WO2009051780A1

WO2009051780A1 - Drug coated stents

Info

Publication number: WO2009051780A1
Application number: PCT/US2008/011852
Authority: WO
Inventors: James B. Mcclain; Douglas Taylor
Original assignee: Micell Technologies, Inc.
Priority date: 2007-10-19
Filing date: 2008-10-17
Publication date: 2009-04-23
Also published as: US20160030643A1; US20100298928A1

Abstract

Provided herein is a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form. In one embodiment, the rapamycin-polymer coating comprises one or more resorbable polymers.

Description

DRUG COATED STENTS

CROSS-REFERENCE

[0001] This application claims the benefit of U.S. Provisional Application No. 60/981,445, filed October 19, 2007; U.S. Provisional Application No. 61/045,928, filed April 17, 2008; and U.S. Provisional Application No. 61/104,669, filed October 10, 2008, which applications are incorporated herein by reference in their entirety.

BACKGROUND OF THE INVENTION

[0002] The present invention relates to methods for depositing a coating comprising a polymer and a pharmaceutical or biological agent in powder form onto a substrate. [0003] It is often beneficial to provide coatings onto substrates, such that the surfaces of such substrates have desired properties or effects. [0004] For example, it is useful to coat biomedical implants to provide for the localized delivery of pharmaceutical or biological agents to target specific locations within the body, for therapeutic or prophylactic benefit. One area of particular interest is that of drug eluting stents (DES) that has recently been reviewed by Ong and Serruys in Nat. Clin. Pract. Cardiovasc. Med., (Dec 2005), VoI 2, No 12, 647. Typically such pharmaceutical or biological agents are co-deposited with a polymer. Such localized delivery of these agents avoids the problems of systemic administration, which may be accompanied by unwanted effects on other parts of the body, or because administration to the afflicted body part requires a high concentration of pharmaceutical or biological agent that may not be achievable by systemic administration. The coating may provide for controlled release, including long-term or sustained release, of a pharmaceutical or biological agent. Additionally, biomedical implants may be coated with materials to provide beneficial surface properties, such as enhanced biocompatibility or lubriciousness.

[0005] Conventionally, coatings have been applied by processes such as dipping, spraying, vapor deposition, plasma polymerization, and electro-deposition. Although these processes have been used to produce satisfactory coatings, there are drawbacks associated therewith. For example it is often difficult to achieve coatings of uniform thicknesses and prevent the occurrence of defects (e.g. bare spots). Also, in many processes, multiple coating steps are frequently necessary, usually requiring drying between or after the coating steps. [0006] Another disadvantage of most conventional methods is that many pharmaceutical or biological agents, once deposited onto a substrate, suffer from poor bioavailability, reduced shelf life, low in vivo stability or uncontrollable elution rates, often attributable to poor control of the morphology and/or secondary structure of the agent. Pharmaceutical agents present significant morphology control challenges using existing spray coating techniques, which conventionally involve a solution containing the pharmaceutical agents being spayed onto a substrate. As the solvent evaporates the agents are typically left in an amorphous state. Lack of or low degree of crystallinity of the spray coated agent can lead to decreased shelf life and too rapid drug elution. Biological agents typically rely, at least in part, on their secondary, tertiary and/or quaternary structures for their activity. While the use of conventional solvent- based spray coating techniques may successfully result in the deposition of a biological agent upon a substrate, it will often result in the loss of at least some of the secondary, tertiary and/or quaternary structure of the agent and therefore a corresponding loss in activity. For example, many proteins lose activity when formulated in carrier matrices as a result of the processing methods.

[0007] Conventional solvent-based spray coating processes are also hampered by inefficiencies related to collection of the coating constituents onto the substrate and the consistency of the final coating. As the size of the substrate decreases, and as the mechanical complexity increases, it grows increasingly difficult to uniformly coat all surfaces of a substrate.

SUMMARY OF THE INVENTION

[0008] One embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form. In one embodiment, the rapamycin-polymer coating comprises one or more resorbable polymers.

[0009] In another embodiment the rapamycin-polymer coating has substantially uniform thickness and rapamycin in the coating is substantially uniformly dispersed within the rapamycin-polymer coating.

[0010] In another embodiment, the one or more resorbable polymers are selected from PLGA (poly(lactide-co-glycolide); DLPLA — ρoly(dl-lactide); LPLA — poly(l-lactide); PGA — polyglycolide; PDO — poly(dioxanone); PGA-TMC — polyCglycolide-co-trimethylene carbonate); PGA-LPLA — poly(l-lactide-co-glycolide); PGA-DLPLA — polyCdl-lactide-co- glycolide); LPLA-DLPLA — ρoly(l-lactide-co-dl-lactide); PDO-PGA-TMC — polyCglycolide-co-trimethylene carbonate-co-dioxanone) and combinations thereof.

[0011] In yet another embodiment the polymer is 50/50 PLGA.

[0012] In still another embodiment the at least part of said rapamycin forms a phase separate from one or more phases formed by said polymer.

[0013] hi another embodiment the rapamycin is at least 50% crystalline.

[0014] In another embodiment the rapamycin is at least 75% crystalline.

[0015] In another embodiment the rapamycin is at least 90% crystalline.

