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Martínez-Jiménez JE, Sathisaran I, Reyes Figueroa F, Reyes S, López-Nieves M, Vlaar CP, Monbaliu JCM, Romañach R, Ruaño G, Stelzer T, Duconge J. A review of precision medicine in developing pharmaceutical products: Perspectives and opportunities. Int J Pharm 2025; 670:125070. [PMID: 39689830 PMCID: PMC11781955 DOI: 10.1016/j.ijpharm.2024.125070] [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: 08/09/2024] [Revised: 11/25/2024] [Accepted: 12/08/2024] [Indexed: 12/19/2024]
Abstract
Over the next decade, Precision Medicine (PM) is poised to become the standard of care in pharmaceutical therapy, necessitating a fundamental transformation in the design and development of innovative custom-made drug products. To date, a comprehensive review linking PM with practical personalized drug formulations is missing. This review attempts to provide an overview of state-of-the-art formulation approaches capable of translating PM evaluation and resulting recommendations (clinical research) into tailored drug products (non-clinical research) for real-world patients. Comprehensive literature searches in four scientific databases (Scopus, SciFinder, Web of Science, and PubMed) were performed. Current approaches to point-of-care PM formulations and needs-based locally distributed manufacturing presently under research & development (R&D) as alternatives to conventional large-scale manufacturing of one-size-fits-all drug products are discussed. The following methods were identified as the most promising PM formulation strategies: tablet splitting, liquid dispensing, compounding pharmacies, additive manufacturing, drug impregnation, drug extrusion, and orodispersible films (ODFs). The challenges and opportunities of current state-of-the-art formulation technologies that can enable making PM routinely accessible in practice settings will be discussed. Additionally, light will be shed on point-of-use manufacturing (Pharmacy on Demand) as an uncharted territory for PM and its pathway towards practical implementation.
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Affiliation(s)
- Jorge E Martínez-Jiménez
- Pharmacogenomics (PGx) Laboratory, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 00936, United States
| | - Indumathi Sathisaran
- Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, PR, 00926, United States
| | - Francheska Reyes Figueroa
- Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, PR, 00926, United States; Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States
| | - Stephanie Reyes
- Pharmacogenomics (PGx) Laboratory, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 00936, United States; Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States
| | - Marisol López-Nieves
- Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States
| | - Cornelis P Vlaar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States
| | - Jean-Christophe M Monbaliu
- Center for Integrated Technology and Organic Synthesis, MolSys Research Unit, University of Liège, B-4000 Liège (Sart Tilman), Belgium
| | - Rodolfo Romañach
- Department of Chemistry, University of Puerto Rico, Mayagüez Campus, Mayagüez, PR 00681, United States
| | - Gualberto Ruaño
- Hartford Hospital Institute of Living, Hartford, CT 06102, United States
| | - Torsten Stelzer
- Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, PR, 00926, United States; Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States.
| | - Jorge Duconge
- Pharmacogenomics (PGx) Laboratory, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, 00936, United States; Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan, PR 00936, United States.
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Mu Y, Zhao L, Shen L. Medication adherence and pharmaceutical design strategies for pediatric patients: An overview. Drug Discov Today 2023; 28:103766. [PMID: 37708932 DOI: 10.1016/j.drudis.2023.103766] [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: 08/07/2023] [Revised: 08/27/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
Medication adherence in pediatric patients is a key factor in drug development and dosage form design. High medication adherence is not only important to achieve the expected treatment effects but can also effectively reduce medical costs. It is an ongoing task to accurately identify differences in medication adherence between children and adults and analyze the factors related to pediatric medication adherence. This is necessary to guide the development of pediatric drugs. This review focuses on factors that influence pediatric medication adherence as well as pharmaceutical design strategies to improve adherence. Current new dosage forms, new technologies, and new devices are comprehensively summarized in terms of their advantages and limitations.
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Affiliation(s)
- Yingying Mu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China
| | - Lijie Zhao
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China.
| | - Lan Shen
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China.
