1
|
Rinderknecht CH, Ning M, Wu C, Wilson MS, Gampe C. Designing inhaled small molecule drugs for severe respiratory diseases: an overview of the challenges and opportunities. Expert Opin Drug Discov 2024; 19:493-506. [PMID: 38407117 DOI: 10.1080/17460441.2024.2319049] [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: 11/27/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Inhaled drugs offer advantages for the treatment of respiratory diseases over oral drugs by delivering the drug directly to the lung, thus improving the therapeutic index. There is an unmet medical need for novel therapies for lung diseases, exacerbated by a multitude of challenges for the design of inhaled small molecule drugs. AREAS COVERED The authors review the challenges and opportunities for the design of inhaled drugs for respiratory diseases with a focus on new target discovery, medicinal chemistry, and pharmacokinetic, pharmacodynamic, and toxicological evaluation of drug candidates. EXPERT OPINION Inhaled drug discovery is facing multiple unique challenges. Novel biological targets are scarce, as is the guidance for medicinal chemistry teams to design compounds with inhalation-compatible features. It is exceedingly difficult to establish a PK/PD relationship given the complexity of pulmonary PK and the impact of physical properties of the drug substance on PK. PK, PD and toxicology studies are technically challenging and require large amounts of drug substance. Despite the current challenges, the authors foresee that the design of inhaled drugs will be facilitated in the future by our increasing understanding of pathobiology, emerging medicinal chemistry guidelines, advances in drug formulation, PBPK models, and in vitro toxicology assays.
Collapse
Affiliation(s)
| | - Miaoran Ning
- Drug Metabolism and Pharmacokinetics, gRED, Genentech, South San Francisco, CA, USA
| | - Connie Wu
- Development Sciences Safety Assessment, Genentech, South San Francisco, CA, USA
| | - Mark S Wilson
- Discovery Immunology, gRED, Genentech, South San Francisco, CA, USA
| | - Christian Gampe
- Discovery Chemistry, gRED, Genentech, South San Francisco, CA, USA
| |
Collapse
|
2
|
Martinez Ledo A, Thibodeaux S, Duong L, Altinoglu E, Dimke T, Shaw D, Rowlands D, Growcott E. Aerosol technology to mimic dry powder inhalation in vitro using pulmonary cell models. Eur J Pharm Biopharm 2023:S0939-6411(23)00123-6. [PMID: 37196872 DOI: 10.1016/j.ejpb.2023.05.009] [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: 02/28/2023] [Revised: 04/21/2023] [Accepted: 05/10/2023] [Indexed: 05/19/2023]
Abstract
Inhaled therapy confers key advantages for the treatment of topical pulmonary diseases and offers potential for systemic delivery of medicines. Dry powder inhalers (DPIs) are generally the preferred devices for pulmonary delivery due to improved stability and satisfactory patient compliance. However, the mechanisms governing drug powder dissolution and availability in the lung and poorly understood. Here, we report a new in vitro system to study epithelial absorption of inhaled dry powders in lung barrier models of the upper and lower airway. The system is based on a CULTEX® RFS (Radial Flow System) cell exposure module joined to a Vilnius aerosol generator and allows the coupling of drug dissolution and permeability assessments. The cellular models recapitulate the barrier morphology and function of healthy and diseased pulmonary epithelium and incorporate the mucosal barrier to enable the investigation of drug powder dissolution in biorelevant conditions. With this system, we found differences in permeability across the airway tree and pinpointed the impact of diseased barriers in paracellular drug transport. Furthermore, we identified a different rank order of permeability for compounds tested in solution or powder form. These results highlight the value of this in vitro drug aerosolization setup for use in research and development of inhaled medicines.
Collapse
Affiliation(s)
- Adriana Martinez Ledo
- Disease Area X, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States
| | - Stefan Thibodeaux
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States
| | - Lisa Duong
- Oncology, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States
| | - Erhan Altinoglu
- Chemical and Pharmaceutical Profiling, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States
| | - Thomas Dimke
- Pharmacokinetic Sciences, Novartis Institutes for BioMedical Research, CH-4056 Basel, Switzerland
| | - Duncan Shaw
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States
| | - David Rowlands
- Disease Area X, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States.
| | - Ellena Growcott
- Disease Area X, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, 02139, United States.
| |
Collapse
|
3
|
Rajasegaran T, How CW, Saud A, Ali A, Lim JCW. Targeting Inflammation in Non-Small Cell Lung Cancer through Drug Repurposing. Pharmaceuticals (Basel) 2023; 16:ph16030451. [PMID: 36986550 PMCID: PMC10051080 DOI: 10.3390/ph16030451] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Lung cancer is the most common cause of cancer-related deaths. Lung cancers can be classified as small-cell (SCLC) or non-small cell (NSCLC). About 84% of all lung cancers are NSCLC and about 16% are SCLC. For the past few years, there have been a lot of new advances in the management of NSCLC in terms of screening, diagnosis and treatment. Unfortunately, most of the NSCLCs are resistant to current treatments and eventually progress to advanced stages. In this perspective, we discuss some of the drugs that can be repurposed to specifically target the inflammatory pathway of NSCLC utilizing its well-defined inflammatory tumor microenvironment. Continuous inflammatory conditions are responsible to induce DNA damage and enhance cell division rate in lung tissues. There are existing anti-inflammatory drugs which were found suitable for repurposing in non-small cell lung carcinoma (NSCLC) treatment and drug modification for delivery via inhalation. Repurposing anti-inflammatory drugs and their delivery through the airway is a promising strategy to treat NSCLC. In this review, suitable drug candidates that can be repurposed to treat inflammation-mediated NSCLC will be comprehensively discussed together with their administration via inhalation from physico-chemical and nanocarrier perspectives.
Collapse
Affiliation(s)
- Thiviyadarshini Rajasegaran
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Chee Wun How
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia
| | - Anoosha Saud
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Azhar Ali
- Cancer Science Institute Singapore, National University of Singapore, Singapore 117599, Singapore
| | - Jonathan Chee Woei Lim
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Correspondence:
| |
Collapse
|
4
|
Zhang J, Wu K, Liu B, Hou S, Li X, Ye X, Liu J, He Q. Bioequivalence study of ipratropium bromide inhalation aerosol using PBPK modelling. Front Med (Lausanne) 2023; 10:1056318. [PMID: 36824609 PMCID: PMC9941642 DOI: 10.3389/fmed.2023.1056318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023] Open
Abstract
Aims Systemic pharmacokinetic (PK) studies can reflect the overall exposure of orally inhaled drug Products (OIDPs) in the blood after inhalation into the lung and can be used to evaluate the bioequivalence of test and reference products. The aim of this article is: (1) to study the PK characteristics and bioequivalence of ipratropium bromide (IB) inhalation aerosol, reference and test products in healthy Chinese subjects; (2) to establish a physiologically based pharmacokinetic (PBPK) model and verify the accuracy of the model in predicting bioequivalence; (3) attempt to use the model to predict the regional distribution of particles in the lung after inhalation, and discuss the effect of gastrointestinal drug absorption of IB on systemic exposure. Methods The study involved two clinical studies. Clinical study-1 (registration number: CTR20201284) was used with non-clinical data to construct and validate a PBPK model in the B2O simulator, a web-based virtual drug development platform. This model assessed different test and reference products' bioequivalence. Results were compared to a second clinical study (Clinical study-2: registration number CTR20202291). The particles' regional distribution in the lung and the gastrointestinal absorption effect on systemic exposure were discussed based on the simulation results. Results The established PBPK model successfully simulated the in vivo PK characteristics of IB inhalation aerosol, with r 2 close to 1. Gastrointestinal absorption had a negligible effect on systemic exposure. Particles accumulated in the alveolar area were cleared within an hour, followed by particles in the bronchioles and bronchi. Conclusion This model provided a reliable method for exploring the correlation between in vitro and in vivo PK studies of IB inhalation aerosols. According to the simulation results, the test and reference products were bioequivalent.
Collapse
Affiliation(s)
- Jisheng Zhang
- Wuxi People’s Hospital Affiliated with Nanjing Medical University, Wuxi, Jiangsu, China
| | - Keheng Wu
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Bo Liu
- School of Chemical Engineering and Pharmacy, Wuhan Institute of Technology, Wuhan, China
| | - Shuguang Hou
- Sichuan Purity Medical Technology Co., Ltd., Sichuan, China
| | - Xue Li
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Xiang Ye
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Jack Liu
- Yinghan Pharmaceutical Technology (Shanghai) Co., Ltd., Shanghai, China
| | - Qing He
- Wuxi People’s Hospital Affiliated with Nanjing Medical University, Wuxi, Jiangsu, China,*Correspondence: Qing He, ✉
| |
Collapse
|
5
|
Wesche F, De Maria L, Leek T, Narjes F, Bird J, Su W, Czechtizky W. Analyzing proteolytic stability and metabolic hotspots of therapeutic peptides in two rodent pulmonary fluids. J Pharm Biomed Anal 2023; 224:115156. [PMID: 36463768 DOI: 10.1016/j.jpba.2022.115156] [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: 09/21/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/20/2022]
Abstract
Peptides and peptide drug conjugates are emerging modalities to treat pulmonary diseases. Peptides are susceptible to proteolytic cleavage. Expression levels of specific proteases in the lung can be significantly increased in disease state and may lead to exaggerated peptide proteolysis. To support optimization of peptides for inhaled administration, we have recently reported a streamlined high-throughput LC-HRMS protocol to determine enzymatic protease stability of peptides. This method has now been complemented with profiling of peptide metabolic stability in two respiratory fluids, a lung supernatant (lung S9) and a bronchioalveolar lavage fluid (BALF) taken from rats. We have tested a set of 28 peptides with high structural diversity, analyzed the whole data set for formed metabolites, and identified the differences of cleavage pattern in the two test fluids. Comparison of our experimental results and literature-derived cleavage site estimates based on e.g. MEROPS show significant differences for a number of peptides. This indicates the need for an experimental workflow using both protease panels and testing of metabolic stability in lung fluid (BALF) to guide peptide optimization and selection of peptides for inhaled in vivo PK/PD studies in our drug discovery projects.