[0016] In another embodiment the rapamycin is at least 95% crystalline. [0017] In another embodiment the rapamycin is at least 99% crystalline.

[0018] hi another embodiment the polymer is a mixture of two or more polymers.

[0019] hi another embodiment the mixture of polymers forms a continuous film around particles of rapamycin.

[0020] hi another embodiment the two or more polymers are intimately mixed. [0021] In another embodiment the mixture comprises no single polymer domain larger than about 20 nm.

[0022] hi another embodiment the each polymer in said mixture comprises a discrete phase.

[0023] hi another embodiment the discrete phases formed by said polymers in said mixture are larger than about lOnm. [0024] hi another embodiment the discrete phases formed by said polymers in said mixture are larger than about 50nm.

[0025] In another embodiment the rapamycin in said stent has a shelf stability of at least 3 months.

[0026] hi another embodiment the rapamycin in said stent has a shelf stability of at least 6 months.

[0027] In another embodiment the rapamycin in said stent has a shelf stability of at least 12 months.

[0028] hi another embodiment the coating is substantially conformal.

[0029] In another embodiment the stent provides an elution profile wherein about 10% to about 50% of rapamycin is eluted at week 1 after the composite is implanted in a subject under physiological conditions, about 25% to about 75% of rapamycin is eluted at week 2 and about 50% to about 100% of rapamycin is eluted at week 6. [0030] In another embodiment the onset of heparin anti-coagulant activity is obtained at week 3 or later.

[0031] In another embodiment heparin anti-coagulant activity remains at an effective level at least 90 days after onset of heparin activity. [0032] In another embodiment heparin anti-coagulant activity remains at an effective level at least 120 days after onset of heparin activity.

[0033] hi another embodiment heparin anti-coagulant activity remains at an effective level at least 200 days after onset of heparin activity. [0034] hi another embodiment the stent framework is a stainless steel framework. [0035] hi another embodiment heparin is attached to the stainless steel framework by reaction with an aminated silane.

[0036] hi another embodiment the the framework is coated with a silane monolayer. [0037] A further embodiment providea coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework by an aminated silane; and a rapamycin- polymer coating wherein at least part of rapamycin is in crystalline form and wherein the polymer is bioabsorbable.

[0038] Still another embodiment provides a coated coronary stent, comprising: a stent framework having a heparin coating disposed thereon; and a macrolide immunosuppressive (limus) drug-polymer coating wherein at least part of the drug is in crystalline form. [0039] In another embodiment the the macrolide immunosuppressive drug comprises one or more of rapamycin, 40-O-(2-Hydroxyethyl)rapamycin (everolimus), 40-O-Benzyl-rapamycin, 40-O-(4'-Hydroxymethyl)benzyl-raparnycin, 40-O-[4'-( 1 ,2-Dihydroxyethyl)]benzyl- rapamycin, 40-O-Allyl-rapamycin, 40-O-[3'-(2,2-Dimethyl-l ,3-dioxolan-4(S)-yl)-prop-2'-en- l'-yl] -rapamycin, (2':E,4'S)-40-O-(4\5'-Dihydroxypent-2'-en-l'-yl)-rapamycin 40-O-(2- Hydroxy)ethoxycar-bonylmethyl-rapamycin, 40-O-(3-Hydroxy)propyl -rapamycin 4O-O-(6- Hydroxy)hexyl-rapamycin 40-O-[2-(2-Hydroxy)ethoxy]ethyl-rapamycin 4O-O-[(3S)-2,2- Dimethyldioxolan-3 -yl]methyl-rapamycin, 40-O- [(2S)-2,3 -Dihydroxyprop- 1 -yl] -rapamycin, 4O-O-(2-Acetoxy)ethyl-rapamycin 4O-O-(2-Nicotinoyloxy)ethyl-rapamycin, 40-0-[2-(N- Morpholino)acetoxy]ethyl-rapamycin 4O-O-(2-N-hiiidazolylacetoxy)ethyl-rapamycin, 40-O- [2-(N-Methyl-N'-piperazinyl)acetoxy] ethyl -rapamycin, 39-O-Desmethyl-39,40-O,O-ethylene- rapamycin, (26R)-26-Dihydro-40-O-(2-hydroxy)ethyl-raparnycin, 28-O-Methyl-rapamycin, 4O-O-(2-Aminoethyl)-rapamycin, 4O-O-(2-Acetaminoethyl)-rapamycin 4O-O-(2- Nicotinamidoethyl)-rapamycin, 4O-O-(2-(N-Methyl-imidazo-2'-ylcarbethoxamido)ethyl)- rapamycin, 4O-O-(2-Ethoxycarbonylaminoethyl)-rapamycin, 40-0(2- Tolylsulfonamidoethyl)-rapamycin, 40-O-[2-(4',5'-Dicarboethoxy-l ',2',3'-triazol-l '-yl)-ethyl]- rapamycin, 42-Epi-(tetrazolyl)rapamycin (tacrolimus), and 42-[3-hydroxy-2- (hydroxymethyl)-2-methylpropanoate]rapamycin (temsirolimus). [0040] In another embodiment the macrolide immunosuppressive drug is at least 50% crystalline.

