Abstract:
The present invention inter-alia relates to an apparatus comprising a receiving opening configured to receive a connecting part of a medical device in a spread condition of the receiving opening and to block receiving the connecting part of the medical device in a relaxed condition of the receiving opening, and a spreader configured to spread the receiving opening in the spread condition such that an opening diameter of the receiving opening is at least as big as an outer diameter of the connecting part of the medical device.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application is a U.S. National Phase Application pursuant to 35 U.S.C. §371 of International Application No. PCT/EP2012/058254 filed May 4, 2012, which claims priority to European Patent Application No. 11165115.4 filed May 6, 2011. The entire disclosure contents of these applications are herewith incorporated by reference into the present application. 
     
    
     FIELD OF INVENTION 
       [0002]    The present patent application inter-alia relates to medical devices for ejecting a dose of a medicament. For instance, the present patent application relates to medical devices of delivering at least two drug agents from separate reservoirs. Such drug agents may comprise a first and a second medicament. The medical device includes a dose setting mechanism for delivering the drug automatically or manually by the user. 
       BACKGROUND 
       [0003]    The drug agents may be contained in two or more multiple dose reservoirs, containers or packages, each containing independent (single drug compound) or pre-mixed (co-formulated multiple drug compounds) drug agents. 
         [0004]    Certain disease states require treatment using one or more different medicaments. Some drug compounds need to be delivered in a specific relationship with each other in order to deliver the optimum therapeutic dose. The present patent application is of particular benefit where combination therapy is desirable, but not possible in a single formulation for reasons such as, but not limited to, stability, compromised therapeutic performance and toxicology. 
         [0005]    For example, in some cases it might be beneficial to treat a diabetic with a long acting insulin (also may be referred to as the first or primary medicament) along with a glucagon-like peptide-1 such as GLP-1 or GLP-1 analog (also may be referred to as the second drug or secondary medicament). 
       SUMMARY 
       [0006]    Accordingly, there exists a need to provide devices for the delivery of two or more medicaments in a single injection or delivery step that is simple for the user to perform without complicated physical manipulations of the drug delivery device. The proposed drug delivery device provides separate storage containers or cartridge retainers for two or more active drug agents. These active drug agents are then only combined and/or delivered to the patient during a single delivery procedure. These active agents may be administered together in a combined dose or alternatively, these active agents may be combined in a sequential manner, one after the other. 
         [0007]    The drug delivery device also allows for the opportunity of varying the quantity of the medicaments. For example, one fluid quantity can be varied by changing the properties of the injection device (e.g., setting a user variable dose or changing the device&#39;s “fixed” dose). The second medicament quantity can be changed by manufacturing a variety of secondary drug containing packages with each variant containing a different volume and/or concentration of the second active agent. 
         [0008]    The drug delivery device may have a single dispense interface. This interface may be configured for fluid communication with the primary reservoir and with a secondary reservoir of medicament containing at least one drug agent. The drug dispense interface can be a type of outlet that allows the two or more medicaments to exit the system and be delivered to the patient. 
         [0009]    The combination of compounds as discrete units or as a mixed unit can be delivered to the body via a double-ended needle assembly. This would provide a combination drug injection system that, from a user&#39;s perspective, would be achieved in a manner that closely matches the currently available injection devices that use standard needle assemblies. One possible delivery procedure may involve the following steps: 
         [0010]    1. Attach a dispense interface to a distal end of the electro-mechanical injection device. The dispense interface comprises a first and a second proximal needle. The first and second needles pierce a first reservoir containing a primary compound and a second reservoir containing a secondary compound, respectively. 
         [0011]    2. Attach a dose dispenser, such as a double-ended needle assembly, to a distal end of the dispense interface. In this manner, a proximal end of the needle assembly is in fluidic communication with both the primary compound and secondary compound. 
         [0012]    3. Dial up/set a desired dose of the primary compound from the injection device, for example, via a graphical user interface (GUI). 
         [0013]    4. After the user sets the dose of the primary compound, the micro-processor controlled control unit may determine or compute a dose of the secondary compound and preferably may determine or compute this second dose based on a previously stored therapeutic dose profile. It is this computed combination of medicaments that will then be injected by the user. The therapeutic dose profile may be user selectable. 
         [0014]    5. Optionally, after the second dose has been computed, the device may be placed in an armed condition. In such an optional armed condition, this may be achieved by pressing and/or holding an “OK” button on a control panel. This condition may provide for greater than a predefined period of time before the device can be used to dispense the combined dose. 
         [0015]    6. Then, the user will insert or apply the distal end of the dose dispenser (e.g., a double ended needle assembly) into the desired injection site. The dose of the combination of the primary compound and the secondary compound (and potentially a third medicament) is administered by activating an injection user interface (e.g., an injection button). 
         [0016]    Both medicaments may be delivered via one injection needle or dose dispenser and in one injection step. This offers a convenient benefit to the user in terms of reduced user steps compared to administering two separate injections. 
         [0017]    After a specific number of injections (e.g. 1 injection, 3 injections, 5 injections, 10 injections, 20 injections, 50 injections or the like) there is a risk for the dose dispenser and/or the dispense interface to be contaminated and, additionally, the tips of the needles of the dose dispenser and/or the dispense interface may be blunted. For instance, a blunted tip of a needle may not be able to sufficiently pierce a septum and/or tissue, for instance inserting a blunted needle in a desired injection site may be very painful. Furthermore, mechanical parts of the dose dispenser and/or the dispense interface such as a valve arrangement may only proper function for a specific number of injections (e.g. 1 injection, 3 injections, 5 injections, 10 injections, 20 injections, 50 injections or the like). 
         [0018]    Therefore, the dose dispenser and the dispense interface are disposable parts. For instance, the dose dispenser should only be used for one injection and the dispense interface should only be used with one first and second reservoir. However, users may, for instance accidentally or in order to save costs, reuse disposable parts such as the dose dispenser and the dispense interface. 
         [0019]    Therefore, the present invention inter-alia faces the technical problem of providing a reuse protection for disposable parts such as a dose dispenser and a dispense interface. 
         [0020]    According to the present invention, an apparatus comprises a receiving opening configured to receive a connecting part of a medical device in a spread condition of the receiving opening and to block receiving the connecting part of the medical device in a relaxed condition of the receiving opening, and a spreader configured to spread the receiving opening in the spread condition such that an opening diameter of the receiving opening is at least as big as an outer diameter of the connecting part of the medical device. 
         [0021]    Furthermore according to the present invention, a method comprises spreading, by a spreader, a receiving opening such that an opening diameter of the receiving opening is at least as big as an outer diameter of a connecting part of a medical device, and receiving, in the receiving opening, a connecting part of a medical device in a spread condition of the receiving opening. 
         [0022]    The medical device may be drug delivery device such as a medical device configured to eject a drug agent (e.g. a dose of a medicament) such as an infusion device or an injection device, for instance an insulin injection pen. Injection devices may be used either by medical personnel or by patients themselves. As an example, type-1 and type-2 diabetes may be treated by patients themselves by injection of insulin doses, for example once or several times per day. 
         [0023]    For instance, the medical device is configured to eject at least two drug agents from separate reservoirs comprising a first and a second medicament, respectively, but it is not limited thereto. Alternatively, the medical device is for instance a conventional medical device configured to eject a drug agent from a single reservoir such as Applicant&#39;s Solostar insulin injection pen. 
         [0024]    The apparatus according to the present invention may be a disposable part attachable to the medical device. For instance, the apparatus may be attachable to the medical device by use of mating attachment means (e.g. axial attachment means) forming a frictional fit, a form fit and/or an interference fit. Examples of mating attachment means include snap locks, snap fits, snap rings, keyed slots, threads and any combinations thereof. Furthermore, the apparatus may only be attachable to specific types of medical devices. 
