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Sandler Topelius N, Shokraneh F, Bahman M, Lahtinen J, Hassinen N, Airaksinen S, Verma S, Hrizanovska L, Lass J, Paaver U, Tähnas J, Kern C, Lagarce F, Fenske D, Malik J, Scherliess H, Cruz SP, Paulsson M, Dekker J, Kammonen K, Rautamo M, Lück H, Pierrot A, Stareprawo S, Tubic-Grozdanis M, Zibolka S, Lösch U, Jeske M, Griesser U, Hummer K, Thalmeier A, Harjans A, Kruse A, Heimke-Brinck R, Khoukh K, Bruno F. Automated Non-Sterile Pharmacy Compounding: A Multi-Site Study in European Hospital and Community Pharmacies with Pediatric Immediate Release Propranolol Hydrochloride Tablets. Pharmaceutics 2024; 16:678. [PMID: 38794340 PMCID: PMC11125381 DOI: 10.3390/pharmaceutics16050678] [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: 03/04/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Pharmacy compounding, the art and science of preparing customized medications to meet individual patient needs, is on the verge of transformation. Traditional methods of compounding often involve manual and time-consuming processes, presenting challenges in terms of consistency, dosage accuracy, quality control, contamination, and scalability. However, the emergence of cutting-edge technologies has paved a way for a new era for pharmacy compounding, promising to redefine the way medications are prepared and delivered as pharmacy-tailored personalized medicines. In this multi-site study, more than 30 hospitals and community pharmacies from eight countries in Europe utilized a novel automated dosing approach inspired by 3D printing for the compounding of non-sterile propranolol hydrochloride tablets. CuraBlend® excipient base, a GMP-manufactured excipient base (pharma-ink) intended for automated compounding applications, was used. A standardized study protocol to test the automated dosing of tablets with variable weights was performed in all participating pharmacies in four different iterative phases. Integrated quality control was performed with an in-process scale and NIR spectroscopy supported by HPLC content uniformity measurements. In total, 6088 propranolol tablets were produced at different locations during this study. It was shown that the dosing accuracy of the process increased from about 90% to 100% from Phase 1 to Phase 4 by making improvements to the formulation and the hardware solutions. The results indicate that through this automated and quality controlled compounding approach, extemporaneous pharmacy manufacturing can take a giant leap forward towards automation and digital manufacture of dosage forms in hospital pharmacies and compounding pharmacies.
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Affiliation(s)
- Niklas Sandler Topelius
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Artillerigatan 6A, 02520 Turku, Finland
| | - Farnaz Shokraneh
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Artillerigatan 6A, 02520 Turku, Finland
| | - Mahsa Bahman
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Artillerigatan 6A, 02520 Turku, Finland
| | - Julius Lahtinen
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
| | - Niko Hassinen
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
| | - Sari Airaksinen
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
| | - Soumya Verma
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
| | - Ludmila Hrizanovska
- CurifyLabs Oy, Salmisaarenaukio 1, 00180 Helsinki, Finland; (F.S.); (J.L.); (S.V.)
