1
|
Legge EJ, Stewart M, Contreras L, Zhang H, Tsikritsis D, Belsey NA, McAllister M, Murphy JR, Mingard K, Minelli C. ADVANCED CHEMICAL AND IMAGING METHODS FOR STUDYING STRUCTURE MORPHOLOGY AND EXCIPIENTS SOLID STATE TRANSFORMATIONS IN PHARMACEUTICAL MULTIPARTICULATE FORMULATIONS. J Pharm Sci 2024:S0022-3549(24)00176-X. [PMID: 38777176 DOI: 10.1016/j.xphs.2024.05.004] [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: 01/17/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
The formulation of paediatric medicines faces significant challenges to meet the requirements for safe and accurate administration, while maintaining a suitable taste. Multiparticulate formulations have a strong potential to address these challenges because they combine dose flexibility with ease of administration. Understanding the stability of multiparticulate formulations over storage as a function of time and environmental parameters, such as humidity and temperature, is important to manage their commercialisation and use. In this work, we have expanded the toolkit of available techniques for studying multiparticulates beyond those such as scanning electron microscopy (SEM) and confocal laser scanning microscopy. We include advanced methods of environmentally-controlled SEM to monitor temperature- and humidity-induced changes in-situ, and a variety of Raman spectroscopies including stimulated Raman scattering microscopy to identify and localise the different ingredients at the surface and inside the multiparticulates. These techniques allowed unprecedented monitoring of specific changes to the particulate structure and distribution of individual ingredients due to product aging. These methods should be considered as valuable novel tools for in-depth characterisation of multiparticulate formulations to further understand chemical changes occurring during their development, manufacturing and long-term storage. We envisage these techniques to be useful in furthering the development of future medicine formulations.
Collapse
Affiliation(s)
| | - Mark Stewart
- National Physical Laboratory, Teddington, TW11 0LW, UK
| | - Lourdes Contreras
- Worldwide Research and Development and Medical, Drug Product Design, Pfizer Ltd., Ramsgate Road, Sandwich, CT13 9NJ, UK
| | - Hannah Zhang
- National Physical Laboratory, Teddington, TW11 0LW, UK
| | | | - Natalie A Belsey
- National Physical Laboratory, Teddington, TW11 0LW, UK; School of Chemistry and Chemical Engineering, University of Surrey, Guildford, GU2 7XH, UK
| | - Mark McAllister
- Worldwide Research and Development and Medical, Drug Product Design, Pfizer Ltd., Ramsgate Road, Sandwich, CT13 9NJ, UK
| | - John Richard Murphy
- Worldwide Research and Development and Medical, Drug Product Design, Pfizer Ltd., Ramsgate Road, Sandwich, CT13 9NJ, UK
| | - Ken Mingard
- National Physical Laboratory, Teddington, TW11 0LW, UK
| | | |
Collapse
|
2
|
Favaron A, Hens B, Montanha M, McAllister M, Tomaszewska I, Moustafa S, de Oliveira MA, Basit AW, Orlu M. Can in vitro/in silico tools improve colonic concentration estimations for oral extended-release formulations? A case study with upadacitinib. J Control Release 2024:S0168-3659(24)00245-1. [PMID: 38641022 DOI: 10.1016/j.jconrel.2024.04.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/12/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
Upadacitinib, classified as a highly soluble drug, is commercially marketed as RINVOQ®, an modified-release formulation incorporating hydroxypropyl methylcellulose as a matrix system to target extended release throughout the gastrointestinal (GI) tract. Our study aimed to explore how drug release will occur throughout the GI tract using a plethora of in vitro and in silico tools. We built a Physiologically-Based Pharmacokinetic (PBPK) model in GastroPlus™ to predict the systemic concentrations of the drug when administered using in vitro dissolution profiles as input to drive luminal dissolution. A series of in vitro dissolution experiments were gathered using the USP Apparatus I, III and IV in presence of biorelevant media, simulating both fasted and fed state conditions. A key outcome from the current study was to establish an in vitro-in vivo correlation (IVIVC) between (i) the dissolution profiles obtained from the USP I, III and IV methods and (ii) the fraction absorbed of drug as deconvoluted from the plasma concentration-time profile of the drug. When linking the fraction dissolved as measured in the USP IV model, a Level A IVIVC was established. Moreover, when using the different dissolution profiles as input for PBPK modeling, it was also observed that predictions for plasma Cmax and AUC were most accurate for USP IV compared to the other models (based on predicted versus observed ratios). Furthermore, the PBPK model has the utility to extract the predicted concentrations at the level of the colon which can be of utmost interest when working with specific in vitro assays.
Collapse
Affiliation(s)
- Alessia Favaron
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK
| | - Bart Hens
- Drug Product Design, Pfizer, Sandwich, Kent CT13 9NJ, United Kingdom.
| | - Maiara Montanha
- Drug Product Design, Pfizer, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Mark McAllister
- Drug Product Design, Pfizer, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Irena Tomaszewska
- Drug Product Design, Pfizer, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Shaimaa Moustafa
- Drug Product Design, Pfizer, Sandwich, Kent CT13 9NJ, United Kingdom
| | | | - Abdul W Basit
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK..
| | - Mine Orlu
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK..
| |
Collapse
|
3
|
Hens B, Sarcevica I, Tomaszewska I, McAllister M. Digitalizing the TIM-1 Model Using Computational Approaches─Part Two: Digital TIM-1 Model in GastroPlus. Mol Pharm 2023; 20:5429-5439. [PMID: 37878668 DOI: 10.1021/acs.molpharmaceut.3c00423] [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] [Indexed: 10/27/2023]
Abstract
A TIM-1 model is an in vitro gastrointestinal (GI) simulator considering crucial physiological parameters that will affect the in vivo drug release process. The outcome of these experiments can indicate the critical bioavailability attributes (CBAs) that will impact the fraction absorbed in vivo. The model is widely used in the nonclinical stage of drug product development to assess the bioaccessible fraction of drugs for numerous candidate formulations. In this work, we developed a digital TIM-1 model in the GastroPlus platform. In a first step, we performed validation experiments to assess the luminal concentrations and bioaccessible fractions for two marker compounds. The digital TIM-1 was able to adequately reflect the luminal concentrations and bioaccessible fractions of these markers under different prandial conditions, confirming the appropriate integration of mass transfer in the TIM-1 model. In a second set of experiments, a case example with PF-07059013 was performed, where luminal concentrations and bioaccessible fractions were predicted for 200 and 1000 mg doses under fasted and achlorhydric conditions. Experimental and simulated data pointed out that the achlorhydric effect was more pronounced at the 1000 mg dose, showing a solubility-limited dissolution and, consequently, decreased bioaccessible fraction. Toward future applications, the digital TIM-1 model will be thoroughly applied to explore a link between in vitro and in vivo outcomes based on more case examples with model compounds with the access of TIM-1 and plasma data. Ideally, this digital TIM-1 can be directly used in GastroPlus to explore an in vitro-in vivo correlation (IVIVC) between the fraction dissolved (digital TIM-1 settings) and the fraction absorbed (human PBPK settings).
Collapse
Affiliation(s)
- Bart Hens
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Inese Sarcevica
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Irena Tomaszewska
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Mark McAllister
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| |
Collapse
|
4
|
Sarcevica I, Hens B, Tomaszewska I, McAllister M. Digitalizing the TIM-1 Model using Computational Approaches-Part One: TIM-1 Data Explorer. Mol Pharm 2023; 20:5416-5428. [PMID: 37878746 DOI: 10.1021/acs.molpharmaceut.3c00422] [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] [Indexed: 10/27/2023]
Abstract
The TIM-1 gastrointestinal model is one of the most advanced in vitro systems currently available for biorelevant dissolution testing. This technology, the initial version of which was developed nearly 30 years ago and has been subject to a number of significant updates over this period, simulates the dynamic environment of the human gastrointestinal tract, including pH, transfer times, secretion of bile, enzymes, and electrolytes. In the pharmaceutical industry, the TIM-1 system is used to support drug product design and provide a biopredictive assessment of drug product performance. Typically, the bioaccessibility data sets generated by TIM-1 experiments are used to qualitatively compare formulation performance, and the use of bioaccessibility data as inputs for physiologically based pharmacokinetic (PBPK) modeling for quantitative predictions is limited. To expand the utility of the TIM-1 model beyond standard bioaccessibility measurements (which define the fraction available for absorption), we have developed a computational tool, TIM-1 Data Explorer, to describe the fluid and mass balance within the TIM-1 system. The use of this tool allows a detailed inspection and in-depth interpretation of the experimental data. In addition to mass balance calculation, this model also can be used to describe the critical processes a drug substance would undergo during a TIM-1 experiment, such as dissolution, precipitation on transfer from the stomach to duodenum, and redissolution. The TIM-1 Data Explorer was validated in two case studies. In the first case study with paracetamol, we have shown the ability of the simulator to adequately describe mass transfer events within the TIM-1 system, and in the second study with a weakly basic in-house compound, PF-07059013, the TIM-1 Data Explorer was successfully used to describe dissolution and precipitation processes.
