Systems and methods for reconfiguring drug delivery devices

Abstract

To provide a method for preparing drug to be delivered, and a drug delivery system for achieving the same method.SOLUTION: A method for preparing drug for delivery comprises: preparing a diluent stored in a diluent container; and preparing a drug product stored in a drug product container. The method may further comprise: fluid connecting the diluent container and the drug product container. In addition, the method may comprise energizing at least part of the diluent into the drug product container from the diluent container by a pump, for reconstructing the drug product at least partially.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS The benefit of priority to U.S. Provisional Application No. 62 / 923,179, filed October 18, 2019, entitled "Systems And Approaches For Drug Delivery Device Reconstitution," is hereby claimed, the entire contents of which are incorporated herein by reference.

[0002] The present disclosure relates generally to drug delivery devices, and more particularly to reconstitution techniques for drug delivery devices. [Background technology]

[0003] Drugs are administered to treat a variety of conditions and diseases. Intravenous ("IV") therapy is a drug administration process in which drugs are delivered directly into a patient's veins using an intravenous fluid contained in a delivery container (e.g., a soft bag). These drug administrations may occur in a medical facility or, in some cases, at a remote location, such as the patient's home. In certain applications, drug products may be shipped to medical facilities (e.g., inpatient facilities, outpatient facilities, and / or pharmacies) in powdered or lyophilized form.

[0004] When reconstituting these drugs for administration, it is particularly important to maintain a sterile environment so as not to deteriorate, compromise the sterility of, or otherwise impair the quality of the drug. Additionally, some classes of drugs, such as bispecific T cell engagers, may require extremely precise amounts of drug product and / or other fluids required for administration to prevent the drug product from becoming toxic. In many cases, medical professionals must prepare the drug by strictly following a set of steps to ensure that a sterile environment is maintained and that the correct amounts of ingredients are added to the delivery container, sometimes including following correct procedures. When reconstituting these drugs for administration, it may be desirable or necessary to utilize a diluent, such as by adding the diluent to the drug product vial. As a result of these various steps and requirements, the reconstitution process can be time-consuming and tedious, and can result in unacceptable or undesirable error rates.

[0005] The current process for reconstituting lyophilized oncology products is often performed by licensed pharmacists in either hospital or specialty compounding pharmacies. The use of a hood is often required to perform the reconstitution process, which provides a sterile working environment that can be cumbersome for pharmacists given the complexity of the process. Additionally, this reconstitution process involves the use of multiple needles to withdraw / add sterile water for injection (WFI), saline, and / or intravenous solution stabilizer (IVSS) solutions. Typically, for relatively complex oncology products, such as bispecific T-cell engager (BiTE®) molecules (e.g., Blincyto®) prepared in IV bags, a specific amount of WFI is added to reconstitute the lyophilized drug product contained in a vial using a needle and syringe system. Then, appropriate amounts of saline and IVSS solutions are added to the empty IV bag before the reconstituted final drug product is introduced. The entire process can require up to five needle and syringe systems, each involving manual handling time and potential needle exposure. Furthermore, the use of a hood during this complex preparation can pose risks.

[0006] Additionally, due to current regulatory requirements implemented by the National Institute for Occupational Safety and Health (NIOSH), certain oncology products are on the hazardous drug list, which requires the use of additional engineering controls, such as closed system drug delivery systems (CSTDs), as an added safeguard. Also, regardless of whether a drug is on the NIOSH list, it may be advantageous to utilize CSTDs and / or other components / systems to minimize or prevent unwanted release of fumes into the air or other exposures.

[0007] As described in further detail below, the present disclosure describes systems and methods for reconfiguring drug delivery devices that embody advantageous alternatives to existing systems and methods, and that may address one or more of the problems or needs described herein as well as provide other benefits and advantages. Summary of the Invention [Means for solving the problem]

[0008] Aspects of the present disclosure provide methods of preparing a drug for delivery, which may include (a) providing a diluent contained in a diluent container, (b) providing a drug product contained in a drug product container, (c) fluidly connecting the diluent container and the drug product container, and (d) forcing at least a portion of the diluent from the diluent container into the drug product container with a pump to at least partially reconstitute the drug product.

[0009] An additional aspect of the present disclosure provides a drug delivery system including a diluent container, a drug product container, at least one fluid pathway connector, and a pump. The diluent container may contain a diluent, and the drug product container may contain a drug product. The at least one fluid pathway may be configured to at least selectively fluidly connect the diluent container and the drug product container. The pump may be in operative communication with the fluid pathway connector and configured to force at least a portion of the diluent from the diluent container into the drug product container to at least partially reconstitute the drug product.

[0010] The above needs are met, at least in part, through the provision of systems and techniques for drug delivery device reconstitution as described in the following detailed description, particularly when studied in conjunction with the drawings. [Brief explanation of the drawings]

[0011] [Figure 1] 1 illustrates exemplary drug delivery system components, according to various embodiments. [Figure 2] 2 illustrates the drug pump shown in FIG. 1 in an operational configuration, according to various embodiments. [Figure 3] 1 illustrates an exemplary drug delivery system, according to various embodiments. [Figure 4] 2 illustrates an exemplary approach for preparing a drug delivery device using the system of FIG. 1, according to various embodiments. [Figure 5]1 illustrates an exemplary use configuration of a drug delivery system, according to various embodiments. [Figure 6] 1 illustrates an exemplary drug delivery system, according to various embodiments. [Figure 7] 1 illustrates an exemplary drug delivery system, according to various embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0012] Those skilled in the art will understand that elements in the figures are drawn for simplicity and clarity and have not necessarily been drawn to scale. For example, the dimensions and / or relative positions of some of the elements in the figures may be exaggerated relative to other elements to help improve understanding of various embodiments of the present invention. Also, common but well-understood elements that are useful or necessary in commercially feasible embodiments are often not shown in order to so as not to overly distract from the illustrations of these various embodiments. Furthermore, it will be appreciated that certain acts and / or steps may be described or shown in a particular chronological order, although those skilled in the art will understand that such specificity with respect to order is not actually required. It will also be understood that the terms and phrases used herein have the ordinary technical meaning, as set forth above, that would be given to such terms and phrases by those skilled in the art, unless a different specific meaning is explained herein.

[0013] The present disclosure generally relates to a drug delivery device and a method of preparing the drug delivery device, the drug delivery device including a diluent container containing a diluent, a drug product container containing a drug product, a fluid pathway connector at least selectively fluidly connecting the diluent container and the drug product container, and a pump in functional communication (e.g., operative connection) with the fluid pathway connector and configured to force at least a portion of the diluent from the diluent container into the drug product container to at least partially reconstitute the drug product. The present disclosure may also include a solution container containing a predetermined amount of saline and a predetermined amount of intravenous stabilization solution ("IVSS"). In such a system, the pump can force at least a portion of the predetermined amount of saline and the predetermined amount of IVSS from the solution container into the drug product container.

