1
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Monedeiro F, Ehall B, Tiffner K, Eberl A, Svehlikova E, Prietl B, Pfeifer V, Senekowitsch J, Remm A, Rebane A, Magnes C, Pieber T, Sinner F, Birngruber T. Characterization of Inflammatory Mediators and Metabolome in Interstitial Fluid Collected with Dermal Open Flow Microperfusion before and at the End of Dupilumab Treatment in Atopic Dermatitis. J Proteome Res 2024; 23:3496-3514. [PMID: 38986055 PMCID: PMC11304394 DOI: 10.1021/acs.jproteome.4c00153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/07/2024] [Accepted: 06/20/2024] [Indexed: 07/12/2024]
Abstract
Dupilumab is a monoclonal antibody approved for the treatment of atopic dermatitis (AD); however, its effects on molecular, cellular, and immunological levels remain to be elucidated. In this study, blood and dermal interstitial fluid (ISF) from nonlesional (NL) and lesional (L) skin were collected from eight patients with moderate to severe AD, before (visit 2-v2) and at the end of a 16-week treatment with dupilumab (visit 10-v10). Clinical treatment effect was demonstrated by significantly decreased AD severity scores at the end of treatment. At v10 versus v2, the percentages of CD4+ interleukin-producing cells showed a decreasing trend in ISF L and NL, unbound IL-4 levels in plasma were increased, IL-5 levels in ISF L reduced, and levels of factors involved in anti-inflammatory pathways and re-epithelization increased. At v2, ISF L showed that AD lesions might have altered amino acid pathways and lipid signaling compared to ISF NL. At v10, ISF L exhibited raised levels of long- and very-long-chain fatty acids and lipids compared to v2. Furthermore, dupilumab administration caused reduced expression of miR-155-5p and miR-378a-3p in ISF L. In conclusion, results from the present study provided novel knowledge by linking local immune and metabolic alterations to AD pathogenesis and treatment response.
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Affiliation(s)
- Fernanda Monedeiro
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
| | - Barbara Ehall
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
- BioTechMed, Mozartgasse
12, Graz 8010, Austria
| | - Katrin Tiffner
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
| | - Anita Eberl
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
| | - Eva Svehlikova
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Barbara Prietl
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
- Center
for Biomarker Research in Medicine (CBmed) GmbH, Stiftingtalstrasse 5, Graz 8010, Austria
| | - Verena Pfeifer
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
- Center
for Biomarker Research in Medicine (CBmed) GmbH, Stiftingtalstrasse 5, Graz 8010, Austria
| | - Julia Senekowitsch
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Anu Remm
- Institute
of Biomedicine and Translational Medicine, University of Tartu, Biomeedikum, Ravila 19, Tartu 50411, Estonia
| | - Ana Rebane
- Institute
of Biomedicine and Translational Medicine, University of Tartu, Biomeedikum, Ravila 19, Tartu 50411, Estonia
| | - Christoph Magnes
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
| | - Thomas Pieber
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
- Center
for Biomarker Research in Medicine (CBmed) GmbH, Stiftingtalstrasse 5, Graz 8010, Austria
| | - Frank Sinner
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
- Division
of Endocrinology and Diabetology, Medical
University of Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Thomas Birngruber
- HEALTH
− Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, Neue Stiftingtalstraße 2, Graz 8010, Austria
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2
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van Osdol WW, Novakovic J, Le Merdy M, Tsakalozou E, Ghosh P, Spires J, Lukacova V. Predicting Human Dermal Drug Concentrations Using PBPK Modeling and Simulation: Clobetasol Propionate Case Study. AAPS PharmSciTech 2024; 25:39. [PMID: 38366149 DOI: 10.1208/s12249-024-02740-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/08/2024] [Indexed: 02/18/2024] Open
Abstract
Quantitative in silico tools may be leveraged to mechanistically predict the dermato-pharmacokinetics of compounds delivered from topical and transdermal formulations by integrating systems of rate equations that describe permeation through the formulation and layers of skin and pilo-sebaceous unit, and exchange with systemic circulation via local blood flow. Delivery of clobetasol-17 propionate (CP) from DermovateTM cream was simulated using the Transdermal Compartmental Absorption & Transit (TCATTM) Model in GastroPlus®. The cream was treated as an oil-in-water emulsion, with model input parameters estimated from publicly available information and quantitative structure-permeation relationships. From the ranges of values available for model input parameters, a set of parameters was selected by comparing model outputs to CP dermis concentration-time profiles measured by dermal open-flow microperfusion (Bodenlenz et al. Pharm Res. 33(9):2229-38, 2016). Predictions of unbound dermis CP concentrations were reasonably accurate with respect to time and skin depth. Parameter sensitivity analyses revealed considerable dependence of dermis CP concentration profiles on drug solubility in the emulsion, relatively less dependence on dispersed phase volume fraction and CP effective diffusivity in the continuous phase of the emulsion, and negligible dependence on dispersed phase droplet size. Effects of evaporative water loss from the cream and corticosteroid-induced vasoconstriction were also assessed. This work illustrates the applicability of computational modeling to predict sensitivity of dermato-pharmacokinetics to changes in thermodynamic and transport properties of a compound in a topical formulation, particularly in relation to rate-limiting steps in skin permeation. Where these properties can be related to formulation composition and processing, such a computational approach may support the design of topically applied formulations.
