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Shaqour B, Natsheh H, Kittana N, Jaradat N, Abualhasan M, Eid AM, Moqady R, AbuHijleh A, Abu Alsaleem S, Ratrout S, De Wever L, Vervaet C, Vanhoorne V. Modified Release 3D-Printed Capsules Containing a Ketoprofen Self-Nanoemulsifying System for Personalized Medical Application. ACS Biomater Sci Eng 2024; 10:3833-3841. [PMID: 38747490 DOI: 10.1021/acsbiomaterials.4c00476] [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] [Indexed: 06/11/2024]
Abstract
This study explores the realm of personalized medicine by investigating the utilization of 3D-printed dosage forms, specifically focusing on patient-specific enteric capsules designed for the modified release of ketoprofen, serving as a model drug. The research investigates two distinct scenarios: the modification of drug release from 3D-printed capsules crafted from hydroxypropyl methylcellulose phthalate:polyethylene glycol (HPMCP:PEG) and poly(vinyl alcohol) (PVA), tailored for pH sensitivity and delayed release modes, respectively. Additionally, a novel ketoprofen-loaded self-nanoemulsifying drug delivery system (SNEDDS) based on pomegranate seed oil (PSO) was developed, characterized, and employed as a fill material for the capsules. Through the preparation and characterization of the HPMCP:PEG based filament via the hot-melt extrusion method, the study thoroughly investigated its thermal and mechanical properties. Notably, the in vitro drug release analysis unveiled the intricate interplay between ketoprofen release, polymer type, and capsule thickness. Furthermore, the incorporation of ketoprofen into the SNEDDS exhibited an enhancement in its in vitro cylooxygenase-2 (COX-2) inhibitory activity. These findings collectively underscore the potential of 3D printing in shaping tailored drug delivery systems, thereby contributing significantly to the advancement of personalized medicine.
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Affiliation(s)
- Bahaa Shaqour
- Mechanical and Mechatronics Engineering Department, Faculty of Engineering and Information Technology, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
- Medical and Health Sciences Research Center, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Hiba Natsheh
- Medical and Health Sciences Research Center, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Naim Kittana
- Medical and Health Sciences Research Center, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
- Department of Biomedical Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Murad Abualhasan
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Ahmad M Eid
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Ruaa Moqady
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Aya AbuHijleh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Saja Abu Alsaleem
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Shahd Ratrout
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus P4110257, Palestine
| | - Lotte De Wever
- Laboratory of Pharmaceutical Technology, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Chris Vervaet
- Laboratory of Pharmaceutical Technology, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Valérie Vanhoorne
- Laboratory of Pharmaceutical Technology, Department of Pharmaceutics, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
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Barakeh W, Zein O, Hemdanieh M, Sleem B, Nassereddine M. Enhancing Hip Arthroplasty Outcomes: The Multifaceted Advantages, Limitations, and Future Directions of 3D Printing Technology. Cureus 2024; 16:e60201. [PMID: 38868274 PMCID: PMC11167579 DOI: 10.7759/cureus.60201] [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] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
In the evolving field of orthopedic surgery, the integration of three-dimensional printing (3D printing) has emerged as a transformative technology, particularly in addressing the rising incidence of degenerative joint diseases. The integration of 3D printing technology in hip arthroplasty offers substantial advantages throughout the surgical process. In preoperative planning, 3D models enable meticulous assessments, aiding in accurate implant selection and precise surgical strategies. Intraoperatively, the technology contributes to precise prosthesis design, reducing operation duration, X-ray exposures, and blood loss. Beyond surgery, 3D printing revolutionizes medical equipment production, imaging, and implant design, showcasing benefits such as enhanced osseointegration and reduced stress shielding with titanium cups. Challenges include a higher risk of postoperative infection due to the porous surfaces of 3D-printed implants, technical complexities in the printing process, and the need for skilled manpower. Despite these challenges, the evolving nature of 3D printing technologies underscores the importance of relying on existing orthopedic surgical practices while emphasizing the need for standardized guidelines to fully harness its potential in improving patient care.