Collapse
Affiliation(s)
- Frank Wesche
- Boehringer Ingelheim Pharma GmbH & Co. KG, Drug Discovery Sciences, Birkendorfer Strasse 65, 88400 Biberach an der Riss, Germany; Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
| | - Leonardo De Maria
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Tomas Leek
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Frank Narjes
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - James Bird
- Drug Metabolism and Pharmacokinetics, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Wu Su
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Werngard Czechtizky
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| |
Collapse
|
6
|
Additive manufacturing in respiratory sciences - Current applications and future prospects. Adv Drug Deliv Rev 2022; 186:114341. [PMID: 35569558 DOI: 10.1016/j.addr.2022.114341] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/21/2022] [Accepted: 05/09/2022] [Indexed: 12/21/2022]
Abstract
Additive Manufacturing (AM) comprises a variety of techniques that enable fabrication of customised objects with specific attributes. The versatility of AM procedures and constant technological improvements allow for their application in the development of medicinal products and medical devices. This review provides an overview of AM applications related to respiratory sciences. For this purpose, both fields of research are briefly introduced and the potential benefits of integrating AM to respiratory sciences at different levels of pharmaceutical development are highlighted. Tailored manufacturing of microstructures as a particle design approach in respiratory drug delivery will be discussed. At the dosage form level, we exemplify AM as an important link in the iterative loop of data driven inhaler design, rapid prototyping and in vitro testing. This review also presents the application of bioprinting in the respiratory field for design of biorelevant in vitro cellular models, followed by an overview of AM-related processes in preventive and therapeutic care. Finally, this review discusses future prospects of AM as a component in a digital health environment.
Collapse
|
7
|
Bäckman P, Cabal A, Clark A, Ehrhardt C, Forbes B, Hastedt J, Hickey A, Hochhaus G, Jiang W, Kassinos S, Kuehl PJ, Prime D, Son YJ, Teague SP, Tehler U, Wylie J. iBCS. 2: Mechanistic Modeling of Pulmonary Availability of Inhaled Drugs versus Critical Product Attributes. Mol Pharm 2022; 19:2040-2047. [PMID: 35609877 PMCID: PMC9257747 DOI: 10.1021/acs.molpharmaceut.2c00112] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This work is the second in a series of publications outlining the fundamental principles and proposed design of a biopharmaceutics classifications system for inhaled drugs and drug products (the iBCS). Here, a mechanistic computer-based model has been used to explore the sensitivity of the primary biopharmaceutics functional output parameters: (i) pulmonary fraction dose absorbed (Fabs) and (ii) drug half-life in lumen (t1/2) to biopharmaceutics-relevant input attributes including dose number (Do) and effective permeability (Peff). Results show the nonlinear sensitivity of primary functional outputs to variations in these attributes. Drugs with Do < 1 and Peff > 1 × 10-6 cm/s show rapid (t1/2 < 20 min) and complete (Fabs > 85%) absorption from lung lumen into lung tissue. At Do > 1, dissolution becomes a critical drug product attribute and Fabs becomes dependent on regional lung deposition. The input attributes used here, Do and Peff, thus enabled the classification of inhaled drugs into parameter spaces with distinctly different biopharmaceutic risks. The implications of these findings with respect to the design of an inhalation-based biopharmaceutics classification system (iBCS) and to the need for experimental methodologies to classify drugs need to be further explored.
Collapse
Affiliation(s)
- Per Bäckman
- Emmace Consulting AB, Medicon Village, Scheelevägen 2, Lund SE-223 81, Sweden
| | - Antonio Cabal
- Eisai, Woodcliff Lake, New Jersey 07677, United States
| | - Andy Clark
- Aerogen Pharma, San Mateo, California 94402, United States
| | | | - Ben Forbes
- King's College London, London WC2R 2LS, U.K
| | - Jayne Hastedt
- JDP Pharma Consulting, San Carlos, California 94070, United States
| | - Anthony Hickey
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States.,RTI International, Research Triangle Park, North Carolina 27709, United States
| | | | - Wenlei Jiang
- Center for Drug Evaluation and Research, Office of Generic Drugs, Office of Research and Standards, U.S. FDA, Silver Spring, Maryland 20993, United States
| | | | - Philip J Kuehl
- Lovelace Biomedical, Albuquerque, New Mexico 87108, United States
| | - David Prime
- Pulmonary Drug Delivery Consultant, Ware SG12, U.K
| | - Yoen-Ju Son
- Genentech, South San Francisco, California 94080, United States
| | | | - Ulrika Tehler
- Advanced Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Gothenburg 43183, Sweden
| | - Jennifer Wylie
- Merck & Co., Inc., Kenilworth, New Jersey 07033, United States
| |
Collapse
|
8
|
Ladumor MK, Unadkat JD. Predicting Regional Respiratory Tissue and Systemic Concentrations of Orally Inhaled Drugs through a Novel PBPK Model. Drug Metab Dispos 2022; 50:519-528. [PMID: 35246463 PMCID: PMC9073946 DOI: 10.1124/dmd.121.000789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Oral inhalation (OI) of drugs is the route of choice to treat respiratory diseases or for recreational drug use (e.g., cannabis). After OI, the drug is deposited in and systemically absorbed from various regions of the respiratory tract. Measuring regional respiratory tissue drug concentrations at the site of action is important for evaluating the efficacy and safety of orally inhaled drugs (OIDs). Because such a measurement is routinely not possible in humans, the only alternative is to predict these concentrations, for example by physiologically based pharmacokinetic (PBPK) modeling. Therefore, we developed an OI-PBPK model to integrate the interplay between regional respiratory drug deposition and systemic absorption to predict regional respiratory tissue and systemic drug concentrations. We validated our OI-PBPK model by comparing the simulated and observed plasma concentration-time profiles of two OIDs, morphine and nicotine. Furthermore, we performed sensitivity analyses to quantitatively demonstrate the impact of key parameters on the extent and pattern of regional respiratory drug deposition, absorption, and the resulting regional respiratory tissue and systemic plasma concentrations. Our OI-PBPK model can be applied to predict regional respiratory tissue and systemic drug concentrations to optimize OID formulations, delivery systems, and dosing regimens. Furthermore, our model could be used to establish the bioequivalence of generic OIDs for which systemic plasma concentrations are not measurable or are not a good surrogate of the respiratory tissue drug concentrations. SIGNIFICANCE STATEMENT: Our OI-PBPK model is the first comprehensive model to predict regional respiratory deposition, as well as systemic and regional tissue concentrations of OIDs, especially at the drug's site of action, which is difficult to measure in humans. This model will help optimize OID formulations, delivery systems, dosing regimens, and bioequivalence assessment of generic OID. Furthermore, this model can be linked with organs-on-chips, pharmacodynamic and quantitative systems pharmacology models to predict and evaluate the safety and efficacy of OID.
Collapse
Affiliation(s)
- Mayur K Ladumor
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington
| | - Jashvant D Unadkat
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington
| |
Collapse
|
9
|
Anderson S, Atkins P, Bäckman P, Cipolla D, Clark A, Daviskas E, Disse B, Entcheva-Dimitrov P, Fuller R, Gonda I, Lundbäck H, Olsson B, Weers J. Inhaled Medicines: Past, Present, and Future. Pharmacol Rev 2022; 74:48-118. [PMID: 34987088 DOI: 10.1124/pharmrev.120.000108] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/06/2021] [Indexed: 12/21/2022] Open
Abstract
The purpose of this review is to summarize essential pharmacological, pharmaceutical, and clinical aspects in the field of orally inhaled therapies that may help scientists seeking to develop new products. After general comments on the rationale for inhaled therapies for respiratory disease, the focus is on products approved approximately over the last half a century. The organization of these sections reflects the key pharmacological categories. Products for asthma and chronic obstructive pulmonary disease include β -2 receptor agonists, muscarinic acetylcholine receptor antagonists, glucocorticosteroids, and cromones as well as their combinations. The antiviral and antibacterial inhaled products to treat respiratory tract infections are then presented. Two "mucoactive" products-dornase α and mannitol, which are both approved for patients with cystic fibrosis-are reviewed. These are followed by sections on inhaled prostacyclins for pulmonary arterial hypertension and the challenging field of aerosol surfactant inhalation delivery, especially for prematurely born infants on ventilation support. The approved products for systemic delivery via the lungs for diseases of the central nervous system and insulin for diabetes are also discussed. New technologies for drug delivery by inhalation are analyzed, with the emphasis on those that would likely yield significant improvements over the technologies in current use or would expand the range of drugs and diseases treatable by this route of administration. SIGNIFICANCE STATEMENT: This review of the key aspects of approved orally inhaled drug products for a variety of respiratory diseases and for systemic administration should be helpful in making judicious decisions about the development of new or improved inhaled drugs. These aspects include the choices of the active ingredients, formulations, delivery systems suitable for the target patient populations, and, to some extent, meaningful safety and efficacy endpoints in clinical trials.
Collapse
Affiliation(s)
- Sandra Anderson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Paul Atkins
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Per Bäckman
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - David Cipolla
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Andrew Clark
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Evangelia Daviskas
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Bernd Disse
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Plamena Entcheva-Dimitrov
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Rick Fuller
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Igor Gonda
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Hans Lundbäck
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Bo Olsson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| | - Jeffry Weers
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (S.A.); Inhaled Delivery Solutions LLC, Durham, North Carolina (P.A.); Emmace Consulting AB Medicon Village, Lund, Sweden (P.B., H.L., B.O.); Insmed Inc., Bridgewater, New Jersey (D.C.); Aerogen Pharma Corporation, San Mateo, California (A.C.); Woolcock Institute of Medical Research, Glebe, New South Wales, Australia (E.D.); Drug Development, Pharmacology and Clinical Pharmacology Consulting, Mainz, Germany (B.D.); Preferred Regulatory Consulting, San Mateo, California (P.E-.D.); Clayton, CA (R.F.); Respidex LLC, Dennis, Massachusetts (I.G.); and cystetic Medicines, Inc., Burlingame, California (J.W.)
| |
Collapse
|
10
|
Kumbhar P, Manjappa A, Shah R, Jha NK, Singh SK, Dua K, Disouza J, Patravale V. Inhalation delivery of repurposed drugs for lung cancer: Approaches, benefits and challenges. J Control Release 2021; 341:1-15. [PMID: 34780880 DOI: 10.1016/j.jconrel.2021.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 12/11/2022]
Abstract
Lung cancer (LC) is one of the leading causes of mortality accounting for almost 25% of cancer deaths throughout the world. The shortfall of affordable and effective first-line chemotherapeutics, the existence of resistant tumors, and the non-optimal route of administration contribute to poor prognosis and high mortality in LC. Administration of repurposed non-oncology drugs (RNODs) loaded in nanocarriers (NCs) via inhalation may prove as an effective alternative strategy to treat LC. Furthermore, their site-specific release through inhalation route using an appropriate inhalation device would offer improved therapeutic efficacy, thereby reducing mortality and improving patients' quality of life. The current manuscript offers a comprehensive overview on use of RNODs in LC treatment with an emphasis on their inhalation delivery and the associated challenges. The role of NCs to improve lung deposition and targeting of RNODs via inhalation are also elaborated. In addition, information about various RNODs in clinical trials for the treatment of LC, possibility for repurposing phytoceuticals against LC via inhalation and the bottlenecks associated with repurposing RNODs against cancer are also highlighted. Based on the reported studies covered in this manuscript, it was understood that delivery of RNODs via inhalation has emerged as a propitious approach. Hence, it is anticipated to provide effective first-line treatment at an affordable cost in debilitating LC from low and middle-income countries (LMIC).