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Affiliation(s)
- William W van Osdol
- Simulations Plus, Incorporated, 42505 10th Street West, Lancaster, California, 93534, USA
| | - Jasmina Novakovic
- Simulations Plus, Incorporated, 42505 10th Street West, Lancaster, California, 93534, USA
| | - Maxime Le Merdy
- Simulations Plus, Incorporated, 42505 10th Street West, Lancaster, California, 93534, USA
| | - Eleftheria Tsakalozou
- Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Priyanka Ghosh
- Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Jessica Spires
- Simulations Plus, Incorporated, 42505 10th Street West, Lancaster, California, 93534, USA.
| | - Viera Lukacova
- Simulations Plus, Incorporated, 42505 10th Street West, Lancaster, California, 93534, USA
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3
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Alomari N, Alhussaini W. Update on the advances and challenges in bioequivalence testing methods for complex topical generic products. Front Pharmacol 2024; 15:1330712. [PMID: 38389924 PMCID: PMC10881717 DOI: 10.3389/fphar.2024.1330712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Most of the government regulatory agencies, including the United States Food and Drug Administration and the European Medicine Agency, demand that the generic complex topical products prove pharmaceutical and bioequivalence. The evaluation of bioequivalence for complex topical dermatological formulations is a challenging task that requires careful consideration of several factors. Although comparative clinical studies are still considered the gold standard approach for establishing bioequivalence in most formulations, these studies can be costly and insensitive to detect formulation differences. Therefore, significant efforts have been made to develop and validate alternative approaches that demonstrate bioequivalence and expedite the availability of high-quality generic topical dermatological products. This article reviews the current methods for determining the bioequivalence of topical formulations in humans, with particular emphasis on recent advances in these methodologies. Most of the alternative methods are sensitive and reproducible, with the capability to ease the financial burden of comparative clinical studies within a short delivery time. The limitations associated with each technique are reviewed in detail.
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Affiliation(s)
- Nedaa Alomari
- Department of Pharmaceutical Analysis, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Waleed Alhussaini
- Department of Pharmaceutical Analysis, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
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4
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Bodenlenz M, Yeoh T, Berstein G, Mathew S, Shah J, Banfield C, Hollingshead B, Steyn SJ, Osgood SM, Beaumont K, Kainz S, Holeček C, Trausinger G, Raml R, Birngruber T. Comparative Study of Dermal Pharmacokinetics Between Topical Drugs Using Open Flow Microperfusion in a Pig Model. Pharm Res 2024; 41:223-234. [PMID: 38158503 PMCID: PMC10879402 DOI: 10.1007/s11095-023-03645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Accurate methods to determine dermal pharmacokinetics are important to increase the rate of clinical success in topical drug development. We investigated in an in vivo pig model whether the unbound drug concentration in the interstitial fluid as determined by dermal open flow microperfusion (dOFM) is a more reliable measure of dermal exposure compared to dermal biopsies for seven prescription or investigational drugs. In addition, we verified standard dOFM measurement using a recirculation approach and compared dosing frequencies (QD versus BID) and dose strengths (high versus low drug concentrations). METHODS Domestic pigs were topically administered seven different drugs twice daily in two studies. On day 7, drug exposures in the dermis were assessed in two ways: (1) dOFM provided the total and unbound drug concentrations in dermal interstitial fluid, and (2) clean punch biopsies after heat separation provided the total concentrations in the upper and lower dermis. RESULTS dOFM showed sufficient intra-study precision to distinguish interstitial fluid concentrations between different drugs, dose frequencies and dose strengths, and had good reproducibility between studies. Biopsy concentrations showed much higher and more variable values. Standard dOFM measurements were consistent with values obtained with the recirculation approach. CONCLUSIONS dOFM pig model is a robust and reproducible method to directly determine topical drug concentration in dermal interstitial fluid. Dermal biopsies were a less reliable measure of dermal exposure due to possible contributions from drug bound to tissue and drug associated with skin appendages.
