The Chronotopic™ System for Pulsatile and Colonic Delivery of Active Molecules in the Era of Precision Medicine: Feasibility by 3D Printing via Fused Deposition Modeling (FDM)

3D printing of partially-coated floating systems for controlled release of drugs into the stomach

This work focused on the development of a retentive drug delivery system (DDS) able to float in the gastric fluids and to ensure prolonged release of drugs over a pre-defined period of time, being then safely emptied from the stomach. To this end, the design step played a pivotal role. The device was thus devised to be composed of a polyvinyl alcohol-based matrix with a tapered geometry, which was partially coated with an insoluble layer of thermoplastic elastomer. This way, release of allopurinol (ALP), used as model drug, could occur only from the uncoated surfaces, while the peculiar geometry of the hydrophilic swellable/erodible matrix was intended to balance the increase in the diffusional path over time with a wider release area. In addition, the coating featured air pockets, whose volume was sized to compensate for the weight force of the DDS once immersed in gastric fluids, thus ensuring its long-lasting buoyancy. By easing the entrance of gastric fluids when the matrix is completely exhausted, such air pockets would also favor sinking and removal of the DDS from the pylorus. Given the multi-layered geometry of the final floating device, including hard-to-fabricate details (e.g. uncoated surfaces, voids), fused deposition modeling 3D printing was identified as the technique of choice for its effectiveness in manufacturing complex shapes. Various formulations were tested for fabricating both the inner matrix and the outer coating, assessing their thermo-mechanical properties, printability and release behavior. The gastro-retentive system demonstrated prolonged buoyancy (> 12 h) and a wide portfolio of ALP release performances, differing in rate and duration, which would make it a promising platform for personalized delivery of drugs in the upper gastrointestinal tract.

Selective laser sintering for printing bilayer tablets

In this study Selective Laser Sintering (SLS) was used to produce bilayer tablets containing rosuvastatin and acetylsalicylic acid. Initially, monolithic tablets of each drug were manufactured using different laser intensities in order to identify their impact on the tablet's dissolution, friability and hardness. After the optimization, the final bilayer tablet was fabricated using a new method, that allowed the printing using different powder blends. For that, a 3D-printed casing was employed to maintain the compartments of the tablet in the correct position during the printing process. The results demonstrated that the increased laser intensities led to denser inner cores, enhanced hardness, decreased friability, and slower drug release. Moreover, the new method was able to produce bilayer tablets completely aligned, showing a minor impact on dissolution when the two compartments were printed together in a single tablet. The work demonstrated the feasibility of using SLS in the production of multi-material drug delivery systems.

3D printing of pharmaceutical dosage forms: Recent advances and applications

Three-dimensional (3D) printing, also referred to as additive manufacturing, is considered to be a game-changing technology in many industries and is also considered to have potential use cases in pharmaceutical manufacturing, especially if individualization is desired. In this review article the authors systematically researched literature published during the last 5 years (2019 - spring 2024) on the topic of 3D printed dosage forms. Besides all kinds of oral dosage forms ranging from tablets and capsules to films, pellets, etc., numerous reports were also identified on parenteral and cutaneous dosage forms and also rectal, vaginal, dental, intravesical, and ophthalmic preparations. In total, more than 500 publications were identified and grouped according to the site of administration, and an overview of the manuscripts is presented here. Furthermore, selected publications are described and discussed in more detail. The review highlights the very different approaches that are currently used in order to develop 3D printed dosage forms but also addresses remaining challenges.

Rise of the (3D printing) machines in healthcare

Three-dimensional printing (3D printing) or "additive manufacturing" first came to prominence in the field of engineering, in particular in the transport sector where the value of its fast and accurate prototyping and manufacture of spare parts was quickly recognised. However, over the last ten years, this revolutionary technology has disrupted established manufacture in an increasingly diverse range of technical areas. Perhaps the most unexpected of these is pharmaceuticals - not merely the manufacture of products such as surgically inserted implants, but also of dosage formulations themselves - now available in all manner of printed delivery forms and vehicles and showing promising control of release properties though 3D printing process choices. This review will provide an overview of how 3D printing technology has developed and expanded across technological boundaries during the past decade, with a closer look at the current opportunities and barriers to its widespread adoption, particularly in the medical and pharmaceutical sectors. Special attention has been paid to patents as a boost and barrier to the expansion of 3D printing in the medical and pharmaceutical sector, with a focus on the patent literature.

