Stereolithography (SLA) 3D printing of ascorbic acid loaded hydrogels: A controlled release study

3D Printing of Thermo-Sensitive Drugs

Three-dimensional (3D) printing is among the rapidly evolving technologies with applications in many sectors. The pharmaceutical industry is no exception, and the approval of the first 3D-printed tablet (Spiratam^®) marked a revolution in the field. Several studies reported the fabrication of different dosage forms using a range of 3D printing techniques. Thermosensitive drugs compose a considerable segment of available medications in the market requiring strict temperature control during processing to ensure their efficacy and safety. Heating involved in some of the 3D printing technologies raises concerns regarding the feasibility of the techniques for printing thermolabile drugs. Studies reported that semi-solid extrusion (SSE) is the commonly used printing technique to fabricate thermosensitive drugs. Digital light processing (DLP), binder jetting (BJ), and stereolithography (SLA) can also be used for the fabrication of thermosensitive drugs as they do not involve heating elements. Nonetheless, degradation of some drugs by light source used in the techniques was reported. Interestingly, fused deposition modelling (FDM) coupled with filling techniques offered protection against thermal degradation. Concepts such as selection of low melting point polymers, adjustment of printing parameters, and coupling of more than one printing technique were exploited in printing thermosensitive drugs. This systematic review presents challenges, 3DP procedures, and future directions of 3D printing of thermo-sensitive formulations.

3D Printed Punctal Plugs for Controlled Ocular Drug Delivery

Dry eye disease is a common ocular disorder that is characterised by tear deficiency or excessive tear evaporation. Current treatment involves the use of eye drops; however, therapeutic efficacy is limited because of poor ocular bioavailability of topically applied formulations. In this study, digital light processing (DLP) 3D printing was employed to develop dexamethasone-loaded punctal plugs. Punctal plugs with different drug loadings were fabricated using polyethylene glycol diacrylate (PEGDA) and polyethylene glycol 400 (PEG 400) to create a semi-interpenetrating network (semi-IPN). Drug-loaded punctal plugs were characterised in terms of physical characteristics (XRD and DSC), potential drug-photopolymer interactions (FTIR), drug release profile, and cytocompatibility. In vitro release kinetics of the punctal plugs were evaluated using an in-house flow rig model that mimics the subconjunctival space. The results showed sustained release of dexamethasone for up to 7 days from punctal plugs made with 20% w/w PEG 400 and 80% w/w PEGDA, while punctal plugs made with 100% PEGDA exhibited prolonged releases for more than 21 days. Herein, our study demonstrates that DLP 3D printing represents a potential manufacturing platform for fabricating personalised drug-loaded punctal plugs with extended release characteristics for ocular administration.

Recent update of 3D printing technology in pharmaceutical formulation development

In modern world, Pharma sector observes steep increase in demand of personalized medicine. Various unique ideas and technology were proposed and implemented by different researchers to prepare personalized medicine and devices. 3-dimensional printing (3DP) is one of the revolutionary technologies which can be used to prepare tailored medicine via CAD (Computer Aided Design) software. 3DP allows researchers to manufacture customized dosage form with desired modifications in geometry which would in turn alter dosage behaviour of the product with reduced side effects. Current achievement of 3DP includes personalized and adjustable dosage form, multifunction drug delivery systems, medical devices, phantoms, and implants specific to patient anatomy. Additionally, 3DP is employed for preparing tailored regenerative medicines. This review focuses on 3DP use in pharmaceuticals including drug delivery systems and medical devices with their method of fabrication. Additionally, different clinical trials as well as different patents done till date are cited in the paper. Furthermore, regulatory issues and future perspective related to 3 D printing is also well discussed.