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Mfoafo KA, Omidian M, Bertol CD, Omidi Y, Omidian H. Neonatal and pediatric oral drug delivery: Hopes and hurdles. Int J Pharm 2021; 597:120296. [PMID: 33524524 DOI: 10.1016/j.ijpharm.2021.120296] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/25/2022]
Abstract
The neonatal and pediatric populations have long been neglected concerning the development of oral dosage forms. For close to two decades, caregivers have had to adjust the doses of the off-label medicines and drugs for adults to suit the neonatal and pediatric needs. This is due to the lack of rules and regulations regarding neonates and pediatrics clinical trials while pharmaceutical industries see this as a non-lucrative approach. Despite such limitations, the administration of solid and liquid dosage forms to neonates and pediatrics necessitates the development of new technologies and even new strategies to meet the needs. Current approaches have not only focused on the development of suitable dosage forms but also the advancement of devices to enhance drug administration to pediatrics and neonates. Though current approaches have significantly added to the number of pediatric and neonatal oral dosage formulations on the market, there is still more room for improvement(s). While novel dosage forms including multiparticulates, orodispersible tablets/films, and chewable tablets have extensively been researched, some administration devices (e.g., nipple shield, pill swallowing cup, and solid dosage pen) have also been explored. Although a few of these products are in the market, the concerted efforts of regulation administrative bodies, pharmaceutical industry settings, and scientists in academia have been oriented to address all issues and advance the neonatal and pediatric-centric pharmaceutical products.
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Affiliation(s)
| | | | | | - Yadollah Omidi
- College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Hossein Omidian
- College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, USA.
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Exploring tablet design options for tailoring drug release and dose via fused deposition modeling (FDM) 3D printing. Int J Pharm 2020; 591:119987. [DOI: 10.1016/j.ijpharm.2020.119987] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/25/2020] [Accepted: 10/11/2020] [Indexed: 01/22/2023]
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Avgerinos T, Kantiranis N, Panagopoulou A, Malamataris S, Kachrimanis K, Nikolakakis I. Mechanical properties and drug release of venlafaxine HCl solid mini matrices prepared by hot-melt extrusion and hot or ambient compression. Drug Dev Ind Pharm 2017; 44:338-348. [PMID: 29023145 DOI: 10.1080/03639045.2017.1391839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective/significance: To elucidate the role of plasticizers in different mini matrices and correlate mechanical properties with drug release. METHODS Cylindrical pellets were prepared by hot-melt extrusion (HME) and mini tablets by hot (HC) and ambient compression (AC). Venlafaxine HCl was the model drug, Eudragit® RSPO the matrix former and citric acid or Lutrol® F127 the plasticizers. The matrices were characterized for morphology, crystallinity, and mechanical properties. The influence of plasticizer's type and content on the extrusion pressure (Pe) during HME and ejection during tableting was examined and the mechanical properties were correlated with drug release parameters. RESULTS Resistance to extrusion and tablet ejection force were reduced by Lutrol® F127 which also produced softer and weaker pellets with faster release, but harder and stronger HC tablets with slower release. HME pellets showed greater tensile strength (T) and 100 times slower release than tablets. Pe correlated with T and resistance to deformation of the corresponding pellets (r2 = 0.963 and 0.945). For both HME and HC matrices the decrease of drug release with T followed a single straight line (r2 = 0.990) and for HME the diffusion coefficient (De) and retreat rate constant (kb) decreased linearly with T (r2 = 0.934 and 0.972). CONCLUSIONS Lutrol® F127 and citric acid are efficient plasticizers and Lutrol® F127 is a thermal binder/lubricant in HC compression. The different bonding mechanisms of the matrices were reflected in the mechanical strength and drug release. Relationships established between T and drug release parameters for HME and HC matrices may be useful during formulation work.
