# Patent

## Title
Coatings containing polycationic peptides for cardiovascular therapy

## Abstract

Coatings for implantable medical devices and methods for fabricating the same are disclosed. The coatings include a region containing a polycationic peptide, such as, for example, the polycationic peptide known as R7.

## Background
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to the field of medical devices, especially devices used for delivery of drugs. Particularly, this invention is directed to coatings for drug delivery devices, such as drug eluting vascular stents. More particularly, this invention is directed to coatings which include polycationic peptides such as polymers and/or oligomers of L-arginine.
2. Description of the State of the Art
Percutaneous transluminal coronary angioplasty (PTCA) is a procedure for treating heart disease. A catheter assembly having a balloon portion is introduced percutaneously into the cardiovascular system of a patient via the brachial or femoral artery. The catheter assembly is advanced through the coronary vasculature until the balloon portion is positioned across the occlusive lesion. Once in position across the lesion, the balloon is inflated to a predetermined size to radially compress against the atherosclerotic plaque of the lesion to remodel the lumen wall. The balloon is then deflated to a smaller profile to allow the catheter to be withdrawn from the patient's vasculature.
A problem associated with the above procedure includes formation of intimal flaps or torn arterial linings which can collapse and occlude the conduit after the balloon is deflated. Moreover, thrombosis and restenosis of the artery may develop over several months after the procedure, which may require another angioplasty procedure or a surgical by-pass operation. To reduce the partial or total occlusion of the artery by the collapse of arterial lining and to reduce the chance of the development of thrombosis and restenosis, a stent is implanted in the lumen to maintain the vascular patency.
Stents are used not only as a mechanical intervention but also as a vehicle for providing biological therapy. As a mechanical intervention, stents act as scaffoldings, functioning to physically hold open and, if desired, to expand the wall of the passageway. Typically, stents are capable of being compressed, so that they can be inserted through small vessels via catheters, and then expanded to a larger diameter once they are at the desired location. Examples in patent literature disclosing stents which have been applied in PTCA procedures include stents illustrated in U.S. Pat. No. 4,733,665 issued to Palmaz, U.S. Pat. No. 4,800,882 issued to Gianturco, and U.S. Pat. No. 4,886,062 issued to Wiktor.
Biological therapy can be achieved by medicating the stents. Medicated stents provide for the local administration of a therapeutic substance at the diseased site. In order to provide an efficacious concentration to the treated site, systemic administration of such medication often produces adverse or toxic side effects for the patient. Local delivery is a preferred method of treatment in that smaller total levels of medication are administered in comparison to systemic dosages, but are concentrated at a specific site. Local delivery thus produces fewer side effects and achieves more favorable results. One proposed method for medicating stents involves the use of a polymeric carrier coated onto the surface of a stent. A solution which includes a solvent, a polymer dissolved in the solvent, and a therapeutic substance dispersed in the blend is applied to the stent. The solvent is allowed to evaporate, leaving on the stent surface a coating of the polymer and the therapeutic substance impregnated in the polymer.
Local administration of therapeutic agents via stents has shown some favorable results in reducing restenosis. However, development of restenosis remains a persistent problem which has not been significantly alleviated by therapeutic substances which are currently used in the market. Accordingly, there is a great need for better and more effective therapeutic compositions, and methods of administering the compositions, for the effective treatment of restenosis.
SUMMARY
A coating for an implantable medical device, such as a stent, is disclosed. The coating comprises a region including a polycationic peptide and a region free from any polycationic peptides. The polycationic peptide can be poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a racemic mixture of poly(L-arginine) or poly(D-arginine). In one embodiment, the region including the polycationic peptide includes a hydrogel containing the polycationic peptide. The hydrogel can be fabricated of substances comprising carboxylated hydrocarbons, polycationic compounds, polyanionic compounds and mixtures thereof. In one embodiment, the region free from the polycationic peptide is positioned on the surface of the device and beneath the region including the polycationic peptide. In an alternative embodiment, the polycationic peptide can be encapsulated in particles in the coating.
A method for fabricating a coating for an implantable medical device, such as a stent, is also disclosed. The method comprises forming a coating on the device, the coating including a polycationic peptide; and treating the coating with a stimulus for enriching a region close to the outer surface of the coating with the polycationic peptide. In one embodiment, the treatment of the coating includes subjecting the device to a humid environment at a selected temperature, for example about 50° C. at a humidity of about 100%. In another embodiment, the treatment can include subjecting the device to an electronic beam or to autoclaving.
A method of modifying a coating for an implantable medical device is disclosed. The method comprises exposing the coating, including a polycationic peptide to ethylene oxide at a selected temperature and conjugating poly(ethylene glycol) to the coating.
A method of fabricating a coating for a medical device is disclosed. The method comprises forming a coating on the device, the coating including a polycationic peptide, and causing some of the bonds of the peptide to be cleaved for increasing the population of the peptide in the coating.
A stent comprising a coating is also disclosed wherein the coating includes a peptide such that the population of the peptide is greater in the outermost region of the coating.
A method of fabricating a coated stent is also disclosed, comprising forming a coating on the stent wherein the coating includes a region containing a peptide and a region free from any peptides.