Chrono-tailored drug delivery systems: recent advances and future directions

Circadian rhythms influence a range of biological processes within the body, with the central clock or suprachiasmatic nucleus (SCN) in the brain synchronising peripheral clocks around the body. These clocks are regulated by external cues, the most influential being the light/dark cycle, in order to synchronise with the external day. Chrono-tailored or circadian drug delivery systems (DDS) aim to optimise drug delivery by releasing drugs at specific times of day to align with circadian rhythms within the body. Although this approach is still relatively new, it has the potential to enhance drug efficacy, minimise side effects, and improve patient compliance. Chrono-tailored DDS have been explored and implemented in various conditions, including asthma, hypertension, and cancer. This review aims to introduce the biology of circadian rhythms and provide an overview of the current research on chrono-tailored DDS, with a particular focus on immunological applications and vaccination. Finally, we draw on some of the key challenges which need to be overcome for chrono-tailored DDS before they can be translated to more widespread use in clinical practice.

3D printing processes in precise drug delivery for personalized medicine

With the advent of personalized medicine, the drug delivery system will be changed significantly. The development of personalized medicine needs the support of many technologies, among which three-dimensional printing (3DP) technology is a novel formulation-preparing process that creates 3D objects by depositing printing materials layer-by-layer based on the computer-aided design method. Compared with traditional pharmaceutical processes, 3DP produces complex drug combinations, personalized dosage, and flexible shape and structure of dosage forms (DFs) on demand. In the future, personalized 3DP drugs may supplement and even replace their traditional counterpart. We systematically introduce the applications of 3DP technologies in the pharmaceutical industry and summarize the virtues and shortcomings of each technique. The release behaviors and control mechanisms of the pharmaceutical DFs with desired structures are also analyzed. Finally, the benefits, challenges, and prospects of 3DP technology to the pharmaceutical industry are discussed.

A pH-sensitive silica nanoparticles for colon-specific delivery and controlled release of catechin: Optimization of loading efficiency and in vitro release kinetics

Catechin is a naturally occurring flavonoid of the flavan-3-ol subclass with numerous biological functions; however, these benefits are diminished due to several factors, including low water solubility and degradation in the stomach's harsh environment. So, this study aimed to develop an intelligent catechin colon-targeting delivery system with a high loading capacity. This was done by coating surface-decorated mesoporous silica nanoparticles with a pH-responsive enteric polymer called Eudragit®-S100. The pristine wormlike mesoporous silica nanoparticles (< 100 nm) with high surface area and large total pore volume were effectively synthesized and modified with the NH2 group using the post-grafting strategy. Various parameters, including solvent polarity, catechin-carrier mass ratio, and adsorption time, were studied to improve the loading of catechin into the aminated silica nanoparticles. Next, the negatively charged Eudragit®-S100 was electrostatically coated onto the positively charged aminated nanocarriers to shield the loaded catechin from the acidic environment of the stomach (pH 1.9) and to facilitate site-specific delivery in the acidic environment of the colon (pH 7.4). The prepared nanomaterials were evaluated using several methods, including The Brauner-Emmett-Teller, surface area analyzer, zeta sizer, Field Emission Scanning Electron Microscope, Powder X-Ray Diffraction, Fourier Transform Infrared Spectroscopy, Energy-Dispersive X-ray Spectroscopy, and Differential Scanning Calorimetry. In vitro dissolution studies revealed that Eudragit®-S100-coated aminated nanomaterials prevented the burst release of the loaded catechin in the acidic environment, with approximately 90% of the catechin only being released at colonic pH (pH > 7) with a supercase II transport mechanism. As a result, silica nanoparticles coated with Eudragit®-S100 would provide an innovative and promising approach in targeted nanomedicine for the oral delivery of catechin and related medicines for treating diseases related to the colon, such as colorectal cancer and irritable bowel syndrome.

Development of a multi-component gastroretentive expandable drug delivery system (GREDDS) for personalized administration of metformin

OBJECTIVES

Efficacy and compliance of type II diabetes treatment would greatly benefit from dosage forms providing controlled release of metformin in the upper gastrointestinal tract. In this respect, the feasibility of a new system ensuring stomach-retention and personalized release of this drug at its absorption window for multiple days was investigated.

METHODS

The system proposed comprised of a drug-containing core and a viscoelastic umbrella-like skeleton, which were manufactured by melt-casting and 3D printing. Prototypes, alone or upon assembly and insertion into commercially-available capsules, were characterized for key parameters: thermo-mechanical properties, accelerated stability, degradation, drug release, deployment performance, and resistance to simulated gastric contractions.