Harnessing artificial intelligence for the next generation of 3D printed medicines

Artificial intelligence (AI) is redefining how we exist in the world. In almost every sector of society, AI is performing tasks with super-human speed and intellect; from the prediction of stock market trends to driverless vehicles, diagnosis of disease, and robotic surgery. Despite this growing success, the pharmaceutical field is yet to truly harness AI. Development and manufacture of medicines remains largely in a 'one size fits all' paradigm, in which mass-produced, identical formulations are expected to meet individual patient needs. Recently, 3D printing (3DP) has illuminated a path for on-demand production of fully customisable medicines. Due to its flexibility, pharmaceutical 3DP presents innumerable options during formulation development that generally require expert navigation. Leveraging AI within pharmaceutical 3DP removes the need for human expertise, as optimal process parameters can be accurately predicted by machine learning. AI can also be incorporated into a pharmaceutical 3DP 'Internet of Things', moving the personalised production of medicines into an intelligent, streamlined, and autonomous pipeline. Supportive infrastructure, such as The Cloud and blockchain, will also play a vital role. Crucially, these technologies will expedite the use of pharmaceutical 3DP in clinical settings and drive the global movement towards personalised medicine and Industry 4.0.

Machine learning predicts 3D printing performance of over 900 drug delivery systems

Three-dimensional printing (3DP) is a transformative technology that is advancing pharmaceutical research by producing personalized drug products. However, advances made via 3DP have been slow due to the lengthy trial-and-error approach in optimization. Artificial intelligence (AI) is a technology that could revolutionize pharmaceutical 3DP through analyzing large datasets. Herein, literature-mined data for developing AI machine learning (ML) models was used to predict key aspects of the 3DP formulation pipeline and in vitro dissolution properties. A total of 968 formulations were mined and assessed from 114 articles. The ML techniques explored were able to learn and provide accuracies as high as 93% for values in the filament hot melt extrusion process. In addition, ML algorithms were able to use data from the composition of the formulations with additional input features to predict the drug release of 3D printed medicines. The best prediction was obtained by an artificial neural network that was able to predict drug release times of a formulation with a mean error of ±24.29 min. In addition, the most important variables were revealed, which could be leveraged in formulation development. Thus, it was concluded that ML proved to be a suitable approach to modelling the 3D printing workflow.

Evolution of Additive Manufacturing in Civil Infrastructure Systems: A Ten-Year Review

As human beings, we have a moral responsibility to act in a manner that takes the wellbeing of humans and Earth into consideration. When building, we must consider two things: the health of the workforce associated with construction and the state of the planet after building. Many engineers in the past have made groundbreaking achievements to revolutionize the civil infrastructure systems (CIS) industry. However, additive manufacturing (AM) has yet to be significantly recognized throughout the CIS industry. In this review, the use of all fundamental materials utilized by AM in CIS like concrete, metals, and polymers, are discussed. The objective of this study is to expand upon the technology of AM, specifically in CIS and to provide a review on the evolution of AM from 2011 to 2021. The different AM techniques that are utilized to construct said structures are also included. The review study suggests that AM can be useful in the CIS industry, as homes, bridges, and benches were manufactured with this technique. To enhance the reader’s visualization, pictures of the related built structures are also presented. It can be concluded that adopting AM techniques in the CIS industry can save material, speed up the construction process, and create a safer environment for the people that work in the CIS industry. Since the research on this subject is limited, further research on polymer printing along with metal printing is recommended.

Biocompatible and photocrosslinkable poly(ethylene glycol)/keratin biocomposite hydrogels

A biocompatible hydrogel is ideal for tissue engineering and regeneration. In this study, methacrylated keratin (KerMA) was synthesized for the first time and then blended with poly(ethylene glycol dimethacrylate) (PEGDMA) to form hydrogel through photocrosslinking. The chemical structure, gelation time, swelling behavior, hydrophilicity, cytotoxicity, and 3D printability of PEGDMA/KerMA hydrogels were characterized and exploited. The PEGDMA/KerMA hydrogels performed good cytocompatibility, providing potential applications for tissue engineering and regenerative medicine.