[0014] For example, a drug product can be bulk lyophilized and loaded into cartridges typically used for administration with an IV pump. If necessary, dehydrated forms of IVSS, NaCl, and any other components required for the final administration solution can be bulk lyophilized and loaded into the cassette for long-term storage. A complementary sterile water for injection (sWFI) cassette can be provided as part of the kit for any administration cassette, with sWFI acting as a diluent to reconstitute the product for administration. Reconstitution can be performed in a simple and elegant manner, utilizing the administration pump itself to perform the reconstitution without additional accessories. The sWFI cartridge can then be coupled with an IV pump, as shown in Figure 6. For example, the two cartridges are connected via a simple Luer adapter or an integral connection on the cartridge. A simple button or mode setting for "reconstitution mode" can then be selected, which instructs the pump to remove the contents of the sWFI cartridge and pump them into the Lyo cartridge to reconstitute the lyophilized product, as shown in Figure 6. After the contents are removed, the fully reconstituted cassette can be connected to a pump for administration to a patient, which may be completed at a pharmacy or another location such as the HCP's office or the patient's home.

[0015] 1 and 2, in accordance with these various embodiments, a drug delivery system 1 or kit and corresponding methods for preparing a drug delivery device using the drug delivery system 1 are provided. A medical professional, caregiver, or patient can use the drug delivery system 1 to prepare a drug delivery device for delivery to a patient. The drug delivery system 1 differs from conventional systems in that many of the components contained within the system 1 are pre-filled and / or pre-mixed in the correct dosage amounts. As a result, the preparation of the drug delivery device by the medical professional, caregiver, or patient is reduced while ensuring that the correct amount of components is administered. The system 1 may be used to provide intravenous, subcutaneous, intra-arterial, intramuscular, and / or epidural delivery techniques. Use of the system 1 may reduce patient anxiety and / or confusion due to reduced preparation complexity and wait times incurred by the drug preparation process. Additionally, the system 1 may allow medical providers, pharmacists, patients, and / or other individuals involved in preparing, providing, or using medications to have a more streamlined, predictable, and / or effective process for drug delivery. For example, system 1 may reduce the time a pharmacist spends preparing a medication for use by a patient, reduce the number of manual steps a pharmacist must perform to prepare a medication for use by a patient, and / or improve the overall efficiency of the medication preparation process. As a more specific example, system 1 may be particularly advantageous for use in medication preparations that involve several steps, such as adding a diluent and then adding a solution containing saline and / or IVSS, and / or for administering medications that require long preparation times.

[0016] The drug delivery system 1 shown in FIG. 1 generally includes a diluent container 10 containing a diluent 12, a drug product container 20 containing a drug product 22, a fluid pathway connector 30 at least selectively fluidly connecting the diluent container 10 and the drug product container 20, and a pump 40 operatively connected to the fluid pathway connector 30 and configured to urge at least a portion of the diluent 12 from the diluent container 10 into the drug product container 20 to at least partially reconstitute the drug product 22. The drug delivery system 1 shown in FIG. 1 may also include a solution container 50 containing a predetermined amount of saline 52 and a predetermined amount of intravenous stabilization solution (“IVSS”) 54. As shown, the predetermined amount of saline 52 and the predetermined amount of IVSS 54 are mixed to form a generally aqueous solution, although other configurations may be suitable. In such a system, the pump 40 can urge at least a portion of the predetermined amount of saline 52 and the predetermined amount of IVSS 54 from the solution container into the drug product container.

[0017] The pump 40 shown in FIG. 1 may be a peristaltic pump, a positive displacement pump, or any other suitable type of pump operatively connected to the fluid pathway connector 30. For example, the fluid pathway connector 30 may be a tube having a looped portion configured to form a generally circular shape, and the removable pump head 42 may be a peristaltic pump head having a tubing segment and a rotating component that follows the generally circular path of travel and clamps the tubing segment along the way, urging fluid to move through the tubing. In such a configuration, the removable pump head 42 is operatively connected to the fluid pathway connector 30 even though the fluid moving through the tubing is not in direct contact with the components of the pump head 42. As another example, the pump may have components that directly contact the fluid moving through the tubing. As another example, any suitable pump may be used. Additionally or alternatively, instead of a pump, the system may utilize another configuration or process for mixing, such as a negative pressure arrangement between various containers, which urges the diluent 12 into the drug product container 20.

[0018] The pump 40 may be activated automatically when one or more of the respective containers 10, 20, 50 are coupled together, or the pump 40 may be activated by an activation button 44 or other suitable component. For example, the activation button 44 may be operatively connected to an internal controller and / or electromechanical components that operate the pump 40.

[0019] Fluid pathway connector 30 may include several different tubes, such as tube 30a coupled to pump head 42, tube 30b fluidly coupled to diluent container 10 via stake connector 34b, tube 30c fluidly connected to drug product container 20 via stake connector 34c, and / or tube 30d fluidly connected to solution container 50 via stake connector 34d. Connectors 32b, 32c, 32d may be quick-connect sterile connectors with respective subcomponents that selectively mate with one another while maintaining sterility or another desired standard of cleanliness. For example, quick-connect sterile connectors may snap-fit, interlock, or thread together; quick-connect sterile connectors may have sheathed and sheathed components that are sheathed or unsheathed upon connection; and / or quick-connect sterile connectors may have a luer lock or modified luer lock configuration. During one exemplary operation, diluent container 10 is selectively coupled to drug product container 20 via connectors 32b, 32c, and pump head 42 operates to force diluent 12 from diluent container 10 to interact with drug product 22 within the drug product container. Then, during another step in the exemplary operation, diluent container 10 is disconnected from fluid connection with pump head 42 via connector 32b, and solution container 50 is then fluidly coupled to tubing 30a via connector 32d. The pump head can then force saline 52 and IVSS 54 into drug product container 20 such that the various components (drug product 22, diluent 12, saline 52, and IVSS 54) are thoroughly mixed and the combination is available for delivery to a patient. As a more specific example, once drug product container 20 has the desired mixture of desired components, drug product container 20 may be fluidly connected to pump head 42 for delivery to a patient via an intravenous line, port, catheter, or other suitable drug delivery component.

[0020] 1 are fluidly coupled to one another two at a time, other suitable configurations may be used, such as where tube 30d is fluidly connected to tube 30b, which in turn is fluidly connected to tube 30c. For example, tube 30d may be fluidly connected to stake 34b such that a pump forces diluent from diluent container 10 until diluent container 10 is empty or substantially empty, and then vacuum force from pump 42 forces the contents of solution container 50 through various components of fluid pathway connector 30 and into drug product container 20.

[0021] Additionally or alternatively, the direction in which each component 12, 22, 52, 54 is aspirated and the containers 10, 20, 50 into which the components are mixed may differ. For example, diluent 12 may be forced into drug product container 20 as described above, and the drug product 22 / diluent 12 mixture may then be forced into solution container 50 for mixing with solution 52 and IVSS 54. Connectors 32b, 32c, 32d allow for flexible configurations for the user.

[0022] In some instances, the IVSS 54 may be provided as a percentage of the total volume of the solution. In these instances, a suitable amount of IVSS 54 may range from about 2% to about 15% (e.g., about 1 mL in a 50 mL container to about 25 mL in a larger 270 mL container; see step 202 in FIG. 4). The IVSS 54 can also act as a pretreatment surfactant or buffer component to prevent drug adsorption to the walls of the container 50. For example, if the container is not adequately and properly coated with IVSS 54, the highly potent nature of some drugs being administered can lead to an undesirable risk of drug molecules adhering to or adsorbing onto the interior walls of the container. Drug adsorption to the walls of the delivery container can adversely affect the drug dosage. In such situations, it may be desirable to utilize the exemplary process described in the previous paragraph.