DETAILED DESCRIPTION
The stent coating according to the embodiments of the present invention may have any one or combination of the following layers or regions in addition to the reservoir layer containing a therapeutic substance: a primer layer, a topcoat layer, and a finishing coat layer. The optional finishing coat layer may also include a drug or a therapeutic substance. The reservoir layer can be applied directly onto the stent surface, or optionally on the primer layer. The optional finishing coat layer can be applied on the topcoat layer and, when present, can be the outermost region of the stent coating. Subsequent to the implantation of the stent, the reservoir layer gradually releases the therapeutic substance.
One example of a drug or therapeutic substance that can be used is a polycationic peptide or a mixture of several polycationic peptides. Representative examples of suitable polycationic peptides include poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), racemic mixtures of poly(L-arginine) and poly(D-arginine), chitosan, and mixtures thereof. L-arginine, also known as R or 2-amino-5-guanidinovaleric acid, is an amino acid having a formula NH═C(NH2)—NH—CH2—CH2—CH2—CH(NH2)—COOH. Polymers and/or oligomers of L-, D-, and/or D, L-arginine that can be used are referred to in the present application as “PArg” and comprise a plurality of repeating monomeric amino acid units connected with peptide bonds. PArg has a general formula

H[NH—CHX—CO]p—OH  (I)

where “p” can be within a range of 5 and 1,000, or, within a range of between 6 and 20. For example, a heptamer (R7) (p=7), or a nonamer (R9) (p=9), can be used.

