wherein the elastomeric stopper is at least partially covered with a layer of expanded polytetrafluoroethylene or a layer of densified expanded polytetrafluoroethylene. (Aspect 32) 32. The medical delivery device according to any one of aspects 27 to 31, wherein the at least one therapeutic agent is selected from DNA targeted receptor genes or DNA fragments of target genes of the group consisting of genetic coagulation factors, cytokines, epigenetic protein families, growth factors, hormones, peptides, signaling molecules, vaccines and combinations thereof. (Aspect 33) 33. The medical delivery device according to any one of aspects 27 to 32, wherein the therapeutic agent is selected from a mutation in a DNA targeted receptor gene or a DNA fragment of a target gene. (Aspect 34) 34. The medical delivery device of any one of aspects 27 to 33, wherein the therapeutic agent is Factor VII. (Aspect 35) The medical delivery device according to any one of embodiments 27 to 34, for use in treating an eye disease. (Aspect 36) 36. The medical delivery device of any one of aspects 27 to 35, wherein the medical delivery device is a syringe, an autoinjector, or a pen. (Aspect 37) a lubricant-free barrel having proximal and distal ends and an interior surface defining a fluid chamber for containing at least one therapeutic agent; an elastomeric stopper having an outer surface that forms a fluid-tight seal with said inner surface; a plunger rod attached to the elastomeric stopper and mounted within the syringe barrel for moving the elastomeric stopper distally within the barrel; a coating material disposed on a portion of an interior surface of the barrel adjacent a proximal end of the barrel to form a reduced diameter region, the reduced diameter region having a diameter smaller than a diameter of an uncoated region of the barrel; and an expanded polytetrafluoroethylene film having a first surface and a second surface, the first surface being secured to the exterior surface of the elastomeric stopper; Including, the stopper includes at least one rib that abuts within the coating material while the stopper is in an uncompressed state; and A medical delivery device, wherein at least one rib contacts an uncoated area of ​​the inner surface while the stopper is in the depressed state. (Aspect 38) 38. The medical delivery device of embodiment 37, wherein the elastomeric stopper comprises a plurality of ribs, each pair of ribs having a valley therebetween. (Aspect 39) 39. The medical delivery device of embodiment 38, further comprising at least one ring member disposed within the at least one valley, said ring member comprising an oxygen absorbing material, an oxygen adsorbing material, or a combination thereof. (Aspect 40) The medical delivery device of embodiment 38 or embodiment 39, wherein each of the valleys comprises at least one of the ring members. (Aspect 41) The medical delivery device of any one of aspects 37 to 40, further comprising a barrier coating on a portion of the elastomeric stopper not exposed to the fluid chamber, the barrier coating comprising an oxygen barrier material. (Aspect 42) 42. The medical delivery device of any one of embodiments 37-41, further comprising a barrier coating over said elastomeric stopper, said barrier coating comprising an oxygen barrier material. (Aspect 43) 43. The medical delivery device according to any one of aspects 37 to 42, wherein the at least one therapeutic agent is selected from DNA targeted receptor genes or DNA fragments of target genes of the group consisting of genetic coagulation factors, cytokines, epigenetic protein families, growth factors, hormones, peptides, signaling molecules, vaccines and combinations thereof. (Aspect 44) 44. The medical delivery device according to any one of aspects 37 to 43, wherein the therapeutic agent is selected from a mutation in a DNA targeted receptor gene or a DNA fragment of a target gene. (Aspect 45) 45. The medical delivery device of any one of aspects 37 to 44, wherein the therapeutic agent is Factor VII. (Aspect 46) The medical delivery device according to any one of embodiments 37 to 45, for use in treating an eye disease. (Aspect 47) 47. The medical delivery device of any one of aspects 37 to 46, wherein the medical delivery device is a syringe, an automatic injector, or a pen. (Aspect 48) a barrel having a proximal end, a distal end and an interior surface having a lubricant thereon; an elastomeric stopper having an outer surface that forms a fluid-tight seal with an inner surface of the barrel; a plunger rod connected to the elastomeric stopper; Including, the barrel defines a fluid chamber for containing at least one therapeutic agent; the barrel having a region of reduced diameter disposed at least at its proximal end to enhance the interference fit between the elastomeric stopper and an inner surface of the barrel; and A medical delivery device, wherein the elastomeric stopper includes at least one rib that abuts within an area of ​​reduced diameter while the elastomeric stopper is in an uncompressed state. (Aspect 49) 49. The medical delivery device of embodiment 48, wherein said medical delivery device is a syringe, an auto-injector or a pen. (Aspect 50) a barrel having a proximal end, a distal end and an interior surface having a lubricant thereon; an elastomeric stopper having an outer surface that forms a fluid-tight seal with an inner surface of the barrel; at least one ring member disposed within the at least one valley; Including, the barrel defines a fluid chamber for containing at least one therapeutic agent; the elastomeric stopper includes a plurality of ribs, each pair of ribs having a valley therebetween; and the at least one ring member comprises an oxygen absorbing material, an oxygen adsorbing material, or a combination thereof; Medical delivery devices. (Aspect 51) 51. The medical delivery device of embodiment 50, wherein the medical delivery device is a syringe, an auto-injector, or a pen. (Aspect 52) a barrel having a proximal end and a distal end and an interior surface having a lubricant thereon; an elastomeric stopper having an outer surface that forms a fluid-tight seal with said inner surface; a plunger rod attached to the elastomeric stopper and mounted within the syringe barrel for moving the elastomeric stopper distally within the barrel; a coating material disposed on a portion of the interior surface of the barrel adjacent the proximal end of the barrel, the coating material forming a region of reduced diameter; an expanded polytetrafluoroethylene film having a first surface and a second surface, the first surface being secured to the exterior surface of the elastomeric stopper; Including, the barrel defines a fluid chamber for containing at least one therapeutic agent; the reduced diameter region having a diameter smaller than a diameter of an uncoated region of the barrel; the stopper includes at least one rib that abuts within the coating material while the stopper is in an uncompressed state; and A medical delivery device, wherein while the stopper is in a depressed state, the at least one rib contacts an uncoated area of ​​the inner surface. (Aspect 53) 53. The medical delivery device of embodiment 52, wherein said medical delivery device is a syringe, an auto-injector or a pen.

