1
|
Magramane S, Vlahović K, Gordon P, Kállai-Szabó N, Zelkó R, Antal I, Farkas D. Inhalation Dosage Forms: A Focus on Dry Powder Inhalers and Their Advancements. Pharmaceuticals (Basel) 2023; 16:1658. [PMID: 38139785 PMCID: PMC10747137 DOI: 10.3390/ph16121658] [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: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
In this review, an extensive analysis of dry powder inhalers (DPIs) is offered, focusing on their characteristics, formulation, stability, and manufacturing. The advantages of pulmonary delivery were investigated, as well as the significance of the particle size in drug deposition. The preparation of DPI formulations was also comprehensively explored, including physico-chemical characterization of powders, powder processing techniques, and formulation considerations. In addition to manufacturing procedures, testing methods were also discussed, providing insights into the development and evaluation of DPI formulations. This review also explores the design basics and critical attributes specific to DPIs, highlighting the significance of their optimization to achieve an effective inhalation therapy. Additionally, the morphology and stability of 3 DPI capsules (Spiriva, Braltus, and Onbrez) were investigated, offering valuable insights into the properties of these formulations. Altogether, these findings contribute to a deeper understanding of DPIs and their development, performance, and optimization of inhalation dosage forms.
Collapse
Affiliation(s)
- Sabrina Magramane
- Department of Pharmaceutics, Semmelweis University, Hőgyes Str. 7, H-1092 Budapest, Hungary; (S.M.); (K.V.); (I.A.)
| | - Kristina Vlahović
- Department of Pharmaceutics, Semmelweis University, Hőgyes Str. 7, H-1092 Budapest, Hungary; (S.M.); (K.V.); (I.A.)
| | - Péter Gordon
- Department of Electronics Technology, Budapest University of Technology and Economics, Egry J. Str. 18, H-1111 Budapest, Hungary;
| | - Nikolett Kállai-Szabó
- Department of Pharmaceutics, Semmelweis University, Hőgyes Str. 7, H-1092 Budapest, Hungary; (S.M.); (K.V.); (I.A.)
| | - Romána Zelkó
- Department of Pharmacy Administration, Semmelweis University, Hőgyes Str. 7–9, H-1092 Budapest, Hungary;
| | - István Antal
- Department of Pharmaceutics, Semmelweis University, Hőgyes Str. 7, H-1092 Budapest, Hungary; (S.M.); (K.V.); (I.A.)
| | - Dóra Farkas
- Department of Pharmaceutics, Semmelweis University, Hőgyes Str. 7, H-1092 Budapest, Hungary; (S.M.); (K.V.); (I.A.)
| |
Collapse
|
2
|
Azeem A, Singh G, Li L, Chan HK, Yang R, Cheng S, Kourmatzis A. Quantifying Agglomerate-to-Wall Impaction in Dry Powder Inhalers. Pharm Res 2023; 40:307-319. [PMID: 36471024 DOI: 10.1007/s11095-022-03446-0] [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: 06/26/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The probability of agglomerate-to-wall collision was quantified using a unique image processing technique applied to high-speed microscopic images. The study aimed to investigate the effects of flow rate and particle size on the percentage of colliding agglomerates detected within an in-house powder dispersion device. METHOD The device consists of a swirl chamber and two tangential inlets in various configurations, designed to emulate the geometric features of commercial devices such as the Aerolizer® and Osmohaler®. The test cases were conducted with constant flow rates of 30 SLPM and 60 SLPM. Four powder samples were tested, including carrier Respitose® SV010 (median volume diameter 104 µm, span 1.7) and mannitol of three constituent primary particle sizes (3 µm, 5 µm and 7 µm; span 1.6 - 1.9). RESULTS At the lower flow rate of 30 SLPM, collision frequencies were significantly different between powders of different constituent particle sizes, but the effects of powder properties diminished on increasing the flow rate to 60 SLPM. At the higher flow rate, all powders experienced a significant increase in the proportion of colliding particles. CONCLUSION Analysis of collision events showed that the probability of collision for each agglomerate increased with agglomerate diameter and velocity. Experimental data of agglomerate-to-wall collision were utilised to develop a logistic regression model that can accurately predict collisions with various powders and flow rates.
Collapse
Affiliation(s)
- Athiya Azeem
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Gajendra Singh
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Engineering, IIT Mandi, Mandi, HP, 175075, India
| | - Lunjian Li
- School of Materials Science and Engineering, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Hak-Kim Chan
- School of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Runyu Yang
- School of Materials Science and Engineering, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Shaokoon Cheng
- School of Engineering, Macquarie University, Sydney, NSW, 2109, Australia
| | - Agisilaos Kourmatzis
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2006, Australia.
| |
Collapse
|
3
|
Adhikari BR, Dummer J, Gordon KC, Das SC. An expert opinion on respiratory delivery of high dose powders for lung infections. Expert Opin Drug Deliv 2022; 19:795-813. [PMID: 35695722 DOI: 10.1080/17425247.2022.2089111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION High dose powder inhalation is evolving as an important approach to to treat lung infections. It is important to its identify applications, consider the factors affecting high dose powder delivery, and assess the effect of high dose drugs in patients. AREA COVERED Both current and pipeline high dose inhalers and their applications have been summarized. Challenges and opportunities to high dose delivery have been highlighted after reviewing formulation techniques in the context of factors affecting aerosolization, devices, and patient factors. EXPERT OPINION High dose inhaled delivery of antimicrobials is an innovative way to increase treatment efficacy of respiratory infections, tackle drug resistance, and the scarcity of new antimicrobials. The high dose inhaled technology also has potential for systemic action; however, innovations in formulation strategies and devices are required to realize its full potential. Advances in formulation strategies include the use of excipients or the engineering of particles to decrease the cohesive property of microparticles and their packing density. Similarly, selection of a synergistic drug instead of an excipient can be considered to increase aerosolization and stability. Device development focused on improving dispersion and loading capacity is also important, and modification of existing devices for high dose delivery can also be considered.
Collapse
Affiliation(s)
| | - Jack Dummer
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Keith C Gordon
- The Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin, New Zealand
| | - Shyamal C Das
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
4
|
Etschmann C, Scherließ R. Formulation of rifampicin softpellets for high dose delivery to the lungs with a novel high dose dry powder inhaler. Int J Pharm 2022; 617:121606. [DOI: 10.1016/j.ijpharm.2022.121606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
|
5
|
Son YJ, Miller DP, Weers JG. Optimizing Spray-Dried Porous Particles for High Dose Delivery with a Portable Dry Powder Inhaler. Pharmaceutics 2021; 13:pharmaceutics13091528. [PMID: 34575603 PMCID: PMC8470347 DOI: 10.3390/pharmaceutics13091528] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022] Open
Abstract
This manuscript critically reviews the design and delivery of spray-dried particles for the achievement of high total lung doses (TLD) with a portable dry powder inhaler. We introduce a new metric termed the product density, which is simply the TLD of a drug divided by the volume of the receptacle it is contained within. The product density is given by the product of three terms: the packing density (the mass of powder divided by the volume of the receptacle), the drug loading (the mass of drug divided by the mass of powder), and the aerosol performance (the TLD divided by the mass of drug). This manuscript discusses strategies for maximizing each of these terms. Spray drying at low drying rates with small amounts of a shell-forming excipient (low Peclet number) leads to the formation of higher density particles with high packing densities. This enables ultrahigh TLD (>100 mg of drug) to be achieved from a single receptacle. The emptying of powder from capsules is directly proportional to the mass of powder in the receptacle, requiring an inhaled volume of about 1 L for fill masses between 40 and 50 mg and up to 3.2 L for a fill mass of 150 mg.
