1
|
Castro-Balado A, Varela-Rey I, Mejuto B, Mondelo-García C, Zarra-Ferro I, Rodríguez-Jato T, Fernández-Ferreiro A. Updated antimicrobial dosing recommendations for obese patients. Antimicrob Agents Chemother 2024:e0171923. [PMID: 38526051 DOI: 10.1128/aac.01719-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
The prevalence of obesity has increased considerably in the last few decades. Pathophysiological changes in obese patients lead to pharmacokinetic (PK) and pharmacodynamic (PD) alterations that can condition the correct exposure to antimicrobials if standard dosages are used. Inadequate dosing in obese patients can lead to toxicity or therapeutic failure. In recent years, additional antimicrobial PK/PD data, extended infusion strategies, and studies in critically ill patients have made it possible to obtain data to provide a better dosage in obese patients. Despite this, it is usually difficult to find information on drug dosing in this population, which is sometimes contradictory. This is a comprehensive review of the dosing of different types of antimicrobials (antibiotics, antifungals, antivirals, and antituberculosis drugs) in obese patients, where the literature on PK and possible dosing strategies in obese adults was critically assessed.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Beatriz Mejuto
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Teresa Rodríguez-Jato
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
2
|
García-Varela L, Codesido J, Perez-Pedrosa A, Muñoz-González M, Ramos-Docampo E, Rey-Bretal D, García-Otero X, Gómez-Lado N, Turrero A, Beiroa D, Rodríguez-Perez AI, Vidal A, Fernández-Ferreiro A, Pubul V, Aguiar P. Biodistribution and pharmacokinetics of [ 89Zr]-anti-VEGF mAbs using PET in glioblastoma rat models. Int J Pharm 2024; 652:123795. [PMID: 38224761 DOI: 10.1016/j.ijpharm.2024.123795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
INTRODUCTION Glioblastomas present intensive angiogenesis, thus anti-Vascular Endothelial Growth Factor (VEGF) antibodies (mAbs) have been proposed as promising therapies. However, the results of clinical trials reported moderate toxicity and limited effectiveness. This study evaluates the in vivo pharmacokinetics and biodistribution of these mAbs in a growing model of glioblastoma in rats using Positron Emission Tomography (PET). MATERIAL &Methods: mAbs were radiolabeled with zirconium-89. Four days after the model induction, animals were injected with 2.33 ± 1.3 MBq of [89Zr]-DFO-bevacizumab (n = 8) or 2.35 ± 0.26 MBq of [89Zr]-DFO-aflibercept (n = 6). PETs were performed at 0H, 48H, 168H, 240H, and 336H post-injection. Tumor induction was confirmed using [18F]-Fluorodeoxyglucose-PET and immunohistochemistry. Radiotracer uptake was estimated in all pre-defined Volumes-of-Interest. RESULTS Anti-VEGF mAbs showed 100 % Radiochemical-Purity. [89Zr]-DFO-bevacizumab showed a significantly higher bioavailability in whole-blood. A significant increase in the tumor uptake was detectable at 168H PET with [89Zr]-DFO-bevacizumab meanwhile with [89Zr]-DFO-aflibercept it was only detectable at 336H. [89Zr]-DFO-bevacizumab tumor uptake was significantly higher than that of [89Zr]-DFO-aflibercept in all the scans. Tumor induction was confirmed in all animal models. CONCLUSION MAbs detect VEGF-expression in glioblastoma models. Tumors were earlier targeted by Bevacizumab. The lower blood availability of aflibercept resulted in a lower tumor uptake than bevacizumab in all the scans.
Collapse
Affiliation(s)
- Lara García-Varela
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Jessica Codesido
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Pharmacy Dept & Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | | | - María Muñoz-González
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Emma Ramos-Docampo
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - David Rey-Bretal
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Angela Turrero
- Cell Cycle and Oncology Group (CiCLOn), Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Spain
| | - Daniel Beiroa
- Centro de Biomedicina Experimental (CEBEGA), University of Santiago de Compostela, Spain
| | - Ana Isabel Rodríguez-Perez
- Cell and Molecular Neurobiology of Parkinson's disease, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Spain. Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain
| | - Anxo Vidal
- Cell Cycle and Oncology Group (CiCLOn), Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Dept & Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Virginia Pubul
- Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging and Pharmacokinetic Modelling Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), University Hospital Santiago de Compostela, Spain
| |
Collapse
|
3
|
Bandín-Vilar E, Toja-Camba FJ, Vidal-Millares M, Durán-Maseda MJ, Pou-Álvarez M, Castro-Balado A, Maroñas O, Gil-Rodríguez A, Carracedo Á, Zarra-Ferro I, Soy D, Fernández-Ferreiro A, Mangas-Sanjuan V, Mondelo-García C. Towards precision medicine of long-acting aripiprazole through population pharmacokinetic modelling. Psychiatry Res 2024; 333:115721. [PMID: 38245977 DOI: 10.1016/j.psychres.2024.115721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/02/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
Population pharmacokinetic (popPK) models constitute a valuable tool for characterizing the pharmacokinetic properties of once-monthly long-acting injectable aripiprazole (LAI aripiprazole) and quantifying the sources of variability in drug exposure. Our aim is to develop a popPK model of both aripiprazole and its metabolite dehydro-aripiprazole in patients treated with LAI aripiprazole, and to personalize the dosing regimen of aripiprazole across different sub-groups of patients. This is a prospective study investigating the pharmacokinetics of LAI aripiprazole. A total of 93 patients were included, 21 for model development and 71 for external model evaluation. A one-compartment model with linear absorption and elimination adequately described both aripiprazole and dehydro-aripiprazole concentrations. The weight of the patients has been shown to be the factor that most influences the absorption. However, the metabolizing phenotype for CYP2D6 and the concomitant treatment with strong inhibitors of this cytochrome have been shown to be the covariates that most influence total drug exposure. This is the first popPK model developed for LAI aripiprazole that includes aripiprazole and its main active metabolite, dehydroaripiprazole. It provides a personalized dosage recommendation that maximizes the probability of achieving optimal therapeutic concentrations and minimizes the difficulties associated with trial-and-error therapeutic strategies carried out in clinical practice.
Collapse
Affiliation(s)
- Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Spain
| | - Francisco José Toja-Camba
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Spain
| | - María Vidal-Millares
- Psychiatry Department, University Clinical Hospital of Santiago de Compostela, Spain
| | | | - Marta Pou-Álvarez
- Psychiatry Department, University Clinical Hospital of Santiago de Compostela, Spain
| | - Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Spain
| | - Olalla Maroñas
- Genomic Medicine Group CIMUS, University of Santiago de Compostela, Santiago de Compostela 15782, Spain; Galician Foundation of Genomic Medicine, Foundation of Health Research Institute of Santiago de Compostela (FIDIS), SERGAS, Santiago de Compostela, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain; Pharmacogenomics and drug discovery, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Almudena Gil-Rodríguez
- Genomic Medicine Group CIMUS, University of Santiago de Compostela, Santiago de Compostela 15782, Spain; Pharmacogenomics and drug discovery, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Ángel Carracedo
- Galician Foundation of Genomic Medicine, Foundation of Health Research Institute of Santiago de Compostela (FIDIS), SERGAS, Santiago de Compostela, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain; Pharmacogenomics and drug discovery, Health Research Institute of Santiago de Compostela (IDIS), Spain; Genetics group, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Dolors Soy
- Pharmacy Department Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Department of Pharmacology, Toxicology and Chemical Therapeutics, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain.
| | - Víctor Mangas-Sanjuan
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain; Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia - University of Valencia, Valencia, Spain.
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Spain.
| |
Collapse
|
4
|
Almuiña-Varela P, García-Quintanilla L, Rodríguez-Cid MJ, Gil-Martínez M, Abraldes MJ, Gómez-Ulla F, Estany-Gestal A, Alcántara-Espinosa JM, Fernández-Rodríguez M, Fernández-Ferreiro A. Relationships between Patient-Reported Outcome Measures and Clinical Measures in Naïve Neovascular Age-Related Macular Degeneration Patients Treated with Intravitreal Ranibizumab. Pharmaceuticals (Basel) 2024; 17:157. [PMID: 38399372 PMCID: PMC10893278 DOI: 10.3390/ph17020157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
Our objective was to evaluate changes in patient-reported outcome measures using the NEI-VFQ 25 questionnaire during a treat and extend regimen in naive neovascular Age-Related Macular Degeneration patients, and its correlation with anatomical and functional data. We conducted a prospective observational study. Patients underwent a treat and extend regimen with intravitreal ranibizumab for neovascular Age-Related Macular Degeneration. Initial response was evaluated at 4th month, and subsequently in every follow-up visit. If a clinical response was achieved, the injection interval was extended in two-week increments, up to a maximum of 12 weeks. Quality of life was assessed using the NEI-VFQ 25 questionnaire at baseline, 4th months, and 12th months. Patients were categorized as good or poor responders based on Best corrected visual acuity, central foveal thickness, intraretinal fluid, or subretinal fluid. Treatment with ranibizumab led to a significant improvement in quality of life, with a mean increase in NEI-VFQ 25 score of 4.27 points in the 12th month. No significant differences in improvement were observed between good and poor responders. Quality of life scores in neovascular Age-Related Macular Degeneration patients improved with intravitreal treatment regardless of the clinical response. The early response following the loading phase could indicate better quality of life after one year of treatment, with Best corrected visual acuity being the clinical parameter with the greatest influence on quality of life.
Collapse
Affiliation(s)
- Pablo Almuiña-Varela
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), 15706 Santiago de Compostela, Spain; (P.A.-V.); (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - Laura García-Quintanilla
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - María José Rodríguez-Cid
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), 15706 Santiago de Compostela, Spain; (P.A.-V.); (M.J.R.-C.); (M.G.-M.); (M.J.A.)
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), 15706 Santiago de Compostela, Spain; (P.A.-V.); (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - Maximino J. Abraldes
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), 15706 Santiago de Compostela, Spain; (P.A.-V.); (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Instituto Oftalmológico Gómez-Ulla, 15706 Santiago de Compostela, Spain;
- Department of Surgery, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | | - Ana Estany-Gestal
- FIDIS-Unidad de Epidemiología e Investigación Clínica, 15706 Santiago de Compostela, Spain; (A.E.-G.); (J.M.A.-E.)
| | | | - Maribel Fernández-Rodríguez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), 15706 Santiago de Compostela, Spain; (P.A.-V.); (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Instituto Oftalmológico Gómez-Ulla, 15706 Santiago de Compostela, Spain;
- Department of Surgery, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| |
Collapse
|
5
|
García-Quintanilla L, Almuiña-Varela P, Rodríguez-Cid MJ, Gil-Martínez M, Abraldes MJ, Gómez-Ulla F, González-Barcia M, Mondelo-García C, Estany-Gestal A, Otero-Espinar FJ, Fernández-Rodríguez M, Fernández-Ferreiro A. The Effect of Systemic Parameters and Baseline Characteristics in Short-Term Response Analysis with Intravitreal Ranibizumab in Treatment-Naive Patients with Neovascular Age-Related Macular Degeneration. Pharmaceutics 2024; 16:105. [PMID: 38258115 PMCID: PMC10818382 DOI: 10.3390/pharmaceutics16010105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Anti-vascular endothelial growth factor drugs keep being the main therapy for neovascular age-related macular degeneration (AMD). Possible predictive parameters (demographic, biochemical and/or inflammatory) could anticipate short-term treatment response with ranibizumab. 46 treatment-naive patients were included in a prospective observational study. They underwent three monthly injections of intravitreal ranibizumab for neovascular AMD and the clinical examination was made at baseline and one month after the third injection. Demographic characteristics, co-morbidities and concomitant treatments were recorded at the baseline visit. Biochemical parameters, complete blood count and inflammation biomarkers were also measured at these times. Uric Acid was found to be statistically significant with a one-point difference between good and poor responders in both basal and treated patients, but only in basal parameters was statistical significance reached (p = 0.007 vs. p = 0.071 in treated patients). Cholesterol and inflammatory parameters such as white blood cell count and neutrophils were significantly reduced over time when treated with intravitreal ranibizumab. On the other hand, women seemed to have a worse prognosis for short-term response to intravitreal ranibizumab treatment. Uric acid may help identify possible non-responders before initial treatment with ranibizumab, and cholesterol and white blood cells could be good candidates to monitor short-term response to ranibizumab treatment.
Collapse
Affiliation(s)
- Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (L.G.-Q.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Pablo Almuiña-Varela
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.J.R.-C.); (M.G.-M.); (M.J.A.)
| | - María José Rodríguez-Cid
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.J.R.-C.); (M.G.-M.); (M.J.A.)
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.J.R.-C.); (M.G.-M.); (M.J.A.)
| | - Maximino J. Abraldes
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Instituto Oftalmológico Gómez-Ulla, 15706 Santiago de Compostela, Spain;
- Department of Surgery, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (L.G.-Q.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (L.G.-Q.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| | - Ana Estany-Gestal
- FIDIS-Unidad de Epidemiología e Investigación Clínica, 15706 Santiago de Compostela, Spain;
| | - Francisco J. Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Maribel Fernández-Rodríguez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.J.R.-C.); (M.G.-M.); (M.J.A.)