Collapse
Affiliation(s)
- Popat Kumbhar
- Tatyasaheb Kore College of Pharmacy, Warananagar, Tal: Panhala, Dist: Kolhapur Maharashtra 416113, India
| | - Arehalli Manjappa
- Tatyasaheb Kore College of Pharmacy, Warananagar, Tal: Panhala, Dist: Kolhapur Maharashtra 416113, India
| | - Rohit Shah
- Appasaheb Birnale College of Pharmacy, Sangli, Maharashtra 416416, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, 201310, Uttar Pradesh, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, NSW 2007, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia..
| | - John Disouza
- Tatyasaheb Kore College of Pharmacy, Warananagar, Tal: Panhala, Dist: Kolhapur Maharashtra 416113, India.
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga, Mumbai, Maharashtra, India, 400019
| |
Collapse
|
11
|
Prediction of pharmacokinetic parameters of inhaled indacaterol formulation in healthy volunteers using physiologically-based pharmacokinetic (PBPK) model. Eur J Pharm Sci 2021; 168:106055. [PMID: 34742834 DOI: 10.1016/j.ejps.2021.106055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Inhaled formulations are the first choices for treating asthma and chronic obstructive pulmonary disease (COPD), attracting the increasing investment and development in the pharmaceutical industry. Both the equivalence of local and systemic exposures need to be considered when assessing the equivalence of generic inhaled drugs, which has become a dilemma in the development of generic inhaled drugs. There is an urgent need for reliable methods such as physiologically-based pharmacokinetic (PBPK) model to assist in the development of inhaled drugs. METHOD To test the strategy that in silico simulation is an effective tool in developing inhaled products and further assessing their clinically feasibility, a long-acting beta2-adrenergic agonists indacaterol, which was referred as the first-line therapy for patient with COPD, was selected as a tool drug. The PBPK model was established and the predicted plasma concentration curve was obtained by inputting the physicochemical properties of indacaterol and adjusting model parameters. The accuracy of simulation was verified by an alignment with the actual data. The main factor affecting PK in vivo was investigated by parameter sensitivity analysis. The biological equivalent size of indacaterol was investigated by virtual bioequivalence analysis. RESULTS The models of indacaterol after intravenous and oral administration were established and confirmed, and used as a background for PBPK model of inhaled administration. All those models showed favorable stability and applicability. Appropriate lung deposition was generated in the PBPK model, and the predicted plasma profile of indacaterol was consistent with the clinical actual observation values. Particle size is the most important factor affecting the PK of indacaterol in vivo. Furthermore, virtual bioequivalence simulation exhibited statistically comparable results between the particle size fluctuates in the range of 3.5-6.5 μm and baseline levels (D90 = 5 μm). CONCLUSIONS The PBPK model can simulate the pharmacokinetics and lung deposition of indacaterol, which will be a powerful tool to assist the development of inhaled drugs.
Collapse
|
12
|
Chow MYT, Tai W, Chang RYK, Chan HK, Kwok PCL. In vitro-in vivo correlation of cascade impactor data for orally inhaled pharmaceutical aerosols. Adv Drug Deliv Rev 2021; 177:113952. [PMID: 34461200 DOI: 10.1016/j.addr.2021.113952] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 12/11/2022]
Abstract
In vitro-in vivo correlation is the establishment of a predictive relationship between in vitro and in vivo data. In the context of cascade impactor results of orally inhaled pharmaceutical aerosols, this involves the linking of parameters such as the emitted dose, fine particle dose, fine particle fraction, and mass median aerodynamic diameter to in vivo lung deposition from scintigraphy data. If the dissolution and absorption processes after deposition are adequately understood, the correlation may be extended to the pharmacokinetics and pharmacodynamics of the delivered drugs. Correlation of impactor data to lung deposition is a relatively new research area that has been gaining recent interest. Although few in number, experiments and meta-analyses have been conducted to examine such correlations. An artificial neural network approach has also been employed to analyse the complex relationships between multiple factors and responses. However, much research is needed to generate more data to obtain robust correlations. These predictive models will be useful in improving the efficiency in product development by reducing the need of expensive and lengthy clinical trials.
Collapse
|
13
|
Sonvico F, Chierici V, Varacca G, Quarta E, D’Angelo D, Forbes B, Buttini F. RespiCell TM: An Innovative Dissolution Apparatus for Inhaled Products. Pharmaceutics 2021; 13:pharmaceutics13101541. [PMID: 34683833 PMCID: PMC8540329 DOI: 10.3390/pharmaceutics13101541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022] Open
Abstract
To overcome some of the shortfalls of the types of dissolution testing currently used for pulmonary products, a new custom-built dissolution apparatus has been developed. For inhalation products, the main in vitro characterisation required by pharmacopoeias is the deposition of the active pharmaceutical ingredient in an impactor to estimate the dose delivered to the target site, i.e., the lung. Hence, the collection of the respirable dose (<5 µm) also appears to be an essential requirement for the study of the dissolution rate of particles, because it results as being a relevant parameter for the pharmacological action of the powder. In this sense, dissolution studies could become a complementary test to the routine testing of inhaled formulation delivered dose and aerodynamic performance, providing a set of data significant for product quality, efficacy and/or equivalence. In order to achieve the above-mentioned objectives, an innovative dissolution apparatus (RespiCell™) suitable for the dissolution of the respirable fraction of API deposited on the filter of a fast screening impactor (FSI) (but also of the entire formulation if desirable) was designed at the University of Parma and tested. The purpose of the present work was to use the RespiCell dissolution apparatus to compare and discriminate the dissolution behaviour after aerosolisation of various APIs characterised by different physico-chemical properties (hydrophilic/lipophilic) and formulation strategies (excipients, mixing technology).
Collapse
Affiliation(s)
- Fabio Sonvico
- Department of Food and Drug, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy; (F.S.); (G.V.); (E.Q.); (D.D.)
- Interdepartmental Center for Innovation in Health Products, Biopharmanet Tec, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy;
| | - Veronica Chierici
- Interdepartmental Center for Innovation in Health Products, Biopharmanet Tec, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy;
| | - Giada Varacca
- Department of Food and Drug, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy; (F.S.); (G.V.); (E.Q.); (D.D.)
| | - Eride Quarta
- Department of Food and Drug, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy; (F.S.); (G.V.); (E.Q.); (D.D.)
| | - Davide D’Angelo
- Department of Food and Drug, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy; (F.S.); (G.V.); (E.Q.); (D.D.)
| | - Ben Forbes
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street, London SE1 9NH, UK;
| | - Francesca Buttini
- Department of Food and Drug, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy; (F.S.); (G.V.); (E.Q.); (D.D.)
- Interdepartmental Center for Innovation in Health Products, Biopharmanet Tec, University of Parma, Parco Area Delle Scienze 27/A, 43124 Parma, Italy;
- Institute of Pharmaceutical Science, King’s College London, 150 Stamford Street, London SE1 9NH, UK;
- Correspondence: ; Tel.: +39-0521-906-008
| |
Collapse
|
14
|
Pasqua E, Hamblin N, Edwards C, Baker-Glenn C, Hurley C. Developing inhaled drugs for respiratory diseases: A medicinal chemistry perspective. Drug Discov Today 2021; 27:134-150. [PMID: 34547449 DOI: 10.1016/j.drudis.2021.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/11/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022]
Abstract
Despite the devastating impact of many lung diseases on human health, there is still a significant unmet medical need in respiratory diseases, for which inhaled delivery represents a crucial strategy. More guidance on how to design and carry out multidisciplinary inhaled projects is needed. When designing inhaled drugs, the medicinal chemist must carefully balance the physicochemical properties of the molecule to achieve optimal target engagement in the lung. Although the medicinal chemistry strategy is unique for each project, and will change depending on multiple factors, such as the disease, target, systemic risk, delivery device, and formulation, general guidelines aiding inhaled drug design can be applied and are summarised in this review.
Collapse
Affiliation(s)
- Elisa Pasqua
- Charles River Laboratories, 8-9 Spire Green Centre, Harlow CM19 5TR, UK.
| | - Nicole Hamblin
- Charles River Laboratories, 8-9 Spire Green Centre, Harlow CM19 5TR, UK; Charles River Laboratories, Chesterford Research Park, Saffron Waldon CB10 1XL, UK
| | - Christine Edwards
- Charles River Laboratories, 8-9 Spire Green Centre, Harlow CM19 5TR, UK
| | - Charles Baker-Glenn
- Charles River Laboratories, Chesterford Research Park, Saffron Waldon CB10 1XL, UK
| | - Chris Hurley
- Charles River Laboratories, 8-9 Spire Green Centre, Harlow CM19 5TR, UK
| |
Collapse
|
15
|
Miller NA, Graves RH, Edwards CD, Amour A, Taylor E, Robb O, O'Brien B, Patel A, Harrell AW, Hessel EM. Physiologically Based Pharmacokinetic Modelling of Inhaled Nemiralisib: Mechanistic Components for Pulmonary Absorption, Systemic Distribution, and Oral Absorption. Clin Pharmacokinet 2021; 61:281-293. [PMID: 34458976 PMCID: PMC8813803 DOI: 10.1007/s40262-021-01066-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVES Physiologically based pharmacokinetic (PBPK) modelling has evolved to accommodate different routes of drug administration and enables prediction of drug concentrations in tissues as well as plasma. The inhalation route of administration has proven successful in treating respiratory diseases but can also be used for rapid systemic delivery, holding great promise for treatment of diseases requiring systemic exposure. The objective of this work was to develop a PBPK model that predicts plasma and tissue concentrations following inhalation administration of the PI3Kδ inhibitor nemiralisib. METHODS A PBPK model was built in GastroPlus® that includes a complete mechanistic description of pulmonary absorption, systemic distribution and oral absorption following inhalation administration of nemiralisib. The availability of clinical data obtained after intravenous, oral and inhalation administration enabled validation of the model with observed data and accurate assessment of pulmonary drug absorption. The PBPK model described in this study incorporates novel use of key parameters such as lung systemic absorption rate constants derived from human physiological lung blood flows, and implementation of the specific permeability-surface area product per millilitre of tissue cell volume (SpecPStc) to predict tissue distribution. RESULTS The inhaled PBPK model was verified using plasma and bronchoalveolar lavage fluid concentration data obtained in human subjects. Prediction of tissue concentrations using the permeability-limited systemic disposition tissue model was further validated using tissue concentration data obtained in the rat following intravenous infusion administration to steady state. CONCLUSIONS Fully mechanistic inhaled PBPK models such as the model described herein could be applied for cross molecule assessments with respect to lung retention and systemic exposure, both in terms of pharmacology and toxicology, and may facilitate clinical indication selection.