Collapse
Affiliation(s)
- Yoen-Ju Son
- Genentech, South San Francisco, CA 94080, USA;
| | | | - Jeffry G. Weers
- Cystetic Medicines, Inc., Burlingame, CA 94010, USA;
- Correspondence: ; Tel.: +1-650-339-3832
| |
Collapse
|
6
|
Heida R, Hinrichs WL, Frijlink HW. Inhaled vaccine delivery in the combat against respiratory viruses: a 2021 overview of recent developments and implications for COVID-19. Expert Rev Vaccines 2021; 21:957-974. [PMID: 33749491 DOI: 10.1080/14760584.2021.1903878] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION As underlined by the late 2019 outbreak of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), vaccination remains the cornerstone of global health-care. Although vaccines for SARS-CoV-2 are being developed at a record-breaking pace, the majority of those that are licensed or currently registered in clinical trials are formulated as an injectable product, requiring a tightly regulated cold-chain infrastructure, and primarily inducing systemic immune responses. AREAS COVERED Here, we shed light on the status of inhaled vaccines against viral pathogens, providing background to the role of the mucosal immune system and elucidating what factors determine an inhalable vaccine's efficacy. We also discuss whether the development of an inhalable powder vaccine formulation against SARS-CoV-2 could be feasible. The review was conducted using relevant studies from PubMed, Web of Science and Google Scholar. EXPERT OPINION We believe that the scope of vaccine research should be broadened toward inhalable dry powder formulations since dry vaccines bear several advantages. Firstly, their dry state can tremendously increase vaccine stability and shelf-life. Secondly, they can be inhaled using disposable inhalers, omitting the need for trained health-care personnel and, therefore, facilitating mass-vaccination campaigns. Thirdly, inhalable vaccines may provide improved protection since they can induce an IgA-mediated mucosal immune response.
Collapse
Affiliation(s)
- Rick Heida
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - Wouter Lj Hinrichs
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
7
|
Zheng Z, Leung SSY, Gupta R. Flow and Particle Modelling of Dry Powder Inhalers: Methodologies, Recent Development and Emerging Applications. Pharmaceutics 2021; 13:189. [PMID: 33535512 PMCID: PMC7912775 DOI: 10.3390/pharmaceutics13020189] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
Dry powder inhaler (DPI) is a device used to deliver a drug in dry powder form to the lungs. A wide range of DPI products is currently available, with the choice of DPI device largely depending on the dose, dosing frequency and powder properties of formulations. Computational fluid dynamics (CFD), together with various particle motion modelling tools, such as discrete particle methods (DPM) and discrete element methods (DEM), have been increasingly used to optimise DPI design by revealing the details of flow patterns, particle trajectories, de-agglomerations and depositions within the device and the delivery paths. This review article focuses on the development of the modelling methodologies of flow and particle behaviours in DPI devices and their applications to device design in several emerging fields. Various modelling methods, including the most recent multi-scale approaches, are covered and the latest simulation studies of different devices are summarised and critically assessed. The potential and effectiveness of the modelling tools in optimising designs of emerging DPI devices are specifically discussed, such as those with the features of high-dose, pediatric patient compatibility and independency of patients' inhalation manoeuvres. Lastly, we summarise the challenges that remain to be addressed in DPI-related fluid and particle modelling and provide our thoughts on future research direction in this field.
Collapse
Affiliation(s)
- Zhanying Zheng
- Center for Turbulence Control, Harbin Institute of Technology, Shenzhen 518055, China
| | - Sharon Shui Yee Leung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong;
| | - Raghvendra Gupta
- Department of Chemical Engineering, Indian Institute of Technology Guwahati, Assam 781039, India;
| |
Collapse
|
8
|
Akkerman-Nijland AM, Grasmeijer F, Kerstjens HAM, Frijlink HW, van der Vaart H, Vonk JM, Hagedoorn P, Rottier BL, Koppelman GH, Akkerman OW. Colistin dry powder inhalation with the Twincer™: An effective and more patient friendly alternative to nebulization. PLoS One 2020; 15:e0239658. [PMID: 32970760 PMCID: PMC7514010 DOI: 10.1371/journal.pone.0239658] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/10/2020] [Indexed: 11/24/2022] Open
Abstract
Background Nebulization of antimicrobial drugs such as tobramycin and colistin is a cornerstone in the treatment of patients with cystic fibrosis (CF) infected with Pseudomonas aeruginosa. However, nebulization has a high treatment burden. The Twincer™ is a dry powder inhaler specifically developed for the inhalation of antibiotics such as colistin. The aim of this study was to compare patient outcomes and experience with colistin dry powder by the Twincer with nebulization of colistin or tobramycin in adult CF patients in a real-life setting. Methods This was a retrospective study from 01-01-2015 until 01-07-2018. Effectiveness was evaluated by comparing FEV1 decline and exacerbation rate during a mean of 4.1 years of nebulization therapy prior to the initiation of the Twincer against the same values during a mean of 1.7 years of treatment with the Twincer. Results Twenty-one patients were evaluated, of whom twelve could be included in the effectiveness analysis, with a total of twenty patient years. Of all patients 71.4% preferred therapy with the Twincer over nebulization. Twincer use resulted in high treatment adherence with an average adherence rate of 92.5%. There was no significant difference in annual decline in FEV1%pred prior to and after start changing from nebulization to the use of the Twincer powder inhaler (median decline -1.56 [-5.57–5.31] and 1.35 [-8.45–6.36]) respectively, p = 0.45 (linear mixed effect model)). No significant difference was found in the number of intravenous or combined total intravenous and oral antibiotic courses during Twincer therapy compared to when using nebulization (1.68 and 2.49 courses during Twincer therapy versus 1.51 and 2.94 courses during nebulization, p = 0.88 and p = 0.63). Conclusion Colistin dry powder inhalation with the Twincer is a more patient friendly alternative to nebulization, and we did not observe significant differences in the clinical outcome, regarding lung function and exacerbation rates.
Collapse
Affiliation(s)
- A. M. Akkerman-Nijland
- Department of Paediatric Pulmonology and Pediatric Allergology, Beatrix Childrens’ Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - F. Grasmeijer
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
- PureIMS B.V., Roden, The Netherlands
| | - H. A. M. Kerstjens
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H. W. Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - H. van der Vaart
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J. M. Vonk
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
| | - P. Hagedoorn
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - B. L. Rottier
- Department of Paediatric Pulmonology and Pediatric Allergology, Beatrix Childrens’ Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - G. H. Koppelman
- Department of Paediatric Pulmonology and Pediatric Allergology, Beatrix Childrens’ Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - O. W. Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| |
Collapse
|
9
|
Tewes F, Bahamondez-Canas TF, Moraga-Espinoza D, Smyth HDC, Watts AB. In vivo efficacy of a dry powder formulation of ciprofloxacin-copper complex in a chronic lung infection model of bioluminescent Pseudomonas aeruginosa. Eur J Pharm Biopharm 2020; 152:210-217. [PMID: 32442738 DOI: 10.1016/j.ejpb.2020.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/01/2020] [Accepted: 05/15/2020] [Indexed: 12/21/2022]
Abstract
A significant limitation of locally delivered treatments for chronic pulmonary infections is often the short residence time within the airways. Ciprofloxacin (CIP), for example, undergoes rapid absorption from the airway lumen. Previously, we demonstrated that the complexation of CIP with copper (CIP-Cu) reduces its apparent epithelial permeability and pulmonary absorption rate without affecting antimicrobial activity against Pseudomonas aeruginosa grown planktonically or as biofilms. This study aimed to evaluate the in vivo efficacy of CIP-Cu, prepared as a dry powder, in a chronic lung infection model. The powders were prepared by jet milling (CIP-HCl) and by spray drying (CIP-Cu). A bioluminescent strain of P. aeruginosa (PAO1::p16Slux) was used to prepare bacteria-loaded agar beads that were inoculated intratracheally to rats. The dynamics of the infection were monitored using luminometry. The bacteria/beads ratio was optimized to allow the highest luminescence signal and animal survival for 8 days. The efficacy of the treatment was evaluated by luminometry in addition to the end-point (Day 8) where colony counting was performed after lung harvesting. Luminescent P. aeruginosa entrapped in agar beads were useful to monitor the spatial development of the chronic lung infection in rats. The rats were treated with the dry powders in a nose-only inhalation exposure system (NOIES). CIP-Cu and CIP-HCl powders showed similar aerodynamic properties and comparable CIP lung deposition. However, treatment with CIP-Cu significantly (p < 0.01) reduced by 4-log the number of CFU of P. aeruginosa per lung in the chronic infection model, whereas CIP-HCl effect was not different from the untreated control group.
