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Kali G, Haddadzadegan S, Bernkop-Schnürch A. Cyclodextrins and derivatives in drug delivery: New developments, relevant clinical trials, and advanced products. Carbohydr Polym 2024; 324:121500. [PMID: 37985088 DOI: 10.1016/j.carbpol.2023.121500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/21/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023]
Abstract
Cyclodextrins (CD) and derivatives are functional excipients that can improve the bioavailability of numerous drugs. Because of their drug solubility improving properties they are used in many pharmaceutical products. Furthermore, the stability of small molecular drugs can be improved by the incorporation in CDs and an unpleasant taste and smell can be masked. In addition to well-established CD derivatives including hydroxypropyl-β-CD, hydroxypropyl-γ-CD, methylated- β-CD and sulfobutylated- β-CD, there are promising new derivatives in development. In particular, CD-based polyrotaxanes exhibiting cellular uptake enhancing properties, CD-polymer conjugates providing sustained drug release, enhanced cellular uptake, and mucoadhesive properties, and thiolated CDs showing mucoadhesive, in situ gelling, as well as permeation and cellular uptake enhancing properties will likely result in innovative new drug delivery systems. Relevant clinical trials showed various new applications of CDs such as the formation of CD-based nanoparticles, stabilizing properties for protein drugs or the development of ready-to-use injection systems. Advanced products are making use of various benefical properties of CDs at the same time. Within this review we provide an overview on these recent developments and take an outlook on how this class of excipients will further shape the landscape of drug delivery.
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Affiliation(s)
- Gergely Kali
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innsbruck 6020, Austria
| | - Soheil Haddadzadegan
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innsbruck 6020, Austria
| | - Andreas Bernkop-Schnürch
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innsbruck 6020, Austria.
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2
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Wang Q, Zhang A, Zhu L, Yang X, Fang G, Tang B. Cyclodextrin-based ocular drug delivery systems: A comprehensive review. Coord Chem Rev 2023. [DOI: 10.1016/j.ccr.2022.214919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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3
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Korenfeld M, Gira J, Jong K, Martel J, Vold S, Walters T, Usner D, Donnenfeld E. OCS-01 (Novel Topical Dexamethasone Formulation) in Inflammation and Pain Post Cataract Surgery: A Randomized, Double-Masked, Vehicle-Controlled Study. Clin Ther 2022; 44:1577-1587. [DOI: 10.1016/j.clinthera.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 12/13/2022]
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4
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Yang Y, Lockwood A. Topical ocular drug delivery systems: Innovations for an unmet need. Exp Eye Res 2022; 218:109006. [DOI: 10.1016/j.exer.2022.109006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/06/2022] [Accepted: 02/20/2022] [Indexed: 02/07/2023]
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5
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Loftsson T, Stefánsson E. Aqueous eye drops containing drug/cyclodextrin nanoparticles deliver therapeutic drug concentrations to both anterior and posterior segment. Acta Ophthalmol 2022; 100:7-25. [PMID: 33876553 DOI: 10.1111/aos.14861] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022]
Abstract
Using topical application to deliver therapeutic concentrations of drugs to the posterior segment of the eye remains very challenging. As a result, posterior segment diseases are usually treated by intravitreal injection or implant. While topical treatments are commonly used for anterior segment conditions, they sometimes require frequent applications. Eye drop formulations based on γ-cyclodextrin (γCD)-based nanoparticle aggregates were developed, which in animal models and clinical studies deliver therapeutic concentrations of drugs (dorzolamide and dexamethasone) to both anterior and posterior segments of the eye. An early study in humans showed dorzolamide/γCD eye drops could achieve comparable intraocular pressure decreases to commercial dorzolamide eye drops, but with less frequent application. Pilot studies with dexamethasone/γCD eye drops suggested that they could be effective in a range of conditions, including diabetic macular oedema, cystoid macular oedema and vitritis secondary to uveitis, postcataract surgery inflammation and postoperative treatment in trabeculectomy. Phase II studies with similar dexamethasone/γCD nanoparticle eye drops in diabetic macular oedema and postcataract surgery inflammation have recently been completed. This technology has the potential to be used with other classes of drug molecules and to replace or complement invasive treatments, providing safer, non-invasive therapies, particularly for posterior segment conditions, that can be self-administered as eye drops by patients.