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Affiliation(s)
- Manfred Bodenlenz
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thean Yeoh
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Gabriel Berstein
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Shibin Mathew
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA.
| | - Jaymin Shah
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | | | - Brett Hollingshead
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Stefanus J Steyn
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Sarah M Osgood
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Kevin Beaumont
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Sonja Kainz
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Christian Holeček
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Gert Trausinger
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Reingard Raml
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thomas Birngruber
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria.
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5
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Mehta M, Schug B, Blume HH, Beuerle G, Jiang W, Koenig J, Paixao P, Tampal N, Tsang YC, Walstab J, Wedemeyer R, Welink J. The Global Bioequivalence Harmonisation Initiative (GBHI): Report of the fifth international EUFEPS/AAPS conference. Eur J Pharm Sci 2023; 190:106566. [PMID: 37591469 DOI: 10.1016/j.ejps.2023.106566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
The series of conferences of the Global Bioequivalence Harmonisation Initiative (GBHI) was started in 2015 by the European Federation for Pharmaceutical Sciences (EUFEPS). All GBHI meetings so far were co-organised together with the American Association of Pharmaceutical Scientists (AAPS). Beginning with the 3rd workshop US-FDA joined as co-sponsor - to support global harmonisation of regulatory recommendations for bioequivalence (BE) assessment. At the 5th GBHI conference, the following BE topics were intensively discussed, and the following main conclusions were drawn: (1) Statistical considerations for BE assessment in specific situations covering scaling approaches for highly variable drug (HVD) products, two-stage adaptive design and opportunities of modelling and simulation to support BE: even though special BE study concepts like adaptive designs are not often used in practise so far, a majority of the workshop participants were in favour of a more frequent application of such approaches. The regulatory conditions relevant in this context need further concretisation and harmonisation between the regions. Moreover, modelling and simulation were considered as a promising and evolving approach, also for BE development programmes. (2) Fed versus fasting conditions in BE trials: Findings that BE between generic products could be confirmed only after fasted administration but failed under fed conditions seem more an exception than the rule. Obviously, BCS class IV compounds are most problematic in this context. Differences in critical excipients such as surfactants or pH-modifiers may be relevant reasons for different sensitivity for interactions in fasted versus fed conditions. Consequently, such deviations in composition of generic preparations should be avoided. Moreover, confirmation of BE may be generally difficult comparing different dosage forms, such like capsules versus tablets, especially in fed state. (3) BE assessment of locally acting drug products applied topically to the skin: Appropriateness and potential benefit of in-vitro tests as alternatives to clinical efficacy studies have been comprehensively discussed. In addition to the already well-established in-vitro release and permeation tests, other techniques were suggested, e.g., Raman spectroscopy or dermal open flow microperfusion. Validation of those methods is challenging and, despite significant progress already achieved during previous years, more research is needed before they may be fully accepted for regulatory purposes. (4) BE evaluation of narrow therapeutic index (NTI) drugs: The discrepancies amongst regulatory agencies in necessity of tighter BE acceptance ranges, the recommendations for inclusion of peak and total drug exposure into BE assessment with more restrictive criteria and the importance of comparison of the product-related within-subject variability for NTI drugs were debated. Arguments in favour and against the different approaches were presented and discussed but need further consideration before harmonisation can be achieved. The highly interactive meeting and extensive exchange between regulators and scientists from industry and academia resulted in useful progress in open BE issues and supported the goal of science-driven harmonisation.