- Instituto Oftalmológico Gómez-Ulla, 15706 Santiago de Compostela, Spain;
- Department of Surgery, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (L.G.-Q.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain;
| |
Collapse
|
6
|
Toja-Camba FJ, Bandín-Vilar E, Hermelo-Vidal G, Feitosa-Medeiros C, Cañizo-Outeiriño A, Castro-Balado A, Varela-Rey I, Zarra-Ferro I, Fernández-Ferreiro A, Mondelo-García C. Towards Precision Medicine in Clinical Practice: Alinity C vs. UHPLC-MS/MS in Plasma Aripiprazole Determination. Pharmaceutics 2024; 16:104. [PMID: 38258114 PMCID: PMC10820753 DOI: 10.3390/pharmaceutics16010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Therapeutic drug monitoring improves the benefit-risk balance of antipsychotic therapy. Ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) is considered the gold-standard method for measuring plasma drug concentrations; however, the Alinity C system has emerged as a promising alternative. This is the first study aimed at comparing UHPLC-MS/MS versus Alinity C in measuring plasma concentrations of aripiprazole and dehydroaripiprazole. A total of 86 plasma samples were analyzed. The active moiety of aripiprazole was measured in 60 samples using both systems and 26 samples were analyzed twice using Alinity C with an intermediate period of 6 months to assess its reproducibility. Spearman's correlation revealed a good association between the two assays (rs = 0.96) and no significance differences were found by McNemar's test when classifying samples between infra-, supra- and therapeutic ranges. Passing-Bablock regression showed a good correlation among methods (rs = 0.93) and a slope of 1.12 indicating a slight tendency of Alinity C to measure higher values than UHPLC-MS/MS. In addition, a good intra-method correlation across the two sequential analyses with Alinity C was obtained (rs = 0.99). Nonetheless, clinical decisions could be different in 15% of the cases depending on the chosen method. No differences were found in active moiety determination by Alinity C depending on the concentration of aripiprazole and dehydroaripiprazole of the samples.
Collapse
Affiliation(s)
- Francisco José Toja-Camba
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
- Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
- Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Gonzalo Hermelo-Vidal
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Carolina Feitosa-Medeiros
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Antonio Cañizo-Outeiriño
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (E.B.-V.); (A.C.-B.); (I.V.-R.); (I.Z.-F.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (G.H.-V.); (C.F.-M.); (A.C.-O.)
| |
Collapse
|
7
|
Toja-Camba FJ, García-Quintanilla L, Rodríguez-Martinez L, Tomine J, Cajade-Pascual F, Feitosa C, Zarra-Ferro I, Barreiro-De-Acosta M, González-López J, Mondelo-García C, Fernández-Ferreiro A. Enhancing Therapeutic Drug Monitoring in Inflammatory Bowel Disease: A Comparative Analysis of Rapid Point-of-Care Infliximab, Adalimumab and Anti-Drug Antibodies' Determination against ELISA. Pharmaceutics 2023; 15:2615. [PMID: 38004593 PMCID: PMC10675023 DOI: 10.3390/pharmaceutics15112615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The introduction of point-of-care (POC) assays into clinical practice in patients with inflammatory disease enables on-demand therapeutic decision making. The aim of this study was to compare the POC test Quantum blue (Bühlmann Laboratories) for infliximab (IFX), adalimumab (ADL), and its anti-drug antibodies with the traditional ELISA assay (Promonitor). A total of 200 serum samples were analyzed. Samples were classified into the following three different groups; sub-therapeutic range (IFX < 3 μg/mL and ADL < 5 μg/mL); therapeutic range (IFX: 3-7 μg/mL and ADL: 5-12 μg/mL) and supra-therapeutic range (IFX levels > 7 μg/mL and ADL levels > 12 μg/mL). Significant higher values were measured using the POC test (p < 0.001) for IFX results but no differences in ADL trough levels were observed (p = 0.3101). Spearman's correlation indicated a good correlation between the two assays (rs = 0.88 for ADL and rs = 0.93 for IFX), and McNemar's test revealed significant differences (p = 0.016) when classifying IFX samples between therapeutic and supra-therapeutic ranges but no significant differences were found among the other ranges for either IFX or ADL. These results show that we should be cautious when using these rapid measurement methods, and new targets should probably be defined for IFX when using this new analytical method.
Collapse
Affiliation(s)
- Francisco José Toja-Camba
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
- Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
- Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Lorena Rodríguez-Martinez
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Julia Tomine
- Pharmacy Department, Faculty of Health, University of Angers, 16, Boulevard Daviers, 49045 Angers, France;
| | - Francisco Cajade-Pascual
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Carolina Feitosa
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Manuel Barreiro-De-Acosta
- Gastroenterology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain;
| | - Jaime González-López
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (F.J.T.-C.); (L.G.-Q.); (F.C.-P.); (I.Z.-F.); (J.G.-L.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (C.F.)
| |
Collapse
|
8
|
Castro-Balado A, Cuartero-Martínez A, Pena-Verdeal H, Hermelo-Vidal G, Schmidt A, Montero B, Hernández-Blanco M, Zarra-Ferro I, González-Barcia M, Mondelo-García C, Giráldez MJ, Yebra-Pimentel E, Otero-Espinar FJ, Fernández-Ferreiro A. Cysteamine Eye Drops in Hyaluronic Acid Packaged in Innovative Single-Dose Systems, Part II: Long-Term Stability and Clinical Ocular Biopermanence. Pharmaceutics 2023; 15:2589. [PMID: 38004568 PMCID: PMC10675239 DOI: 10.3390/pharmaceutics15112589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in several tissues and organs causing, among others, severe eye symptoms. The high instability of cysteamine eye drops makes it difficult to develop formulations with an acceptable shelf life to be prepared in hospital pharmacy departments. Previously, a new compounded formulation of cysteamine eye drops in hyaluronic acid (HA) packaged in innovative single-dose systems was developed. METHODS Long-term stability at -20 °C of this formulation was studied considering the content of cysteamine, pH, osmolality, viscosity, and microbiological analysis. The oxygen permeability of single-dose containers was also studied and an ocular biopermanence study was conducted in healthy volunteers measuring lacrimal stability and volume parameters. RESULTS Data confirm that cysteamine concentration remained above 90% for 120 days, all parameters remaining within the accepted range for ophthalmic formulations. The permeability of the containers was reduced over time, while ocular biopermanence was maintained despite the freezing process and storage time. CONCLUSIONS 0.55% cysteamine hydrochloride formulation in HA and packaged in single-dose containers preserved at -20 °C is stable for 120 days protected from light, presenting high potential for its translation into clinical practice when commercial presentations are not available.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (I.Z.-F.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Andrea Cuartero-Martínez
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| | - Hugo Pena-Verdeal
- Department of Applied Physics (Optometry), Faculty of Optics and Optometry, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (H.P.-V.); (M.J.G.); (E.Y.-P.)
- Optometry Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Gonzalo Hermelo-Vidal
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| | - Anja Schmidt
- Group of Polymers, Physics and Earth Sciences Department, Campus Industrial de Ferrol (CIF), CITENI, Escuela Politécnica de Ingeniería (EPEF), Universidade da Coruña, C/Mendizabal s/n, 15403 Ferrol, Spain; (A.S.); (B.M.)
| | - Belén Montero
- Group of Polymers, Physics and Earth Sciences Department, Campus Industrial de Ferrol (CIF), CITENI, Escuela Politécnica de Ingeniería (EPEF), Universidade da Coruña, C/Mendizabal s/n, 15403 Ferrol, Spain; (A.S.); (B.M.)
| | - Manuela Hernández-Blanco
- Microbiology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain;
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (I.Z.-F.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (I.Z.-F.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (I.Z.-F.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| | - María Jesús Giráldez
- Department of Applied Physics (Optometry), Faculty of Optics and Optometry, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (H.P.-V.); (M.J.G.); (E.Y.-P.)
- Optometry Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- Department of Applied Physics (Optometry), Faculty of Optics and Optometry, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (H.P.-V.); (M.J.G.); (E.Y.-P.)
- Optometry Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Francisco J. Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (I.Z.-F.); (M.G.-B.); (C.M.-G.)
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.C.-M.); (G.H.-V.)
| |
Collapse
|
9
|
García-Quintanilla L, Almuiña-Varela P, Maroñas O, Gil-Rodriguez A, Rodríguez-Cid MJ, Gil-Martinez M, Abraldes MJ, Gómez-Ulla de Irazazabal F, González-Barcia M, Mondelo-Garcia C, Cruz R, Estany-Gestal A, Fernández-Rodríguez M, Fernández-Ferreiro A. Influence of Genetic Polymorphisms on the Short-Term Response to Ranibizumab in Patients With Neovascular Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2023; 64:34. [PMID: 37862026 PMCID: PMC10599160 DOI: 10.1167/iovs.64.13.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose To determine whether genetic risk single nucleotide polymorphisms (SNPs) for age-related macular degeneration (AMD) influence short-term response to intravitreal ranibizumab treatment. Methods Forty-four treatment-naive AMD patients were included in a prospective observational study. They underwent three monthly injections of intravitreal ranibizumab for neovascular AMD. After an initial clinical examination (baseline measurement), a follow-up visit was performed to determine treatment response one month after the third injection (treatment evaluation). Patients were evaluated based on ophthalmoscopy, fluorescein angiography, optical coherence tomography (OCT), and OCT angiography. Peripheral venous blood was collected for DNA analysis at baseline visit. Patients were genotyped for single-nucleotide polymorphisms within AMD-relevant genes and classified on good or poor responders based on visual acuity, central retinal thickness, intraretinal fluid, and subretinal fluid. Results One hundred ten AMD-associated SNPs have been analyzed. Six were found to be relevant when associated to ranibizumab treatment response. The genetic variants rs890293 (CYP2J2), rs11200638 (HTRA1), rs405509 (APOE), rs9513070 (FLT1), and rs8135665 (SLC16A8) predisposed patients to a good response, whereas rs3093077 (CRP) was associated with a poor response. FTL1, SLC16A8, and APOE were the SNPs that showed significance (P < 0.05) but did not pass Bonferroni correction. Conclusions This is the first study that links novel polymorphisms in genes such as CRP, SCL16A8, or CYP2J2 to treatment response to ranibizumab therapy. On the other hand, HTRA1, FLT1, and APOE are linked to a good ranibizumab response. These SNPs may be good candidates for short-term treatment response biomarkers in AMD patients. However, further studies will be necessary to confirm our findings.
Collapse
Affiliation(s)
- Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Pablo Almuiña-Varela
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), Santiago de Compostela, Spain
| | - Olalla Maroñas
- Grupo de Genética, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
- Grupo de Medicina Xenómica, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
- Grupo de Medicina Xenómica, Fundación Pública Galega de Medicina Xenómica (FPGMX), Santiago de Compostela, Galicia, Spain
| | - Almudena Gil-Rodriguez
- Grupo de Genética, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
- Grupo de Medicina Xenómica, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María José Rodríguez-Cid
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), Santiago de Compostela, Spain
| | - María Gil-Martinez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), Santiago de Compostela, Spain
| | - Maximino J. Abraldes
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), Santiago de Compostela, Spain
- Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
- Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Cristina Mondelo-Garcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Raquel Cruz
- Grupo de Medicina Xenómica, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Estany-Gestal
- FIDIS-Unidad de Epidemiología e Investigación Clínica, Santiago de Compostela (A Coruña), Spain
| | - Maribel Fernández-Rodríguez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela, (SERGAS), Santiago de Compostela, Spain
- Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
- Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
10
|
Bandín-Vilar E, García-Quintanilla L, Castro-Balado A, Zarra-Ferro I, González-Barcia M, Campos-Toimil M, Mangas-Sanjuan V, Mondelo-García C, Fernández-Ferreiro A. Correction: A Review of Population Pharmacokinetic Analyses of Linezolid. Clin Pharmacokinet 2023; 62:1331. [PMID: 37535241 DOI: 10.1007/s40262-023-01295-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Affiliation(s)
- Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Manuel Campos-Toimil
- Physiology and Pharmacology of Chronic Diseases (FIFAEC), Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Víctor Mangas-Sanjuan
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain.
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia, Valencia, Spain.
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain.
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Travesía da Choupana, 15706, Santiago de Compostela, Spain.
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| |
Collapse
|
11
|
Rodríguez-Martínez L, Castro-Balado A, Hermelo-Vidal G, Bandín-Vilar E, Varela-Rey I, Toja-Camba FJ, Rodríguez-Jato T, Novo-Veleiro I, Varela-García PM, Zarra-Ferro I, González-Barcia M, Mondelo-García C, Mateos J, Fernández-Ferreiro A. Ampicillin Stability in a Portable Elastomeric Infusion Pump: A Step Forward in Outpatient Parenteral Antimicrobial Therapy. Pharmaceutics 2023; 15:2099. [PMID: 37631313 PMCID: PMC10458095 DOI: 10.3390/pharmaceutics15082099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Outpatient parenteral antimicrobial therapy (OPAT) with continuous infusion pumps is postulated as a very promising solution to treat complicated infections, such as endocarditis or osteomyelitis, that require patients to stay in hospital during extended periods of time, thus reducing their quality of life and increasing the risk of complications. However, stability studies of drugs in elastomeric devices are scarce, which limits their use in OPAT. Therefore, we evaluated the stability of ampicillin in sodium chloride 0.9% at two different concentrations, 50 and 15 mg/mL, in an elastomeric infusion pump when stored in the refrigerator and subsequently in real-life conditions at two different temperatures, 25 and 32 °C, with and without the use of a cooling device. The 15 mg/mL ampicillin is stable for up to 72 h under refrigeration, allowing subsequent dosing at 25 °C for 24 h with and without a cooling device, but at 32 °C its concentration drops below 90% after 8 h. In contrast, 50 mg/mL ampicillin only remains stable for the first 24 h under refrigeration, and subsequent administration at room temperature is not possible, even with the use of a cooling system. Our data support that 15 mg/mL AMP is suitable for use in OPAT if the volume and rate of infusion are tailored to the dosage needs of antimicrobial treatments.