In formula (I), “X” represents 1-guanidinopropyl radical having the structure —CH2—CH2—CH2—NH—C(NH2)═NH. The terms “polymers and/or oligomers of D-, L-, and/or D, L-arginine,” “poly(L-arginine),” “poly(D-arginine),” “poly(D,L-arginine),” and “PArg” used in the present application are intended to include L-, D-, and/or D,L-arginine in both its polymeric and oligomeric form.
Poly(ethylene-co-vinyl alcohol) (EVAL) is one example of a polymer that can be used for any of the coating layers. EVAL is a product of hydrolysis of ethylene-vinyl acetate copolymers and has the general formula —[CH2—CH2]m—[CH2—CH(OH)]n—. EVAL may also include a terpolymer having up to about 5 molar % of units derived from styrene, propylene and other suitable unsaturated monomers. A brand of copolymer of ethylene and vinyl alcohol distributed commercially under the trade name EVAL by Aldrich Chemical Co. of Milwaukee, Wis., can be used.
Other examples of polymers that can be used include polyacrylates, such as poly(butyl methacrylate) (PBMA), poly(ethyl methacrylate) (PEMA), and poly(ethyl methacrylate-co-butyl methacrylate) [P(EMA-BMA)]; fluorinated polymers and/or copolymers, such as poly(vinylidene fluoride) (PVDF) and poly(vinylidene fluoride-co-hexafluoro propene) (PVDF-HFP); and blends of polyacrylates and fluorinated polymers and/or copolymers. One example of the blend of a polyacrylate and a fluorinated polymer that can be used can contain between about 10 and about 95% (mass) of the fluorinated polymer.
Representative examples of other suitable polymers include poly(hydroxyvalerate), poly(L-lactic acid), polycaprolactone, poly(lactide-co-glycolide), poly(hydroxybutyrate), poly(hydroxybutyrate-co-valerate), polydioxanone, polyorthoester, polyanhydride, poly(glycolic acid), poly(D,L-lactic acid), poly(glycolic acid-co-trimethylene carbonate), polyphosphoester, polyphosphoester urethane, poly(amino acids), cyanoacrylates, poly(trimethylene carbonate), poly(iminocarbonate), co-poly(ether-esters) (e.g. PEO/PLA), polyalkylene oxalates, polyphosphazenes, biomolecules (such as fibrin, fibrinogen, cellulose, starch, collagen and hyaluronic acid), polyurethanes, silicones, polyesters, polyolefins, polyisobutylene and ethylene-alphaolefin copolymers, vinyl halide polymers and copolymers (such as polyvinyl chloride), polyvinyl ethers (such as polyvinyl methyl ether), polyvinylidene chloride, polyacrylonitrile, polyvinyl ketones, polyvinyl aromatics (such as polystyrene), polyvinyl esters (such as polyvinyl acetate), copolymers of vinyl monomers with each other and olefins (such as ethylene-methyl methacrylate copolymers, acrylonitrile-styrene copolymers, ABS resins, and ethylene-vinyl acetate copolymers), polyamides (such as Nylon 66 and polycaprolactam), alkyd resins, polycarbonates, polyoxymethylenes, polyimides, polyethers, epoxy resins, polyurethanes, rayon, rayon-triacetate, cellulose, cellulose acetate, cellulose butyrate, cellulose acetate butyrate, cellophane, cellulose nitrate, cellulose propionate, cellulose ethers, and carboxymethyl cellulose.
A. A Solution or Suspension Method for Incorporating PArg into Stent Coatings
The coating can be formed on the stent by dissolving the polymer in a solvent, or a mixture of solvents, and applying the resulting polymer solution on the stent by spraying or immersing the stent in the solution. To incorporate PArg into the reservoir layer and/or the optional finishing coat layer, PArg in a form of a solution can be combined with the polymer solution.
Representative examples of some solvents suitable for making the polymer solution include N,N-dimethylacetamide (DMAC), N,N-dimethylformamide (DMF), tethrahydrofurane (THF), cyclohexanone, xylene, toluene, acetone, i-propanol, methyl ethyl ketone, propylene glycol monomethyl ether, methyl butyl ketone, ethyl acetate, n-butyl acetate, and dioxane. Some solvent mixtures can be used as well. Representative examples of the mixtures include:
(1) DMAC and methanol (e.g., 50:50 by mass mixture);
(2) water, i-propanol, and DMAC (e.g., 10:3:87 by mass mixture);