RESULTS

Each part of the system was successfully manufactured using purposely-selected materials and the performance of final prototypes matched the desired one. This included: i) easy folding of the skeleton against the core in the collapsed administered shape, ii) rapid recovery of the cumbersome configuration at the target site, even upon storage, and iii) prolonged release of metformin.

CONCLUSIONS

Composition, geometry, and performance of the system developed in this work were deemed acceptable for stomach-retention and prolonged as well as customizable release of metformin in its absorption window, laying promising bases for further development steps.

Drug-Eluting Sutures by Hot-Melt Extrusion: Current Trends and Future Potentials

Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.

Exploiting Pharma 4.0 Technologies in the Non-Biological Complex Drugs Manufacturing: Innovations and Implications

The pharmaceutical industry has entered an era of transformation with the emergence of Pharma 4.0, which leverages cutting-edge technologies in manufacturing processes. These hold tremendous potential for enhancing the overall efficiency, safety, and quality of non-biological complex drugs (NBCDs), a category of pharmaceutical products that pose unique challenges due to their intricate composition and complex manufacturing requirements. This review attempts to provide insight into the application of select Pharma 4.0 technologies, namely machine learning, in silico modeling, and 3D printing, in the manufacturing process of NBCDs. Specifically, it reviews the impact of these tools on NBCDs such as liposomes, polymeric micelles, glatiramer acetate, iron carbohydrate complexes, and nanocrystals. It also addresses regulatory challenges associated with the implementation of these technologies and presents potential future perspectives, highlighting the incorporation of digital twins in this field of research as it seems to be a very promising approach, namely for the optimization of NBCDs manufacturing processes.

Unidirectional drug release from 3D printed personalized buccal patches using FDM technology

Oromucosal delivery of active ingredients of drugs provides a superior administration route for the treatment of oral diseases, due to avoidance of the first pass effect. In the present work, in view of the characteristics of large differences between oral ulcer symptoms and different lesion sizes, dexamethasone acetate unidirectional drug release buccal patches has been prepared based on Fused Deposition Modelling (FDM). Unidirectional drug release was achieved by covering the top and side with ethyl cellulose. Polyvinyl alcohol as a drug carrier, xylitol as a plasticizer. First, the protection effect of different thicknesses of the protective layer is investigated to determine the thickness of the protective layer. Co-extrusion printing method was adapted, utilizing blank filament to regulate preparations with different areas' drug loading. The results show that co-extrusion had no significant impact on the overall patches' drug release and adhesion properties. The physicochemical properties of the patches were also characterized. Evaluation of irritation is showed that these patches do not cause irritation to the oral mucosa of rats. Pharmacodynamic evaluation results showed that the preparation could promote the reduction of ulcer area. The results showed that FDM printing is a convenient and practical approach in manufacturing buccal patches.

Mechanically promoted lipid-based filaments via composition tuning for extrusion-based 3D-printing

Lipid excipients are favorable materials in pharmaceutical formulations owing to their natural, biodegradable, low-toxic and solubility/permeability enhancing properties. The application of these materials with advanced manufacturing platforms, particularly filament-based 3D-printing, is attractive for personalized manufacturing of thermolabile drugs. However, the filament's weak mechanical properties limit their full potential. In this study, highly flexible filaments were extruded using PG6-C16P, a lipid-based excipient belonging to the group of polyglycerol esters of fatty acids (PGFAs), based on tuning the ratio between its major and minor composition fractions. Increasing the percentage of the minor fractions in the system was found to enhance the relevant mechanical filament properties by 50-fold, guaranteeing a flawless 3D-printability. Applying a novel liquid feeding approach further improved the mechanical filament properties at lower percentage of minor fractions, whilst circumventing the issues associated with the standard extrusion approach such as low throughput. Upon drug incorporation, the filaments retained high mechanical properties with a controlled drug release pattern. This work demonstrates PG6-C16 P as an advanced lipid-based material and a competitive printing excipient that can empower filament-based 3D-printing.