Collapse
Affiliation(s)
- Frédéric Tewes
- INSERM U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073 Poitiers Cedex 9, France; College of Pharmacy, The University of Texas at Austin, 2409 West University Avenue, PHR 4.214, Austin, TX 78712, USA.
| | - Tania F Bahamondez-Canas
- College of Pharmacy, The University of Texas at Austin, 2409 West University Avenue, PHR 4.214, Austin, TX 78712, USA; Escuela de Farmacia, Universidad de Valparaiso, Gran Bretaña 1093, Playa Ancha, Valparaíso, Chile; Centro de Investigación Farmacopea, Universidad de Valparaíso, Santa Marta 183, Playa Ancha, Valparaíso, Chile
| | - Daniel Moraga-Espinoza
- College of Pharmacy, The University of Texas at Austin, 2409 West University Avenue, PHR 4.214, Austin, TX 78712, USA; Escuela de Farmacia, Universidad de Valparaiso, Gran Bretaña 1093, Playa Ancha, Valparaíso, Chile; Centro de Investigación Farmacopea, Universidad de Valparaíso, Santa Marta 183, Playa Ancha, Valparaíso, Chile
| | - Hugh D C Smyth
- College of Pharmacy, The University of Texas at Austin, 2409 West University Avenue, PHR 4.214, Austin, TX 78712, USA
| | - Alan B Watts
- College of Pharmacy, The University of Texas at Austin, 2409 West University Avenue, PHR 4.214, Austin, TX 78712, USA
| |
Collapse
|
10
|
Sibum I, Hagedoorn P, Kluitman MPG, Kloezen M, Frijlink HW, Grasmeijer F. Dispersibility and Storage Stability Optimization of High Dose Isoniazid Dry Powder Inhalation Formulations with L-Leucine or Trileucine. Pharmaceutics 2019; 12:pharmaceutics12010024. [PMID: 31881695 PMCID: PMC7022271 DOI: 10.3390/pharmaceutics12010024] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis is the leading cause of death from a single infectious pathogen worldwide. Lately, the targeted delivery of antibiotics to the lungs via inhalation has received increasing interest. In a previous article, we reported on the development of a spray-dried dry powder isoniazid formulation containing an L-leucine coating. It dispersed well but had poor physical stability. In this study, we aimed to improve the stability by improving the leucine coating. To this end, we optimized the spray-drying conditions, the excipient content, and the excipient itself. Using L-leucine, the tested excipient contents (up to 5%) did not result in a stable powder. Contrary to L-leucine, the stability attained with trileucine was satisfactory. Even when exposed to 75% relative humidity, the formulation was stable for at least three months. The optimal formulation contained 3% trileucine w/w. This formulation resulted in a maximum fine particle dose of 58.00 ± 2.56 mg when a nominal dose of 80 mg was dispersed from the Cyclops® dry powder inhaler. The improved moisture protection and dispersibility obtained with trileucine are explained by its amorphous nature and a higher surface enrichment during drying. Dispersion efficiency of the device decreases at higher nominal doses.
Collapse
|
11
|
Why Wait? The Case for Treating Tuberculosis with Inhaled Drugs. Pharm Res 2019; 36:166. [PMID: 31650321 DOI: 10.1007/s11095-019-2704-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/13/2019] [Indexed: 11/27/2022]
Abstract
The discovery of drugs to treat tuberculosis (TB) was a major medical milestone in the twentieth century. However, from the outset, drug resistance was observed. Currently, of the 10 million people that exhibit TB symptoms each year, 450,000 have multidrug or extensively drug resistant (MDR or XDR) TB. While greater understanding of the host and pathogen (Mycobacterium tuberculosis, Mtb) coupled with scientific ingenuity will lead to new drugs and vaccines, in the meantime 4000 people die daily from TB. Thus, efforts to improve existing TB drugs should also be prioritized. Improved efficacy and decreased dose and associated toxicity of existing drugs would translate to greater compliance, life expectancy and quality of life of Mtb infected individuals. One potential strategy to improve existing drugs is to deliver them by inhalation as aerosols to the lung, the primary site of Mtb infection. Inhaled drugs are used for other pulmonary diseases, but they have yet to be utilized for TB. Inhaled therapies for TB represent an untapped opportunity that the pharmaceutical, clinical and regulatory communities should consider.
Collapse
|
12
|
Beugeling M, De Zee J, Woerdenbag HJ, Frijlink HW, Wilschut JC, Hinrichs WLJ. Respiratory syncytial virus subunit vaccines based on the viral envelope glycoproteins intended for pregnant women and the elderly. Expert Rev Vaccines 2019; 18:935-950. [PMID: 31446807 DOI: 10.1080/14760584.2019.1657013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Respiratory syncytial virus (RSV) causes high morbidity and mortality rates among infants, young children, and the elderly worldwide. Unfortunately, a safe and effective vaccine is still unavailable. In 1966, a formalin-inactivated RSV vaccine failed and resulted in the death of two young children. This failure shifted research toward the development of subunit-based vaccines for pregnant women (to passively vaccinate infants) and the elderly. Among these subunit-based vaccines, the viral envelope glycoproteins show great potential as antigens. Areas covered: In this review, progress in the development of safe and effective subunit RSV vaccines based on the viral envelope glycoproteins and intended for pregnant women and the elderly, are reviewed and discussed. Studies published in the period 2012-2018 were included. Expert opinion: Researchers are close to bringing safe and effective subunit-based RSV vaccines to the market using the viral envelope glycoproteins as antigens. However, it remains a major challenge to elicit protective immunity, with a formulation that has sufficient (storage) stability. These issues may be overcome by using the RSV fusion protein in its pre-fusion conformation, and by formulating this protein as a dry powder. It may further be convenient to administer this powder via the pulmonary route.
Collapse
Affiliation(s)
- Max Beugeling
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen , Groningen , The Netherlands
| | - Jildou De Zee
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen , Groningen , The Netherlands
| | - Herman J Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen , Groningen , The Netherlands
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen , Groningen , The Netherlands
| | - Jan C Wilschut
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Wouter L J Hinrichs
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen , Groningen , The Netherlands
| |
Collapse
|
13
|
Mucosal Vaccination via the Respiratory Tract. Pharmaceutics 2019; 11:pharmaceutics11080375. [PMID: 31374959 PMCID: PMC6723941 DOI: 10.3390/pharmaceutics11080375] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 12/11/2022] Open
Abstract
Vaccine delivery via mucosal surfaces is an interesting alternative to parenteral vaccine administration, as it avoids the use of a needle and syringe. Mucosal vaccine administration also targets the mucosal immune system, which is the largest lymphoid tissue in the human body. The mucosal immune response involves systemic, antigen-specific humoral and cellular immune response in addition to a local response which is characterised by a predominantly cytotoxic T cell response in combination with secreted IgA. This antibody facilitates pathogen recognition and deletion prior to entrance into the body. Hence, administration via the respiratory mucosa can be favoured for all pathogens which use the respiratory tract as entry to the body, such as influenza and for all diseases directly affecting the respiratory tract such as pneumonia. Additionally, the different mucosal tissues of the human body are interconnected via the so-called “common mucosal immune system”, which allows induction of an antigen-specific immune response in distant mucosal sites. Finally, mucosal administration is also interesting in the area of therapeutic vaccination, in which a predominant cellular immune response is required, as this can efficiently be induced by this route of delivery. The review gives an introduction to respiratory vaccination, formulation approaches and application strategies.