Collapse
Affiliation(s)
- Inese Sarcevica
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Bart Hens
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Irena Tomaszewska
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| | - Mark McAllister
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich CT13 9ND, U.K
| |
Collapse
|
5
|
Piscitelli J, Hens B, Tomaszewska I, Wollenberg L, Litwiler K, McAllister M, Reddy M. Effect of Food and a Proton-Pump Inhibitor on the Absorption of Encorafenib: An In Vivo- In Vitro- In Silico Approach. Mol Pharm 2023; 20:2589-2599. [PMID: 37037186 PMCID: PMC10155203 DOI: 10.1021/acs.molpharmaceut.3c00016] [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: 04/12/2023]
Abstract
Encorafenib is a kinase inhibitor indicated for the treatment of patients with BRAF mutant melanoma and BRAF mutant metastatic colorectal cancer. To understand the effect of food and coadministration with a proton-pump inhibitor (PPI), in vitro, in vivo, and in silico data were generated to optimize the clinical dose, evaluate safety, and better understand the oral absorption process under these conditions. Study 1 evaluated the effect of food on the plasma pharmacokinetics, safety, and tolerability after a single oral dose of encorafenib 100 mg. Study 2 evaluated the same end points with coadministration of encorafenib and rabeprazole (PPI perpetrator). The in vitro gastrointestinal TIM-1 model was used to investigate the release of encorafenib and the amount available for absorption under different testing conditions (fasted, fed, and with the use of a PPI). The fasted, fed, and PPI states were predicted for the encorafenib commercial capsule in GastroPlus 9.8. In study 1, both AUCinf and AUClast decreased by 4% with the administration of a high-fat meal. The Cmax was 36% lower than with fasted conditions. All 3 exposure parameters in study 2 (AUCinf, AUClast, and Cmax) had mean changes of <10% when encorafenib was coadministered with a PPI. Using the in vitro gastrointestinal simulator TIM-1, the model demonstrated a similar release of drug, as the bioaccessible fraction, in the 3 conditions was equal (≥80%), predicting no PPI or food effect for this drug formulation. The modeling in GastroPlus 9.8 demonstrated complete absorption of encorafenib when formulated as an amorphous solid dispersion. To obtain these results, it was crucial to integrate the amorphous solubility of the drug that shows a 20-fold higher solubility at pH 6.8 compared with crystalline solubility. The increased amorphous solubility is likely the reason no PPI effect was observed compared with fasted state conditions. The prolongation in gastric emptying in the fed state resulted in delayed plasma Tmax for encorafenib. No dose adjustment is necessary when encorafenib is administered in the fed state or when coadministered with a PPI. Both the TIM-1 and physiologically based pharmacokinetic model results were consistent with the observed clinical data, suggesting that these will be valuable tools for future work.
Collapse
Affiliation(s)
- Joseph Piscitelli
- Pfizer Inc., Global Product Development, La Jolla, California 92121, United States
| | - Bart Hens
- Pfizer Inc., Drug Product Design, Sandwich CT13 9NJ, United Kingdom
| | | | - Lance Wollenberg
- Pfizer Inc., Early Clinical Development, Boulder, Colorado 80301, United States
| | - Kevin Litwiler
- Pfizer Inc., Global Product Development, Boulder, Colorado 80301, United States
| | - Mark McAllister
- Pfizer Inc., Drug Product Design, Sandwich CT13 9NJ, United Kingdom
| | - Micaela Reddy
- Pfizer Inc., Early Clinical Development, Boulder, Colorado 80301, United States
| |
Collapse
|
6
|
McAllister M, Rourke KF, Hoy N. Comparative evaluation of 90-day patient outcomes and healthcare encounters following extended day surgery urethroplasty. Can Urol Assoc J 2023:cuaj.8219. [PMID: 36952302 DOI: 10.5489/cuaj.8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
INTRODUCTION Most centers have shifted to an extended day surgery (XDS) model for urethroplasty. Our study characterizes outcomes and unplanned healthcare encounters of patients undergoing XDS urethroplasty compared to case-matched inpatient controls. METHODS We conducted a retrospective, two-surgeon, single-center study of patients undergoing XDS urethroplasty (discharge <24 hrs) from November 2020 to November 2021. Patients were case-control matched based on age, stricture length, location, and etiology to patients who had previously undergone inpatient urethroplasty. Data was analyzed using descriptive and univariable statistics. Multivariable analysis by Cox proportional hazard regression was used to identify associations with postoperative complications. RESULTS Ninety patients (mean age=53.8 years) underwent XDS urethroplasty during the study period. Mean stricture length was 4.4 cm standard deviation [SD] 2.4). Rates of postoperative complications were similar between XDS (17%, n=15) and admitted patients (21%, n=19), and XDS was not associated with increased risk on univariable analysis (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.31-1.3, p=0.36). When stratifying by location, penile stricture (OR 4.21, 95% CI 1.3-13.8, p=0.02), and lichen sclerosus (OR 2.91, 95% CI 0.79-9.9, p=0.08) were associated with increased risk of postoperative complication. On multivariable analysis, only penile stricture was identified as significant (OR 4.78, 95% CI 1.2-19.4, p=0.03). Forty-eight percent (n=43) of patients had unplanned healthcare encounters postoperatively, with similar numbers of phone calls (n=37) and emergency department visits (n=36) between groups. CONCLUSIONS Our study shows that XDS urethroplasty is not associated with increased rates of complications relative to inpatient admission. This data supports using an XDS pathway for resource-efficient treatment of urethral strictures in a universal healthcare setting.
Collapse
Affiliation(s)
- Mark McAllister
- Division of Urology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Keith F Rourke
- Division of Urology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nathan Hoy
- Division of Urology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
7
|
Hens B, Seegobin N, Bermejo M, Tsume Y, Clear N, McAllister M, Amidon GE, Amidon GL. Dissolution Challenges Associated with the Surface pH of Drug Particles: Integration into Mechanistic Oral Absorption Modeling. AAPS J 2022; 24:17. [PMID: 34982285 DOI: 10.1208/s12248-021-00663-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/12/2021] [Accepted: 10/20/2021] [Indexed: 12/16/2022] Open
Abstract
The present work aimed to differentiate between in vitro dissolution profiles of ibuprofen as input for GastroPlus™ and to see the impact on systemic exposure. In vitro dissolution profiles of ibuprofen obtained under low- and high-buffered dissolution media were used as input using the z-factor approach. In a second step, a customized surface pH calculator was applied to predict the surface pH of ibuprofen under these low- and high-buffered dissolution conditions. These surface pH values were adopted in GastroPlus™ and simulations were performed to predict the systemic outcome. Simulated data were compared with systemic data of ibuprofen obtained under fasted state conditions in healthy subjects. The slower dissolution rate observed when working under low-buffered conditions nicely matched with the slower dissolution rate as observed during the clinical aspiration study and was in line with the systemic exposure of the drug. Finally, a population simulation was performed to explore the impact of z-factor towards bioequivalence (BE) criteria (so-called safe space). Concerning future perspectives, the customized calculator should be developed in such a way to make it possible to predict the dissolution rate (being informed by the particle size distribution) which, in its turn, can be used as a surrogate to predict the USP2 dissolution curve. Subsequently, validation can be done by using this profile as input for PBPK platforms.
Collapse
Affiliation(s)
- Bart Hens
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich, CT13 9ND, UK.
| | - Nidhi Seegobin
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich, CT13 9ND, UK.,UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London, WC1N 1AX, UK
| | - Marival Bermejo
- Department of Engineering, Pharmacy Section, Miguel Hernandez University, 03550, San Juan de Alicante, Alicante, Spain
| | - Yasuhiro Tsume
- Merck & Co., Inc, 126 E Lincoln Ave, Rahway, New Jersey, 07065, USA
| | - Nicola Clear
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich, CT13 9ND, UK
| | - Mark McAllister
- Drug Product Design, Pfizer, Discovery Park, Ramsgate Road, Sandwich, CT13 9ND, UK
| | - Gregory E Amidon
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109-1065, USA
| | - Gordon L Amidon
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, 428 Church Street, Ann Arbor, Michigan, 48109-1065, USA.
| |
Collapse
|
8
|
Lalla U, Koegelenberg CFN, Allwood BW, Sigwadhi LN, Irusen EM, Zemlin AE, Masha TE, Erasmus RT, Chapanduka ZC, Prozesky H, Taljaard J, Parker A, Decloedt EH, Retief F, Jalavu TP, Ngah VD, Yalew A, Tamuzi JL, Baines N, McAllister M, Zumla A, Nyasulu PS. Comparison of patients with severe COVID-19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID-19 pandemic. Afr J Thorac Crit Care Med 2021; 27:10.7196/AJTCCM.2021.v27i4.185. [PMID: 35359698 PMCID: PMC8948479 DOI: 10.7196/ajtccm.2021.v27i4.185] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background The second wave of coronavirus disease 2019 (COVID-19), dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Beta variant, has been reported to be associated with increased severity in South Africa (SA). Objectives To describe and compare clinical characteristics, management and outcomes of COVID-19 patients admitted to an intensive care unit (ICU) in SA during the first and second waves. Methods In a prospective, single-centre, descriptive study, we compared all patients with severe COVID-19 admitted to ICU during the first and second waves. The primary outcomes assessed were ICU mortality and ICU length of stay (LOS). Results In 490 patients with comparable ages and comorbidities, no difference in mortality was demonstrated during the second compared with the first wave (65.9% v. 62.5%, p=0.57). ICU LOS was longer in the second wave (10 v. 6 days, p<0.001). More female admissions (67.1% v. 44.6%, p<0.001) and a greater proportion of patients were managed with invasive mechanical ventilation than with non-invasive respiratory support (39.0% v. 14%, p<0.001) in the second wave. Conclusion While clinical characteristics were comparable between the two waves, a higher proportion of patients was invasively ventilated and ICU stay was longer in the second. ICU mortality was unchanged.