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A Randomized, Prospective Clinical Study Evaluating Dexamethasone Intraocular Suspension 9% vs Prednisolone Acetate 1% in Controlling Postoperative Pain and Inflammation in Patients Undergoing Bilateral Sequential Cataract Surgery. J Cataract Refract Surg 2022; 48:906-911. [DOI: 10.1097/j.jcrs.0000000000000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/08/2022] [Indexed: 11/26/2022]
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Kagkelaris K, Panayiotakopoulos G, Georgakopoulos CD. Nanotechnology-based formulations to amplify intraocular bioavailability. Ther Adv Ophthalmol 2022; 14:25158414221112356. [PMID: 35873277 PMCID: PMC9301101 DOI: 10.1177/25158414221112356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
Conventional drug delivery formulations, such as eye drops and ointments, are
mainly administered by topical instillation. The topical delivery of ophthalmic
drugs is a challenging endeavor despite the eye is easily accessible. Unique and
complex barriers, serving as protection against extrinsic harmful factors,
hamper therapeutic intraocular drug concentrations. Bioavailability for deeper
ocular tissues of the anterior segment of the eye is exceptionally low. As the
bioavailability of the active substance is the major hurdle to overcome, dosing
is increased, so the side effects do. Both provoke patient poor compliance,
confining the desired therapeutic outcome. The incidence and severity of adverse
reactions amplify evenly in the case of chronic treatments. Current research
focuses on the development of innovative delivery strategies to address low
ocular bioavailability and provide safe and convenient dosing schemes. The main
objective of this review is to explore and present the latest developments in
ocular drug delivery formulations for the treatment of the pathology of the
anterior segment of the eye. Nanotechnology-based formulations, that is, organic
nanoparticles (liposomes, niosomes/discosomes, dendrimers, nanoemulsions,
nanosuspensions, nanoparticles/nanospheres) and inorganic nanoparticles,
nanoparticle-laden therapeutic contact lenses, in situ gelling
systems, and ocular inserts, are summarized and presented accordingly.
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Affiliation(s)
- Konstantinos Kagkelaris
- Department of Ophthalmology, School of Medicine, University of Patras, 26500 Patras, Greece
- Department of General Pharmacology, School of Medicine, University of Patras, Patras, Greece
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Lucia Appleton S, Navarro-Orcajada S, Martínez-Navarro FJ, Caldera F, López-Nicolás JM, Trotta F, Matencio A. Cyclodextrins as Anti-inflammatory Agents: Basis, Drugs and Perspectives. Biomolecules 2021; 11:biom11091384. [PMID: 34572597 PMCID: PMC8472668 DOI: 10.3390/biom11091384] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022] Open
Abstract
Inflammation is a biological response of the immune system to harmful stimuli. Importantly, inflammation is also a hallmark of several human diseases such as cancer or diabetes. Novel drugs to treat this response are constantly researched, but the formulation is usually forgotten. Cyclodextrins (CDs) are a well-known excipient for complexing and drug delivery. Anti-inflammatory drugs and bioactive compounds with similar activities have been favored from these CD processes. CDs also illustrate anti-inflammatory activity per se. This review tried to describe the capacities of CDs in this field, and is divided into two parts: Firstly, a short description of the inflammation disease (causes, symptoms, treatment) is explained; secondly, the effects of different CDs alone or forming inclusion complexes with drugs or bioactive compounds are discussed.
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Affiliation(s)
- Silvia Lucia Appleton
- Dip. Di Chimica, Università di Torino, via P. Giuria 7, 10125 Torino, Italy; (S.L.A.); (F.C.); (F.T.)
| | - Silvia Navarro-Orcajada
- Departamento de Bioquímica y Biología Molecular A, Unidad Docente de Biología, Facultad de Veterinaria, Regional Campus of International Excellence “Campus Mare Nostrum”, Universidad de Murcia, 30100 Murcia, Spain; (S.N.-O.); (J.M.L.-N.)
| | - Francisco Juan Martínez-Navarro
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Medicine (Hepatology), Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: (F.J.M.-N.); or (A.M.)
| | - Fabrizio Caldera
- Dip. Di Chimica, Università di Torino, via P. Giuria 7, 10125 Torino, Italy; (S.L.A.); (F.C.); (F.T.)
| | - José Manuel López-Nicolás
- Departamento de Bioquímica y Biología Molecular A, Unidad Docente de Biología, Facultad de Veterinaria, Regional Campus of International Excellence “Campus Mare Nostrum”, Universidad de Murcia, 30100 Murcia, Spain; (S.N.-O.); (J.M.L.-N.)
| | - Francesco Trotta
- Dip. Di Chimica, Università di Torino, via P. Giuria 7, 10125 Torino, Italy; (S.L.A.); (F.C.); (F.T.)
| | - Adrián Matencio
- Dip. Di Chimica, Università di Torino, via P. Giuria 7, 10125 Torino, Italy; (S.L.A.); (F.C.); (F.T.)
- Correspondence: (F.J.M.-N.); or (A.M.)
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Lorenzo-Veiga B, Alvarez-Lorenzo C, Loftsson T, Sigurdsson HH. Age-related ocular conditions: Current treatments and role of cyclodextrin-based nanotherapies. Int J Pharm 2021; 603:120707. [PMID: 33991594 DOI: 10.1016/j.ijpharm.2021.120707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 02/03/2023]
Abstract
Age-related eye disorders are chronic diseases that affect millions of people worldwide. They cause visual impairment and, in some cases, irreversible blindness. Drug targeting to the retina is still a challenge due to the difficulties with drug distribution, crossing eye barriers, and reaching intraocular tissues in an effective therapeutic concentration. Although intravitreal injections can directly deliver drugs to the posterior segment of the eye, it remains an invasive technique and leads to several side effects. Conventional formulations such as emulsions, suspensions, or ointments have been related to frequent instillation and inability to reach intraocular tissues. New drug delivery systems and medical devices have also been designed. Nevertheless, these treatments are not always effective and sometimes require the presence of a specialist for the administration of the dose. Therefore, treatments for age-related ocular diseases remain as one of the major unmet clinical needs to manage these widespread eye conditions. Nanotechnology may become the adequate tool for developing effective and non-invasive therapies suitable for self-administration. In this review, we discuss emerging therapeutic options based on nanoengineering of cyclodextrin nanocarriers for the treatment of age-related eye disorders, including their pathophysiology, pharmacological options, and feasibility of clinical translation.