Collapse
Affiliation(s)
- Neil A Miller
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA, 93534, USA.
| | - Rebecca H Graves
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA, 93534, USA
| | | | | | - Ed Taylor
- GlaxoSmithKline R&D, Gunnelswood Road, Ware, Hertfordshire, UK
| | - Olivia Robb
- GlaxoSmithKline R&D, Stevenage, Hertfordshire, UK
| | | | - Aarti Patel
- GlaxoSmithKline R&D, Gunnelswood Road, Ware, Hertfordshire, UK
| | | | | |
Collapse
|
16
|
Radivojev S, Luschin-Ebengreuth G, Pinto JT, Laggner P, Cavecchi A, Cesari N, Cella M, Melli F, Paudel A, Fröhlich E. Impact of simulated lung fluid components on the solubility of inhaled drugs and predicted in vivo performance. Int J Pharm 2021; 606:120893. [PMID: 34274456 DOI: 10.1016/j.ijpharm.2021.120893] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/03/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022]
Abstract
Orally inhaled products (OIPs) are gaining increased attention, as pulmonary delivery is a preferred route for the treatment of various diseases. Yet, the field of inhalation biopharmaceutics is still in development phase. For a successful correlation between various in vitro data obtained during formulation characterization and in vivo performance, it is necessary to understand the impact of parameters such as solubility and dissolution of drugs. In this work, we used in vitro-in silico feedback-feedforward approach to gain a better insight into the biopharmaceutics behavior of inhaled Salbutamol Sulphate (SS) and Budesonide (BUD). The thorough characterization of the in vitro test media and the impact of different in vitro fluid components such as lipids and protein on the solubility of aforementioned drugs was studied. These results were subsequently used as an input into the developed in silico models to investigate potential PK parameter changes in vivo. Results revealed that media comprising lipids and albumin were the most biorelevant and impacted the solubility of BUD the most. On the contrary, no notable impact was seen in case of SS. The use of simple media such as phosphate buffer saline (PBS) might be sufficient to use in solubility studies of the highly soluble and permeable drugs. However, its use for the poorly soluble drugs is limited due to the greater potential for interactions within in vivo environment. The use of in silico tools showed that the model response varies, depending on the used media. Therefore, this work highlights the relevance of carefully selecting the media composition when investigating solubility and dissolution behavior, especially in the early phases of drug development and of poorly soluble drugs.
Collapse
Affiliation(s)
- Snezana Radivojev
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, Graz 8010, Austria; Center for Medical Research, Medical University of Graz, Stiftingtalstraße 24, Graz 8010, Austria
| | | | - Joana T Pinto
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, Graz 8010, Austria
| | - Peter Laggner
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, Graz 8010, Austria
| | | | - Nicola Cesari
- Chiesi Farmaceutici S.p.A., Via Palermo, 26 A, Parma, 43122, Italy
| | - Massimo Cella
- Chiesi Farmaceutici S.p.A., Via Palermo, 26 A, Parma, 43122, Italy
| | - Fabrizio Melli
- Chiesi Farmaceutici S.p.A., Via Palermo, 26 A, Parma, 43122, Italy
| | - Amrit Paudel
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, Graz 8010, Austria; Institute of Process and Particle Engineering, Graz University of Technology, Inffeldgasse 13, Graz, 8010, Austria.
| | - Eleonore Fröhlich
- Research Center Pharmaceutical Engineering GmbH, Inffeldgasse 13, Graz 8010, Austria; Center for Medical Research, Medical University of Graz, Stiftingtalstraße 24, Graz 8010, Austria.
| |
Collapse
|
17
|
Gallegos-Catalán J, Warnken Z, Bahamondez-Canas TF, Moraga-Espinoza D. Innovating on Inhaled Bioequivalence: A Critical Analysis of the Current Limitations, Potential Solutions and Stakeholders of the Process. Pharmaceutics 2021; 13:1051. [PMID: 34371741 PMCID: PMC8309038 DOI: 10.3390/pharmaceutics13071051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 12/23/2022] Open
Abstract
Orally inhaled drug products (OIDPs) are an important group of medicines traditionally used to treat pulmonary diseases. Over the past decade, this trend has broadened, increasing their use in other conditions such as diabetes, expanding the interest in this administration route. Thus, the bioequivalence of OIDPs is more important than ever, aiming to increase access to affordable, safe and effective medicines, which translates into better public health policies. However, regulatory agencies leading the bioequivalence process are still deciding the best approach for ensuring a proposed inhalable product is bioequivalent. This lack of agreement translates into less cost-effective strategies to determine bioequivalence, discouraging innovation in this field. The Next-Generation Impactor (NGI) is an example of the slow pace at which the inhalation field evolves. The NGI was officially implemented in 2003, being the last equipment innovation for OIDP characterization. Even though it was a breakthrough in the field, it did not solve other deficiencies of the BE process such as dissolution rate analysis on physiologically relevant conditions, being the last attempt of transferring technology into the field. This review aims to reveal the steps required for innovation in the regulations defining the bioequivalence of OIDPs, elucidating the pitfalls of implementing new technologies in the current standards. To do so, we collected the opinion of experts from the literature to explain these trends, showing, for the first time, the stakeholders of the OIDP market. This review analyzes the stakeholders involved in the development, improvement and implementation of methodologies that can help assess bioequivalence between OIDPs. Additionally, it presents a list of methods potentially useful to overcome some of the current limitations of the bioequivalence standard methodologies. Finally, we review one of the most revolutionary approaches, the inhaled Biopharmaceutical Classification System (IBCs), which can help establish priorities and order in both the innovation process and in regulations for OIDPs.
Collapse
Affiliation(s)
- Jonattan Gallegos-Catalán
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso 2340000, Chile; (J.G.-C.); (T.F.B.-C.)
| | | | - Tania F. Bahamondez-Canas
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso 2340000, Chile; (J.G.-C.); (T.F.B.-C.)
- Centro de Investigación Farmacopea Chilena, Universidad de Valparaíso, Valparaíso 2340000, Chile
| | - Daniel Moraga-Espinoza
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso 2340000, Chile; (J.G.-C.); (T.F.B.-C.)
- Centro de Investigación Farmacopea Chilena, Universidad de Valparaíso, Valparaíso 2340000, Chile
| |
Collapse
|
18
|
Zhao J, Feng Y, Tian G, Taylor C, Arden NS. Influences of puff protocols and upper airway anatomy on cannabis pharmacokinetics: A CFPD-PK study. Comput Biol Med 2021; 132:104333. [PMID: 33770654 DOI: 10.1016/j.compbiomed.2021.104333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 02/02/2023]
Abstract
Predicting the optimal administration doses of the inhaled Δ9-tetrahydrocannabinol (THC), i.e., one of the major natural compounds in cannabis, is critical for maximizing the therapeutic outcomes and minimizing the toxic side effects. Thus, it is essential to developing an aerosol dosimetry model to simulate the transport, deposition, and translocation of inhaled THC aerosols from the human respiratory system to the systemic region. In this study, a computational fluid-particle dynamics (CFPD) plus pharmacokinetics (PK) model was developed and validated to quantify the localized vapor and particle uptake rates of THC and the resultant THC-plasma concentrations using two human upper airway geometries. In addition, two different puff protocols (4.0/10.0 s and 1.6/11.4 s as the inhalation/holding time ratios) were employed, associated with two different inhaled THC doses (2.0 mg and 8.82 mg, respectively). The computational results demonstrated that multiple parameters had noticeable influences on THC particle deposition and vapor absorption in the upper airways, as well as the resultant pharmacokinetic behaviors. These factors include anatomical features of the upper airway, puff flow rate, duration, and holding time. The results indicated that puff protocol with 4.0/10.0 s inhalation/holding time ratio would be recommended if the treatment needs THC delivery to the deeper lung. Furthermore, the inhaled THC dose had a dominant effect on the THC-plasma PK profiles, which could override the influences of anatomical variability and puff protocols. The developed CFPD-PK modeling framework has the potential to provide localized lung absorption data and PK profiles for in vitro-in vivo correlation, as well as supporting the development and assessment of drug products containing cannabis or cannabis-derived compounds.
Collapse
Affiliation(s)
- Jianan Zhao
- School of Chemical Engineering, Oklahoma State University, USA; Office of Pharmaceutical Quality, Center for Drug Evaluation Research, US Food and Drug Administration, USA
| | - Yu Feng
- School of Chemical Engineering, Oklahoma State University, USA.
| | - Geng Tian
- Office of Pharmaceutical Quality, Center for Drug Evaluation Research, US Food and Drug Administration, USA.
| | - Cassandra Taylor
- Office of Pharmaceutical Quality, Center for Drug Evaluation Research, US Food and Drug Administration, USA
| | - N Sarah Arden
- Office of Pharmaceutical Quality, Center for Drug Evaluation Research, US Food and Drug Administration, USA
| |
Collapse
|
19
|
Matera MG, Calzetta L, Ora J, Rogliani P, Cazzola M. Pharmacokinetic/pharmacodynamic approaches to drug delivery design for inhalation drugs. Expert Opin Drug Deliv 2021; 18:891-906. [PMID: 33412922 DOI: 10.1080/17425247.2021.1873271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction: Inhaled drugs are important in the treatment of many lung pathologies, but to be therapeutically effective they must reach unbound concentrations at their effect site in the lung that are adequate to interact with their pharmacodynamic properties (PD) and exert the pharmacological action over an appropriate dosing interval. Therefore, the evaluation of pharmacokinetic (PK)/PD relationship is critical to predict their possible therapeutic effect.Areas covered: We review the approaches used to assess the PK/PD relationship of the major classes of inhaled drugs that are prescribed to treat pulmonary pathologies.Expert opinion: There are still great difficulties in producing data on lung concentrations of inhaled drugs and interpreting them as to their ability to induce the desired therapeutic action. The structural complexity of the lungs, the multiplicity of processes involved simultaneously and the physical interactions between the lungs and drug make any PK/PD approach to drug delivery design for inhalation medications extremely challenging. New approaches/methods are increasing our understanding about what happens to inhaled drugs, but they are still not ready for regulatory purposes. Therefore, we must still rely on plasma concentrations based on the axiom that they reflect both the extent and the pattern of deposition within the lungs.