Collapse
Affiliation(s)
- Lorena Rodríguez-Martínez
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
| | - Ana Castro-Balado
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Gonzalo Hermelo-Vidal
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
| | - Enrique Bandín-Vilar
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Iria Varela-Rey
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Francisco José Toja-Camba
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Teresa Rodríguez-Jato
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Ignacio Novo-Veleiro
- Home Hospitalization Unit, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Pablo Manuel Varela-García
- Internal Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Jesús Mateos
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
| | - Anxo Fernández-Ferreiro
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (L.R.-M.); (A.C.-B.); (A.F.-F.)
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| |
Collapse
|
12
|
Varela-Rey I, de la Iglesia D, San Bruno-Ruz A, Mejuto-Fernández R, Monteserín-Ron L, López-Diaz J, García-Salom P, González-Cantalapiedra A, Manuel Brea J, Piña-Márquez R, Díaz-Tomé V, González-Barcia M, Zarra-Ferro I, Mondelo-García C, Dominguez-Muñoz JE, Otero-Espinar FJ, Fernández-Ferreiro A. Design and biopharmaceutical preclinical characterisation of a new thermosensitive hydrogel for the removal of gastric polyps. Int J Pharm 2023; 635:122706. [PMID: 36803925 DOI: 10.1016/j.ijpharm.2023.122706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIMS Submucosal injection agents are widely used solutions in gastric polyp resection techniques. Currently, many different solutions are used in clinical practice, but most are not authorised for this use or are not biopharmaceutical characterised. The objective of this multidisciplinary work is to test the efficacy of a novel thermosensitive hydrogel designed specifically for this indication. METHODS A mixture design of various components (Pluronic®, hyaluronic acid and sodium alginate) was carried out to select the combination with optimal properties for this use. Three final thermosensitive hydrogels were selected on which biopharmaceutical characterisation was performed and stability and biocompatibility were analysed. Efficacy in maintaining elevation was tested ex vivo on pig mucosa and in vivo in pigs RESULTS: The mixture design allowed selection of the ideal combinations of agents for the characteristics sought. The thermosensitive hydrogels studied showed high values of hardness and viscosity at 37 °C, maintaining good syringeability. One of them demonstrated superiority in maintaining polyp elevation in the ex vivo assay and non-inferiority in the in vivo assay. CONCLUSION The thermosensitive hydrogel specifically designed for this use is promising both for its biopharmaceutical characteristics and for its demonstrated efficacy. This study lays the foundation for evaluating the hydrogel in humans.
Collapse
Affiliation(s)
- Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Daniel de la Iglesia
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Alba San Bruno-Ruz
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Rafael Mejuto-Fernández
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Luzdivina Monteserín-Ron
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Javier López-Diaz
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Pedro García-Salom
- Pharmacy Department, University Clinical Hospital Dr. Balmis, 03010 Alicante, Spain
| | | | | | | | - Victoria Díaz-Tomé
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - J Enrique Dominguez-Muñoz
- Digestive Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| |
Collapse
|
13
|
Blanco-Fernández G, Blanco-Fernandez B, Fernández-Ferreiro A, Otero-Espinar FJ. Lipidic lyotropic liquid crystals: Insights on biomedical applications. Adv Colloid Interface Sci 2023; 313:102867. [PMID: 36889183 DOI: 10.1016/j.cis.2023.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/26/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023]
Abstract
Liquid crystals (LCs) possess unique physicochemical properties, translatable into a wide range of applications. To date, lipidic lyotropic LCs (LLCs) have been extensively explored in drug delivery and imaging owing to the capability to encapsulate and release payloads with different characteristics. The current landscape of lipidic LLCs in biomedical applications is provided in this review. Initially, the main properties, types, methods of fabrication and applications of LCs are showcased. Then, a comprehensive discussion of the main biomedical applications of lipidic LLCs accordingly to the application (drug and biomacromolecule delivery, tissue engineering and molecular imaging) and route of administration is examined. Further discussion of the main limitations and perspectives of lipidic LLCs in biomedical applications are also provided. STATEMENT OF SIGNIFICANCE: Liquid crystals (LCs) are those systems between a solid and liquid state that possess unique morphological and physicochemical properties, translatable into a wide range of biomedical applications. A short description of the properties of LCs, their types and manufacturing procedures is given to serve as a background to the topic. Then, the latest and most innovative research in the field of biomedicine is examined, specifically the areas of drug and biomacromolecule delivery, tissue engineering and molecular imaging. Finally, prospects of LCs in biomedicine are discussed to show future trends and perspectives that might be utilized. This article is an ampliation, improvement and actualization of our previous short forum article "Bringing lipidic lyotropic liquid crystal technology into biomedicine" published in TIPS.
Collapse
Affiliation(s)
- Guillermo Blanco-Fernández
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Paraquasil Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Institute of Materials (iMATUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Bárbara Blanco-Fernandez
- CIBER in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Madrid, Spain; Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Baldiri Reixac 10-12, Barcelona 08028, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Paraquasil Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Institute of Materials (iMATUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| |
Collapse
|
14
|
Busto-Iglesias M, Rodríguez-Martínez L, Rodríguez-Fernández CA, González-López J, González-Barcia M, de Domingo B, Rodríguez-Rodríguez L, Fernández-Ferreiro A, Mondelo-García C. Perspectives of Therapeutic Drug Monitoring of Biological Agents in Non-Infectious Uveitis Treatment: A Review. Pharmaceutics 2023; 15:pharmaceutics15030766. [PMID: 36986627 PMCID: PMC10051556 DOI: 10.3390/pharmaceutics15030766] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Biological drugs, especially those targeting anti-tumour necrosis factor α (TNFα) molecule, have revolutionized the treatment of patients with non-infectious uveitis (NIU), a sight-threatening condition characterized by ocular inflammation that can lead to severe vision threatening and blindness. Adalimumab (ADA) and infliximab (IFX), the most widely used anti-TNFα drugs, have led to greater clinical benefits, but a significant fraction of patients with NIU do not respond to these drugs. The therapeutic outcome is closely related to systemic drug levels, which are influenced by several factors such as immunogenicity, concomitant treatment with immunomodulators, and genetic factors. Therapeutic drug monitoring (TDM) of drug and anti-drug antibody (ADAbs) levels is emerging as a resource to optimise biologic therapy by personalising treatment to bring and maintain drug concentration within the therapeutic range, especially in those patients where a clinical response is less than expected. Furthermore, some studies have described different genetic polymorphisms that may act as predictors of response to treatment with anti-TNFα agents in immune-mediated diseases and could be useful in personalising biologic treatment selection. This review is a compilation of the published evidence in NIU and in other immune-mediated diseases that support the usefulness of TDM and pharmacogenetics as a tool to guide clinicians’ treatment decisions leading to better clinical outcomes. In addition, findings from preclinical and clinical studies, assessing the safety and efficacy of intravitreal administration of anti-TNFα agents in NIU are discussed.
Collapse
Affiliation(s)
- Manuel Busto-Iglesias
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Lorena Rodríguez-Martínez
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Carmen Antía Rodríguez-Fernández
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
- Ophthalmology Department, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Jaime González-López
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Begoña de Domingo
- Ophthalmology Department, University Clinical Hospital of Santiago Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Luis Rodríguez-Rodríguez
- Musculoskeletal Pathology Group, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: (L.R.-R.); (A.F.-F.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (L.R.-R.); (A.F.-F.)
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| |
Collapse
|
15
|
Castro-Balado A, Novo-Veleiro I, Vázquez-Agra N, Barbeito-Castiñeiras G, Estany-Gestal A, Trastoy-Pena R, González-Barcia M, Zarra-Ferro I, del Río-Garma MC, Crespo-Diz C, Delgado-Sánchez O, Otero-Espinar FJ, Mondelo-García C, Pose-Reino A, Fernández-Ferreiro A. Efficacy and Safety of Inhaled Ethanol in Early-Stage SARS-CoV-2 Infection in Older Adults: A Phase II Randomized Clinical Trial. Pharmaceutics 2023; 15:pharmaceutics15020667. [PMID: 36839987 PMCID: PMC9966500 DOI: 10.3390/pharmaceutics15020667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Inhaled ethanol in the early stages of SARS-CoV-2 infection may reduce the viral load, decreasing progression and improving prognosis. The ALCOVID-19 trial was designed to study the efficacy and safety of inhaled ethanol in older adults at initial phases of infection. METHODS Randomized, triple-blind, placebo-controlled phase II clinical trial. Experimental group (n = 38) inhaled 65° ethanol through an oxygen flow, while in the control group (n = 37), water for injection was used. General endpoint was to evaluate disease progression according to the modified World Health Organization (WHO) Clinical Progression Scale. Specific effectiveness endpoints were body temperature, oxygen saturation, viral load assessed by cycle threshold (Ct) on real-time polymerase chain reaction (RT-PCR), analytical biomarkers and use of antibiotics or corticosteroids. Specific safety outcomes were the absence of ethanol in plasma, electrographic, analytical, or respiratory alterations. RESULTS In the intention-to-treat population, no differences were found regarding disease progression. Mean Ct values increased over time in both groups, being numerically higher in the ethanol group, reaching a value above 33 only in the ethanol group on day 14, a value above which patients are considered non-infective. No differences were found in the other specific effectiveness endpoints. Inhaled ethanol was proven to be safe as no plasma ethanol was detected, and there were no electrocardiographic, analytical, or respiratory alterations. CONCLUSIONS The efficacy of inhaled ethanol in terms of the progression of SARS-CoV-2 infection was not demonstrated in the present trial. However, it is positioned as a safe treatment for elderly patients with early-stage COVID-19.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Ignacio Novo-Veleiro
- Internal Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Néstor Vázquez-Agra
- Internal Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Gema Barbeito-Castiñeiras
- Microbiology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Ana Estany-Gestal
- Epidemiology and Clinical Research Unit, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Rocío Trastoy-Pena
- Microbiology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - María Carmen del Río-Garma
- Clinical Analytic Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Carlos Crespo-Diz
- Pharmacy Department, University Clinical Hospital of Pontevedra (SERGAS), 36162 Pontevedra, Spain
| | | | - Francisco J. Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (A.P.-R.); (A.F.-F.); Tel.: +34-981-951-423 (A.F.-F.)
| | - Antonio Pose-Reino
- Internal Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (A.P.-R.); (A.F.-F.); Tel.: +34-981-951-423 (A.F.-F.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (A.P.-R.); (A.F.-F.); Tel.: +34-981-951-423 (A.F.-F.)
| |
Collapse
|
16
|
Blanco-Fernandez G, Blanco-Fernandez B, Fernández-Ferreiro A, Otero-Espinar F. Bringing lipidic lyotropic liquid crystal technology into biomedicine. Trends Pharmacol Sci 2023; 44:7-10. [PMID: 35400560 DOI: 10.1016/j.tips.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/27/2022]
Abstract
Liquid crystals (LCs), discovered more than 130 years ago, are now emerging in the field of biomedicine. This article highlights the recent uses of lipid lyotropic LCs in therapeutics delivery, imaging, and tissue engineering and invites the scientific community to continue exploring the design of more complex LCs.
Collapse
Affiliation(s)
- Guillermo Blanco-Fernandez
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Paraquasil Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Institute of Materials (iMATUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Barbara Blanco-Fernandez
- CIBER in Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Madrid, Spain; Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Baldiri Reixac 10-12, Barcelona, 08028, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| | - Francisco Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Paraquasil Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Institute of Materials (iMATUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| |
Collapse
|
17
|
García-Otero X, Mondelo-García C, Bandín-Vilar E, Gómez-Lado N, Silva-Rodríguez J, Rey-Bretal D, Victoria Otero-Espinar M, Adan A, González-Barcia M, Aguiar P, Otero-Espinar FJ, Fernández-Ferreiro A. PET study of intravitreal adalimumab pharmacokinetics in a uveitis rat model. Int J Pharm 2022; 627:122261. [DOI: 10.1016/j.ijpharm.2022.122261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/17/2022] [Accepted: 09/28/2022] [Indexed: 11/24/2022]
|
18
|
Castro-Balado A, Bandín-Vilar E, Cuartero-Martínez A, García-Quintanilla L, Hermelo-Vidal G, García-Otero X, Rodríguez-Martínez L, Mateos J, Hernández-Blanco M, Aguiar P, Zarra-Ferro I, González-Barcia M, Mondelo-García C, Otero-Espinar FJ, Fernández-Ferreiro A. Cysteamine Eye Drops in Hyaluronic Acid Packaged in Innovative Single-Dose Systems: Stability and Ocular Biopermanence. Pharmaceutics 2022; 14:pharmaceutics14102194. [PMID: 36297629 PMCID: PMC9607622 DOI: 10.3390/pharmaceutics14102194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in different tissues and organs causing, among other symptoms, severe ocular manifestations. Cysteamine eye drops are prepared in hospital pharmacy departments to facilitate access to treatment, for which vehicles that provide adequate biopermanence, as well as adaptable containers that maintain its stability, are required. Difficulties related to cysteamine preparation, as well as its tendency to oxidize to cystamine, show the importance of conducting rigorous galenic characterization studies. This work aims to develop and characterize an ophthalmic compounded formulation of cysteamine prepared with hyaluronic acid and packaged in innovative single-dose systems. For this task, the effect of different storage temperatures and the presence/absence of nitrogen on the physicochemical stability of the formulation and its packaging was studied in a scaled manner, until reaching the optimal storage conditions. The results showed that 0.55% cysteamine, prepared with hyaluronic acid and packaged in single-dose containers, is stable for 30 days when stored at −20 °C. In addition, opening vials every 4 h at room temperature after 30 days of freezing maintains the stability of the cysteamine formulation for up to 16 h. Moreover, ocular biopermanence studies were conducted using molecular imaging, concluding that the biopermanence offered by the vehicle is not affected by the freezing process, where a half-life of 31.11 min for a hyaluronic acid formulation stored for 30 days at −20 °C was obtained, compared with 14.63 min for 0.9% sodium chloride eye drops.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Andrea Cuartero-Martínez
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Gonzalo Hermelo-Vidal
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
- Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Lorena Rodríguez-Martínez
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Jesús Mateos
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Manuela Hernández-Blanco
- Microbiology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (F.J.O.-E.); (A.F.-F.)