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Affiliation(s)
- Blanca Lorenzo-Veiga
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
| | - Carmen Alvarez-Lorenzo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D-Farma Group (GI-1645), Facultad de Farmacia and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
| | - Hakon Hrafn Sigurdsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
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10
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Jóhannesson G, Gottfredsdóttir MS, Ásgrimsdóttir GM, Loftsson T, Stefánsson E. Can postoperative dexamethasone nanoparticle eye drops replace mitomycin C in trabeculectomy? Acta Ophthalmol 2020; 98:607-612. [PMID: 32067381 DOI: 10.1111/aos.14370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Compare (a) nonmitomycin C (MMC) trabeculectomy and 1.5% dexamethasone nanoparticle (DexNP) eye drops postoperatively with (b) trabeculectomy with MMC and Maxidex® eye drops postoperatively. METHODS Randomized prospective single masked clinical trial with 20 patients with primary open-angle glaucoma undergoing primary trabeculectomy. The study group consisted of 10 patients without MMC intraoperatively and postoperative DexNP eye drops, and the control group consisted of 10 patients treated with MMC intraoperatively and postoperative Maxidex® . The drops were tapered out over 8 weeks. The main outcome measures were as follows: rates of complete success, that is intraocular pressure (IOP) within target pressures at different time-points without IOP-lowering medication, or reoperation. Secondary outcome measures included the following: relative success rate (with IOP-lowering medications), number of glaucoma medications and reoperations. Patients were followed for 36 months. RESULTS Both groups showed similar postoperative course and IOP reduction. Intraocular pressures (IOPs) in the DexNP group and in the control group were 25.6 and 24.4 mmHg, respectively, at baseline. Intraocular pressures (IOPs) were reduced to 13.2 and 14.5 mmHg at 12 months, 11.7 and 12.6 mmHg at 24 months and 11.7 and 12.1 mmHg at 36 months, respectively. There were no statistically significant differences between the groups in absolute (p = 0.36) or relative (p = 1.0) success rates, number of medications (p = 0.71) or reoperations (p = 1.0) between the groups at any time-point. CONCLUSIONS DexNP eye drops are effective postoperative treatment following trabeculectomy. The potent anti-inflammatory and antifibrotic effect of DexNP may offer an alternative to mitomycin C in glaucoma surgery.
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Affiliation(s)
- Gauti Jóhannesson
- Department of Clinical Sciences Ophthalmology Umeå University Umeå Sweden
- Wallenberg Centre for Molecular Medicine Umeå University Umeå Sweden
- Department of Ophthalmology Faculty of Medicine National University Hospital University of Iceland Reykjavik Iceland
| | - María Soffía Gottfredsdóttir
- Department of Ophthalmology Faculty of Medicine National University Hospital University of Iceland Reykjavik Iceland
| | | | - Thorsteinn Loftsson
- Oculis ehf. Reykjavik Iceland
- Faculty of Pharmaceutical Science University of Iceland Reykjavik Iceland
| | - Einar Stefánsson
- Department of Ophthalmology Faculty of Medicine National University Hospital University of Iceland Reykjavik Iceland
- Oculis ehf. Reykjavik Iceland
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11
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Brooks CC, Jabbehdari S, Gupta PK. Dexamethasone 0.4mg Sustained-Release Intracanalicular Insert in the Management of Ocular Inflammation and Pain Following Ophthalmic Surgery: Design, Development and Place in Therapy. Clin Ophthalmol 2020; 14:89-94. [PMID: 32021072 PMCID: PMC6968807 DOI: 10.2147/opth.s238756] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 12/19/2019] [Indexed: 01/19/2023] Open
Abstract
Inflammation and pain are two prevalent findings after ocular surgery. Corticosteroids are widely administrated as a core treatment to control post-surgical inflammation and pain. Improper patient adherence to post-operative eye drop regimens, limited bioavailability of topical eye drops, and the negative impact of preservatives used in many of these eye drops, has made a strong case for novel therapies in the treatment of post-operative pain and inflammation. This review of the literature will focus on the role of intracanalicular sustained-release dexamethasone (Dextenza, Ocular Therapeutix, Bedford, MA, USA) for the management of ocular inflammation and pain.