[0023] In some examples, IVSS 54 may contain polysorbate. In some examples, IVSS 54 formulations may contain about 1.25 M lysine monohydrochloride, 25 mM citric acid monohydrate, 0.1% (w / v) polysorbate 80, and have a pH of about 7.0. In other examples, IVSS 54 may contain a similar formulation but also contain at least about 0.9% NaCl and about 0.001 to about 0.1% (w / v) polysorbate 80. It is understood that different BiTEs require different final percentages of IVSS 54 in the delivery container. This percentage may vary from about 0.5% to about 12% of the final volume in the delivery container. Furthermore, citrate may increase the risk of glass delamination when filled into glass vials. If citrate is required for drug product stabilization (determined on a product-by-product basis), the delivery container may be constructed from crystal zenith (CZ) polymer or other plastic compositions. Other examples of ingredients for a suitable IVSS54 are possible. A suitable IVSS54 concentration prevents protein-plastic interaction and / or surface adsorption, more particularly at the lower end of the concentration range where even small losses can potentially alter the effective amount. The following table shows exemplary ingredient concentrations for various IVSS concentrations:

[0024] [Table 1]

[0025] By providing the components 12, 22, 52, 54 in selectively connectable containers, it may no longer be necessary to prepare a needle and syringe assembly to inject one component into another container, ensure that the prepared needle and syringe assembly is sterile, and / or ensure that the correct volumes or amounts of components are added together.

[0026] Some conventional systems may provide a delivery container overfilled with saline when more saline than required for the dose is provided in the delivery container. These systems may require removal of a certain amount of saline prior to preparation of the drug dose, which may require the preparation of a sterile extraction tool (e.g., a needle and syringe assembly) to carefully extract the correct amount of saline. Conversely, the disclosed system 1 further eliminates this process, as the delivery container is prefilled with the required amount of ingredients. Additionally, the risk of needlestick injuries due to the transfer of ingredients may also be reduced or mitigated.

[0027] Additionally, many or all of the above steps may be automated or semi-automated or reduced in time / extent, potentially saving time and effort for those preparing and / or using the drug.

[0028] As described above, drug product container 20 contains a predetermined amount (e.g., about 2 mcg to about 100 mcg) of drug product 22 or active pharmaceutical ingredient ("API"), depending on the BiTE® and container size, which, in the illustrated example, is in powder form (i.e., lyophilized form) requiring reconstitution. In other examples, drug product 22 may be in liquid form and may not require reconstitution. Nevertheless, because system 1 contains a precise amount of drug product 22, there is no need to add additional amounts to drug product 22 in a sterile environment. In some examples, the API may optionally be in the form of a half-life extended ("HLE") BiTE® and / or an IV-administered monoclonal antibody ("mAb"). These HLE BiTEs contain antibody Fc regions that advantageously provide different drug properties, such as longer and extended half-lives. Thus, such APIs may be preferred because they can maintain a level of patient protection over a relatively long period of time. Nevertheless, in other examples, the API may be in the form of a standard BiTE to be administered in a specialized medical setting.

[0029] In some embodiments, the drug delivery system 1 may have a built-in reconstitution subsystem for diluting the lyophilized drug into a liquid form. In certain such embodiments, a diluent reservoir for storing the diluted solution may be included, and a lyophilized reservoir for storing the lyophilized compound separately from the diluted solution may be included. Additionally, a fluidic drive mechanism may be included for mixing the diluted solution in the diluent reservoir with the lyophilized compound in the lyophilized reservoir. In some embodiments, the fluidic drive mechanism may move the diluted solution from the diluent reservoir to the lyophilized reservoir and / or provide any circulation and / or agitation necessary to achieve complete reconstitution. In some embodiments, an additional reservoir for the final reconstituted drug may be included, or may serve as a delivery reservoir from which the reconstituted drug is released to the patient, while in other embodiments, the lyophilized reservoir may serve as a delivery reservoir. While in certain embodiments, the reconstitution subsystem may be physically integrated into the drug delivery system 1, in other embodiments, the reconstitution subsystem may constitute a separate unit in fluid communication with the drug delivery system 1. Having separate units may simplify the reconfiguration process for healthcare providers in certain cases.

[0030] Drug product container 20 may be in the form of an IV bag, vial, pre-filled syringe, or similar container including a reconstitution container body defining an internal volume. The internal volume may be sterile. In some approaches, the reconstitution container adapter may also be a CSTD that fits, engages, and / or mates with a vial adapter (or, in instances where the pre-filled reconstitution container is in the form of a syringe, the container adapter may be a needle). Additionally or alternatively, drug product 22 may be bulk lyophilized and loaded into cartridges or containers typically used for administration with an IV pump. If desired, dehydrated forms of IVSS, NaCl, and any other components required for the final administration solution may be bulk lyophilized and loaded into cassettes for long-term storage.

[0031] Pre-filled diluent container 10 contains a predetermined amount (e.g., about 0.5 mL to about 10 mL) of diluent 12 (e.g., preservative-free water for injection or "WFI") to be added to pre-filled drug product container 20 for reconstitution of drug product 22. In some instances, WFI preserved with benzyl alcohol (or containing any other preservative) may be used.

[0032] As previously mentioned, in some instances, the prefilled drug product container may be in the form of a prefilled syringe containing the drug product. In these instances, the drug product may be in the form of a liquid BiTE® formulation used in conjunction with a monoclonal antibody (mAb). In these instances, the drug product may be added directly to the delivery container without the use of a vial adapter system (such as the CSTD described above), which may advantageously simplify and / or improve supply chain and manufacturing controls when more traditional needle-syringe injection / delivery into the container is preferred, and may also allow for more compact commercial packaging that occupies less space in storage systems at healthcare facilities. In these instances, the prefilled drug product vial may or may not need to be reconstituted prior to transfer of the drug product to the delivery container.

[0033] System 1 may be distributed and / or sold as a common kit package 60, although other suitable distribution / packaging is also appropriate. The drug product may be in the form of an extended half-life bispecific T cell engager (BiTE®), although other drug products are also appropriate. Diluent 12 includes water for injection (“WFI”), although other diluents may also be appropriate. Containers 10, 20, 50 may be soft (e.g., flexible) bags, such as IV bags, although other containers may also be appropriate. In some examples, one or more of containers 10, 20, 50 are in the form of IV infusion bags constructed from plastic or other materials, e.g., 250 mL 0.9% sodium chloride IV bags constructed from suitable materials such as polyolefin, non-DEHP (diethylhexyl phthalate), PVC, polyurethane, or EVA (ethylene vinyl acetate), and may be filled to a capacity of approximately 270 mL to account for potential moisture loss during long-term storage.

[0034] The contents of the container may then be gently stirred, vortexed, and / or inverted during some or all of the above steps to mix the ingredients, thereby forming the desired mixture. Similarly, the mixture may be visually inspected for imperfections and / or to ensure proper mixing has occurred.