         [0025]    For instance, the apparatus is a dispense interface or a dose dispenser attachable to a medical device configured to eject a drug agent. 
         [0026]    A dispense interface may be configured to be in fluid communication with at least one reservoir of the medical device containing at least one medicament. For instance, the drug dispense interface is a type of outlet that allows the at least one medicament to exit the medical device. The dispense interface may comprise a valve arrangement. Such a valve arrangement may be configured to prevent contamination of the at least one medicament in the at least one reservoir. For instance, the valve arrangement is configured to prevent back flow of the at least one medicament when the medicament is delivered/ejected. 
         [0027]    A dose dispenser may be configured to be in fluid communication with at least one reservoir of the medical device containing at least one medicament and/or with a dispense interface. For instance, the dose dispenser is a needle assembly, for instance a double-ended needle assembly and/or a standard needle assembly. One end of such a needle assembly may be inserted into a desired injection site before an injection. 
         [0028]    The receiving opening may be an opening in which a connecting part of the medical device is to be received to enable an attachment of the apparatus to the medical device. The connecting part of the medical device may at least partially to be received in the receiving opening in order to enable a cooperation of the mating attachment means of the apparatus and the medical device. For instance, the mating attachment means of the apparatus and the medical device may be aligned when the connecting part is at least partially received in the receiving opening. 
         [0029]    In particular, the connecting part of the medical device may be a connecting part of at least one reservoir of the medical device. The reservoir is for instance a replaceable cartridge and/or a refillable container containing a medicament. For instance, the connecting part of the medical device is configured to enable a fluid communication between the at least one reservoir of the medical device and the apparatus. The connecting part of the medical device may comprise a fluid connector such as a valve arrangement, a piercable septum or the like. 
         [0030]    The receiving opening may at least partially be spreadable such that at least the opening diameter of the receiving opening is enlargeable by spreading the receiving opening. For instance, the receiving opening is made from an elastic material. The diameter of the receiving opening may not be constant. For instance, the opening diameter of the receiving opening may be the minimum (cross-sectional) diameter of the receiving opening. 
         [0031]    In the spread condition, the opening diameter of the receiving opening is for instance enlarged such that the opening diameter of the receiving opening is at least as big as an outer diameter of the connecting part of the medical device. The outer diameter of the connecting part may be the maximum (cross-sectional) diameter of the connecting part of the medical device. 
         [0032]    In the relaxed condition, the opening diameter of the receiving opening is for instance not enlarged or not sufficiently enlarged such that the opening diameter of the receiving opening is smaller than the outer diameter of the connecting part of the medical device. In the relaxed condition, the receiving opening may be closed. 
         [0033]    The receiving opening may have the shape of a (hollow) truncated cone, wherein the truncated end of the truncated cone-shaped receiving opening may be open. The diameter of the base of this truncated cone-shaped receiving opening may be at least as big as the outer diameter of the connecting part of the medical device; and the diameter of the open, truncated end of the truncated cone-shaped receiving opening may be the opening diameter of the receiving opening. 
         [0034]    The spreader may be at least partially insertable in the receiving opening such that the receiving opening is spread (e.g. the opening diameter of the receiving opening is enlarged and is as big as the outer diameter of the spreader). The spreader may be arranged in the open, truncated end of the truncated cone-shaped receiving opening. For instance, the outer diameter of the spreader is at least as big as the outer diameter of the connecting part. Thus, when the spreader is inserted in the receiving opening as described above, the receiving opening may be in the spread condition. When the spreader is for instance removed from the receiving opening, the receiving opening may be in the relaxed condition. Accordingly, inserting and removing the spreader may allow changing the condition of the receiving opening. 
         [0035]    In the spread condition, the connecting part of the medical device is for instance at least partially receivable in the receiving opening such that a cooperation of the mating attachment means of the apparatus and the medical device is enabled. In contrast to this in the relaxed condition, the connecting part of the medical device is for instance not or only partially receivable in the receiving opening such that a cooperation of the mating attachment means of the apparatus and the medical device is disabled. For instance, the attachment means of the apparatus and the medical device are only aligned, if the connecting part is entirely or partially received in the receiving opening. 
         [0036]    The spread and relaxed condition may inter-alia enable and disable, respectively, receiving a connecting part of the medical device in the receiving opening and/or an attachment of the apparatus to the medical device. By changing the condition of the receiving opening from the initial spread condition to the relaxed condition, after the apparatus is attached to the medical device, a reuse of the apparatus may be prevented. This is inter-alia advantageous in order to prevent a reuse of the apparatus. 
         [0037]    In the following, features and embodiments (exhibiting further features) of the present invention will be described, which are understood to equally apply to the apparatus and the method as described above. These single features/embodiments are considered to be exemplary and non-limiting, and to be respectively combinable independently from other disclosed features/embodiments of the apparatus and the method as described above. Nevertheless, these features/embodiments shall also be considered to be disclosed in all possible combinations with each other and with the apparatus and the method as described above. For instance, a mentioning that an apparatus according to the present invention is configured to perform a certain action should be understood to also disclose an according method step of the method according to the present invention. 
         [0038]    According to an embodiment of the present invention, the spreader is further configured to relax the receiving opening in the relaxed condition such that the opening diameter of the receiving opening is smaller than the outer diameter of the connecting part of the medical device. For instance, if the spreader is at least partially removed from the receiving opening, the receiving opening may at least partially relax such that the opening diameter of the receiving opening is in the relaxed condition. 
         [0039]    This embodiment is inter-alia advantageous in order to allow changing the condition of the receiving opening. 
         [0040]    According to an embodiment of the present invention, the apparatus further comprises a connector configured to connect to the connecting part of the medical device, wherein the connector is arranged in the receiving opening. 
         [0041]    The connector may be configured to enable a fluid communication between the apparatus and the medical device. For instance, the connector is configured to enable a fluid communication with a reservoir of the medical device such as a cartridge. In particular, the connector of the apparatus may correspond to a connector of the connecting part of the medical device. These mating connectors may be any known fluid connectors. For instance, the mating connectors may be mating luer-taper connectors. Alternatively, the connector of the apparatus may be a needle configured for piercing a septum of the medical device, for instance a septum of a reservoir such as a cartridge and/or a container. 
         [0042]    The connector of the apparatus is arranged in the receiving opening. In particular, the connector of the apparatus may be arranged in the receiving opening such that the connector is only connectable with the connecting part of the medical device, if the connecting part of the medical device is at least partially receivable in the receiving opening. For instance, the receiving opening encompasses the connector. The apparatus may only be connectable with the medical device, if the receiving opening is in the spread condition. This embodiment is inter-alia advantageous in order to prevent a connection of the apparatus with the medical device in the relaxed condition. 
         [0043]    Alternatively, there are also similar embodiments thinkable in which the apparatus comprises a connector which is not arranged in the receiving opening, but in which the apparatus may only be connectable with the medical device, if the receiving opening is in the spread condition. 
         [0044]    According to an embodiment of the present invention, the receiving opening is formed from blades arranged cylindrical and/or tapered around the connector. For instance, the blades are arranged to at least partially form a lateral surface of the receiving opening. The blades may be arranged to form the lateral surface of a truncated cone. In particular, the blades may be arranged such that their surfaces at least partially form the lateral surface of the truncated cone. For instance, the blades form a closed or an at least partially closed lateral surface of the truncated cone. The diameter of the base of this truncated cone-shaped receiving opening may be at least as big as the outer diameter of the connecting part of the medical device; and the diameter of the open, truncated end of the truncated cone-shaped receiving opening may be the opening diameter of the receiving opening. 
         [0045]    Alternatively or additionally, the blades may form the lateral surface of a cylinder. 
         [0046]    The connector is for instance at least partially arranged in or on the base of the receiving opening. For instance, the connector is completely encompassed in the receiving opening. 