Collapse
|
14
|
Yeung S, Traini D, Tweedie A, Lewis D, Church T, Young PM. Assessing Aerosol Performance of a Dry Powder Carrier Formulation with Increasing Doses Using a Novel Inhaler. AAPS PharmSciTech 2019; 20:94. [PMID: 30690674 DOI: 10.1208/s12249-019-1302-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/03/2019] [Indexed: 02/02/2023] Open
Abstract
This study aims to investigate the implications of loaded formulation mass on aerosol performance using a reservoir novel dry powder inhaler containing a custom dosing cup to deliver carrier-based formulation to the lungs. A 3D printed dosing cup with volume size of 133.04 mm3 was manufactured to allow for the progressive loading of different carrier formulation masses of 1% beclomethasone dipropionate BDP (w/w) formulation (10 to 60 mg, with increments of 10 mg), in a novel customizable DPI device. Scanning electron micrographs were used to investigate BDP detachment from carrier particles post-aerosolisation and particle deposition on the USP induction port. The subsequent aerosol performance analysis was performed using the next generation impactor (NGI). Incrementally increasing the loading mass to 60 mg led to decreases in BDP detachment from carrier particles, resulting in significant decreases in aerosol performance. Increases in loading dose mass led to progressively decreased detachment of BDP from the carrier and the overall aerosol performance in comparison to the initial mass of 10 mg. These results are likely to be due to a decrease in void volume within the dosing cup with increased loading mass leading to altered airflow, decreased impaction forces and the possibility of a significant quantity of large carrier particles introducing a 'sweeping' effect on the inhaler inner surface. This study has shown that despite the decreased BDP detachment from the carrier and decreased aerosol performance, the dose delivered to the lung still increased due to the higher loaded dose.
Collapse
|
15
|
Lee HJ, Kwon IH, Lee HG, Kwon YB, Woo HM, Cho SM, Choi YW, Chon J, Kim K, Kim DW, Park CW. Spiral mouthpiece design in a dry powder inhaler to improve aerosolization. Int J Pharm 2018; 553:149-156. [DOI: 10.1016/j.ijpharm.2018.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/30/2018] [Accepted: 10/14/2018] [Indexed: 10/28/2022]
|
16
|
Buttini F, Balducci AG, Colombo G, Sonvico F, Montanari S, Pisi G, Rossi A, Colombo P, Bettini R. Dose administration maneuvers and patient care in tobramycin dry powder inhalation therapy. Int J Pharm 2018; 548:182-191. [DOI: 10.1016/j.ijpharm.2018.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/01/2018] [Accepted: 06/03/2018] [Indexed: 12/17/2022]
|
17
|
Bhide Y, Tomar J, Dong W, de Vries-Idema J, Frijlink HW, Huckriede A, Hinrichs WLJ. Pulmonary delivery of influenza vaccine formulations in cotton rats: site of deposition plays a minor role in the protective efficacy against clinical isolate of H1N1pdm virus. Drug Deliv 2018; 25:533-545. [PMID: 29451040 PMCID: PMC6058687 DOI: 10.1080/10717544.2018.1435748] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Administration of influenza vaccines to the lungs could be an attractive alternative to conventional parenteral administration. In this study, we investigated the deposition site of pulmonary delivered liquid and powder influenza vaccine formulations and its relation to their immunogenicity and protective efficacy. In vivo deposition studies in cotton rats revealed that, the powder formulation was mainly deposited in the trachea ( ∼ 65%) whereas the liquid was homogenously distributed throughout the lungs ( ∼ 96%). In addition, only 60% of the antigen in the powder formulation was deposited in the respiratory tract with respect to the liquid formulation. Immunogenicity studies showed that pulmonary delivered liquid and powder influenza formulations induced robust systemic and mucosal immune responses (significantly higher by liquids than by powders). When challenged with a clinical isolate of homologous H1N1pdm virus, all animals pulmonary administered with placebo had detectable virus in their lungs one day post challenge. In contrast, none of the vaccinated animals had detectable lung virus titers, except for two out of eight animals from the powder immunized group. Also, pulmonary vaccinated animals showed no or little signs of infection like increase in breathing frequency or weight loss upon challenge as compared to animals from the negative control group. In conclusion, immune responses induced by liquid formulation were significantly higher than responses induced by powder formulation, but the overall protective efficacy of both formulations was comparable. Thus, pulmonary immunization is capable of inducing protective immunity and the site of antigen deposition seems to be of minor relevance in inducing protection.
Collapse
Affiliation(s)
- Yoshita Bhide
- a Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Jasmine Tomar
- b Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - Wei Dong
- a Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Jacqueline de Vries-Idema
- a Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Henderik W Frijlink
- b Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - Anke Huckriede
- a Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Wouter L J Hinrichs
- b Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| |
Collapse
|
18
|
Sibum I, Hagedoorn P, de Boer AH, Frijlink HW, Grasmeijer F. Challenges for pulmonary delivery of high powder doses. Int J Pharm 2018; 548:325-336. [PMID: 29991452 DOI: 10.1016/j.ijpharm.2018.07.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/20/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
Abstract
In recent years there is an increasing interest in the pulmonary delivery of large cohesive powder doses, i.e. drugs with a low potency such as antibiotics or drugs with a high potency that need a substantial fraction of excipient(s) such as vaccines stabilized in sugar glasses. The pulmonary delivery of high powder doses comes with unique challenges. For low potency drugs, the use of excipients should be minimized to limit the powder mass to be inhaled as much as possible. To achieve this objective the inhaler design should be adapted to the properties of the API in order to achieve a compatible combination of the drug formulation and inhaler device. The inhaler should have an appropriate powder dosing principle for which prefilled compartments seem most appropriate. The drug formulation should not only allow for accurate filling of these compartments but also enable efficient compartment emptying during inhalation. The dispersion principle must have the capacity to disperse considerable amounts of powder in a short time frame that allows the powder to reach the deep lung. Last, but not least, the inhaler should be simple and intuitive in use, be cost-effective and exhibit accurate and consistent, preferably patient independent, pulmonary delivery performance.
Collapse
Affiliation(s)
- Imco Sibum
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands.
| | - Paul Hagedoorn
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Anne Haaije de Boer
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Henderik Willem Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Floris Grasmeijer
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
19
|
Scherließ R, Etschmann C. DPI formulations for high dose applications - Challenges and opportunities. Int J Pharm 2018; 548:49-53. [PMID: 29940300 DOI: 10.1016/j.ijpharm.2018.06.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/08/2018] [Accepted: 06/17/2018] [Indexed: 02/07/2023]
Abstract
This opinion piece gives reasons for high dose DPI applications, points out challenges and shows opportunities and possible solutions for high dose DPI. This piece of work shall set the stage for more in-depth reviews of state of the art and research papers addressing the challenges of high dose DPI which shall be included in the special issue of IJP.
Collapse
Affiliation(s)
- Regina Scherließ
- Department of Pharmaceutics and Biopharmaceutics, Kiel University, Grasweg 9a, 24118 Kiel, Germany.
| | - Christian Etschmann
- Department of Pharmaceutics and Biopharmaceutics, Kiel University, Grasweg 9a, 24118 Kiel, Germany
| |
Collapse
|
20
|
Kanojia G, Have RT, Soema PC, Frijlink H, Amorij JP, Kersten G. Developments in the formulation and delivery of spray dried vaccines. Hum Vaccin Immunother 2018; 13:2364-2378. [PMID: 28925794 PMCID: PMC5647985 DOI: 10.1080/21645515.2017.1356952] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Spray drying is a promising method for the stabilization of vaccines, which are usually formulated as liquids. Usually, vaccine stability is improved by spray drying in the presence of a range of excipients. Unlike freeze drying, there is no freezing step involved, thus the damage related to this step is avoided. The edge of spray drying resides in its ability for particles to be engineered to desired requirements, which can be used in various vaccine delivery methods and routes. Although several spray dried vaccines have shown encouraging preclinical results, the number of vaccines that have been tested in clinical trials is limited, indicating a relatively new area of vaccine stabilization and delivery. This article reviews the current status of spray dried vaccine formulations and delivery methods. In particular it discusses the impact of process stresses on vaccine integrity, the application of excipients in spray drying of vaccines, process and formulation optimization strategies based on Design of Experiment approaches as well as opportunities for future application of spray dried vaccine powders for vaccine delivery.