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Affiliation(s)
- Theodoros Avgerinos
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Nikolaos Kantiranis
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Athanasia Panagopoulou
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Stavros Malamataris
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Kyriakos Kachrimanis
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Ioannis Nikolakakis
- a Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences , Aristotle University of Thessaloniki , Thessaloniki , Greece
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Arnfast L, Kamruzzaman M, Löbmann K, Aho J, Baldursdottir S, Rades T, Rantanen J. Melt Extrusion of High-Dose Co-Amorphous Drug-Drug Combinations : Theme: Formulation and Manufacturing of Solid Dosage Forms Guest Editors: Tony Zhou and Tonglei Li. Pharm Res 2017; 34:2689-2697. [PMID: 28929263 DOI: 10.1007/s11095-017-2254-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/29/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE Many future drug products will be based on innovative manufacturing solutions, which will increase the need for a thorough understanding of the interplay between drug material properties and processability. In this study, hot melt extrusion of a drug-drug mixture with minimal amount of polymeric excipient was investigated. METHODS Using indomethacin-cimetidine as a model drug-drug system, processability of physical mixtures with and without 5% (w/w) of polyethylene oxide (PEO) were studied using Differential Scanning Calorimetry (DSC) and Small Amplitude Oscillatory Shear (SAOS) rheometry. Extrudates containing a co-amorphous glass solution were produced and the solid-state composition of these was studied with DSC. RESULTS Rheological analysis indicated that the studied systems display viscosities higher than expected for small molecule melts and addition of PEO decreased the viscosity of the melt. Extrudates of indomethacin-cimetidine alone displayed amorphous-amorphous phase separation after 4 weeks of storage, whereas no phase separation was observed during the 16 week storage of the indomethacin-cimetidine extrudates containing 5% (w/w) PEO. CONCLUSIONS Melt extrusion of co-amorphous extrudates with low amounts of polymer was found to be a feasible manufacturing technique. Addition of 5% (w/w) polymer reduced melt viscosity and prevented phase separation.
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Affiliation(s)
- Lærke Arnfast
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark
| | - Md Kamruzzaman
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark
| | - Korbinian Löbmann
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark
| | - Johanna Aho
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark
| | - Stefania Baldursdottir
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark
| | - Thomas Rades
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark.,Faculty of Science and Engineering, Åbo Akademi University, Tykistökatu 6A, 20521, Turku, Finland
| | - Jukka Rantanen
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, -2100, Copenhagen, DK, Denmark.
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Khorasani M, Edinger M, Raijada D, Bøtker J, Aho J, Rantanen J. Near-infrared chemical imaging (NIR-CI) of 3D printed pharmaceuticals. Int J Pharm 2016; 515:324-330. [DOI: 10.1016/j.ijpharm.2016.09.075] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
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Micropellet-loaded rods with dose-independent sustained release properties for individual dosing via the Solid Dosage Pen. Int J Pharm 2016; 499:271-279. [DOI: 10.1016/j.ijpharm.2016.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/28/2015] [Accepted: 01/01/2016] [Indexed: 02/04/2023]
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Lopez FL, Ernest TB, Tuleu C, Gul MO. Formulation approaches to pediatric oral drug delivery: benefits and limitations of current platforms. Expert Opin Drug Deliv 2015; 12:1727-40. [PMID: 26165848 PMCID: PMC4673516 DOI: 10.1517/17425247.2015.1060218] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction: Most conventional drug delivery systems are not acceptable for pediatric patients as they differ in their developmental status and dosing requirements from other subsets of the population. Technology platforms are required to aid the development of age-appropriate medicines to maximize patient acceptability while maintaining safety, efficacy, accessibility and affordability. Areas covered: The current approaches and novel developments in the field of age-appropriate drug delivery for pediatric patients are critically discussed including patient-centric formulations, administration devices and packaging systems. Expert opinion: Despite the incentives provided by recent regulatory modifications and the efforts of formulation scientists, there is still a need for implementation of pharmaceutical technologies that enable the manufacture of licensed age-appropriate formulations. Harmonization of endeavors from regulators, industry and academia by sharing learning associated with data obtained from pediatric investigation plans, product development pathways and scientific projects would be the way forward to speed up bench-to-market age appropriate formulation development. A collaborative approach will benefit not only pediatrics, but other patient populations such as geriatrics would also benefit from an accelerated patient-centric approach to drug delivery.
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Affiliation(s)
- Felipe L Lopez
- a 1 University College London, School of Pharmacy, Department of Pharmaceutics , 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Terry B Ernest
- b 2 GlaxoSmithKline, Product Development , New Frontiers Science Park, Third Avenue, Harlow, Essex CM19 5AW, UK
| | - Catherine Tuleu
- a 1 University College London, School of Pharmacy, Department of Pharmaceutics , 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Mine Orlu Gul
- a 1 University College London, School of Pharmacy, Department of Pharmaceutics , 29-39 Brunswick Square, London WC1N 1AX, UK
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