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Affiliation(s)
- Cassandra C Brooks
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
| | - Sayena Jabbehdari
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Preeya K Gupta
- Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA
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12
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Jug M. Cyclodextrin-based drug delivery systems. NANOMATERIALS FOR CLINICAL APPLICATIONS 2020:29-69. [DOI: 10.1016/b978-0-12-816705-2.00002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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13
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Binevski PV, Balabushevich NG, Uvarova VI, Vikulina AS, Volodkin D. Bio-friendly encapsulation of superoxide dismutase into vaterite CaCO3 crystals. Enzyme activity, release mechanism, and perspectives for ophthalmology. Colloids Surf B Biointerfaces 2019; 181:437-449. [DOI: 10.1016/j.colsurfb.2019.05.077] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/22/2019] [Accepted: 05/30/2019] [Indexed: 12/22/2022]
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Gote V, Sikder S, Sicotte J, Pal D. Ocular Drug Delivery: Present Innovations and Future Challenges. J Pharmacol Exp Ther 2019; 370:602-624. [DOI: 10.1124/jpet.119.256933] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/01/2019] [Indexed: 12/12/2022] Open
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Mazet R, Choisnard L, Levilly D, Wouessidjewe D, Gèze A. Investigation of Combined Cyclodextrin and Hydrogel Formulation for Ocular Delivery of Dexamethasone Acetate by Means of Experimental Designs. Pharmaceutics 2018; 10:pharmaceutics10040249. [PMID: 30513707 PMCID: PMC6320851 DOI: 10.3390/pharmaceutics10040249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/16/2022] Open
Abstract
Dexamethasone acetate (DXMa) has proven its efficiency to treat corneal inflammation, without a great propensity to increase intraocular pressure. Unfortunately, its poor aqueous solubility, associated with a rapid precorneal elimination, results in a low drug bioavailability and a low penetration after topical ocular administration. The main objective of this study was to improve the apparent aqueous solubility of DXMa using cyclodextrins. First, hydroxypropyl-β-CD (HPβCD) and hydroxypropyl-γ-CD (HPγCD) were used to enhance DXMa concentration in aqueous solution. The β and γ HPCD derivatives allowed the increase of the DXMa amount in solution at 25 °C by a factor of 500 and 1500, respectively. Second, with the aim of improving the persistence of the complex solution after instillation in the eye, the formulations of DXMa-based CD solutions with marketed ophthalmic gels (CELLUVISC®, GEL-LARMES®, and VISMED®) were investigated and optimized by means of special cubic mixture designs, allowing the defining of mixed gels loaded with 0.7% (HPβCD) and 2% (HPγCD) DXMa with osmolality within acceptable physiological range. Finally, in vitro drug release assays from the mixed gels were performed and compared with reference eye drops. Similarly to MAXIDEX® and DEXAFREE®, in the case of mixed gel containing HPβCD, more than 90% of the drug was released within 2 h, while in mixed gel containing HPγCD, the release of DXMa was partial, reaching ≈60% in 2 h. This difference will have to be further addressed with ex vivo and in vivo ocular delivery experiments.
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Affiliation(s)
- Roseline Mazet
- Faculty of Pharmacy, University of Grenoble Alpes, DPM, UMR CNRS 5063, ICMG FR 2607, F-38400 Saint Martin d'Hères, France.
- Pôle Pharmacie, Grenoble University Hospital, 38000 Grenoble, France.
| | - Luc Choisnard
- Faculty of Pharmacy, University of Grenoble Alpes, DPM, UMR CNRS 5063, ICMG FR 2607, F-38400 Saint Martin d'Hères, France.
| | - Delphine Levilly
- Faculty of Pharmacy, University of Grenoble Alpes, DPM, UMR CNRS 5063, ICMG FR 2607, F-38400 Saint Martin d'Hères, France.
| | - Denis Wouessidjewe
- Faculty of Pharmacy, University of Grenoble Alpes, DPM, UMR CNRS 5063, ICMG FR 2607, F-38400 Saint Martin d'Hères, France.
| | - Annabelle Gèze
- Faculty of Pharmacy, University of Grenoble Alpes, DPM, UMR CNRS 5063, ICMG FR 2607, F-38400 Saint Martin d'Hères, France.
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Pepose JS, Ahuja A, Liu W, Narvekar A, Haque R. Randomized, Controlled, Phase 2 Trial of Povidone-Iodine/Dexamethasone Ophthalmic Suspension for Treatment of Adenoviral Conjunctivitis. Am J Ophthalmol 2018; 194:7-15. [PMID: 29787732 DOI: 10.1016/j.ajo.2018.05.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE To evaluate the efficacy/safety of an ophthalmic suspension of povidone-iodine (PVP-I) 0.6% and dexamethasone 0.1% in patients with acute adenoviral conjunctivitis. DESIGN Multicenter, randomized, vehicle-controlled, double-masked trial. METHODS Adults with a positive Rapid Pathogen Screening Adeno-Detector Plus test were randomized 1:1:1 to PVP-I 0.6%/dexamethasone 0.1%, PVP-I 0.6%, or vehicle, bilaterally 4 times daily for 5 days (days 1-5). Patients were evaluated on days 3, 6, and 12 (+1-day window). Efficacy measures included clinical resolution and adenoviral eradication. RESULTS Overall, 144 patients were included in the efficacy analysis (PVP-I/dexamethasone, n = 48; PVP-I, n = 50; vehicle, n = 46). The proportion of patients with clinical resolution (primary study eye with last observation carried forward [LOCF]) at the day 6 visit was higher with PVP-I/dexamethasone (31.3%) than with vehicle (10.9%; P = .0158) and PVP-I (18.0%; P = nonsignificant). The proportion with adenoviral eradication (primary study eye with LOCF) was higher with PVP-I/dexamethasone than with vehicle at the day 3 (35.4% vs 8.7%; P = .0019) and day 6 (79.2% vs 56.5%; P = .0186) visits and vs PVP-I (day 3 visit, 32.0%; day 6 visit, 62.0%; each P = nonsignificant). Treatment-emergent adverse events (AEs) occurred in 69.0% (vehicle), 62.7% (PVP-I), and 53.4% (PVP-I/dexamethasone) of patients in the safety dataset. Discontinuation owing to AEs occurred in 37 patients (vehicle, n = 16; PVP-I, n = 12; PVP-I/dexamethasone, n = 9). CONCLUSION PVP-I/dexamethasone appeared safe and well tolerated, and significantly improved clinical resolution and adenoviral eradication in patients with acute adenoviral conjunctivitis.