Collapse
Affiliation(s)
- Gaurav Kanojia
- a Intravacc (Institute for Translational Vaccinology) , Bilthoven , The Netherlands.,b Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - Rimko Ten Have
- a Intravacc (Institute for Translational Vaccinology) , Bilthoven , The Netherlands
| | - Peter C Soema
- a Intravacc (Institute for Translational Vaccinology) , Bilthoven , The Netherlands
| | - Henderik Frijlink
- b Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | | | - Gideon Kersten
- a Intravacc (Institute for Translational Vaccinology) , Bilthoven , The Netherlands.,c Division of Drug Delivery Technology, Leiden Academic Center for Drug Research , Leiden University , Leiden , The Netherlands
| |
Collapse
|
21
|
|
22
|
Pulmonary Pharmacokinetics of Colistin following Administration of Dry Powder Aerosols in Rats. Antimicrob Agents Chemother 2017; 61:AAC.00973-17. [PMID: 28807905 DOI: 10.1128/aac.00973-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/06/2017] [Indexed: 01/05/2023] Open
Abstract
Colistin has been administered via nebulization for the treatment of respiratory tract infections. Recently, dry powder inhalation (DPI) has attracted increasing attention. The current study aimed to investigate the pharmacokinetics (PK) of colistin in epithelial lining fluid (ELF) and plasma following DPI and intravenous (i.v.) administration in healthy Sprague-Dawley rats. Rats were given colistin as DPI intratracheally (0.66 and 1.32 mg base/kg of body weight) or i.v. injection (0.66 mg base/kg). Histopathological examination of lung tissue was performed at 24 h. Colistin concentrations in both ELF and plasma were quantified, and a population PK model was developed and compared to a previously published PK model of nebulized colistin in rats. A two-compartment structural model was developed to describe the PK of colistin in both ELF and plasma following pulmonary or i.v. administration. The model-estimated clearance from the central plasma compartment was 0.271 liter/h/kg (standard error [SE] = 2.51%). The transfer of colistin from the ELF compartment to the plasma compartment was best described by a first-order rate constant (clearance of colistin from the ELF compartment to the plasma compartment = 4.03 × 10-4 liter/h/kg, SE = 15%). DPI appeared to have a higher rate of absorption (time to the maximum concentration in plasma after administration of colistin by DPI, ≤10 min) than nebulization (time to the maximum concentration in plasma after administration of colistin by nebulization, 20 to 30 min), but the systemic bioavailabilities by the two routes of administration were similar (∼46.5%, SE = 8.43%). Histopathological examination revealed no significant differences in inflammation in lung tissues between the two treatments. Our findings suggest that colistin DPI is a promising alternative to nebulization considering the similar PK and safety profiles of the two forms of administration. The PK and histopathological information obtained is critical for the development of optimal aerosolized colistin regimens with activity against lung infections caused by Gram-negative bacteria.
Collapse
|
23
|
van der Wiel E, Lexmond AJ, van den Berge M, Postma DS, Hagedoorn P, Frijlink HW, Farenhorst MP, de Boer AH, Ten Hacken NHT. Targeting the small airways with dry powder adenosine: a challenging concept. Eur Clin Respir J 2017; 4:1369328. [PMID: 29057065 PMCID: PMC5642194 DOI: 10.1080/20018525.2017.1369328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/28/2017] [Indexed: 12/04/2022] Open
Abstract
Background: Small-particle inhaled corticosteroids (ICS) provide a higher small airway deposition than large-particle ICS. However, we are still not able to identify asthma patients who will profit most from small-particle treatment. Objective: We aimed to identify these patients by selectively challenging the small and large airways. We hypothesized that the airways could be challenged selectively using small- and large-particle adenosine, both inhaled at a high and a low flow rate. Design: In this cross-over study 11 asthma subjects performed four dry powder adenosine tests, with either small (MMAD 2.7 µm) or large (MMAD 6.0 µm) particles, inhaled once with a low flow rate (30 l min–1) and once with a high flow rate (60 l min–1). Spirometry and impulse oscillometry were performed after every bronchoprovocation step. We assumed that FEV1 reflects the large airways, and FEF25–75%, R5-R20 and X5 reflect the small airways. Results: The four adenosine tests were not significantly different with respect to the threshold values of FEV1 (p = 0.12), FEF25–75% (p = 0.37), R5-R20 (p = 0.60) or X5 (p = 0.46). Both small- and large-particle adenosine induced a response in the small airways in the majority of the tests. Conclusions: In contrast to our hypothesis, all four adenosine tests provoked a response in the small airways and we could not identify different large- or small-airway responders. Interestingly, even the test with large particles and a high flow rate induced a small-airway response, suggesting that selective challenging of the small airways is not necessary. Future studies should investigate the relation between particle deposition and the site of an airway response.
Collapse
Affiliation(s)
- Erica van der Wiel
- Department of Pulmonary Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anne J Lexmond
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands
| | - Maarten van den Berge
- Department of Pulmonary Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dirkje S Postma
- Department of Pulmonary Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Paul Hagedoorn
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands
| | - Martijn P Farenhorst
- Lung Function Department, University Medical Center Groningen, Groningen, the Netherlands
| | - Anne H de Boer
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands
| | - Nick H T Ten Hacken
- Department of Pulmonary Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
24
|
Optimization of a DPI Inhaler: A Computational Approach. J Pharm Sci 2017; 106:850-858. [DOI: 10.1016/j.xphs.2016.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/02/2016] [Accepted: 11/08/2016] [Indexed: 11/20/2022]
|
25
|
de Boer AH, Hagedoorn P, Hoppentocht M, Buttini F, Grasmeijer F, Frijlink HW. Dry powder inhalation: past, present and future. Expert Opin Drug Deliv 2016; 14:499-512. [PMID: 27534768 DOI: 10.1080/17425247.2016.1224846] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Early dry powder inhalers (DPIs) were designed for low drug doses in asthma and COPD therapy. Nearly all concepts contained carrier-based formulations and lacked efficient dispersion principles. Therefore, particle engineering and powder processing are increasingly applied to achieve acceptable lung deposition with these poorly designed inhalers. Areas covered: The consequences of the choices made for early DPI development with respect of efficacy, production costs and safety and the tremendous amount of energy put into understanding and controlling the dispersion performance of adhesive mixtures are discussed. Also newly developed particle manufacturing and powder formulation processes are presented as well as the challenges, objectives, and new tools available for future DPI design. Expert opinion: Improved inhaler design is desired to make DPIs for future applications cost-effective and safe. With an increasing interest in high dose drug delivery, vaccination and systemic delivery via the lungs, innovative formulation technologies alone may not be sufficient. Safety is served by increasing patient adherence to the therapy, minimizing the use of unnecessary excipients and designing simple and self-intuitive inhalers, which give good feedback to the patient about the inhalation maneuver. For some applications, like vaccination and delivery of hygroscopic formulations, disposable inhalers may be preferred.
Collapse
Affiliation(s)
- A H de Boer
- a Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - P Hagedoorn
- a Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - M Hoppentocht
- a Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - F Buttini
- b Department of Pharmacy , University of Parma , Parma , Italy
| | - F Grasmeijer
- a Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| | - H W Frijlink
- a Department of Pharmaceutical Technology and Biopharmacy , University of Groningen , Groningen , The Netherlands
| |
Collapse
|
26
|
Parumasivam T, Chang RYK, Abdelghany S, Ye TT, Britton WJ, Chan HK. Dry powder inhalable formulations for anti-tubercular therapy. Adv Drug Deliv Rev 2016; 102:83-101. [PMID: 27212477 DOI: 10.1016/j.addr.2016.05.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 12/31/2022]
Abstract
Tuberculosis (TB) is an intracellular infectious disease caused by the airborne bacterium, Mycobacterium tuberculosis. Despite considerable research efforts, the treatment of TB continues to be a great challenge in part due to the requirement of prolonged therapy with multiple high-dose drugs and associated side effects. The delivery of pharmacological agents directly to the respiratory system, following the natural route of infection, represents a logical therapeutic approach for treatment or vaccination against TB. Pulmonary delivery is non-invasive, avoids first-pass metabolism in the liver and enables targeting of therapeutic agents to the infection site. Inhaled delivery also potentially reduces the dose requirement and the accompanying side effects. Dry powder is a stable formulation of drug that can be stored without refrigeration compared to liquids and suspensions. The dry powder inhalers are easy to use and suitable for high-dose formulations. This review focuses on the current innovations of inhalable dry powder formulations of drug and vaccine delivery for TB, including the powder production method, preclinical and clinical evaluations of inhaled dry powder over the last decade. Finally, the risks associated with pulmonary therapy are addressed. A novel dry powder formulation with high percentages of respirable particles coupled with a cost effective inhaler device is an appealing platform for TB drug delivery.