Collapse
Affiliation(s)
- U Lalla
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - C F N Koegelenberg
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - B W Allwood
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - L N Sigwadhi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - E M Irusen
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - A E Zemlin
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service (NHLS) Tygerberg Hospital, Cape Town, South Africa
| | - T E Masha
- Faculty of Health and Wellness Sciences, Peninsula University of Technology Bellville Campus, Cape Town
| | - R T Erasmus
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service (NHLS) Tygerberg Hospital, Cape Town, South Africa
| | - Z C Chapanduka
- Division of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - H Prozesky
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - J Taljaard
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - A Parker
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - E H Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - F Retief
- Department of Anaesthesia and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - T P Jalavu
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service (NHLS) Tygerberg Hospital, Cape Town, South Africa
| | - V D Ngah
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A Yalew
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Ethiopia
- National Data Management Centre for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - J L Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - N Baines
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - M McAllister
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, Royal Free Campus, London, UK; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - P S Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
9
|
McAllister M, Chen J, Smith S, King A, Dingle TC, Mansour S. 184. Staphylococcus aureus Bacteremia Management and Outcomes Following Infectious Disease Consult Over Time at a Tertiary Care Center in Canada. Open Forum Infect Dis 2021. [DOI: 10.1093/ofid/ofab466.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality. Infectious disease consultation (IDC) is associated with increased adherence to guideline management and improved patient outcomes. We describe the IDC rate over time and impact of IDC on the management and outcomes of patients with SAB.
Methods
This retrospective chart review includes adult patients (≥ 18 years) hospitalized at the University of Alberta Hospital, Edmonton, Canada who had at least 1 blood culture growing Staphylococcus aureus during two time periods (A: Jan 2010 to Dec 2012; B: Jan to Oct 2020). Patients who died or were made palliative within 48hrs following bacteremia were excluded. Descriptive statistics were used to compare appropriateness of SAB management and outcomes in patients receiving IDC and those who did not (NIDC).
Results
325 patients in period A and 129 in period B were included. Baseline demographics were similar. IDC rate increased from 63% to 88% (p< 0.001) between the study periods. IDC was associated with increased odds of receiving an echocardiogram (OR=3.56, 95% CI 2.22 – 5.57; OR=20.4, 95% 4.13 – 110.6, p< 0.001) and appropriate duration of antimicrobial therapy (OR=6.74, 95% 3.93 – 11.54; OR=43.2, 95% 5.72 – 529.5, p< 0.001) between study periods. Mean length of stay decreased in patients receiving IDC (44.8 vs 28.1 days, p=0.005) and increased in NIDC patients (19.9 vs 28.7 days, p=0.216). IDC was associated with lower 30-day mortality in period A (OR=3.53, 95% 1.95 – 6.36), however this association was not observed in period B (OR=1.43, 95% 0.40 – 5.56). There was a trend towards decreased odds of mortality in patients receiving early IDC (≤2 days from bacteremia, n=65) compared to late IDC (≥3 days from bacteremia, n=45) (OR=2.59, 95% 0.95 – 7.10, p=0.077).
Conclusion
Our centre’s IDC rate for SAB increased over time without specific intervention. IDC increased the odds of appropriate SAB management and was associated with decreased length of stay in period B. IDC was associated with lower 30-day mortality in period A and trended towards lower mortality in period B. Specifically, early IDC decreased odds of 30-day mortality compared to late IDC. These results suggest that routine early IDC be part of SAB management.
Disclosures
All Authors: No reported disclosures
Collapse
Affiliation(s)
| | - Justin Chen
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Arienne King
- University of Alberta, Edmonton, Alberta, Canada
| | - Tanis C Dingle
- University of Alberta, Alberta Precision Labs, Edmonton, Alberta, Canada
| | | |
Collapse
|
10
|
Vinarov Z, Abrahamsson B, Artursson P, Batchelor H, Berben P, Bernkop-Schnürch A, Butler J, Ceulemans J, Davies N, Dupont D, Flaten GE, Fotaki N, Griffin BT, Jannin V, Keemink J, Kesisoglou F, Koziolek M, Kuentz M, Mackie A, Meléndez-Martínez AJ, McAllister M, Müllertz A, O'Driscoll CM, Parrott N, Paszkowska J, Pavek P, Porter CJH, Reppas C, Stillhart C, Sugano K, Toader E, Valentová K, Vertzoni M, De Wildt SN, Wilson CG, Augustijns P. Current challenges and future perspectives in oral absorption research: An opinion of the UNGAP network. Adv Drug Deliv Rev 2021; 171:289-331. [PMID: 33610694 DOI: 10.1016/j.addr.2021.02.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [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: 11/27/2020] [Revised: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
Although oral drug delivery is the preferred administration route and has been used for centuries, modern drug discovery and development pipelines challenge conventional formulation approaches and highlight the insufficient mechanistic understanding of processes critical to oral drug absorption. This review presents the opinion of UNGAP scientists on four key themes across the oral absorption landscape: (1) specific patient populations, (2) regional differences in the gastrointestinal tract, (3) advanced formulations and (4) food-drug interactions. The differences of oral absorption in pediatric and geriatric populations, the specific issues in colonic absorption, the formulation approaches for poorly water-soluble (small molecules) and poorly permeable (peptides, RNA etc.) drugs, as well as the vast realm of food effects, are some of the topics discussed in detail. The identified controversies and gaps in the current understanding of gastrointestinal absorption-related processes are used to create a roadmap for the future of oral drug absorption research.
Collapse
Affiliation(s)
- Zahari Vinarov
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Department of Chemical and Pharmaceutical Engineering, Sofia University, Sofia, Bulgaria
| | - Bertil Abrahamsson
- Oral Product Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - Per Artursson
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Hannah Batchelor
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Philippe Berben
- Pharmaceutical Development, UCB Pharma SA, Braine- l'Alleud, Belgium
| | - Andreas Bernkop-Schnürch
- Department of Pharmaceutical Technology, Institute of Pharmacy, University of Innsbruck, Innsbruck, Austria
| | - James Butler
- GlaxoSmithKline Research and Development, Ware, United Kingdom
| | | | - Nigel Davies
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Gøril Eide Flaten
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, United Kingdom
| | | | | | | | | | | | - Martin Kuentz
- Institute for Pharma Technology, University of Applied Sciences and Arts Northwestern Switzerland, Basel, Switzerland
| | - Alan Mackie
- School of Food Science & Nutrition, University of Leeds, Leeds, United Kingdom
| | | | | | - Anette Müllertz
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Petr Pavek
- Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | | | - Christos Reppas
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Kiyohiko Sugano
- College of Pharmaceutical Sciences, Ritsumeikan University, Shiga, Japan
| | - Elena Toader
- Faculty of Medicine, University of Medicine and Pharmacy of Iasi, Romania
| | - Kateřina Valentová
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Maria Vertzoni
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Saskia N De Wildt
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Clive G Wilson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Patrick Augustijns
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
| |
Collapse
|
11
|
Ross SA, Hurt AP, Antonijevic M, Bouropoulos N, Ward A, Basford P, McAllister M, Douroumis D. Continuous Manufacture and Scale-Up of Theophylline-Nicotinamide Cocrystals. Pharmaceutics 2021; 13:419. [PMID: 33804705 PMCID: PMC8004052 DOI: 10.3390/pharmaceutics13030419] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of the study was the manufacturing and scale-up of theophylline-nicotinamide (THL-NIC) pharmaceutical cocrystals processed by hot-melt extrusion (HME). The barrel temperature profile, feed rate and screw speed were found to be the critical processing parameters with a residence time of approximately 47 s for the scaled-up batches. Physicochemical characterization using scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and X-ray diffraction of bulk and extruded materials revealed the formation of high purity cocrystals (98.6%). The quality of THL-NIC remained unchanged under accelerated stability conditions.
Collapse
Affiliation(s)
- Steven A. Ross
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent ME4 4TB, UK; (S.A.R.); (A.P.H.); (M.A.)
| | - Andrew P. Hurt
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent ME4 4TB, UK; (S.A.R.); (A.P.H.); (M.A.)
| | - Milan Antonijevic
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent ME4 4TB, UK; (S.A.R.); (A.P.H.); (M.A.)
| | - Nicolaos Bouropoulos
- Department of Materials Science, University of Patras, Rio, 26504 Patras, Greece;
- Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature, Chemical Processes, 26504 Patras, Greece
| | - Adam Ward
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, West Yorkshire HD1 3DH, UK;
| | - Pat Basford
- Pfizer Global Research & Development, Ramsgate Road, Sandwich CT13 9NJ, UK; (P.B.); (M.M.)
| | - Mark McAllister
- Pfizer Global Research & Development, Ramsgate Road, Sandwich CT13 9NJ, UK; (P.B.); (M.M.)
| | - Dennis Douroumis
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent ME4 4TB, UK; (S.A.R.); (A.P.H.); (M.A.)
| |
Collapse
|
12
|
Hens B, Augustijns P, Lennernäs H, McAllister M, Abrahamsson B. Leveraging Oral Drug Development to a Next Level: Impact of the IMI-Funded OrBiTo Project on Patient Healthcare. Front Med (Lausanne) 2021; 8:480706. [PMID: 33748152 PMCID: PMC7973356 DOI: 10.3389/fmed.2021.480706] [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: 06/25/2019] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
A thorough understanding of the behavior of drug formulations in the human gastrointestinal (GI) tract is essential when working in the field of oral drug development in a pharmaceutical company. For orally administered drug products, various GI processes, including disintegration of the drug formulation, drugrelease, dissolution, precipitation, degradation, dosage form transit and permeation, dictate absorption into the systemic circulation. These processes are not always fully captured in predictive in vitro and in silico tools, as commonly applied in the pre-clinical stage of formulation drug development. A collaborative initiative focused on the science of oral biopharmaceutics was established in 2012 between academic institutions and industrial companies to innovate, optimize and validate these in vitro and in silico biopharmaceutical tools. From that perspective, the predictive power of these models can be revised and, if necessary, optimized to improve the accuracy toward predictions of the in vivo performance of orally administered drug products in patients. The IMI/EFPIA-funded "Oral Bioavailability Tools (OrBiTo)" project aimed to improve our fundamental understanding of the GI absorption process. The gathered information was integrated into the development of new (or already existing) laboratory tests and computer-based methods in order to deliver more accurate predictions of drug product behavior in a real-life setting. These methods were validated with the use of industrial data. Crucially, the ultimate goal of the project was to set up a scientific framework (i.e., decision trees) to guide the use of these new tools in drug development. The project aimed to facilitate and accelerate the formulation development process and to significantly reduce the need for animal experiments in this area as well as for human clinical studies in the future. With respect to the positive outcome for patients, high-quality oral medicines will be developed where the required dose is well-calculated and consistently provides an optimal clinical effect. In a first step, this manuscript summarizes the setup of the project and how data were collected across the different work packages. In a second step, case studies of how this project contributed to improved knowledge of oral drug delivery which can be used to develop improved products for patients will be illustrated.