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17
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Pharmaceutical challenges and perspectives in developing ophthalmic drug formulations. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2018. [DOI: 10.1007/s40005-018-0404-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Nikolskaya II, Beznos OV, Eltsov AI, Gachok IV, Chesnokova NB, Varlamov VP, Kost OA. The Inclusion of Timolol and Lisinopril in Calcium Phosphate Particles Covered by Chitosan: Application in Ophthalmology. ACTA ACUST UNITED AC 2018. [DOI: 10.3103/s0027131418020116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Jansook P, Ogawa N, Loftsson T. Cyclodextrins: structure, physicochemical properties and pharmaceutical applications. Int J Pharm 2017; 535:272-284. [PMID: 29138045 DOI: 10.1016/j.ijpharm.2017.11.018] [Citation(s) in RCA: 424] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 01/20/2023]
Abstract
Since their discovery over 100 years ago cyclodextrins (CDs) have been the subject of numerous scientific publications. In 2016 alone CDs were the subject of over 2200 research articles published in peer-reviewed journals and mentioned in over 2300 patents and patent applications, many of which were on pharmaceutical applications. Natural CDs and their derivatives are used as enabling pharmaceutical excipients that enhance aqueous solubility of poorly soluble drugs, increase drug permeability through biological membranes and improve drug bioavailability. Unlike conventional penetration enhancers, their hydrophilic structure and high molecular weight prevents them from penetrate into lipophilic membranes leaving biological membranes intact. The natural CDs and some of their derivatives have monographs in pharmacopeias and are also commonly used as food additives and in toiletry products. CDs form inclusion complexes with lipophilic moieties of hydrophobic drugs. Furthermore, CDs are able to form non-inclusion complexes and self-assembled aggregates; small and large complex aggregates with micellar-like structures that can enhance drug solubility. Excipients commonly used in pharmaceutical formulations may have additive or inhibiting effect on the CD solubilization. Here various methods used to investigate CD aggregate formation are reviewed as well as techniques that are used to increase the solubilizing effects of CDs; methods that enhance the apparent intrinsic solubility of drugs and/or the complexation efficacy and decrease the amount of CD needed to develop CD-containing pharmaceutical formulations. It will be explained how too much or too little CD can hamper drug bioavailability, and the role of CDs in solid dosage forms and parenteral formulations, and examples given on how CDs can enhance drug delivery after ocular, nasal and pulmonary administration.
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Affiliation(s)
- Phatsawee Jansook
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phyathai Road, Wangmai, Pathumwan, Bangkok 10330, Thailand
| | - Noriko Ogawa
- Department of Pharmaceutical Engineering, School of Pharmacy, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya, Aichi 464-8650, Japan
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
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20
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Abstract
The risk of severe eye problems has been found to increase significantly with age, particularly between the fifth and sixth decades of life. Cataracts, dry eye, neovascular age-related macular degeneration, diabetic retinopathy and retinal vein occlusion (RVO) are very common and very different age-related ocular diseases that reduce the patient's quality of life. The rationale for using corticosteroids to treat anterior and posterior ocular segment diseases is driven by inflammation. Dexamethasone, one of the most powerful corticosteroids available, is widely used for topical or intravitreal administration. Topical dexamethasone has proven efficacy for the management of postoperative inflammation in the anterior segment after cataract surgery and symptom relief in dry-eye disease. A new sustained-release 700 µg dexamethasone intravitreal implant (DEX) was recently approved for the treatment of macular edema following RVO, diabetic macular edema, or non-infectious uveitis, and its use is increasing, especially when other therapeutic agents have failed. The most common side effects are increased intraocular pressure and cataract formation. The potency of DEX, alone or in combination with other agents, makes DEX a promising option for treating several retinal diseases.