| | - Francisco J. Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (F.J.O.-E.); (A.F.-F.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (C.M.-G.); (F.J.O.-E.); (A.F.-F.)
| |
Collapse
|
19
|
Rodríguez-Fernández CA, Iglesias MB, de Domingo B, Conde-Pérez K, Vallejo JA, Rodríguez-Martínez L, González-Barcia M, Llorenç V, Mondelo-Garcia C, Poza M, Fernández-Ferreiro A. Microbiome in Immune-Mediated Uveitis. Int J Mol Sci 2022; 23:ijms23137020. [PMID: 35806031 PMCID: PMC9266430 DOI: 10.3390/ijms23137020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
In the last decades, personalized medicine has been increasing its presence in different fields of medicine, including ophthalmology. A new factor that can help us direct medicine towards the challenge of personalized treatments is the microbiome. The gut microbiome plays an important role in controlling immune response, and dysbiosis has been associated with immune-mediated diseases such as non-infectious uveitis (NIU). In this review, we gather the published evidence, both in the pre-clinical and clinical studies, that support the possible role of intestinal dysbiosis in the pathogenesis of NIU, as well as the modulation of the gut microbiota as a new possible therapeutic target. We describe the different mechanisms that have been proposed to involve dysbiosis in the causality of NIU, as well as the potential pharmacological tools that could be used to modify the microbiome (dietary supplementation, antibiotics, fecal microbiota transplantation, immunomodulators, or biologic drugs) and, consequently, in the control of the NIU. Furthermore, there is increasing scientific evidence suggesting that the treatment with anti-TNF not only restores the composition of the gut microbiota but also that the study of the composition of the gut microbiome will help predict the response of each patient to anti-TNF treatment.
Collapse
Affiliation(s)
| | - Manuel Busto Iglesias
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.B.I.); (M.G.-B.); (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Begoña de Domingo
- Ophthalmology Department, University Clinical Hospital of Santiago Compostela (SERGAS), 15706 Santiago de Compostela, Spain;
| | - Kelly Conde-Pérez
- Microbiology Research Group: meiGAbiome, Biomedical Research Institute (INIBIC), Center for Advanced Research (CICA), University of A Coruña (UDC), CIBER of Infectious Diseases (CIBERINF), 15006 A Coruña, Spain; (K.C.-P.); (J.A.V.)
| | - Juan A. Vallejo
- Microbiology Research Group: meiGAbiome, Biomedical Research Institute (INIBIC), Center for Advanced Research (CICA), University of A Coruña (UDC), CIBER of Infectious Diseases (CIBERINF), 15006 A Coruña, Spain; (K.C.-P.); (J.A.V.)
| | - Lorena Rodríguez-Martínez
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.B.I.); (M.G.-B.); (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Victor Llorenç
- Clínic Institute of Ophthalmology (ICOF), Clinic Hospital of Barcelona, 08028 Barcelona, Spain;
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Clínic Hospital of Barcelona, 08036 Barcelona, Spain
| | - Cristina Mondelo-Garcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.B.I.); (M.G.-B.); (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Margarita Poza
- Microbiology Research Group: meiGAbiome, Biomedical Research Institute (INIBIC), Center for Advanced Research (CICA), University of A Coruña (UDC), CIBER of Infectious Diseases (CIBERINF), 15006 A Coruña, Spain; (K.C.-P.); (J.A.V.)
- Correspondence: (M.P.); (A.F.-F.)
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (M.B.I.); (M.G.-B.); (C.M.-G.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
- Correspondence: (M.P.); (A.F.-F.)
| |
Collapse
|
20
|
González-Barcia M, Mondelo-García C, Otero-Espinar FJ, Fernández-Ferreiro A. Selected evidence and cherry picking pharmaceutical compounding. Farm Hosp 2022; 46:100-101. [PMID: 35379104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Miguel González-Barcia
- Pharmacy Department, Hospital Clínico Universitario, Santiago de Compostela. Spain. Grupo Farmacología Clínica, Instituto Investigación Sanitaria, Santiago de Compostela. Spain..
| | - Cristina Mondelo-García
- Grupo Farmacología Clínica, Instituto Investigación Sanitaria, Santiago de Compostela. Spain. Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Universidad de Santiago de Compostela, Santiago de Compostela. Spain..
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Universidad de Santiago de Compostela, Santiago de Compostela. Spain..
| | - Anxo Fernández-Ferreiro
- Grupo Farmacología Clínica, Instituto Investigación Sanitaria, Santiago de Compostela. Spain. Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Universidad de Santiago de Compostela, Santiago de Compostela. Spain..
| |
Collapse
|
21
|
Fernández-Ferreiro A, Formigo-Couceiro FJ, Veiga-Gutierrez R, Maldonado-Lobón JA, Hermida-Cao AM, Rodriguez C, Bañuelos O, Olivares M, Blanco-Rojo R. Effects of Loigolactobacillus coryniformis K8 CECT 5711 on the Immune Response of Elderly Subjects to COVID-19 Vaccination: A Randomized Controlled Trial. Nutrients 2022; 14:228. [PMID: 35011103 PMCID: PMC8747230 DOI: 10.3390/nu14010228] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 02/04/2023] Open
Abstract
Elderly people are particularly vulnerable to COVID-19, with a high risk of developing severe disease and a reduced immune response to the COVID-19 vaccine. A randomized, placebo-controlled, double-blind trial to assess the effect of the consumption of the probiotic Loigolactobacillus coryniformis K8 CECT 5711 on the immune response generated by the COVID-19 vaccine in an elderly population was performed. Two hundred nursing home residents >60 yrs that had not COVID-19 were randomized to receive L. coryniformis K8 or a placebo daily for 3 months. All volunteers received a complete vaccination schedule of a mRNA vaccine, starting the intervention ten days after the first dose. Specific IgG and IgA antibody levels were analyzed 56 days after the end of the immunization process. No differences between the groups were observed in the antibody levels. During the intervention, 19 subjects had COVID-19 (11 receiving K8 vs. 8 receiving placebo, p = 0.457). Subgroup analysis in these patients showed that levels of IgG were significantly higher in those receiving K8 compared to placebo (p = 0.038). Among subjects >85 yrs that did not get COVID-19, administration of K8 tended to increase the IgA levels (p = 0.082). The administration of K8 may enhance the specific immune response against COVID-19 and may improve the COVID-19 vaccine-specific responses in elderly populations.
Collapse
Affiliation(s)
- Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.F.-F.); (R.V.-G.); (A.M.H.-C.)
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | | | - Roi Veiga-Gutierrez
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.F.-F.); (R.V.-G.); (A.M.H.-C.)
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Jose A. Maldonado-Lobón
- Research and Development Department, Biosearch Life, a Kerry Company, 18004 Granada, Spain; (J.A.M.-L.); (C.R.); (O.B.); (M.O.)
| | - Ana M. Hermida-Cao
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.F.-F.); (R.V.-G.); (A.M.H.-C.)
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Carlos Rodriguez
- Research and Development Department, Biosearch Life, a Kerry Company, 18004 Granada, Spain; (J.A.M.-L.); (C.R.); (O.B.); (M.O.)
| | - Oscar Bañuelos
- Research and Development Department, Biosearch Life, a Kerry Company, 18004 Granada, Spain; (J.A.M.-L.); (C.R.); (O.B.); (M.O.)
| | - Mónica Olivares
- Research and Development Department, Biosearch Life, a Kerry Company, 18004 Granada, Spain; (J.A.M.-L.); (C.R.); (O.B.); (M.O.)
| | - Ruth Blanco-Rojo
- Research and Development Department, Biosearch Life, a Kerry Company, 18004 Granada, Spain; (J.A.M.-L.); (C.R.); (O.B.); (M.O.)
| |
Collapse
|
22
|
Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodriguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:578-586. [PMID: 34756279 DOI: 10.1016/j.oftale.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
Collapse
Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), Spain
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, Spain
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
| | - M J Rodriguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, Spain
| | | | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain; Departamento de Salud Alicante-Sant Joan, Alicante, Spain; Universidad Miguel Hernández, Elche (Alicante), Spain
| |
Collapse
|
23
|
Mondelo-García C, Bandín-Vilar E, García-Quintanilla L, Castro-Balado A, Del Amo EM, Gil-Martínez M, Blanco-Teijeiro MJ, González-Barcia M, Zarra-Ferro I, Fernández-Ferreiro A, Otero-Espinar FJ. Current Situation and Challenges in Vitreous Substitutes. Macromol Biosci 2021; 21:e2100066. [PMID: 33987966 DOI: 10.1002/mabi.202100066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/23/2021] [Indexed: 12/11/2022]
Abstract
Vitreo-retinal disorders constitute a significant portion of treatable ocular diseases. These pathologies often require vitreo-retinal surgery and, as a consequence, the use of vitreous substitutes. Nowadays, the vitreous substitutes that are used in clinical practice are mainly divided into gases (air, SF6 , C2 F6 , C3 F8 ) and liquids (perfluorocarbon liquids, silicone oils, and heavy silicone oils). There are specific advantages and drawbacks to each of these, which determine their clinical indications. However, developing the ideal biomaterial for vitreous substitution continues to be one of the most important challenges in ophthalmology, and a multidisciplinary approach is required. In this sense, recent research has focused on the development of biocompatible, biodegradable, and injectable hydrogels (natural, synthetic, and smart), which also act as medium and long-term internal tamponade agents. This comprehensive review aims to cover the main characteristics and indications for use of the extensive range of vitreous substitutes that are currently used in clinical practice, before going on to describe the hydrogels that have been developed recently and which have emerged as promising biomaterials for vitreous substitution.
Collapse
Affiliation(s)
- Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Eva M Del Amo
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, 70211, Finland
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain
| | - María José Blanco-Teijeiro
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, 15782, Spain
| |
Collapse
|
24
|
Blanco-Dorado S, Belles Medall MD, Pascual-Marmaneu O, Campos-Toimil M, Otero-Espinar FJ, Rodríguez-Riego R, Rodríguez-Jato T, Zarra-Ferro I, Lamas MJ, Fernández-Ferreiro A. Therapeutic drug monitoring of voriconazole: validation of a high performance liquid chromatography method and comparison with an ARK immunoassay. Eur J Hosp Pharm 2021. [DOI: 10.1136/ejhpharm-2019-002155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
25
|
Castro-Balado A, Mondelo-García C, Zarra-Ferro I, Fernández-Ferreiro A. Erratum found in «Farmacia Hospitalaria. 2020;44(4):149-57». Farm Hosp 2021; 45:11682. [PMID: 33709895 DOI: 10.7399/fh.11682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Affiliation(s)
- Ana Castro-Balado
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain. Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela. Spain..
| | - Cristina Mondelo-García
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| | - Irene Zarra-Ferro
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| | - Anxo Fernández-Ferreiro
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| |
Collapse
|
26
|
Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodríguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(21)00034-4. [PMID: 33612365 DOI: 10.1016/j.oftal.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
Collapse
Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), España
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, España
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS) , Santiago de Compostela, España; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, España
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, España
| | - M J Rodríguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, España
| | - E Ignacio
- Universidad de Cádiz, Cádiz, Espa0ña
| | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España; Departamento de Salud Alicante-Sant Joan, Alicante, España; Universidad Miguel Hernández, Elche (Alicante), España
| |
Collapse
|
27
|
Díaz-Tomé V, García-Otero X, Varela-Fernández R, Martín-Pastor M, Conde-Penedo A, Aguiar P, González-Barcia M, Fernández-Ferreiro A, Otero-Espinar FJ. In situ forming and mucoadhesive ophthalmic voriconazole/HPβCD hydrogels for the treatment of fungal keratitis. Int J Pharm 2021; 597:120318. [PMID: 33540021 DOI: 10.1016/j.ijpharm.2021.120318] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/18/2022]
Abstract
Fungal keratitis is a severe infectious corneal disease. At present, no voriconazole ophthalmic formulations are approved by the FDA or EMA. This lack of therapeutic options leads to the reformulation of intravenous voriconazole preparations (VFEND®) by the hospital pharmacy departments to prepare the appropriate ophthalmic formulations (pharmacy compounding). However, the limited residence time of these formulations leads to an intensive treatment posology that may increase the occurrence of side effects. In the present study, two different hydrogels were developed and characterized in order to improve the voriconazole's ophthalmic solubility, permanence, and security. Voriconazole-cyclodextrin (HPβCD or HPɣCD) inclusion complexes in aqueous solutions were characterized by NMR and molecular modeling. Complexes were formed by encapsulation of voriconazole into the cyclodextrin's internal cavity which considerably increases its water solubility. Ocular safety was proven by ocular irritation studies. Permeability studies suggest both hydrogels have good corneal permeability. Furthermore, in vivo ocular permanence study by PET/CT showed a longer permanence time on the ocular surface (t1/2 = 58.91 ± 13.4 min and 96.28 ± 49.11 min for VZHAH and VZISH 0.65 respectively) compared to the voriconazole control formulation (VFEND® t1/2 = 32.27 ± 15.56 min). Results suggest these formulations are a good alternative for the treatment of fungal keratitis.
