Reduction of inflammatory mass with spinal catheters

Abstract

Devices, systems and methods for delivering one or more drugs to the cerebrospinal fluid periodically replace continuous infusion of the a solution with intermittent bolus infusion of the solution to reduce the local concentration of a drug over time at a vertebral level in the patient's spinal canal relative to the drug infused continuously through the infusion section of a catheter intrathecally into a patient's spinal canal at the vertebral level. Such periodic replacement of continuous infusion with intermittent bolus infusion assists in prevention formation of an inflammatory mass at the vertebral level.

1 - 30 . (canceled) 
     
     
         31 . An implantable infusion device configured to prevent inflammatory mass formation associated with continuous intrathecal infusion of a first solution containing a first drug through a first infusion section of a catheter into a patient's spinal canal at a first vertebral level, wherein the first drug has a local concentration over time at the first vertebral level in the patient's spinal canal, the implantable infusion device comprising:
 a reservoir, wherein the reservoir is configured to house the first solution containing the first drug;   an outlet port fluidly coupled to the reservoir;   a pump assembly operably coupled to the reservoir and configured to cause the first solution to flow from the reservoir through the outlet; and   a controller operably coupled to the pump assembly and configured to control the rate at which the pump assembly causes fluid to flow from the reservoir through the outlet, wherein the controller is configured to cause the pump assembly to periodically replace continuous infusion of the first solution with intermittent bolus infusion of the first solution to reduce the local concentration of the first drug over time at the first vertebral level in the patient's spinal canal relative to the first drug infused continuously through the first infusion section of a catheter intrathecally into a patient's spinal canal at the first vertebral level.   
     
     
         32 . The device of  claim 31 , wherein the controller is programmed with instructions that cause the pump assembly to periodically replace continuous infusion of the first solution with intermittent bolus infusion of the first solution. 
     
     
         33 . An implantable infusion device configured to prevent inflammatory mass formation associated with continuous intrathecal infusion of a first solution containing a first drug through a first infusion section of a catheter into a patient's spinal canal at a first vertebral level, wherein the first drug has a local concentration over time at the first vertebral level in the patient's spinal canal, comprising:
 a first reservoir configured to house the first solution containing the first drug;   a second reservoir configured to house a second solution containing a drug, which may be the same as, or different from, the first drug;   an outlet port fluidly coupled to the first reservoir and the second reservoir;   a pump assembly operably coupled to the first reservoir and the second reservoir and configured to cause fluid to flow from the first reservoir through the outlet and to cause fluid to flow from the second reservoir through the outlet; and   a controller operably coupled to the pump assembly and configured to control the rate at which the pump assembly causes fluid to flow from the first reservoir through the outlet and to control the rate at which the pump assembly causes fluid to flow from the second reservoir through the outlet, wherein the controller is configured to cause the pump assembly to periodically replace infusion of fluid from the first reservoir with fluid infusion from the second reservoir to reduce the local concentration of the first drug over time at the first vertebral level in the patient's spinal canal relative to the first drug infused continuously through the first infusion section of a catheter intrathecally into a patient's spinal canal at the first vertebral level.   
     
     
         34 . The device of  claim 33 , wherein the controller is programmed with instructions that cause the pump assembly to periodically replace infusion of fluid from the first reservoir with fluid infusion from the second reservoir. 
     
     
         35 . A system comprising:
 a device of  claim 33 ;   the first solution housed in the first reservoir; and   the second solution housed in the second reservoir.   
     
     
         36 . The system of  claim 35 , wherein the drug in the second solution is the same as the first drug in the first solution. 
     
     
         37 . The system of  claim 36 , wherein the density of the first solution is different from the density of the second solution. 
     
     
         38 . The system of  claim 37 , wherein the concentration of the drug in the first solution is different from the concentration of the drug in the second solution. 
     
     
         39 . The system of  claim 36 , wherein the concentration of the drug in the first solution is different from the concentration of the drug in the second solution. 
     
     
         40 . The system of  claim 35 , wherein the drug in the second solution is different from the first drug in the first solution. 
     
     
         41 . The system of  claim 40 , wherein the density of the first solution is different from the density of the second solution. 
     
     
         42 . The system of  claim 41 , wherein the concentration of the drug in the first solution is different from the concentration of the drug in the second solution. 
     
     
         43 . The system of  claim 40 , wherein the concentration of the drug in the first solution is different from the concentration of the drug in the second solution. 
     
     
         44 . The system of  claim 40 , wherein the first drug and the second drug are useful for treating the same disease. 
     
     
         45 . An implantable infusion system, comprising:
 (i) an implantable infusion device having:
 a first reservoir configured to house a first solution containing a first drug; 
 a second reservoir configured to house a second solution containing a drug, which may be the same as, or different from, the first drug, 
 a first outlet port fluidly coupled to the first reservoir, 
 a second outlet port fluidly coupled to the second reservoir, and 
 a pump assembly operably coupled to the first reservoir and the second reservoir and configured to cause fluid to flow from the first reservoir through the first outlet and to cause fluid to flow from the second reservoir through the second outlet; and 
   (ii) a catheter operably couplable to the first and second outlet ports of the infusion device, the catheter having a first infusion section and a second infusion section spaced apart from the first infusion section, wherein the first infusion section is fluidly coupled with the first outlet port when the catheter is operably coupled to the infusion device and wherein the second infusion section is fluidly coupled with the second outlet port when the catheter is operably coupled to the infusion device.   
     
     
         46 . A system comprising:
 a system of  claim 45 ;   the first solution housed in the first reservoir; and   the second solution housed in the second reservoir.   
     
     
         47 . The system of  claim 46 , wherein the drug in the second solution is the same as the first drug in the first solution. 
     
     
         48 . The system of  claim 47 , wherein the density of the first solution is different from the density of the second solution. 
     
     
         49 . The system of  claim 46 , wherein the drug in the second solution is different from the first drug in the first solution. 
     
     
         50 . The system of  claim 46 , wherein the first drug and the second drug are useful for treating the same disease.