Collapse
Affiliation(s)
- Bart Hens
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.,Drug Product Design, Pfizer, Sandwich, United Kingdom
| | - Patrick Augustijns
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Hans Lennernäs
- Department of Pharmaceutical Biosciences and Technology, Uppsala University, Uppsala, Sweden
| | | | - Bertil Abrahamsson
- Oral Product Development, Pharmaceutical Technology and Development, Operations, AstraZeneca Gothenburg, Mölndal, Sweden
| |
Collapse
|
13
|
Effinger A, McAllister M, Tomaszewska I, O'Driscoll CM, Taylor M, Gomersall S, Heaton J, Smith KL, Sarcevica I, Young SL, Fotaki N. Investigating the Impact of Crohn's Disease on the Bioaccessibility of a Lipid-Based Formulation with an In Vitro Dynamic Gastrointestinal Model. Mol Pharm 2021; 18:1530-1543. [PMID: 33656882 DOI: 10.1021/acs.molpharmaceut.0c00807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/30/2022]
Abstract
The aim of the study was to investigate the impact of Crohn's disease (CD) on the performance of a lipid-based formulation of ciprofloxacin in a complex gastrointestinal simulator (TIM-1, TNO) and to compare the luminal environment in terms of bile salt and lipid composition in CD and healthy conditions. CD conditions were simulated in the TIM-1 system with a reduced concentration of porcine pancreatin and porcine bile. The bioaccessibility of ciprofloxacin was similar in simulated CD and healthy conditions considering its extent as well as its time course in the jejunum and ileum filtrate. Differences were observed in terms of the luminal concentration of triglycerides, monoglycerides, and fatty acids in the different TIM-1 compartments, indicating a reduction and delay in the lipolysis of formulation excipients in CD. The quantitative analysis of bile salts revealed higher concentrations for healthy conditions (standard TIM-1 fasted-state protocol) in the duodenum and jejunum TIM-1 compartments compared to published data in human intestinal fluids of healthy subjects. The reduced concentrations of bile salts in simulated CD conditions correspond to the levels observed in human intestinal fluids of healthy subjects in the fasted state.A lipidomics approach with ultra performance liquid chromatography (UPLC)/mass spectrometry (MS) has proven to be a time-efficient method to semiquantitatively analyze differences in fatty acid and bile salt levels between healthy and CD conditions. The dynamic luminal environment in CD and healthy conditions after administration of a lipid-based formulation can be simulated using the TIM-1 system. For ciprofloxacin, an altered luminal lipid composition had no impact on its performance indicating a low risk of altered performance in CD patients.
Collapse
Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, U.K
| | | | | | - Caitriona M O'Driscoll
- School of Pharmacy, University College Cork, Cavanagh Pharmacy Building, Cork T12 YT20, Ireland
| | - Mark Taylor
- Pfizer Analytical Research and Development, Sandwich CT13 9NJ, U.K
| | - Steve Gomersall
- Pfizer Analytical Research and Development, Sandwich CT13 9NJ, U.K
| | - James Heaton
- Pfizer Analytical Research and Development, Sandwich CT13 9NJ, U.K
| | - Kieran L Smith
- Pfizer Analytical Research and Development, Sandwich CT13 9NJ, U.K
| | - Inese Sarcevica
- Pfizer Analytical Research and Development, Sandwich CT13 9NJ, U.K
| | - Sam L Young
- Pfizer Drug Product Design, Sandwich CT13 9NJ, U.K
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, U.K
| |
Collapse
|
14
|
Effinger A, O'Driscoll CM, McAllister M, Fotaki N. Predicting budesonide performance in healthy subjects and patients with Crohn's disease using biorelevant in vitro dissolution testing and PBPK modeling. Eur J Pharm Sci 2021; 157:105617. [PMID: 33164838 DOI: 10.1016/j.ejps.2020.105617] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/02/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Drug product performance might be affected in Crohn's disease (CD) patients compared to healthy subjects due to pathophysiological changes. Since a low number of clinical studies is performed in this patient population, physiologically-based pharmacokinetic (PBPK) models with integrated results from biorelevant in vitro dissolution studies could be used to assess differences in the bioavailability of drugs. Using this approach, budesonide was used as model drug and its performance in healthy subjects and CD patients was predicted and compared against observed pharmacokinetic data. The in vitro release tests, under healthy versus CD conditions, revealed a similar extent of drug release from a controlled-release budesonide formulation in the fasted state, whereas in the fed state a lower extent was observed with CD. Differences in the physiology of CD patients were identified in literature and their impact on budesonide performance was investigated with a PBPK model, revealing the highest impact on the simulated bioavailability for the reduced hepatic CYP3A4 enzyme abundance and lower human serum albumin concentration. For CD patients, a higher budesonide exposure compared to healthy subjects was predicted with a PBPK population adapted to CD physiology and in agreement with observed pharmacokinetic data. Budesonide performance in the fasted and fed state was successfully predicted in healthy subjects and CD patients using PBPK modeling and in vitro release testing. Following this approach, predictions of the direction and magnitude of changes in bioavailability due to CD could be made for other drugs and guide prescribers to adjust dosage regimens for CD patients accordingly.
Collapse
Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
| |
Collapse
|
15
|
Jamei M, Abrahamsson B, Brown J, Bevernage J, Bolger MB, Heimbach T, Karlsson E, Kotzagiorgis E, Lindahl A, McAllister M, Mullin JM, Pepin X, Tistaert C, Turner DB, Kesisoglou F. Current status and future opportunities for incorporation of dissolution data in PBPK modeling for pharmaceutical development and regulatory applications: OrBiTo consortium commentary. Eur J Pharm Biopharm 2020; 155:55-68. [DOI: 10.1016/j.ejpb.2020.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/03/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022]
|
16
|
Phillips NA, Lillico DM, Qin R, McAllister M, El-Din MG, Belosevic M, Stafford JL. Inorganic fraction of oil sands process-affected water induces mammalian macrophage stress gene expression and acutely modulates immune cell functional markers at both the gene and protein levels. Toxicol In Vitro 2020; 66:104875. [DOI: 10.1016/j.tiv.2020.104875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 12/22/2022]
|
17
|
Effinger A, M O'Driscoll C, McAllister M, Fotaki N. Gastrointestinal diseases and their impact on drug solubility: Ulcerative Colitis. Eur J Pharm Sci 2020; 152:105458. [PMID: 32645424 DOI: 10.1016/j.ejps.2020.105458] [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: 03/27/2020] [Revised: 06/12/2020] [Accepted: 07/05/2020] [Indexed: 12/11/2022]
Abstract
For poorly soluble compounds, drug product performance in patients with Ulcerative Colitis (UC) compared to healthy subjects can be affected due to differences in drug solubility in GI fluids. A risk assessment tool was developed to identify compounds with a high risk of altered solubility in the GI fluids of UC patients. Pathophysiological changes impacting on the composition of GI fluids in UC patients were considered and UC biorelevant media representative of the stomach, intestine and colon were developed based on biorelevant media based on healthy subjects and literature data using a Design of Experiment approach. The UC media were characterised and revealed differences in surface tension, osmolality and buffer capacity compared to media based on healthy subjects. The solubility of six drugs was investigated in UC biorelevant media and results were related to media- and drug-dependent factors. A lower drug solubility in UC intestinal media was observed for compounds with a high lipophilicity. In UC simulated colonic fluids, drug solubility was altered for ionisable compounds. Additionally, a higher solubility of neutral lipophilic drugs was observed in UC fasted state colonic media with increased concentrations of soluble proteins. The developed UC biorelevant media offer the possibility to identify the risk of altered drug solubilisation in UC patients without conducting expensive clinical trials. A high risk was related to drug ionization properties and lipophilicity in the current study with all investigated drugs showing differences in solubility in biorelevant media based on UC patients compared to healthy subjects.