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Affiliation(s)
- Wael Barakeh
- Orthopedic Surgery, American University of Beirut, Beirut, LBN
| | - Omar Zein
- Orthopedic Surgery, American University of Beirut, Beirut, LBN
| | - Maya Hemdanieh
- Orthopedic Surgery, American University of Beirut, Beirut, LBN
| | - Bshara Sleem
- Orthopedic Surgery, American University of Beirut, Beirut, LBN
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Chacko IA, Ramachandran G, Sudheesh MS. Unmet technological demands in orodispersible films for age-appropriate paediatric drug delivery. Drug Deliv Transl Res 2024; 14:841-857. [PMID: 37957474 DOI: 10.1007/s13346-023-01451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/15/2023]
Abstract
Age-appropriateness of a formulation is the ability to deliver variable but accurate doses to the paediatric population in a safe and acceptable manner to improve medical adherence and reduce medication errors. Paediatric drug delivery is a challenging area of formulation research due to the existing gap in knowledge. This includes the unknown safety of excipients in the paediatric population, the need for an age-appropriate formulation, the lack of an effective taste-masking method and the lack of paediatric pharmacokinetic data and patient acceptability. It is equally important to establish methods for predicting the biopharmaceutical performance of a paediatric formulation as a function of age. Overcoming the challenges of existing technologies and providing custom-made solutions for the development of age-appropriate formulation is, therefore, a daunting task. Orodispersible films (ODF) are promising as age-appropriate formulations, an unmet need in paediatric drug delivery. New technological improvements in taste masking, improving solubility and rate of dissolution of insoluble drugs, the flexibility of dosing and extemporaneous preparation of these films in a hospital good manufacturing practises (GMP) setup using 3D printing can increase its acceptance among clinicians, patients and caregivers. The current review discusses the problems and possibilities in ODF technology to address the outstanding issues of age-appropriateness, which is the hallmark of patient acceptance and medical adherence in paediatrics.
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Affiliation(s)
- Indhu Annie Chacko
- Department of Pharmaceutics, Amrita School of Pharmacy, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, 682041, Ponekkara, Kochi, India
| | - Gayathri Ramachandran
- Department of Pharmaceutics, Amrita School of Pharmacy, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, 682041, Ponekkara, Kochi, India
| | - M S Sudheesh
- Department of Pharmaceutics, Amrita School of Pharmacy, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, 682041, Ponekkara, Kochi, India.
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Chen H, Zheng K, Bu T, Li X, Wang X, Pan H. Fabrication of 3D-Printed Hydrocortisone Triple Pulsatile Tablet Using Fused Deposition Modelling Technology. AAPS PharmSciTech 2024; 25:58. [PMID: 38472689 DOI: 10.1208/s12249-024-02757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/01/2024] [Indexed: 03/14/2024] Open
Abstract
Hydrocortisone (HC) is the optimal drug for adolescents diagnosed with congenital adrenal hyperplasia (CAH). Because traditional dosage regimens HC are inconvenient, our study used fused deposition modeling (FDM) three-dimensional (3D) printing technology to solve the problems caused by traditional preparations. First, we designed a core-shell structure tablet with an inner instant release component and an outer delayed release shell. The instant release component was Kollicoat IR: glycerol (GLY): HC = 76.5:13.5:10. Then, we used Affinisol® HPMC 15LV to realize delayed release. Furthermore, we investigated the relationship between the thickness of the delayed release shell and the delayed release time, and an equation was derived through binomial regression analysis. Based on that equation, a novel triple pulsatile tablet with an innovative structure was devised. The tablet was divided into three components, and the drug was released multiple times at different times. The dose and release rate of the tablets can be adjusted by modifying the infill rate of the printing model. The results indicated that the triple pulsatile tablet exhibited desirable release behavior in vitro. Moreover, the physicochemical properties of the drug, excipients, filaments, and tablets were characterized. All these results indicate that the FDM 3D printing method is a convenient technique for producing preparations with intricate structures.