Collapse
Affiliation(s)
- Maria Gabriella Matera
- Unit of Pharmacology, Dept. Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigino Calzetta
- Unit of Respiratory Disease and Lung Function, Dept. Medicine and Surgery, University of Parma, Parma, Italy
| | - Josuel Ora
- Unit of Respiratory Medicine, Dept. Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Dept. Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Dept. Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
20
|
Organic Cation Transporters in the Lung-Current and Emerging (Patho)Physiological and Pharmacological Concepts. Int J Mol Sci 2020; 21:ijms21239168. [PMID: 33271927 PMCID: PMC7730617 DOI: 10.3390/ijms21239168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023] Open
Abstract
Organic cation transporters (OCT) 1, 2 and 3 and novel organic cation transporters (OCTN) 1 and 2 of the solute carrier 22 (SLC22) family are involved in the cellular transport of endogenous compounds such as neurotransmitters, l-carnitine and ergothioneine. OCT/Ns have also been implicated in the transport of xenobiotics across various biological barriers, for example biguanides and histamine receptor antagonists. In addition, several drugs used in the treatment of respiratory disorders are cations at physiological pH and potential substrates of OCT/Ns. OCT/Ns may also be associated with the development of chronic lung diseases such as allergic asthma and chronic obstructive pulmonary disease (COPD) and, thus, are possible new drug targets. As part of the Special Issue "Physiology, Biochemistry and Pharmacology of Transporters for Organic Cations", this review provides an overview of recent findings on the (patho)physiological and pharmacological functions of organic cation transporters in the lung.
Collapse
|
21
|
Eriksson J, Thörn H, Lennernäs H, Sjögren E. Pulmonary drug absorption and systemic exposure in human: Predictions using physiologically based biopharmaceutics modeling. Eur J Pharm Biopharm 2020; 156:191-202. [DOI: 10.1016/j.ejpb.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022]
|
22
|
Ruzycki CA, Murphy B, Nathoo H, Finlay WH, Martin AR. Combined in Vitro-in Silico Approach to Predict Deposition and Pharmacokinetics of Budesonide Dry Powder Inhalers. Pharm Res 2020; 37:209. [PMID: 32995953 DOI: 10.1007/s11095-020-02924-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE A combined in vitro - in silico methodology was designed to estimate pharmacokinetics of budesonide delivered via dry powder inhaler. METHODS Particle size distributions from three budesonide DPIs, measured with a Next Generation Impactor and Alberta Idealized Throat, were input into a lung deposition model to predict regional deposition. Subsequent systemic exposure was estimated using a pharmacokinetic model that incorporated Nernst-Brunner dissolution in the conducting airways to predict the net influence of dissolution, mucociliary clearance, and absorption. RESULTS DPIs demonstrated significant in vitro differences in deposition, resulting in large differences in simulated regional deposition in the central conducting airways and the alveolar region. Similar but low deposition in the small conducting airways was observed with each DPI. Pharmacokinetic predictions showed good agreement with in vivo data from the literature. Peak systemic concentration was tied primarily to the alveolar dose, while the area under the curve was more dependent on the total lung dose. Tracheobronchial deposition was poorly correlated with pharmacokinetic data. CONCLUSIONS Combination of realistic in vitro experiments, lung deposition modeling, and pharmacokinetic modeling was shown to provide reasonable estimation of in vivo systemic exposure from DPIs. Such combined approaches are useful in the development of orally inhaled drug products.
Collapse
Affiliation(s)
- Conor A Ruzycki
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Brynn Murphy
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Hafeez Nathoo
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.
| | - Andrew R Martin
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
23
|
Sou T, Bergström CAS. Contemporary Formulation Development for Inhaled Pharmaceuticals. J Pharm Sci 2020; 110:66-86. [PMID: 32916138 DOI: 10.1016/j.xphs.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/22/2022]
Abstract
Pulmonary delivery has gained increased interests over the past few decades. For respiratory conditions, targeted drug delivery directly to the site of action can achieve a high local concentration for efficacy with reduced systemic exposure and adverse effects. For systemic conditions, the unique physiology of the lung evolutionarily designed for rapid gaseous exchange presents an entry route for systemic drug delivery. Although the development of inhaled formulations has come a long way over the last few decades, many aspects of it remain to be elucidated. In particular, a reliable and well-understood method for in vitro-in vivo correlations remains to be established. With the rapid and ongoing advancement of technology, there is much potential to better utilise computational methods including different types of modelling and simulation approaches to support inhaled formulation development. This review intends to provide an introduction on some fundamental concepts in pulmonary drug delivery and inhaled formulation development followed by discussions on some challenges and opportunities in the translation of inhaled pharmaceuticals from preclinical studies to clinical development. The review concludes with some recent advancements in modelling and simulation approaches that could play an increasingly important role in modern formulation development of inhaled pharmaceuticals.
Collapse
Affiliation(s)
- Tomás Sou
- Drug Delivery, Department of Pharmacy, Uppsala University, Uppsala, Sweden; Pharmacometrics, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
| | - Christel A S Bergström
- Drug Delivery, Department of Pharmacy, Uppsala University, Uppsala, Sweden; The Swedish Drug Delivery Center, Department of Pharmacy, Uppsala University, Uppsala, Sweden
| |
Collapse
|
24
|
Melillo N, Grandoni S, Cesari N, Brogin G, Puccini P, Magni P. Inter-compound and Intra-compound Global Sensitivity Analysis of a Physiological Model for Pulmonary Absorption of Inhaled Compounds. AAPS J 2020; 22:116. [PMID: 32862303 PMCID: PMC7456635 DOI: 10.1208/s12248-020-00499-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/06/2020] [Indexed: 12/25/2022] Open
Abstract
In recent years, global sensitivity analysis (GSA) has gained interest in physiologically based pharmacokinetics (PBPK) modelling and simulation from pharmaceutical industry, regulatory authorities, and academia. With the case study of an in-house PBPK model for inhaled compounds in rats, the aim of this work is to show how GSA can contribute in PBPK model development and daily use. We identified two types of GSA that differ in the aims and, thus, in the parameter variability: inter-compound and intra-compound GSA. The inter-compound GSA aims to understand which are the parameters that mostly influence the variability of the metrics of interest in the whole space of the drugs' properties, and thus, it is useful during the model development. On the other hand, the intra-compound GSA aims to highlight how much the uncertainty associated with the parameters of a given drug impacts the uncertainty in the model prediction and so, it is useful during routine PBPK use. In this work, inter-compound GSA highlighted that dissolution- and formulation-related parameters were mostly important for the prediction of the fraction absorbed, while the permeability is the most important parameter for lung AUC and MRT. Intra-compound GSA highlighted that, for all the considered compounds, the permeability was one of the most important parameters for lung AUC, MRT and plasma MRT, while the extraction ratio and the dose for the plasma AUC. GSA is a crucial instrument for the quality assessment of model-based inference; for this reason, we suggest its use during both PBPK model development and use.
Collapse
Affiliation(s)
- Nicola Melillo
- Laboratory of Bioinformatics, Mathematical Modelling and Synthetic Biology, Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Via Ferrata 5, I-27100, Pavia, Italy
| | - Silvia Grandoni
- Laboratory of Bioinformatics, Mathematical Modelling and Synthetic Biology, Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Via Ferrata 5, I-27100, Pavia, Italy
| | - Nicola Cesari
- Pharmacokinetics, Biochemistry and Metabolism Department, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Giandomenico Brogin
- Pharmacokinetics, Biochemistry and Metabolism Department, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Paola Puccini
- Pharmacokinetics, Biochemistry and Metabolism Department, Chiesi Farmaceutici S.p.A., Parma, Italy
| | - Paolo Magni
- Laboratory of Bioinformatics, Mathematical Modelling and Synthetic Biology, Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Via Ferrata 5, I-27100, Pavia, Italy.
| |
Collapse
|
25
|
Eriksson J, Sjögren E, Lennernäs H, Thörn H. Drug Absorption Parameters Obtained Using the Isolated Perfused Rat Lung Model Are Predictive of Rat In Vivo Lung Absorption. AAPS JOURNAL 2020; 22:71. [PMID: 32394314 PMCID: PMC7214485 DOI: 10.1208/s12248-020-00456-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/06/2020] [Indexed: 02/04/2023]
Abstract
The ex vivo isolated perfused rat lung (IPL) model has been demonstrated to be a useful tool during drug development for studying pulmonary drug absorption. This study aims to investigate the potential use of IPL data to predict rat in vivo lung absorption. Absorption parameters determined from IPL data (ex vivo input parameters) in combination with intravenously determined pharmacokinetic data were used in a biopharmaceutics model to predict experimental rat in vivo plasma concentration-time profiles and lung amount after inhalation of five different inhalation compounds. The performance of simulations using ex vivo input parameters was compared with simulations using in vitro input parameters, to determine whether and to what extent predictability could be improved by using input parameters determined from the more complex ex vivo model. Simulations using ex vivo input parameters were within twofold average difference (AAFE < 2) from experimental in vivo data for all compounds except one. Furthermore, simulations using ex vivo input parameters performed significantly better than simulations using in vitro input parameters in predicting in vivo lung absorption. It could therefore be advantageous to base predictions of drug performance on IPL data rather than on in vitro data during drug development to increase mechanistic understanding of pulmonary drug absorption and to better understand how different substance properties and formulations might affect in vivo behavior of inhalation compounds.
Collapse
Affiliation(s)
- Johanna Eriksson
- Department of Pharmacy, Uppsala University, Box 580, SE-751 23, Uppsala, Sweden
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Box 580, SE-751 23, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Box 580, SE-751 23, Uppsala, Sweden.
| | - Helena Thörn
- Inhalation PD Unit, Pharmaceutical Technology & Development, Operations, AstraZeneca, Pepparedsleden 1, 43183, Gothenburg, Sweden
| |
Collapse
|
26
|
Mehta PP, Ghoshal D, Pawar AP, Kadam SS, Dhapte-Pawar VS. Recent advances in inhalable liposomes for treatment of pulmonary diseases: Concept to clinical stance. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101509] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
27
|
Model-Informed Drug Discovery and Development Strategy for the Rapid Development of Anti-Tuberculosis Drug Combinations. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10072376] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The increasing emergence of drug-resistant tuberculosis requires new effective and safe drug regimens. However, drug discovery and development are challenging, lengthy and costly. The framework of model-informed drug discovery and development (MID3) is proposed to be applied throughout the preclinical to clinical phases to provide an informative prediction of drug exposure and efficacy in humans in order to select novel anti-tuberculosis drug combinations. The MID3 includes pharmacokinetic-pharmacodynamic and quantitative systems pharmacology models, machine learning and artificial intelligence, which integrates all the available knowledge related to disease and the compounds. A translational in vitro-in vivo link throughout modeling and simulation is crucial to optimize the selection of regimens with the highest probability of receiving approval from regulatory authorities. In vitro-in vivo correlation (IVIVC) and physiologically-based pharmacokinetic modeling provide powerful tools to predict pharmacokinetic drug-drug interactions based on preclinical information. Mechanistic or semi-mechanistic pharmacokinetic-pharmacodynamic models have been successfully applied to predict the clinical exposure-response profile for anti-tuberculosis drugs using preclinical data. Potential pharmacodynamic drug-drug interactions can be predicted from in vitro data through IVIVC and pharmacokinetic-pharmacodynamic modeling accounting for translational factors. It is essential for academic and industrial drug developers to collaborate across disciplines to realize the huge potential of MID3.