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Ban J, Zhang Y, Huang X, Deng G, Hou D, Chen Y, Lu Z. Corneal permeation properties of a charged lipid nanoparticle carrier containing dexamethasone. Int J Nanomedicine 2017; 12:1329-1339. [PMID: 28243093 PMCID: PMC5317251 DOI: 10.2147/ijn.s126199] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Drug delivery carriers can maintain effective therapeutic concentrations in the eye. To this end, we developed lipid nanoparticles (L/NPs) in which the surface was modified with positively charged chitosan, which engaged in hydrogen bonding with the phospholipid membrane. We evaluated in vitro corneal permeability and release characteristics, ocular irritation, and drug dynamics of modified and unmodified L/NPs in aqueous humor. The size of L/NPs was uniform and showed a narrow distribution. Corneal permeation was altered by the presence of chitosan and was dependent on particle size; the apparent permeability coefficient of dexamethasone increased by 2.7 and 1.8 times for chitosan-modified and unmodified L/NPs, respectively. In conclusion, a chitosan-modified system could be a promising method for increasing the ocular bioavailability of unmodified L/NPs by enhancing their retention time and permeation into the cornea. These findings provide a theoretical basis for the development of effective drug delivery systems in the treatment of ocular disease.
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Affiliation(s)
- Junfeng Ban
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Yan Zhang
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Xin Huang
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Guanghan Deng
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Dongzhi Hou
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Yanzhong Chen
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Zhufen Lu
- Guangdong Provincial Key Laboratory of Advanced Drug Delivery Systems, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
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Sawa M. Laser flare-cell photometer: principle and significance in clinical and basic ophthalmology. Jpn J Ophthalmol 2016; 61:21-42. [PMID: 27888376 DOI: 10.1007/s10384-016-0488-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 10/07/2016] [Indexed: 12/19/2022]
Abstract
A slit-lamp examination is an indispensable and essential clinical evaluation method in ophthalmology, but, it is qualitative subjective. To complement its weaknesses in making a quantitative evaluation of flare intensity and number of cells in the aqueous humor in the eye, we invented the laser flare-cell photometer in 1988. The instrument enables a non-invasive quantitative evaluation of flare intensity and number of cells in the aqueous with good accuracy and repeatability as well as maneuverability equal to slit-lamp microscopy. The instrument can elucidate the pathophysiology in the blood-aqueous barrier (BAB) function in a variety of ocular disorders. The accuracy of the instrument makes it possible to investigate not only the pathophysiology of intraocular disorders but also the effects of various drugs and surgical procedures in BAB. The instrument does not only lighten the burden on patients in clinical examinations and study but it also helps minimize the sacrifice of experimental animals and improves the reliability of the results by minimizing inter-individual variations through its good repeatability. Here I shall relate how the instrument has been applied to clinical and basic studies in ophthalmology and what novel knowledge its application contributed to pathophysiology in ophthalmology.
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Affiliation(s)
- Mitsuru Sawa
- Public Interest Incorporated Foundation Isshinkai, 3-37-8 Hongo, Bunkyo, Tokyo, 113-0033, Japan. .,Emeritus Professor, Nihon University, Tokyo, Japan.
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Chen PQ, Han XM, Zhu YN, Xu J. Comparison of the anti-inflammatory effects of fluorometholone 0.1% combined with levofloxacin 0.5% and tobramycin/dexamethasone eye drops after cataract surgery. Int J Ophthalmol 2016; 9:1619-1623. [PMID: 27990365 DOI: 10.18240/ijo.2016.11.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/28/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the combination of fluorometholone 0.1% and levofloxacin 0.5% to tobramycin/dexamethasone eye drops in controlling inflammation and preventing infection after phacoemulsification with an intraocular lens implantation. METHODS Sixty eyes from 60 patients undergoing cataract phacoemulsification were randomized into two groups; half of the patients were treated with fluorometholone (6 times/d) combined with levofloxacin (4 times/d), while the other half were treated with tobramycin/dexamethasone (4 times/d) eye drops for one week. Preoperative and postoperative intraocular pressure, aqueous flare, corneal thickness, and signs and symptoms were recorded before the operation and 1wk following treatments. RESULTS There were no statistically significant differences between the two groups in corneal thickness (P≥0.629), aqueous flare (P≥0.398), and signs and symptoms scores (P≥0.350) at each time point. Ocular hypertension was only observed in two eyes in the tobramycin/dexamethasone group. CONCLUSION Fluorometholone combined with levofloxacin treatment shows comparable efficacy but without the tendency to increase intraocular pressure; thus, it might be a better regimen for postoperative use.