         [0047]    The blades may be at least partially tilting around the base of the receiving opening. For instance, the blades are made from an elastic material. The blades may be tilting such that the blades at least partially form a lateral surface of the truncated cone in a first tilt position and a lateral surface of a cylinder in a second tilt position. 
         [0048]    By tilting the blades from the first to the second tilt position, the opening diameter of the receiving opening may be enlarged. The first tilt position may correspond to the relaxed condition of the receiving opening and the second tilt position may correspond to the spread condition of the receiving opening. 
         [0049]    Alternatively or additionally, there are also embodiments thinkable in which the blades form a cone in the first tilt position and a truncated cone in the second tilt position or a truncated cone in the first and second tilt position. 
         [0050]    This embodiment is inter-alia advantageous in order to form the receiving opening and/or to allow changing the condition of the receiving opening, for instance by tilting the blades. 
         [0051]    According to an embodiment of the present invention, the spreader is movable from a spreading position in the receiving opening of the apparatus to a relaxing position in the receiving opening of the apparatus. The spreading position may correspond to the spread condition of the receiving opening and the relaxing position may correspond to the relaxed condition of the receiving opening. 
         [0052]    In the spreading position, the spreader is for instance arranged in the open, truncated end of the truncated cone-shaped receiving opening; and, in the relaxing position, the spreader is for instance arranged outside of the open, truncated end of the truncated cone-shaped receiving opening. In the spreading position, the maximum (cross-sectional) outer diameter of the spreader may be arranged in the plane of the open, truncated end of the truncated cone-shaped receiving opening and, in the relaxing position the maximum outer diameter of the spreader may be positioned out of the plane of the open, truncated end of the truncated cone-shaped receiving opening. 
         [0053]    The spreader may be movable from the spreading position to the relaxing position. For instance, the spreader may be moved from the spreading position to the relaxing position by moving (e.g. pushing) the spreader entirely into the receiving opening. For instance, the spreader may be hollow such that the spreader may not block a connector arranged in the receiving opening. Alternatively or additionally, the receiving opening may comprise a recess configured to at least partially receive the spreader in the receiving opening. 
         [0054]    Accordingly, the condition of the receiving opening may be changed from the spread condition to the relaxed condition by moving the spreader from the spreading position to the relaxing position. This embodiment is inter-alia advantageous in order to allow changing the condition of the receiving opening. 
         [0055]    According to an embodiment of the present invention, the spreader is configured to be moved from the spreading position in the receiving opening of the apparatus to the relaxing position in the receiving opening of the apparatus, when the connecting part of the medical device is received in the receiving opening. For instance, in the spreading position, the spreader may at least partially engage with the receiving opening and/or the receiving opening may at least partially engage with the spreader to secure the spreader in the spreading position. For instance, the spreader may comprise a notch (e.g. a circumferential notch) with which the receiving opening may engage to secure the spreader in the spreading position. In this example, the securing force is to be overcome to move the spreader from the spreading position to the relaxing position. 
         [0056]    For instance, the connecting part of the medical device may push the spreader into the receiving opening, when the connecting part of the medical device is received in the receiving opening. Although, the spreader is moved from the spreading position to the relaxing position, the receiving opening may be in the spread condition as long as the apparatus is attached to the medical device. For instance, the connecting part of the medical device at least partially spreads the receiving opening. After removing the apparatus from the medical device, the spreader may remain in the relaxing position. 
         [0057]    Accordingly, the condition of the receiving opening may be automatically changed from the spread condition to the relaxed condition, when the apparatus is removed from the medical device. A reattachment of the apparatus to the medical device and/or a reuse of the apparatus is prevented. 
         [0058]    Furthermore, the position of the spreader may allow a user to determine whether the apparatus has been used. For instance, the spreader may only viewable in the spreading position indicating that the apparatus is unused and can be attached to a medical device. The spreader may by coloured to simplify the determination for the user. 
         [0059]    This embodiment is inter-alia advantageous in order to automatically allow changing the condition of the receiving opening, to prevent a reuse/reattachment of the apparatus and/or to allow a user to determine whether the apparatus has been used. 
         [0060]    According to an embodiment of the present invention, the receiving opening is configured to lock the spreader in the relaxing position. For instance, the spreader may be secured in the relaxing position such that the spreader can not be moved from the relaxing position to the spreading position. As an example, the outer diameter of the spreader may be bigger than the opening diameter of the receiving opening in the relaxed condition. In this example, the spreader is locked in the relaxing position in the receiving opening. 
         [0061]    This embodiment is inter-alia advantageous in order to prevent a change of the condition of the receiving opening from the relaxed condition to the spread condition. 
         [0062]    According to an embodiment of the present invention, the receiving opening is spring-loaded and/or elastic. For instance, the blades forming the lateral surface of the receiving opening may be spring-loaded. Alternatively or additionally, the blades may be made from an elastic material such as plastic. 
         [0063]    The spring-load and/or the elasticity may force the receiving opening in the relaxed condition such that the corresponding spring-force and/or elastic-force has to be overcome to change the condition of the receiving opening from the relaxed condition to the spread condition. When the spreader and/or the connecting part of the medical device is removed from the receiving opening, the spring-load and/or elasticity may force the receiving opening back in the relaxed condition. For instance, the spring-load and/or elasticity locks the spreader in the relaxing position. 
         [0064]    Accordingly, the condition of the receiving opening may automatically change from the spread condition to the relaxed condition, when the spreader and/or the connecting part of the medical device is removed from the receiving opening. Furthermore, a change of the condition of the receiving opening from the relaxed condition to the spread condition may be prevented. 
         [0065]    This embodiment is inter-alia advantageous in order to automatically allow changing the condition of the receiving opening and/or to prevent a reuse/reattachment of the apparatus. 
         [0066]    According to an embodiment of the present invention, the receiving opening has a round cross-section. 
         [0067]    According to an embodiment of the present invention, the spreader is at least partially tapered. For instance, the spreader may be a cone. The pointed base (e.g. the apex) of the spreader may allow the spreader to be easily inserted in the receiving opening; and the enlarged base may prevent the spreader from being removed from the receiving opening. 
         [0068]    According to an embodiment of the present invention, the spreader is round and/or ring-shaped. For instance, the ring-opening of a ring-shaped spreader may not block a connector arranged in the receiving opening, when the spreader is pushed in the relaxing position in the receiving opening. 
         [0069]    According to an embodiment of the present invention, an outer diameter of the spreader is at least as big as the outer diameter of the connecting part of the medical device. For instance, when the spreader is arranged in the open, truncated end of the truncated cone-shaped receiving hole, the receiving opening may be in the spread condition. When the spreader is for instance removed, the receiving opening may be in the relaxed condition. 
         [0070]    According to an embodiment of the present invention, the spreader and/or the receiving opening is made from plastic. For instance, the spreader and/or the receiving opening is a moulded plastic part. This embodiment is inter-alia advantageous in order to allow a cost effective production of the spreader and/or the receiving opening and/or to provide a biocompatible spreader and/or receiving opening. 
         [0071]    According to an embodiment of the present invention, the medical device is configured to eject a medicament and the apparatus is a dispense interface and/or a dose dispenser attachable to the medical apparatus. 
         [0072]    According to an embodiment of the present invention, the method further comprises moving, when receiving the connecting part of the medical device, the spreader from a spreading position in the receiving opening to a relaxing position in the receiving opening, locking the spreader in the relaxing position, and blocking the receiving the connecting part of the medical device in a relaxed condition of the receiving opening. 
         [0073]    Accordingly, the condition of the receiving opening may automatically change from the spread condition to the relaxed condition, when the spreader and/or the connecting part of the medical device is removed from the receiving opening. Furthermore, a change of the condition of the receiving opening from the relaxed condition to the spread condition may be prevented. Furthermore, a reattachment or a reuse of the apparatus may be prevented. 