Collapse
|
28
|
Kolli AR, Kuczaj AK, Martin F, Hayes AW, Peitsch MC, Hoeng J. Bridging inhaled aerosol dosimetry to physiologically based pharmacokinetic modeling for toxicological assessment: nicotine delivery systems and beyond. Crit Rev Toxicol 2020; 49:725-741. [PMID: 31903848 DOI: 10.1080/10408444.2019.1692780] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
One of the challenges for toxicological assessment of inhaled aerosols is to accurately predict their deposited and absorbed dose. Transport, evolution, and deposition of liquid aerosols are driven by complex processes dominated by convection-diffusion that depend on various factors related to physics and chemistry. These factors include the physicochemical properties of the pure substance of interest and associated mixtures, the physical and chemical properties of the aerosols generated, the interplay between different factors during transportation and deposition, and the subject-specific inhalation topography. Several inhalation-based physiologically based pharmacokinetic (PBPK) models have been developed, but the applicability of these models for aerosols has yet to be verified. Nicotine is among several substances that are often delivered via the pulmonary route, with varied kinetics depending upon the route of exposure. This was used as an opportunity to review and discuss the current knowledge and state-of-the-art tools combining aerosol dosimetry predictions with PBPK modeling efforts. A validated tool could then be used to perform for toxicological assessment of other inhaled therapeutic substances. The Science Panel from the Alliance of Risk Assessment have convened at the "Beyond Science and Decisions: From Problem Formulation to Dose-Response Assessment" workshop to evaluate modeling approaches and address derivation of exposure-internal dose estimations for inhaled aerosols containing nicotine or other substances. The discussion involved PBPK model evaluation criteria, challenges, and choices that arise in such a model design, development, and application as a computational tool for use in human toxicological assessments.
Collapse
Affiliation(s)
- A R Kolli
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - A K Kuczaj
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland.,Department of Applied Mathematics, Faculty EEMCS, University of Twente, Enschede, The Netherlands
| | - F Martin
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - A W Hayes
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - M C Peitsch
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - J Hoeng
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| |
Collapse
|
29
|
Raut A, Dhapare S, Venitz J, Sakagami M. Pharmacokinetic profile analyses for inhaled drugs in humans using the lung delivery and disposition model. Biopharm Drug Dispos 2019; 41:32-43. [PMID: 31691979 DOI: 10.1002/bdd.2210] [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] [Received: 08/30/2019] [Revised: 10/09/2019] [Accepted: 10/27/2019] [Indexed: 11/09/2022]
Abstract
The kinetic clarification of lung disposition for inhaled drugs in humans via pharmacokinetic (PK) modeling aids in their development and regulation for systemic and local delivery, but remains challenging due to its multiplex nature. This study exercised our lung delivery and disposition kinetic model to derive the kinetic descriptors for the lung disposition of four drugs [calcitonin, tobramycin, ciprofloxacin and fluticasone propionate (FP)] inhaled via different inhalers from the published PK profile data. With the drug dose delivered to the lung (DTL) estimated from the corresponding γ-scintigraphy or in vivo predictive cascade impactor data, the model-based curve-fitting and statistical moment analyses derived the rate constants of lung absorption (ka ) and non-absorptive disposition (knad ). The ka values differed substantially between the drugs (0.05-1.00 h-1 ), but conformed to the lung partition-based membrane diffusion except for FP, and were inhaler/delivery/deposition-independent. The knad values also varied widely (0.03-2.32 h-1 ), yet appeared to be explained by the presence or absence of non-absorptive disposition in the lung via mucociliary clearance, local tissue degradation, binding/sequestration and/or phagocytosis, and to be sensitive to differences in lung deposition. For FP, its ka value of 0.2 h-1 was unusually low, suggesting solubility/dissolution-limited slow lung absorption, but was comparable between two inhaler products. Thus, the difference in the PK profile was attributed to differences in the DTL and the knad value, the latter likely originating from different aerosol sizes and regional deposition in the lung. Overall, this empirical, rather simpler model-based analysis provided a quantitative kinetic understanding of lung absorption and non-absorptive disposition for four inhaled drugs from PK profiles in humans.
Collapse
Affiliation(s)
- Anuja Raut
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298, USA
| | - Sneha Dhapare
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298, USA
| | - Jürgen Venitz
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298, USA
| | - Masahiro Sakagami
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298, USA
| |
Collapse
|
30
|
Advanced in vitro lung-on-chip platforms for inhalation assays: From prospect to pipeline. Eur J Pharm Biopharm 2019; 144:11-17. [PMID: 31499161 DOI: 10.1016/j.ejpb.2019.09.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 01/14/2023]
Abstract
With rapid advances in micro-fabrication processes and the availability of biologically-relevant lung cells, the development of lung-on-chip platforms is offering novel avenues for more realistic inhalation assays in pharmaceutical research, and thereby an opportunity to depart from traditional in vitro lung assays. As advanced models capturing the cellular pulmonary make-up at an air-liquid interface (ALI), lung-on-chips emulate both morphological features and biological functionality of the airway barrier with the ability to integrate respiratory breathing motions and ensuing tissue strains. Such in vitro systems allow importantly to mimic more realistic physiological respiratory flow conditions, with the opportunity to integrate physically-relevant transport determinants of aerosol inhalation therapy, i.e. recapitulating the pathway from airborne flight to deposition on the airway lumen. In this short opinion, we discuss such points and describe how these attributes are paving new avenues for exploring improved drug carrier designs (e.g. shape, size, etc.) and targeting strategies (e.g. conductive vs. respiratory regions) amongst other. We argue that while technical challenges still lie along the way in rendering in vitro lung-on-chip platforms more widespread across the general pharmaceutical research community, significant momentum is steadily underway in accelerating the prospect of establishing these as in vitro "gold standards".
Collapse
|
31
|
Radivojev S, Pinto JT, Fröhlich E, Paudel A. Insights into DPI sensitivity to humidity: An integrated in-vitro-in-silico risk-assessment. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.05.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
32
|
Eriksson J, Thörn H, Sjögren E, Holmstén L, Rubin K, Lennernäs H. Pulmonary Dissolution of Poorly Soluble Compounds Studied in an ex Vivo Rat Lung Model. Mol Pharm 2019; 16:3053-3064. [DOI: 10.1021/acs.molpharmaceut.9b00289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Johanna Eriksson
- Department of Pharmacy, Uppsala University, Uppsala 75123, Sweden
| | | | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Uppsala 75123, Sweden
| | | | | | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Uppsala 75123, Sweden
| |
Collapse
|
33
|
Polak S, Tylutki Z, Holbrook M, Wiśniowska B. Better prediction of the local concentration-effect relationship: the role of physiologically based pharmacokinetics and quantitative systems pharmacology and toxicology in the evolution of model-informed drug discovery and development. Drug Discov Today 2019; 24:1344-1354. [PMID: 31132414 DOI: 10.1016/j.drudis.2019.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 03/04/2019] [Accepted: 05/21/2019] [Indexed: 12/15/2022]
Abstract
Model-informed drug discovery and development (MID3) is an umbrella term under which sit several computational approaches: quantitative systems pharmacology (QSP), quantitative systems toxicology (QST) and physiologically based pharmacokinetics (PBPK). QSP models are built using mechanistic knowledge of the pharmacological pathway focusing on the putative mechanism of drug efficacy; whereas QST models focus on safety and toxicity issues and the molecular pathways and networks that drive these adverse effects. These can be mediated through exaggerated on-target or off-target pharmacology, immunogenicity or the physiochemical nature of the compound. PBPK models provide a mechanistic description of individual organs and tissues to allow the prediction of the intra- and extra-cellular concentration of the parent drug and metabolites under different conditions. Information on biophase concentration enables the prediction of a drug effect in different organs and assessment of the potential for drug-drug interactions. Together, these modelling approaches can inform the exposure-response relationship and hence support hypothesis generation and testing, compound selection, hazard identification and risk assessment through to clinical proof of concept (POC) and beyond to the market.
Collapse
Affiliation(s)
- Sebastian Polak
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 Street, 30-688 Kraków, Poland; Certara-Simcyp, Level 2-Acero, 1 Concourse Way, Sheffield, S1 2BJ, UK.
| | - Zofia Tylutki
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 Street, 30-688 Kraków, Poland; Certara-Simcyp, Level 2-Acero, 1 Concourse Way, Sheffield, S1 2BJ, UK
| | - Mark Holbrook
- Certara-Simcyp, Level 2-Acero, 1 Concourse Way, Sheffield, S1 2BJ, UK
| | - Barbara Wiśniowska
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 Street, 30-688 Kraków, Poland
| |
Collapse
|
34
|
Walenga RL, Babiskin AH, Zhao L. In Silico Methods for Development of Generic Drug-Device Combination Orally Inhaled Drug Products. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2019; 8:359-370. [PMID: 31044532 PMCID: PMC6618094 DOI: 10.1002/psp4.12413] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/07/2019] [Indexed: 12/03/2022]
Abstract
The development of generic, single‐entity, drug–device combination products for orally inhaled drug products is challenging in part because of the complex nature of device design characteristics and the difficulties associated with establishing bioequivalence for a locally acting drug product delivered to the site of action in the lung. This review examines in silico models that may be used to support the development of generic orally inhaled drug products and how model credibility may be assessed.