[0041] Another embodiment provides a method for preparing a coated coronary stent comprising the following steps: forming a silane layer on a stainless or cobalt -chromium stent framework; covalently attaching heparin molecules to the silane layer; forming a macrolide immunosuppressive (limus) drug-polymer coating on the stent framework wherein at least part of the drug is in crystalline form.

[0042] hi another embodiment the macrolide is deposited in dry powder form. [0043] In another embodiment the bioabsorbable polymer is deposited in dry powder form. [0044] In another embodiment the polymer is deposited by an e-SEDS process. [0045] In another embodiment the polymer is deposited by an e-RESS process.

[0046] Another embodiment provides a method further comprising sintering said coating under conditions that do not substantially modify the morphology of said macrolide. [0047] Yet another embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; a first layer of bioabsorbable polymer; and a rapamycin-polymer coating wherein comprising rapamycin and a second bioabsorbable polymer wherein at least part of rapamycin is in crystalline form and wherein the first polymer is a slow absorbing polymer and the second polymer is a fast absorbing polymer.

INCORPORATION BY REFERENCE

[0048] All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.

DETAILED DESCRIPTION OF THE INVENTION

[0049] Illustration of selected embodiments of the inventions is provided in appended Figures 1-13. [0050] The present invention is explained in greater detail below. This description is not intended to be a detailed catalog of all the different ways in which the invention may be implemented, or all the features that may be added to the instant invention. For example, features illustrated with respect to one embodiment may be incorporated into other embodiments, and features illustrated with respect to a particular embodiment may be deleted from that embodiment. In addition, numerous variations and additions to the various embodiments suggested herein will be apparent to those skilled in the art in light of the instant disclosure, which do not depart from the instant invention. Hence, the following specification is intended to illustrate some particular embodiments of the invention, and not to exhaustively specify all permutations, combinations and variations thereof.

[0051] One embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form. In one embodiment, the rapamycin-polymer coating comprises one or more resorbable polymers.

Definitions

[0052] As used in the present specification, the following words and phrases are generally intended to have the meanings as set forth below, except to the extent that the context in which they are used indicates otherwise.

[0053] Examples of therapeutic agents employed in conjunction with the invention include, rapamycin, 40-O-(2-Hydroxyethyl)rapamycin (everolimus), 40-O-Benzyl-rapamycin, 40-O- (4' -Hydroxymethyl)benzyl -rapamycin, 40-O-[4'-(l ,2-Dihydroxyethyl)]benzyl-rapamycin, 40- O-Allyl-rapamycin, 40-O-[3'-(2,2-Dimethyl-l,3-dioxolan-4(S)-yl)-prop-2'-en-r-yl]- rapamycin, (2':E,4'S)-40-O-(4^l,5'-Dihydroxypent-2'-en-r-yl)-rapamycin 40-O-(2-

Hydroxy)ethoxycar-bonylmethyl-rapamycin, 40-O-(3-Hydroxy)propyl-rapamycin 4O-O-(6- Hydroxy)hexyl-rapamycin 40-O-[2-(2-Hydroxy)ethoxy]ethyl-raparnycin 4O-O-[(3 S)-2,2- Dimethyldioxolan-3-yl]methyl-rapamycin, 40-O-[(2S)-2,3-Dihydroxyprop-l-yl]-rapamycin, 4O-O-(2-Acetoxy)ethyl-rapamycin 4O-O-(2-Nicotinoyloxy)ethyl-rapamycin, 4O-O-[2-(N- Morpholino)acetoxy] ethyl -rapamycin 4O-O-(2-N-Imidazolylacetoxy)ethyl-rapamycin, 40-O- [2-(N-Methyl-N'-piperazinyl)acetoxy]ethyl-rapamycin, 39-O-Desmethyl-39,40-O,O-ethylene- rapamycin, (26R)-26-Dihydro-40-O-(2-hydroxy)ethyl-rapamycin, 28-O-Methyl-rapamycin, 4O-O-(2-Aminoethyl)-rapamycin, 4O-O-(2-Acetaminoethyl)-rapamycin 4O-O-(2- Nicotinamidoethyl)-rapamycin, 4O-O-(2-(N-Methyl-imidazo-2'-ylcarbethoxamido)ethyl)- rapamycin, 4O-O-(2-Ethoxycarbonylaminoethyl)-rapamycin, 40-O-(2- Tolylsulfonamidoethyl)-rapamycin, 40-O-[2-(4^l,5'-Dicarboethoxy-l',2',3'-triazol-l'-yl)-ethyl]- rapamycin, 42-Epi-(tetrazolyl)rapamycin (tacrolimus), and 42-[3-hydroxy-2- (hydroxymethyl)-2-methylpropanoate]rapamycin (temsirolimus).

[0054] The active ingredients may, if desired, also be used in the form of their pharmaceutically acceptable salts or derivatives (meaning salts which retain the biological effectiveness and properties of the compounds of this invention and which are not biologically or otherwise undesirable), and in the case of chiral active ingredients it is possible to employ both optically active isomers and racemates or mixtures of diastereoisomers.