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Affiliation(s)
- Hao Chen
- School of Pharmacy, Liaoning University, 66 Chongshan Middle Road, Shenyang, 110036, China
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, China
| | - Kai Zheng
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, China
| | - Tianshi Bu
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, China
| | - Xin Li
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, China
| | - Xiangyu Wang
- School of Pharmacy, Liaoning University, 66 Chongshan Middle Road, Shenyang, 110036, China
| | - Hao Pan
- School of Pharmacy, Liaoning University, 66 Chongshan Middle Road, Shenyang, 110036, China.
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Chahuan A, Verma A, Shekho D, Mishra R, Awasthi A. Revolutionizing the World of Pharmaceuticals: Unleashing the Game-Changing Power of 3D Printing. Curr Drug Targets 2024; 25:513-516. [PMID: 38712375 DOI: 10.2174/0113894501304163240429081741] [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: 02/05/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 05/08/2024]
Affiliation(s)
- Abhishek Chahuan
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Abhishek Verma
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Devank Shekho
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Ritika Mishra
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, 142001, India
| | - Ankit Awasthi
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, 142001, India
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Ramtoola Z, Catibusic A, Ameen H, Cullen S, Barlow JW. Evaluation of the type and frequency of extemporaneous formulations dispensed in hospital and community pharmacies. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100380. [PMID: 38146320 PMCID: PMC10749281 DOI: 10.1016/j.rcsop.2023.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Extemporaneous compounding is practiced globally by pharmacists to allow for dispensing of personalised doses of medicinal products not commercially available. Extemporaneous compounding must result in a product which is safe and effective. However, data on formulation and expiry of extemporaneous products may not be readily available. Pharmacists access various resources including compounding databases to obtain information on composition, preparation, and expiry of extemporaneous preparations. Objectives The aim of this study was to evaluate the type and frequency of extemporaneous compounding in hospital and community pharmacies in the Republic of Ireland (ROI) and to obtain contemporary information on compounding practices and resources used. Methods All community and hospital pharmacists registered with the Pharmaceutical Society of Ireland, were invited to participate in an on-line survey. The study was approved by the Royal College of Surgeons in Ireland (RCSI) research ethics committee. Results A total of 202 pharmacists responded to the survey, of which 145 were community-based, 52 hospital-based, and 5 practicing in both. On average, hospital and community pharmacists (n = 138) dispensed <2-10 prescriptions for extemporaneous products per month. Pharmacists reported compounding 13 different types of extemporaneous preparations. Of these, dermatological preparations and oral liquid formulations (OLFs) were most commonly compounded. Extemp.ie, an Irish compounding database, was the most frequently used resource for compounding guidance and product expiry. Conclusions The results of this study show that extemporaneous compounding is still practiced in hospital and community pharmacies in the ROI. The limited response of 4.6% obtained may reflect that extemporaneous compounding is concentrated in a relatively small number of pharmacies. There remains a clinical need for extemporaneous products in the ROI and extemporaneous compounding continues to be an invaluable skillset for pharmacists.