         [0074]    This embodiment is inter-alia advantageous in order to automatically allow changing the 
         [0075]    condition of the receiving opening and/or to prevent a reuse/reattachment of the apparatus. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0076]    These as well as other advantages of various embodiments of the present invention will become apparent to those of ordinary skill in the art by reading the following detailed description, with appropriate reference to the accompanying drawings, in which: 
           [0077]      FIG. 1  illustrates a perspective view of the delivery device illustrated in  FIG. 1   a  and  1   b  with an end cap of the device removed; 
           [0078]      FIG. 2  illustrates a perspective view of the delivery device distal end showing the cartridge; 
           [0079]      FIG. 3  illustrates a perspective view of the cartridge holder illustrated in  FIG. 1  with one cartridge retainer in an open position; 
           [0080]      FIG. 4  illustrates a dispense interface and a dose dispenser that may be removably attached to a distal end of the delivery device illustrated in  FIG. 1 ; 
           [0081]      FIG. 5  illustrates the dispense interface and the dose dispenser illustrated in  FIG. 4  attached to a distal end of the delivery device illustrated in  FIG. 1 ; 
           [0082]      FIG. 6  illustrates one arrangement of the dose dispenser without a reuse protection that may be attached to a distal end of the delivery device; 
           [0083]      FIG. 7  illustrates a perspective view of the dispense interface illustrated in  FIG. 4 ; 
           [0084]      FIG. 8  illustrates another perspective view of the dispense interface without a reuse protection illustrated in  FIG. 4 ; 
           [0085]      FIG. 9  illustrates a cross-sectional view of the dispense interface without a reuse protection illustrated in  FIG. 4 ; 
           [0086]      FIG. 10  illustrates an exploded view of the dispense without a reuse protection interface illustrated in  FIG. 4 ; 
           [0087]      FIG. 11  illustrates a cross-sectional view of the dispense interface without a reuse protection and dose dispenser without a reuse protection attached to a drug delivery device, such as the device illustrated in  FIG. 1 ; 
           [0088]      FIG. 12  illustrates an embodiment of a receiving opening of a reuse protection for the dispense interface illustrated in  FIG. 4 ; 
           [0089]      FIG. 13  illustrates cross-sectional views of the receiving opening illustrated in  FIG. 12  mounted on the dispense interface illustrated in  FIG. 4 ; 
       
    
    
     DETAILED DESCRIPTION 
       [0090]    The drug delivery device illustrated in  FIG. 1  comprises a main body  14  that extends from a proximal end  16  to a distal end  15 . At the distal end  15 , a removable end cap or cover  18  is provided. This end cap  18  and the distal end  15  of the main body  14  work together to provide a snap fit or form fit connection so that once the cover  18  is slid onto the distal end  15  of the main body  14 , this frictional fit between the cap and the main body outer surface  20  prevents the cover from inadvertently falling off the main body. 
         [0091]    The main body  14  contains a micro-processor control unit, an electro-mechanical drive train, and at least two medicament reservoirs. When the end cap or cover  18  is removed from the device  10  (as illustrated in  FIG. 1 ), a dispense interface  200  is attached to the distal end  15  of the main body  14 , and a dose dispenser (e.g., a needle assembly) is attached to the interface. The drug delivery device  10  can be used to administer a computed dose of a second medicament (secondary drug compound) and a variable dose of a first medicament (primary drug compound) through a single needle assembly, such as a double ended needle assembly. 
         [0092]    A control panel region  60  is provided near the proximal end of the main body  14 . Preferably, this control panel region  60  comprises a digital display  80  along with a plurality of human interface elements that can be manipulated by a user to set and inject a combined dose. In this arrangement, the control panel region comprises a first dose setting button  62 , a second dose setting button  64  and a third button  66  designated with the symbol “OK.” In addition, along the most proximal end of the main body, an injection button  74  is also provided (not visible in the perspective view of  FIG. 1 ). 
         [0093]    The cartridge holder  40  can be removably attached to the main body  14  and may contain at least two cartridge retainers  50  and  52 . Each retainer is configured so as to contain one medicament reservoir, such as a glass cartridge. Preferably, each cartridge contains a different medicament. 
         [0094]    In addition, at the distal end of the cartridge holder  40 , the drug delivery device illustrated in  FIG. 1  includes a dispense interface  200 . As will be described in relation to  FIG. 4 , in one arrangement, this dispense interface  200  includes a main outer body  212  that is removably attached to a distal end  42  of the cartridge housing  40 . As can be seen in  FIG. 1 , a distal end  214  of the dispense interface  200  preferably comprises a needle hub  216 . This needle hub  216  may be configured so as to allow a dose dispenser, such as a conventional pen type injection needle assembly, to be removably attached to the drug delivery device  10 . 
         [0095]    Once the device is turned on, the digital display  80  shown in  FIG. 1  illuminates and provides the user certain device information, preferably information relating to the medicaments contained within the cartridge holder  40 . For example, the user is provided with certain information relating to both the primary medicament (Drug A) and the secondary medicament (Drug B). 
         [0096]    As shown in  FIG. 3 , the first and a second cartridge retainers  50 ,  52  comprise hinged cartridge retainers. These hinged retainers allow user access to the cartridges.  FIG. 3  illustrates a perspective view of the cartridge holder  40  illustrated in  FIG. 1  with the first hinged cartridge retainer  50  in an open position.  FIG. 3  illustrates how a user might access the first cartridge  90  by opening up the first retainer  50  and thereby having access to the first cartridge  90 . 
         [0097]    As mentioned above when discussing  FIG. 1 , a dispense interface  200  is coupled to the distal end of the cartridge holder  40 .  FIG. 4  illustrates a flat view of the dispense interface  200  unconnected to the distal end of the cartridge holder  40 . A dose dispenser or needle assembly that may be used with the interface  200  is also illustrated and is provided in a protective outer cap  420 . 
         [0098]    In  FIG. 5 , the dispense interface  200  illustrated in  FIG. 4  is shown coupled to the cartridge holder  40 . The axial attachment means between the dispense interface  200  and the cartridge holder  40  can be any known axial attachment means to those skilled in the art, including snap locks, snap fits, snap rings, keyed slots, and combinations of such connections. The connection or attachment between the dispense interface and the cartridge holder may also contain additional features (not shown), such as connectors, stops, splines, ribs, grooves, pips, clips and the like design features, that ensure that specific hubs are attachable only to matching drug delivery devices. Such additional features would prevent the insertion of a non-appropriate secondary cartridge to a non-matching injection device. 
         [0099]      FIG. 5  also illustrates the needle assembly  400  and protective cover  420  coupled to the distal end of the dispense interface  200  that may be screwed onto the needle hub of the interface  200 .  FIG. 6  illustrates a cross sectional view of the double ended needle assembly  402  attached to the dispense interface  200  in  FIG. 5 . 
         [0100]    The needle assembly  400  illustrated in  FIG. 6  comprises a double ended needle  406  and a hub  401 . The double ended needle or cannula  406  is fixedly mounted in a needle hub  401 . This needle hub  401  comprises a circular disk shaped element which has along its periphery a circumferential depending sleeve  403 . Along an inner wall of this hub member  401 , a thread  404  is provided. This thread  404  allows the needle hub  401  to be screwed onto the dispense interface  200  which, in one embodiment, is provided with a corresponding outer thread along a distal hub. At a center portion of the hub element  401  there is provided a protrusion  402 . This protrusion  402  projects from the hub in an opposite direction of the sleeve member. A double ended needle  406  is mounted centrally through the protrusion  402  and the needle hub  401 . This double ended needle  406  is mounted such that a first or distal piercing end  405  of the double ended needle forms an injecting part for piercing an injection site (e.g., the skin of a user). 