[0055] "Stability" as used herein in refers to the stability of the drug in a polymer coating deposited on a substrate in its final product form (e.g., stability of the drug in a coated stent). The term stability will define 5% or less degradation of the drug in the final product form. [0056] "shelf life" is referred to herein mainly in connection with a product wherein the pharmaceutical agent or agents are stable as defined above for a desired period of time. To achieve the desired shelf life for the product as a whole other parameters which are outside the scope of this application should also be controlled (packaging, storage, etc.) [0057] "Heparin activity" as referred to herein indicates that heparin molecules attached to the stent framework become exposed after bioabsorbable polymer that may be covering the molecules is absorbed thereby uncovering the heparin molecules and making them available for acting as anti-coagulant agents. This is to be contrasted with the situation where the heparin molecules are covered by a polymer layer and therefore cannot be accessed for anticoagulant activity. As more of the polymer layer is absorbed more heparin molecules are uncovered thereby increasing anticoagulant activity of the heparin coated stent framework. [0058] "Secondary, tertiary and quaternary structure " as used herein are defined as follows. The active biological agents of the present invention will typically possess some degree of secondary, tertiary and/or quaternary structure, upon which the activity of the agent depends. As an illustrative, non-limiting example, proteins possess secondary, tertiary and quaternary structure. Secondary structure refers to the spatial arrangement of amino acid residues that are near one another in the linear sequence. The α-helix and the β-strand are elements of secondary structure. Tertiary structure refers to the spatial arrangement of amino acid residues that are far apart in the linear sequence and to the pattern of disulfide bonds. Proteins containing more than one polypeptide chain exhibit an additional level of structural organization. Each polypeptide chain in such a protein is called a subunit. Quaternary structure refers to the spatial arrangement of subunits and the nature of their contacts. For example hemoglobin consists of two α and two β chains. It is well known that protein function arises from its conformation or three dimensional arrangement of atoms (a stretched out polypeptide chain is devoid of activity). Thus one aspect of the present invention is to manipulate active biological agents, while being careful to maintain their conformation, so as not to lose their therapeutic activity.

[0059] "Polymer" as used herein, refers to a series of repeating monomelic units that have been cross-linked or polymerized. Any suitable polymer can be used to carry out the present invention. It is possible that the polymers of the invention may also comprise two, three, four or more different polymers. In some embodiments, of the invention only one polymer is used. In some preferred embodiments a combination of two polymers are used. Combinations of polymers can be in varying ratios, to provide coatings with differing properties. Those of skill in the art of polymer chemistry will be familiar with the different properties of polymeric compounds.

[0060] "Therapeutically desirable morphology" as used herein refers to the gross form and structure of the pharmaceutical agent, once deposited on the substrate, so as to provide for optimal conditions of ex vivo storage, in vivo preservation and/or in vivo release. Such optimal conditions may include, but are not limited to increased shelf life, increased in vivo stability, good biocompatibility, good bioavailability or modified release rates. Typically, for the present invention, the desired morphology of a pharmaceutical agent would be crystalline or semi-crystalline or amorphous, although this may vary widely depending on many factors including, but not limited to, the nature of the pharmaceutical agent, the disease to be treated/prevented, the intended storage conditions for the substrate prior to use or the location within the body of any biomedical implant. Preferably at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90% or 100% of the pharmaceutical agent is in crystalline or semi- crystalline form.

[0061] "Stabilizing agent" as used herein refers to any substance that maintains or enhances the stability of the biological agent. Ideally these stabilizing agents are classified as Generally Regarded As Safe (GRAS) materials by the US Food and Drug Administration (FDA). Examples of stabilizing agents include, but are not limited to carrier proteins, such as albumin, gelatin, metals or inorganic salts. Pharmaceutically acceptable excipient that may be present can further be found in the relevant literature, for example in the Handbook of Pharmaceutical Additives: An International Guide to More Than 6000 Products by Trade Name, Chemical, Function, and Manufacturer; Michael and Irene Ash (Eds.); Gower Publishing Ltd.; Aldershot, Hampshire, England, 1995.

[0062] "Compressed fluid" as used herein refers to a fluid of appreciable density (e.g., >0.2 g/cc) that is a gas at standard temperature and pressure. "Supercritical fluid", "near-critical fluid", "near-supercritical fluid", "critical fluid", "densified fluid" or "densified gas" as used herein refers to a compressed fluid under conditions wherein the temperature is at least 80% of the critical temperature of the fluid and the pressure is at least 50% of the critical pressure of the fluid. [0063] Examples of substances that demonstrate supercritical or near critical behavior suitable for the present invention include, but are not limited to carbon dioxide, isobutylene, ammonia, water, methanol, ethanol, ethane, propane, butane, pentane, dimethyl ether, xenon, sulfur hexafluoride, halogenated and partially halogenated materials such as chlorofluorocarbons, hydrochlorofluorocarbons, hydrofluorocarbons, perfluorocarbons (such as perfluoromethane and perfuoropropane, chloroform, trichloro-fluoromethane, dichloro- difluoromethane, dichloro-tetrafluoroethane) and mixtures thereof. [0064] "Sintering" as used herein refers to the process by which parts of the matrix or the entire polymer matrix becomes continuous (e.g., formation of a continuous polymer film). As discussed below, the sintering process is controlled to produce a fully conformal continuous matrix (complete sintering) or to produce regions or domains of continuous coating while producing voids (discontinuities) in the matrix. As well, the sintering process is controlled such that some phase separation is obtained between polymer different polymers (e.g., polymers A and B) and/or to produce phase separation between discrete polymer particles. Through the sintering process, the adhesions properties of the coating are improved to reduce flaking of detachment of the coating from the substrate during manipulation in use. As described below, in some embodiments, the sintering process is controlled to provide incomplete sintering of the polymer matrix. In embodiments involving incomplete sintering, a polymer matrix is formed with continuous domains, and voids, gaps, cavities, pores, channels or, interstices that provide space for sequestering a therapeutic agent which is released under controlled conditions. Depending on the nature of the polymer, the size of polymer particles and/or other polymer properties, a compressed gas, a densified gas, a near critical fluid or a super-critical fluid may be employed. In one example, carbon dioxide is used to treat a substrate that has been coated with a polymer and a drug, using dry powder and RESS electrostatic coating processes. In another example, isobutylene is employed in the sintering process. In other examples a mixture of carbon dioxide and isobutylene is employed.