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Affiliation(s)
- Zebunnissa Ramtoola
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 111 St. Stephen's Green, Dublin 2, Ireland
| | - Ayumi Catibusic
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 111 St. Stephen's Green, Dublin 2, Ireland
| | - Hitam Ameen
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 111 St. Stephen's Green, Dublin 2, Ireland
| | - Sarah Cullen
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 111 St. Stephen's Green, Dublin 2, Ireland
| | - James W. Barlow
- Department of Chemistry, RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
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Seoane-Viaño I, Xu X, Ong JJ, Teyeb A, Gaisford S, Campos-Álvarez A, Stulz A, Marcuta C, Kraschew L, Mohr W, Basit AW, Goyanes A. A case study on decentralized manufacturing of 3D printed medicines. Int J Pharm X 2023; 5:100184. [PMID: 37396623 PMCID: PMC10314212 DOI: 10.1016/j.ijpx.2023.100184] [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: 03/26/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
Pharmaceutical 3D printing (3DP) is one of the emerging enabling technologies of personalised medicines as it affords the ability to fabricate highly versatile dosage forms. In the past 2 years, national medicines regulatory authorities have held consultations with external stakeholders to adapt regulatory frameworks to embrace point-of-care manufacturing. The proposed concept of decentralized manufacturing (DM) involves the provision of feedstock intermediates (pharma-inks) prepared by pharmaceutical companies to DM sites for manufacturing into the final medicine. In this study, we examine the feasibility of this model, with respect to both manufacturing and quality control. Efavirenz-loaded granulates (0-35%w/w) were produced by a manufacturing partner and shipped to a 3DP site in a different country. Direct powder extrusion (DPE) 3DP was subsequently used to prepare printlets (3D printed tablets), with mass ranging 266-371 mg. All printlets released more than 80% drug load within the first 60 min of the in vitro drug release test. An in-line near-infrared spectroscopy system was used as a process analytical technology (PAT) to quantify the printlets' drug load. Calibration models were developed using partial least squares regression, which showed excellent linearity (R2 = 0.9833) and accuracy (RMSE = 1.0662). Overall, this work is the first to report the use of an in-line NIR system to perform real-time analysis of printlets prepared using pharma-inks produced by a pharmaceutical company. By demonstrating the feasibility of the proposed distribution model through this proof-of-concept study, this work paves the way for investigation of further PAT tools for quality control in 3DP point-of-care manufacturing.
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Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Paraquasil Group (GI-2109), Faculty of Pharmacy, iMATUS and Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela 15782, Spain
| | - Xiaoyan Xu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Jun Jie Ong
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Ahmed Teyeb
- Brunel Innovation Centre, Brunel University London, Uxbridge UB8 3PH, UK
| | - Simon Gaisford
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - André Campos-Álvarez
- FABRX Artificial Intelligence, Carretera de Escairón, 14, Currelos (O Saviñao), CP 27543, Spain
- FABRX Ltd., Henwood House, Henwood, Ashford TN24 8DH, UK
| | - Anja Stulz
- Losan Pharma GmbH, Otto-Hahn-Strasse 13, 79395 Neuenburg, Germany
| | - Carmen Marcuta
- Losan Pharma GmbH, Otto-Hahn-Strasse 13, 79395 Neuenburg, Germany
| | - Lilia Kraschew
- Losan Pharma GmbH, Otto-Hahn-Strasse 13, 79395 Neuenburg, Germany
| | - Wolfgang Mohr
- Losan Pharma GmbH, Otto-Hahn-Strasse 13, 79395 Neuenburg, Germany
| | - Abdul W. Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- FABRX Artificial Intelligence, Carretera de Escairón, 14, Currelos (O Saviñao), CP 27543, Spain
- FABRX Ltd., Henwood House, Henwood, Ashford TN24 8DH, UK
| | - Alvaro Goyanes
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- FABRX Artificial Intelligence, Carretera de Escairón, 14, Currelos (O Saviñao), CP 27543, Spain
- FABRX Ltd., Henwood House, Henwood, Ashford TN24 8DH, UK
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, iMATUS and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela (USC), Santiago de Compostela 15782, Spain
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Englezos K, Wang L, Tan ECK, Kang L. 3D printing for personalised medicines: implications for policy and practice. Int J Pharm 2023; 635:122785. [PMID: 36849040 DOI: 10.1016/j.ijpharm.2023.122785] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
The current healthcare dynamic has shifted from one-size-fits-all to patient-centred care, with our increased understanding of pharmacokinetics and pharmacogenomics demanding a switch to more individualised therapies. As the pharmaceutical industry remains yet to succumb to the push of a technological paradigm shift, pharmacists lack the means to provide completely personalised medicine (PM) to their patients in a safe, affordable, and widely accessible manner. As additive manufacturing technology has already established its strength in producing pharmaceutical formulations, it is necessary to next consider methods by which this technology can create PM accessible from pharmacies. In this article, we reviewed the limitations of current pharmaceutical manufacturing methods for PMs, three-dimensional (3D) printing techniques that are most beneficial for PMs, implications of bringing this technology into pharmacy practice, and implications for policy surrounding 3D printing techniques in the manufacturing of PMs.