[0035] Once the drug product 22 and other ingredients have been mixed, if desired, the drug product container 20 (or any container holding the mixed drug product 22 and other ingredients) may be delivered to a patient using a pump 40. For example, the same pump head 42 may be used, but with one end connected to the container 10 and the other end connected to the patient. Alternatively, a new, unused pump head 42 may be used for this next step. The pump head 42 may be disposable or reusable. Similarly, the remainder of the pump 40 may be reusable or disposable (preferably reusable for environmental and cost benefits). The pump may also have different modes, such as a “reconstitution mode” in which the pump operates under one set of parameters and a “delivery mode” in which the pump operates under another set of parameters. Alternatively, or additionally, the pump may operate in different modes or speeds or other parameters under the control of the pump itself or under the control of another device, such as a wirelessly paired smartphone or other suitable device.

[0036] The pump 40 may include a door 48 and a lock 46 to facilitate removal and insertion of pump head 42 components and / or for operational safety reasons. The pump 40 may be configured to not operate unless the door 48 and lock 46 are in a desired position.

[0037] 2 shows pump 40 in an exemplary drug delivery mode, in which drug product 22 is dissolved and mixed components 12, 22, 52, 54 are evenly distributed throughout container 20. A reconstitution mode may appear similar or identical to the configuration shown in FIG. 2, but with additional containers coupled together.

[0038] 1 may be connected to either the diluent container 10 or the solution container 50 at any time, depending on which of these containers is currently transferring fluid to the drug product container 20. The drug delivery system 300 shown in FIG. 7 includes many components similar to or identical to those shown and described above in FIG. 1, except that the system 300 additionally includes a valve 360. As described in further detail below, the valve 360 ​​may allow the fluid pathway connector 330 to remain connected to both the diluent container 310 and the solution container 350 throughout the reconstitution process. Elements of the drug delivery system 300 not described in further detail below may have a configuration, function, and / or structure similar to or identical to the correspondingly numbered elements described above with respect to the drug delivery system 1 shown in FIG. 1.

[0039] Valve 360 ​​may be configured to selectively fluidly connect one of diluent container 310 and solution container 350 to drug product container 320. For example, valve 360 ​​may have at least two inlets or ports fluidly connected to diluent container 310 and solution container 350 via tube 330e and tube 330f, respectively. Valve 360 ​​may additionally have at least one outlet or port fluidly connected to pump head 342 via tube 330a. As a more specific example, valve 360 ​​may include a movable or actuable component that, depending on its position or state, opens a passage between one of the two inlets and the outlet while closing a passage between the other of the two inlets and the outlet. As an even more specific example, valve 360 ​​may be a three-way valve, including, for example, a three-way ball valve with an L-shaped fluid passage within a rotor. As another example, the valve 360 ​​may include an electronically controllable element, such as a solenoid, for selectively fluidly connecting one of the diluent container 310 and the solution container 350 to the drug product container 320. As another example, the valve 360 ​​may incorporate a hydrophilic filter. The hydrophilic filter may be configured to forcibly draw or directly withdraw fluid from the other of the diluent container 310 and the solution container 350 upon depletion of fluid from one of the diluent container 310 and the solution container 350. As a more specific example, the hydrophilic filter may be configured to allow the passage of fluid but prevent the passage of gas, such that upon depletion of fluid from one of the diluent container 310 and the solution container 350, the hydrophilic filter may close the passage to the empty container and, in at least some configurations, the hydrophilic filter may direct suction from the pump 340 to withdraw fluid from the other of the diluent container 310 and the solution container 350.

[0040] 7, the valve 360 ​​may be a separate component from the pump 340 and the pump head 342. In other embodiments, the valve 360 ​​may be incorporated into the pump 340 and / or the pump head 342.

[0041] During one exemplary reconstitution process, valve 360 ​​may be configured to fluidly connect diluent container 310 to drug product container 320, and pump head 342 may be driven by pump 340 to force diluent 312 from diluent container 310 to interact with drug product 322 in drug product container 320. Then, during another step in the exemplary operation, valve 360 ​​may be configured to fluidly disconnect the diluent container from drug product container 320 and instead fluidly connect solution container 350 to drug product container 320. Pump head 342 may then be driven by pump 340 to force saline 352 and IVSS 354 into drug product container 320 such that the various components (e.g., drug product 322, diluent 312, saline 352, and IVSS 354) are thoroughly mixed and the combination is available for delivery to a patient. Once the drug product container 320 has the desired mixture of desired components, the drug product container 320 may be fluidly connected to the pump head 342 for delivery to the patient via an intravenous line, port, catheter, or other suitable drug delivery component. In some embodiments, these drug delivery components may be connected to one of the ports on the valve 360 ​​or to another port on the valve 360 ​​used to connect the valve 360 ​​with the diluent container 310 or the solution container 350 during the reconstitution process.

[0042] 3-5, according to various embodiments, a drug delivery system 100 or kit and a corresponding method 200 for preparing a drug delivery device using the drug delivery system 100 are provided. Many or all of the features of system 100 may be utilized with many or all of the features of system 1. Additionally, many or all of the features of system 1 may be utilized with many or all of the features of system 100.

[0043] A medical professional, caregiver, or patient can use drug delivery system 100 to prepare a drug delivery device for delivery to a patient. Drug delivery system 100 differs from conventional systems in that many of the components contained within system 100 are pre-loaded and / or pre-mixed in the correct dosage amounts. As a result, preparation of the drug delivery device by the medical professional, caregiver, or patient is reduced while ensuring that the correct amount of components is administered. System 100 may be used to provide intravenous, subcutaneous, intra-arterial, intramuscular, and / or epidural delivery techniques. Use of system 100 may reduce patient anxiety and / or confusion due to reduced preparation complexity and waiting times incurred by the drug preparation process.

[0044] Generally, as shown in FIG. 3 , drug delivery system 100 includes a prefilled delivery container 102, a prefilled drug product vial 110, and a prefilled reconstitution container 120. More specifically, prefilled delivery container 102 includes a container body 103 defining an interior volume 104, a delivery container adapter 105, and an IV line outlet 109 to which tubing can be connected for delivering the prescription drug. In some examples, prefilled delivery container 102 is in the form of an IV drip bag constructed from plastic or other materials, e.g., a 250 mL 0.9% sodium chloride IV bag constructed of a suitable material such as polyolefin, non-DEHP (diethylhexyl phthalate), PVC, polyurethane, or EVA (ethylene vinyl acetate), and can be filled to a capacity of approximately 270 mL to account for potential moisture loss during long-term storage. Other examples of suitable delivery containers are also possible, such as glass bottles or containers (see, e.g., FIG. 5 ). Exemplary suitable pre-filled delivery containers 102 are described in U.S. Patent Application Nos. 62 / 804,447, filed February 12, 2019, and 62 / 877,286, filed July 22, 2019, the entire contents of each of which are incorporated by reference.