[0065] When an amorphous material is heated to a temperature above its glass transition temperature, or when a crystalline material is heated to a temperature above a phase transition temperature, the molecules comprising the material are more mobile, which in turn means that they are more active and thus more prone to reactions such as oxidation. However, when an amorphous material is maintained at a temperature below its glass transition temperature, its molecules are substantially immobilized and thus less prone to reactions. Likewise, when a crystalline material is maintained at a temperature below its phase transition temperature, its molecules are substantially immobilized and thus less prone to reactions. Accordingly, processing drug components at mild conditions, such as the deposition and sintering conditions described herein, minimizes cross-reactions and degradation of the drug component. One type of reaction that is minimized by the processes of the invention relates to the ability to avoid conventional solvents which in turn minimizes autoxidation of drug, whether in amorphous, semi-crystalline, or crystalline form, by reducing exposure thereof to free radicals, residual solvents and autoxidation initiators.

[0066] "Rapid Expansion of Supercritical Solutions" or "RESS" as used herein involves the dissolution of a polymer into a compressed fluid, typically a supercritical fluid, followed by rapid expansion into a chamber at lower pressure, typically near atmospheric conditions . The rapid expansion of the supercritical fluid solution through a small opening, with its accompanying decrease in density, reduces the dissolution capacity of the fluid and results in the nucleation and growth of polymer particles. The atmosphere of the chamber is maintained in an electrically neutral state by maintaining an isolating "cloud" of gas in the chamber. Carbon dioxide or other appropriate gas is employed to prevent electrical charge is transferred from the substrate to the surrounding environment.

[0067] "Bulk properties" properties of a coating including a pharmaceutical or a biological agent that can be enhanced through the methods of the invention include for example: adhesion, smoothness, conformality, thickness, and compositional mixing. [0068] "Electrostatically charged" or "electrical potential" or "electrostatic capture" as used herein refers to the collection of the spray-produced particles upon a substrate that has a different electrostatic potential than the sprayed particles. Thus, the substrate is at an attractive electronic potential with respect to the particles exiting, which results in the capture of the particles upon the substrate, i.e. the substrate and particles are oppositely charged, and the particles transport through the fluid medium of the capture vessel onto the surface of the substrate is enhanced via electrostatic attraction. This may be achieved by charging the particles and grounding the substrate or conversely charging the substrate and grounding the particles, or by some other process, which would be easily envisaged by one of skill in the art of electrostatic capture.

[0069] The present invention provides several advantages which overcome or attenuate the limitations of current technology for bioabsorbable stents. [0070] One embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form. In one embodiment, the rapamycin-polymer coating comprises one or more resorbable polymers.

[0071] In another embodiment the rapamycin-polymer coating has substantially uniform thickness and rapamycin in the coating is substantially uniformly dispersed within the rapamycin-polymer coating.

[0072] In another embodiment, the one or more resorbable polymers are selected from PLGA (poly(lactide-co-glycolide); DLPLA — poly(dl-lactide); LPLA — poly(l-lactide); PGA — polyglycolide; PDO — poly(dioxanone); PGA-TMC — polyCglycolide-co-trimethylene carbonate); PGA-LPLA — poly(l-lactide-co-glycolide); PGA-DLPLA — poly(dl-lactide-co- glycolide); LPLA-DLPLA — poly(l-lactide-co-dl-lactide); PDO-PGA-TMC — polyCglycolide-co-trimethylene carbonate-co-dioxanone) and combinations thereof. [0073] In another embodiment the stent provides an elution profile wherein about 10% to about 50% of rapamycin is eluted at week 1 after the composite is implanted in a subject under physiological conditions, about 25% to about 75% of rapamycin is eluted at week 2 and about 50% to about 100% of rapamycin is eluted at week 6.