Collapse
Affiliation(s)
- Victoria Díaz-Tomé
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela. Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela. Spain; Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Rubén Varela-Fernández
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela. Spain; Clinical Neurosciences Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Manuel Martín-Pastor
- Nuclear Magnetic Resonance Unit, Research Infrastructures Area, Universidade de Santiago de Compostela, Campus Vida, Santiago de Compostela, Spain
| | - Andrea Conde-Penedo
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela. Spain
| | - Pablo Aguiar
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department. University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department. University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela. Spain; Paraquasil Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| |
Collapse
|
28
|
García-Otero X, Díaz-Tomé V, Varela-Fernández R, Martín-Pastor M, González-Barcia M, Blanco-Méndez J, Mondelo-García C, Bermudez MA, Gonzalez F, Aguiar P, Fernández-Ferreiro A, Otero-Espinar FJ. Development and Characterization of a Tacrolimus/Hydroxypropyl-β-Cyclodextrin Eye Drop. Pharmaceutics 2021; 13:pharmaceutics13020149. [PMID: 33498753 PMCID: PMC7911614 DOI: 10.3390/pharmaceutics13020149] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 02/03/2023] Open
Abstract
Uveitis is a vision inflammatory disorder with a high prevalence in developing countries. Currently, marketed treatments remain limited and reformulation is usually performed to obtain a tacrolimus eye drop as a therapeutic alternative in corticosteroid-refractory eye disease. The aim of this work was to develop a mucoadhesive, non-toxic and stable topical ophthalmic formulation that can be safely prepared in hospital pharmacy departments. Four different ophthalmic formulations were prepared based on the tacrolimus/hydroxypropyl-β-cyclodextrin (HPβCD) inclusion complexes’ formation. Phase solubility diagrams, Nuclear Magnetic Resonance (NMR) and molecular modeling studies showed the formation of 1:1 and 1:2 tacrolimus/HPβCD inclusion complexes, being possible to obtain a 0.02% (w/v) tacrolimus concentration by using 40% (w/v) HPβCD aqueous solutions. Formulations also showed good ophthalmic properties in terms of pH, osmolality and safety. Stability studies proved these formulations to be stable for at least 3 months in refrigeration. Ex vivo bioadhesion and in vivo ocular permanence showed good mucoadhesive properties with higher ocular permanence compared to the reference pharmacy compounding used in clinical settings (t1/2 of 86.2 min for the eyedrop elaborated with 40% (w/v) HPβCD and Liquifilm® versus 46.3 min for the reference formulation). Thus, these novel eye drops present high potential as a safe alternative for uveitis treatment, as well as a versatile composition to include new drugs intended for topical ophthalmic administration.
Collapse
Affiliation(s)
- Xurxo García-Otero
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (X.G.-O.); (V.D.-T.); (R.V.-F.); (J.B.-M.)
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Victoria Díaz-Tomé
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (X.G.-O.); (V.D.-T.); (R.V.-F.); (J.B.-M.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.G.-B.); (C.M.-G.)
| | - Rubén Varela-Fernández
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (X.G.-O.); (V.D.-T.); (R.V.-F.); (J.B.-M.)
- Clinical Neurosciences Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Manuel Martín-Pastor
- Nuclear Magnetic Resonance Unit, Research Infrastructures Area, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Miguel González-Barcia
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.G.-B.); (C.M.-G.)
| | - José Blanco-Méndez
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (X.G.-O.); (V.D.-T.); (R.V.-F.); (J.B.-M.)
- Paraquasil Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.G.-B.); (C.M.-G.)
| | - Maria A. Bermudez
- Physiology Department–CIMUS, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Francisco Gonzalez
- Ophthalmology Department, Clinical University Hospital Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain;
- Department of Surgery and Medical-Surgical Specialties and CIMUS, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (P.A.); (A.F.-F.); (F.J.O.-E.); Tel.: +34-881814878 (F.J.O.-E.)
| | - Anxo Fernández-Ferreiro
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.G.-B.); (C.M.-G.)
- Correspondence: (P.A.); (A.F.-F.); (F.J.O.-E.); Tel.: +34-881814878 (F.J.O.-E.)
| | - Francisco J. Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (X.G.-O.); (V.D.-T.); (R.V.-F.); (J.B.-M.)
- Paraquasil Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence: (P.A.); (A.F.-F.); (F.J.O.-E.); Tel.: +34-881814878 (F.J.O.-E.)
| |
Collapse
|
29
|
Gómez-Lado N, López-Arias E, Iglesias-Rey R, Díaz-Platas L, Medín-Aguerre S, Fernández-Ferreiro A, Posado-Fernández A, García-Varela L, Rodríguez-Pérez M, Campos F, Del Pino P, Ruibal Á, Pardo-Montero J, Castillo J, Aguiar P, Sobrino T. [ 18F]-FMISO PET/MRI Imaging Shows Ischemic Tissue around Hematoma in Intracerebral Hemorrhage. Mol Pharm 2020; 17:4667-4675. [PMID: 33186043 DOI: 10.1021/acs.molpharmaceut.0c00932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Intracerebral hemorrhage (ICH), being the most severe cerebrovascular disease, accounts for 10-15% of all strokes. Hematoma expansion is one of the most important factors associated with poor outcome in intracerebral hemorrhage (ICH). Several studies have suggested that an "ischemic penumbra" might arise when the hematoma has a large expansion, but clinical studies are inconclusive. We performed a preclinical study to demonstrate the presence of hypoxic-ischemic tissue around the hematoma by means of longitudinal [18F]-fluoromisonidazole ([18F]-FMISO) PET/MRI studies over time in an experimental ICH model. Our results showed that all [18F]-FMISO PET/MRI images exhibited hypoxic-ischemic tissue around the hematoma area. A significant increase of [18F]-FMISO uptake was found at 18-24 h post-ICH when the maximum of hematoma volume is achieved and this increase disappeared before 42 h. These results demonstrate the presence of hypoxic tissue around the hematoma and open the possibility of new therapies aimed to reduce ischemic damage associated with ICH.
Collapse
Affiliation(s)
- Noemí Gómez-Lado
- Molecular Imaging Research Group, Nuclear Medicine Department, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain.,Molecular Imaging and Medical Physics Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela (USC), University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Esteban López-Arias
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Ramón Iglesias-Rey
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Lucía Díaz-Platas
- Galician PET Radiopharmacy Unit, GALARIA, University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Santiago Medín-Aguerre
- Galician PET Radiopharmacy Unit, GALARIA, University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacology Group, Pharmacy Department, University Clinical Hospital, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Adrián Posado-Fernández
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Lara García-Varela
- Molecular Imaging Research Group, Nuclear Medicine Department, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Manuel Rodríguez-Pérez
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Pablo Del Pino
- Center for Research in Biological Chemistry and Molecular Materials (CIQUS), Particle Physics Departament, University of Santiago de Compostela, Santiago de Compostela 15706, Spain
| | - Álvaro Ruibal
- Molecular Imaging Research Group, Nuclear Medicine Department, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain.,Molecular Imaging and Medical Physics Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela (USC), University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Juan Pardo-Montero
- Group of Medical Physics and Biomathematics, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| | - Pablo Aguiar
- Molecular Imaging Research Group, Nuclear Medicine Department, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain.,Molecular Imaging and Medical Physics Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela (USC), University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela 15706, Spain
| |
Collapse
|
30
|
Castro-Balado A, Mondelo-García C, Varela-Rey I, Moreda-Vizcaíno B, Sierra-Sánchez JF, Rodríguez-Ares MT, Hermelo-Vidal G, Zarra-Ferro I, González-Barcia M, Yebra-Pimentel E, Giráldez-Fernández MJ, Otero-Espinar FJ, Fernández-Ferreiro A. Recent Research in Ocular Cystinosis: Drug Delivery Systems, Cysteamine Detection Methods and Future Perspectives. Pharmaceutics 2020; 12:E1177. [PMID: 33287176 PMCID: PMC7761701 DOI: 10.3390/pharmaceutics12121177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/27/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022] Open
Abstract
Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in different tissues and organs. Although renal damage prevails during initial stages, the deposition of cystine crystals in the cornea causes severe ocular manifestations. At present, cysteamine is the only topical effective treatment for ocular cystinosis. The lack of investment by the pharmaceutical industry, together with the limited stability of cysteamine, make it available only as two marketed presentations (Cystaran® and Cystadrops®) and as compounding formulations prepared in pharmacy departments. Even so, new drug delivery systems (DDSs) need to be developed, allowing more comfortable dosage schedules that favor patient adherence. In the last decades, different research groups have focused on the development of hydrogels, nanowafers and contact lenses, allowing a sustained cysteamine release. In parallel, different determination methods and strategies to increase the stability of the formulations have also been developed. This comprehensive review aims to compile all the challenges and advances related to new cysteamine DDSs, analytical determination methods, and possible future therapeutic alternatives for treating cystinosis.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Beatriz Moreda-Vizcaíno
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Jesús F. Sierra-Sánchez
- Pharmacy Department, Hospital de Jerez de la Frontera, Jerez de la Frontera, 11407 Cádiz, Spain;
| | - María Teresa Rodríguez-Ares
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain;
| | - Gonzalo Hermelo-Vidal
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| | - Eva Yebra-Pimentel
- Department of Applied Physics, Optometry, Faculty of Optics and Optometry, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (E.Y.-P.); (M.J.G.-F.)
| | - María Jesús Giráldez-Fernández
- Department of Applied Physics, Optometry, Faculty of Optics and Optometry, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (E.Y.-P.); (M.J.G.-F.)
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain; (A.C.-B.); (C.M.-G.); (I.V.-R.); (I.Z.-F.); (M.G.-B.)
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain;
| |
Collapse
|
31
|
Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, García-Otero X, Antúnez-López JR, Ruibal Á, Varela-Correa JJ, Aguiar P, Basit AW, Otero-Espinar FJ, González-Barcia M, Goyanes A, Luzardo-Álvarez A, Fernández-Ferreiro A. 3D Printed Tacrolimus Rectal Formulations Ameliorate Colitis in an Experimental Animal Model of Inflammatory Bowel Disease. Biomedicines 2020; 8:E563. [PMID: 33276641 PMCID: PMC7761558 DOI: 10.3390/biomedicines8120563] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to fabricate novel self-supporting tacrolimus suppositories using semisolid extrusion 3-dimensional printing (3DP) and to investigate their efficacy in an experimental model of inflammatory bowel disease. Blends of Gelucire 44/14 and coconut oil were employed as lipid excipients to obtain suppository formulations with self-emulsifying properties, which were then tested in a TNBS (2,4,6-trinitrobenzenesulfonic acid) induced rat colitis model. Disease activity was monitored using PET/CT medical imaging; maximum standardized uptake values (SUVmax), a measure of tissue radiotracer accumulation rate, together with body weight changes and histological assessments, were used as inflammatory indices to monitor treatment efficacy. Following tacrolimus treatment, a significant reduction in SUVmax was observed on days 7 and 10 in the rat colon sections compared to non-treated animals. Histological analysis using Nancy index confirmed disease remission. Moreover, statistical analysis showed a positive correlation (R2 = 71.48%) between SUVmax values and weight changes over time. Overall, this study demonstrates the effectiveness of 3D printed tacrolimus suppositories to ameliorate colitis and highlights the utility of non-invasive PET/CT imaging to evaluate new therapies in the preclinical area.
Collapse
Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
- Tejerina Foundation, José Abascal 40, 28003 Madrid, Spain
| | - Juan Jesús Varela-Correa
- Pharmacy Department, University Hospital Ourense (SERGAS), Calle Ramón Puga Noguerol 54, 32005 Ourense, Spain;
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Abdul W. Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
| | - Alvaro Goyanes
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- 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 Group (GI-1645), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| |
Collapse
|
32
|
Blanco-Dorado S, Maroñas O, Latorre-Pellicer A, Rodríguez Jato MT, López-Vizcaíno A, Gómez Márquez A, Bardán García B, Belles Medall D, Barbeito Castiñeiras G, Pérez Del Molino Bernal ML, Campos-Toimil M, Otero Espinar F, Blanco Hortas A, Durán Piñeiro G, Zarra Ferro I, Carracedo Á, Lamas MJ, Fernández-Ferreiro A. Impact of CYP2C19 Genotype and Drug Interactions on Voriconazole Plasma Concentrations: A Spain Pharmacogenetic-Pharmacokinetic Prospective Multicenter Study. Pharmacotherapy 2020; 40:17-25. [PMID: 31782536 DOI: 10.1002/phar.2351] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Voriconazole, a first-line agent for the treatment of invasive fungal infections, is mainly metabolized by cytochrome P450 (CYP) 2C19. A significant portion of patients fail to achieve therapeutic voriconazole trough concentrations, with a consequently increased risk of therapeutic failure. OBJECTIVE To show the association between subtherapeutic voriconazole concentrations and factors affecting voriconazole pharmacokinetics: CYP2C19 genotype and drug-drug interactions. METHODS Adults receiving voriconazole for antifungal treatment or prophylaxis were included in a multicenter prospective study conducted in Spain. The prevalence of subtherapeutic voriconazole troughs was analyzed in the rapid metabolizer and ultra-rapid metabolizer patients (RMs and UMs, respectively), and compared with the rest of the patients. The relationship between voriconazole concentration, CYP2C19 phenotype, adverse events (AEs), and drug-drug interactions was also assessed. RESULTS In this study 78 patients were included with a wide variability in voriconazole plasma levels with only 44.8% of patients attaining trough concentrations within the therapeutic range of 1 and 5.5 µg/ml. The allele frequency of *17 variant was found to be 29.5%. Compared with patients with other phenotypes, RMs and UMs had a lower voriconazole plasma concentration (RM/UM: 1.85 ± 0.24 µg/ml vs other phenotypes: 2.36 ± 0.26 µg/ml). Adverse events were more common in patients with higher voriconazole concentrations (p<0.05). No association between voriconazole trough concentration and other factors (age, weight, route of administration, and concomitant administration of enzyme inducer, enzyme inhibitor, glucocorticoids, or proton pump inhibitors) was found. CONCLUSION These results suggest the potential clinical utility of using CYP2C19 genotype-guided voriconazole dosing to achieve concentrations in the therapeutic range in the early course of therapy. Larger studies are needed to confirm the impact of pharmacogenetics on voriconazole pharmacokinetics.
