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Guy RH. Drug delivery to and through the skin. Drug Deliv Transl Res 2024; 14:2032-2040. [PMID: 38837116 PMCID: PMC11208237 DOI: 10.1007/s13346-024-01614-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/06/2024]
Abstract
Drug delivery technology has advanced significantly over >50 years, and has produced remarkable innovation, countless publications and conferences, and generations of talented and creative scientists. However, a critical review of the current state-of-the-art reveals that the translation of clever and sophisticated drug delivery technologies into products, which satisfy important, unmet medical needs and have been approved by the regulatory agencies, has - given the investment made in terms of time and money - been relatively limited. Here, this point of view is illustrated using a case study of technology for drug delivery into and through the skin and aims: to examine the historical development of this field and the current state-of-the-art; to understand why the translation of drug delivery technologies into products that improve clinical outcomes has been quite slow and inefficient; and to suggest how the impact of technology may be increased and the process of concept to approved product accelerated.
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Affiliation(s)
- Richard H Guy
- Department of Life Sciences, University of Bath, Claverton Down, Bath, BA2 7AY, U.K..
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Lourenço D, Miranda M, Sousa JJ, Vitorino C. Therapeutic-driven framework for bioequivalence assessment of complex topical generic drug products. Int J Pharm 2024; 661:124398. [PMID: 38964491 DOI: 10.1016/j.ijpharm.2024.124398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/07/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
Despite the continuous research on understanding how topical drugs and the skin interact, the development of a topical generic product remains a challenge. Due to their local action effect rather than systemic, establishing suitable frameworks for documenting bioequivalence between reference and test formulations is anything but straightforward. In previous years, clinical endpoint trials were considered the gold standard method to demonstrate bioequivalence between topical products. Nevertheless, significant financial and time resources were required to be allocated owing to the inherent complexity of these studies. To address this problem, regulatory authorities have begun to accept alternative approaches that could lead to a biowaiver, avoiding the need for clinical endpoint trials. These alternatives encompass various in vitro and/or in vivo techniques that have been analysed and the benefits and drawbacks of each method have been considered. Furthermore, other factors like the integration of a quality by design framework to ensure a comprehensive understanding of the product and process quality attributes have also been taken into account. This review delves into international regulatory recommendations for semisolid topical products, with a focus on those established by the European Medicines Agency, as well as the Food and Drug Administration. Both approaches were carefully examined, discussing aspects such as acceptance criteria, sample size, and microstructure evaluation. Additionally, novel and innovative therapeutic-driven approaches based on in vitro disease models for the rapid and effective development of topical generic products are presented.
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Affiliation(s)
- Diogo Lourenço
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Margarida Miranda
- Coimbra Chemistry Center, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal; Coimbra Chemistry Centre, Institute of Molecular Sciences-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal.
| | - João José Sousa
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal; Coimbra Chemistry Centre, Institute of Molecular Sciences-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
| | - Carla Vitorino
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal; Coimbra Chemistry Centre, Institute of Molecular Sciences-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal.
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Mohammed YH, Namjoshi SN, Jung N, Windbergs M, Benson HAE, Grice JE, Raney SG, Roberts MS. Topical Semisolid Drug Product Critical Quality Attributes with Relevance to Cutaneous Bioavailability and Pharmacokinetics: Part I-Bioequivalence of Acyclovir Topical Creams. Pharm Res 2024; 41:1507-1520. [PMID: 38955999 PMCID: PMC11263457 DOI: 10.1007/s11095-024-03736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE To develop a toolkit of test methods for characterizing potentially critical quality attributes (CQAs) of topical semisolid products and to evaluate how CQAs influence the rate and extent of active ingredient bioavailability (BA) by monitoring cutaneous pharmacokinetics (PK) using an In Vitro Permeation Test (IVPT). METHODS Product attributes representing the physicochemical and structural (Q3) arrangement of matter, such as attributes of particles and globules, were assessed for a set of test acyclovir creams (Aciclostad® and Acyclovir 1A Pharma) and compared to a set of reference acyclovir creams (Zovirax® US, Zovirax® UK and Zovirax® Australia). IVPT studies were performed with all these creams using heat-separated human epidermis, evaluated with both, static Franz-type diffusion cells and a flow through diffusion cell system. RESULTS A toolkit developed to characterize quality and performance attributes of these acyclovir topical cream products identified certain differences in the Q3 attributes and the cutaneous PK of acyclovir between the test and reference sets of products. The cutaneous BA of acyclovir from the set of reference creams was substantially higher than from the set of test creams. CONCLUSIONS This research elucidates how differences in the composition or manufacturing of product formulations can alter Q3 attributes that modulate myriad aspects of topical product performance. The results demonstrate the importance of understanding the Q3 attributes of topical semisolid drug products, and of developing appropriate product characterization tests. The toolkit developed here can be utilized to guide topical product development, and to mitigate the risk of differences in product performance, thereby supporting a demonstration of bioequivalence (BE) for prospective topical generic products and reducing the reliance on comparative clinical endpoint BE studies.