         [0101]    Similarly, a second or proximal piercing end  406  of the needle assembly  400  protrudes from an opposite side of the circular disc so that it is concentrically surrounded by the sleeve  403 . In one needle assembly arrangement, the second or proximal piercing end  406  may be shorter than the sleeve  403  so that this sleeve to some extent protects the pointed end of the back sleeve. The needle cover cap  420  illustrated in  FIGS. 11 and 12  provides a form fit around the outer surface  403  of the hub  401 . 
         [0102]    Referring now to  FIG. 4-11 , one embodiment of this interface  200  will now be discussed. In this one embodiment, this interface  200  comprises: 
         [0103]    a. a main outer body  210 , 
         [0104]    b. an first inner body  220 , 
         [0105]    c. a second inner body  230 , 
         [0106]    d. a first piercing needle  240 , 
         [0107]    e. a second piercing needle  250 , 
         [0108]    f. a valve seal  260 , and 
         [0109]    g. a septum  270 . 
         [0110]    The main outer body  210  comprises a main body proximal end  212  and a main body distal end  214 . At the proximal end  212  of the outer body  210 , a connecting member is configured so as to allow the dispense interface  200  to be attached to the distal end of the cartridge holder  40 . Preferably, the connecting member is configured so as to allow the dispense interface  200  to be removably connected the cartridge holder  40 . In one preferred interface arrangement, the proximal end of the interface  200  is configured with an upwardly extending wall  218  having at least one recess. For example, as may be seen from  FIG. 8 , the upwardly extending wall  218  comprises at least a first recess  217  and a second recess  219 . 
         [0111]    Preferably, the first and the second recesses  217 ,  219  are positioned within this main outer body wall so as to cooperate with an outwardly protruding member located near the distal end of the cartridge housing  40  of the drug delivery device  10 . For example, this outwardly protruding member  48  of the cartridge housing may be seen in  FIGS. 4 and 5 . A second similar protruding member is provided on the opposite side of the cartridge housing. As such, when the interface  200  is axially slid over the distal end of the cartridge housing  40 , the outwardly protruding members will cooperate with the first and second recess  217 ,  219  to form an interference fit, form fit, or snap lock. Alternatively, and as those of skill in the art will recognize, any other similar connection mechanism that allows for the dispense interface and the cartridge housing  40  to be axially coupled could be used as well. 
         [0112]    The main outer body  210  and the distal end of the cartridge holder  40  act to form an axially engaging snap lock or snap fit arrangement that could be axially slid onto the distal end of the cartridge housing. In one alternative arrangement, the dispense interface  200  may be provided with a coding feature so as to prevent inadvertent dispense interface cross use. That is, the inner body of the hub could be geometrically configured so as to prevent an inadvertent cross use of one or more dispense interfaces. 
         [0113]    A mounting hub is provided at a distal end of the main outer body  210  of the dispense interface  200 . Such a mounting hub can be configured to be releasably connected to a needle assembly. As just one example, this connecting means  216  may comprise an outer thread that engages an inner thread provided along an inner wall surface of a needle hub of a needle assembly, such as the needle assembly  400  illustrated in  FIG. 6 . Alternative releasable connectors may also be provided such as a snap lock, a snap lock released through threads, a bayonet lock, a form fit, or other similar connection arrangements. 
         [0114]    The dispense interface  200  further comprises a first inner body  220 . Certain details of this inner body are illustrated in  FIG. 8-11 . Preferably, this first inner body  220  is coupled to an inner surface  215  of the extending wall  218  of the main outer body  210 . More preferably, this first inner body  220  is coupled by way of a rib and groove form fit arrangement to an inner surface of the outer body  210 . For example, as can be seen from  FIG. 9 , the extending wall  218  of the main outer body  210  is provided with a first rib  213   a  and a second rib  213   b . This first rib  213   a  is also illustrated in  FIG. 10 . These ribs  213   a  and  213   b  are positioned along the inner surface  215  of the wall  218  of the outer body  210  and create a form fit or snap lock engagement with cooperating grooves  224   a  and  224   b  of the first inner body  220 . In an embodiment, these cooperating grooves  224   a  and  224   b  are provided along an outer surface  222  of the first inner body  220 . 
         [0115]    In addition, as can be seen in  FIG. 8-10 , a proximal surface  226  near the proximal end of the first inner body  220  may be configured with at least a first proximally positioned piercing needle  240  comprising a proximal piercing end portion  244 . Similarly, the first inner body  220  is configured with a second proximally positioned piercing needle  250  comprising a proximally piercing end portion  254 . Both the first and second needles  240 ,  250  are rigidly mounted on the proximal surface  226  of the first inner body  220 . 
         [0116]    Preferably, this dispense interface  200  further comprises a valve arrangement. Such a valve arrangement could be constructed so as to prevent cross contamination of the first and second medicaments contained in the first and second reservoirs, respectively. A preferred valve arrangement may also be configured so as to prevent back flow and cross contamination of the first and second medicaments. 
         [0117]    In one preferred system, dispense interface  200  includes a valve arrangement in the form of a valve seal  260 . Such a valve seal  260  may be provided within a cavity  231  defined by the second inner body  230 , so as to form a holding chamber  280 . Preferably, cavity  231  resides along an upper surface of the second inner body  230 . This valve seal comprises an upper surface that defines both a first fluid groove  264  and second fluid groove  266 . For example,  FIG. 9  illustrates the position of the valve seal  260 , seated between the first inner body  220  and the second inner body  230 . During an injection step, this seal valve  260  helps to prevent the primary medicament in the first pathway from migrating to the secondary medicament in the second pathway, while also preventing the secondary medicament in the second pathway from migrating to the primary medicament in the first pathway. Preferably, this seal valve  260  comprises a first non-return valve  262  and a second non-return valve  268 . As such, the first non-return valve  262  prevents fluid transferring along the first fluid pathway  264 , for example a groove in the seal valve  260 , from returning back into this pathway  264 . Similarly, the second non-return valve  268  prevents fluid transferring along the second fluid pathway  266  from returning back into this pathway  266 . 
         [0118]    Together, the first and second grooves  264 ,  266  converge towards the non-return valves  262  and  268  respectively, to then provide for an output fluid path or a holding chamber  280 . This holding chamber  280  is defined by an inner chamber defined by a distal end of the second inner body both the first and the second non return valves  262 ,  268  along with a pierceable septum  270 . As illustrated, this pierceable septum  270  is positioned between a distal end portion of the second inner body  230  and an inner surface defined by the needle hub of the main outer body  210 . 
         [0119]    The holding chamber  280  terminates at an outlet port of the interface  200 . This outlet port  290  is preferably centrally located in the needle hub of the interface  200  and assists in maintaining the pierceable seal  270  in a stationary position. As such, when a double ended needle assembly is attached to the needle hub of the interface (such as the double ended needle illustrated in  FIG. 6 ), the output fluid path allows both medicaments to be in fluid communication with the attached needle assembly. 
         [0120]    The hub interface  200  further comprises a second inner body  230 . As can be seen from  FIG. 9 , this second inner body  230  has an upper surface that defines a recess, and the valve seal  260  is positioned within this recess. Therefore, when the interface  200  is assembled as shown in  FIG. 9 , the second inner body  230  will be positioned between a distal end of the outer body  210  and the first inner body  220 . Together, second inner body  230  and the main outer body hold the septum  270  in place. The distal end of the inner body  230  may also form a cavity or holding chamber that can be configured to be fluid communication with both the first groove  264  and the second groove  266  of the valve seal. 
         [0121]    Axially sliding the main outer body  210  over the distal end of the drug delivery device attaches the dispense interface  200  to the multi-use device. In this manner, a fluid communication may be created between the first needle  240  and the second needle  250  with the primary medicament of the first cartridge and the secondary medicament of the second cartridge, respectively. 