Collapse
Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
| |
Collapse
|
18
|
Etherson K, Dunn C, Matthews W, Pamelund H, Barragat C, Sanderson N, Izumi T, Mathews CDC, Halbert G, Wilson C, McAllister M, Mann J, Østergaard J, Butler J, Khadra I. An interlaboratory investigation of intrinsic dissolution rate determination using surface dissolution. Eur J Pharm Biopharm 2020; 150:24-32. [PMID: 32061919 DOI: 10.1016/j.ejpb.2020.02.005] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to conduct an interlaboratory ring-study, with six partners (academic and industrial), investigating the measurement of intrinsic dissolution rate (IDR) using surface dissolution imaging (SDI) equipment. Measurement of IDR is important in pharmaceutical research as it provides characterising information on drugs and their formulations. This work allowed us to assess the SDI's interlaboratory performance for measuring IDR using a defined standard operating procedure (see supporting information) and six drugs assigned as low (tadalafil, bromocriptine mesylate), medium (carvedilol, indomethacin) and high (ibuprofen, valsartan) solubility compounds. Fasted State Simulated Intestinal Fluid (FaSSIF) and blank FaSSIF (without sodium taurocholate and lecithin) (pH 6.5) were used as media. Using the standardised protocol an IDR value was obtained for all compounds and the results show that the overall IDR rank order matched the solubility rank order. Interlaboratory variability was also examined and it was observed that the variability for lower solubility compounds was higher, coefficient of variation >50%, than for intermediate and high solubility compounds, with the exception of indomethacin in FaSSIF medium. Inter laboratory variability is a useful descriptor for understanding the robustness of the protocol and the system variability. On comparison to another published small-scale IDR study the rank ordering with respect to dissolution rate is identical except for the high solubility compounds. This results indicates that the SDI robustly measures IDR however, no recommendation on the use of one small scale method over the other is made.
Collapse
Affiliation(s)
- Kelly Etherson
- Product Development & Supply, GlaxoSmithKline R&D, Ware, UK
| | - Claire Dunn
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Wayne Matthews
- Product Development & Supply, GlaxoSmithKline R&D, Stevenage, UK
| | - Henrik Pamelund
- Product Development & Supply, GlaxoSmithKline R&D, Stevenage, UK; Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Camille Barragat
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Natalie Sanderson
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - Toshiko Izumi
- Drug Product Design, Pharmaceutical Sciences, Pfizer Ltd., Sandwich, UK
| | | | - Gavin Halbert
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Clive Wilson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Mark McAllister
- Drug Product Design, Pharmaceutical Sciences, Pfizer Ltd., Sandwich, UK
| | - James Mann
- Pharmaceutical Technology & Development, AstraZeneca, Macclesfield, UK
| | - Jesper Østergaard
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - James Butler
- Product Development & Supply, GlaxoSmithKline R&D, Ware, UK
| | - Ibrahim Khadra
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
| |
Collapse
|
19
|
McAllister M, Ryan C, Dodd L, Goldenberg M, Brien DL. A thematic literature review of innovative strategies to prepare nursing students for aged-care. Nurse Educ Today 2020; 87:104355. [PMID: 32062413 DOI: 10.1016/j.nedt.2020.104355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/30/2019] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The exponential rise in people living longer but requiring residential care is adding pressure to already overstretched aged care nurses. Consequently, a person-centred care culture in residential care remains aspirational, rather than a reality. For nursing students in Australia and elsewhere, clinical placements in aged care facilities are under-utilised due to negative perceptions about the likelihood for learning. Creative strategies to engage students to safely challenge ageist thinking and to inspire enthusiasm for learning in this context are needed. OBJECTIVES The purpose of this thematic review of the literature is to better understand challenges related to learning in aged care settings and identify innovative strategies to enhance nursing student learning experiences in residential aged care placements. REVIEW METHODS A literature review was undertaken in 2019 using CINAHL, PUBMED, Elsevier, Medline, ProQuest and Google Scholar. The search was limited to papers that were peer reviewed, in English, and published between 2001 and the date of review (mid-2019) in order to situate the review in the new millennium. RESULTS 47 articles and books were included in the review that introduce solutions and innovative strategies that could be used to improve students' attitudes to learning in aged care and from older people. The literature review was categorized into three main themes, including: barriers to working with older people; the need for pedagogical change to foster empathy; and innovative strategies to address barriers. CONCLUSION These themes are useful to consider in designing engaging learning and teaching for nursing students to be effective in working in aged care.
Collapse
Affiliation(s)
- M McAllister
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Australia.
| | - C Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Australia
| | - L Dodd
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Australia
| | - M Goldenberg
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Australia
| | - D L Brien
- School of Education and the Creative Arts, Central Queensland University, Australia
| |
Collapse
|
20
|
Swainson SME, Taresco V, Pearce AK, Clapp LH, Ager B, McAllister M, Bosquillon C, Garnett MC. Exploring the enzymatic degradation of poly(glycerol adipate). Eur J Pharm Biopharm 2019; 142:377-386. [PMID: 31319123 DOI: 10.1016/j.ejpb.2019.07.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 05/24/2019] [Revised: 06/24/2019] [Accepted: 07/14/2019] [Indexed: 02/08/2023]
Abstract
Poly(glycerol adipate) (PGA) is a biodegradable, biocompatible, polymer with a great deal of potential in the field of drug delivery. Active drug molecules can be conjugated to the polymer backbone or encapsulated in self-assembled nanoparticles for targeted and systemic delivery. Here, a range of techniques have been used to characterise the enzymatic degradation of PGA extensively for the first time and to provide an indication of the way the polymer will behave and release drug payloads in vivo. Dynamic Light Scattering was used to monitor change in nanoparticle size, indicative of degradation. The release of a fluorescent dye, coupled to PGA, upon incubation with enzymes was measured over a 96 h period as a model of drug release from polymer drug conjugates. The changes to the chemical structure and molecular weight of PGA following enzyme exposure were characterised using FTIR, NMR and GPC. These techniques provided evidence of the biodegradability of PGA, its susceptibility to degradation by a range of enzymes commonly found in the human body and the polymer's potential as a drug delivery platform.
Collapse
Affiliation(s)
- Sadie M E Swainson
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Vincenzo Taresco
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Amanda K Pearce
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Lucie H Clapp
- Department of Medicine, University College London, London WC1E 6JF, United Kingdom
| | - Barry Ager
- Drug Product Design, Pfizer Ltd, Sandwich CT13 9ND, United Kingdom
| | - Mark McAllister
- Drug Product Design, Pfizer Ltd, Sandwich CT13 9ND, United Kingdom
| | - Cynthia Bosquillon
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Martin C Garnett
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom.
| |
Collapse
|
21
|
Xie J, Obiefuna V, Hodgkinson JW, McAllister M, Belosevic M. Teleost antimicrobial peptide hepcidin contributes to host defense of goldfish (Carassius auratus L.) against Trypanosoma carassii. Dev Comp Immunol 2019; 94:11-15. [PMID: 30659854 DOI: 10.1016/j.dci.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/31/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
Hepcidin is an antimicrobial peptide and an iron regulatory protein that prevents the release of excess iron in the blood. There is evidence suggesting that teleost hepcidin is a major player in antimicrobial defense against various bacteria species, but little is known regarding the effects of teleost hepcidin in protozoan parasitic infections. We examined the role of hepcidin during the course of infection of goldfish with Trypanosoma carassii. Quantitative real-time PCR was used to determine the expression of hepcidin in goldfish immune organs during the course of T. carassii infection. During the acute phase of the T. carassii infection, the mRNA levels of hepcidin were up-regulated in liver and kidney. In contrast, an up-regulation of hepcidin mRNA expression in spleen was observed during the chronic phase of the infection. Furthermore, a synthetic goldfish hepcidin peptide induced trypanosome lysis in vitro, and parasite surface disruption was confirmed by scanning electron microscopy (SEM) analysis. These results suggest that, in addition to well-characterized direct antibacterial activities, teleost hepcidin also exhibits trypanocidal activity.
Collapse
Affiliation(s)
- Jiasong Xie
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Victory Obiefuna
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Jordan W Hodgkinson
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Mark McAllister
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Miodrag Belosevic
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
22
|
Butler J, Hens B, Vertzoni M, Brouwers J, Berben P, Dressman J, Andreas CJ, Schaefer KJ, Mann J, McAllister M, Jamei M, Kostewicz E, Kesisoglou F, Langguth P, Minekus M, Müllertz A, Schilderink R, Koziolek M, Jedamzik P, Weitschies W, Reppas C, Augustijns P. In vitro models for the prediction of in vivo performance of oral dosage forms: Recent progress from partnership through the IMI OrBiTo collaboration. Eur J Pharm Biopharm 2019; 136:70-83. [DOI: 10.1016/j.ejpb.2018.12.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/19/2018] [Indexed: 02/08/2023]
|
23
|
Loisios-Konstantinidis I, Paraiso RLM, Fotaki N, McAllister M, Cristofoletti R, Dressman J. Application of the relationship between pharmacokinetics and pharmacodynamics in drug development and therapeutic equivalence: a PEARRL review. J Pharm Pharmacol 2019; 71:699-723. [DOI: 10.1111/jphp.13070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/19/2019] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
The objective of this review was to provide an overview of pharmacokinetic/pharmacodynamic (PK/PD) models, focusing on drug-specific PK/PD models and highlighting their value added in drug development and regulatory decision-making.
Key findings
Many PK/PD models, with varying degrees of complexity and physiological understanding have been developed to evaluate the safety and efficacy of drug products. In special populations (e.g. paediatrics), in cases where there is genetic polymorphism and in other instances where therapeutic outcomes are not well described solely by PK metrics, the implementation of PK/PD models is crucial to assure the desired clinical outcome. Since dissociation between the pharmacokinetic and pharmacodynamic profiles is often observed, it is proposed that physiologically based pharmacokinetic and PK/PD models be given more weight by regulatory authorities when assessing the therapeutic equivalence of drug products.
Summary
Modelling and simulation approaches already play an important role in drug development. While slowly moving away from ‘one-size fits all’ PK methodologies to assess therapeutic outcomes, further work is required to increase confidence in PK/PD models in translatability and prediction of various clinical scenarios to encourage more widespread implementation in regulatory decision-making.