Controlling drug release with additive manufacturing-based solutions

3D printing is an innovative manufacturing technology with great potential to revolutionise solid dosage forms. Novel features of 3D printing technology confer advantage over conventional solid dosage form manufacturing technologies, including rapid prototyping and an unparalleled capability to fabricate complex geometries with spatially separated conformations. Such a novel technology could transform the pharmaceutical industry, enabling the production of highly personalised dosage forms with well-defined release profiles. In this work, we review the current state of the art of using additive manufacturing for predicting and understanding drug release from 3D printed novel structures. Furthermore, we describe a wide spectrum of 3D printing technologies, materials, procedure, and processing parameters used to fabricate fundamentally different matrices with different drug releases. The different methods to manipulate drug release patterns including the surface area-to-mass ratio, infill pattern, geometry, and composition, are critically evaluated. Moreover, the drug release mechanisms and models that could aid exploiting the release profile are also covered. Finally, this review also covers the design opportunities alongside the technical and regulatory challenges that these rapidly evolving technologies present.

Polymeric drug delivery systems by additive manufacturing

Additive manufacturing (AM) is gaining interests in drug delivery applications, offering innovative opportunities for the design and development of systems with complex geometry and programmed controlled release profile. In addition, polymer-based drug delivery systems can improve drug safety, efficacy, patient compliance, and are the key materials in AM. Therefore, combining AM and polymers can be beneficial to overcome the existing limitations in the development of controlled release drug delivery systems. Considering these advantages, here we are focusing on the recent developments in the field of polymeric drug delivery systems prepared by AM. This review provides a comprehensive overview on a holistic polymer-AM perspective for drug delivery systems with discussion on the materials, properties, design and fabrication techniques and the mechanisms used to achieve a controlled release system. The current challenges and future perspectives for personalized medicine and clinical use of these systems are also briefly discussed.

Effective and simple prediction model of drug release from "ghost tablets" fabricated using a digital light projection-type 3D printer

The application of 3D printing technology to pharmaceuticals is expanding, and 3D-printed drug formulations comprising various materials and excipients have been developed using different types of 3D printers. Here, we used a digital light processing-type 3D printer to fabricate poly(ethylene glycol) diacrylate (PEGDA)-based "ghost tablets" that release entrapped drug but do not disintegrate. Three drugs with different aqueous solubilities were incorporated separately into the tablets, and the effects of printer ink composition and printing conditions on tablet formation and drug release were investigated. We also constructed a simple and effective model to predict the drug release profiles of the 3D-printed PEGDA-based tablets based on printer ink compositions and printing conditions. Drug release profiles were constructed by combining data for the amount of drug released at a specified time (15 hr) predicted by a regression algorithm generated by machine learning (multiple linear regression) and the drug release kinetics model generated by a binary classification algorithm (support vector machine). The proposed prediction model is unique and provides information useful for the development of 3D-printed PEGDA-based tablets as future tailored medicines.

Practicality of 3D Printed Personalized Medicines in Therapeutics

Technological advances in science over the past century have paved the way for remedial treatment outcomes in various diseases. Pharmacogenomic predispositions, the emergence of multidrug resistance, medication and formulation errors contribute significantly to patient mortality. The concept of "personalized" or "precision" medicines provides a window to addressing these issues and hence reducing mortality. The emergence of three-dimensional printing of medicines over the past decades has generated interests in therapeutics and dispensing, whereby the provisions of personalized medicines can be built within the framework of producing medicines at dispensaries or pharmacies. This plan is a good replacement of the fit-for-all modality in conventional therapeutics, where clinicians are constrained to prescribe pre-formulated dose units available on the market. However, three-dimension printing of personalized medicines faces several hurdles, but these are not insurmountable. In this review, we explore the relevance of personalized medicines in therapeutics and how three-dimensional printing makes a good fit in current gaps within conventional therapeutics in order to secure an effective implementation of personalized medicines. We also explore the deployment of three-dimensional printing of personalized medicines based on practical, legal and regulatory provisions.

Additive Manufacturing of Polymer Materials: Progress, Promise and Challenges

The use of additive manufacturing (AM) has moved well beyond prototyping and has been established as a highly versatile manufacturing method with demonstrated potential to completely transform traditional manufacturing in the future. In this paper, a comprehensive review and critical analyses of the recent advances and achievements in the field of different AM processes for polymers, their composites and nanocomposites, elastomers and multi materials, shape memory polymers and thermo-responsive materials are presented. Moreover, their applications in different fields such as bio-medical, electronics, textiles, and aerospace industries are also discussed. We conclude the article with an account of further research needs and future perspectives of AM process with polymeric materials.