| | - Jana Lass
- Tartu University Hospital, 50406 Tartu, Estonia;
| | - Urve Paaver
- Institute of Pharmacy, Tartu University, 50411 Tartu, Estonia;
| | | | | | | | | | - Julia Malik
- Asklepios Klinik Nord, 22417 Hamburg, Germany;
| | | | | | - Mattias Paulsson
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, SE-751 85 Uppsala, Sweden
| | - Jan Dekker
- UMC Utrecht, 3584 CX Utrecht, The Netherlands
| | | | - Maria Rautamo
- HUS Helsinki University Hospital, 00029 Helsinki, Finland;
- Faculty of Pharmacy, University of Helsinki, 00100 Helsinki, Finland
| | - Hendrik Lück
- UKSH Universitätsklinikum Schleswig-Holstein, 24105 Kiel, Germany;
- UKSH Universitätsklinikum Schleswig-Holstein, 24105 Lubeck, Germany
| | - Antoine Pierrot
- Centre Hospitalier Universitaire Vaudois, 1005 Lausanne, Switzerland
| | | | | | - Stefanie Zibolka
- Universitätsklinikum Magdeburg A.ö.R., 39120 Magdeburg, Germany;
| | - Uli Lösch
- Universitätsspital Basel, 4031 Basel, Switzerland;
| | | | - Ulrich Griesser
- Institute of Pharmacy, University of Innsbruck, 6020 Innsbruck, Austria;
| | - Karin Hummer
- Landeskrankenanstalten-Betriebsgesellschaft—KABEG (Klagenfurt), 9020 Klagenfurt am Wörthersee, Austria
| | | | - Anna Harjans
- Universitätsklinikum Heidelberg, 69120 Heidelberg, Germany
| | | | - Ralph Heimke-Brinck
- University Hospital Erlangen (Apotheke des Universitätsklinikums Erlangen), 91054 Erlangen, Germany;
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2
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Milliken RL, Quinten T, Andersen SK, Lamprou DA. Application of 3D printing in early phase development of pharmaceutical solid dosage forms. Int J Pharm 2024; 653:123902. [PMID: 38360287 DOI: 10.1016/j.ijpharm.2024.123902] [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: 12/21/2023] [Revised: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
Three-dimensional printing (3DP) is an emerging technology, offering the possibility for the development of dose-customized, effective, and safe solid oral dosage forms (SODFs). Although 3DP has great potential, it does come with certain limitations, and the traditional drug manufacturing platforms remain the industry standard. The consensus appears to be that 3DP technology is expected to benefit personalized medicine the most, but that it is unlikely to replace conventional manufacturing for mass production. The 3DP method, on the other hand, could prove well-suited for producing small batches as an adaptive manufacturing technique for enabling adaptive clinical trial design for early clinical studies. The purpose of this review is to discuss recent advancements in 3DP technologies for SODFs and to focus on the applications for SODFs in the early clinical development stages, including a discussion of current regulatory challenges and quality controls.
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Affiliation(s)
- Rachel L Milliken
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Thomas Quinten
- Janssen Pharmaceutica, Research & Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Sune K Andersen
- Janssen Pharmaceutica, Research & Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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3
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Ianno V, Vurpillot S, Prillieux S, Espeau P. Pediatric Formulations Developed by Extrusion-Based 3D Printing: From Past Discoveries to Future Prospects. Pharmaceutics 2024; 16:441. [PMID: 38675103 PMCID: PMC11054634 DOI: 10.3390/pharmaceutics16040441] [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: 01/30/2024] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 04/28/2024] Open
Abstract
Three-dimensional printing (3DP) technology in pharmaceutical areas is leading to a significant change in controlled drug delivery and pharmaceutical product development. Pharmaceutical industries and academics are becoming increasingly interested in this innovative technology due to its inherent inexpensiveness and rapid prototyping. The 3DP process could be established in the pharmaceutical industry to replace conventional large-scale manufacturing processes, particularly useful for personalizing pediatric drugs. For instance, shape, size, dosage, drug release and multi-drug combinations can be tailored according to the patient's needs. Pediatric drug development has a significant global impact due to the growing needs for accessible age-appropriate pediatric medicines and for acceptable drug products to ensure adherence to the prescribed treatment. Three-dimensional printing offers several significant advantages for clinical pharmaceutical drug development, such as the ability to personalize medicines, speed up drug manufacturing timelines and provide on-demand drugs in hospitals and pharmacies. The aim of this article is to highlight the benefits of extrusion-based 3D printing technology. The future potential of 3DP in pharmaceuticals has been widely shown in the last few years. This article summarizes the discoveries about pediatric pharmaceutical formulations which have been developed with extrusion-based technologies.
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Affiliation(s)
- Veronica Ianno
- CNRS, INSERM, Chemical and Biological Technologies for Health Group (UTCBS), Université Paris Cité, 75006 Paris, France;
- Delpharm Reims, 51100 Reims, France; (S.V.); (S.P.)