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Affiliation(s)
- M Mehta
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - B Schug
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany.
| | - H H Blume
- SocraTec C&S GmbH, Oberursel, Germany; Frankfurt Foundation Quality of Medicines, Frankfurt/Main, Germany
| | | | - W Jiang
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - J Koenig
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - P Paixao
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Portugal
| | - N Tampal
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | | | - J Walstab
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany
| | - R Wedemeyer
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany
| | - J Welink
- Medicines Evaluation Board, Utrecht, the Netherlands
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6
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Iachina I, Eriksson AH, Bertelsen M, Petersson K, Jansson J, Kemp P, Engell KM, Brewer JR, Nielsen KT. Dissolvable microneedles for transdermal drug delivery showing skin pentation and modified drug release. Eur J Pharm Sci 2023; 182:106371. [PMID: 36621615 DOI: 10.1016/j.ejps.2023.106371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
Topical therapies for chronic skin diseases suffer from a low patient compliance due to the inconvenient treatment regimens of available products. Dissolvable microneedles (MN) with modified release offer an interesting possibility to increase the compliance by acting as a depot in the skin and thereby decreasing the dosing frequency. Furthermore, the bioavailability can be increased significantly by bypassing the barrier of the skin by the direct penetration of the MN into the skin. In this study the depot effect and skin penetration of an innovative dissolvable MN patch was assessed by insertion in ex vivo human skin and in vivo using minipigs. The MN patches are based on biodegradable polymers and the active pharmaceutical ingredients calcipotriol (Calci) and betamethasone-17-21-dipropionate (BDP) used to treat psoriasis. Using computed tomography (CT) and Coherent anti-Stokes Raman scattering (CARS) microscopy it was possible to visualize the skin penetration and follow the morphology of the MN as function of time in the skin. The depot effect was assessed by studying the modified in vitro release in an aqueous buffer and by comparing the drug release of a single application of a patch both ex vivo and in vivo to daily application of a marketed oleogel containing the same active pharmaceutical ingredients. The CT and CARS images showed efficient penetration of the MN patches into the upper dermis and a slow swelling process of the drug containing tip over a period of 8 days. Furthermore, CARS demonstrated that it can be used as a noninvasive technique with potential applicability in clinical settings. The in vitro release studies show a release of 54% over a time period of 30 days. The pharmacological relevance of MNs was confirmed in human skin explants and in vivo after single application and showed a similar response on calcipotriol and BDP mediated signaling events compared to daily application of the active oleogel. Altogether it was demonstrated that the MN can penetrate the skin and have the potential to provide a depot effect.
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Affiliation(s)
- Irina Iachina
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - André H Eriksson
- In Vivo Biology & Biomarkers, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Malene Bertelsen
- In Vivo Biology & Biomarkers, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Karsten Petersson
- Explorative Formulation & Technologies, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Jörgen Jansson
- Explorative Formulation & Technologies, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Pernille Kemp
- Explorative Formulation & Technologies, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Karen M Engell
- Small Molecule Early Pharmaceutical Development, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark
| | - Jonathan R Brewer
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark.
| | - Kim T Nielsen
- Advanced Analytical and Structural Chemistry, LEO Pharma A/S, Industriparken 55, Ballerup 2750, Denmark.