[0074] A further embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework by an aminated silane; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form and wherein the polymer is bioabsorbable. [0075] Still another embodiment provides a coated coronary stent, comprising: a stent framework having a heparin coating disposed thereon; and a macrolide immunosuppressive (limus) drug-polymer coating wherein at least part of the drug is in crystalline form. [0076] In another embodiment the the macrolide immunosuppressive drug comprises one or more of rapamycin, 40-O-(2-Hydroxyethyl)rapamycin (everolimus), 40-O-Benzyl-rapamycin, 40-O-(4'-Hydroxymethyl)benzyl-rapamycin, 40-O-[4'-( 1 ,2-Dihydroxyethyl)]benzyl- rapamycin, 40-O-Allyl-rapamycin, 40-O-[3'-(2,2-Dimethyl-l ,3-dioxolan-4(S)-yl)-prop-2'-en- l'-yl]-rapamycin, (2^t:E,4^lS)-40-O-(4',5'-Dihydroxypent-2'-en-l^l-yl)-rapamycin 40-O-(2- Hydroxy)ethoxycar-bonylmethyl-rapamycin, 40-O-(3 -Hydroxy)propyl -rapamycin 4O-O-(6- Hydroxy)hexyl-rapamycin 40-O-[2-(2-Hydroxy)ethoxy]ethyl-rapamycin 4O-O-[(3S)-2,2- Dimethyldioxolan-3-yl]methyl-rapamycin, 40-O-[(2S)-2,3-Dihydroxyprop- 1 -yl] -rapamycin, 4O-O-(2-Acetoxy)ethyl-rapamycin 4O-O-(2-Nicotinoyloxy)ethyl-rapamycin, 4O-O-[2-(N- Mθφholino)acetoxy]ethyl-rapamycin 4O-O-(2-N-Imidazolylacetoxy)ethyl -rapamycin, 40-O- [2-(N-Methyl-N'-piperazinyl)acetoxy] ethyl -rapamycin, 39-O-Desmethyl-39,40-O,O-ethylene- rapamycin, (26R)-26-Dihydro-40-O-(2-hydroxy)ethyl-rapamycin, 28-O-Methyl-rapamycin, 4O-O-(2-Aminoethyl)-rapamycin, 4O-O-(2-Acetaminoethyl)-rapamycin 4O-O-(2- Nicotinamidoethyl)-rapamycin, 4O-O-(2-(N-Methyl-imidazo-2'-ylcarbethoxamido)ethyl)- rapamycin, 4O-O-(2-Ethoxycarbonylaminoethyl)-rapamycin, 40-O-(2-

Tolylsulfonamidoethyl)-rapamycin, 40-O-[2-(4^l,5'-Dicarboethoxy-l',2',3'-triazol-r-yl)-ethyl]- rapamycin, 42-Epi-(tetrazolyl)rapamycin (tacrolimus), and 42-[3-hydroxy-2-

(hydroxymethyl)-2-methylpropanoate]rapamycin (temsirolimus).

[0077] In another embodiment the macrolide immunosuppressive drug is at least 50% crystalline.

[0078] Another embodiment provides a method for preparing a coated coronary stent comprising the following steps: forming a silane layer on a stainless or cobalt -chromium stent framework; covalently attaching heparin molecules to the silane layer; forming a macrolide immunosuppressive (limus) drug-polymer coating on the stent framework wherein at least part of the drug is in crystalline form.

[0079] In another embodiment the macrolide is deposited in dry powder form.

[0080] In another embodiment the bioabsorbable polymer is deposited in dry powder form.

[0081] In another embodiment the polymer is deposited by an e-SEDS process.

[0082] In another embodiment the polymer is deposited by an e-RESS process. [0083] Another embodiment provides a method further comprising sintering said coating under conditions that do not substantially modify the morphology of said macrolide. [0084] Yet another embodiment provides a coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; a first layer of bioabsorbable polymer; and a rapamycin-polymer coating wherein comprising rapamycin and a second bioabsorbable polymer wherein at least part of rapamycin is in crystalline form and wherein the first polymer is a slow absorbing polymer and the second polymer is a fast absorbing polymer. [0085] Illustrative embodiments of the present invention are provided in appended Figures 1- 13.

[0086] The foregoing is illustrative of the present invention, and is not to be construed as limiting thereof. While embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims

CLAIMS:

1. A coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form.

2. The coated coronary stent of Claim 1 , wherein the rapamycin-polymer coating comprises one or more resorbable polymers.

3. The coated coronary stent of Claim 2, wherein said rapamycin-polymer coating has substantially uniform thickness and rapamycin in the coating is substantially uniformly dispersed within the rapamycin-polymer coating.

4. The coated coronary stent of Claim 2 wherein the one or more resorbable polymers are selected from PLGA (poly(lactide-co-glycolide); DLPLA — poly(dl-lactide); LPLA — ρoly(l-lactide); PGA — polyglycolide; PDO — poly(dioxanone); PGA-TMC — poly(glycolide-co-trimethylene carbonate); PGA-LPLA — poly(l-lactide-co-glycolide);

PGA-DLPLA — poly(dl-lactide-co-glycolide); LPLA-DLPLA — poly(l-lactide-co-dl- lactide); PDO-PGA-TMC — poly(glycolide-co-trimethylene carbonate-co-dioxanone) and combinations thereof.

5. The coronary stent of Claim 2 wherein the polymer is 50/50 PLGA.

6. The coated coronary stent of Claim 1 , wherein at least part of said rapamycin forms a phase separate from one or more phases formed by said polymer.