3D printing tablets for high-precision dose titration of caffeine

Through 3D printing (3DP), many parameters of solid oral dosage forms can be customised, allowing for truly personalised medicine in a way that traditional pharmaceutical manufacturing would struggle to achieve. One of the many options for customisation involves dose titration, allowing for gradual weaning of a medication at dose intervals smaller than what is available commercially. In this study we demonstrate the high accuracy and precision of 3DP dose titration of caffeine, selected due to its global prevalence as a behavioural drug and well-known titration-dependent adverse reactions in humans. This was achieved using a simple filament base of polyvinyl alcohol, glycerol, and starch, utilising hot melt extrusion coupled with fused deposition modelling 3DP. Tablets containing 25 mg, 50 mg, and 100 mg doses of caffeine were successfully printed with drug content in the accepted range prescribed for conventional tablets (90 - 110%), and excellent precision whereby the weights of all doses showed a relative standard deviation of no more than 3%. Importantly, these results proved 3D printed tablets to be far superior to splitting a commercially available caffeine tablet. Additional assessment of filament and tablet samples were reviewed by differential scanning calorimetry, thermogravimetric analysis, HPLC, and scanning electron microscopy, showing no evidence of degradation of caffeine or the raw materials, with smooth and consistent filament extrusion. Upon dissolution, all tablets achieved greater than 70% release between 50 and 60 min, showing a predictable rapid release profile regardless of dose. The outcomes of this study highlight the benefits that dose titration with 3DP can offer, especially to more commonly prescribed medications that can have even more harmful withdrawal-induced adverse reactions.

Fabrication of timed-release indomethacin core-shell tablets for chronotherapeutic drug delivery using dual nozzle Fused Deposition Modeling (FDM) 3D printing

In the present study, timed-release indomethacin tablets, releasing drug after predetermined lag times, were developed for the effective treatment of early morning stiffness in rheumatoid arthritis using two-nozzle fused deposition modeling (FDM) 3D printing with a Bowden extruder. The developed core-shell tablets consisted of a drug-containing core and release-regulating shell with different designed thicknesses (i.e., 0.4 mm, 0.6 mm, 0.8 mm). The filaments to fabricate cores and shells were prepared using hot-melt extrusion (HME), and different filament compositions were formulated for core tablets and screened for rapid release and printability. Eventually, the HPMCAS-based formulation comprised a core tablet enclosed by a shell of Affinisol™ 15LV, a swellable polymer. During 3D printing, one nozzle was dedicated to printing core tablets loaded with indomethacin, and the other nozzle was dedicated to printing shells, making a whole structure produced at once without inconvenient filament change and nozzle cleanout. The mechanical properties of filaments were compared using a texture analyzer. The core-shell tablets were characterized for dissolution profiles and physical attributes (e.g., dimension, friability, hardness). SEM image indicated a smooth and complete surface of the core-shell tablets. The tablets showed 4-8 hours of lag depending on the shell thicknesses and released most of the drugs in 3 hours, regardless of the shell thicknesses. The core-shell tablets showed high reproducibility but exhibited low dimensional accuracy in the shell thickness. This study explored the suitability of using two-nozzle FDM 3D printing with Bowden extrusion for producing personalized chronotherapeutic core-shell tablets and discussed possible challenges that needed to be considered for a successful printing process using this technology.

Effect of Tartrazine as Photoabsorber for Improved Printing Resolution of 3D Printed "Ghost Tablets": Non-Erodible Inert Matrices

Stereolithography (SLA) 3D printing of pharmaceuticals suffers from the problem of light scattering, which leads to over-curing, resulting in the printing of objects that are non-compliant with design dimensions and the overloading of drugs. To minimize this problem, photoabsorbers such as tartrazine (food grade) can be used to absorb the stray light produced by scattering, leading to unintended photopolymerization. Ghost tablets (i.e., non-erodible inert matrices) were additively manufactured using SLA with varying ratios of polyethylene glycol diacrylate (PEGDA): polyethylene glycol (PEG) 300, along with tartrazine concentrations. The 3D printed ghost tablets containing maximum (0.03%) tartrazine were extremely precise in size and adhered to the nominal value of the metformin hydrochloride content. Resolution analysis reinstated the influence of tartrazine in achieving highly precise objects of even 0.07 mm² area. Furthermore, 3D printed ghost tablets were characterized using analytical means, and swelling studies. Additionally, ghost tablets were tested for their mechanical robustness using dynamic mechanical and texture analysis, and were able to withstand strains of up to 5.0% without structural failure. The printed ghost tablets displayed a fast metformin hydrochloride release profile, with 93.14% release after 12 h when the PEG 300 ratio was at its maximum. Ghost tablets were also subjected to in vivo X-ray imaging, and the tablets remained intact even after four hours of administration and were eventually excreted in an intact form through fecal excretion.