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7
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Tsakalozou E, Alam K, Ghosh P, Spires J, Polak S, Fang L, Sammeta S, Zhao P, Arora S, Raney SG. Mechanistic modeling of drug products applied to the skin: A workshop summary report. CPT Pharmacometrics Syst Pharmacol 2022; 12:575-584. [DOI: 10.1002/psp4.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Eleftheria Tsakalozou
- Division of Quantitative Methods and Modeling Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA) Silver Spring Maryland USA
| | - Khondoker Alam
- Division of Quantitative Methods and Modeling Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA) Silver Spring Maryland USA
| | - Priyanka Ghosh
- Division of Therapeutic Performance I Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA) Silver Spring Maryland USA
| | | | - Sebastian Polak
- Certara UK, Simcyp Division Sheffield UK
- Jagiellonian University Medical College Krakow Poland
| | - Lanyan Fang
- Division of Quantitative Methods and Modeling Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA) Silver Spring Maryland USA
| | | | - Ping Zhao
- Bill & Melinda Gates Foundation Seattle Washington USA
| | - Sumit Arora
- Certara UK, Simcyp Division Sheffield UK
- Janssen Pharmaceutical, Companies of Johnson & Johnson Beerse Belgium
| | - Sam G. Raney
- Division of Therapeutic Performance I Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA) Silver Spring Maryland USA
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8
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Birngruber T, Tiffner KI, Mautner SI, Sinner FM. Dermal open flow microperfusion for PK-based clinical bioequivalence studies of topical drug products. Front Pharmacol 2022; 13:1061178. [PMID: 36483734 PMCID: PMC9723326 DOI: 10.3389/fphar.2022.1061178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 07/21/2024] Open
Abstract
Topically applied drug products have experienced an extraordinary price increase in the United States, mostly due to a lack of generic products. Generic drug development is hindered by high costs and risks associated with clinical endpoint studies required to show bioequivalence (BE) of prospective generic products relative to their reference products. There is a continued need for cost- and time-efficient alternatives to clinical endpoint studies to determine BE of topically applied dermal drug products. Cutaneous PK-based BE studies present such an alternative and dOFM (dermal open flow microperfusion) has already been successfully used in several verifications studies to show an accurate and sensitive assessment of the rate and extent at which drugs become available in the skin. dOFM technology is discussed as well as the dOFM setup of clinical pilot and main studies to achieve BE assessment with a minimum number of participants and an outlook is given on the use of dOFM technology for other drug products.
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Affiliation(s)
| | | | | | - Frank M. Sinner
- HEALTH—Institute for Biomedicine and Health Sciences, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
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9
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Raney SG, Ghosh P, Ramezanli T, Lehman PA, Franz TJ. Cutaneous Pharmacokinetic Approaches to Compare Bioavailability and/or Bioequivalence for Topical Drug Products. Dermatol Clin 2022; 40:319-332. [PMID: 35750415 DOI: 10.1016/j.det.2022.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The evaluation of bioequivalence (BE) involves comparing the test product to its reference product in a study whose fundamental scientific principles allow inferring of the clinical performance of the products. Several test methods have been discussed and developed to evaluate topical bioavailability (BA) and BE. Pharmacokinetics-based approaches characterize the rate and extent to which an active ingredient becomes available at or near its site of action in the skin. Such methodologies are considered to be among the most accurate, sensitive, and reproducible approaches for determining the BA or BE of a product.
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Affiliation(s)
- Sam G Raney
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA.
| | - Priyanka Ghosh
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Tannaz Ramezanli
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Paul A Lehman
- QPS Holdings, LLC, 3 Innovation Way, Suite 240, Newark, DE 19711, USA
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10
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Kuzma BA, Senemar S, Ramezanli T, Ghosh P, Raney SG, Stagni G. The dose-duration effect on cutaneous pharmacokinetics of metronidazole from topical dermatological formulations in Yucatan mini-pigs. Eur J Pharm Biopharm 2022; 175:43-52. [DOI: 10.1016/j.ejpb.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/13/2022] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
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11
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Mautz TT, Krapf JM, Goldstein AT. Topical Corticosteroids in the Treatment of Vulvar Lichen Sclerosus: A Review of Pharmacokinetics and Recommended Dosing Frequencies. Sex Med Rev 2021; 10:42-52. [PMID: 34226161 DOI: 10.1016/j.sxmr.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