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Affiliation(s)
- Y H Mohammed
- Therapeutics Research Centre, Frazer Institute, The University of Queensland, Brisbane, Australia.
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD, 4102, Australia.
| | - S N Namjoshi
- Therapeutics Research Centre, Frazer Institute, The University of Queensland, Brisbane, Australia
| | - N Jung
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt, Germany
| | - M Windbergs
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt, Germany
| | - H A E Benson
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - J E Grice
- Therapeutics Research Centre, Frazer Institute, The University of Queensland, Brisbane, Australia
| | - S G Raney
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
| | - M S Roberts
- Therapeutics Research Centre, Frazer Institute, The University of Queensland, Brisbane, Australia
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
- Therapeutics Research Centre, Basil Hetzel Institute for Translational Medical Research, The Queen Elizabeth Hospital, Adelaide, Australia
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Iliopoulos F, Tu D, Pence IJ, Li X, Ghosh P, Luke MC, Raney SG, Rantou E, Evans CL. Determining topical product bioequivalence with stimulated Raman scattering microscopy. J Control Release 2024; 367:864-876. [PMID: 38346503 DOI: 10.1016/j.jconrel.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Abstract
Generic drugs are essential for affordable medicine and improving accessibility to treatments. Bioequivalence (BE) is typically demonstrated by assessing a generic product's pharmacokinetics (PK) relative to a reference-listed drug (RLD). Accurately estimating cutaneous PK (cPK) at or near the site of action can be challenging for locally acting topical products. Certain cPK approaches are available for assessing local bioavailability (BA) in the skin. Stimulated Raman scattering (SRS) microscopy has unique capabilities enabling continuous, high spatial and temporal resolution and quantitative imaging of drugs within the skin. In this paper, we developed an approach based on SRS and a polymer-based standard reference for the evaluation of topical product BA and BE in human skin ex vivo. BE assessment of tazarotene-containing formulations was achieved using cPK parameters obtained within different skin microstructures. The establishment of BE between the RLD and an approved generic product was successfully demonstrated. Interestingly, within the constraints of the current study design the results suggest similar BA between the tested gel formulation and the reference cream formulation, despite the differences in the formulation/dosage form. Another formulation containing polyethylene glycol as the vehicle was demonstrated to be not bioequivalent to the RLD. Compared to using the SRS approach without a standard reference, the developed approach enabled more consistent and reproducible results, which is crucial in BE assessment. The abundant information from the developed approach can help to systematically identify key areas of study design that will enable a better comparison of topical products and support an assessment of BE.
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Affiliation(s)
- Fotis Iliopoulos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown 02129, MA, USA
| | - Dandan Tu
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown 02129, MA, USA
| | - Isaac J Pence
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown 02129, MA, USA
| | - Xiaolei Li
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown 02129, MA, USA
| | - Priyanka Ghosh
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring 20993, MD, USA
| | - Markham C Luke
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring 20993, MD, USA
| | - Sam G Raney
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring 20993, MD, USA
| | - Elena Rantou
- Office of Biostatistics, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring 20993, MD, USA
| | - Conor L Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown 02129, MA, USA.
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Bodenlenz M, Yeoh T, Berstein G, Mathew S, Shah J, Banfield C, Hollingshead B, Steyn SJ, Osgood SM, Beaumont K, Kainz S, Holeček C, Trausinger G, Raml R, Birngruber T. Comparative Study of Dermal Pharmacokinetics Between Topical Drugs Using Open Flow Microperfusion in a Pig Model. Pharm Res 2024; 41:223-234. [PMID: 38158503 PMCID: PMC10879402 DOI: 10.1007/s11095-023-03645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Accurate methods to determine dermal pharmacokinetics are important to increase the rate of clinical success in topical drug development. We investigated in an in vivo pig model whether the unbound drug concentration in the interstitial fluid as determined by dermal open flow microperfusion (dOFM) is a more reliable measure of dermal exposure compared to dermal biopsies for seven prescription or investigational drugs. In addition, we verified standard dOFM measurement using a recirculation approach and compared dosing frequencies (QD versus BID) and dose strengths (high versus low drug concentrations). METHODS Domestic pigs were topically administered seven different drugs twice daily in two studies. On day 7, drug exposures in the dermis were assessed in two ways: (1) dOFM provided the total and unbound drug concentrations in dermal interstitial fluid, and (2) clean punch biopsies after heat separation provided the total concentrations in the upper and lower dermis. RESULTS dOFM showed sufficient intra-study precision to distinguish interstitial fluid concentrations between different drugs, dose frequencies and dose strengths, and had good reproducibility between studies. Biopsy concentrations showed much higher and more variable values. Standard dOFM measurements were consistent with values obtained with the recirculation approach. CONCLUSIONS dOFM pig model is a robust and reproducible method to directly determine topical drug concentration in dermal interstitial fluid. Dermal biopsies were a less reliable measure of dermal exposure due to possible contributions from drug bound to tissue and drug associated with skin appendages.