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Affiliation(s)
- Pei-Qing Chen
- Eye Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Xue-Mei Han
- Zhejiang Hospital of Traditional Chinese Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Ya-Nan Zhu
- Eye Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Jia Xu
- Eye Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
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Sustained-release dexamethasone for the treatment of ocular inflammation and pain after cataract surgery. J Cataract Refract Surg 2016; 41:2049-59. [PMID: 26703279 DOI: 10.1016/j.jcrs.2015.11.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of dexamethasone as a sustained-release drug depot when placed in the canaliculus for the treatment of ocular inflammation and pain in cataract surgery patients. SETTING Four private practice sites in the United States. DESIGN Multicenter randomized double-masked clinical trial. METHODS Patients were randomized (1:1) to receive either the sustained-release dexamethasone or a placebo vehicle punctum plug inserted into the inferior distal canaliculus of the operated eye intraoperatively during cataract surgery. The primary endpoints were the proportions of patients with absence of cells or pain in the anterior chamber at 8 days. Secondary endpoints included cells, flare, pain, and the presence of the device at various timepoints through 30 days. RESULTS Approximately one fifth (20.7%) of patients in the sustained-release dexamethasone group had an absence of anterior chamber cells at 8 days compared with 10.0% in the placebo group (P = .1495). A higher proportion of patients in the sustained-release dexamethasone group (79.3%) than in the placebo group (30.0%) had an absence of ocular pain at 8 days (P < .0001) and at all other timepoints (P < .0002). There were significantly higher proportions of patients in the sustained-release dexamethasone group than in the placebo group with an absence of anterior chamber cells, anterior chamber flare, and pain at several timepoints through 30 days (P ≤ .0251). CONCLUSION Sustained-release dexamethasone provided elution of drug for up to 1 month after cataract surgery, providing clinically significant reductions in inflammation and pain. FINANCIAL DISCLOSURE Dr. Masket is a consultant to and shareholder in Ocular Therapeutix, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
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Mao Z, Chen XB, Zhong YM, Guo XX, Liu X. Damage to the Blood-Aqueous Barrier in Ocular Blunt Trauma and Its Association with Intraocular Pressure Elevation. Ophthalmic Res 2016; 56:92-7. [DOI: 10.1159/000445352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/10/2016] [Indexed: 11/19/2022]
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Skin transport of PEGylated poly(ε-caprolactone) nanoparticles assisted by (2-hydroxypropyl)-β-cyclodextrin. J Colloid Interface Sci 2015; 454:112-20. [DOI: 10.1016/j.jcis.2015.05.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 02/05/2023]
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Pleyer U, Ursell PG, Rama P. Intraocular pressure effects of common topical steroids for post-cataract inflammation: are they all the same? Ophthalmol Ther 2013; 2:55-72. [PMID: 25135807 PMCID: PMC4108144 DOI: 10.1007/s40123-013-0020-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Indexed: 11/30/2022] Open
Abstract
The efficacy of topical corticosteroids as ocular anti-inflammatory agents following cataract surgery is well-documented. They also help to prevent a number of complications associated with post-operative ocular inflammation, including corneal edema and cystoid macular edema. However, topical corticosteroids are associated with side effects, such as increased intraocular pressure (IOP). Indeed, corticosteroid-induced ocular hypertension and the potential for steroid-induced glaucoma remain the leading drawbacks of topical corticosteroid therapy. Some individuals are known to experience a high degree of IOP elevation with low doses or short durations of treatment with topical corticosteroids. Careful monitoring of IOP in such individuals is essential. Few randomized, controlled studies are available on the comparative safety and efficacy of common topical corticosteroids in the treatment of post-operative ocular inflammation. Furthermore, the lack of consistent reporting criteria for clinically significant IOP increases across clinical studies makes meaningful comparisons among corticosteroids difficult. This review aims to examine data from available published studies, including studies in steroid responders, to determine whether topical corticosteroids are the same in terms of their effect on IOP. Early generation corticosteroids, such as dexamethasone and prednisolone, are more likely to result in clinically significant increases in IOP. Newer corticosteroids, such as rimexolone and the retro-metabolically designed corticosteroid, loteprednol etabonate, offer similar anti-inflammatory efficacy to older corticosteroids with less effect on IOP. However, randomized controlled trials of newer corticosteroids are needed. The proportion of patients exhibiting an increase of ≥10 mmHg IOP in clinical studies has emerged as the most clinically relevant parameter for ophthalmologists to consider when deciding on which topical corticosteroid to use.
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Affiliation(s)
- Uwe Pleyer
- Department of Ophthalmology, University Medicine Charité, Humboldt University, Charitéplatz 1, 10117, Berlin, Germany,
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Wang QW, Yao K, Xu W, Chen PQ, Shentu XC, Xie X, Weng Y, Zhang L, Jin CF, Wu W, Zhu YN, Yu YH. Bromfenac Sodium 0.1%, Fluorometholone 0.1% and Dexamethasone 0.1% for Control of Ocular Inflammation and Prevention of Cystoid Macular Edema after Phacoemulsification. Ophthalmologica 2013; 229:187-94. [PMID: 23429038 DOI: 10.1159/000346847] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 12/12/2012] [Indexed: 11/19/2022]
Affiliation(s)
- Qi-wei Wang
- Eye Center, 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
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Achouri D, Alhanout K, Piccerelle P, Andrieu V. Recent advances in ocular drug delivery. Drug Dev Ind Pharm 2012; 39:1599-617. [PMID: 23153114 DOI: 10.3109/03639045.2012.736515] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Amongst the various routes of drug delivery, the field of ocular drug delivery is one of the most interesting and challenging endeavors facing the pharmaceutical scientist. Recent research has focused on the characteristic advantages and limitations of the various drug delivery systems, and further research will be required before the ideal system can be developed. Administration of drugs to the ocular region with conventional delivery systems leads to short contact time of the formulations on the epithelium and fast elimination of drugs. This transient residence time involves poor bioavailability of drugs which can be explained by the tear production, non-productive absorption and impermeability of corneal epithelium. Anatomy of the eye is shortly presented and is connected with ophthalmic delivery and bioavailability of drugs. In the present update on ocular dosage forms, chemical delivery systems such as prodrugs, the use of cyclodextrins to increase solubility of various drugs, the concept of penetration enhancers and other ocular drug delivery systems such as polymeric gels, bioadhesive hydrogels, in-situ forming gels with temperature-, pH-, or osmotically induced gelation, combination of polymers and colloidal systems such as liposomes, niosomes, cubosomes, microemulsions, nanoemulsions and nanoparticles are discussed. Novel ophthalmic delivery systems propose the use of many excipients to increase the viscosity or the bioadhesion of the product. New formulations like gels or colloidal systems have been tested with numerous active substances by in vitro and in vivo studies. Sustained drug release and increase in drug bioavailability have been obtained, offering the promise of innovation in drug delivery systems for ocular administration. Combining different properties of pharmaceutical formulations appears to offer a genuine synergy in bioavailability and sustained release. Promising results are obtained with colloidal systems which present very comfortable conditions of use and prolonged action.