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Affiliation(s)
- Klaudia Englezos
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Lingxin Wang
- Pharmacy Department, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
| | - Edwin C K Tan
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Lifeng Kang
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia.
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Beer N, Kaae S, Genina N, Sporrong SK, Alves TL, Hoebert J, De Bruin ML, Hegger I. Magistral Compounding with 3D Printing: A Promising Way to Achieve Personalized Medicine. Ther Innov Regul Sci 2023; 57:26-36. [PMID: 35943712 PMCID: PMC9755095 DOI: 10.1007/s43441-022-00436-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Magistral compounding has always been an integral part of pharmacy practice. The increasing demand worldwide for personalized drug treatments might be accommodated by an increase in magistral compounding. The new, flexible technology of 3D medicine printing could advance this process even further. However, the issue of how 3D medicine printing can be implemented within the existing magistral compounding infrastructure has not been explored. AIMS To investigate how 3D printing can be integrated into the existing compounding system by taking regulatory, economic, and profession-oriented aspects into account. METHODS Semi-structured interviews were conducted with relevant Dutch stakeholders representing various health institutions, such as health ministries and boards, professional bodies, and different types of pharmacies. Participants were identified through purposeful sampling. Content analysis was applied to identify the main themes. RESULTS A total of 15 Dutch stakeholders were interviewed. It was found that the prevalence of compounding in community pharmacies in the Netherlands has decreased as a result of the practice shifting to specialized compounding pharmacies due to higher costs, lack of space, and the need to fulfill quality requirements. All interviewees considered 3D printing to be a promising compounding technique for community pharmacies, as it offers an automated approach with high digital flexibility and enables adapted formulations, including 'polypills.' Regulatory and quality assurance challenges were considered comparable to those of normal magistral products; however, there remain pending regulatory issues regarding quality control, particularly for Active Pharmaceutical Ingredients containing intermediate feedstock materials (e.g., prefilled cartridges) in 3D printing. 3D printing was believed to become cost effective over time. CONCLUSION In the Netherlands, specialized compounding pharmacies have largely taken over compounding activities. 3D printing could be introduced within this system; however, challenges regarding how to regulate prefilled cartridges have yet to be addressed. Compounding using 3D printing in regular community pharmacies could enhance patients' individualized treatment; however, this activity would require incentives to stimulate the return of compounding to normal pharmacy practice.
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Affiliation(s)
- Netta Beer
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark
| | - Susanne Kaae
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark
| | - Natalja Genina
- Manufacturing and Materials Research Group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - Sofia Kälvemark Sporrong
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark ,Social Pharmacy Group, Department of Pharmacy, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Teresa Leonardo Alves
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Joëlle Hoebert
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marie Louise De Bruin
- Copenhagen Centre for Regulatory Science, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark ,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ingrid Hegger
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Hoffmann L, Breitkreutz J, Quodbach J. Fused Deposition Modeling (FDM) 3D Printing of the Thermo-Sensitive Peptidomimetic Drug Enalapril Maleate. Pharmaceutics 2022; 14:2411. [PMID: 36365230 PMCID: PMC9695326 DOI: 10.3390/pharmaceutics14112411] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 07/21/2023] Open
Abstract
Fused deposition modeling (FDM) 3D printing was used to produce 3D printed tablets with the thermo-sensitive model peptidomimetic drug enalapril maleate (EM). Two different formulations were prepared to investigate the degradation of enalapril maleate during the FDM 3D printing process. Soluplus® and Eudragit® E PO were chosen as polymers. After hot-melt extrusion (HME) and FDM 3D printing, both formulations were characterised regarding their solid-state properties using DSC and XRD. The degradation of the drug was analysed by determination of the content in the extrudates and 3D printed tablets, and dissolution was assessed. Various approaches have been attempted to prevent degradation of enalapril maleate, including utilization of a larger nozzle diameter and higher printing speeds to reduce heat exposition. None of these approaches were successful in preventing drug degradation. However, significant differences in the amount of degradation between the two formulations with different polymers could be observed. Thus, the FDM 3D printing process was not feasible without any degradation for the thermo-sensitive drug enalapril maleate. A maximum of 85.55 ± 1.48% enalapril was recovered in Eudragit® E PO tablets printed with a 0.4 mm nozzle at a temperature of 180 °C and with a speed of 30 mm/s.