Collapse
Affiliation(s)
| | - Rafael L M Paraiso
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, Faculty of Science, University of Bath, Bath, UK
| | | | - Rodrigo Cristofoletti
- Division of Therapeutic Equivalence, Brazilian Health Surveillance Agency (ANVISA), Brasilia, Brazil
| | - Jennifer Dressman
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
24
|
McAllister M, Phillips N, Belosevic M. Trypanosoma carassii infection in goldfish (Carassius auratus L.): changes in the expression of erythropoiesis and anemia regulatory genes. Parasitol Res 2019; 118:1147-1158. [PMID: 30747294 DOI: 10.1007/s00436-019-06246-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/01/2019] [Indexed: 12/12/2022]
Abstract
Trypanosoma carassii is a flagellated bloodstream parasite of cyprinid fish with pathogenesis manifesting primarily as anemia in experimentally infected fish. This anemia is characterized by decreases in the number of circulating red blood cells (RBCs) during peak parasitemia. We examined changes in the key blood metrics and expression of genes known to be important in the regulation of erythropoiesis. Increasing parasitemia was strongly correlated with an overall decrease in the total number of circulating RBCs. Gene expression of key erythropoiesis regulators (EPO, EPOR, GATA1, Lmo2, and HIFα) and proinflammatory cytokines (IFNγ and TNFα) were measured and their expressions differed from those in fish made anemic by injections of phenylhydrazine (PHZ). Significant upregulation of pro-erythropoietic genes was observed in PHZ-induced anemia, but not during peak parasitic infection. Previously, we reported on functional characterization of goldfish erythropoietin (rgEPO) and its ability to induce survival and differentiation of erythroid progenitor cells in vitro. Treatment of goldfish during the infection with rgEPO reduced the severity of anemia but failed to fully prevent the onset of the anemic state in infected fish. Proinflammatory cytokines have been implicated in the suppression of erythropoiesis during trypanosomiasis, specifically the cytokines TNFα, IFNγ, and IL-1β. Analysis of key proinflammatory cytokines revealed that mRNA levels of IFNγ and TNFα were upregulated in response to infection, but only TNFα increased in response to PHZ treatment. Synergistic activity of the proinflammatory cytokines may be required to sustain prolonged anemia. These findings provide insight into the relationship between T. carassii and host anemia and suggest that T. carassii may directly or indirectly suppress host erythropoiesis.
Collapse
Affiliation(s)
- Mark McAllister
- Department of Biological Sciences, CW-405 Biological Sciences Building, University of Alberta, Edmonton, AB, T6G 2E9, Canada
| | - Nicole Phillips
- Department of Biological Sciences, CW-405 Biological Sciences Building, University of Alberta, Edmonton, AB, T6G 2E9, Canada
| | - Miodrag Belosevic
- Department of Biological Sciences, CW-405 Biological Sciences Building, University of Alberta, Edmonton, AB, T6G 2E9, Canada.
| |
Collapse
|
25
|
Gan H, McAllister M, Constancio V, Payne S, Underwood M, Leung H, Edwards J. The prognostic significance of androgen receptor phosphorylation and the immune infiltrate in prostate cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy493.015] [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] [Indexed: 11/13/2022] Open
|
26
|
Pentafragka C, Symillides M, McAllister M, Dressman J, Vertzoni M, Reppas C. The impact of food intake on the luminal environment and performance of oral drug products with a view to in vitro and in silico simulations: a PEARRL review. J Pharm Pharmacol 2018; 71:557-580. [DOI: 10.1111/jphp.12999] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/04/2018] [Indexed: 01/24/2023]
Abstract
Abstract
Objectives
Using the type of meal and dosing conditions suggested by regulatory agencies as a basis, this review has two specific objectives: first, to summarize our understanding on the impact of food intake on luminal environment and drug product performance and second, to summarize the usefulness and limitations of available in vitro and in silico methodologies for the evaluation of drug product performance after food intake.
Key findings
Characterization of the luminal environment and studies evaluating product performance in the lumen, under conditions suggested by regulatory agencies for simulating the fed state, are limited. Various in vitro methodologies have been proposed for evaluating drug product performance in the fed state, but systematic validation is lacking. Physiologically based pharmacokinetic (PBPK) modelling approaches require the use of in vitro biorelevant data and, to date, have been used primarily for investigating the mechanisms via which an already observed food effect is mediated.
Summary
Better understanding of the impact of changes induced by the meal administration conditions suggested by regulatory agencies on the luminal fate of the drug product is needed. Relevant information will be useful for optimizing the in vitro test methods and increasing the usefulness of PBPK modelling methodologies.
Collapse
Affiliation(s)
- Christina Pentafragka
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Mira Symillides
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Jennifer Dressman
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt/Main, Germany
| | - Maria Vertzoni
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Reppas
- Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
27
|
Effinger A, O'Driscoll CM, McAllister M, Fotaki N. Impact of gastrointestinal disease states on oral drug absorption – implications for formulation design – a PEARRL review. J Pharm Pharmacol 2018; 71:674-698. [DOI: 10.1111/jphp.12928] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/16/2018] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
Drug product performance in patients with gastrointestinal (GI) diseases can be altered compared to healthy subjects due to pathophysiological changes. In this review, relevant differences in patients with inflammatory bowel diseases, coeliac disease, irritable bowel syndrome and short bowel syndrome are discussed and possible in vitro and in silico tools to predict drug product performance in this patient population are assessed.
Key findings
Drug product performance was altered in patients with GI diseases compared to healthy subjects, as assessed in a limited number of studies for some drugs. Underlying causes can be observed pathophysiological alterations such as the differences in GI transit time, the composition of the GI fluids and GI permeability. Additionally, alterations in the abundance of metabolising enzymes and transporter systems were observed. The effect of the GI diseases on each parameter is not always evident as it may depend on the location and the state of the disease. The impact of the pathophysiological change on drug bioavailability depends on the physicochemical characteristics of the drug, the pharmaceutical formulation and drug metabolism. In vitro and in silico methods to predict drug product performance in patients with GI diseases are currently limited but could be a useful tool to improve drug therapy.
Summary
Development of suitable in vitro dissolution and in silico models for patients with GI diseases can improve their drug therapy. The likeliness of the models to provide accurate predictions depends on the knowledge of pathophysiological alterations, and thus, further assessment of physiological differences is essential.
Collapse
Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| |
Collapse
|
28
|
McAllister M, Zane P. Industry-Academic Collaboration in Oral Biopharmaceutics: The European IMI OrBiTo Project. Mol Pharm 2017; 14:4129-4131. [PMID: 29198121 DOI: 10.1021/acs.molpharmaceut.7b00940] [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: 11/28/2022]
Affiliation(s)
- Mark McAllister
- Drug Product Design, Pfizer , Sandwich CT13 9NJ, United Kingdom
| | - Patricia Zane
- Sanofi , Bridgewater, New Jersey 08807, United States
| |
Collapse
|
29
|
Constâncio V, McAllister M, Patek S, Underwood M, Leung H, Edwards J. Evaluation of combined cytoplasmic AR in tumour cells expression and tumour CD3 T-cells infiltrate as a prognostic score for patients with prostate cancer: PS145. Porto Biomed J 2017; 2:181-182. [PMID: 32258628 DOI: 10.1016/j.pbj.2017.07.017] [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: 10/18/2022] Open
Affiliation(s)
- V Constâncio
- Biology Department, University of Aveiro, Portugal.,Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, United Kingdom
| | - M McAllister
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, United Kingdom
| | - S Patek
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, United Kingdom
| | - M Underwood
- Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - H Leung
- Beatson Institute of Cancer Research, United Kingdom
| | - J Edwards
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, United Kingdom
| |
Collapse
|
30
|
Parkinson L, McAllister M, Molyneux N, Franck L, Jeffrey D. EXPLORING PROGRAMS FOR REDUCING SOCIAL ISOLATION AND DEPRESSION IN RURAL AGED CARE CLIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3167] [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: 11/12/2022] Open
Affiliation(s)
- L. Parkinson
- CQUniversity, Rockhampton, Queensland, Australia,
| | | | - N. Molyneux
- CQUniversity, Rockhampton, Queensland, Australia,
| | - L. Franck
- CQUniversity, Rockhampton, Queensland, Australia,
| | - D. Jeffrey
- PresCare, Brisbane, Queensland, Australia
| |
Collapse
|
31
|
Zhao A, Zheng L, Casus M, Judd P, Finn M, Ho M, Jaffer A, Kamal S, Lappan-Gracon S, McAllister M, Oliver K, Warmington K, Talarico S. IT’S NOT JUST A TOOTH: A POSTER CAMPAIGN TO PROMOTE ORAL HEALTH AT SICKKIDS. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.071] [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] [Indexed: 11/13/2022] Open
|
32
|
Leung LY, McAllister M, Selim M, Fisher M. Factors Influencing Oral Anticoagulant Prescribing Practices for Atrial Fibrillation. J Stroke 2017; 19:232-235. [PMID: 28460492 PMCID: PMC5466293 DOI: 10.5853/jos.2016.01102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 08/15/2016] [Accepted: 08/23/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lester Y Leung
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA, USA
| | - Mark McAllister
- Department of Neurosciences, Saint Elizabeth's Medical Center, Brighton, MA, USA
| | - Magdy Selim
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Marc Fisher
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| |
Collapse
|
33
|
Lennernäs H, Lindahl A, Van Peer A, Ollier C, Flanagan T, Lionberger R, Nordmark A, Yamashita S, Yu L, Amidon GL, Fischer V, Sjögren E, Zane P, McAllister M, Abrahamsson B. In Vivo Predictive Dissolution (IPD) and Biopharmaceutical Modeling and Simulation: Future Use of Modern Approaches and Methodologies in a Regulatory Context. Mol Pharm 2017; 14:1307-1314. [DOI: 10.1021/acs.molpharmaceut.6b00824] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- H. Lennernäs
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - A. Lindahl
- Medical Products Agency, Uppsala, Sweden
| | - A. Van Peer
- Janssen
Research and Development, Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - C. Ollier
- Sanofi US, 55 Corporate Drive, Bridgewater, New Jersey 08807, United States
| | | | - R. Lionberger
- Office of Research
and Standards, Office of Generic Drugs, Center for Drug Evaluation
and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | | | - S. Yamashita
- Faculty
of Pharmaceutical Sciences, Setsunan University, Nagaotoge-cho 45-1, Hirakata, Osaka 573-0101, Japan
| | - L. Yu
- Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, Maryland 20993, United States
| | - G. L. Amidon
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-1065, United States
| | - V. Fischer
- Drug Metabolism and Pharmacokinetics, Research & Development, AbbVie, North Chicago, Illinois 60064, United States
| | - E. Sjögren
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - P. Zane
- Sanofi US, 55 Corporate Drive, Bridgewater, New Jersey 08807, United States
| | - M. McAllister
- Pharmaceutical Development, GlaxoSmithKline, New
Frontiers Science Park, Harlow, Essex CM19
5AW, United Kingdom
| | | |
Collapse
|
34
|
Lacy-Jones K, Hayward P, Andrews S, Gledhill I, McAllister M, Abrahamsson B, Rostami-Hodjegan A, Pepin X. Biopharmaceutics data management system for anonymised data sharing and curation: First application with orbito IMI project. Comput Methods Programs Biomed 2017; 140:29-44. [PMID: 28254086 DOI: 10.1016/j.cmpb.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 05/19/2016] [Revised: 09/06/2016] [Accepted: 11/10/2016] [Indexed: 06/06/2023]
Abstract
The OrBiTo IMI project was designed to improve the understanding and modelling of how drugs are absorbed. To achieve this 13 pharmaceutical companies agreed to share biopharmaceutics drug properties and performance data, as long as they were able to hide certain aspects of their dataset if required. This data was then used in simulations to test how three in silico Physiological Based Pharmacokinetic (PBPK) tools performed. A unique database system was designed and implemented to store the drug data. The database system was unique, in that it had the ability to make different sections of a dataset visible or hidden depending on the stage of the project. Users were also given the option to hide identifying API attributes, to help prevent identification of project members from previously published data. This was achieved by applying blinding strategies to data parameters and the adoption of a unique numbering system. An anonymous communication tool was proposed to exchange comments about data, which enabled its curation and evolution. This paper describes the strategy adopted for numbering and blinding of the data, the tools developed to gather and search data as well as the tools used for communicating around the data with the aim of publicising the approach for other pre-competitive research between organisations.
