Preformulation and characterization of a lidocaine hydrochloride and dexamethasone sodium phosphate thermo-reversible and bioadhesive long-acting gel for intraperitoneal administration

Long-Acting Gel Formulations: Advancing Drug Delivery across Diverse Therapeutic Areas

This multifaceted landscape of long-acting gels in diverse medical fields, aims to enhance therapeutic outcomes through localized treatment and controlled drug release. The objective involves advancements spanning cancer treatment, immunotherapy, diabetes management, neuroendocrine disorders, ophthalmic applications, contraception, HIV/AIDS treatment, chronic diseases, wound care, and antimicrobial treatments. It explores the potential of long-acting gels to offer sustained and extended drug release, targeted therapy, and innovative administration routes while addressing limitations such as scalability challenges and regulatory hurdles. Future directions focus on personalized therapies, biodegradability, combination therapies, interdisciplinary innovation, regulatory considerations, and patient-centric development. This comprehensive review highlights the pivotal role of long-acting gels in transforming therapeutic approaches and improving patient outcomes across various medical conditions.

Randomized trial of poloxamer 407-based ropivacaine hydrogel after thoracoscopic pulmonary resection

BACKGROUND

We conducted a comparative study to evaluate the efficacy of poloxamer 407-based ropivacaine hydrogel at the wound site (Gel) and continuous thoracic paravertebral block (On-Q) for postoperative pain following thoracoscopic pulmonary resection.

METHODS

This prospective, randomized, noninferiority study included 89 patients randomized into the two groups; Gel (poloxamer 407-based 0.75% ropivacaine, 22.5 mg) and On-Q (0.2% ropivacaine, 4 mg/hour for 48 hours). The primary outcome measure was total fentanyl consumption and secondary outcome measures were the need for rescue analgesia and pain intensity using the numeric rating scale (NRS).

RESULTS

There was no significant difference in total fentanyl consumption between the Gel group and the On-Q group (1504.29 ± 315.72 mcg vs 1560.32 ± 274.81 mcg, p = 0.374). Pain intensity using the NRS between the Gel group and the On-Q group demonstrated no statistical differences (6 hours: 3.56 vs 3.55, p = 0.958; 24 hours: 3.21 vs 3.00, p = 0.250; 48 hours: 2.75 vs 2.49, p = 0.233; and 72 hours: 2.39 vs 2.33, p = 0.811), and there was no significant difference in the frequency of analgesic rescue medication use (3.70 vs 3.33, p = 0.417).

CONCLUSIONS

We confirm the noninferiority of Gel compared with On-Q for acute postoperative pain following thoracoscopic pulmonary resection. Considering a technical simplicity and low systemic toxicity of the local injection of Gel, this analgesic modality may be worthy of further research and is thus considered to have potential as a viable alternative to On-Q for regional analgesia.

Levobupivacaine-Loaded Liposome Associated with Thermogel for Prolonged Analgesia

Pain is a phenomenon present in the majority of the population, affecting, among others, the elderly, overweight people, and especially recently operated patients, analgesia being necessary. In the specific case of relief of postoperative pain, different kinds of anesthetics are being used, among them bupivacaine, a widely used drug which promotes long-lasting analgesic effects. However, cardiotoxicity and neurotoxicity are related to its repetitive use. To overcome these shortcomings, Novabupi® (a racemic mixture) was developed and is marketed as an injectable solution. This formulation contains an enantiomeric excess of the levogyre isomer, which has reduced toxicity effects. Seeking to rationalize its use by extending the duration of effect and reducing the number of applications, the objectives of this work were to develop and evaluate liposomes containing Novabupi (LBPV), followed by incorporation into thermogel. Liposomes were prepared using the lipid hydration method, followed by size reduction using sonication, and the developed formulations were characterized by hydrodynamic diameter, polydispersity index (PDI), surface zeta potential, and encapsulation efficiency. The selected optimal liposomal formulation was successfully incorporated into a thermogel without loss of thermoresponsive properties, being suitable for administration as a subcutaneous injection. In the ex vivo permeation studies with fresh rodent skin, the thermogel with liposomes loaded with 0.5% LBPV (T-gel formulation 3) showed higher permeation rates compared to the starting formulation, thermogel with 0.5% LBPV (T-Gel 1), which will probably translate into better therapeutic benefits for treatment of postoperative analgesia, especially with regard to the number of doses applied.