Insights into the Safety and Versatility of 4D Printed Intravesical Drug Delivery Systems

This paper focuses on recent advancements in the development of 4D printed drug delivery systems (DDSs) for the intravesical administration of drugs. By coupling the effectiveness of local treatments with major compliance and long-lasting performance, they would represent a promising innovation for the current treatment of bladder pathologies. Being based on a shape-memory pharmaceutical-grade polyvinyl alcohol (PVA), these DDSs are manufactured in a bulky shape, can be programmed to take on a collapsed one suitable for insertion into a catheter and re-expand inside the target organ, following exposure to biological fluids at body temperature, while releasing their content. The biocompatibility of prototypes made of PVAs of different molecular weight, either uncoated or coated with Eudragit®-based formulations, was assessed by excluding relevant in vitro toxicity and inflammatory response using bladder cancer and human monocytic cell lines. Moreover, the feasibility of a novel configuration was preliminarily investigated, targeting the development of prototypes provided with inner reservoirs to be filled with different drug-containing formulations. Samples entailing two cavities, filled during the printing process, were successfully fabricated and showed, in simulated urine at body temperature, potential for controlled release, while maintaining the ability to recover about 70% of their original shape within 3 min.

Perspectives of colon-specific drug delivery in the management of morning symptoms of rheumatoid arthritis

Rheumatoid arthritis is a chronic condition that is characterized by joint pain and inflammation. It is an autoimmune disorder in which the body tissues are erroneously attacked by the immune system of the host itself. It has been evident that rheumatoid arthritis symptoms follow a 24 h circadian rhythm and exhibit high thresholds of pain, functional disability, and stiffness predominantly early in the morning. Colon-specific drug delivery systems can be utilized in the formulations to be used in the treatment of rheumatoid arthritis. The colon-specific drug delivery system has shown promising results in the treatment of different diseases at the colonic site like Crohn's disease, ulcerative colitis, colon cancer, etc. The colon-specific drug delivery is capable of delivering the formulation at the predetermined location and predetermined time. The early morning symptoms of rheumatoid arthritis like pain and inflammation can be treated using the various approaches of the colon-specific drug delivery system because it will lead to patient compliance as the patient will not require administering the formulation immediately after waking up in the morning. This review also explains the immunological factors which may trigger rheumatoid arthritis in human beings. It further explores conventional approaches like pH-dependant, microorganisms-driven, pressure-controlled, and time-dependant formulations. By employing two or more conventional approaches given above the various novel approaches have been designed to eliminate the drawbacks of individual techniques.

3D printing: Innovative solutions for patients and pharmaceutical industry

Three-dimensional (3D) printing is an emerging technology with great potential in pharmaceutical applications, providing innovative solutions for both patients and pharmaceutical industry. This technology offers precise construction of the structure of dosage forms and can benefit drug product design by providing versatile release modes to meet clinical needs and facilitating patient-centric treatment, such as personalized dosing, accommodate treatment of specific disease states or patient populations. Utilization of 3D printing also facilitates digital drug product development and manufacturing. Development of 3D printing at early clinical stages and commercial scale pharmaceutical manufacturing has substantially advanced in recent years. In this review, we discuss how 3D printing accelerates early-stage drug development, including pre-clinical research and early phase human studies, and facilitates late-stage product manufacturing as well as how the technology can benefit patients. The advantages, current status, and challenges of employing 3D printing in large scale manufacturing and personalized dosing are introduced respectively. The considerations and efforts of regulatory agencies to address 3D printing technology are also discussed.

Investigation on the use of fused deposition modeling for the production of IR dosage forms containing Timapiprant

The present work focused on evaluating the feasibility of fused deposition modeling (FDM) in the development of a dosage form containing Timapiprant (TMP), also known as CHF6532, which is a novel active molecule indicated in the potential treatment of eosinophilic asthma upon oral administration. The resulting product could be an alternative, with potential towards personalization, of immediate release (IR) tablets used in the clinical studies. Formulations based on different polymeric carriers were screened, leading to the identification of a polyvinyl alcohol-based one, which turned out acceptable for versatility in terms of active ingredient content, printability and dissolution performance (i.e. capability to meet the dissolution specification set, envisaging >80% of the drug dissolved within 30 min). Following an in-depth evaluation on the influence of TMP solid state and of the voids volume resulting from printing on dissolution, few prototypes with shapes especially devised for therapy customization were successfully printed and were compliant with the dissolution specification set.