(3) i-propanol, and DMAC (e.g., 80:20, 50:50, or 20:80 by mass mixtures);
(4) acetone and cyclohexanone (e.g., 80:20, 50:50, or 20:80 by mass mixtures);
(5) acetone and xylene (e.g. 50:50 by mass mixture); and
(6) acetone, FLUX REMOVER AMS, and xylene (e.g., 10:50:40 by mass mixture).
FLUX REMOVER AMS is the trade name of a solvent manufactured by Tech Spray, Inc. of Amarillo, Tex. comprising about 93.7% of a mixture of 3,3-dichloro-1,1,1,2,2-pentafluoropropane and 1,3-dichloro-1,1,2,2,3-pentafluoropropane, and the balance of methanol, with trace amounts of nitromethane. Those having ordinary skill in the art will select the solvent or a mixture of solvents suitable for a particular polymer being dissolved.
Instead of introducing PArg in a solution, PArg can be introduced as a colloid system, such as a suspension in an appropriate solvent phase. The suspension can be mixed with a polymer solution. One example of the solvent phase can be a mixture of water, i-propanol and DMAC, containing between about 3 and 6 mass % of water, between about 18 and 19% of i-propanol, and the balance, DMAC solvent.
After the stent coating has been formed, the stent can then be additionally treated to enrich the surface with PArg. Various techniques of treatment can be used depending on the kind of PArg and whether a finishing coat layer is used.
In one embodiment, the coated stent can be exposed to the environment of a humidifying chamber. This treatment is particularly useful for R7 or R9. The length of such treatment can be, for example, about 24 hours, at a temperature of about 50° C. and relative humidity of about 100%. Any commercially available chamber can be used. As a result of the exposure of the stent to high humidity levels at elevated temperatures, the outermost surface of the coating is enriched with the peptide (e.g., R7 or R9).
If the finishing coat layer is not used, the stent can be treated after the reservoir layer containing the peptide (e.g., R7 or R9) has been applied, but prior to applying the topcoat layer. Consequently, as a result of the treatment, the surface of the drug-polymer layer gets enriched with the R7 or R9, followed by fabrication of the topcoat layer.
In another embodiment of the invention, the coated stent can be treated with high energy electronic beams. This method of treatment can be most effectively employed when the PArg is higher than nonamer, or in other words, in formula (I), p should be greater than about 20. For example, the PArg can have a weight-average molecular weight of about 5,000, corresponding to a “p” value of about 29. Under the influence of the electronic beam, the peptide bonds of PArg undergo cleavage, causing de-polymerization of PArg. Consequently, the population of the peptide (e.g., R7 or R9) in the stent coating increases. The length of the electronic beam treatment can be about 1 second. The standard equipment used for sterilization of the stents can be used, with the electronic beam having energy of about 2.5 MRad (25 kilograys).
Alternatively, instead of treatment with the electronic beam, the stent can be treated by autoclaving. High pressure and temperature in the autoclave will also cause de-polymerization of PArg leading to the enrichment of the stent coating with the sub-population of R7 or R9. The conditions of autoclaving will be selected by those having ordinary skill in the art.
In accordance with yet another embodiment, the coated stent can be sterilized at a high temperature, for example, above about 100° C. During sterilization, PArg contained in the outermost layer of the stent coating can be exposed to ethylene oxide.
Under conditions of high temperature, the proton at the nitrogen atom of the peptide bond —NH—CO— of PArg will be activated and will attack the oxyran ring of ethylene oxide causing the ring to open forming an ethylene glycol (—CH2—CH2—O—) moiety. As a result poly(ethylene glycol) (PEG) can be chemically bonded to the coating's surface. The path of the reaction can be shown as reaction (II):