Collapse
Affiliation(s)
- Thaigarajan Parumasivam
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Rachel Yoon Kyung Chang
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Sharif Abdelghany
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Jordan, Amman 1192, Jordan
| | - Tian Tian Ye
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Warwick John Britton
- Tuberculosis Research Program, Centenary Institute, The University of Sydney, NSW 2006, Australia; Infectious Diseases and Immunology, Sydney Medical School, The University of Sydney, NSW 2006, Australia
| | - Hak-Kim Chan
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia.
| |
Collapse
|
27
|
Tomar J, Born PA, Frijlink HW, Hinrichs WLJ. Dry influenza vaccines: towards a stable, effective and convenient alternative to conventional parenteral influenza vaccination. Expert Rev Vaccines 2016; 15:1431-1447. [DOI: 10.1080/14760584.2016.1182869] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
28
|
Tissue heme oxygenase-1 exerts anti-inflammatory effects on LPS-induced pulmonary inflammation. Mucosal Immunol 2016; 9:98-111. [PMID: 25943274 DOI: 10.1038/mi.2015.39] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 04/01/2015] [Indexed: 02/04/2023]
Abstract
Heme oxygenase-1 (HO-1) has been shown to display anti-inflammatory properties in models of acute pulmonary inflammation. For the first time, we investigated the role of leukocytic HO-1 using a model of HO-1(flox/flox) mice lacking leukocytic HO-1 that were subjected to lipopolysaccharide (LPS)-induced acute pulmonary inflammation. Immunohistology and flow cytometry demonstrated that activation of HO-1 using hemin decreased migration of polymorphonuclear leukocytes (PMNs) to the lung interstitium and bronchoalveolar lavage (BAL) in the wild-type and, surprisingly, also in HO-1(flox/flox) mice, emphasizing the anti-inflammatory potential of nonmyeloid HO-1. Nevertheless, hemin reduced the CXCL1, CXCL2/3, tumor necrosis factor-α (TNFα), and interleukin 6 (IL6) levels in both animal strains. Microvascular permeability was attenuated by hemin in wild-type and HO-1(flox/flox) mice, indicating a crucial role of non-myeloid HO-1 in endothelial integrity. The determination of the activity of HO-1 in mouse lungs revealed no compensatory increase in the HO-1(flox/flox) mice. Topical administration of hemin via inhalation reduced the dose required to attenuate PMN migration and microvascular permeability by a factor of 40, emphasizing its clinical potential. In addition, HO-1 stimulation was protective against pulmonary inflammation when initiated after the inflammatory stimulus. In conclusion, nonmyeloid HO-1 is crucial for the anti-inflammatory effect of this enzyme on PMN migration to different compartments of the lung and on microvascular permeability.
Collapse
|
29
|
Berkenfeld K, Lamprecht A, McConville JT. Devices for dry powder drug delivery to the lung. AAPS PharmSciTech 2015; 16:479-90. [PMID: 25964142 PMCID: PMC4444630 DOI: 10.1208/s12249-015-0317-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 02/25/2015] [Indexed: 11/30/2022] Open
Abstract
Dry powder inhalers (DPIs) are an important and increasingly investigated method of modern therapy for a growing number of respiratory diseases. DPIs are a promising option for certain patient populations, and may help to overcome several limitations that are associated with other types of inhalation delivery systems (e.g., accuracy and reproducibility of the dose delivered, compliance and adherence issues, or environmental aspects). Today, more than 20 different dry powder inhalers are on the market to deliver active pharmaceutical ingredients (APIs) for local and/or systemic therapy. Depending on the mechanism of deagglomeration, aerosolization, dose metering accuracy, and the interpatient variability, dry powder inhalers demonstrate varying performance levels. During development, manufacturers focus on improving aspects characteristic of their specific DPI devices, depending on the intended type of application and any particular requirements associated with it. With the wide variety of applications related to specific APIs, there exists a range of different devices with distinct features. In addition to the routinely used multi-use DPIs, several single-use disposable devices are under development or already approved. The recent introduction of disposable devices will expand the range of possible applications for use by including agents such as vaccines, analgesics, or even rescue medications. This review article discusses the performance and advantages of recently approved dry powder inhalers as well as disposable single-use inhalers that are currently under development.
Collapse
Affiliation(s)
- Kai Berkenfeld
- />College of Pharmacy, University of New Mexico, Albuquerque, New Mexico USA
- />Laboratory of Pharmaceutical Technology and Biopharmaceutics, Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Alf Lamprecht
- />Laboratory of Pharmaceutical Technology and Biopharmaceutics, Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Jason T. McConville
- />College of Pharmacy, University of New Mexico, Albuquerque, New Mexico USA
- />Laboratory of Pharmaceutical Technology and Biopharmaceutics, Friedrich-Wilhelms-Universität, Bonn, Germany
| |
Collapse
|
30
|
Spray-dried amikacin sulphate powder for inhalation in cystic fibrosis patients: The role of ethanol in particle formation. Eur J Pharm Biopharm 2015; 93:165-72. [DOI: 10.1016/j.ejpb.2015.03.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 01/16/2023]
|
31
|
Inhaled antimicrobial therapy – Barriers to effective treatment. Adv Drug Deliv Rev 2015; 85:24-43. [DOI: 10.1016/j.addr.2014.08.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/20/2014] [Accepted: 08/25/2014] [Indexed: 02/08/2023]
|
32
|
de Boer A, Hoppentocht M. Comment on: inhaled antimicrobial therapy-Barriers to effective treatment, by J.Weers, Adv. Drug Deliv. Rev. (2014), http://dx.doi.org/ 10.1016/j.addr.2014.08.013. Adv Drug Deliv Rev 2015; 85:e1-2. [PMID: 25913565 DOI: 10.1016/j.addr.2015.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
33
|
The Cyclops for pulmonary delivery of aminoglycosides; a new member of the Twincer™ family. Eur J Pharm Biopharm 2015; 90:8-15. [DOI: 10.1016/j.ejpb.2015.01.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/10/2015] [Accepted: 01/13/2015] [Indexed: 11/18/2022]
|
34
|
de Boer AH, Hagedoorn P. The role of disposable inhalers in pulmonary drug delivery. Expert Opin Drug Deliv 2014; 12:143-57. [DOI: 10.1517/17425247.2014.952626] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
35
|
Loira-Pastoriza C, Todoroff J, Vanbever R. Delivery strategies for sustained drug release in the lungs. Adv Drug Deliv Rev 2014; 75:81-91. [PMID: 24915637 DOI: 10.1016/j.addr.2014.05.017] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/15/2014] [Accepted: 05/28/2014] [Indexed: 01/09/2023]
Abstract
Drug delivery to the lungs by inhalation offers a targeted drug therapy for respiratory diseases. However, the therapeutic efficacy of inhaled drugs is limited by their rapid clearance in the lungs. Carriers providing sustained drug release in the lungs can improve therapeutic outcomes of inhaled medicines because they can retain the drug load within the lungs and progressively release the drug locally at therapeutic levels. This review presents the different formulation strategies developed to control drug release in the lungs including microparticles and the wide array of nanomedicines. Large and porous microparticles offer excellent aerodynamic properties. Their large geometric size reduces their uptake by alveolar macrophages, making them a suitable carrier for sustained drug release in the lungs. Similarly, nanocarriers present significant potential for prolonged drug release in the lungs because they largely escape uptake by lung-surface macrophages and can remain in the pulmonary tissue for weeks. They can be embedded in large and porous microparticles in order to facilitate their delivery to the lungs. Conjugation of drugs to polymers as polyethylene glycol can be particularly beneficial to sustain the release of proteins in the lungs as it allows high protein loading. Drug conjugates can be readily delivered to respiratory airways by any current nebulizer device. Nonetheless, liposomes represent the formulation most advanced in clinical development. Liposomes can be prepared with lipids endogenous to the lungs and are particularly safe. Their composition can be adjusted to modulate drug release and they can encapsulate both hydrophilic and lipophilic compounds with high drug loading.