Expandable Drug Delivery Systems Based on Shape Memory Polymers: Impact of Film Coating on Mechanical Properties and Release and Recovery Performance

Retentive drug delivery systems (DDSs) are intended for prolonged residence and release inside hollow muscular organs, to achieve either local or systemic therapeutic goals. Recently, formulations based on shape memory polymers (SMPs) have gained attention in view of their special ability to recover a shape with greater spatial encumbrance at the target organ (e.g., urinary bladder or stomach), triggered by contact with biological fluids at body temperature. In this work, poly(vinyl alcohol) (PVA), a pharmaceutical-grade SMP previously shown to be an interesting 4D printing candidate, was employed to fabricate expandable organ-retentive prototypes by hot melt extrusion. With the aim of improving the mechanical resistance of the expandable DDS and slowing down relevant drug release, the application of insoluble permeable coatings based on either Eudragit^® RS/RL or Eudragit^® NE was evaluated using simple I-shaped specimens. The impact of the composition and thickness of the coating on the shape memory, swelling, and release behavior as well as on the mechanical properties of these specimens was thoroughly investigated and the effectiveness of the proposed strategy was demonstrated by the results obtained.

Accelerating 3D printing of pharmaceutical products using machine learning

Three-dimensional printing (3DP) has seen growing interest within the healthcare industry for its ability to fabricate personalized medicines and medical devices. However, it may be burdened by the lengthy empirical process of formulation development. Active research in pharmaceutical 3DP has led to a wealth of data that machine learning could utilize to provide predictions of formulation outcomes. A balanced dataset is critical for optimal predictive performance of machine learning (ML) models, but data available from published literature often only include positive results. In this study, in-house and literature-mined data on hot melt extrusion (HME) and fused deposition modeling (FDM) 3DP formulations were combined to give a more balanced dataset of 1594 formulations. The optimized ML models predicted the printability and filament mechanical characteristics with an accuracy of 84%, and predicted HME and FDM processing temperatures with a mean absolute error of 5.5 °C and 8.4 °C, respectively. The performance of these ML models was better than previous iterations with a smaller and a more imbalanced dataset, highlighting the importance of providing a structured and heterogeneous dataset for optimal ML performance. The optimized models were integrated in an updated web-application, M3DISEEN, that provides predictions on filament characteristics, printability, HME and FDM processing temperatures, and drug release profiles (https://m3diseen.com/predictionsFDM/). By simulating the workflow of preparing FDM-printed pharmaceutical products, the web-application expedites the otherwise empirical process of formulation development, facilitating higher pharmaceutical 3DP research throughput.

Novel Approach to Pharmaceutical 3D-Printing Omitting the Need for Filament-Investigation of Materials, Process, and Product Characteristics

The utilized 3D printhead employs an innovative hot-melt extrusion (HME) design approach being fed by drug-loaded polymer granules and making filament strands obsolete. Oscillatory rheology is a key tool for understanding the behavior of a polymer melt in extrusion processes. In this study, small amplitude shear oscillatory (SAOS) rheology was applied to investigate formulations of model antihypertensive drug Metoprolol Succinate (MSN) in two carrier polymers for pharmaceutical three-dimensional printing (3DP). For a standardized printing process, the feeding polymers viscosity results were correlated to their printability and a better understanding of the 3DP extrudability of a pharmaceutical formulation was developed. It was found that the printing temperature is of fundamental importance, although it is limited by process parameters and the decomposition of the active pharmaceutical ingredients (API). Material characterization including differential scanning calorimetry (DSC) and thermogravimetric analyses (TGA) of the formulations were performed to evaluate component miscibility and ensure thermal durability. To assure the development of a printing process eligible for approval, all print runs were investigated for uniformity of mass and uniformity of dosage in accordance with the European Pharmacopoeia (Ph. Eur.).

3D Printed Fractal-like Structures with High Percentage of Drug for Zero-Order Colonic Release

Colonic drug delivery of drugs is an area of great interest due to the need to treat high prevalence colonic local diseases as well as systemic conditions that may benefit from the advantages associated to this route of drug administration. In the last decade, the use of 3D printing technologies has expanded, offering the possibility of preparing personalized medicines in small batches directly at the point of care. The aim of this work is to design a high drug loaded 3D printed system prepared by a combination of Fused Deposition Modelling (FDM) and Injection Volume Filling (IVF) techniques intended for zero-order colonic drug release. For this purpose, different batches of binary and ternary filaments based on the thermoplastic polyurethane Tecoflex EG-72D (TPU), theophylline anhydrous (AT) as model drug, and magnesium stearate as lubricant have been developed and characterized. Filaments with the highest drug load and the best rheological properties were selected for the manufacture of a printed fractal-like structure based on multiple toroids. This design was proposed to provide high surface area, leading to increased drug release and water uptake in the colonic region. This structure was 3D printed by FDM and then coated in a unique step by IVF technology using the enteric polymer DrugCoat S 12.5. This way, an additional coating process is avoided, reducing costs and production time. Studies of drug release confirmed the ability of the structures to provide a five-hour period of constant drug delivery in the colonic region.