Levobupivacaine Thermogel for Long-acting Analgesia

The adequate management of analgesia, by pharmacological methods or not, is a great challenge. Local anesthetics are used for pain relief, mainly by parenteral, intramuscular, catheter, and other routes of administration. The use of in situ forming systems becomes an alternative for the control of pain. The present research investigates development of thermogels containing poloxamer and levobupivacaine. All formulations were prepared by the cold method; the compatibilities of the excipients were evaluated by DSC, rheology and viscosities, transition temperature, syringeability, release kinetics, and permeation. The compatibility of the tested excipients with the drug was initially observed; all formulations had a viscosity increase at 37°C. Different delivery rates were observed in both the release and permeation studies. The developed systems maintained the in vitro release of the drug for a long period, likely decreasing side effects in vivo and avoiding the need for supplementary analgesia by other routes.

Osmolality predictive models of different polymers as tools in parenteral and ophthalmic formulation development

During the development of parenteral dosage forms, different physicochemical studies are required to ensure stable, effective and safe formulations. The osmolality of this kind of dosage forms should bear a close similarity to the body fluids to prevent local irritation, pain or even more significant side effects like endothelial damage. The osmotic studies performed in Polyethylene glycol 400 (PEG 400), Polyethylene glycol 4000 (PEG 4000), Poloxamer 407 (P407), Sodium Hyaluronate (SH), Chondroitin Sulphate Sodium (CS), Cremophor RH 40 (CRE40) and Polyvinyl alcohol (PVA) aqueous solutions, showed that the theoretical determination of the osmolality based on their molecular weight as the only determinant factor did not agree with the values obtained by the measurement of colligative properties such as the freezing point depression. The data obtained from this study and its analysis, provided predictive equations that can be used as tools in the primary development to estimate formulation's osmolality at different concentrations; and its evolution over a period at the hypothetical worst-case scenario of storage temperature.

Association of Silver Nanoparticles and Curcumin Solid Dispersion: Antimicrobial and Antioxidant Properties

The last century, more precisely after 1945, was marked by major advances in the treatment of infectious diseases which promoted a decrease in mortality and morbidity. Despite these advances, currently the development of antimicrobial resistance has been growing drastically and therefore there is a pressing need to search for new compounds. Silver nanoparticles (AgNps) have been demonstrating good antimicrobial activity against different bacteria, viruses, and fungi. Curcumin (CUR) extracted from rhizomes of Curcuma longa has a variety of applications including antiinflammatory, antioxidant, and antibacterial agent. The association between silver nanoparticles and curcumin in a formulation can be a good alternative to control infectious diseases due the antimicrobial properties of both compounds. The objective of this work was to develop a formulation composed of a thermoresponsive gel-with antimicrobial and antioxidant properties due to the association of AgNps with PVP and PVA polymers. After AgNp synthesis, these were incorporated together with the previously prepared CUR/P407 (1:2) solid dispersion (SD) into a polymer dispersion of 20% P407 (thermosensitive gel). Our results showed that the association between the AgNps with CUR SD demonstrated good antioxidant activity as compared to the standard compound. Measures of MIC showed more efficacy against Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa) than for Gram-positive bacteria (Staphylococcus aureus). This association enhances antimicrobial activity against E. coli and P aeruginosa and added antioxidant value in formulations.

Thermogelling properties of purified poloxamer 407

Poloxamers are triblock copolymers with a center block of hydrophobic polypropylene oxide (PPO) flanked by two hydrophilic polyethyleneoxide (PEO) blocks. Among this family of copolymers, poloxamer 407 is a non-ionic surfactant with reversible gelation properties above a particular polymer concentration and a particular temperature. Easy preparation of poloxamer 407 based sterile injectable formulations have made this copolymer a good candidate for drug delivery, specifically when controlled release of the drug is required. Previously, the applications of compendial poloxamer 407 preparations were demonstrated; however, low viscosity, poor elasticity, and sol-to-gel transition temperature (T_sol-gel) over a wide temperature range were observed. A purification process was introduced to eliminate impurities and low molecular weight copolymer molecules from the compendial poloxamer 407 resulting in higher viscosity values with T_sol-gel in a narrow temperature range. Here, poloxamer 407 was purified based on the proposed process and the rheological and analytical evaluation of the purified poloxamer 407 was conducted and compared to unpurified, compendial poloxamer 407. Then, the impact of poloxamer 407 concentration on gel formation was evaluated. For drug delivery applications, the effect of relevant buffer salts and the effect of addition of ethanol to the poloxamer 407 solutions were rheologically evaluated.