7. The coated coronary stent of Claim 1, wherein said rapamycin is at least 50% crystalline.

8. The coated coronary stent of Claim 1, wherein said rapamycin is at least 75% crystalline.

9. The coated coronary stent of Claim 1 , wherein said rapamycin is at least 90% crystalline.

10. The coated coronary stent of Claim 1, wherein said rapamycin is at least 95% crystalline.

11. The coated coronary stent of Claim 1, wherein said rapamycin is at least 99% crystalline.

12. The coated coronary stent of Claim 1, wherein said polymer is a mixture of two or more polymers.

13. The coated coronary stent of Claim 12, wherein said mixture of polymers forms a continuous film around particles of rapamycin.

14. The coated coronary stent of Claim 12, wherein said two or more polymers are intimately mixed.

15. The coated coronary stent of Claim 14, wherein said mixture comprises no single polymer domain larger than about 20 ran.

16. The coated coronary stent of Claim 12, wherein each polymer in said mixture comprises a discrete phase.

17. The coated coronary stent of Claim 16, wherein discrete phases formed by said polymers in said mixture are larger than about 1 Onm.

18. The coated coronary stent of Claim 16, wherein discrete phases formed by said polymers in said mixture are larger than about 50nm.

19. The coated coronary stent of Claim 1, wherein rapamycin in said stent has a shelf stability of at least 3 months.

20. The coated coronary stent of Claim 1 , wherein rapamycin in said stent has a shelf stability of at least 6 months.

21. The coated coronary stent of Claim 1, wherein rapamycin in said stent has a shelf stability of at least 12 months.

22. The coated cornoray stent of Claim 1 wherein said coating is substantially conformal.

23. The coated coronary stent of Claim 1, wherein said stent provides an elution profile wherein about 10% to about 50% of rapamycin is eluted at week 1 after the composite is implanted in a subject under physiological conditions, about 25% to about 75% of rapamycin is eluted at week 2 and about 50% to about 100% of rapamycin is eluted at week 6.

24. The coated coronary stent of Claim 1 wherein onset of heparin anti-coagulant activity is obtained at week 3 or later.

25. The coated coronary stent of Claim 1 wherein heparin anti-coagulant activity remains at an effective level at least 90 days after onset of heparin activity.

26. The coated coronary stent of Claim 1 wherein heparin anti-coagulant activity remains at an effective level at least 120 days after onset of heparin activity.

27. The coated coronary stent of Claim 1 wherein heparin anti-coagulant activity remains at an effective level at least 200 days after onset of heparin activity.

28. The coated stent of Claim 1, wherein the stent framework is a stainless steel framework.

29. The coated stent of Claim 27, wherein heparin is attached to the stainless steel framework by reaction with an aminated silane.

30. The coated stent of Claim 29 wherein the framework is coated with a silane monolayer.

31. A coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework by an aminated silane; and a rapamycin-polymer coating wherein at least part of rapamycin is in crystalline form and wherein the polymer is bioabsorbable.

32. A coated coronary stent, comprising: a stent framework having a heparin coating disposed thereon; and a macrolide immunosuppressive (limus) drug-polymer coating wherein at least part of the drug is in crystalline form.

33. The coated stent of Claim 32, wherein the macrolide immunosuppressive drug comprises one or more of rapamycin, 40-O-(2-Hydroxyethyl)rapamycin (everolimus), 40-O-Benzyl- rapamycin, 40-O-(4'-Hydroxymethyl)benzyl-rapamycin, 40-O-[4'-(l,2-

Dihydroxyethyl)]benzyl-rapamycin, 40-O-Allyl-rapamycin, 40-O-[3'-(2,2-Dimethyl- 1 ,3- dioxolan-4(S)-yl)-prop-2'-en-l'-yl] -rapamycin, (2^l:E,4'S)-40-O-(4',5^t-Dihydroxypent-2¹- en- 1 '-yl)-rapamycin 40-O-(2-Hydroxy)ethoxycar-bonylmethyl-rapamycin, 40-O-(3 - Hydroxy)propyl-rapamycin 4O-O-(6-Hydroxy)hexyl-rapamycin 40-O-[2-(2- Hydroxy)ethoxy]ethyl-rapamycin 4O-O-[(3S)-2,2-Dimethyldioxolan-3-yl]methyl- rapamycin, 40-O-[(2S)-2,3-Dihydroxyprop-l -yl] -rapamycin, 4O-O-(2-Acetoxy)ethyl- rapamycin 4O-O-(2-Nicotinoyloxy)ethyl-rapamycin, 4O-O-[2-(N- Morpholino)acetoxy]ethyl-rapamycin 4O-O-(2-N-hnidazolylacetoxy)ethyl-rapamycin, 40-O-[2-(N-Methyl-N'-piperazinyl)acetoxy]ethyl-rapamycin, 39-O-Desmethyl-39,40- 0,0-ethylene-rapamycin, (26R)-26-Dihydro-40-O-(2-hydroxy)ethyl-rapamycin, 28-0- Methyl-rapamycin, 4O-O-(2-Aminoethyl)-rapamycin, 40-0(2 -Acetaminoethyl)- rapamycin 40-0-(2-Nicotinamidoethyl)-rapamycin, 40-0-(2-(N-Methyl-imidazo-2'- ylcarbethoxamido)ethyl)-rapamycin, 4O-O-(2-Ethoxycarbonylaminoethyl)-rapamycin, 40-O-(2-Tolylsulfonamidoethyl)-rapamycin, 40-O-[2-(4',5'-Dicarboethoxy-l',2',3'-triazol- l'-yl)-ethyl]-rapamycin, 42-Epi-(tetrazolyl)rapamycin (tacrolimus), and 42-[3-hydroxy-2-

(hydroxymethyl)-2-methylpropanoate]rapamycin (temsirolimus).