[0045] The delivery container adapter 105 may be a closed drug transfer system ("CSTD") that allows for the transfer of drugs and / or fluids into the container body 103. Exemplary CSTD devices may include the OnGuard CSTD, BD PhaSeal CSTD components, Equashield CSTD, Codon CSTD, etc., offered by B. Braun Medical Inc. Additionally, non-closed drug transfer systems may be used, such as vial and bag adapters from West Pharmaceuticals. Other examples are possible. The pre-filled delivery container 102 may include any number of delivery container adapters 105 having different specifications (e.g., port sizes) to accommodate the use of different drug product vials 110.

[0046] The pre-filled delivery container 102 accommodates a predetermined (e.g., fixed) amount of excipient solution. For example, the pre-filled delivery container 102 may include a predetermined amount of saline solution 108 (e.g., about 50 mL to 500 mL of 0.9% sodium chloride, preferably about 110 mL or about 270 mL, depending on the size of the container) and a predetermined amount of intravenous stabilization solution (“IVSS”) 106. In some examples, the IVSS 106 may be provided as a percentage of the total volume of the solution. In these examples, an appropriate amount of IVSS 106 may range from about 2% to about 15% (e.g., about 1 mL in a 50 mL container 102 to about 25 mL in a larger 270 mL container; see step 202 in FIG. 4). In some examples, the pre-filled delivery container 102 may have a total volume of about 270 mL. The IVSS 106 may also act as a pre-treatment surfactant or buffer component to prevent drug adsorption to the walls of the container 102. For example, if the container 102 is not adequately and properly coated with the IVSS 106, the highly potent nature of some drugs being administered can lead to an undesirable risk of drug molecules adhering to or adsorbing onto the interior walls of the container 102. Drug adsorption to the walls 102 of the delivery container can adversely affect the drug dosage. In some examples, the IVSS 106 may include polysorbate 80. In some examples, the IVSS 106 formulation may include approximately 1.25 M lysine monohydrochloride, 25 mM citric acid monohydrate, 0.1% (w / v) polysorbate 80, and have a pH of approximately 7.0. In other examples, the IVSS 106 may include a similar formulation but with at least about 0.9% NaCl and about 0.001 to about 0.1% (w / v) polysorbate 80. It is understood that different BiTEs require different final proportions of IVSS 106 in the delivery container 102. This percentage can vary between about 0.5% and about 12% of the final volume in the delivery container 102. Additionally, citrate may increase the risk of glass delamination when filled into glass vials. If citrate is required for drug product stabilization (as determined on a product-by-product basis), the delivery container 102 may be constructed from CZ or other plastic compositions. Other examples of components for a suitable IVSS 106 are also possible.An appropriate IVSS106 concentration prevents protein-plastic interaction and / or surface adsorption, more particularly at the lower end of the concentration range where even small losses can potentially alter the effective amount. The following table shows exemplary component concentrations for various IVSS concentrations.

[0047] [Table 2]

[0048] By providing the IVSS 106 pre-filled in the delivery container 102, the overall footprint of the system 100 is reduced, as a separate container used to house the IVSS 106 is no longer needed. Additionally, it is no longer necessary to prepare a needle and syringe assembly to inject the IVSS 106 into the delivery container, ensure that the prepared needle and syringe assembly is sterile, and / or ensure that the correct volume of IVSS is added to the container 102.

[0049] Some conventional systems may provide a delivery container 102 overfilled with saline 108 when more saline 108 is provided in the delivery container than is needed for the dose. These systems may require removal of a certain amount of saline 108 prior to preparation of the drug dose, which may require preparing a sterile extraction tool (e.g., a needle and syringe assembly) to carefully extract the precise amount of saline 108. Conversely, the disclosed system 100 further eliminates this process, as the delivery container 102 is prefilled with the required amount of saline 108. Additionally, the risk of needlestick injuries resulting from the transfer of the IVSS 106 into and / or the transfer of saline 108 from the container 102 may also be reduced or mitigated.

[0050] The pre-filled drug product vial or syringe 110 includes a vial body 111 and a vial adapter 114 that define an interior volume 112. The interior volume 112 may be sterile. In some approaches, the vial adapter 114 may also be a CSTD that fits, engages, and / or couples with the delivery container adapter 105. Similar to the pre-filled drug delivery container 102, the interior volume 112 of the pre-filled drug product vial 110 contains a predetermined amount of drug product or active pharmaceutical ingredient ("API") 116 (e.g., about 2 mcg to about 100 mcg), depending on the vial size and BiTE®, which, in the illustrated example, is in powder form (i.e., lyophilized form) requiring reconstitution. In other examples, the drug product 116 may be in liquid form and may not require reconstitution. Nevertheless, because the system 100 contains a precise amount of the drug product 116, there is no need to add additional amounts to the drug product 116 in a sterile environment. In some instances, the API may optionally be in the form of a half-life extended ("HLE") BiTE® and / or an IV-administered monoclonal antibody ("mAb"). These HLE BiTEs contain antibody Fc regions that advantageously provide different drug properties, such as longer and extended half-lives. Thus, such APIs may be preferred as they may maintain a level of protection for patients over a relatively long period of time. Nevertheless, in other instances, the API may be in the form of a standard BiTE to be administered in a professional medical setting.

[0051] The prefilled reconstitution container 120 may be in the form of a vial, prefilled syringe, or similar container including a reconstitution container body 121 defining an interior volume 122 and a reconstitution container adapter 124. The interior volume 122 may be sterile. In some approaches, the reconstitution container adapter 124 may also be a CSTD that fits, engages, and / or couples with the vial adapter 114 (or, in examples where the prefilled reconstitution container 120 is in the form of a syringe, the container adapter 124 may be a needle). Similar to the prefilled drug delivery container 102 and the prefilled drug product vial 110, the prefilled reconstitution container 120 contains a predetermined amount of diluent (e.g., preservative-free water for injection or "WFI") 126 (e.g., about 0.5 mL to about 10 mL) to be added to the prefilled drug product vial 110 for reconstitution of the drug product 116. In some examples, WFI preserved with benzyl alcohol (or containing any other preservative) may be used.

[0052] More specifically, the drug product 116 is reconstituted prior to addition to the delivery container 102 by mating the vial adapter 114 of the prefilled drug product vial 110 with the reconstitution container adapter 124 of the prefilled reconstitution container 120 to transfer the diluent 124 into the drug product vial 110 (see step 204 in FIG. 4 ). The contents may then be gently stirred, vortexed, and / or inverted to mix the ingredients, thereby forming the desired mixture. The reconstituted drug product vial 110 may then be visually inspected for imperfections and / or to ensure proper mixing has occurred.

[0053] As previously mentioned, in some examples, the pre-filled drug product vial 110 may be in the form of a pre-filled syringe containing the drug product 116. In these examples, the drug product 116 may be in the form of a liquid BiTE® formulation used in conjunction with a monoclonal antibody (mAb). In these examples, the drug product 116 may be added directly to the delivery container 102 without the use of a vial adapter system (such as the CSTD described above), which may advantageously simplify and / or improve supply chain and manufacturing controls when more traditional needle-syringe injection / delivery into the container 102 is preferred, and may also allow for more compact commercial packaging that occupies less space in storage systems at healthcare facilities. In these examples, the pre-filled drug product vial 110 may or may not need to be reconstituted prior to transfer of the drug product 116 to the delivery container 102.