Collapse
Affiliation(s)
- Sara Blanco-Dorado
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Olalla Maroñas
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela, Spain
| | - Ana Latorre-Pellicer
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María Teresa Rodríguez Jato
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | - Ana López-Vizcaíno
- Pharmacy Department, University Hospital Lucus Augusti (HULA), Lugo, Spain
| | | | | | | | - Gema Barbeito Castiñeiras
- Microbiology Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | | | - Manuel Campos-Toimil
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Francisco Otero Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Andrés Blanco Hortas
- Epidemiology Unit, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), University Hospital Lucus Augusti (HULA), Lugo, Spain
| | - Goretti Durán Piñeiro
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Irene Zarra Ferro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| |
Collapse
|
33
|
Luaces-Rodríguez A, Del Amo EM, Mondelo-García C, Gómez-Lado N, Gonzalez F, Ruibal Á, González-Barcia M, Zarra-Ferro I, Otero-Espinar FJ, Fernández-Ferreiro A, Aguiar P. PET study of ocular and blood pharmacokinetics of intravitreal bevacizumab and aflibercept in rats. Eur J Pharm Biopharm 2020; 154:330-337. [PMID: 32659326 DOI: 10.1016/j.ejpb.2020.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/23/2022]
Abstract
Intravitreal injections are the standard procedure in the treatment of retinal pathologies, such as the administration of the anti-VEGF antibodies in age-related macular degeneration. The aim of this study is to evaluate the intraocular and blood pharmacokinetics after an intravitreal injection of 89Zr-labelled bevacizumab and 89Zr-labelled aflibercept in Sprague-Dawley rats using Positron Emission Tomography. First, both antibodies were radiolabelled to zirconium-89 with a maximum specific activity of 15 Mbq/mg for bevacizumab and 10 Mbq/mg for aflibercept. Four µL containing 1-1.2 Mq of 89Zr-labelled compound were injected into the vitreous through a 35 G needle. A microPET acquisition was carried out immediately after the injection and at different time points through a 12-day study and blood samples were obtained through the tail vein. Radiolabelling was successfully performed with a radiochemical purity after ultrafiltration above 95% for both agents. Both antibodies ocular curves followed a two-compartment model in which an intraocular elimination half-life of 16.44 h was found for 89Zr-bevacizumab and 4.51 h for 89Zr-aflibercept, considering the alpha phase as the elimination phase. Regarding the beta phase, a half-life of 3.23 days for 89Zr-bevacizumab and 4.69 days for 89Zr-aflibercept were observed. With regards to blood concentration, 89Zr-bevacizumab showed a blood half-life of 7.08 days, whereas 89Zr-aflibercept's was 3.18 days, by a one-compartment model with first-order absorption kinetics. In conclusion, this study shows for the first time the ocular and blood pharmacokinetic analysis after intravitreal injection of aflibercept and bevacizumab in rats.
Collapse
Affiliation(s)
- Andrea Luaces-Rodríguez
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Eva M Del Amo
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Cristina Mondelo-García
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Gonzalez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), CIMUS, University of Santiago de Compostela (USC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Álvaro Ruibal
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| | - Pablo Aguiar
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| |
Collapse
|
34
|
Castro-Balado A, Mondelo-García C, Zarra-Ferro I, Fernández-Ferreiro A. New ophthalmic drug delivery systems. Farm Hosp 2020; 44:149-157. [PMID: 32646346 DOI: 10.7399/fh.11388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
For decades, topical ophthalmic drug administration through the use of eye drops has been the most widely used technique for the treatment of eye diseases. The development of galenic formulation has led to the use and commercialization of new formulations, such as suspensions, emulsions, and ophthalmic ointments that increase residence time in the site of action. Recently, new administration systems have been developed, such as devices and inserts that provide the sustained release of active substance. Some of these systems are already available on the market, whereas others are still undergoing clinical trials, such as promising systems based on nanostructures (nanocapsules, cyclodextrins, nanoemulsions, etc.). Similarly, various formulations and devices have been developed in the field of intravitreal administration, with different implants available on the European market for the treatment of age-related macular degeneration (AMD), diabetic macular edema, or infections that affect the posterior segment. This review includes current developments in ophthalmic topical and intravitreal drug administration routes as well as those under investigation.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain. Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela. Spain..
| | - Cristina Mondelo-García
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| | - Irene Zarra-Ferro
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| | - Anxo Fernández-Ferreiro
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza (SERGAS), Santiago de Compostela. Spain. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela. Spain..
| |
Collapse
|
35
|
Castro-Balado A, Varela-Rey I, Bandín-Vilar EJ, Busto-Iglesias M, García-Quintanilla L, Mondelo-García C, Fernández-Ferreiro A. Clinical research in hospital pharmacy during the fight against COVID-19. Farm Hosp 2020; 44:66-70. [PMID: 32533675 DOI: 10.7399/fh.11494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The health crisis resulting from the rapid spread of SARS-CoV-2 worlwide, added to the low evidence of currently used treatments has led to the development of a large number of clinical trials (CT) and observational studies. Likewise, important measures have been adopted in healthcare and research centers aimed at halting the pandemic as soon as possible. The objective of this study is to gather the main aspects of the clinical research studies undertaken by the Departments of Hospital Pharmacy (DHP) of Spain during the COVID-19 crisis. The decision of the Spanish Society of Hospital Pharmacy (SEFH) to sponsor CTs made it possible that 13% of DHP had been led at least one CT. The Spanish Agency for Medicines and Medical Devices (AEMPS), in coordination with Institutional Review Boards, has adopted a fast-track review procedure to accelerate authorizations for CTs related to the treatment or prevention of COVID-19. There have also been numerous public and private calls for financing research projects aimed at contributing to the fight against this virus. Despite the pandemic, actions have been taken to continue ongoing CTs and studies while the safety and well-being of patients are guaranteed. More specifically, the AEMPS and the European Medicines Agency (EMA) have issued guidelines that incorporate changes to CT protocols that will have to be applied until the pandemic is over. In this health emergency, the scientific community has found itself in a race against time to generate evidence. It is at this moment that hospital pharmacists emerge as key players in clinical research and are contributing to a rational, effective and safe healthcare decision-making.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Iria Varela-Rey
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Enrique José Bandín-Vilar
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Manuel Busto-Iglesias
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Laura García-Quintanilla
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Cristina Mondelo-García
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| | - Anxo Fernández-Ferreiro
- Servicio de Farmacia, Área Sanitaria de Santiago de Compostela e Barbanza, Servicio Gallego de Salud, Santiago de Compostela. España. Grupo de Farmacología Clínica, Instituto de Investigación Sanitaria de Santiago de Compostela. España..
| |
Collapse
|
36
|
Gil-Martínez M, Rodríguez-Cid MJ, Fenández-Rodríguez MI, Blanco-Teijero MJ, Abraldes MJ, Bandín Vilar E, Zarra-Ferro I, González-Barcia M, Gómez-Ulla F, Fernández-Ferreiro A. Clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal injection of antivascular endothelial growth factor. Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:211-216. [PMID: 32156487 DOI: 10.1016/j.oftal.2020.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/22/2020] [Accepted: 01/25/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. METHODS Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied. RESULTS Seven patients have had a sterile endophthalmitis onset within 4days after intravitreal injection (aflibercept n=5 and ranibizumab n=2). These patients have some active neovascular condition: age related macular degeneration (n=4), myopic choroidal neovascularization (n=1) or macular edema: diabetic macular edema (n=1), branch retinal vein occlusion (n=1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. CONCLUSION Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment.
Collapse
Affiliation(s)
- M Gil-Martínez
- Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, La Coruña, España
| | - M J Rodríguez-Cid
- Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España
| | - M I Fenández-Rodríguez
- Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, La Coruña, España
| | - M J Blanco-Teijero
- Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España
| | - M J Abraldes
- Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, La Coruña, España
| | - E Bandín Vilar
- Servicio de Farmacia, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Grupo de Farmacología, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, La Coruña, España
| | - I Zarra-Ferro
- Servicio de Farmacia, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Grupo de Farmacología, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, La Coruña, España
| | - M González-Barcia
- Servicio de Farmacia, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Grupo de Farmacología, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, La Coruña, España
| | - F Gómez-Ulla
- Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, La Coruña, España
| | - A Fernández-Ferreiro
- Servicio de Farmacia, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Grupo de Farmacología, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, La Coruña, España.
| |
Collapse
|
37
|
Gil-Martínez M, Santos-Ramos P, Fernández-Rodríguez M, Abraldes MJ, Rodríguez-Cid MJ, Santiago-Varela M, Fernández-Ferreiro A, Gómez-Ulla F. Pharmacological Advances in the Treatment of Age-related Macular Degeneration. Curr Med Chem 2020; 27:583-598. [PMID: 31362645 DOI: 10.2174/0929867326666190726121711] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 07/05/2019] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
Abstract
Age-related macular degeneration is an acquired degenerative disease that is responsible for severe loss of vision in elderly people. There are two types: dry age-related macular degeneration and wet age-related macular degeneration. Its treatment has been improved and tries to be tailored in the future. The aim of this review is to summarize the pharmacological advances in the treatment of age-related macular degeneration. Regarding dry AMD, there is no effective treatment to reduce its progression. However, some molecules such as lampalizumab and eculizumab were under investigation, although they have shown low efficacy. Herein, in an attempt to prevent dry AMD progression, the most important studies suggested increasing the antioxidants intake and quitting the smoke habit. On the other hand, wet AMD has more developed treatment. Nowadays, the gold standard treatment is anti-VEGF injections. However, more effective molecules are currently under investigation. There are different molecules under research for dry AMD and wet AMD. This fact could help us treat our patients with more effective and lasting drugs but more clinical trials and safety studies are required in order to achieve an optimal treatment.
Collapse
Affiliation(s)
- María Gil-Martínez
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain.,Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
| | - Paz Santos-Ramos
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Maribel Fernández-Rodríguez
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain.,Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain.,Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maximino J Abraldes
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain.,Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain.,Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria José Rodríguez-Cid
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain.,Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Santiago-Varela
- Department of Ophthalmology, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department and Pharmacology Group, Univ Hospital of Santiago de Compostela (SERGAS) and Health Research Intitute (IDIS), Santiago de Compostela, Spain
| | - Francisco Gómez-Ulla
- Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain.,Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
38
|
Maroñas O, García-Quintanilla L, Luaces-Rodríguez A, Fernández-Ferreiro A, Latorre-Pellicer A, Abraldes MJ, Lamas MJ, Carracedo A. Anti-VEGF Treatment and Response in Age-related Macular Degeneration: Disease's Susceptibility, Pharmacogenetics and Pharmacokinetics. Curr Med Chem 2020; 27:549-569. [PMID: 31296152 DOI: 10.2174/0929867326666190711105325] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/03/2019] [Accepted: 06/28/2019] [Indexed: 02/06/2023]
Abstract
The current review is focussing different factors that contribute and directly correlate to the onset and progression of Age-related Macular Degeneration (AMD). In particular, the susceptibility to AMD due to genetic and non-genetic factors and the establishment of risk scores, based on the analysis of different genes to measure the risk of developing the disease. A correlation with the actual therapeutic landscape to treat AMD patients from the point of view of pharmacokinetics and pharmacogenetics is also exposed. Treatments commonly used, as well as different regimes of administration, will be especially important in trying to classify individuals as "responders" and "non-responders". Analysis of different genes correlated with drug response and also the emerging field of microRNAs (miRNAs) as possible biomarkers for early AMD detection and response will be also reviewed. This article aims to provide the reader a review of different publications correlated with AMD from the molecular and kinetic point of view as well as its commonly used treatments, major pitfalls and future directions that, to our knowledge, could be interesting to assess and follow in order to develop a personalized medicine model for AMD.