[Preparation and in vitro evaluation of fused deposition modeling 3D printed compound tablets of captopril and hydrochlorothiazide]

OBJECTIVE

To explore the feasibility of preparing compound tablets for the treatment of hypertension by fused deposition modeling (FDM) 3D printing technology and to evaluate the quality of the printed compound tablets in vitro.

METHODS

Polyvinyl alcohol (PVA) filaments were used as the exci-pient to prepare the shell of tablet. The ellipse-shaped tablets (the length of major axes of ellipse was 20 mm, the length of the minor axes of ellipse was 10 mm, the height of tablet was 5 mm) with two separate compartments were designed and printed using FDM 3D printer. The height of layer was 0.2 mm, and the thickness of roof or floor was 0.6 mm. The thickness of shell was 1.2 mm, and the thickness of the partition wall between the two compartments was 0.6 mm. Two cardiovascular drugs, captopril (CTP) and hydrochlorothiazide (HCT), were selected as model drugs for the printed compound tablet and filled in the two compartments of the tablet, respectively. The microscopic morphology of the tablets was observed by scanning electron microscopy (SEM). The weight variation of the tablets was investigated by electronic scale. The hardness of the tablets was measured by a single-column mechanical test system. The contents of the drugs in the tablets were determined by high performance liquid chromatography (HPLC), and the dissolution apparatus was used to measure the in vitro drug release of the tablets.

RESULTS

The prepared FDM 3D printed compound tablets were all in good shape without printing defects. The average weight of the tablets was (644.3±6.55) mg. The content of CTP and HCT was separately (52.3±0.26) mg and (49.6±0.74) mg. A delayed in vitro release profile was observed for CTP and HCT, and the delayed release time for CTP and HCT in vitro was 20 min and 40 min, respectively. The time for 70% of CTP and HCT released was separately 30 min and 60 min.

CONCLUSION

CTP and HCT compound tablets were successfully prepared by FDM 3D printing technology, and the printed tablets were of good qualities.

Administration strategies and smart devices for drug release in specific sites of the upper GI tract

Targeting the release of drugs in specific sites of the upper GI tract would meet local therapeutic goals, improve the bioavailability of specific drugs and help overcoming compliance-related limitations, especially in chronic illnesses of great social/economic impact and involving polytherapies (e.g. Parkinson's and Alzeimer's disease, tubercolosis, malaria, HIV, HCV). It has been traditionally pursued using gastroretentive (GR) systems, i.e. low-density, high-density, magnetic, adhesive and expandable devices. More recently, the interest towards oral administration of biologics has prompted the development of novel drug delivery systems (DDSs) provided with needles and able to inject different formulations in the mucosa of the upper GI tract and particularly of esophagus, stomach or small intestine. Besides comprehensive literature analysis, DDSs identified as smart devices in view of their high degree of complexity in terms of design, working mechanism, materials employed and manufacturing steps were discussed making use of graphic tools.

Solid Dispersion Formulations by FDM 3D Printing-A Review

Additive manufacturing (AM) is revolutionizing the way medicines are designed, manufactured, and utilized. Perhaps, AM appears to be ideal for the fit-for-purpose manufacturing of medicines in contrast to the several disadvantages associated with the conventional fit-for-all mass production that accounts for less than 50% of pharmacotherapeutic treatment/management of diseases especially among children and elderly patients, as well as patients with special needs. In this review, we discuss the current trends in the application of additive manufacturing to prepare personalized dosage forms on-demand focusing the attention on the relevance of coupling solid dispersion with FDM 3D printing. Combining the two technologies could offer many advantages such as to improve the solubility, dissolution, and oral bioavailability of poorly soluble drugs in tandem with the concept of precision medicine and personalized dosing and to address the dilemma of commercial availability of FDM filaments loaded with Class II and/or Class IV drugs. However, thermal treatment especially for heat-sensitive drugs, regulatory, and ethical obligations in terms of quality control and quality assurance remain points of concern. Hence, a concerted effort is needed between the scientific community, the pharmaceutical industries, the regulatory agencies, the clinicians and clinical pharmacists, and the end-users to address these concerns.