34. The coated coronary stent of Claim 31, wherein said macrolide immunosuppressive drug is at least 50% crystalline.

35. A method for preparing a coated coronary stent comprising the following steps: forming a silane layer on a stainless or cobalt -chromium stent framework; covalently attaching heparin molecules to the silane layer; forming a macrolide immunosuppressive (limus) drug-polymer coating on the stent framework wherein at least part of the drug is in crystalline form.

36. The method of Claim 34 wherein the macrolide is deposited in dry powder form.

37. The method of Claim 34 wherein the bioabsorbable polymer is deposited in dry powder form.

38. The method of Claim 34 wherein the polymer is deposited by an e-SEDS process.

39. The method of Claim 34 wherein the polymer is deposited by an e-RESS process.

40. The method of Claim 34 further comprising sintering said coating under conditions that do not substantially modify the morphology of said macrolide.

41. The method of Claim 34, wherein the macrolide immunosuppressive drug comprises one or more of rapamycin, 40-O-(2-Hydroxyethyl)rapamycin (everolimus), 40-O-Benzyl- rapamycin, 40-O-(4'-Hydroxymethyl)benzyl-rapamycin, 40-O-[4'-(l,2- Dihydroxyethyl)]benzyl-rapamycin, 40-O-Allyl-rapamycin, 40-O-[3'-(2,2-Dimethyl- 1 ,3- dioxolan-4(S)-yl)-prop-2'-en-r-yl]-rapamycin, (2^?:E,4'S)-40-O-(4',5'-Dihydroxypent-2'- en- 1 '-yl)-rapamycin 40-O-(2-Hydroxy)ethoxycar-bonylmethyl-rapamycin, 40-O-(3- Hydroxy)propyl-rapamycin 4O-O-(6-Hydroxy)hexyl-rapamycin 40-O-[2-(2- Hydroxy)ethoxy]ethyl-rapamycin 40-0-[(3S)-2,2-Dimethyldioxolan-3-yl]methyl- rapamycin, 40-O-[(2S)-2,3-Dihydroxyprop-l -yl] -rapamycin, 4O-O-(2-Acetoxy)ethyl- rapamycin 4O-O-(2-Nicotinoyloxy)ethyl-rapamycin, 40-0-[2-(N- Moφholino)acetoxy]ethyl-rapamycin 4O-O-(2-N-Imidazolylacetoxy)ethyl-rapamycin, 40-O-[2-(N-Methyl-N'-piperazinyl)acetoxy]ethyl-rapamycin, 39-O-Desmethyl-39,40- 0,0-ethylene-rapamycin, (26R)-26-Dihydro-40-O-(2-hydroxy)ethyl-rapamycin, 28-O- Methyl-rapamycin, 4O-O-(2-Aminoethyl)-rapamycin, 4O-O-(2-Acetarninoethyl)- rapamycin 4O-O-(2-Nicotinamidoethyl)-rapamycin, 4O-O-(2-(N-Methyl-imidazo-2'- ylcarbethoxamido)ethyl)-rapamycin, 4O-O-(2-Ethoxycarbonylaminoethyl)-rapamycin, 40-O-(2-Tolylsulfonamidoethyl)-rapamycin, 40-O-[2-(4',5'-Dicarboethoxy- 1 ',2',3'-triazol- r-yl)-ethyl]-rapamycin, 42-Epi-(tetrazolyl)rapamycin (tacrolimus), and 42-[3-hydroxy-2- (hydroxymethyl)-2-methylpropanoate]rapamycin (temsirolimus).

42. The method of Claim 34 wherein one or more resorbable polymers are selected from

PLGA (poly(lactide-co-glycolide); DLPLA — poly(dl-lactide); LPLA — poly(l-lactide); PGA — polyglycolide; PDO — poly(dioxanone); PGA-TMC — poly(glycolide-co- trimethylene carbonate); PGA-LPLA — polyO-lactide-co-glycolide); PGA-DLPLA — poly(dl-lactide-co-glycolide); LPLA-DLPLA — poly(l-lactide-co-dl-lactide); PDO-PGA- TMC — poly(glycolide-co-trimethylene carbonate-co-dioxanone).

43. A coated coronary stent, comprising: a stent framework; heparin molecules attached to the stent framework; a first layer of bioabsorbable polymer; and a rapamycin-polymer coating wherein comprising rapamycin and a second bioabsorbable polymer wherein at least part of rapamycin is in crystalline form and wherein the first polymer is a slow absorbing polymer and the second polymer is a fast absorbing polymer.

44. The stent of Claim 43 wherein the fast absorbing polymer is PLGA copolymer with a ratio of about 40:60 to about 60:40 and the slow absorbing polymer is a PLGA copolymer with a ration of about 70:30 to about 90:10.