| | | | | | - Philippe Espeau
- CNRS, INSERM, Chemical and Biological Technologies for Health Group (UTCBS), Université Paris Cité, 75006 Paris, France;
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4
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Shuklinova O, Wyszogrodzka-Gaweł G, Baran E, Lisowski B, Wiśniowska B, Dorożyński P, Kulinowski P, Polak S. Can 3D Printed Tablets Be Bioequivalent and How to Test It: A PBPK Model Based Virtual Bioequivalence Study for Ropinirole Modified Release Tablets. Pharmaceutics 2024; 16:259. [PMID: 38399313 PMCID: PMC10893163 DOI: 10.3390/pharmaceutics16020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
As the field of personalized dosing develops, the pharmaceutical manufacturing industry needs to offer flexibility in terms of tailoring the drug release and strength to the individual patient's needs. One of the promising tools which have such capacity is 3D printing technology. However, manufacturing small batches of drugs for each patient might lead to huge test burden, including the need to conduct bioequivalence trials of formulations to support the change of equipment or strength. In this paper we demonstrate how to use 3D printing in conjunction with virtual bioequivalence trials based on physiologically based pharmacokinetic (PBPK) modeling. For this purpose, we developed 3D printed ropinirole formulations and tested their bioequivalence with the reference product Polpix. The Simcyp simulator and previously developed ropinirole PBPK model were used for the clinical trial simulations. The Weibull-fitted dissolution profiles of test and reference formulations were used as inputs for the model. The virtual bioequivalence trials were run using parallel design. The study power of 80% was reached using 125 individuals. The study demonstrated how to use PBPK modeling in conjunction with 3D printing to test the virtual bioequivalence of newly developed formulations. This virtual experiment demonstrated the bioequivalence of one of the newly developed formulations with a reference product available on a market.
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Affiliation(s)
- Olha Shuklinova
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 16 Łazarza St., 31-530 Kraków, Poland
- Simcyp Division, Certara UK Limited, Level 2-Acero, 1 Concourse Way, Sheffield S1 2BJ, UK;
| | - Gabriela Wyszogrodzka-Gaweł
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; (G.W.-G.); (B.L.); (B.W.); (P.D.)
| | - Ewelina Baran
- Institute of Technology, University of the National Education Commission, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (P.K.)
| | - Bartosz Lisowski
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; (G.W.-G.); (B.L.); (B.W.); (P.D.)
| | - Barbara Wiśniowska
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; (G.W.-G.); (B.L.); (B.W.); (P.D.)
| | - Przemysław Dorożyński
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; (G.W.-G.); (B.L.); (B.W.); (P.D.)
| | - Piotr Kulinowski
- Institute of Technology, University of the National Education Commission, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (P.K.)
| | - Sebastian Polak
- Simcyp Division, Certara UK Limited, Level 2-Acero, 1 Concourse Way, Sheffield S1 2BJ, UK;
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland; (G.W.-G.); (B.L.); (B.W.); (P.D.)
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Johannesson J, Pathare MM, Johansson M, Bergström CAS, Teleki A. Synergistic stabilization of emulsion gel by nanoparticles and surfactant enables 3D printing of lipid-rich solid oral dosage forms. J Colloid Interface Sci 2023; 650:1253-1264. [PMID: 37478742 DOI: 10.1016/j.jcis.2023.07.055] [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: 01/31/2023] [Revised: 06/24/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023]
Abstract
Pharmaceutical formulation of oral dosage forms is continuously challenged by the low solubility of new drug candidates. Pickering emulsions, emulsions stabilized with solid particles, are a promising alternative to surfactants for developing long-term stable emulsions that can be tailored for controlled release of lipophilic drugs. In this work, a non-emulsifying lipid-based formulation (LBF) loaded with fenofibrate was formulated into an oil-in-water (O/W) emulsion synergistically stabilized by stearic acid and silica (SiO2) nanoparticles. The emulsion had a droplet size of 341 nm with SiO2 particles partially covering the oil-water interface. In vitro lipid digestion was faster for the emulsion compared to the corresponding LBF due to the larger total surface area available for digestion. Cellulose biopolymers were added to the emulsion to produce a gel for semi-solid extrusion (SSE) 3D printing into tablets. The emulsion gel showed suitable rheological attributes for SSE, with a trend of higher viscosity, yield stress, and storage modulus (G'), compared to a conventional self-emulsifying lipid-based emulsion gel. The developed emulsion gel allows for a non-emulsifying LBF to be transformed into solid dosage forms for rapid lipid digestion and drug release of a poorly water-soluble drug in the small intestine.