Collapse
Affiliation(s)
- Cristina Loira-Pastoriza
- Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Julie Todoroff
- Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Rita Vanbever
- Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| |
Collapse
|
36
|
Healy AM, Amaro MI, Paluch KJ, Tajber L. Dry powders for oral inhalation free of lactose carrier particles. Adv Drug Deliv Rev 2014; 75:32-52. [PMID: 24735676 DOI: 10.1016/j.addr.2014.04.005] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/24/2014] [Accepted: 04/04/2014] [Indexed: 02/07/2023]
Abstract
Dry powder inhaler (DPI) products have traditionally comprised a simple formulation of micronised drug mixed with a carrier excipient, typically lactose monohydrate. The presence of the carrier is aimed at overcoming issues of poor flowability and dispersibility, associated with the cohesive nature of small, micronised active pharmaceutical ingredient (API) particles. Both the powder blend and the DPI device must be carefully designed so as to ensure detachment of the micronised drug from the carrier excipient on inhalation. Over the last two decades there has been a significant body of research undertaken on the design of carrier-free formulations for DPI products. Many of these formulations are based on sophisticated particle engineering techniques; a common aim in formulation design of carrier-free products being to reduce the intrinsic cohesion of the particles, while maximising dispersion and delivery from the inhaler. In tandem with the development of alternative formulations has been the development of devices designed to ensure the efficient delivery and dispersion of carrier-free powder on inhalation. In this review we examine approaches to both the powder formulation and inhaler design for carrier-free DPI products.
Collapse
|
37
|
Chan JGY, Wong J, Zhou QT, Leung SSY, Chan HK. Advances in device and formulation technologies for pulmonary drug delivery. AAPS PharmSciTech 2014; 15:882-97. [PMID: 24728868 DOI: 10.1208/s12249-014-0114-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/13/2014] [Indexed: 12/31/2022] Open
Abstract
Inhaled pharmaceuticals are formulated and delivered differently according to the therapeutic indication. However, specific device-formulation coupling is often fickle, and new medications or indications also demand new strategies. The discontinuation of chlorofluorocarbon propellants has seen replacement of older metered dose inhalers with dry powder inhaler formulations. High-dose dry powder inhalers are increasingly seen as an alternative dosage form for nebulised medications. In other cases, new medications have completely bypassed conventional inhalers and been formulated for use with unique inhalers such as the Staccato® device. Among these different devices, integration of software and electronic assistance has become a shared trend. This review covers recent device and formulation advances that are forming the current landscape of inhaled therapeutics.
Collapse
|
38
|
Zhou Q(T, Tang P, Leung SSY, Chan JGY, Chan HK. Emerging inhalation aerosol devices and strategies: where are we headed? Adv Drug Deliv Rev 2014; 75:3-17. [PMID: 24732364 DOI: 10.1016/j.addr.2014.03.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 03/23/2014] [Accepted: 03/24/2014] [Indexed: 02/07/2023]
Abstract
Novel inhaled therapeutics including antibiotics, vaccines and anti-hypertensives, have led to innovations in designing suitable delivery systems. These emerging design technologies are in urgent demand to ensure high aerosolisation performance, consistent efficacy and satisfactory patient adherence. Recent vibrating-mesh and software technologies have resulted in nebulisers that have remarkably accurate dosing and portability. Alternatively, dry powder inhalers (DPIs) have become highly favourable for delivering high-dose and single-dose drugs with the aid of advanced particle engineering. In contrast, innovations are needed to overcome the technical constrains in drug-propellant incompatibility and delivering high-dose drugs with pressurised metered dose inhalers (pMDIs). This review discusses recent and emerging trends in pulmonary drug delivery systems.
Collapse
|
39
|
Hoppentocht M, Hagedoorn P, Frijlink H, de Boer A. Technological and practical challenges of dry powder inhalers and formulations. Adv Drug Deliv Rev 2014; 75:18-31. [PMID: 24735675 DOI: 10.1016/j.addr.2014.04.004] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 03/17/2014] [Accepted: 04/04/2014] [Indexed: 11/27/2022]
Abstract
In the 50 years following the introduction of the first dry powder inhaler to the market, several developments have occurred. Multiple-unit dose and multi-dose devices have been introduced, but first generation capsule inhalers are still widely used for new formulations. Many new particle engineering techniques have been developed and considerable effort has been put in understanding the mechanisms that control particle interaction and powder dispersion during inhalation. Yet, several misconceptions about optimal inhaler performance manage to survive in modern literature. It is, for example still widely believed that a flow rate independent fine particle fraction contributes to an inhalation performance independent therapy, that dry powder inhalers perform best at 4 kPa (or 60 L/min) and that a high resistance device cannot be operated correctly by patients with reduced lung function. Nevertheless, there seems to be a great future for dry powder inhalation. Many new areas of interest for dry powder inhalation are explored and with the assistance of new techniques like computational fluid dynamics and emerging particle engineering technologies, this is likely to result in a new generation of inhaler devices and formulations, that will enable the introduction of new therapies based on inhaled medicines.
Collapse
|
40
|
Abstract
The market for inhalable dry powder medication has consistently grown over past years. Targeting the lungs has been recognized to offer several advantages compared with oral application of drugs. The successive development of inhalation products has led to advances in local treatment of different respiratory diseases, but has also demonstrated the possibility to utilize the lungs for systemic drug delivery. Since a dry powder inhalation product is always a combination of drug formulation and inhalation device, the requirements for the development of such a system may be particularly complex. Therefore, this review aims to give an overview of the necessary considerations for a successful dry powder inhaler development.
Collapse
|
41
|
Lexmond AJ, van der Wiel E, Hagedoorn P, Bult W, Frijlink HW, ten Hacken NHT, de Boer AH. Adenosine dry powder inhalation for bronchial challenge testing, part 2: proof of concept in asthmatic subjects. Eur J Pharm Biopharm 2014; 88:148-52. [PMID: 24780441 DOI: 10.1016/j.ejpb.2014.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
Adenosine is an indirect stimulus to assess bronchial hyperresponsiveness (BHR(2)) in asthma. Bronchial challenge tests are usually performed with nebulised solutions of adenosine 5'-monophosphate (AMP(3)). The nebulised AMP test has several disadvantages, like long administration times and a restrictive maximum concentration that does not result in BHR in all patients. In this study, we investigated the applicability of dry powder adenosine for assessment of BHR in comparison to nebulised AMP. Dry powder adenosine was prepared in doubling doses (0.01-80 mg) derived from the nebulised AMP test with addition of two higher doses. Five asthmatic subjects performed two bronchial challenge tests, one with nebulised AMP following the 2-min tidal breathing method; the second with dry powder adenosine administered with an investigational inhaler and single slow inhalations (inspiratory flow rate 30-40 L/min). All subjects reached a 20% fall in FEV₁(4) with the new adenosine test (PD20(5)) compared to four subjects with the AMP test (PC₂₀(6)). Dry powder adenosine was well tolerated by all subjects and better appreciated than nebulised AMP. In conclusion, this new bronchial challenge test appears to be a safe and convenient alternative to the nebulised AMP test to assess BHR in asthmatic subjects.