Clinical translation of advanced colonic drug delivery technologies

Targeted drug delivery to the colon offers a myriad of benefits, including treatment of local diseases, direct access to unique therapeutic targets and the potential for increasing systemic drug bioavailability and efficacy. Although a range of traditional colonic delivery technologies are available, these systems exhibit inconsistent drug release due to physiological variability between and within individuals, which may be further exacerbated by underlying disease states. In recent years, significant translational and commercial advances have been made with the introduction of new technologies that incorporate independent multi-stimuli release mechanisms (pH and/or microbiota-dependent release). Harnessing these advanced technologies offers new possibilities for drug delivery via the colon, including the delivery of biopharmaceuticals, vaccines, nutrients, and microbiome therapeutics for the treatment of both local and systemic diseases. This review details the latest advances in colonic drug delivery, with an emphasis on emerging therapeutic opportunities and clinical technology translation.

Intravesical drug delivery approaches for improved therapy of urinary bladder diseases

Diseases of the urinary bladder have high incidence rates and burden healthcare costs. Their pharmacological treatment involves systemic and local drug administration. The latter is generally accomplished through instillation of liquid formulations and requires repeated or long-term catheterization that is associated with discomfort, inflammation and bacterial infections. Consequently, compliance issues and dropouts are frequently reported. Moreover, instilled drugs are progressively diluted as the urine volume increases and rapidly excreted. When penetration of drugs into the bladder wall is needed, the poor permeability of the urothelium has also to be accounted for. Therefore, much research effort is spent to overcome these hurdles, thereby improving the efficacy of available therapies. Particularly, indwelling delivery systems suited for i) insertion into the bladder through the urethra, ii) intra-organ retention and prolonged release for the desired time lapse, iii) final elimination, either spontaneous or by manual removal, have been proposed to reduce the number of catheterization procedures and reach higher drug levels at the target site. Vesical retention of such devices is allowed by the relevant expansion that can either be triggered from the outside or achieved exploiting elastic and purposely 4D printed shape memory materials. In this article, the main rationales and strategies for improved intravesical delivery are reviewed.

Connected healthcare: Improving patient care using digital health technologies

Now more than ever, traditional healthcare models are being overhauled with digital technologies of Healthcare 4.0 increasingly adopted. Worldwide, digital devices are improving every stage of the patient care pathway. For one, sensors are being used to monitor patient metrics 24/7, permitting swift diagnosis and interventions. At the treatment stage, 3D printers are under investigation for the concept of personalised medicine by allowing patients access to on-demand, customisable therapeutics. Robots are also being explored for treatment, by empowering precision surgery, rehabilitation, or targeted drug delivery. Within medical logistics, drones are being leveraged to deliver critical treatments to remote areas, collect samples, and even provide emergency aid. To enable seamless integration within healthcare, the Internet of Things technology is being exploited to form closed-loop systems that remotely communicate with one another. This review outlines the most promising healthcare technologies and devices, their strengths, drawbacks, and opportunities for clinical adoption.

Cellulase as an "active" excipient in prolonged-release HPMC matrices: A novel strategy towards zero-order release kinetics

Hydrophilic matrices are of utmost interest for oral prolonged release of drugs. However, they show decreasing release rate over time, mainly due to lengthening of the diffusional pathway across the gel formed upon glass-rubber transition of the polymer. Therefore, achievement of zero-order release kinetics, which could reflect in constant drug plasma levels, is still an open issue. With the aim of improving the release performance of hydroxypropyl methylcellulose (HPMC) systems, the use of cellulolytic enzymes was proposed to aid erosion of the swollen matrix, thereby counteracting the release rate decrease particularly toward the end of the process. The effectiveness of this strategy was evaluated by studying the mass loss and drug tracer release from tableted matrices consisting of high-viscosity HPMC (Methocel® K4M), Acetaminophen and increasing amounts (0.5-10% on HPMC) of a cellulolytic product (Sternzym® C13030). A faster erosion and progressive shift to linearity of the overall release profiles were observed as a function of the enzyme concentration. Release was markedly linear from matrices containing 5 and 10% Sternzym® C13030. In partially coated matrices with these cellulase concentrations, such results were in agreement with data of erosion and swelling front movement, which exhibited early and long-lasting synchronization.