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Affiliation(s)
- Jenny Johannesson
- Department of Pharmacy, Uppsala University, SE-751 23 Uppsala, Sweden
| | - Malhar Manik Pathare
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, SE-751 23 Uppsala, Sweden
| | - Mathias Johansson
- Department of Molecular Sciences, Swedish University of Agricultural Sciences (SLU), SE-750 07 Uppsala, Sweden
| | | | - Alexandra Teleki
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, SE-751 23 Uppsala, Sweden.
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6
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Johannesson J, Wu M, Johansson M, Bergström CAS. Quality attributes for printable emulsion gels and 3D-printed tablets: Towards production of personalized dosage forms. Int J Pharm 2023; 646:123413. [PMID: 37726040 DOI: 10.1016/j.ijpharm.2023.123413] [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: 05/24/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
3D-printing technology offers a flexible manufacturing platform with the potential to address the need of personalized dosage forms. However, quality aspects of such small-scale, on-demand production of pharmaceutical products intended for personalization is still limited. The aim of this study was therefore to study critical quality control attributes of lipid tablets produced by semi-solid extrusion (SSE) 3D printing from emulsion gels incorporating a poorly water-soluble drug. Quality attributes for both the printable emulsion gel and the printed dosage forms were assessed. The emulsion gel was shown to be printable with accurate dosing for at least one month of storage at 4 °C. Tablets were 3D printed in different sizes and a correlation, R2 value of 0.99, was found between the weight and the drug content. The 3D-printed tablets complied with the mass and drug content uniformity requirements described in the European Pharmacopoeia.. Solid-state characterization of the tablets during short-term storage revealed no signs of crystallinity of the drug. Lastly, the lipid digestion and drug release were unchanged after short-term storage of the tablets. This study demonstrates the potential of SSE 3D printing for personalized dosing of a lipid-based formulation strategy and discusses central quality attributes for the printable formulation and the 3D-printed dosage form.
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Affiliation(s)
- Jenny Johannesson
- Department of Pharmacy, Uppsala University, SE 751 23 Uppsala, Sweden
| | - Mingjun Wu
- Department of Pharmacy, Uppsala University, SE 751 23 Uppsala, Sweden
| | - Mathias Johansson
- Department of Molecular Sciences, Swedish University of Agricultural Sciences (SLU), SE 750 07 Uppsala, Sweden
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7
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Barbieri E, Minotti C, Cavagnis S, Giaquinto C, Cappello B, Penazzato M, Lallemant M. Paediatric medicine issues and gaps from healthcare workers point of view: survey results and a narrative review from the global accelerator for paediatric formulations project. Front Pharmacol 2023; 14:1200848. [PMID: 37529704 PMCID: PMC10390094 DOI: 10.3389/fphar.2023.1200848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
The WHO Model List of Essential Medicines for Children (EMLc) has not been systematically revised in the last few years. We conducted a survey addressed to healthcare professionals prescribing, preparing, or administering medicines to children and a narrative review to identify problematic paediatric formulations or missing medicines in all therapeutic fields to inform the review of the EMLc in 2023. A total of 285 physicians (63%), 28 nurses (6%) and 142 pharmacists (31%), mostly working in the hospital setting, reported at least one problematic medicine. 290 medicines were reported as missing (completely or the child-appropriate formulation). The top three most mentioned were ciprofloxacin together with phenobarbital and omeprazole. 387 medicines were reported as problematic (34% were oral liquid formulations, 34% tablets, 18% parenteral preparations. Mostly of the products were antibacterials (27%), cardiovascular medicines (11%) and antivirals (11%). The obtained responses show the perspective of healthcare workers working around the world, particularly in the European region (25%), in the African region (24%), and in the Region of the Americas (19%), with limited representation from Northern Africa and the Middle East. Our results need to be analysed with the outputs of other ongoing works before specific products can enter the WHO-hosted Global Accelerator for Paediatric formulations network prioritisation process. Efforts to develop appropriate formulations for children should be accelerated so that the uncertainties associated with off-label drug preparation and use are minimised, and therapeutic benefits are optimised.