Collapse
Affiliation(s)
- Anne J Lexmond
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Groningen, The Netherlands.
| | - Erica van der Wiel
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Paul Hagedoorn
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Groningen, The Netherlands.
| | - Wouter Bult
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.
| | - Henderik W Frijlink
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Groningen, The Netherlands.
| | - Nick H T ten Hacken
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Anne H de Boer
- University of Groningen, Department of Pharmaceutical Technology and Biopharmacy, Groningen, The Netherlands.
| |
Collapse
|
42
|
Hoppentocht M, Hagedoorn P, Frijlink H, de Boer A. Developments and strategies for inhaled antibiotic drugs in tuberculosis therapy: A critical evaluation. Eur J Pharm Biopharm 2014; 86:23-30. [DOI: 10.1016/j.ejpb.2013.10.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/21/2013] [Accepted: 10/28/2013] [Indexed: 01/17/2023]
|
43
|
Hoe S, Boraey MA, Ivey JW, Finlay WH, Vehring R. Manufacturing and device options for the delivery of biotherapeutics. J Aerosol Med Pulm Drug Deliv 2013; 27:315-28. [PMID: 24299502 DOI: 10.1089/jamp.2013.1090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Biotherapeutic aerosol formulations are an intense area of interest for systemic and local drug delivery. This article provides a short overview of typical factors required specifically for biotherapeutic aerosol formulation design, the processing options open for consideration, and the issue of inhalation device selection. Focusing on spray drying, four case studies are used to highlight the relevant issues, describing investigations into: (1) the mechanical stresses occurring in bacteriophage formulations during spray-dryer atomization; (2) modeling of the spray-dryer process and droplet drying kinetics, to assist process design and predictions of formulation stability; (3) a predictive approach to the design and processing of a five-component dry powder aerosol formulation; and (4) the survival of bacteriophages after pressurized metered dose inhaler atomization.
Collapse
Affiliation(s)
- Susan Hoe
- Department of Mechanical Engineering, University of Alberta , Edmonton, AB, Canada
| | | | | | | | | |
Collapse
|
44
|
Claus S, Weiler C, Schiewe J, Friess W. How can we bring high drug doses to the lung? Eur J Pharm Biopharm 2013; 86:1-6. [PMID: 24300444 DOI: 10.1016/j.ejpb.2013.11.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/28/2013] [Accepted: 11/25/2013] [Indexed: 11/28/2022]
Abstract
In the last decades, dry powder inhalation has become a very attractive option for pulmonary drug delivery to treat lung diseases like cystic fibroses and lung infections. In contrast to the traditional pulmonary application of drugs for asthma and chronic obstructive pulmonary disease, these therapies require higher lung doses to be administered. The developments and improvements toward high dose powder pulmonary drug delivery are summarized and discussed in this chapter. These include the invention and improvement of novel inhaler devices as well as the further development of formulation principles and new powder engineering methods. The implementation of these strategies is subsequently described for some prototypes and formulations in research and development stage as well as for already marketed dry powder products. Finally, possible adverse effects that can occur after inhalation of high powder doses are shortly addressed.
Collapse
Affiliation(s)
- Sarah Claus
- Department of Pharmacy, Pharmaceutical Technology and Biopharmaceutics, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany
| | - Claudius Weiler
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Joerg Schiewe
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Wolfgang Friess
- Department of Pharmacy, Pharmaceutical Technology and Biopharmaceutics, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany.
| |
Collapse
|
45
|
Lexmond AJ, Hagedoorn P, van der Wiel E, Ten Hacken NHT, Frijlink HW, de Boer AH. Adenosine dry powder inhalation for bronchial challenge testing, part 1: inhaler and formulation development and in vitro performance testing. Eur J Pharm Biopharm 2013; 86:105-14. [PMID: 24140941 DOI: 10.1016/j.ejpb.2013.06.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/31/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
Abstract
Dry powder administration of adenosine by use of an effective inhaler may be an interesting alternative to nebulisation of adenosine 5'-monophosphate in bronchial challenge testing, because of a shorter administration time and more consistent delivered fine particle dose over the entire dose range. In this study, we tested various powder formulations and classifier based dispersion principles and investigated the in vitro performance of the most promising formulation/classifier combination in a new test inhaler system. Spray-dried formulations of either pure adenosine (100%) or adenosine and lactose as diluent (1% and 10% adenosine) were prepared to cover the entire expected dose range for adenosine (0.01-20mg). All three powders, in all 12 suggested doses, dispersed well with the newly developed test inhaler with a multiple air jet classifier disperser, into aerosols with an average volume median diameter of 3.1μm (3.0-3.3μm). For eleven out of 12 dose steps, the fine particle fractions<5μm as percent of the loaded dose varied within the range of 67-80% (mean: 74%). The new test concept allows for more consistent aerosol delivery over the entire dose range with narrower size distributions than nebulisation and thus may improve adenosine administration in bronchial challenge testing.
Collapse
Affiliation(s)
- Anne J Lexmond
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
| | - Paul Hagedoorn
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
| | - Erica van der Wiel
- Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Nick H T Ten Hacken
- Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
| | - Anne H de Boer
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
| |
Collapse
|
46
|
Zhou QT, Gengenbach T, Denman JA, Yu HH, Li J, Chan HK. Synergistic antibiotic combination powders of colistin and rifampicin provide high aerosolization efficiency and moisture protection. AAPS JOURNAL 2013; 16:37-47. [PMID: 24129586 DOI: 10.1208/s12248-013-9537-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/17/2013] [Indexed: 11/30/2022]
Abstract
For many respiratory infections caused by multidrug-resistant Gram-negative bacteria, colistin is the only effective antibiotic despite its nephrotoxicity. A novel inhaled combination formulation of colistin with a synergistic antimicrobial component of rifampicin was prepared via co-spray drying, aiming to deliver the drug directly to the respiratory tract and minimize drug resistance and adverse effects. Synergistic antibacterial activity against Acinetobacter baumannii was demonstrated for the combination formulation with high emitted doses (96%) and fine particle fraction total (FPFtotal; 92%). Storage of the spray-dried colistin alone formulation in the elevated relative humidity (RH) of 75% resulted in a substantial deterioration in the aerosolization performance because the amorphous colistin powders absorbed significant amount of water up to 30% by weight. In contrast, the FPFtotal values of the combination formulation stored at various RH were unchanged, which was similar to the aerosolization behavior of the spray-dried rifampicin-alone formulation. Advanced surface chemistry measurements by XPS and ToF-SIMS demonstrated a dominance of rifampicin on the combination particle surfaces, which contributed to the moisture protection at the elevated RH. This study shows a novel inhalable powder formulation of antibiotic combination with the combined beneficial properties of synergistic antibacterial activity, high aerosolization efficiency, and moisture protection.
Collapse
Affiliation(s)
- Qi Tony Zhou
- Advanced Drug Delivery Group, Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | | |
Collapse
|
47
|
Zhou Q(T, Morton DA, Yu HH, Jacob J, Wang J, Li J, Chan HK. Colistin Powders with High Aerosolisation Efficiency for Respiratory Infection: Preparation and In Vitro Evaluation. J Pharm Sci 2013; 102:3736-47. [DOI: 10.1002/jps.23685] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 07/01/2013] [Accepted: 07/10/2013] [Indexed: 11/12/2022]
|
48
|
Tonnis WF, Lexmond AJ, Frijlink HW, de Boer AH, Hinrichs WLJ. Devices and formulations for pulmonary vaccination. Expert Opin Drug Deliv 2013; 10:1383-97. [DOI: 10.1517/17425247.2013.810622] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
49
|
|
50
|
Grasmeijer F, Hagedoorn P, Frijlink HW, de Boer AH. Characterisation of high dose aerosols from dry powder inhalers. Int J Pharm 2012; 437:242-9. [DOI: 10.1016/j.ijpharm.2012.08.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/04/2012] [Accepted: 08/09/2012] [Indexed: 11/16/2022]
|