         [0122]      FIG. 11  illustrates the dispense interface  200  after it has been attached to the distal end  42  of the cartridge holder  40  of the drug delivery device  10  illustrated in  FIG. 1 . A double ended needle  400  is also attached to the distal end of this interface. The cartridge holder  40  is illustrated as having a first cartridge containing a first medicament and a second cartridge containing a second medicament. 
         [0123]    When the interface  200  is first attached to the distal end of the cartridge holder  40 , the proximal piercing end  244  of the first piercing needle  240  pierces the septum of the first cartridge  90  and thereby resides in fluid communication with the primary medicament  92  of the first cartridge  90 . A distal end of the first piercing needle  240  will also be in fluid communication with a first fluid path groove  264  defined by the valve seal  260 . 
         [0124]    Similarly, the proximal piercing end  254  of the second piercing needle  250  pierces the septum of the second cartridge  100  and thereby resides in fluid communication with the secondary medicament  102  of the second cartridge  100 . A distal end of this second piercing needle  250  will also be in fluid communication with a second fluid path groove  266  defined by the valve seal  260 . 
         [0125]      FIG. 11  illustrates an embodiment of such a dispense interface  200  that is coupled to a distal end  15  of the main body  14  of drug delivery device  10 . Preferably, such a dispense interface  200  is removably coupled to the cartridge holder  40  of the drug delivery device  10 . 
         [0126]    As illustrated in  FIG. 11 , the dispense interface  200  is coupled to the distal end of a cartridge housing  40 . This cartridge holder  40  is illustrated as containing the first cartridge  90  containing the primary medicament  92  and the second cartridge  100  containing the secondary medicament  102 . Once coupled to the cartridge housing  40 , the dispense interface  200  essentially provides a mechanism for providing a fluid communication path from the first and second cartridges  90 ,  100  to the common holding chamber  280 . This holding chamber  280  is illustrated as being in fluid communication with a dose dispenser. Here, as illustrated, this dose dispenser comprises the double ended needle assembly  400 . As illustrated, the proximal end of the double ended needle assembly is in fluid communication with the chamber  280 . 
         [0127]    In one embodiment, the dispense interface is configured so that it attaches to the main body in only one orientation, that is it is fitted only one way round. As such as illustrated in  FIG. 11 , once the dispense interface  200  is attached to the cartridge holder  40 , the primary needle  240  can only be used for fluid communication with the primary medicament  92  of the first cartridge  90  and the interface  200  would be prevented from being reattached to the holder  40  so that the primary needle  240  could now be used for fluid communication with the secondary medicament  102  of the second cartridge  100 . Such a one way around connecting mechanism may help to reduce potential cross contamination between the two medicaments  92  and  102 . 
         [0128]      FIGS. 12   a  and  b  illustrate an embodiment of a receiving opening  300  of a reuse protection for the dispense interface illustrated in  FIG. 4 . For instance, the receiving opening  300  comprising the blades  302   a - 302   j  is a moulded plastic part. 
         [0129]    As illustrated in  FIGS. 12   a  and  b , the lateral surface of the receiving opening  300  is formed from blades  301  (i.e. blades  301   a - 301   j ). In  FIG. 12   a  and  b  the blades  301  form the lateral surface of a truncated cone. Accordingly, the receiving opening  300  is truncated cone-shaped. Therein, the truncated end of the receiving opening  300  is open (see opening  304 ). The opening  304  has the opening diameter  305  (e.g. opening diameters  305   a  and  b ). The blades  301  have distal edges  302  (i.e. edges  302   a - 302   j , respectively). The distal edges  302  of the blades  301  are tilting edges such that the blades  301  are elastically tilting around the distal edges  302 . The elasticity causes an elastic force that constricts the blades  301 , for instance in the direction of the center of opening  304 . The blades  301  have proximal edges  303  (i.e. edges  303   a - 303   j , respectively), which define the opening  304 . 
         [0130]    In  FIG. 12   a , the blades  301  are in a first tilt position. Therein, the adjacent edges of the blades  301  are meeting such that the lateral surface of the receiving opening  300  is closed and the blades  301  are constricted. Thus, the receiving opening  300  is in a relaxed condition and the opening  304  has the minimum opening diameter  305   a.    
         [0131]    In  FIG. 12   b , the blades  301  are in a second tilt position and form the lateral surface of the receiving opening  300 . Therein, the lateral surface of the receiving opening  300  is partially opened and opening  304  has the opening diameter  305   b . The opening diameter  305   b  is bigger than the opening diameter  305   a . Thus, the receiving opening is in a spread condition. 
         [0132]    Due to the elastic force constricting the blades  301 , a counterforce pushing apart the blades  301  has to be applied to maintain the opening diameter  305   b  of the receiving opening  300 ; otherwise, the blades  301  will return to the first tilt position. 
         [0133]    In  FIG. 12   c , a ring-shaped spreader  600  is inserted in opening  304  of the receiving opening  300 . Therein, the proximal edges  303  of the blades  301  are forced in touch with the lateral surface of the spreader  600  by the elastic force as described above. The spreader has a ring-opening  601 . Since the outer diameter  602  of the spreader  600  equals the opening diameter  305   b  of the receiving opening  300  illustrated in  FIG. 12   b , the spreader  600  pushes apart (i.e. spreads) the blades  301  and prevent the blades  301  from returning to the first tilt position. The opening diameter  305   b  of opening  304  is maintained as long as the spreader is inserted in the opening  304  of the receiving opening. Accordingly, this position of the spreader  600  is called spreading position. 
         [0134]      FIG. 13   a  to  d  illustrate a cross-sectional view of the receiving opening  300  illustrated in  FIGS. 12   a  and  b  mounted on the dispense interface  200  illustrated in  FIG. 4 . 
         [0135]    In  FIG. 13   a  to  d , the receiving opening  300  is mounted on the proximal surface  226  of the dispense interface  200 . Therein, the receiving opening  300  at least partially encompasses the first proximally positioned piercing needle  240  and the proximal piercing end portion  244  thereof. Another, receiving opening  300  may similarly encompass the second proximally positioned piercing needle  250 . 
         [0136]    A spreader  500  is inserted in opening  304  of the receiving opening  300 . The lateral surface of the spreader  500  is at least partially formed as a truncated cone with a tapered surface  501  and a notch  502 . Alternatively, the lateral surface of the spreader  500  may at least partially be formed as a truncated cone with a tapered surface  501  but without a notch  502 . Alternatively or additionally, the lateral surface of the spreader  500  may at least partially be formed as a cylinder (e.g. the spreader may be the ring-shaped spreader illustrated in  FIG. 12   c ). 
         [0137]    The notch  502  is arranged at the truncated end of spreader  500 . At the truncated end and/or at the notch  502 , the spreader  500  has the minimum outer diameter  503 . The minimum outer diameter  503  of the spreader  500  equals the minimum opening diameter  305   a  of the receiving opening  300  illustrated in  FIG. 12   a.    
         [0138]    At the base, the spreader  500  has the maximum outer diameter  504 . The maximum outer diameter  504  equals the opening diameter  305   b  of the receiving opening  300  illustrated in  FIG. 12   b . Furthermore, spreader  500  is hollow and has a longitudinal opening  505 . 
         [0139]    As illustrated in  FIG. 13   a , the proximal edges  303  of the blades  301  engage with the notch  502  such that the receiving opening is in the relaxed condition illustrated in  FIG. 12 . Therein, the spreader  500  is secured in this position by the proximal edges  303  of the blades  301  forced in engagement with notch  502  by the elastic force as described above. For instance, the spreader  500  may be arranged in the receiving opening  300  as illustrated in  FIG. 13   a  during the production of the dispense interface  200 . 