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Affiliation(s)
- Lena Hoffmann
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Jörg Breitkreutz
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Julian Quodbach
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
- Department of Pharmaceutics, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
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3D-Powder-Bed-Printed Pharmaceutical Drug Product Tablets for Use in Clinical Studies. Pharmaceutics 2022; 14:pharmaceutics14112320. [PMID: 36365136 PMCID: PMC9699453 DOI: 10.3390/pharmaceutics14112320] [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: 09/22/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Printing of phase 1 and 2a clinical trial formulations represents an interesting industrial application of powder bed printing. Formulations for clinical trials are challenging because they should enable flexible changes in the strength of the dosage form by varying the active pharmaceutical ingredient (API) percentage and tablet mass. The aim of this study was to investigate how powder bed 3D printing can be used for development of flexible platforms for clinical trials, suitable for both hydrophilic and hydrophobic APIs, using only conventional tableting excipients. A series of pre-formulation and formulation studies were performed to develop two platform formulations for clinical trials using acetaminophen and diclofenac sodium as model compounds and lactose and starch as excipients. The results showed that the type of starch used as the formulation binder must be optimized based on the type of API. Moreover, powder blend flow and liquid penetration ability proved to be critical material attributes (CMAs) that need to be controlled, particularly at high drug loading. Optimization of these CMAs was performed by selecting the appropriate particle size of the API or by addition of silica. A critical process parameter that had to be controlled for production of tablets of good quality was the quantity of the printing ink. After optimization of both the formulation and process parameters, two platform formulations, that is, one for each API, were successfully developed. Within each platform, drug loading from 5 up to 50% w/w and tablet mass from 50 to 500 mg were achieved. All 3D-printed tablets could be produced at tensile strength above 0.2 MPa, and most tablets could enable immediate release (i.e., >80% w/w within 30 min).
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Ballardini RM, Mimler M, Minssen T, Salmi M. 3D Printing, Intellectual Property Rights and Medical Emergencies: In Search of New Flexibilities. IIC - INTERNATIONAL REVIEW OF INTELLECTUAL PROPERTY AND COMPETITION LAW 2022; 53:1149-1173. [PMID: 36065358 PMCID: PMC9434072 DOI: 10.1007/s40319-022-01235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic has exponentially accelerated the use of 3D printing (3DP) technologies in healthcare. Surprisingly, though, we have seen hardly any public intellectual property right (IPR) disputes concerning the 3D-printed medical equipment produced to cope with this crisis. Yet it can be assumed that a great variety of IPRs could potentially have been enforced against the use of various items of equipment printed out without express consent from IP holders. Many reasons might have motivated IP owners not to enforce their rights during the pandemic, such as the fear of acquiring a bad reputation during a declared situation of national emergency. There is no internationally recognised general exception to IPR enforcement for health emergencies, while several − sometimes ineffective − tools, like compulsory licensing, voluntary licensing arrangements and potential TRIPS waivers, have been considered or used to facilitate access to and the distribution of innovations in critical situations. During the COVID-19 emergency, this has meant that the 3DP community has been operating in a state of relative uncertainty including with regard to the risks of IP infringement. This study contextualises these issues for pandemic-relevant 3DP. Building upon experience gathered during the COVID-19 pandemic, we look to the future to see what novel mechanisms within the IPR system could provide the additional flexibility required for dealing more smoothly, with the help and support of digital technologies, with situations such as global health emergencies.