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Affiliation(s)
- Djamila Achouri
- IMBE, UMR CNRS 7263 IRD 237, Aix-Marseille Université , Marseille , France
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30
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Moschos MM, Chatziralli IP, Pantazis P, Rouvas AA, Sergentanis TN. Is Topical Diclofenac Essential Before and After Uneventful Phacoemulsification Cataract Surgery? J Ocul Pharmacol Ther 2012; 28:335-9. [DOI: 10.1089/jop.2011.0256] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miyanaga M, Miyai T, Nejima R, Maruyama Y, Miyata K, Kato S. Effect of bromfenac ophthalmic solution on ocular inflammation following cataract surgery. Acta Ophthalmol 2009; 87:300-5. [PMID: 19183412 DOI: 10.1111/j.1755-3768.2008.01433.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE This study compared the post-cataract surgery anti-inflammatory effects of topical treatment with 0.1% bromfenac, 0.1% betamethasone or both on postoperative anterior chamber inflammation and corneal swelling. METHODS Seventy-two patients with no eye disease other than cataract were enrolled in a prospective, randomized study to undergo phacoemulsification combined with intraocular lens implantation. After cataract surgery, patients were randomized to treatment with bromfenac, betamethasone or both agents. Twenty-five eyes were assigned to bromfenac, 23 to betamethasone and 24 to the combined treatment group. Inflammatory reactions in the anterior chamber were measured with laser flare photometry preoperatively and at 1 and 3 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Intraocular pressure (IOP) and corneal thickness were measured at the same time-points. Best corrected visual acuity (BCVA) was measured preoperatively and at 2 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Specular microscope endothelial photography of the central region of the cornea was performed preoperatively and at 3 months after surgery. RESULTS There were no significant differences among the bromfenac, betamethasone and combined treatment groups in BCVA, IOP, aqueous flare or corneal thickness. Cystoid macular oedema was present in one eye treated with betamethasone. CONCLUSIONS There were no significant differences in anti-inflammatory effects among the three treatments. These findings suggest that bromfenac is as effective as betamethasone in minimizing inflammatory reactions after cataract surgery.
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Affiliation(s)
- Masaru Miyanaga
- Department of Ophthalmology, Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan.
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Buech G, Bertelmann E, Pleyer U, Siebenbrodt I, Borchert HH. Formulation of Sirolimus Eye Drops and Corneal Permeation Studies. J Ocul Pharmacol Ther 2007; 23:292-303. [PMID: 17593014 DOI: 10.1089/jop.2006.130] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was the development of eye drops with 1 mg/mL sirolimus and the evaluation of the drug's ability to permeate the freshly isolated pig cornea. Cyclodextrin solutions, liposomes, hydrotrope mixtures, poloxamer gels, and a microemulsion were tested for their suitability to dissolve the extremely hydrophobic drug sirolimus (solubility in water 2.6 microg/mL). The drug content in the formulations was determined by high-performance liquid chromatography, whereas this method is not sensitive enough for the quantification of therapeutic concentrations (7-12 ng/mL). Thus, the acceptor samples of the permeation tests were examined by microparticle enzyme immunoassay. A microemulsion is a suitable vehicle to prepare eye drops with sufficient sirolimus concentrations of 1 mg/mL in a formulation with acceptable tolerance and satisfactory stability over 12 months. However, the drug cannot permeate the intact cornea. After removal of the corneal epithelium, drug concentrations in the acceptor sample reach the lower limit of therapeutical levels. Conclusively, the present sirolimus eye drops might be promising therapeutic tools for the immunomodulatory treatment of ocular surface disorders, such as keratoconjunctivitis sicca, vernal conjunctivitis, or atopical blepharitis. They are not suitable to achieve therapeutic concentrations in the aqueous humour of patients with intact cornea.
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Affiliation(s)
- Guido Buech
- Institute of Pharmacy, Free University of Berlin, Berlin, Germany
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Loftsson T, Stefánsson E. Cyclodextrins in ocular drug delivery: theoretical basis with dexamethasone as a sample drug. J Drug Deliv Sci Technol 2007. [DOI: 10.1016/s1773-2247(07)50001-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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