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Affiliation(s)
- Elisa Barbieri
- Division of Pediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
- Penta—Child Health Research, Padova, Italy
| | - Chiara Minotti
- Division of Pediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
| | | | - Carlo Giaquinto
- Division of Pediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
- Penta—Child Health Research, Padova, Italy
| | - Bernadette Cappello
- Department of Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Martina Penazzato
- WHO Research for Health Department, World Health Organization, Geneva, Switzerland
| | - Marc Lallemant
- Penta—Child Health Research, Padova, Italy
- Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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8
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Jørgensen AK, Ong JJ, Parhizkar M, Goyanes A, Basit AW. Advancing non-destructive analysis of 3D printed medicines. Trends Pharmacol Sci 2023; 44:379-393. [PMID: 37100732 DOI: 10.1016/j.tips.2023.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 04/28/2023]
Abstract
Pharmaceutical 3D printing (3DP) has attracted significant interest over the past decade for its ability to produce personalised medicines on demand. However, current quality control (QC) requirements for traditional large-scale pharmaceutical manufacturing are irreconcilable with the production offered by 3DP. The US Food and Drug Administration (FDA) and the UK Medicines and Healthcare Products Regulatory Agency (MHRA) have recently published documents supporting the implementation of 3DP for point-of-care (PoC) manufacturing along with regulatory hurdles. The importance of process analytical technology (PAT) and non-destructive analytical tools in translating pharmaceutical 3DP has experienced a surge in recognition. This review seeks to highlight the most recent research on non-destructive pharmaceutical 3DP analysis, while also proposing plausible QC systems that complement the pharmaceutical 3DP workflow. In closing, outstanding challenges in integrating these analytical tools into pharmaceutical 3DP workflows are discussed.
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Affiliation(s)
- Anna Kirstine Jørgensen
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Jun Jie Ong
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Maryam Parhizkar
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Alvaro Goyanes
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; FabRx Ltd., Henwood House, Henwood, Ashford TN24 8DH, UK; FabRx Artificial Intelligence, Carretera de Escairón 14, 27543 Currelos (O Saviñao) Lugo, Spain.
| | - Abdul W Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., Henwood House, Henwood, Ashford TN24 8DH, UK; FabRx Artificial Intelligence, Carretera de Escairón 14, 27543 Currelos (O Saviñao) Lugo, Spain.
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Lyousoufi M, Lafeber I, Kweekel D, de Winter BCM, Swen JJ, Le Brun PPH, Bijleveld-Olierook ECM, van Gelder T, Guchelaar HJ, Moes DJAR, Schimmel KJM. Development and Bioequivalence of 3D-Printed Medication at the Point-of-Care: Bridging the Gap Toward Personalized Medicine. Clin Pharmacol Ther 2023; 113:1125-1131. [PMID: 36762628 DOI: 10.1002/cpt.2870] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Personalized medicine is currently hampered by the lack of flexible drug formulations. Especially for pediatric patients, manual compounding of personalized drug formulations by pharmacists is required. Three-Dimensional (3D) printing of medicines, which enables small-scale manufacturing at the point-of-care, can fulfill this unmet clinical need. This study investigates the feasibility of developing a 3D-printed tablet formulation at the point-of-care which complies to quality requirements for clinical practice, including bioequivalence. Development, manufacturing, and quality control of the 3D-printed tablets was performed at the manufacturing facility and laboratory of the department of Clinical Pharmacy and Toxicology at Leiden University Medical Center. Sildenafil was used as a model drug for the tablet formulation. Along with the 3D-printed tablets a randomized, an open-label, 2-period, crossover, single-dose clinical trial to assess bioequivalence was performed in healthy adults. Bioequivalence was established if areas under the plasma concentration curve from administration to the time of the last quantifiable concentration (AUC0-t ) and maximum plasma concentration (Cmax ) ratios were within the limits of 80.00-125.00%. The manufacturing process provided reproducible 3D-printed tablets that adhered to quality control requirements and were consequently used in the clinical trial. The clinical trial was conducted in 12 healthy volunteers. The 90% confidence intervals (CIs) of both AUC0-t and Cmax ratios were within bioequivalence limits (AUC0-t 90% CI: 87.28-104.14; Cmax 90% CI: 80.23-109.58). For the first time, we demonstrate the development of a 3D-printed tablet formulation at the point-of-care that is bioequivalent to its marketed originator. The 3D printing of personalized formulations is a disruptive technology for compounding, bridging the gap toward personalized medicine.