The high temperature treatment in the presence of ethylene glycol thus makes it possible to sterilize the stent and to simultaneously conjugate PEG, a biologically active substance, to the stent coating.
B. Incorporating PArg into Stent Coatings Using Hydrogels
PArg can be incorporated in the stent coating by using hydrogel technology. For example, a hydrogel can be prepared by mixing R7 and poly(glutamic acid) (PGlA). A R7: PGlA ratio can be between about 1:1 and 5:1. Instead of PGlA, other highly carboxylated hydrocarbons can be used in the alternative, for instance, polyalginate, sulfonated dextran, or mixtures thereof. A portion of PGlA or its alternatives can be replaced with other polycationic or polyanionic compounds. Examples of such polycationic or polyanionic compounds include PArg, polylysine, poly(dimethylaminoethyl methacrylate) (PDMAEM), poly(acrylic acid), and polysaccharides.
The hydrogel containing R7 can be mixed with the polymer solution forming the drug-polymer layer or the optional finishing coat layer. The hydrogel can be used to cause endothelialization. Those having ordinary skills in the art may also choose to use the hydrogel in applications not involving stent coatings. Examples of such applications include using the hydrogel in tissue sealants, with biological adhesives designed to accelerate healing, and with biocompatible viscosifiers such as hyaluronic acid or carboxymethyl cellulose.
C. Incorporating PArg into Stent Coatings Using Micro- or Nanoparticles
PArg can be incorporated in the stent coating by being first incorporated into particles of micron to sub-micron size (i.e., micro- or nanoparticles). For example, the particles can have diameter between about 0.5 and 4.0 μm. The particles comprise a sphere-type outer shell made of an encapsulating polymer and an inside space filled with PArg. The particles can be made by an emulsion method according to techniques known to those having ordinary skill in the art. Examples of suitable encapsulating polymers having varying rates of hydrolysis include poly(glycolic acid) (PGA), poly(D-lactic acid) (PDLA), poly(L-lactic acid) (PLLA), poly(butylene terephthalate-co-ethylene glycol), PBT-PEG, and mixtures thereof.
The micro- or nanoparticles containing R7 can be suspended in the polymer solution forming the drug-polymer layer and/or the finishing coat layer and applied onto the stent. The peptide particles-to-polymer ratio can be within a range of between about 1:5 and 1:10. When the stent is in contact with body fluids, the polymer forming the outer shell of the particles will hydrolyze and degrade thus releasing the peptide, such as the R7.
The polycationic peptides can be introduced alone or blended with other active agent(s). Generally speaking, the active agent can include any substance capable of exerting a therapeutic or prophylactic effect in the practice of the present invention. Examples of agents include antiproliferative substances such as actinomycin D, or derivatives and analogs thereof. Synonyms of actinomycin D include dactinomycin, actinomycin IV, actinomycin II, actinomycin X1, and actinomycin C1. The active agent can also fall under the genus of antineoplastic, anti-inflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antimitotic, antibiotic, antiallergic and antioxidant substances. Examples of such antineoplastics and/or antimitotics include paclitaxel, docetaxel, methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, doxorubicin hydrochloride, and mitomycin. Examples of such antiplatelets, anticoagulants, antifibrin, and antithrombins include sodium heparin, low molecular weight heparins, heparinoids, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclin analogues, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein IIb/IIIa platelet membrane receptor antagonist antibody, recombinant hirudin, and thrombin. Examples of such cytostatic or antiproliferative agents include angiopeptin, angiotensin converting enzyme inhibitors such as captopril, cilazapril or lisinopril, calcium channel blockers (such as nifedipine), colchicine, fibroblast growth factor (FGF) antagonists, fish oil (ω-3-fatty acid), histamine antagonists, lovastatin (an inhibitor of HMG-CoA reductase, a cholesterol lowering drug), monoclonal antibodies (such as those specific for Platelet-Derived Growth Factor (PDGF) receptors), nitroprusside, phosphodiesterase inhibitors, prostaglandin inhibitors, suramin, serotonin blockers, steroids, thioprotease inhibitors, triazolopyrimidine (a PDGF antagonist), and nitric oxide. An example of an antiallergic agent is permirolast potassium. Other therapeutic substances or agents which may be appropriate include alpha-interferon, genetically engineered epithelial cells, rapamycin, derivatives and analogs of rapamycin, estradiol, clobetasol, and dexamethasone. Functional derivatives or structural analogs of the aforementioned drugs can also be used, such as any suitable derivative of rapamycin.
PArg can be synthesized as a dendritic (branched to a large degree) polymer which can fully envelop and thus host the active substance, more particularly cationic agents, leading to synergistic effects. Examples of the biologically active substances suitable of being hosted by PArg in the dendritic form include silver cation and sulfonyl amide.
The coatings and methods of the present invention have been described with reference to a stent, such as a balloon expandable or self-expandable stent. The use of the coating is not limited to stents, however, and the coating can also be used with a variety of other medical devices. Examples of implantable medical devices that can be used in conjunction with the embodiments of this invention include stent-grafts, grafts (e.g., aortic grafts), artificial heart valves, cerebrospinal fluid shunts, pacemaker electrodes, axius coronary shunts and endocardial leads (e.g., FINELINE and ENDOTAK, available from Guidant Corporation). The underlying structure of the device can be of virtually any design. The device can be made of a metallic material or an alloy such as, but not limited to, cobalt-chromium alloys (e.g., ELGILOY), stainless steel (316L), “MP35N,” “MP20N,” ELASTINITE, Nitinol, tantalum, tantalum-based alloys, nickel-titanium alloy, platinum, platinum-based alloys such as, e.g., platinum-iridium alloy, iridium, gold, magnesium, titanium, titanium-based alloys, zirconium-based alloys, or combinations thereof. Devices made from bioabsorbable or biostable polymers can also be used with the embodiments of the present invention.