Collapse
Affiliation(s)
- Ross L Walenga
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew H Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Liang Zhao
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| |
Collapse
|
35
|
Ganguly K, Carlander U, Garessus EDG, Fridén M, Eriksson UG, Tehler U, Johanson G. Computational modeling of lung deposition of inhaled particles in chronic obstructive pulmonary disease (COPD) patients: identification of gaps in knowledge and data. Crit Rev Toxicol 2019; 49:160-173. [DOI: 10.1080/10408444.2019.1584153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Koustav Ganguly
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Carlander
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Estella DG Garessus
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Markus Fridén
- Respiratory, Inflammation and Autoimmunity IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
- Translational PKPD, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Ulf G Eriksson
- Early Clinical Development, IMED Biotech Unit, Quantitative Clinical Pharmacology, AstraZeneca, Gothenburg, Sweden
| | - Ulrika Tehler
- Pharmaceutical Sciences, IMED Biotech Unit, Early Product Development, AstraZeneca, Gothenburg, Sweden
| | - Gunnar Johanson
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
36
|
Kosmidis K, Dassios G. Monte Carlo simulations in drug release. J Pharmacokinet Pharmacodyn 2019; 46:165-172. [PMID: 30880356 DOI: 10.1007/s10928-019-09625-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
We present methods based on simple sampling Monte Carlo simulations that are used in the study of controlled drug release from devices of various shapes and characteristics. The manuscript is part of a special tribute issue for Prof. Panos Macheras and we have chosen applications of the Monte Carlo method in the field of drug release that were pioneered by him and his research group. Thus, we focus on the investigation of diffusion based release and we present methods that go beyond the application of the classical fickian diffusion equation. We describe methods that have proven to be effective in illuminating the profound effects of the substrate heterogeneity on the drug release profiles and demonstrate some of the most powerful applications of agent based simulations and numerical methods in the field of pharmacokinetics.
Collapse
Affiliation(s)
- Kosmas Kosmidis
- Division of Theoretical Physics, Physics Department, Aristotele University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - George Dassios
- Division of Applied Mathematics, Department of Chemical Engineering, University of Patras, Patras, Greece
| |
Collapse
|
37
|
Boger E, Fridén M. Physiologically Based Pharmacokinetic/Pharmacodynamic Modeling Accurately Predicts the Better Bronchodilatory Effect of Inhaled Versus Oral Salbutamol Dosage Forms. J Aerosol Med Pulm Drug Deliv 2019; 32:1-12. [DOI: 10.1089/jamp.2017.1436] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Elin Boger
- Department of Drug Metabolism and Pharmacokinetics, Respiratory, Inflammation, and Autoimmunity IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden
| | - Markus Fridén
- Department of Drug Metabolism and Pharmacokinetics, Respiratory, Inflammation, and Autoimmunity IMED Biotech Unit, AstraZeneca R&D, Gothenburg, Sweden
- Translational PKPD, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
38
|
Longest PW, Bass K, Dutta R, Rani V, Thomas ML, El-Achwah A, Hindle M. Use of computational fluid dynamics deposition modeling in respiratory drug delivery. Expert Opin Drug Deliv 2019; 16:7-26. [PMID: 30463458 PMCID: PMC6529297 DOI: 10.1080/17425247.2019.1551875] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Respiratory drug delivery is a surprisingly complex process with a number of physical and biological challenges. Computational fluid dynamics (CFD) is a scientific simulation technique that is capable of providing spatially and temporally resolved predictions of many aspects related to respiratory drug delivery from initial aerosol formation through respiratory cellular drug absorption. AREAS COVERED This review article focuses on CFD-based deposition modeling applied to pharmaceutical aerosols. Areas covered include the development of new complete-airway CFD deposition models and the application of these models to develop a next-generation of respiratory drug delivery strategies. EXPERT OPINION Complete-airway deposition modeling is a valuable research tool that can improve our understanding of pharmaceutical aerosol delivery and is already supporting medical hypotheses, such as the expected under-treatment of the small airways in asthma. These complete-airway models are also being used to advance next-generation aerosol delivery strategies, like controlled condensational growth. We envision future applications of CFD deposition modeling to reduce the need for human subject testing in developing new devices and formulations, to help establish bioequivalence for the accelerated approval of generic inhalers, and to provide valuable new insights related to drug dissolution and clearance leading to microdosimetry maps of drug absorption.
Collapse
Affiliation(s)
- P. Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | - Karl Bass
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rabijit Dutta
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Vijaya Rani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Morgan L. Thomas
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Ahmad El-Achwah
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
39
|
Krishna R, Kesisoglou F. Clinical Endpoint Bioequivalence Studies Are Needed: A Perspective From Brand Drugs. Clin Pharmacol Ther 2018; 105:298-300. [PMID: 30456848 DOI: 10.1002/cpt.1245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/25/2018] [Indexed: 11/05/2022]
|
40
|
Martin AR, Moore CP, Finlay WH. Models of deposition, pharmacokinetics, and intersubject variability in respiratory drug delivery. Expert Opin Drug Deliv 2018; 15:1175-1188. [PMID: 30388902 DOI: 10.1080/17425247.2018.1544616] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Aerosol drug delivery to the lungs via inhalation is widely used in the treatment of respiratory diseases. The deposition pattern of inhaled particles within the airways of the respiratory tract is key in determining the initial delivered dose. Thereafter, dose-dependent processes including drug release or dissolution, clearance, and absorption influence local and systemic exposure to inhaled drugs over time. AREAS COVERED Empirical correlations, numerical simulation, and in vitro airway geometries that permit improved prediction of extrathoracic and lung deposition fractions in a variety of age groups and breathing conditions are described. Efforts to link deposition models with pharmacokinetic models predicting lung and systemic exposure to inhaled drugs over time are then reviewed. Finally, new methods to predict intersubject variability in extrathoracic deposition, capturing variability in both size and shape of the upper airways, are highlighted. EXPERT OPINION Recent work has been done to expand in vitro deposition experiments to a wide range of age groups and breathing conditions, to link regional lung deposition models with pharmacokinetic models, and to improve prediction of intersubject variability. These efforts are improving predictive understanding of respiratory drug delivery, and will aid the development of new inhaled drugs and delivery devices.
Collapse
Affiliation(s)
- Andrew R Martin
- a Department of Mechanical Engineering , University of Alberta , Edmonton , AB , Canada
| | - Charles P Moore
- a Department of Mechanical Engineering , University of Alberta , Edmonton , AB , Canada
| | - Warren H Finlay
- a Department of Mechanical Engineering , University of Alberta , Edmonton , AB , Canada
| |
Collapse
|
41
|
Bäckström E, Hamm G, Nilsson A, Fihn BM, Strittmatter N, Andrén P, Goodwin RJA, Fridén M. Uncovering the regional localization of inhaled salmeterol retention in the lung. Drug Deliv 2018; 25:838-845. [PMID: 29587546 PMCID: PMC6058612 DOI: 10.1080/10717544.2018.1455762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Treatment of respiratory disease with a drug delivered via inhalation is generally held as being beneficial as it provides direct access to the lung target site with a minimum systemic exposure. There is however only limited information of the regional localization of drug retention following inhalation. The aim of this study was to investigate the regional and histological localization of salmeterol retention in the lungs after inhalation and to compare it to systemic administration. Lung distribution of salmeterol delivered to rats via nebulization or intravenous (IV) injection was analyzed with high-resolution mass spectrometry imaging (MSI). Salmeterol was widely distributed in the entire section at 5 min after inhalation, by 15 min it was preferentially retained in bronchial tissue. Via a novel dual-isotope study, where salmeterol was delivered via inhalation and d3-salmeterol via IV to the same rat, could the effective gain in drug concentration associated with inhaled delivery relative to IV, expressed as a site-specific lung targeting factor, was 5-, 31-, and 45-fold for the alveolar region, bronchial sub-epithelium and epithelium, respectively. We anticipate that this MSI-based framework for quantifying regional and histological lung targeting by inhalation will accelerate discovery and development of local and more precise treatments of respiratory disease.
Collapse
Affiliation(s)
- Erica Bäckström
- a Drug Metabolism and Pharmacokinetics, Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
| | - Gregory Hamm
- b Pathology Sciences, Drug Safety & Metabolism IMED Biotech Unit , AstraZeneca , Cambridge , UK
| | - Anna Nilsson
- c Biomolecular Mass Spectrometry Imaging, National Resource for MSI, Science for Life Laboratory, Dept. of Pharmaceutical Biosciences , Uppsala University , Uppsala , Sweden
| | - Britt-Marie Fihn
- a Drug Metabolism and Pharmacokinetics, Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden
| | - Nicole Strittmatter
- b Pathology Sciences, Drug Safety & Metabolism IMED Biotech Unit , AstraZeneca , Cambridge , UK
| | - Per Andrén
- c Biomolecular Mass Spectrometry Imaging, National Resource for MSI, Science for Life Laboratory, Dept. of Pharmaceutical Biosciences , Uppsala University , Uppsala , Sweden
| | - Richard J A Goodwin
- b Pathology Sciences, Drug Safety & Metabolism IMED Biotech Unit , AstraZeneca , Cambridge , UK
| | - Markus Fridén
- a Drug Metabolism and Pharmacokinetics, Respiratory, Inflammation and Autoimmunity IMED Biotech Unit , AstraZeneca , Gothenburg , Sweden.,d Translational PKPD Group, Department of Pharmaceutical Biosciences , Uppsala University , Uppsala , Sweden
| |
Collapse
|
42
|
Hassoun M, Royall PG, Parry M, Harvey RD, Forbes B. Design and development of a biorelevant simulated human lung fluid. J Drug Deliv Sci Technol 2018; 47:485-491. [PMID: 30283501 PMCID: PMC6156579 DOI: 10.1016/j.jddst.2018.08.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Biorelevant fluids are required to enable meaningful in vitro experimental determinations of the biopharmaceutical properties of inhaled medicines, e.g. drug solubility, particle dissolution, cellular uptake. Our aim was to develop a biorelevant simulated lung fluid (SLF) with a well-defined composition and evidence-based directions for use. The SLF contained dipalmitoylphosphotidylcholine, dipalmitoylphosphatidylglycerol, cholesterol, albumin, IgG, transferrin and antioxidants. Freshly made SLF had pH 7.2, viscosity 1.138 × 10−3 Pa s, conductivity 14.5 mS/m, surface tension 54.9 mN/m and density 0.999 g/cm3. Colour, surface tension and conductivity were the most sensitive indicators of product deterioration. The simulant was stable for 24 h and 48 h at 37 °C and 21 °C, respectively, (in-use stability) and for 14 days when stored in a refrigerator (storage stability). To extend stability, the SLF was vacuum freeze-dried in batches to produce lyophilised powder that can be reconstituted readily when needed at the point of use. In conclusion, we have reported the composition and manufacture of a biorelevant, synthetic SLF, provided a detailed physico-chemical characterisation and recommendations for how to store and use a product that can be used to generate experimental data to provide inputs to computational models that predict drug bioavailability in the lungs.