         [0140]      FIG. 13   b  illustrates the situation, during the attachment of the dispense interface  200  illustrated in  FIG. 13   a  to the drug delivery device  10  illustrated in  FIG. 1 . In particular, the dispense interface  200  is attached to the distal end  42  of the cartridge holder  40  of the drug delivery device  10  as described above. 
         [0141]    In order to attach the dispense interface  200  to the drug delivery device  10 , the distal end  42  of the cartridge holder  40  relatively moves in the direction A. Therein, the distal end  42  of the cartridge holder  40  pushes the spreader  500  in the direction A into the receiving opening. Due to the movement of the spreader  500  in the direction A, the proximal edges  303  of blades  301  slip along the tapered surface  501  of the spreader  500  such that the receiving opening  300  is spread by the spreader  500  and the opening diameter  305  of the receiving opening  300  enlarges. 
         [0142]    The use of a spreader with a tapered surface and a notch is inter-alia advantageous in order to prevent a deterioration of the elasticity of the receiving opening, which may appear if the receiving opening is spread for a longer time such as the time between the production of the dispense interface and the attachment of the dispense interface to a drug delivery device. 
         [0143]    As illustrated in  FIG. 13   b , the proximal edges  303  encompass the base of the spreader  500 . The diameter of the base of the spreader is the maximum outer diameter  504  of the spreader  500  and equals the opening diameter  305   b  of the receiving opening  300  illustrated in  FIG. 12   b . Furthermore, the maximum outer diameter  504  of the spreader  500  equals the outer diameter  43  of the distal end  42  of the cartridge holder  40 . Thus, the receiving opening  300  is in the spread condition, the spreader  500  is in the spreading position and the distal end  42  of the cartridge holder  40  is receivable in the receiving opening  300 . The diameter of the base  306  of the receiving opening  300  is at least as big as the opening diameter  305   b  of the receiving opening  300 . 
         [0144]      FIG. 13   c  illustrates the situation, when the dispense interface  200  illustrated in  FIG. 13   a  is attached to the drug delivery device  10  illustrated in  FIG. 1 . As illustrated in  FIG. 13   c , the distal end  42  of the cartridge holder  40  is received in the receiving opening  300 . Therein, the proximal edges  303  of the blades  301  touch the distal end  42  of the cartridge holder  40  and the spreader is arranged at the base  306  of the receiving opening  300 . The first proximally positioned piercing needle  240  of the dispense interface protrudes through opening  505  of the spreader  500 . The proximal piercing end portion  244  of the first proximally positioned piercing needle  240  pierces the septum of the first cartridge  90  and thereby resides in fluid communication with the primary medicament  92  of the first cartridge  90  as described above. 
         [0145]      FIG. 13   d  illustrates the situation, when the dispense interface  200  illustrated in  FIG. 13   a  is removed from the drug delivery device  10  illustrated in  FIG. 1 . Therein, the receiving opening  300  is returned to the relaxed condition illustrated in  FIG. 12   a  by the elastic force as described above. The blades  301  are constricted and lock the spreader  500  at the base  306  of the receiving opening. The opening diameter  305   a  is smaller than the outer diameter  43  of the distal end  42  of the cartridge holder  40 . Thus, the spreader  500  is locked in the relaxing position and a reattachment of the dispense interface  200  to the drug delivery device  10  is prevented. 
         [0146]    As illustrated in  FIG. 13   a  to  d , the reuse protection comprising the receiving opening  300  prevents the reuse (e.g. the reattachment) of the dispense interface  200 . The reuse protection illustrated in  FIG. 13   a  to  d  is not limited to the dispense interface  200  as illustrated in  FIG. 4 . The reuse protection may also be used to prevent the reuse of a needle assembly such as needle assembly  400 . 
         [0147]    The term “drug” or “medicament”, as used herein, means a pharmaceutical formulation containing at least one pharmaceutically active compound, 
         [0148]    wherein in one embodiment the pharmaceutically active compound has a molecular weight up to 1500 Da and/or is a peptide, a proteine, a polysaccharide, a vaccine, a DNA, a RNA, an enzyme, an antibody or a fragment thereof, a hormone or an oligonucleotide, or a mixture of the above-mentioned pharmaceutically active compound, 
         [0149]    wherein in a further embodiment the pharmaceutically active compound is useful for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy, thromboembolism disorders such as deep vein or pulmonary thromboembolism, acute coronary syndrome (ACS), angina, myocardial infarction, cancer, macular degeneration, inflammation, hay fever, atherosclerosis and/or rheumatoid arthritis, 
         [0150]    wherein in a further embodiment the pharmaceutically active compound comprises at least one peptide for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy, 
         [0151]    wherein in a further embodiment the pharmaceutically active compound comprises at least one human insulin or a human insulin analogue or derivative, glucagon-like peptide (GLP-1) or an analogue or derivative thereof, or exedin-3 or exedin-4 or an analogue or derivative of exedin-3 or exedin-4. 
         [0152]    Insulin analogues are for example Gly(A21), Arg(B31), Arg(B32) human insulin; Lys(B3), Glu(B29) human insulin; Lys(B28), Pro(B29) human insulin; Asp(B28) human insulin; human insulin, wherein proline in position B28 is replaced by Asp, Lys, Leu, Val or Ala and wherein in position B29 Lys may be replaced by Pro; Ala(B26) human insulin; Des(B28-B30) human insulin; Des(B27) human insulin and Des(B30) human insulin. 
         [0153]    Insulin derivates are for example B29-N-myristoyl-des(B30) human insulin; B29-N-palmitoyl-des(B30) human insulin; B29-N-myristoyl human insulin; B29-N-palmitoyl human insulin; B28-N-myristoyl LysB28ProB29 human insulin; B28-N-palmitoyl-LysB28ProB29 human insulin; B30-N-myristoyl-ThrB29LysB30 human insulin; B30-N-palmitoyl-ThrB29LysB30 human insulin; B29-N—(N-palmitoyl-Y-glutamyl)-des(B30) human insulin; B29-N—(N-lithocholyl-Y-glutamyl)-des(B30) human insulin; B29-N-(Ω-carboxyheptadecanoyl)-des(B30) human insulin and B29-N-(Ω-carboxyheptadecanoyl) human insulin. 
         [0154]    Exendin-4 for example means Exendin-4(1-39), a peptide of the sequence H-His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH2. 