3D Printing as a Promising Tool in Personalized Medicine

Personalized medicine has the potential to revolutionize the healthcare sector, its goal being to tailor medication to a particular individual by taking into consideration the physiology, drug response, and genetic profile of that individual. There are many technologies emerging to cause this paradigm shift from the conventional "one size fits all" to personalized medicine, the major one being three-dimensional (3D) printing. 3D printing involves the establishment of a three-dimensional object, in a layer upon layer manner using various computer software. 3D printing can be used to construct a wide variety of pharmaceutical dosage forms varying in shape, release profile, and drug combination. The major technological platforms of 3D printing researched on in the pharmaceutical sector include inkjet printing, binder jetting, fused filament fabrication, selective laser sintering, stereolithography, and pressure-assisted microsyringe. A possible future application of this technology could be in a clinical setting, where prescriptions could be dispensed based on individual needs. This manuscript points out the various 3D printing technologies and their applications in research for fabricating pharmaceutical products, along with their pros and cons. It also presents its potential in personalized medicine by individualizing the dose, release profiles, and incorporating multiple drugs in a polypill. An insight on how it tends to various populations is also provided. An approach of how it can be used in a clinical setting is also highlighted. Also, various challenges faced are pointed out, which must be overcome for the success of this technology in personalized medicine.

Evaluation of exposure time and visible light irradiation in LCD 3D printing of ibuprofen extended release tablets

Liquid crystal display (LCD) 3D printing technology is one of the three currently available photocuring three-dimensional printing technologies. LCD 3D printers usually use wavelengths in the ultraviolent (UV) range. However, recently introduced light-emitting diodes (LED) projectors enable visible light-induced photopolymerization, which would have an advantage in terms of safety in drug production. The aim of this work was to investigate the feasibility of printing ibuprofen extended release tablets under visible light irradiation and to evaluate characteristics of printed tablets. Influences of exposure time and wavelengths (UV versus visible light) on characteristics of tablets were evaluated. Tablets were printed using 405 nm and 450 nm LED light. Visible light enabled significantly faster printing as well as better dimensions accuracy of printed tablets. It was noticed that printing under 450 nm LED resulted in slightly softer tablets compared to tablets printing with 405 nm LED. Extended ibuprofen release was obtained from all formulations. Exposure time did not have influence on drug release in formulations with low water content. However, in a formulation with higher water content, the exposure time had a pronounced effect on drug release (in eight hours of testing, differences were from 27% to 95%). Wavelength affected the release rate of ibuprofen. Tablets prepared using 450 nm LEDs released ibuprofen faster than tablets prepared with 405 nm LEDs. The main mechanism of ibuprofen release was diffusion, regardless of exposure time and wavelength. Characteristics of obtained tablets indicate that further optimization of this process is necessary, but this new printing process approach opens the possibility for novel wavelength consideration in order to obtain the safe printing process of tablets.

Tailoring Atomoxetine Release Rate from DLP 3D-Printed Tablets Using Artificial Neural Networks: Influence of Tablet Thickness and Drug Loading

Various three-dimensional printing (3DP) technologies have been investigated so far in relation to their potential to produce customizable medicines and medical devices. The aim of this study was to examine the possibility of tailoring drug release rates from immediate to prolonged release by varying the tablet thickness and the drug loading, as well as to develop artificial neural network (ANN) predictive models for atomoxetine (ATH) release rate from DLP 3D-printed tablets. Photoreactive mixtures were comprised of poly(ethylene glycol) diacrylate (PEGDA) and poly(ethylene glycol) 400 in a constant ratio of 3:1, water, photoinitiator and ATH as a model drug whose content was varied from 5% to 20% (w/w). Designed 3D models of cylindrical shape tablets were of constant diameter, but different thickness. A series of tablets with doses ranging from 2.06 mg to 37.48 mg, exhibiting immediate- and modified-release profiles were successfully fabricated, confirming the potential of this technology in manufacturing dosage forms on demand, with the possibility to adjust the dose and release behavior by varying drug loading and dimensions of tablets. DSC (differential scanning calorimetry), XRPD (X-ray powder diffraction) and microscopic analysis showed that ATH remained in a crystalline form in tablets, while FTIR spectroscopy confirmed that no interactions occurred between ATH and polymers.