[0054] The reconstituted drug contained within the pre-filled drug vial 110 may then be transferred into the drug delivery container 102 by mating the vial adapter 114 of the pre-filled drug product vial 110 with the delivery container adapter 105 of the delivery container 102 (see step 206 in FIG. 4 ). As a result, this transfer of the reconstituted drug into the delivery container 102 may be accomplished quickly (thus significantly reducing preparation time) and safely due to the absence of a withdrawal assembly (e.g., a luer-lock needle and syringe mechanism). The systems described herein avoid and / or eliminate the possibility of needle sticks and / or spills due to vial overpressurization. Additionally, contamination is reduced due to the use of a closed drug transfer system, whereas conventional assemblies use components that are open to the environment and therefore potentially exposed to contamination.

[0055] Drug delivery system 100 may include any number of additional and / or optional features or alternatives. For example, any one or more of delivery container adapter 105, vial adapter 114, or reconstitution container adapter 124 may be in the form of ports or coupling mechanisms coupled to pre-filled delivery container 102, pre-filled drug product vial 110, and reconstitution container 120, respectively. These ports may then be coupled to a CSTD device to enable flow between the desired containers. Thus, a CSTD device having appropriate coupling mechanism dimensions may be included in system 100.

[0056] The above description describes various devices, assemblies, components, subsystems, and methods of use related to drug delivery devices. The devices, assemblies, components, subsystems, methods, or drug delivery devices may further include or be used in conjunction with drugs, including, but not limited to, the drugs identified below and their generic and biosimilar equivalents. As used herein, the term drug may be used interchangeably with other similar terms and may refer to any type of pharmaceutical or therapeutic material, including traditional and non-traditional medicines, nutraceuticals, supplements, biologics, biologically active agents and compositions, large molecules, biosimilars, bioequivalents, therapeutic antibodies, polypeptides, proteins, small molecules, and generic drugs. Non-therapeutic injectable materials are also encompassed. Drugs may be in liquid form, lyophilized form, or reconstituted from a lyophilized form. The following list of exemplary drugs should not be considered exhaustive or limiting.

[0057] The drug is contained in a reservoir. Optionally, the reservoir is a primary container that is either filled or pre-filled with the drug for treatment. The primary container can be a vial, cartridge, or pre-filled syringe.

[0058] In some embodiments, the reservoir of the drug delivery device may be loaded with, or the device may be used in conjunction with, a colony-stimulating factor, such as granulocyte colony-stimulating factor (G-CSF). Such G-CSF formulations include, but are not limited to, Neulasta® (pegfilgrastim, PEGylated filgrastim, PEGylated G-CSF, PEGylated hu-Met-G-CSF) and Neupogen® (filgrastim, G-CSF, hu-Met-G-CSF).

[0059] In other embodiments, the drug delivery device may contain or be used in conjunction with an erythropoiesis-stimulating agent (ESA), which may be in liquid or lyophilized form. An ESA is any molecule that stimulates erythropoiesis. In some embodiments, the ESA is an erythropoiesis-stimulating protein. As used herein, "erythropoiesis-stimulating protein" refers to any protein that directly or indirectly causes activation of the erythropoietin receptor, for example, by binding to the receptor and causing receptor dimerization. Erythropoiesis-stimulating proteins include erythropoietin and variants, analogs, or derivatives thereof that bind to and activate the erythropoietin receptor, antibodies that bind to and activate the erythropoietin receptor, or peptides that bind to and activate the erythropoietin receptor. Erythropoiesis-stimulating proteins include Epogen® (epoetin alfa), Aranesp® (darbepoetin alfa), Dynepo® (epoetin delta), Mircera® (methoxypolyethylene glycol epoetin beta), Hematide®, MRK-2578, INS-22, Retacrit® (epoetin zeta), Neorecormon® (epoetin beta), Silapo® (epoetin zeta), and Binocrit® (epoetin alfa). Epoetin alpha, epoetin beta, epoetin iota, epoetin omega, epoetin delta, epoetin zeta, epoetin theta, and epoetin delta, PEGylated erythropoietin, carbamylated erythropoietin, and molecules or variants or analogs thereof.