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Weaver E, O'Hagan C, Lamprou DA. The sustainability of emerging technologies for use in pharmaceutical manufacturing. Expert Opin Drug Deliv 2022; 19:861-872. [PMID: 35732275 DOI: 10.1080/17425247.2022.2093857] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Sustainability within the pharmaceutical industry is becoming a focal point for many companies, to improve the longevity and social perception of the industry. Both additive manufacturing (AM) and microfluidics (MFs) are continuously progressing, so are far from their optimization in terms of sustainability; hence, it is the aim of this review to highlight potential gaps alongside their beneficial features. Discussed throughout this review also will be an in-depth discussion on the environmental, legal, economic, and social particulars relating to these emerging technologies. AREAS COVERED Additive manufacturing (AM) and microfluidics (MFs) are discussed in depth within this review, drawing from up-to-date literature relating to sustainability and circular economies. This applies to both technologies being utilized for therapeutic and analytical purposes within the pharmaceutical industry. EXPERT OPINION It is the role of emerging technologies to be at the forefront of promoting a sustainable message by delivering plausible environmental standards whilst maintaining efficacy and economic viability. AM processes are highly customizable, allowing for their optimization in terms of sustainability, from reducing printing time to reducing material usage by removing supports. MFs too are supporting sustainability via reduced material wastage and providing a sustainable means for point of care analysis.
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Affiliation(s)
- Edward Weaver
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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Additive Manufacturing Strategies for Personalized Drug Delivery Systems and Medical Devices: Fused Filament Fabrication and Semi Solid Extrusion. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27092784. [PMID: 35566146 PMCID: PMC9100145 DOI: 10.3390/molecules27092784] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 12/26/2022]
Abstract
Novel additive manufacturing (AM) techniques and particularly 3D printing (3DP) have achieved a decade of success in pharmaceutical and biomedical fields. Highly innovative personalized therapeutical solutions may be designed and manufactured through a layer-by-layer approach starting from a digital model realized according to the needs of a specific patient or a patient group. The combination of patient-tailored drug dose, dosage, or diagnostic form (shape and size) and drug release adjustment has the potential to ensure the optimal patient therapy. Among the different 3D printing techniques, extrusion-based technologies, such as fused filament fabrication (FFF) and semi solid extrusion (SSE), are the most investigated for their high versatility, precision, feasibility, and cheapness. This review provides an overview on different 3DP techniques to produce personalized drug delivery systems and medical devices, highlighting, for each method, the critical printing process parameters, the main starting materials, as well as advantages and limitations. Furthermore, the recent developments of fused filament fabrication and semi solid extrusion 3DP are discussed. In this regard, the current state of the art, based on a detailed literature survey of the different 3D products printed via extrusion-based techniques, envisioning future directions in the clinical applications and diffusion of such systems, is summarized.
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Solid Dispersion Formulations by FDM 3D Printing-A Review. Pharmaceutics 2022; 14:pharmaceutics14040690. [PMID: 35456524 PMCID: PMC9032529 DOI: 10.3390/pharmaceutics14040690] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 01/06/2023] Open
Abstract
Additive manufacturing (AM) is revolutionizing the way medicines are designed, manufactured, and utilized. Perhaps, AM appears to be ideal for the fit-for-purpose manufacturing of medicines in contrast to the several disadvantages associated with the conventional fit-for-all mass production that accounts for less than 50% of pharmacotherapeutic treatment/management of diseases especially among children and elderly patients, as well as patients with special needs. In this review, we discuss the current trends in the application of additive manufacturing to prepare personalized dosage forms on-demand focusing the attention on the relevance of coupling solid dispersion with FDM 3D printing. Combining the two technologies could offer many advantages such as to improve the solubility, dissolution, and oral bioavailability of poorly soluble drugs in tandem with the concept of precision medicine and personalized dosing and to address the dilemma of commercial availability of FDM filaments loaded with Class II and/or Class IV drugs. However, thermal treatment especially for heat-sensitive drugs, regulatory, and ethical obligations in terms of quality control and quality assurance remain points of concern. Hence, a concerted effort is needed between the scientific community, the pharmaceutical industries, the regulatory agencies, the clinicians and clinical pharmacists, and the end-users to address these concerns.