Collapse
Affiliation(s)
- Olalla Maroñas
- Grupo de Medicina Xenomica, Centro Nacional de Genotipado (CEGEN-PRB3), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Servicio de Farmacia, Xerencia de Xestión Integrada de Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Departamento de Farmacia e Tecnoloxia Farmaceutica e Instituto de Farmacia Industrial, Facultade de Farmacia, Universidade de Santiago de Compostela, Spain.,Grupo de Farmacoloxia Clínica, Instituto de Investigacion en Salud de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Departamento de Farmacia e Tecnoloxia Farmaceutica e Instituto de Farmacia Industrial, Facultade de Farmacia, Universidade de Santiago de Compostela, Spain.,Grupo de Farmacoloxia Clínica, Instituto de Investigacion en Salud de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Departamento de Farmacia, Hospital Clínico Universitario de Santiago de Compostela (SERGAS) (CHUS), Santiago de Compostela, Spain
| | - Ana Latorre-Pellicer
- Unidad de Genetica Clínica y Genomica Funcional, Departamento de Farmacologia-Fisiología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Maximino J Abraldes
- Servicio de Oftalmoloxía, Xerencia de Xestion Integrada de Santiago de Compostela, Santiago de Compostela, Spain.,Departamento de Ciruxía e Especialidades Médico- Quirúrxicas, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - María J Lamas
- Grupo de Farmacoloxia Clínica, Instituto de Investigacion en Salud de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Angel Carracedo
- Grupo de Medicina Xenomica, Centro Nacional de Genotipado (CEGEN-PRB3), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, CIBER de Enfermedades Raras (CIBERER), Santiago de Compostela, Spain.,Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain
| |
Collapse
|
39
|
Varela-Fernández R, Díaz-Tomé V, Luaces-Rodríguez A, Conde-Penedo A, García-Otero X, Luzardo-Álvarez A, Fernández-Ferreiro A, Otero-Espinar FJ. Drug Delivery to the Posterior Segment of the Eye: Biopharmaceutic and Pharmacokinetic Considerations. Pharmaceutics 2020; 12:E269. [PMID: 32188045 PMCID: PMC7151081 DOI: 10.3390/pharmaceutics12030269] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 01/22/2023] Open
Abstract
The treatment of the posterior-segment ocular diseases, such as age-related eye diseases (AMD) or diabetic retinopathy (DR), present a challenge for ophthalmologists due to the complex anatomy and physiology of the eye. This specialized organ is composed of various static and dynamic barriers that restrict drug delivery into the target site of action. Despite numerous efforts, effective intraocular drug delivery remains unresolved and, therefore, it is highly desirable to improve the current treatments of diseases affecting the posterior cavity. This review article gives an overview of pharmacokinetic and biopharmaceutics aspects for the most commonly-used ocular administration routes (intravitreal, topical, systemic, and periocular), including information of the absorption, distribution, and elimination, as well as the benefits and limitations of each one. This article also encompasses different conventional and novel drug delivery systems designed and developed to improve drug pharmacokinetics intended for the posterior ocular segment treatment.
Collapse
Affiliation(s)
- Rubén Varela-Fernández
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Neurosciences Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Victoria Díaz-Tomé
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Andrea Conde-Penedo
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Molecular Imaging Group. University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela (USC), Campus vida, 15782 Santiago de Compostela, Spain; (R.V.-F.); (V.D.-T.); (A.L.-R.); (A.C.-P.); (X.G.-O.); (A.L.-Á.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain
| |
Collapse
|
40
|
Blanco Dorado S, Maroñas Amigo O, Latorre-Pellicer A, Rodríguez Jato MT, López-Vizcaíno A, Gómez Márquez A, Bardán García B, Belles Medall D, Barbeito Castiñeiras G, Pérez Del Molino Bernal ML, Campos-Toimil M, Otero Espinar F, Blanco Hortas A, Zarra Ferro I, Carracedo Á, Lamas MJ, Fernández-Ferreiro A. A multicentre prospective study evaluating the impact of proton-pump inhibitors omeprazole and pantoprazole on voriconazole plasma concentrations. Br J Clin Pharmacol 2020; 86:1661-1666. [PMID: 32110830 DOI: 10.1111/bcp.14267] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/04/2020] [Accepted: 01/20/2020] [Indexed: 02/06/2023] Open
Abstract
Voriconazole is an antifungal metabolised by CYP2C19 enzyme, which can be inhibited by proton-pump inhibitors (PPIs). A prospective observational study was carried out to determine the influence of PPIs on voriconazole pharmacokinetic. The 78 patients included were divided into 4 groups: omeprazole (n = 32), pantoprazole (n = 25), esomeprazole (n = 3) and no PPI (n = 18). Patients with no PPI had no significant difference in plasma voriconazole concentration when compared with those with PPI (2.63 ± 2.13 μg/mL [95% confidence interval {CI} 1.57-3.69] vs 2.11 ± 1.73 μg/mL [95%CI 1.67-2.55], P > .05). However, voriconazole plasma concentration was significantly lower in patients treated with pantoprazole vs those treated with omeprazole (1.44 ± 1.22 μg/mL [95%CI 0.94-1.94) vs 2.67 ± 1.88 μg/mL [95%CI 2.02-3.32], P = .013) suggesting a greater CYP2C19 enzyme inhibitory effect of omeprazole. This study demonstrates the greater CYP inhibition capacity of omeprazole and should be helpful for the choice of PPIs for patients treated with voriconazole.
Collapse
Affiliation(s)
- Sara Blanco Dorado
- Pharmacy Department, University Clinical Hospital Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela,, Santiago de Compostela, Spain
| | - Olalla Maroñas Amigo
- Genomic Medicine Group, Centro Nacional de Genotipado, CIBERER, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
| | - Ana Latorre-Pellicer
- Genomic Medicine Group, Centro Nacional de Genotipado, CIBERER, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | | | | | - Gema Barbeito Castiñeiras
- Microbiology Department, University Clinical Hospital Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Manuel Campos-Toimil
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela,, Santiago de Compostela, Spain
| | - Francisco Otero Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela,, Santiago de Compostela, Spain
| | - Andrés Blanco Hortas
- Epidemiology Unit, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela, University Hospital Lucus Augusti,, Spain
| | - Irene Zarra Ferro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Genomic Medicine Group, Centro Nacional de Genotipado, CIBERER, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela, Santiago de Compostela, Spain.,Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela,, Santiago de Compostela, Spain
| |
Collapse
|
41
|
López-González FJ, Moscoso A, Efthimiou N, Fernández-Ferreiro A, Piñeiro-Fiel M, Archibald SJ, Aguiar P, Silva-Rodríguez J. Spill-in counts in the quantification of 18F-florbetapir on Aβ-negative subjects: the effect of including white matter in the reference region. EJNMMI Phys 2019; 6:27. [PMID: 31858289 PMCID: PMC6923310 DOI: 10.1186/s40658-019-0258-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/25/2019] [Indexed: 12/17/2022] Open
Abstract
Background We aim to provide a systematic study of the impact of white matter (WM) spill-in on the calculation of standardized uptake value ratios (SUVRs) on Aβ-negative subjects, and we study the effect of including WM in the reference region as a compensation. In addition, different partial volume correction (PVC) methods are applied and evaluated. Methods We evaluated magnetic resonance imaging and 18F-AV-45 positron emission tomography data from 122 cognitively normal (CN) patients recruited at the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Cortex SUVRs were obtained by using the cerebellar grey matter (CGM) (SUVRCGM) and the whole cerebellum (SUVRWC) as reference regions. The correlations between the different SUVRs and the WM uptake (WM-SUVRCGM) were studied in patients, and in a well-controlled framework based on Monte Carlo (MC) simulation. Activity maps for the MC simulation were derived from ADNI patients by using a voxel-wise iterative process (BrainViset). Ten WM uptakes covering the spectrum of WM values obtained from patient data were simulated for different patients. Three different PVC methods were tested (a) the regional voxel-based (RBV), (b) the iterative Yang (iY), and (c) a simplified analytical correction derived from our MC simulation. Results WM-SUVRCGM followed a normal distribution with an average of 1.79 and a standard deviation of 0.243 (13.6%). SUVRCGM was linearly correlated to WM-SUVRCGM (r = 0.82, linear fit slope = 0.28). SUVRWC was linearly correlated to WM-SUVRCGM (r = 0.64, linear fit slope = 0.13). Our MC results showed that these correlations are compatible with those produced by isolated spill-in effect (slopes of 0.23 and 0.11). The impact of the spill-in was mitigated by using PVC for SUVRCGM (slopes of 0.06 and 0.07 for iY and RBV), while SUVRWC showed a negative correlation with SUVRCGM after PVC. The proposed analytical correction also reduced the observed correlations when applied to patient data (r = 0.27 for SUVRCGM, r = 0.18 for SUVRWC). Conclusions There is a high correlation between WM uptake and the measured SUVR due to spill-in effect, and that this effect is reduced when including WM in the reference region. We also evaluated the performance of PVC, and we proposed an analytical correction that can be applied to preprocessed data.
Collapse
Affiliation(s)
- Francisco Javier López-González
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain
| | - Alexis Moscoso
- Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - Nikos Efthimiou
- PET Research Centre, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Anxo Fernández-Ferreiro
- Pharmacy Department and Pharmacology Group, University Hospital (SERGAS) and Health Research Institute Santiago Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - Manuel Piñeiro-Fiel
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain
| | - Stephen J Archibald
- PET Research Centre, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Pablo Aguiar
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain. .,Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain.
| | - Jesús Silva-Rodríguez
- Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain.,R&D Department, Qubiotech Health Intelligence SL, A Coruña, Galicia, Spain
| | | |
Collapse
|
42
|
Luaces-Rodríguez A, Mondelo-García C, Zarra-Ferro I, González-Barcia M, Aguiar P, Fernández-Ferreiro A, Otero-Espinar FJ. Intravitreal anti-VEGF drug delivery systems for age-related macular degeneration. Int J Pharm 2019; 573:118767. [PMID: 31669558 DOI: 10.1016/j.ijpharm.2019.118767] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 01/07/2023]
Abstract
Age-related macular degeneration is the most common cause of vision loss in elderly people in developed countries. Nowadays, in clinical practice, three anti-VEGF drugs are commonly used (bevacizumab, aflibercept and ranibizumab), requiring repeated intravitreal injections. In order to minimise the number of injections, research on intravitreal drug delivery systems (DDSs) is needed. In this review, the DDSs developed up to date regarding intravitreal anti-VEGF drugs have been summarised, which include systems as hydrogels, liposomes, microparticles, nanoparticles or implants. Most of the studies have focused on the extended in vitro release behaviour of the developed DDSs, but data as antibody bioactivity, biocompatibility or in vivo stability is sometimes scarce. Moreover, as DDS development relies on in vivo pharmacokinetic analyses to evaluate the extended drug release, all the information regarding anti-VEGF intravitreal pharmacokinetics in different animal species have been compiled.
Collapse
Affiliation(s)
- Andrea Luaces-Rodríguez
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain; Molecular Imaging Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain.
| |
Collapse
|
43
|
Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, Rey-Bretal D, Lamela-Gómez I, Otero-Espinar FJ, Blanco-Méndez J, Antúnez-López JR, Pombo-Pasín M, Aguiar P, Ruibal Á, Luzardo-Álvarez A, Fernández-Ferreiro A. Evaluation of the therapeutic activity of melatonin and resveratrol in Inflammatory Bowel Disease: A longitudinal PET/CT study in an animal model. Int J Pharm 2019; 572:118713. [PMID: 31593809 DOI: 10.1016/j.ijpharm.2019.118713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022]
Abstract
Inflammatory Bowel Disease (IBD) is a group of chronic disorders of the gastrointestinal tract, which two main types are Crohn's disease and ulcerative colitis. Although conventional therapeutic strategies have demonstrated to be effective in the IBD treatment, it is necessary to incorporate novel therapeutic agents that target other mechanisms involved in the pathogenesis of the disease, such as oxidative stress. For this reason, the efficacy in vivo of two antioxidant compounds, melatonin and resveratrol, has been investigated in an animal model of TNBS (2, 4, 6-trinitrobenzenesulfonic acid) induced colitis. PET/CT (Positron emission tomography/Computer Tomography) scans were performed to assess disease activity and evaluate treatment response. SUVmax (Standardized Uptake Value) values, body weight changes and histological evaluation were used as inflammatory indices to measure the efficacy of both treatments. SUVmax values increased rapidly after induction of colitis, but after the beginning of the treatment (day 3) a statistically significant decrease was observed on days 7 and 10 in treated animals compared to the non-treated group. This remission of the disease was also confirmed by histological analysis of the colon tissue using the Nancy histological index (p value < 0.05 for differences between non-treated and both groups of treated animals). Moreover, statistical analysis showed a correlation (R2 = 65.52%) between SUVmax values and weight changes throughout the treatment. Overall, this study demonstrates the potential of resveratrol, and melatonin in lower extent, as therapeutic agents in the IBD treatment.
Collapse
Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - David Rey-Bretal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Iván Lamela-Gómez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Blanco-Méndez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - María Pombo-Pasín
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain; Tejerina Foundation, José Abascal 40, Madrid Zip Code: 28003, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela, Zip Code: 15706, Spain.
| |
Collapse
|
44
|
García-Quintanilla L, Luaces-Rodríguez A, Gil-Martínez M, Mondelo-García C, Maroñas O, Mangas-Sanjuan V, González-Barcia M, Zarra-Ferro I, Aguiar P, Otero-Espinar FJ, Fernández-Ferreiro A. Pharmacokinetics of Intravitreal Anti-VEGF Drugs in Age-Related Macular Degeneration. Pharmaceutics 2019; 11:pharmaceutics11080365. [PMID: 31370346 PMCID: PMC6723750 DOI: 10.3390/pharmaceutics11080365] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/27/2022] Open
Abstract
Intravitreal administration of anti-vascular endothelial growth factor (VEGF) antibodies has become the standard treatment for Age-Related Macular Degeneration; however, the knowledge of their pharmacokinetics is limited. A comprehensive review of the preclinical and clinical pharmacokinetic data that were obtained in different studies with intravitreal bevacizumab, ranibizumab, and aflibercept has been conducted. Moreover, the factors that can influence the vitreous pharmacokinetics of these drugs, as well as the methods that were used in the studies for analytical determination, have been exposed. These anti-VEGF drugs present different charge and molecular weights, which play an important role in vitreous distribution and elimination. The pharmacokinetic parameters that were collected differ depending on the species that were involved in the studies and on physiological and pathological conditions, such as vitrectomy and lensectomy. Knowledge of the intravitreal pharmacokinetics of the anti-VEGF drugs that were used in clinical practice is of vital importance.