Claims

1. a silicone-free barrel having a proximal end, a distal end and an interior surface defining a fluid chamber for containing at least one therapeutic agent; an elastomeric stopper having an outer surface that forms a fluid-tight seal with said inner surface; a plunger rod attached to the stopper and mounted within the barrel for moving the stopper distally within the barrel; a barrier coating disposed on the plunger rod and on at least a portion of the elastomeric stopper, the barrier coating comprising an oxygen barrier material; and 13. A medical delivery device comprising:

2. The medical delivery device of claim 1 , wherein the barrier coating surrounds a portion of the elastomeric stopper that is not exposed to the fluid chamber.

3. The medical delivery device of claim 1 , wherein the barrier coating completely surrounds the elastomeric stopper.

4. 10. The medical delivery device of claim 1, wherein the elastomeric stopper is at least partially covered with a layer of expanded polytetrafluoroethylene or a layer of densified expanded polytetrafluoroethylene.

5. The medical delivery device of claim 1 , wherein the at least one therapeutic agent is selected from DNA fragments of DNA targeted receptor genes or target genes of the group consisting of genetic coagulation factors, cytokines, epigenetic protein families, growth factors, hormones, peptides, signaling molecules, vaccines, and combinations thereof.

6. 6. The medical delivery device of claim 5, wherein the therapeutic agent is selected from a mutation in a DNA targeted receptor gene or a DNA fragment of a target gene.

7. The medical delivery device of claim 5 , wherein the therapeutic agent is Factor VII.

8. The medical delivery device of claim 1 for use in treating an eye disease.

9. 10. The medical delivery device of claim 1, wherein the medical delivery device is a syringe, an automatic injector, or a pen.

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