I Spy with My Little Eye: A Paediatric Visual Preferences Survey of 3D Printed Tablets

3D printing (3DP) in the pharmaceutical field is a disruptive technology that allows the preparation of personalised medicines at the point of dispensing. The paediatric population presents a variety of pharmaceutical formulation challenges such as dose flexibility, patient compliance, taste masking and the fear or difficulty to swallow tablets, all factors that could be overcome using the adaptable nature of 3DP. User acceptability studies of 3D printed formulations have been previously carried out in adults; however, feedback from children themselves is essential in establishing the quality target product profile towards the development of age-appropriate medicines. The aim of this study was to investigate the preference of children for different 3D printed tablets (Printlets™) as an important precursor to patient acceptability studies. Four different 3DP technologies; digital light processing (DLP), selective laser sintering (SLS), semi-solid extrusion (SSE) and fused deposition modeling (FDM) were used to prepare placebo printlets with similar physical attributes including size and shape. A single-site, two-part survey was completed with participants aged 4-11 years to determine their preference and opinions based on visual inspection of the printlets. A total of 368 participants completed an individual open questionnaire to visually select the best and worst printlet, and 310 participants completed further non-compulsory open questions to elaborate on their choices. Overall, the DLP printlets were the most visually appealing to the children (61.7%) followed by the SLS printlets (21.2%), and with both the FDM (5.4%) and SSE (11.7%) printlets receiving the lowest scores. However, after being informed that the SSE printlets were chewable, the majority of participants changed their selection and favoured this printlet, despite their original choice, in line with children's preference towards chewable dosage forms. Participant age and sex displayed no significant differences in printlet selection. Printlet descriptions were grouped into four distinct categories; appearance, perceived taste, texture and familiarity, and were found to be equally important when creating a quality target product profile for paediatric 3D printed formulations. This study is the first to investigate children's perceptions of printlets, and the findings aim to provide guidance for further development of paediatric-appropriate medicines using different 3DP technologies.

Multivariate Design of 3D Printed Immediate-Release Tablets with Liquid Crystal-Forming Drug-Itraconazole

The simplicity of object shape and composition modification make additive manufacturing a great option for customized dosage form production. To achieve this goal, the correlation between structural and functional attributes of the printed objects needs to be analyzed. So far, it has not been deeply investigated in 3D printing-related papers. The aim of our study was to modify the functionalities of printed tablets containing liquid crystal-forming drug itraconazole by introducing polyvinylpyrrolidone-based polymers into the filament-forming matrices composed predominantly of poly(vinyl alcohol). The effect of the molecular reorganization of the drug and improved tablets’ disintegration was analyzed in terms of itraconazole dissolution. Micro-computed tomography was applied to analyze how the design of a printed object (in this case, a degree of an infill) affects its reproducibility during printing. It was also used to analyze the structure of the printed dosage forms. The results indicated that the improved disintegration obtained due to the use of Kollidon^®CL-M was more beneficial for the dissolution of itraconazole than the molecular rearrangement and liquid crystal phase transitions. The lower infill density favored faster dissolution of the drug from printed tablets. However, it negatively affected the reproducibility of the 3D printed object.

Vat photopolymerization 3D printing for advanced drug delivery and medical device applications

Three-dimensional (3D) printing is transforming manufacturing paradigms within healthcare. Vat photopolymerization 3D printing technology combines the benefits of high resolution and favourable printing speed, offering a sophisticated approach to fabricate bespoke medical devices and drug delivery systems. Herein, an overview of the vat polymerization techniques, their unique applications in the fields of drug delivery and medical device fabrication, material examples and the advantages they provide within healthcare, is provided. The challenges and drawbacks presented by this technology are also discussed. It is forecast that the adoption of 3D printing could pave the way for a personalised health system, advancing from traditional treatments pathways towards digital healthcare.