Topical corticosteroids are often utilized as the first-line treatment for vulvar lichen sclerosus (VLS). However, there is wide variability in dosing regimens, as well as a lack of consensus on maintenance dosing. Available guidelines on dosing frequency and regimen continuation for VLS are based on clinical expert opinion and do not necessarily reflect the pharmacokinetics of topical corticosteroids. Over the past few decades, there have been many advances in the techniques used to measure the local and systemic absorption of topical corticosteroids. These techniques have led to a greater understanding of the pharmacokinetics and bioavailabilities of these medications. However, it is not clear how this new information has been applied in evaluating dosing regimens and commonly cited risks when considering short- and long-term use in different vulvar dermatoses. This purpose of this review is to evaluate the available evidence on pharmacokinetics, absorption rates, and concentration levels of topical corticosteroids in lesional and nonlesional skin. Additionally, the evidence regarding commonly cited risks of topical corticosteroid use, including dermal thinning, adrenal suppression, systemic immunosuppression, and tachyphylaxis are reviewed. Differences in the effects of topical corticosteroids on the varied tissues of the vulva are specifically explored. Finally, these considerations are applied to evaluate the current treatment guidelines for VLS to provide direction in determining an evidenced-based dosing regimen and to inform future research in this area. Mautz TT, Krapf JM, Goldstein AT. Topical Corticosteroids in the Treatment of Vulvar Lichen Sclerosus: A Review of Pharmacokinetics and Recommended Dosing Frequencies. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
| | - Jill M Krapf
- The Centers for Vulvovaginal Disorders, New York, NY, USA; The George Washington University School of Medicine and Health Sciences, Department of Obstetrics and Gynecology, Washington, DC, USA
| | - Andrew T Goldstein
- The Centers for Vulvovaginal Disorders, New York, NY, USA; The George Washington University School of Medicine and Health Sciences, Department of Obstetrics and Gynecology, Washington, DC, USA
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12
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Eirefelt S, Hummer J, Basse LH, Bertelsen M, Johansson F, Birngruber T, Sinner F, Larsen J, Nielsen SF, Lambert M. Evaluating Dermal Pharmacokinetics and Pharmacodymanic Effect of Soft Topical PDE4 Inhibitors: Open Flow Microperfusion and Skin Biopsies. Pharm Res 2020; 37:243. [PMID: 33188482 DOI: 10.1007/s11095-020-02962-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the difference in clinical efficacy in AD patients between two topical PDE4 inhibitors using dermal open flow microperfusion and cAMP as a pharmacodynamic read-out in fresh human skin explants. METHODS Clinical formulations were applied to intact or barrier disrupted human skin explants and both skin biopsy samples and dermal interstitial fluid was sampled for measuring drug concentration. Furthermore, cAMP levels were determined in the skin biopsies as a measure of target engagement. RESULTS Elevated cAMP levels were observed with LEO 29102 while no evidence of target engagement was obtained with LEO 39652. In barrier impaired skin the dISF concentration of LEO 29102 was 2100 nM while only 33 nM for LEO 39652. For both compounds the concentrations measured in skin punch biopsies were 7-33-fold higher than the dISF concentrations. CONCLUSIONS Low unbound drug concentration in dISF in combination with minimal target engagement of LEO 39652 in barrier impaired human skin explants supports that lack of clinical efficacy of LEO 39652 in AD patients is likely due to insufficient drug availability at the target. We conclude that dOFM together with a pharmacodynamic target engagement biomarker are strong techniques for establishing skin PK/PD relations and that skin biopsies should be used with caution.
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Affiliation(s)
- Stefan Eirefelt
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark
| | - Joanna Hummer
- Joanneum Research Forschungsgesellschaft mbH, Health-Institute for Biomedicine and Health Sciences, Neue Stiftingtalstraße 2, 8010, Graz, Austria
| | - Line Hollesen Basse
- Discovery & Development PKPD, Novo Nordisk A/S, Novo Nordisk Park, 2760, Måløv, Denmark
| | - Malene Bertelsen
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark
| | - Fredrik Johansson
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark
| | - Thomas Birngruber
- Joanneum Research Forschungsgesellschaft mbH, Health-Institute for Biomedicine and Health Sciences, Neue Stiftingtalstraße 2, 8010, Graz, Austria
| | - Frank Sinner
- Joanneum Research Forschungsgesellschaft mbH, Health-Institute for Biomedicine and Health Sciences, Neue Stiftingtalstraße 2, 8010, Graz, Austria
| | - Jens Larsen
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark
| | - Simon Feldbæk Nielsen
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark
| | - Maja Lambert
- LEO Pharma Global Research & Development, Industriparken 55, 2750, Ballerup, Denmark.