“MP35N” and “MP20N” are trade names for alloys of cobalt, nickel, chromium and molybdenum available from Standard Press Steel Co. of Jenkintown, Pa. “MP35N” consists of 35% cobalt, 35% nickel, 20% chromium, and 10% molybdenum. “MP20N” consists of 50% cobalt, 20% nickel, 20% chromium, and 10% molybdenum.
Embodiments of the present invention can be further illustrated by the following set forth examples.
EXAMPLE 1
A first composition can be prepared by mixing the following components:
(a) between about 1.0 mass % and about 15 mass %, for example, about 2.0 mass % of EVAL; and
(b) the balance, DMAC solvent.
The first composition can be applied onto the surface of a bare 13 mm TETRA stent (available from Guidant Corporation) by spraying and dried to form a primer layer. A spray coater can be used, having a 0.014 fan nozzle maintained at about 60° C. with a feed pressure of about 0.2 atm (about 3 psi) and an atomization pressure of about 1.3 atm (about 20 psi). About 70 μg of the wet coating can be applied. The primer can be baked at about 140° C. for about 2 hours, yielding a dry primer layer.
A second composition can be prepared by mixing the following components:
(c) between about 1.0 mass % and about 15 mass %, for example, about 1.7 mass % of EVAL;
(d) between about 0.05 mass % and about 2.0 mass %, for example, about 0.7 mass % of R7; and
(e) the balance, a solvent mixture, comprising i-propanol (IPA), distilled water and DMAC in a ratio IPA:H2O:DMAC of about 1:4:33.
The second composition can be applied onto the dried primer layer to form a first sub-layer of the drug-polymer layer, using the same spraying technique and equipment used for applying the primer layer. About 200 μg of the wet coating can be applied, followed by drying, e.g., by baking as described above.
A third composition, a suspension of R7, can be prepared by mixing the following components:
(f) between about 1.0 mass % and about 15 mass %, for example, about 1.6 mass % of EVAL;
(g) between about 0.05 mass % and about 2.0 mass %, for example, about 0.3 mass % of R7; and
(h) the balance, a solvent mixture, comprising i-propanol (IPA), distilled water and DMAC in a ratio IPA:H2O:DMAC of between about 3:1:12 and 6:1:25.
The suspension composition can be applied onto the dried first sub-layer of the drug-polymer layer, to complete forming the drug-polymer layer, using the same spraying technique and equipment used for applying the primer layer and the first sub-layer of the drug-polymer layer. About 200 μg of the suspension can be applied, followed by drying, e.g., by baking as described above.
A fourth composition can be prepared by mixing the following components:
(i) between about 1.0 mass % and about 15 mass %, for example, about 2.0 mass % of PBMA; and
(j) the balance, a mixture of solvents, xylene, FLUX REMOVER AMS, and acetone in a ratio of about 25:19:5 by mass.
The fourth composition can be applied onto the dried drug-polymer layer, to form a topcoat layer, using the same spraying technique and equipment. About 100 μg of the wet coating can be applied, followed by drying, e.g., by baking as described above.
A fifth composition can be prepared by mixing the following components:
(k) between about 1.0 mass % and about 15 mass %, for example, about 2.0 mass % of PBMA; and
(l) between about 0.05 mass % and about 2.0 mass %, for example, about 0.7 mass % of R7; and
(m) the balance, a mixture of solvents, xylene, FLUX REMOVER AMS, and acetone in a ratio of about 25:19:5 by mass.
The fifth composition can be applied onto the dried topcoat layer, to form a finishing coat layer, using the same spraying technique and equipment used for applying the primer, the drug-polymer, and the topcoat layers. About 100 μg of the wet coating can be applied, followed by drying, e.g., by baking as described above.
EXAMPLE 2
A coating comprising a primer layer and a drug-polymer layer can be applied onto a stent, as described in steps (a) through (h) of Example 1. The stent can be placed in a humidifying chamber, at the temperature of about 50° C. and a relative humidity of about 100%, for about 24 hours. A topcoat composition can be prepared by mixing the following components:
(a) between about 1.0 mass % and about 15 mass %, for example, about 2.0 mass % of PBMA; and
(b) the balance, a mixture of solvents, xylene, FLUX REMOVER AMS, and acetone in a ratio of about 25:19:5 by mass.
The stent can be removed from the humidifying chamber and dried. The topcoat composition can then be applied onto the drug-polymer layer, to form a topcoat layer, using the same spraying technique and equipment as described in Example 1. About 100 μg of the wet coating can be applied, followed by drying, e.g., by baking as described above.
EXAMPLE 3
A stent coating can be made as described in Example 1, except instead of R7, poly(L-arginine) having weight-average molecular weight of about 5,000 is used. For this kind of PArg, p=29. The coated stent can be then subjected to an electronic beam having an energy of about 2.5 MRad for about 1 second.
While particular embodiments of the present invention have been shown and described, it will be obvious to those skilled in the art that changes and modifications can be made without departing from this invention in its broader aspects. Therefore, the appended claims are to encompass within their scope all such changes and modifications as fall within the true spirit and scope of this invention.