Collapse
Affiliation(s)
- Mireille Hassoun
- King's College London, Institute of Pharmaceutical Science, London, SE1 9NH, UK
| | - Paul G Royall
- King's College London, Institute of Pharmaceutical Science, London, SE1 9NH, UK
| | - Mark Parry
- Intertek-Melbourn Scientific Limited, Melbourn, SG8 6DN, UK
| | - Richard D Harvey
- Institute of Pharmacy, Martin-Luther-Universität Halle-Wittenberg, 06108, Halle (Saale), Germany
| | - Ben Forbes
- King's College London, Institute of Pharmaceutical Science, London, SE1 9NH, UK
| |
Collapse
|
43
|
Clippinger AJ, Allen D, Behrsing H, BéruBé KA, Bolger MB, Casey W, DeLorme M, Gaça M, Gehen SC, Glover K, Hayden P, Hinderliter P, Hotchkiss JA, Iskandar A, Keyser B, Luettich K, Ma-Hock L, Maione AG, Makena P, Melbourne J, Milchak L, Ng SP, Paini A, Page K, Patlewicz G, Prieto P, Raabe H, Reinke EN, Roper C, Rose J, Sharma M, Spoo W, Thorne PS, Wilson DM, Jarabek AM. Pathway-based predictive approaches for non-animal assessment of acute inhalation toxicity. Toxicol In Vitro 2018; 52:131-145. [PMID: 29908304 PMCID: PMC6760245 DOI: 10.1016/j.tiv.2018.06.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/01/2018] [Accepted: 06/08/2018] [Indexed: 01/14/2023]
Abstract
New approaches are needed to assess the effects of inhaled substances on human health. These approaches will be based on mechanisms of toxicity, an understanding of dosimetry, and the use of in silico modeling and in vitro test methods. In order to accelerate wider implementation of such approaches, development of adverse outcome pathways (AOPs) can help identify and address gaps in our understanding of relevant parameters for model input and mechanisms, and optimize non-animal approaches that can be used to investigate key events of toxicity. This paper describes the AOPs and the toolbox of in vitro and in silico models that can be used to assess the key events leading to toxicity following inhalation exposure. Because the optimal testing strategy will vary depending on the substance of interest, here we present a decision tree approach to identify an appropriate non-animal integrated testing strategy that incorporates consideration of a substance's physicochemical properties, relevant mechanisms of toxicity, and available in silico models and in vitro test methods. This decision tree can facilitate standardization of the testing approaches. Case study examples are presented to provide a basis for proof-of-concept testing to illustrate the utility of non-animal approaches to inform hazard identification and risk assessment of humans exposed to inhaled substances.
Collapse
Affiliation(s)
- Amy J Clippinger
- PETA International Science Consortium Ltd., Society Building, 8 All Saints Street, London N1 9RL, United Kingdom.
| | - David Allen
- Integrated Laboratory Systems, Contractor Supporting the NTP Interagency Center for the Evaluation of Alternative Toxicological Methods, Research Triangle Park, NC, United States
| | - Holger Behrsing
- Institute for In Vitro Sciences, 30 West Watkins Mill Road, Suite 100, Gaithersburg, MD 20878, United States
| | - Kelly A BéruBé
- Cardiff School of Biosciences, Museum Avenue, CF10 3AX, Wales, United Kingdom
| | - Michael B Bolger
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA 93534, United States
| | - Warren Casey
- NIH/NIEHS/DNTP/NICEATM, Research Triangle Park, North Carolina 27709, United States
| | | | - Marianna Gaça
- British American Tobacco plc, Globe House, 4 Temple Place, London WC2R 2PG, United Kingdom
| | - Sean C Gehen
- Dow AgroSciences, Indianapolis, IN, United States
| | - Kyle Glover
- Defense Threat Reduction Agency, Aberdeen Proving Ground, MD 21010, United States
| | - Patrick Hayden
- MatTek Corporation, 200 Homer Ave, Ashland, MA 01721, United States
| | | | | | - Anita Iskandar
- Philip Morris Products SA, Philip Morris International R&D, Neuchâtel, Switzerland
| | - Brian Keyser
- RAI Services Company, 401 North Main Street, Winston-Salem, NC 27101, United States
| | - Karsta Luettich
- Philip Morris Products SA, Philip Morris International R&D, Neuchâtel, Switzerland
| | - Lan Ma-Hock
- BASF SE, Carl-Bosch-Strasse 38, 67056 Ludwigshafen am Rhein, Germany
| | - Anna G Maione
- MatTek Corporation, 200 Homer Ave, Ashland, MA 01721, United States
| | - Patrudu Makena
- RAI Services Company, 401 North Main Street, Winston-Salem, NC 27101, United States
| | - Jodie Melbourne
- PETA International Science Consortium Ltd., Society Building, 8 All Saints Street, London N1 9RL, United Kingdom
| | | | - Sheung P Ng
- E.I. du Pont de Nemours and Company, DuPont Haskell Global Center for Health Sciences, P. O. Box 30, Newark, DE 19714, United States
| | - Alicia Paini
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Kathryn Page
- The Clorox Company, 4900 Johnson Dr, Pleasanton, CA 94588, United States
| | - Grace Patlewicz
- U.S. Environmental Protection Agency, Office of Research and Development, National Center for Computational Toxicology, Research Triangle Park, NC, United States
| | - Pilar Prieto
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Hans Raabe
- Institute for In Vitro Sciences, 30 West Watkins Mill Road, Suite 100, Gaithersburg, MD 20878, United States
| | - Emily N Reinke
- U.S. Army Public Health Center, 8252 Blackhawk Rd. Bldg. E-5158, ATTN: MCHB-PH-HEF Gunpowder, MD 21010-5403, United States
| | - Clive Roper
- Charles River Edinburgh Ltd., Edinburgh EH33 2NE, United Kingdom
| | - Jane Rose
- Procter & Gamble Co, 11530 Reed Hartman Highway, Cincinnati, OH 45241, United States
| | - Monita Sharma
- PETA International Science Consortium Ltd., Society Building, 8 All Saints Street, London N1 9RL, United Kingdom
| | - Wayne Spoo
- RAI Services Company, 401 North Main Street, Winston-Salem, NC 27101, United States
| | - Peter S Thorne
- University of Iowa College of Public Health, Iowa City, IA, United States
| | | | - Annie M Jarabek
- U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Research Triangle Park, NC, United States
| |
Collapse
|
44
|
Boger E, Wigström O. A Partial Differential Equation Approach to Inhalation Physiologically Based Pharmacokinetic Modeling. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2018; 7:638-646. [PMID: 30084547 PMCID: PMC6202470 DOI: 10.1002/psp4.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The heterogeneous nature of the lungs and the range of processes affecting pulmonary drug disposition make prediction of inhaled drugs challenging. These predictions are critical, as the local exposure cannot be measured and current inhalation physiologically based pharmacokinetic (PBPK) models do not capture all necessary features. Utilizing partial differential equations, we present an inhalation PBPK model to describe the heterogeneity in both lung physiology and particle size. The model mechanistically describes important processes, such as deposition, mucociliary clearance, and dissolution. In addition, simplifications are introduced to reduce computational cost without loss of accuracy. Three case studies exemplify how the model can enhance our understanding of pulmonary drug disposition. Specific findings include that most small airways can be targeted by inhalation, and overdosing may eradicate the advantage of inhalation. The presented model can guide the design of inhaled molecules, formulations, as well as clinical trials, providing opportunities to explore regional targeting.
Collapse
Affiliation(s)
- Elin Boger
- Respiratory, Inflammation and Autoimmunity IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Oskar Wigström
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| |
Collapse
|
45
|
Borghardt JM, Kloft C, Sharma A. Inhaled Therapy in Respiratory Disease: The Complex Interplay of Pulmonary Kinetic Processes. Can Respir J 2018; 2018:2732017. [PMID: 30018677 PMCID: PMC6029458 DOI: 10.1155/2018/2732017] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/26/2018] [Accepted: 05/10/2018] [Indexed: 11/18/2022] Open
Abstract
The inhalation route is frequently used to administer drugs for the management of respiratory diseases such as asthma or chronic obstructive pulmonary disease. Compared with other routes of administration, inhalation offers a number of advantages in the treatment of these diseases. For example, via inhalation, a drug is directly delivered to the target organ, conferring high pulmonary drug concentrations and low systemic drug concentrations. Therefore, drug inhalation is typically associated with high pulmonary efficacy and minimal systemic side effects. The lung, as a target, represents an organ with a complex structure and multiple pulmonary-specific pharmacokinetic processes, including (1) drug particle/droplet deposition; (2) pulmonary drug dissolution; (3) mucociliary and macrophage clearance; (4) absorption to lung tissue; (5) pulmonary tissue retention and tissue metabolism; and (6) absorptive drug clearance to the systemic perfusion. In this review, we describe these pharmacokinetic processes and explain how they may be influenced by drug-, formulation- and device-, and patient-related factors. Furthermore, we highlight the complex interplay between these processes and describe, using the examples of inhaled albuterol, fluticasone propionate, budesonide, and olodaterol, how various sequential or parallel pulmonary processes should be considered in order to comprehend the pulmonary fate of inhaled drugs.
Collapse
Affiliation(s)
- Jens Markus Borghardt
- Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Charlotte Kloft
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany
| | - Ashish Sharma
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| |
Collapse
|
46
|
Strong P, Ito K, Murray J, Rapeport G. Current approaches to the discovery of novel inhaled medicines. Drug Discov Today 2018; 23:1705-1717. [PMID: 29775668 DOI: 10.1016/j.drudis.2018.05.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/11/2018] [Accepted: 05/10/2018] [Indexed: 01/16/2023]
Abstract
Inhaled administration is underutilised because the drug discovery process is viewed as challenging, risky, and expensive. However, unmet medical need continues to grow, and significant opportunities exist to discover novel inhaled medicines delivering the required lung concentrations while minimising systemic exposure. This profile could be achieved by a combination of properties, including lung retention and low oral bioavailability. Property-based rules exist for orally administered compounds, but there has been limited progress defining in silico predictors to guide the discovery of novel inhaled drugs. Recently, the use of informative cell- and tissue-based screens has greatly facilitated the identification of compounds with optimal characteristics for inhaled delivery. Here, we address opportunities for novel inhaled drugs, and the key challenges and uncertainties hampering progress.
Collapse
Affiliation(s)
- Peter Strong
- Pulmocide Ltd, 52 Princes Gate, Exhibition Road, London SW7 2 PG, UK
| | - Kazuhiro Ito
- Pulmocide Ltd, 52 Princes Gate, Exhibition Road, London SW7 2 PG, UK
| | - John Murray
- Pulmocide Ltd, 52 Princes Gate, Exhibition Road, London SW7 2 PG, UK
| | - Garth Rapeport
- Pulmocide Ltd, 52 Princes Gate, Exhibition Road, London SW7 2 PG, UK.
| |
Collapse
|
47
|
Inhalation Biopharmaceutics: Progress Towards Comprehending the Fate of Inhaled Medicines. Pharm Res 2017; 34:2451-2453. [DOI: 10.1007/s11095-017-2304-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 11/25/2022]
|