[0060] Among certain exemplary proteins are the specific proteins described below, including fusions, fragments, analogs, variants, or derivatives thereof: OPGL-specific antibodies (also referred to as RANKL-specific antibodies, peptibodies, etc.), peptibodies, related proteins, etc., including fully humanized and human OPGL-specific antibodies, particularly fully humanized monoclonal antibodies; myostatin-binding proteins, peptibodies, related proteins, etc., including myostatin-specific peptibodies; IL-4 receptor-specific antibodies, peptibodies, related proteins, etc., which particularly inhibit activities mediated by binding of IL-4 and / or IL-13 to their receptors. Interleukin 1-receptor 1 ("IL1-R1")-specific antibodies, peptibodies, related proteins, etc.; Ang2-specific antibodies, peptibodies, related proteins, etc.; NGF-specific antibodies, peptibodies, related proteins, etc.; CD22-specific antibodies, peptibodies, related proteins, etc., particularly dimers of human-mouse monoclonal hLL2 gamma chain disulfide bound to human-mouse monoclonal hLL2 kappa chain, e.g., the human form of epratuzumab (CAS Registry Number 501423-23-0). human CD22-specific antibodies, including, but not limited to, humanized and fully human monoclonal antibodies, particularly including, but not limited to, human CD22-specific IgG antibodies, such as humanized and fully human antibodies, including, but not limited to, humanized and fully human monoclonal antibodies, including, but not limited to, anti-IGF-1R antibodies; IGF-1 receptor-specific antibodies, peptibodies, and related proteins, including, but not limited to, anti-IGF-1R antibodies; B-7-related protein 1-specific antibodies, peptibodies, and related proteins, including, but not limited to, those that inhibit the interaction of B7RP-1 with ICOS, the natural receptor for B7RP-1 on activated T cells, including, but not limited to, a B7RP-specific fully human monoclonal IgG2 antibody; HuMax, e.g., 146B7; IL-15 specific antibodies, peptibodies, related proteins, etc., including, but not limited to, IL-15 antibodies and related proteins, particularly humanized monoclonal antibodies; human IFNIFN-γ-specific antibodies, peptibodies, related proteins, etc., including but not limited to, IFN-γ-specific antibodies, and including but not limited to, fully human anti-IFN-γ antibodies; TALL-1-specific antibodies, peptibodies, related proteins, etc., and other TALL-specific binding proteins; parathyroid hormone ("PTH")-specific antibodies, peptibodies, related proteins, etc.; thrombopoietin receptor ("TPO-R")-specific antibodies, peptibodies, related proteins, etc.; hepatocyte growth factor / scatter factor (HGF / SF):cMet axis, such as fully human monoclonal antibodies that neutralize HGF / SF. Hepatocyte growth factor ("HGF")-specific antibodies, peptibodies, related proteins, etc., including those targeting (HGF / SF:c-Met); TRAIL-R2-specific antibodies, peptibodies, related proteins, etc.; activin A-specific antibodies, peptibodies, proteins, etc.; TGF-β-specific antibodies, peptibodies, related proteins, etc.; amyloid β protein-specific antibodies, peptibodies, related proteins, etc.; and those that bind c-Kit and / or other stem cell factor receptors. Proteins including, but not limited to, c-Kit-specific antibodies, peptibodies, related proteins, etc.; OX40L-specific antibodies, peptibodies, related proteins, etc., including, but not limited to, proteins that bind to OX40L and / or other ligands of the OX40 receptor; Activase® (alteplase, tPA), Aranesp® (darbepoetin alfa), Epogen® (epoetin alfa, or erythropoietin), GLP-1, Avonex® (interferon beta-1a), Bexxar® (tositumomab, an anti-CD22 monoclonal antibody), Betaseron® (interferon-beta), Campath® (alemtuzumab, an anti-CD52 monoclonal antibody), Dynepo® (epoetin delta), Velcade® (bortezomib), MLN0002 (anti-α4β7mAb), MLN1202 (anti-CCR2 chemokine receptor mAb), Enbrel® (etanercept, TNF receptor / Fc fusion protein, TNF blocker), Eprex® (epoetin alfa), Erbitux® (cetuximab, anti-EGFR / HER1 / c-ErbB-1), Genotropin® (somatropin, human growth hormone), Herceptin® (trastuzumab, anti-HER2 / neu(erbB2) receptor mAb), Humatrope® (somatropin, human growth hormone), Humira® (adalimumab), Vectibix® (panitumumab), Xgeva® ®) (denosumab), Prolia® (denosumab), Enbrel® (etanercept, TNF-receptor / Fc fusion protein, TNF blocker), Nplate® (romiplostim), rilotumumab, ganitumab, conatumumab, brodalumab, insulin in solution, Infergen® (interferon alfacon-1), Natrecor® (nesiritide, recombinant human B-type natriuretic peptide (hBNP), Kineret® (anakinra), Leukine® (sargamostim, rhuGM-CSF), LymphoCide® (epratuzumab, anti-CD22 mAb), Benlysta™ (lymphostat B, belimumab, anti-BlyS mAb), Metalyse® (tenecteplase, t-PA analog), Mircera® (methoxypolyethylene glycol-epoetin beta), Mylotarg® (gemtuzumab ozogamicin), Raptiva® (efalizumab), Cimzia® (certolizumab pegol, CDP 870), Soliris™ (eculizumab), pexelizumab (anti-complement C5), Numax® (MEDI-524), Lucentis® (ranibizumab), Panorex® (17-1A, edrecolomab), Trabio® (lerdelimumab), TheraCimhR3 (nimotuzumab), Omnitarg (pertuzumab, 2C4), Osidem® (IDM-1), OvaRex® (B43.13), Nuvion® (vigilizumab), cantuzumab mertansine (huC242-DM1), NeoRecormon® (epoetin beta), Neumega® (oprelvekin, human interleukin-11), Orthoclone OKT3® (muromonab-CD3, anti-CD3 monoclonal antibody), Procrit® (epoetin alfa), Remicade® (infliximab, anti-TNFα monoclonal antibody), Reopro® (abciximab, anti-GP IL6 receptor monoclonal antibody), Actemra® (anti-IL6 receptor mAb), Avastin® (bevacizumab), HuMax-CD4 (zanolimumab), Rituxan® (rituximab, anti-CD20 mAb), Tarceva® (erlotinib), Roferon-A® (interferon alpha-2a), Simulect® (basiliximab), Prexige® (lumiracoxib), Synagis® (palivizumab), 146B7-CHO (anti-IL15 antibody, see U.S. Pat. No. 7,153,507), Tysabri® (natalizumab, anti-alpha4 integrin mAb), Valortim® (MDX-1303, anti-anthrax protective antigen mAb), ABthrax™, Xolair® (omalizumab), ETI211 (anti-MRSA mAb), IL-1 trap (the Fc portion of human IgG1 and the extracellular domains of both IL-1 receptor components (type I receptor and receptor accessory protein)), VEGF trap (IgG1 Ig domain of VEGFR1 fused to Fc), Zenapax® (daclizumab), Zenapax® (daclizumab, anti-IL-2Rα mAb), Zevalin® (ibritumomab tiuxetan), Zetia® (ezetimibe), Orencia® (atacicept, TACI-Ig), anti-CD80 monoclonal antibody (galiximab), anti-CD23mAb (lumiliximab), BR2-Fc (huBR3 / huFc fusion protein, soluble BAFF antagonist), CNTO 148 (golimumab, anti-TNFα mAb), HGS-ETR1 (mapatuzumab, human anti-TRAIL receptor-1 mAb), HuMax-CD20 (ocrelizumab, anti-CD20 human mAb), HuMax-EGFR (zalutumumab), M200 (volociximab, anti-α5β1 integrin mAb), MDX-010 (ipilimumab, anti-CTLA-4 mAb, and VEGFR-1 (IMC-18F1), anti-BR3 mAb, anti-C. difficile toxin A and toxin BC mAbs MDX-066 (CDA-1) and MDX-1388), anti-CD22 dsFv-PE38 conjugate (CAT-3888 and CAT-8015), anti-CD25 mAb (HuMax-TAC), anti-CD3 mAb (NI-0401), adecatumumab, anti-CD30 mAb (MDX-060), MDX-1333 (anti-IFNAR), anti-CD38 mAb (HuMax CD38), anti-CD40L mAb, anti-Cripto mAb, anti-CTGF idiopathic pulmonary fibrosis stage 1 fibrogen (FG-3019), anti-CTLA4 mAb, anti-eotaxin 1 mAb (CAT-213), anti-FGF8 mAb, anti-ganglioside GD2 mAb, anti-ganglioside GM2 mAb, anti-GDF-8 human mAb (MYO-029), anti-GM-CSF receptor mAb (CAM-3001), anti-HepC mAb (HuMax HepC), anti-IFNα mAb (MEDI-545, MDX-1103), anti-IGF1R mAb, anti-IGF-1R mAb (HuMax-Inflam), anti-IL12 mAb (ABT-874), anti-IL12 / IL23 mAb (CNTO 1275), anti-IL13 mAb (CAT-354), anti-IL2Ra mAb (HuMax-TAC), anti-IL5 receptor mAb, anti-integrin receptor mAb (MDX-018, CNTO 95), anti-IP10 ulcerative colitis mAb (MDX-1100), BMS-66513, anti-mannose receptor / hCGβ mAb (MDX-1307), anti-mesothelin dsFv-PE38 conjugate (CAT-5001), anti-PD1 mAb (MDX-1106(ONO-4538)), anti-PDGFRα antibody (IMC-3G3), anti-TGFβmAb(GC-1008), TRAIL-2 mAb (HGS-ETR2), TWEAK mAb, VEGFR / Flt-1 mAb, ZP3 mAb (HuMax-ZP3)