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Larsen J, Lambert M, Pettersson H, Vifian T, Larsen M, Ollerstam A, Hegardt P, Eskilsson C, Laursen S, Soehoel A, Skak-Nielsen T, Hansen LM, Knudsen NØ, Eirefelt S, Sørensen MD, Stilou TG, Nielsen SF. Discovery and Early Clinical Development of Isobutyl 1-[8-Methoxy-5-(1-oxo-3H-isobenzofuran-5-yl)-[1,2,4]triazolo[1,5-a]pyridin-2-yl]cyclopropanecarboxylate (LEO 39652), a Novel “Dual-Soft” PDE4 Inhibitor for Topical Treatment of Atopic Dermatitis. J Med Chem 2020; 63:14502-14521. [DOI: 10.1021/acs.jmedchem.0c00797] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Santos LL, Swofford NJ, Santiago BG. In Vitro Permeation Test (IVPT) for Pharmacokinetic Assessment of Topical Dermatological Formulations. ACTA ACUST UNITED AC 2020; 91:e79. [PMID: 32991075 DOI: 10.1002/cpph.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In vitro assessment of topical (dermal) pharmacokinetics is a critical aspect of the drug development process for semi-solid products (e.g., solutions, foams, sprays, creams, gels, lotions, ointments), allowing for informed selection of new chemical entities, optimization of prototype formulations during the nonclinical stage, and determination of bioequivalence of generics. It can also serve as a tool to further understand the impact of different excipients on drug delivery, product quality, and formulation microstructure when used in parallel with other techniques, such as analyses of rheology, viscosity, microscopic characteristics, release rate, particle size, and oil droplet size distribution. The in vitro permeation test (IVPT), also known as in vitro skin penetration/permeation test, typically uses ex vivo human skin in conjunction with diffusion cells, such as Franz (or vertical) or Bronaugh (or flow-through) diffusion cells, and is the technique of choice for dermal pharmacokinetics assessment. Successful execution of the IVPT also involves the development and use of fit-for-purpose bioanalytical methods and procedures. The protocols described herein provide detailed steps for execution of the IVPT utilizing flow-through diffusion cells and for key aspects of the development of a liquid chromatography-tandem mass spectrometry method intended for analysis of the generated samples (epidermis, dermis, and receptor solution). © 2020 Wiley Periodicals LLC. Basic Protocol 1: In vitro permeation test Support Protocol: Dermatoming of ex vivo human skin Basic Protocol 2: Bioanalytical methodology in the context of the in vitro permeation test.
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Affiliation(s)
- Leandro L Santos
- Dermatology Unit, Topical Drug Delivery & DMPK, GlaxoSmithKline, Collegeville, Pennsylvania.,Current affiliation: Incyte Corporation, Inflammation & AutoImmunity, Clinical Research, Wilmington, Delaware
| | - Nathaniel J Swofford
- Dermatology Unit, Topical Drug Delivery & DMPK, GlaxoSmithKline, Collegeville, Pennsylvania.,Current affiliation: Functional Genomics, High-Throughput Biology and Imaging, GlaxoSmithKline, Collegeville, Pennsylvania
| | - Brandon G Santiago
- Dermatology Unit, Topical Drug Delivery & DMPK, GlaxoSmithKline, Collegeville, Pennsylvania.,Current affiliation: Bioanalysis, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Collegeville, Pennsylvania
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Bodenlenz M, Augustin T, Birngruber T, Tiffner KI, Boulgaropoulos B, Schwingenschuh S, Raney SG, Rantou E, Sinner F. Variability of Skin Pharmacokinetic Data: Insights from a Topical Bioequivalence Study Using Dermal Open Flow Microperfusion. Pharm Res 2020; 37:204. [PMID: 32989514 PMCID: PMC7522073 DOI: 10.1007/s11095-020-02920-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Dermal open flow microperfusion (dOFM) has previously demonstrated its utility to assess the bioequivalence (BE) of topical drug products in a clinical study. We aimed to characterize the sources of variability in the dermal pharmacokinetic data from that study. METHODS Exploratory statistical analyses were performed with multivariate data from a clinical dOFM-study in 20 healthy adults evaluating the BE, or lack thereof, of Austrian test (T) and U.S. reference (R) acyclovir cream, 5% products. RESULTS The overall variability of logAUC values (CV: 39% for R and 45% for T) was dominated by inter-subject variability (R: 82%, T: 91%) which correlated best with the subject's skin conductance. Intra-subject variability was 18% (R) and 9% (T) of the overall variability; skin treatment sites or methodological factors did not significantly contribute to that variability. CONCLUSIONS Inter-subject variability was the major component of overall variability for acyclovir, and treatment site location did not significantly influence intra-subject variability. These results support a dOFM BE study design with T and R products assessed simultaneously on the same subject, where T and R treatment sites do not necessarily need to be next to each other. Localized variation in skin microstructure may be primarily responsible for intra-subject variability.