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Affiliation(s)
- Maryam Lyousoufi
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Iris Lafeber
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dinemarie Kweekel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda C M de Winter
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jesse J Swen
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul P H Le Brun
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Teun van Gelder
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dirk Jan A R Moes
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Kirsten J M Schimmel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
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10
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The Quest for Child-Friendly Carrier Materials Used in the 3D Semi-Solid Extrusion Printing of Medicines. Pharmaceutics 2022; 15:pharmaceutics15010028. [PMID: 36678657 PMCID: PMC9865971 DOI: 10.3390/pharmaceutics15010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
This work gives a brief overview of carrier materials currently used in pharmaceutical studies on the three-dimensional (3D) semi-solid extrusion (SSE) printing of medicines for pediatrics. The suitability of using these carrier materials in pediatric formulations, concerning safety and toxicity, was reviewed by consulting the 'Safety & Toxicity of Excipients for Pediatrics' (STEP) database and the Food and Drug Administration (FDA) regulations. In the second part of this work, carrier materials were tested on their ability to form a semi-solid mixture with lactose by dual asymmetric centrifugation (DAC) and printing by SSE. With the combination of theoretical and experimental studies, this work will guide research toward grounded decision-making when it comes to carrier material selection for pharmaceutical pediatric 3D SSE printing formulations.
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Funk NL, Fantaus S, Beck RCR. Immediate release 3D printed oral dosage forms: How different polymers have been explored to reach suitable drug release behaviour. Int J Pharm 2022; 625:122066. [PMID: 35926751 DOI: 10.1016/j.ijpharm.2022.122066] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
Three-dimensional (3D) printing has been gaining attention as a new technological approach to obtain immediate release (IR) dosage forms. The versatility conferred by 3D printing techniques arises from the suitability of using different polymeric materials in the production of solids with different porosities, geometries, sizes, and infill patterns. The appropriate choice of polymer can facilitate in reaching IR specifications and afford other specific properties to 3D printed solid dosage forms. This review aims to provide an overview of the polymers that have been employed in the development of IR 3D printed dosage forms, mainly considering their in vitro drug release behaviour. The physicochemical and mechanical properties of the IR 3D printed dosage forms will also be discussed, together with the manufacturing process strategies. Up to now, methacrylic polymers, cellulosic polymers, vinyl derivatives, glycols and different polymeric blends have been explored to produce IR 3D printed dosage forms. Their effects on drug release profiles are critically discussed here, giving a complete overview to drive formulators towards a rational choice of polymeric material and thus contributing to future studies in 3D printing of pharmaceuticals.
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Affiliation(s)
- Nadine Lysyk Funk
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Nanocarreadores e Impressão 3D em Tecnologia Farmacêutica (Nano3D), Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Stephani Fantaus
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ruy Carlos Ruver Beck
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratório de Nanocarreadores e Impressão 3D em Tecnologia Farmacêutica (Nano3D), Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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Lafeber I, Ruijgrok EJ, Guchelaar HJ, Schimmel KJM. 3D Printing of Pediatric Medication: The End of Bad Tasting Oral Liquids?—A Scoping Review. Pharmaceutics 2022; 14:pharmaceutics14020416. [PMID: 35214148 PMCID: PMC8880000 DOI: 10.3390/pharmaceutics14020416] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
3D printing of pediatric-centered drug formulations can provide suitable alternatives to current treatment options, though further research is still warranted for successful clinical implementation of these innovative drug products. Extensive research has been conducted on the compliance of 3D-printed drug products to a pediatric quality target product profile. The 3D-printed tablets were of particular interest in providing superior dosing and release profile similarity compared to conventional drug manipulation and compounding methods, such as oral liquids. In the future, acceptance of 3D-printed tablets in the pediatric patient population might be better than current treatments due to improved palatability. Further research should focus on expanding clinical knowledge, providing regulatory guidance and expansion of the product range, including dosage form possibilities. Moreover, it should enable the use of diverse good manufacturing practice (GMP)-ready 3D printing techniques for the production of various drug products for the pediatric patient population.
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Affiliation(s)
- Iris Lafeber
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
| | - Elisabeth J. Ruijgrok
- Department of Hospital Pharmacy, Erasmus MC—Sophia Children’s Hospital, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands;
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
| | - Kirsten J. M. Schimmel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
- Correspondence: ; Tel.: +31-(0)71-52-62790
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