[0061] In some embodiments, the drug delivery device may contain or be used in conjunction with a sclerostin antibody, such as, but not limited to, romosozumab, brosozumab, or BPS 804 (Novartis), or in other embodiments, a monoclonal antibody (IgG) that binds to human proprotein convertase subtilisin / kexin type 9 (PCSK9). Such PCSK9-specific antibodies include, but are not limited to, Repatha® (evolocumab) and Praluent® (alirocumab). In other embodiments, the drug delivery device may contain or be used in conjunction with rilotumumab, bixalomer, trebananib, ganitumab, conatumumab, motesanib diphosphate, brodalumab, vidupiprant, or panitumumab. In some embodiments, the reservoir of the drug delivery device may be loaded with, or the device may be used in conjunction with, IMLYGIC® (talimogene laherparepvec) or another oncolytic HSV for the treatment of melanoma or other cancers, including but not limited to, OncoVEXGALV / CD; OrienX010; G207, 1716; NV1020; NV12023; NV1034; and NV1042. In some embodiments, the drug delivery device may contain, or be used in conjunction with, an endogenous tissue inhibitor of metalloproteinase (TIMP), such as, but not limited to, TIMP-3. Antagonistic antibodies of the human calcitonin gene-related peptide (CGRP) receptor, such as, but not limited to, erenumab, and bispecific antibody molecules targeting the CGRP receptor and other headache targets, may also be delivered using the drug delivery devices of the present disclosure. Additionally, bispecific T cell engager (BiTE®) antibodies, such as, but not limited to, a half-life extended BiTE comprising an antibody Fc region, BLINCYTO® (blinatumomab), can be used in or with the drug delivery devices of the present disclosure. In some embodiments, the drug delivery devices may contain or be used with APJ large molecule agonists, such as, but not limited to, apelin or analogs thereof.In some embodiments, a therapeutically effective amount of anti-thymic stromal lymphopoietin (TSLP) or a TSLP receptor antibody is used in or with the drug delivery device of the present disclosure.

[0062] The drug delivery devices, assemblies, components, subsystems, and methods have been described in terms of exemplary, but not limited to, embodiments. This detailed description should be construed as exemplary only and does not describe every possible embodiment of the present disclosure. Many alternative embodiments can be implemented using either current technology or technology developed after the filing date of this patent, and such embodiments will still fall within the scope of the claims that define the invention disclosed herein.

[0063] Those skilled in the art will appreciate that numerous modifications, variations, and combinations can be made to the above-described embodiments without departing from the spirit and scope of the invention disclosed herein, and that such modifications, variations, and combinations are to be construed as being within the scope of the inventive concept.

Claims

1. 1. A method of preparing a drug prior to delivery to a patient, comprising: providing a diluent contained in a diluent container; providing a drug product contained within a drug product container; fluidly connecting the diluent container and the drug product container; fluidly connecting a solution container with said drug product container; forcing at least a portion of the diluent from the diluent container into the drug product container with a pump to at least partially reconstitute the drug product; forcing at least a portion of at least one solution from the solution container into the drug product container with the pump; Including, wherein the pump is configured to deliver at least a portion of the at least partially reconstituted combination of the drug product and the at least one solution directly from the drug product container to the patient via at least one of an intravenous line, a port, and a catheter.

2. The method of claim 1 further comprising the step of operating the pump.

3. 3. The method of claim 1 or 2, wherein the at least one solution comprises a predetermined amount of saline and a predetermined amount of intravenous stabilization solution ("IVSS") contained within the solution container.

4. The method of claim 3, further comprising forcing at least a portion of the predetermined amount of saline and the predetermined amount of IVSS from the solution container into the drug product container by the pump.

5. 4. The method of claim 3, further comprising providing a valve configured to selectively fluidly connect one of the diluent container and the solution container to the drug product container.

6. configuring the valve to fluidly connect one of the diluent container and the solution container to the drug product container; forcing, by the pump, at least a portion of the diluent from the diluent container and one of the predetermined amount of saline and at least a portion of the predetermined amount of IVSS from the solution container into the drug product container; The method of claim 5 further comprising:

7. configuring the valve to fluidly connect the other of the diluent container and the solution container to the drug product container; forcing the at least a portion of the diluent from the diluent container and the other of the predetermined amount of saline and the predetermined amount of IVSS from the solution container into the drug product container with the pump; The method of claim 6 further comprising:

8. The method of any one of claims 5 to 7, wherein the valve includes a hydrophilic filter.

9. The method of any one of claims 1 to 8, wherein the diluent comprises water for injection ("WFI").

10. The method according to any one of claims 1 to 9, wherein the diluent container is a soft bag.

11. The method of any one of claims 1 to 10, wherein the drug product container is a soft bag.

12. The method according to any one of claims 1 to 11, wherein the solution container is a soft bag.

13. The method of any one of claims 1 to 12, further comprising fluidly coupling the diluent container to the drug product container via a sterile connector.

14. 14. The method of any one of claims 1 to 13, further comprising fluidly coupling the solution container to the drug product container via a sterile connector.

15. The method of any one of claims 3 to 8, wherein the IVSS comprises a pretreatment surfactant or polysorbate 80.

16. The method of any one of claims 3 to 8, 15, wherein the predetermined amount of diluent is from about 0.5 mL to about 10 mL.

17. The method according to any one of claims 3 to 8 and 15 to 16, wherein the predetermined amount of saline is about 50 mL to about 500 mL.

18. 18. The method of any one of claims 3 to 8, 15 to 17, wherein the predetermined amount of IVSS is about 1 mL to about 30 mL.

19. 19. The method of any one of claims 1 to 18, further comprising removing the drug product container and the diluent container from a common kit package.

20. 20. The method of any one of claims 1 to 19, wherein the drug product is in the form of a bispecific T cell engager (BiTE®).

21. 21. The method of claim 20, wherein the BiTE is a half-life extended (HLE) BiTE.

22. 1. A drug delivery system comprising: a diluent container for containing a diluent; a drug product container containing the drug product; at least one fluid pathway connector configured to at least selectively fluidly connect one of the diluent container and the solution container to the drug product container; a pump operatively connected to the fluid pathway connector and configured to urge at least a portion of the diluent from the diluent container into the drug product container to at least partially reconstitute the drug product, and to urge at least a portion of at least one solution from the solution container into the drug product container to deliver at least a portion of the reconstituted drug product and at least one solution combination directly from the drug product container to a patient via at least one of an intravenous line, a port, and a catheter; A drug delivery system comprising:

23. 23. The drug delivery system of claim 22, further comprising a solution container containing at least one solution, the at least one solution comprising a predetermined amount of saline and a predetermined amount of intravenous stabilization solution ("IVSS").

24. 24. The drug delivery system of claim 23, wherein the pump is configured to force the volume of saline and at least a portion of the volume of IVSS from the solution container into the drug product container.

25. 25. The drug delivery system of claim 23 or 24, wherein the at least one fluid pathway connector includes a valve configured to selectively fluidly connect one of the diluent container and the solution container to the drug product container.

26. 26. The drug delivery system of claim 25, wherein the valve includes a hydrophilic filter.

27. The drug delivery system of any one of claims 22 to 26, wherein the pump is a peristaltic pump.

28. 28. The drug delivery system of any one of claims 22 to 27, wherein the diluent container, the drug product container, and the pump are from a common kit package.

29. 30. The drug delivery system of claim 28, wherein the common kit package further comprises the solution container and the at least one fluid pathway connector.

30. 30. The drug delivery system of any one of claims 22 to 29, wherein the drug product is in the form of a bispecific T cell engager (BiTE®).

31. 31. The drug delivery system of claim 30, wherein the BiTE is a half-life extended (HLE) BiTE.

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