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Affiliation(s)
- Manfred Bodenlenz
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thean Yeoh
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Gabriel Berstein
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Shibin Mathew
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA.
| | - Jaymin Shah
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | | | - Brett Hollingshead
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Stefanus J Steyn
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Sarah M Osgood
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Kevin Beaumont
- Pfizer Research Technology Center, 1 Portland St, Cambridge, MA, 02139, USA
| | - Sonja Kainz
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Christian Holeček
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Gert Trausinger
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Reingard Raml
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria
| | - Thomas Birngruber
- HEALTH - Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft M.B.H, Neue Stiftingtalstrasse 2, 8010, Graz, Austria.
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Shahinfar S, Maibach H. Enigma of Intramuscular Triamcinolone Acetonide (Kenalog ®) Efficacy. Clin Pharmacokinet 2023; 62:1189-1199. [PMID: 37598107 DOI: 10.1007/s40262-023-01297-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/21/2023]
Abstract
Triamcinolone acetonide is a glucocorticosteroid used in standard clinical practice for its anti-inflammatory properties. Although it can be given via different routes of administration, the intramuscular route is unique compared with other corticosteroids-its effects remain potent over a longer period of time. We summarize the existing literature on the pharmacokinetic and pharmacodynamic mechanisms of intramuscular triamcinolone acetonide (Kenalog®). The fascinating nature of the purported efficacy of triamcinolone acetonide may be attributed to differing binding mechanisms, low solubility in blood, a low renal clearance rate, and various metabolites and other yet defined effects on skin. The enigma of the purported efficacy of triamcinolone acetonide may lie in the fact that it has a unique nature of having a long-term effect on dermatologic disease using a seemingly low dose compared with other routes of administration and other corticosteroids. Possible reasons for this may be binding differences at the intramuscular site, low solubility due to acetonide esters, a slow rate of absorption from the injected site, and a low renal clearance rate. There is still much to be learned about its mechanism of action, which may be of clinical and therapeutic significance.
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Affiliation(s)
- Sheeva Shahinfar
- Texas A&M University School of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA.
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Herbig ME, Evers DH, Gorissen S, Köllmer M. Rational Design of Topical Semi-Solid Dosage Forms-How Far Are We? Pharmaceutics 2023; 15:1822. [PMID: 37514009 PMCID: PMC10386014 DOI: 10.3390/pharmaceutics15071822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Specific aspects of semi-solid dosage forms for topical application include the nature of the barrier to be overcome, aspects of susceptibility to physical and chemical instability, and a greater influence of sensory perception. Advances in understanding the driving forces of skin penetration as well as the design principles and inner structure of formulations, provide a good basis for the more rational design of such dosage forms, which still often follow more traditional design approaches. This review analyses the opportunities and constraints of rational formulation design approaches in the industrial development of new topical drugs. As the selection of drug candidates with favorable physicochemical properties increases the speed and probability of success, models for drug selection based on theoretical and experimental approaches are discussed. This paper reviews how progress in the scientific understanding of mechanisms and vehicle-influence of skin penetration can be used for rational formulation design. The characterization of semi-solid formulations is discussed with a special focus on modern rheological approaches and analytical methods for investigating and optimizing the chemical stability of active ingredients in consideration of applicable guidelines. In conclusion, the combination of a good understanding of scientific principles combined with early consideration of regulatory requirements for product quality are enablers for the successful development of innovative and robust semi-solid formulations for topical application.
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Birngruber T, Tiffner KI, Mautner SI, Sinner FM. Dermal open flow microperfusion for PK-based clinical bioequivalence studies of topical drug products. Front Pharmacol 2022; 13:1061178. [PMID: 36483734 PMCID: PMC9723326 DOI: 10.3389/fphar.2022.1061178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 07/21/2024] Open
Abstract
Topically applied drug products have experienced an extraordinary price increase in the United States, mostly due to a lack of generic products. Generic drug development is hindered by high costs and risks associated with clinical endpoint studies required to show bioequivalence (BE) of prospective generic products relative to their reference products. There is a continued need for cost- and time-efficient alternatives to clinical endpoint studies to determine BE of topically applied dermal drug products. Cutaneous PK-based BE studies present such an alternative and dOFM (dermal open flow microperfusion) has already been successfully used in several verifications studies to show an accurate and sensitive assessment of the rate and extent at which drugs become available in the skin. dOFM technology is discussed as well as the dOFM setup of clinical pilot and main studies to achieve BE assessment with a minimum number of participants and an outlook is given on the use of dOFM technology for other drug products.
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Affiliation(s)
| | | | | | - Frank M. Sinner
- HEALTH—Institute for Biomedicine and Health Sciences, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
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