Collapse
Affiliation(s)
- Kristin Lacy-Jones
- Simcyp Limited, Blades Enterprise Centre, John Street, Sheffield, UK, S2 4SU.
| | - Philip Hayward
- Simcyp Limited, Blades Enterprise Centre, John Street, Sheffield, UK, S2 4SU
| | - Steve Andrews
- Simcyp Limited, Blades Enterprise Centre, John Street, Sheffield, UK, S2 4SU
| | - Ian Gledhill
- Simcyp Limited, Blades Enterprise Centre, John Street, Sheffield, UK, S2 4SU
| | | | | | - Amin Rostami-Hodjegan
- Simcyp Limited, Blades Enterprise Centre, John Street, Sheffield, UK, S2 4SU; Manchester School of Pharmacy, University of Manchester, Stopford Building, Oxford Road, Manchester, UK, M13 9PT
| | - Xavier Pepin
- AstraZeneca Global Operations, Pharmaceutical Technology and Development Silk Road Business Park, Charter Way, Macclesfield, SK10 2NA, England
| |
Collapse
|
35
|
Hooker GW, Babu D, Myers MF, Zierhut H, McAllister M. Standards for the Reporting of Genetic Counseling Interventions in Research and Other Studies (GCIRS): an NSGC Task Force Report. J Genet Couns 2017; 26:355-360. [PMID: 28236280 PMCID: PMC5415582 DOI: 10.1007/s10897-017-0076-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/11/2016] [Indexed: 01/30/2023]
Abstract
As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.
Collapse
Affiliation(s)
- Gillian W Hooker
- NextGxDx, 810 Crescent Centre Dr, Suite 280, Franklin, TN, 37067, USA.
| | - D Babu
- Ambry Genetics, Aliso Viejo, CA, USA
| | - M F Myers
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA
| | - H Zierhut
- University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
36
|
Grignard E, Taylor R, McAllister M, Box K, Fotaki N. Considerations for the development of in vitro dissolution tests to reduce or replace preclinical oral absorption studies. Eur J Pharm Sci 2016; 99:193-201. [PMID: 27940084 DOI: 10.1016/j.ejps.2016.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 07/19/2016] [Revised: 12/01/2016] [Accepted: 12/04/2016] [Indexed: 01/24/2023]
Abstract
The pharmaceutical development of new chemical entities can be hampered by their solubility and/or dissolution limitations. Currently, these properties are characterised mostly during in vivo pre-clinical studies. The development of appropriate in vitro methods to study the solubility and dissolution properties in preclinical species would lead to a significant reduction or replacement of the animal experiments at this stage of development. During clinical development, media simulating the human gastrointestinal tract fluids are commonly used and a similar approach mimicking laboratory animals' gastrointestinal tract fluids would impact on the preclinical stage of development. This review summarises the current knowledge regarding the gastrointestinal physiology of the most common laboratory animals, and animal simulated gastric and intestinal media are proposed.
Collapse
Affiliation(s)
- Elise Grignard
- Department of Pharmacy and Pharmacology, University of Bath, UK
| | | | | | - Karl Box
- Sirius Analytical Instruments Ltd., East Sussex, UK
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, UK.
| |
Collapse
|
37
|
Margolskee A, Darwich AS, Pepin X, Pathak SM, Bolger MB, Aarons L, Rostami-Hodjegan A, Angstenberger J, Graf F, Laplanche L, Müller T, Carlert S, Daga P, Murphy D, Tannergren C, Yasin M, Greschat-Schade S, Mück W, Muenster U, van der Mey D, Frank KJ, Lloyd R, Adriaenssen L, Bevernage J, De Zwart L, Swerts D, Tistaert C, Van Den Bergh A, Van Peer A, Beato S, Nguyen-Trung AT, Bennett J, McAllister M, Wong M, Zane P, Ollier C, Vicat P, Kolhmann M, Marker A, Brun P, Mazuir F, Beilles S, Venczel M, Boulenc X, Loos P, Lennernäs H, Abrahamsson B. IMI - oral biopharmaceutics tools project - evaluation of bottom-up PBPK prediction success part 1: Characterisation of the OrBiTo database of compounds. Eur J Pharm Sci 2016; 96:598-609. [PMID: 27671970 DOI: 10.1016/j.ejps.2016.09.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 05/10/2016] [Revised: 08/12/2016] [Accepted: 09/17/2016] [Indexed: 12/11/2022]
Abstract
Predicting oral bioavailability (Foral) is of importance for estimating systemic exposure of orally administered drugs. Physiologically-based pharmacokinetic (PBPK) modelling and simulation have been applied extensively in biopharmaceutics recently. The Oral Biopharmaceutical Tools (OrBiTo) project (Innovative Medicines Initiative) aims to develop and improve upon biopharmaceutical tools, including PBPK absorption models. A large-scale evaluation of PBPK models may be considered the first step. Here we characterise the OrBiTo active pharmaceutical ingredient (API) database for use in a large-scale simulation study. The OrBiTo database comprised 83 APIs and 1475 study arms. The database displayed a median logP of 3.60 (2.40-4.58), human blood-to-plasma ratio of 0.62 (0.57-0.71), and fraction unbound in plasma of 0.05 (0.01-0.17). The database mainly consisted of basic compounds (48.19%) and Biopharmaceutics Classification System class II compounds (55.81%). Median human intravenous clearance was 16.9L/h (interquartile range: 11.6-43.6L/h; n=23), volume of distribution was 80.8L (54.5-239L; n=23). The majority of oral formulations were immediate release (IR: 87.6%). Human Foral displayed a median of 0.415 (0.203-0.724; n=22) for IR formulations. The OrBiTo database was found to be largely representative of previously published datasets. 43 of the APIs were found to satisfy the minimum inclusion criteria for the simulation exercise, and many of these have significant gaps of other key parameters, which could potentially impact the interpretability of the simulation outcome. However, the OrBiTo simulation exercise represents a unique opportunity to perform a large-scale evaluation of the PBPK approach to predicting oral biopharmaceutics.