## Claims

1. A method for fabricating a coating for an implantable medical device, comprising:
(a) forming a coating on the device, the coating including a polycationic peptide; and
(b) treating the coating with a stimulus that cleaves peptide bonds for enriching a region close to the outer surface of the coating with the polycationic peptide.

2. The method of claim 1, wherein the implantable medical device is a stent.

3. The method of claim 1, wherein the polycationic peptide includes poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a mixture of poly(L-arginine) and poly(D-arginine).

4. The method of claim 1, wherein the treating of the coating includes subjecting the device to a humid environment at a selected temperature.

5. The method of claim 4, wherein the temperature is about 50° C. and the humidity is about 100%.

6. The method of claim 1, wherein the treating includes subjecting the device to an electronic beam or to autoclaving.

7. The method of claim 6, wherein the electronic beam has energy of about 2.5 MRad.

8. A coating for an implantable medical device, the coating comprising two regions, a first region including a polycationic peptide and a second region free from the polycationic peptide, wherein the polycationic peptide is encapsulated in particles in the coating.

9. The coating of claim 8, wherein the region free from the polycationic peptide is positioned on the surface of the device and beneath the region including the polycationic peptide.

10. The coating of claim 8, wherein the particles are fabricated of a substance selected from a group consisting of poly(glycolic acid), poly(D-lactic acid), poly(L-lactic acid), poly(butylene terephtalate-co-ethylene glycol) and mixtures thereof.

11. A method of modifying a coating for an implantable medical device, the coating including a polycationic peptide, comprising exposing the coating to ethylene oxide at a selected temperature and conjugating poly(ethylene glycol) to the coating.

12. A method of fabricating a coating for a medical device, comprising forming a coating on the device, the coating including a polycationic peptide, and causing some of the peptide bonds in the polycationic peptide to be cleaved, whereby the population of free peptides in the coating is increased.

13. The method of claim 11, wherein the polycationic peptide includes poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a mixture of poly(L-arginine) and poly(D-arginine).

14. The method of claim 11, wherein the device is a stent.

15. The method of claim 12, wherein the polycationic peptide includes poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a mixture of poly(L-arginine) and poly(D-arginine).

16. The method of claim 12, wherein the device is a stent.

17. A method of fabricating a coated stent, comprising forming a coating comprising two regions on the stent wherein the coating includes a first region containing a peptide and a second region free from the peptide wherein the peptide is encapsulated in particles in the coating.

18. A coating for a medical device comprising a peptide that has been cleaved such that the population of the peptide is greatest at the outmost region of the coating.

19. The coating of claim 8, wherein the implantable medical device is a stent.

20. The coating of claim 8, wherein the polycationic peptide includes poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a mixture of poly(L-arginine) and poly(D-arginine).

21. The method of claim 17, wherein the implantable medical device is a stent.

22. The method of claim 17, wherein the polycationic peptide includes poly(L-arginine), poly(D-arginine), poly(D,L-arginine), poly(L-lysine), poly(D-lysine), poly(δ-guanidino-α-aminobutyric acid), and a mixture of poly(L-arginine) and poly(D-arginine).