Collapse
Affiliation(s)
- Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Olalla Maroñas
- Genomic Medicine Group, Galician Public Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Víctor Mangas-Sanjuan
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, 46100 Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia, 46100 Valencia, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Molecular Imaging Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain.
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| |
Collapse
|
45
|
Moscoso A, Silva-Rodríguez J, Aldrey JM, Cortés J, Fernández-Ferreiro A, Gómez-Lado N, Ruibal Á, Aguiar P. Staging the cognitive continuum in prodromal Alzheimer's disease with episodic memory. Neurobiol Aging 2019; 84:1-8. [PMID: 31479859 DOI: 10.1016/j.neurobiolaging.2019.07.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 11/26/2022]
Abstract
It is unclear whether episodic memory is an appropriate descriptor of the cognitive continuum in mild cognitive impairment (MCI). Here, we investigated the ability of episodic memory to track cognitive changes in patients with MCI with biomarker evidence of Alzheimer's disease (AD). We examined 387 MCI amyloid-positive subjects, cognitively staged as "early" or "late" on the basis of episodic memory impairment. Cross-sectional and longitudinal comparisons between these 2 groups were performed for each amyloid, tau, and neurodegeneration (AT(N)) profile. Cross-sectional analyses indicate that "early" MCI represents a transitional phase between normal cognition and "late" MCI in the AD biomarker pathway. After adjusting by confounders and levels of A, T, and (N), "late" MCI progressed significantly faster than "early" MCI only in profiles with both abnormal amyloid and tau markers (A+T+(N)- p < 0.05, A+T+(N)+ p < 0.001). Episodic memory staging is useful for describing symptoms in prodromal AD and complements the AT(N) profiles. Our findings might have implications for the Numeric Clinical staging scheme of the National Institute on Aging and Alzheimer's Association research framework.
Collapse
Affiliation(s)
- Alexis Moscoso
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Jesús Silva-Rodríguez
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Jose Manuel Aldrey
- Neurology Department, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Julia Cortés
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department and Pharmacology group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain; Department of Radiology, Molecular Imaging Group, Faculty of Medicine, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela, Spain; Fundación Tejerina, Madrid, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Hospital CHUS-IDIS, Santiago de Compostela, Spain; Department of Radiology, Molecular Imaging Group, Faculty of Medicine, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela, Spain.
| | | |
Collapse
|
46
|
Castro-Balado A, Mondelo-García C, González-Barcia M, Zarra-Ferro I, Otero-Espinar FJ, Ruibal-Morell Á, Aguiar-Fernández P, Fernández-Ferreiro A. Ocular Biodistribution Studies using Molecular Imaging. Pharmaceutics 2019; 11:pharmaceutics11050237. [PMID: 31100961 PMCID: PMC6572242 DOI: 10.3390/pharmaceutics11050237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 02/07/2023] Open
Abstract
Classical methodologies used in ocular pharmacokinetics studies have difficulties to obtain information about topical and intraocular distribution and clearance of drugs and formulations. This is associated with multiple factors related to ophthalmic physiology, as well as the complexity and invasiveness intrinsic to the sampling. Molecular imaging is a new diagnostic discipline for in vivo imaging, which is emerging and spreading rapidly. Recent developments in molecular imaging techniques, such as positron emission tomography (PET), single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI), allow obtaining reliable pharmacokinetic data, which can be translated into improving the permanence of the ophthalmic drugs in its action site, leading to dosage optimisation. They can be used to study either topical or intraocular administration. With these techniques it is possible to obtain real-time visualisation, localisation, characterisation and quantification of the compounds after their administration, all in a reliable, safe and non-invasive way. None of these novel techniques presents simultaneously high sensitivity and specificity, but it is possible to study biological procedures with the information provided when the techniques are combined. With the results obtained, it is possible to assume that molecular imaging techniques are postulated as a resource with great potential for the research and development of new drugs and ophthalmic delivery systems.
Collapse
Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Cristina Mondelo-García
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Miguel González-Barcia
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Irene Zarra-Ferro
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.
| | - Álvaro Ruibal-Morell
- Nuclear Medicine Department, University Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain.
- Molecular Imaging Group. Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Pablo Aguiar-Fernández
- Nuclear Medicine Department, University Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain.
- Molecular Imaging Group. Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.
| |
Collapse
|
47
|
Blanco-Dorado S, Cea-Arestin C, González Carballo A, Latorre-Pellicer A, Maroñas Amigo O, Barbeito Castiñeiras G, Pérez del Molino Bernal ML, Campos-Toimil M, Fernández-Ferreiro A, Lamas MJ. An Observational Study of the Efficacy and Safety of Voriconazole in a Real-Life Clinical Setting. J Chemother 2018; 31:49-57. [DOI: 10.1080/1120009x.2018.1524085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Sara Blanco-Dorado
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
| | - Cristina Cea-Arestin
- Department of Clinical Analysis, University Hospital Vall D'Hebron, Barcelona, Spain,
| | - Alba González Carballo
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
| | - Ana Latorre-Pellicer
- Medicina Xenómica Group, CIBERER, University of Santiago de Compostela (USC), Santiago de Compostela, Spain,
| | - Olalla Maroñas Amigo
- Medicina Xenómica Group, CIBERER, University of Santiago de Compostela (USC), Santiago de Compostela, Spain,
| | - Gema Barbeito Castiñeiras
- Microbiology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
| | | | - Manuel Campos-Toimil
- Department of Pharmacology of Chronic Diseases (CD Pharma), Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
- Department of Pharmacology of Chronic Diseases (CD Pharma), Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María J. Lamas
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
| |
Collapse
|
48
|
Campaña-Seoane M, Pérez-Gago A, Vázquez G, Conde N, González P, Martinez A, Martínez X, García Varela L, Herranz M, Aguiar P, Fernández-Ferreiro A, Laguna R, Otero-Espinar FJ. Vaginal residence and pharmacokinetic preclinical study of topical vaginal mucoadhesive W/S emulsions containing ciprofloxacin. Int J Pharm 2018; 554:276-283. [PMID: 30423417 DOI: 10.1016/j.ijpharm.2018.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/29/2018] [Accepted: 11/09/2018] [Indexed: 01/05/2023]
Abstract
The aim of this work is to test the in vivo behavior of a mucoadhesive vaginal emulsion resistant to the clearance of vaginal fluids using ciprofloxacin (CPX) as an anti-infective model of drug. CPX is a broad-spectrum antibiotic used in the treatment of sexual tissues infections, as intravenous injection in a dose of 20 mg every 12 h. In this study, CPX was incorporated in water in silicone (W/S) mucoadhesive emulsions and the in vivo residence time and the CPX in vivo absorption and distribution to the sexual organs was studied using the rat as animal model. W/S emulsion shows excellent in vitro bioadhesion having high resistance to the vaginal fluids clearance. The drug release profiles show a constant release of CPX during at least 6 h according to a zero-order kinetics. In vivo computerized PET/CT Image Analysis after intravaginal administration to rats indicates that W/S emulsions remain in the vaginal area for a long time and shows a good absorption of the radiotracers used as markers through the vaginal mucosa. Ciprofloxacin pharmacokinetic studies developed after the single intravaginal administration of W/S emulsion shows a good absorption and distribution of CPX on the uterus and ovarian tissue. A significant concentration of CPX in the sexual tissues was observed after 24 h of administration of W/S emulsion. Therefore, W/S emulsions have a good in vivo residence and drug release in the vaginal mucosae showing a great potential for the treatment of sexual tissues infections, as vaginal bioadhesive delivery systems of antinfectious drugs.
Collapse
Affiliation(s)
- Maria Campaña-Seoane
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Ana Pérez-Gago
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Gonzalo Vázquez
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Nerea Conde
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Paula González
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Ariana Martinez
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Xurxo Martínez
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain
| | - Lara García Varela
- Nuclear Medicine Department, University Clinical Hospital Santiago de Compostela (SERGAS), Spain
| | - Michel Herranz
- Nuclear Medicine Department, University Clinical Hospital Santiago de Compostela (SERGAS), Spain
| | - Pablo Aguiar
- Nuclear Medicine Department, University Clinical Hospital Santiago de Compostela (SERGAS), Spain
| | - Anxo Fernández-Ferreiro
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Reyes Laguna
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain; Institute of Industrial Pharmacy, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Departament of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain; Institute of Industrial Pharmacy, University of Santiago de Compostela, Campus Vida s/n, 15782 Santiago de Compostela, Spain.
| |
Collapse
|
49
|
Luaces-Rodríguez A, Touriño-Peralba R, Alonso-Rodríguez I, García-Otero X, González-Barcia M, Rodríguez-Ares MT, Martínez-Pérez L, Aguiar P, Gómez-Lado N, Silva-Rodríguez J, Herranz M, Ruibal-Morell Á, Lamas MJ, Otero-Espinar FJ, Fernández-Ferreiro A. Preclinical characterization and clinical evaluation of tacrolimus eye drops. Eur J Pharm Sci 2018; 120:152-161. [PMID: 29705214 DOI: 10.1016/j.ejps.2018.04.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/02/2018] [Accepted: 04/24/2018] [Indexed: 12/28/2022]
Abstract
Severe allergic ocular diseases as atopic keratoconjunctivitis can induce corneal damage due to inflammatory substances released from giant papillae. Tacrolimus eye drops are one of the current therapeutic alternatives for its treatment. This work is aimed at developing and characterizing a 0.03% tacrolimus ophthalmic formulation, which was introduced in three types of vehicles (BBS, PVA and Hyaluronic Acid). For this, we have performed in vitro (stability studies) and in vivo assays (corneal permanence time measured directly by Positron Emission Tomography) of three potential formulations. Next, the best formulation was selected, and its toxicological profile and clinical effectiveness have been evaluated. The biopermanence studies (direct measurements and PET/CT) showed that the formulations with PVA and Hyaluronic Acid present more retention time on the ocular surface of rats than PBS. From the stability study, we have determined that tacrolimus with PVA in cold storage is the best option. Tacrolimus with PVA has shown lower cytotoxicity than cyclosporine at early times. On the other hand, the pilot study performed has shown significant improvements in patients, with no noticeable adverse reactions. Based on stability, biopermanence, safety and clinical effectiveness studies, we concluded that tacrolimus-PVA eye drops are a suitable candidate for its clinical application in inflammatory ophthalmology diseases.
Collapse
Affiliation(s)
- Andrea Luaces-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Rosario Touriño-Peralba
- Ophthalmology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Iria Alonso-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - María Teresa Rodríguez-Ares
- Ophthalmology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Laura Martínez-Pérez
- Ophthalmology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jesús Silva-Rodríguez
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Michel Herranz
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Álvaro Ruibal-Morell
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| |
Collapse
|
50
|
Díaz-Tomé V, Luaces-Rodríguez A, Silva-Rodríguez J, Blanco-Dorado S, García-Quintanilla L, Llovo-Taboada J, Blanco-Méndez J, García-Otero X, Varela-Fernández R, Herranz M, Gil-Martínez M, Lamas MJ, González-Barcia M, Otero-Espinar FJ, Fernández-Ferreiro A. Ophthalmic Econazole Hydrogels for the Treatment of Fungal Keratitis. J Pharm Sci 2018; 107:1342-1351. [PMID: 29305870 DOI: 10.1016/j.xphs.2017.12.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
Econazole is a feasible alternative treatment in the management of fungal keratitis. Nevertheless, its low water solubility is considered the main limitation to the incorporation into ophthalmic formulations. In this work, econazole nitrate is solubilized by using cyclodextrins to achieve an optimum therapeutic concentration. Phase solubility diagrams suggest α-cyclodextrin as the most effective cyclodextrin and later the inclusion complex formed with this one was characterized in solution by 1D, 2D-NMR, and molecular modeling. Econazole-α-cyclodextrin inclusion complex was included in 2 types of ocular hydrogels: a natural polysaccharides ion-sensitive hydrogel and a hyaluronic acid hydrogel. Both of them show no ocular irritation in the hen's egg test on chorioallantoic membrane assay and a controlled econazole release over time. Permeability studies suggest that hydrogels do not modify the econazole nitrate permeability through bovine cornea in comparison with an econazole-α-cyclodextrin inclusion complex solution. Finally, ocular biopermanence studies performed using positron emission tomography show these hydrogels present a high retention time on the eye. Results suggest the developed formulations have a high potential as vehicles for the econazole topical ocular administration as fungal keratitis treatment.
Collapse
Affiliation(s)
- Victoria Díaz-Tomé
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jesús Silva-Rodríguez
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Sara Blanco-Dorado
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - José Llovo-Taboada
- Microbiology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - José Blanco-Méndez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Rubén Varela-Fernández
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Michel Herranz
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
| |
Collapse
|