Collapse
|
38
|
Watford A, Prosser A, O'Leary C, Phillips S, McAllister M, Ketchell R, Belk R. 221 Contemplating growing older with cystic fibrosis (CF): the experiences of patients taking ivacaftor within two UK CF adult centres. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30460-x] [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] [Indexed: 11/25/2022]
|
39
|
|
40
|
Katzenellenbogen JM, Atkins ER, Thompson SC, Hersh D, Coffin J, Flicker L, Hayward C, Ciccone N, Woods D, McAllister M, Armstrong EM. Missing voices: Profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records. Int J Stroke 2015; 11:103-16. [DOI: 10.1177/1747493015607521] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Limited data exist on the extent of specific functional sequelae, including acquired communication disorder, among Aboriginal stroke survivors, making planning of multidisciplinary services difficult. Aims To obtain estimates of the extent and profile of acquired communication disorder in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia and investigate potential disparities in receiving in-hospital speech pathology services among survivors with acquired communication disorder. Methods Stroke cases surviving their first stroke episode during 2002–2011 were identified using Western Australia-wide person-based linked hospital and mortality data, and their five-year comorbidity profiles determined. The mid-year prevalence of stroke cases with acquired communication disorder was estimated for 2011. Regression methods were used to investigate determinants of receiving speech pathology services among acquired communication disorder cases. Results Of 14,757 stroke survivors aged 15–79 years admitted in 2002–2011, 33% had acquired communication disorder (22% aphasia/dysphasia) and 777 (5.3%) were Aboriginal. Aboriginal patients were more likely to be younger, live remotely, and have comorbidities. A diagnosis of aphasia was more common in Aboriginal than non-Aboriginal patients 15–44 years (p = 0.003). A minimum of 107 Aboriginal and 2324 non-Aboriginal stroke patients with acquired communication disorder lived in Western Australia in 2011. Aboriginal status was not associated with receiving in-hospital speech services among acquired communication disorder patients in unadjusted or adjusted models. Conclusions The relative youth, geographical distribution, high comorbidity prevalence, and cultural needs of Aboriginal stroke patients with acquired communication disorder should inform appropriate service design for speech pathology and rehabilitation. Innovative models are required to address workforce issues, given low patient volumes.
Collapse
Affiliation(s)
- JM Katzenellenbogen
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - ER Atkins
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
- The George Institute for Global Health, Sydney, Australia
| | - SC Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - D Hersh
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - J Coffin
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - L Flicker
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
| | - C Hayward
- Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Australia
| | - N Ciccone
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - D Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - M McAllister
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - EM Armstrong
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| |
Collapse
|
41
|
Abstract
Many cardiac disorders and their treatment are associated with an increased risk for ischemic or hemorrhagic stroke, so it is important for cardiologists to be aware of recent advances in the field of stroke prevention. Atrial fibrillation (AF) is the most common cardiac disorder associated with a substantial risk for ischemic stroke (IS). The availability of implantable cardiac monitoring devices has substantially increased the detection rate of occult AF after IS. The 4 new oral anticoagulants have advantages when compared with warfarin, the standard therapy in AF to prevent IS, demonstrating a reduced risk for IS or intracerebral hemorrhage. Patients with cardiomyopathy, cardiac valve replacement, recent myocardial infarction, larger aortic arch atheroma and patent foramen ovale all have some level of increased risk for IS. The best approach for IS prevention in these disorders remains unsettled and varying approaches are recommended.
Collapse
Affiliation(s)
- Marc Fisher
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
42
|
Hamilton D, Hodgson K, Kiermeier A, McAllister M. Preliminary verification of molecular techniques to more accurately assess the risk from Toxoplasma gondii in pork. Anim Prod Sci 2015. [DOI: 10.1071/anv55n12ab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
43
|
McAllister M, Dearing A. Patient reported outcomes and patient empowerment in clinical genetics services. Clin Genet 2014; 88:114-21. [PMID: 25307491 DOI: 10.1111/cge.12520] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 07/28/2014] [Revised: 10/06/2014] [Accepted: 10/06/2014] [Indexed: 12/20/2022]
Abstract
Evaluation of clinical genetics services (CGS), including genetic counseling and genetic testing, has been problematic. Patient mortality and morbidity are unlikely to be directly improved by interventions offered in CGS. Patient-reported outcomes (PROs) are not routinely measured in CGS evaluation, but this may change as patient-reported outcome measures (PROMs) become a key part of how healthcare services are managed and funded across the world. However, there is no clear consensus about which PROMs are most useful for CGS evaluation. This review summarizes the published research on how PROs from CGS have been measured and how patients may benefit from using those services, with a focus on patient empowerment. Many patient benefits (PROs) identified repeatedly in the research literature can be re-interpreted within a patient empowerment framework. Other important PROs identified include family functioning, social functioning, altruism, sense of purpose, enabling development of future research and treatment/participating in research. Well-validated measures are available to capture (dimensions of) patient empowerment. Although generic measures of family functioning are available, suitable measures capturing social functioning, development of future treatments, and altruism were not identified in this review. Patient empowerment provides one useful approach to measuring PROs from CGS.
Collapse
Affiliation(s)
- M McAllister
- Institute of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - A Dearing
- Institute of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
44
|
Bergström CA, Holm R, Jørgensen SA, Andersson SB, Artursson P, Beato S, Borde A, Box K, Brewster M, Dressman J, Feng KI, Halbert G, Kostewicz E, McAllister M, Muenster U, Thinnes J, Taylor R, Mullertz A. Early pharmaceutical profiling to predict oral drug absorption: Current status and unmet needs. Eur J Pharm Sci 2014; 57:173-99. [DOI: 10.1016/j.ejps.2013.10.015] [Citation(s) in RCA: 192] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 10/17/2013] [Accepted: 10/27/2013] [Indexed: 01/17/2023]
|
45
|
Kostewicz ES, Abrahamsson B, Brewster M, Brouwers J, Butler J, Carlert S, Dickinson PA, Dressman J, Holm R, Klein S, Mann J, McAllister M, Minekus M, Muenster U, Müllertz A, Verwei M, Vertzoni M, Weitschies W, Augustijns P. In vitro models for the prediction of in vivo performance of oral dosage forms. Eur J Pharm Sci 2014; 57:342-66. [DOI: 10.1016/j.ejps.2013.08.024] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/07/2013] [Accepted: 08/13/2013] [Indexed: 11/17/2022]
|
46
|
Happell B, Platania-Phung C, Gray R, Hardy S, Lambert T, McAllister M, Davies C. A role for mental health nursing in the physical health care of consumers with severe mental illness. J Psychiatr Ment Health Nurs 2011; 18:706-11. [PMID: 21896113 DOI: 10.1111/j.1365-2850.2010.01666.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.
Collapse
Affiliation(s)
- B Happell
- Institute for Health and Social Science Research and School of Nursing and Midwifery, CQ University Australia, Rockhampton, QLD, Australia.
| | | | | | | | | | | | | |
Collapse
|
47
|
McAllister M, Wood AM, Dunn G, Shiloh S, Todd C. The Genetic Counseling Outcome Scale: a new patient-reported outcome measure for clinical genetics services. Clin Genet 2011; 79:413-24. [PMID: 21255005 DOI: 10.1111/j.1399-0004.2011.01636.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to develop a patient-reported outcome measure (PROM) for clinical genetics services. Previous research was used to develop a draft 84-item questionnaire, which was completed by 527 members of patient support groups. Responses were subjected to exploratory factor analysis (EFA). Parallel analysis was used to identify the number of factors to extract using oblique rotation. Twenty-four questions were selected to form the Genetic Counseling Outcome Scale (GCOS-24). Two hundred and forty-one patients completed a questionnaire pack before and after attendance at a genetics clinic that included the GCOS-24, and validated measures of health locus of control, perceived personal control, anxiety, depression, satisfaction with life and authenticity. Concurrent validity of the GCOS-24 was assessed using bivariate correlation. Sensitivity to change of the GCOS-24 was assessed using analysis of variance. EFA identified a single overarching construct consisting of seven dimensions. Internal consistency (α = 0.87) and test-retest reliability (r = 0.86) are good. The GCOS-24 shows convergent and divergent validities, and sensitivity to change over time with a medium-to-large effect size (Cohen's d = 0.70). The GCOS-24 has potential as a clinical genetics-specific PROM.
Collapse
Affiliation(s)
- M McAllister
- Medical Genetics Research Group, School of Biomedicine, The University of Manchester, Manchester, UK.
| | | | | | | | | |
Collapse
|
48
|
Affiliation(s)
- Mark McAllister
- Research Formulation, Pfizer PGRD, Sandwich, Kent, CT13 9NJ, U.K
| |
Collapse
|
49
|
Crabb J, McAllister M, Blair A. Who should swing the stethoscope? An audit of baseline physical examination and blood monitoring on new patients accepted by an early intervention in psychosis team. Early Interv Psychiatry 2009; 3:312-6. [PMID: 22642736 DOI: 10.1111/j.1751-7893.2009.00140.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM It has been established that patients with severe mental illness are at increased risk of physical illness and that physical health screening should be performed when an individual experiences a first episode of psychosis. The aim of the audit was to examine how physical health screening was achieved in the real world of an early intervention in psychosis (EIP) service in Scotland. Of particular interest was considering if primary or secondary care were more effective in providing specific physical health assessment for those presenting to the service. METHODS A case note audit was performed. RESULTS The audit shows that physical examination and blood tests were being completed in the majority of service users under the care of the Esteem service. However, an unacceptably high number were not undergoing sufficient initial screening for metabolic syndrome or having baseline monitoring prior to commencing antipsychotic medication. CONCLUSIONS Our results suggest that relying on primary care to provide physical health screening was not an effective approach in a population experiencing first-episode psychosis. Having a psychiatrist motivated to perform physical health screening within the EIP team may help to improve the uptake of physical health screening. Strategies to improve physical health screening in EIP services are discussed.
Collapse
Affiliation(s)
- Jim Crabb
- Department of Liaison Psychiatry, Southern General Hospital, Glasgow, UK
| | | | | |
Collapse
|
50
|
Brooks S, Kheradpir E, McAllister M, Kwan J, Burgher-McLellan K, Kalmokoff M. In-feed administered sub-therapeutic chlortetracycline alters community composition and structure but not the abundance of community resistance determinants in the fecal flora of the rat. Anaerobe 2009; 15:145-54. [DOI: 10.1016/j.anaerobe.2009.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|