In vitro particulate and in vivo drug retention study of a novel polyethylene oxide formulation for drug-coated balloons

The purpose of this study was to investigate the newly developed drug-coated balloon (DCB) using polyethylene oxide (PEO) as a platform and to compare it directly with a commercially available DCB in a preclinical experimental setting. The PEO balloon was characterized for coating morphology and degree of paclitaxel (PAT) crystallinity. PAT tissue levels were then measured up to 30 days in a healthy porcine model (10 swine, 20 vessels) after treatment with either a PEO balloon or a commercially available DCB. An in vitro bench-top model was used to compare the particulates released from the PEO balloon and commercially available DCB. The coating on the PEO balloon was smooth and homogeneous with PAT in its amorphous state. From the porcine survival study, the PAT tissue levels were comparable between PEO balloon and commercially available DCB after 7 days of treatment. Both the PEO balloon and the commercially available DCB retained therapeutic drug up to 30 days. During the simulated in vitro model, the PEO balloon shed significantly fewer particulates that were smaller than those of the commercially available DCB. Most important, the PEO balloon shed 25 times fewer large particulates than the commercially available DCB. The amorphous PAT in the PEO balloon provided comparable drug tissue retention levels to those of the commercially available DCB and fewer particulates. Thus prepared PEO balloon proved to be safe and effective in the preclinical experimental setting. The clinical outcomes of these findings need further investigation. Drug-coated balloons (DCBs) have not been indicated for use in lesions below the knee (BTK). Although it is not fully understood why DCBs have failed BTK, the latest literature has indicated that a DCB that retains drug in the tissues for an extended time while also limiting particulate formation may be beneficial BTK. The polyethylene oxide balloon developed in this study had comparable drug retention to a commercially available DCB and fewer particulates. Therefore, the polyethylene oxide balloon should be investigated further for clinical importance in a porcine model using BTK lesions.