         [0155]    Exendin-4 derivatives are for example selected from the following list of compounds: 
         [0156]    H-(Lys)4-des Pro36, des Pro37 Exendin-4(1-39)-NH2, 
         [0157]    H-(Lys)5-des Pro36, des Pro37 Exendin-4(1-39)-NH2, 
         [0158]    des Pro36 [Asp28] Exendin-4(1-39), 
         [0159]    des Pro36 [IsoAsp28] Exendin-4(1-39), 
         [0160]    des Pro36 [Met(O)14, Asp28] Exendin-4(1-39), 
         [0161]    des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39), 
         [0162]    des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39), 
         [0163]    des Pro36 [Trp(O2)25, IsoAsp28] Exendin-4(1-39), 
         [0164]    des Pro36 [Met(O)14 Trp(O2)25, Asp28] Exendin-4(1-39), 
         [0165]    des Pro36 [Met(O)14 Trp(O2)25, IsoAsp28] Exendin-4(1-39); or 
         [0166]    des Pro36 [Asp28] Exendin-4(1-39), 
         [0167]    des Pro36 [IsoAsp28] Exendin-4(1-39), 
         [0168]    des Pro36 [Met(O)14, Asp28] Exendin-4(1-39), 
         [0169]    des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39), 
         [0170]    des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39), 
         [0171]    des Pro36 [Trp(O2)25, IsoAsp28] Exendin-4(1-39), 
         [0172]    des Pro36 [Met(O)14 Trp(O2)25, Asp28] Exendin-4(1-39), 
         [0173]    des Pro36 [Met(O)14 Trp(O2)25, IsoAsp28] Exendin-4(1-39), 
         [0174]    wherein the group -Lys6-NH2 may be bound to the C-terminus of the Exendin-4 derivative; 
         [0175]    or an Exendin-4 derivative of the sequence 
         [0176]    H-(Lys)6-des Pro36 [Asp28] Exendin-4(1-39)-Lys6-NH2, 
         [0177]    des Asp28 Pro36, Pro37, Pro38Exendin-4(1-39)-NH2, 
         [0178]    H-(Lys)6-des Pro36, Pro38 [Asp28] Exendin-4(1-39)-NH2, 
         [0179]    H-Asn-(Glu)5des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-NH2, 
         [0180]    des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0181]    H-(Lys)6-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0182]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0183]    H-(Lys)6-des Pro36 [Trp(O2)25, Asp28] Exendin-4(1-39)-Lys6-NH2, 
         [0184]    H-des Asp28 Pro36, Pro37, Pro38 [Trp(O2)25] Exendin-4(1-39)-NH2, 
         [0185]    H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-NH2, 
         [0186]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-NH2, 
         [0187]    des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0188]    H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0189]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0190]    H-(Lys)6-des Pro36 [Met(O)14, Asp28] Exendin-4(1-39)-Lys6-NH2, 
         [0191]    des Met(O)14 Asp28 Pro36, Pro37, Pro38 Exendin-4(1-39)-NH2, 
         [0192]    H-(Lys)6-desPro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2, 
         [0193]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2, 
         [0194]    des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0195]    H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0196]    H-Asn-(Glu)5 des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0197]    H-Lys6-des Pro36 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-Lys6-NH2, 
         [0198]    H-des Asp28 Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25] Exendin-4(1-39)-NH2, 
         [0199]    H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)—NH2, 
         [0200]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-NH2, 
         [0201]    des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, 
         [0202]    H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(S1-39)-(Lys)6-NH2, 
         [0203]    H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2; 
         [0204]    or a pharmaceutically acceptable salt or solvate of any one of the aforementioned Exedin-4 derivative. 
         [0205]    Hormones are for example hypophysis hormones or hypothalamus hormones or regulatory active peptides and their antagonists as listed in Rote Liste, ed. 2008, Chapter 50, such as Gonadotropine (Follitropin, Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin), Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin, Buserelin, Nafarelin, Goserelin. 
         [0206]    A polysaccharide is for example a glucosaminoglycane, a hyaluronic acid, a heparin, a low molecular weight heparin or an ultra low molecular weight heparin or a derivative thereof, or a sulphated, e.g. a poly-sulphated form of the above-mentioned polysaccharides, and/or a pharmaceutically acceptable salt thereof. An example of a pharmaceutically acceptable salt of a poly-sulphated low molecular weight heparin is enoxaparin sodium. 
         [0207]    Antibodies are globular plasma proteins (˜150 kDa http://en.wikipedia.org/wiki/Dalton_%28unit%29) that are also known as immunoglobulins which share a basic structure. As they have sugar chains added to amino acid residues, they are glycoproteins. The basic functional unit of each antibody is an immunoglobulin (Ig) monomer (containing only one Ig unit); secreted antibodies can also be dimeric with two Ig units as with IgA, tetrameric with four Ig units like teleost fish IgM, or pentameric with five Ig units, like mammalian IgM. 
         [0208]    The Ig monomer is a “Y”-shaped molecule that consists of four polypeptide chains; two identical heavy chains and two identical light chains connected by disulfide bonds between cysteine residues. Each heavy chain is about 440 amino acids long; each light chain is about 220 amino acids long. Heavy and light chains each contain intrachain disulfide bonds which stabilize their folding. Each chain is composed of structural domains called Ig domains. These domains contain about 70-110 amino acids and are classified into different categories (for example, variable or V, and constant or C) according to their size and function. They have a characteristic immunoglobulin fold in which two β sheets create a “sandwich” shape, held together by interactions between conserved cysteines and other charged amino acids. 
         [0209]    There are five types of mammalian Ig heavy chain denoted by α, δ, ε, γ, and μ. The type of heavy chain present defines the isotype of antibody; these chains are found in IgA, IgD, IgE, IgG, and IgM antibodies, respectively. 
         [0210]    Distinct heavy chains differ in size and composition; α and γ contain approximately 450 amino acids and δ approximately 500 amino acids, while μ and ε have approximately 550 amino acids. Each heavy chain has two regions, the constant region (CH) and the variable region (VH). In one species, the constant region is essentially identical in all antibodies of the same isotype, but differs in antibodies of different isotypes. Heavy chains γ, α and δ have a constant region composed of three tandem Ig domains, and a hinge region for added flexibility; heavy chains μ and ε have a constant region composed of four immunoglobulin domains. The variable region of the heavy chain differs in antibodies produced by different B cells, but is the same for all antibodies produced by a single B cell or B cell clone. The variable region of each heavy chain is approximately 110 amino acids long and is composed of a single Ig domain. 
         [0211]    In mammals, there are two types of immunoglobulin light chain denoted by λ and κ. A light chain has two successive domains: one constant domain (CL) and one variable domain (VL). The approximate length of a light chain is 211 to 217 amino acids. Each antibody contains two light chains that are always identical; only one type of light chain, κ or λ, is present per antibody in mammals. 
         [0212]    Although the general structure of all antibodies is very similar, the unique property of a given antibody is determined by the variable (V) regions, as detailed above. More specifically, variable loops, three each the light (VL) and three on the heavy (VH) chain, are responsible for binding to the antigen, i.e. for its antigen specificity. These loops are referred to as the Complementarity Determining Regions (CDRs). Because CDRs from both VH and VL domains contribute to the antigen-binding site, it is the combination of the heavy and the light chains, and not either alone, that determines the final antigen specificity. 
         [0213]    An “antibody fragment” contains at least one antigen binding fragment as defined above, and exhibits essentially the same function and specificity as the complete antibody of which the fragment is derived from. Limited proteolytic digestion with papain cleaves the Ig prototype into three fragments. Two identical amino terminal fragments, each containing one entire L chain and about half an H chain, are the antigen binding fragments (Fab). The third fragment, similar in size but containing the carboxyl terminal half of both heavy chains with their interchain disulfide bond, is the crystallizable fragment (Fc). The Fc contains carbohydrates, complement-binding, and FcR-binding sites. Limited pepsin digestion yields a single F(ab′)2 fragment containing both Fab pieces and the hinge region, including the H—H interchain disulfide bond. F(ab′)2 is divalent for antigen binding. The disulfide bond of F(ab′)2 may be cleaved in order to obtain Fab′. Moreover, the variable regions of the heavy and light chains can be fused together to form a single chain variable fragment (scFv). 
         [0214]    Pharmaceutically acceptable salts are for example acid addition salts and basic salts. Acid addition salts are e.g. HCl or HBr salts. Basic salts are e.g. salts having a cation selected from alkali or alkaline, e.g. Na+, or K+, or Ca2+, or an ammonium ion N+(R1)(R2)(R3)(R4), wherein R1 to R4 independently of each other mean: hydrogen, an optionally substituted C1-C6-alkyl group, an optionally substituted C2-C6-alkenyl group, an optionally substituted C6-C10-aryl group, or an optionally substituted C6-C10-heteroaryl group. Further examples of pharmaceutically acceptable salts are described in “Remington&#39;s Pharmaceutical Sciences” 17. ed. Alfonso R. Gennaro (Ed.), Mark Publishing Company, Easton, Pa., U.S.A., 1985 and in Encyclopedia of Pharmaceutical Technology. 
         [0215]    Pharmaceutically acceptable solvates are for example hydrates.