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Affiliation(s)
- Manfred Bodenlenz
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thomas Augustin
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thomas Birngruber
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Katrin I Tiffner
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Beate Boulgaropoulos
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Simon Schwingenschuh
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Sam G Raney
- Division of Therapeutic Performance Office of Research and Standards Office of Generic Drugs, United States (U.S.) Food and Drug Administration, 10903 New Hampshire Avenue, MD, 20993, Silver Spring, USA
| | - Elena Rantou
- Division of Biostatistics VIII, Office of Biostatistics, Office of Translational Sciences, United States (U.S.) Food and Drug Administration, 10903 New Hampshire Avenue, MD, 20993, Silver Spring, USA
| | - Frank Sinner
- HEALTH - Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft m.b.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria.
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Kotzbeck P, Hofmann E, Nischwitz SP, Kamolz LP. Differentiating local and systemic inflammatory responses to burn injuries. Burns 2019; 45:1934-1935. [DOI: 10.1016/j.burns.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/14/2018] [Indexed: 12/20/2022]
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Schwingenschuh S, Scharfetter H, Martinsen ØG, Boulgaropoulos B, Augustin T, Tiffner KI, Dragatin C, Raml R, Hoefferer C, Prandl EC, Sinner F, Hajnsek M. Assessment of skin permeability to topically applied drugs by skin impedance and admittance. Physiol Meas 2017; 38:N138-N150. [PMID: 28967873 DOI: 10.1088/1361-6579/aa904e] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Pharmacokinetic and pharmacodynamic studies of topically applied drugs are commonly performed by sampling of interstitial fluid with dermal open flow microperfusion and subsequent analysis of the samples. However, the reliability of results from the measured concentration-time profile of the penetrating drug suffers from highly variable skin permeability to topically applied drugs that is mainly caused by inter- and intra-subject variations of the stratum corneum. Thus, statistically significant results can only be achieved by performing high numbers of experiments. To reduce the expenditures needed for such high experiment numbers we aimed to assess the correlation between skin permeability and skin impedance/skin admittance. APPROACH We performed an ex vivo drug penetration study with human skin, based on the hypothesis that inter-subject variations of the respective concentration-time profiles can be correlated with variations of the passive electrical properties of the skin. Therefore, skin impedance and skin admittance were related to the skin permeability to the model drug Clobetasol-17-proprionate. MAIN RESULTS The measured low frequency skin impedance and the skin admittance correlated linearly with the drug concentration-time profiles from dermal sampling. SIGNIFICANCE Skin permeability can be assessed by measuring the passive electrical properties of the skin, which enables correction of skin permeability variations. This allows reduction of experiment numbers in future pharmacokinetic and pharmacodynamic studies with human skin ex vivo and in vivo and leads to diminished study costs.
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Affiliation(s)
- Simon Schwingenschuh
- Joanneum Research, HEALTH-Institute for Biomedicine and Health Sciences, Graz, Austria
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Abstract
Background The availability of generic topical dermatological drug products is constrained by the limited methods established to assess topical bioequivalence (BE). A novel cutaneous pharmacokinetic approach, dermal open-flow microperfusion (dOFM), can continuously assess the rate and extent to which a topical drug becomes available in the dermis, to compare in vivo dermal bioavailability (BA) and support BE evaluations for topical products. Objective To evaluate whether dOFM is an accurate, sensitive, and reproducible in vivo method to characterize the intradermal BA of acyclovir from 5 % acyclovir creams, comparing a reference (R) product either to itself or to a different test (T) product. Methods In a single-center clinical study, R or T products were applied to six randomized treatment sites on the skin of 20 healthy human subjects. Two dOFM probes were inserted in each treatment site to monitor the intradermal acyclovir concentration for 36 h. Comparative BA (of R vs. R and T vs. R) was evaluated based on conventional BE criteria for pharmacokinetic endpoints (area under the curve and maximum plasma concentration) where the 90 % confidence interval of the geometric mean ratio between the T and R falls within 0.80–1.25. Results The positive control products (R vs. R) were accurately and reproducibly confirmed to be bioequivalent, while the negative control products (T vs. R) were sensitively discriminated not to be bioequivalent. Conclusions dOFM accurately, sensitively, and reproducibly characterized the dermal BA in a manner that can support BE evaluations for topical acyclovir 5 % creams in a study with n = 40 (20 subjects in this study).
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