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The Advent of a New Era in Digital Healthcare: A Role for 3D Printing Technologies in Drug Manufacturing? Pharmaceutics 2022; 14:pharmaceutics14030609. [PMID: 35335984 PMCID: PMC8952205 DOI: 10.3390/pharmaceutics14030609] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/24/2022] Open
Abstract
The technological revolution has physically affected all manufacturing domains, at the gateway of the fourth industrial revolution. Three-dimensional (3D) printing has already shown its potential in this new reality, exhibiting remarkable applications in the production of drug delivery systems. As part of this concept, personalization of the dosage form by means of individualized drug dose or improved formulation functionalities has concentrated global research efforts. Beyond the manufacturing level, significant parameters must be considered to promote the real-time manufacturing of pharmaceutical products in distributed areas. The majority of current research activities is focused on formulating 3D-printed drug delivery systems while showcasing different scenarios of installing 3D printers in patients' houses, hospitals, and community pharmacies, as well as in pharmaceutical industries. Such research presents an array of parameters that must be considered to integrate 3D printing in a future healthcare system, with special focus on regulatory issues, drug shortages, quality assurance of the product, and acceptability of these scenarios by healthcare professionals and public parties. The objective of this review is to critically present the spectrum of possible scenarios of 3D printing implementation in future healthcare and to discuss the inevitable issues that must be addressed.
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Lafeber I, Ruijgrok EJ, Guchelaar HJ, Schimmel KJM. 3D Printing of Pediatric Medication: The End of Bad Tasting Oral Liquids?-A Scoping Review. Pharmaceutics 2022; 14:416. [PMID: 35214148 PMCID: PMC8880000 DOI: 10.3390/pharmaceutics14020416] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
3D printing of pediatric-centered drug formulations can provide suitable alternatives to current treatment options, though further research is still warranted for successful clinical implementation of these innovative drug products. Extensive research has been conducted on the compliance of 3D-printed drug products to a pediatric quality target product profile. The 3D-printed tablets were of particular interest in providing superior dosing and release profile similarity compared to conventional drug manipulation and compounding methods, such as oral liquids. In the future, acceptance of 3D-printed tablets in the pediatric patient population might be better than current treatments due to improved palatability. Further research should focus on expanding clinical knowledge, providing regulatory guidance and expansion of the product range, including dosage form possibilities. Moreover, it should enable the use of diverse good manufacturing practice (GMP)-ready 3D printing techniques for the production of various drug products for the pediatric patient population.
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Affiliation(s)
- Iris Lafeber
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
| | - Elisabeth J. Ruijgrok
- Department of Hospital Pharmacy, Erasmus MC—Sophia Children’s Hospital, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands;
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
| | - Kirsten J. M. Schimmel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (I.L.); (H.-J.G.)
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O’Reilly CS, Elbadawi M, Desai N, Gaisford S, Basit AW, Orlu M. Machine Learning and Machine Vision Accelerate 3D Printed Orodispersible Film Development. Pharmaceutics 2021; 13:2187. [PMID: 34959468 PMCID: PMC8706962 DOI: 10.3390/pharmaceutics13122187] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 01/17/2023] Open
Abstract
Orodispersible films (ODFs) are an attractive delivery system for a myriad of clinical applications and possess both large economical and clinical rewards. However, the manufacturing of ODFs does not adhere to contemporary paradigms of personalised, on-demand medicine, nor sustainable manufacturing. To address these shortcomings, both three-dimensional (3D) printing and machine learning (ML) were employed to provide on-demand manufacturing and quality control checks of ODFs. Direct ink writing (DIW) was able to fabricate complex ODF shapes, with thicknesses of less than 100 µm. ML algorithms were explored to classify the ODFs according to their active ingredient, by using their near-infrared (NIR) spectrums. A supervised model of linear discriminant analysis was found to provide 100% accuracy in classifying ODFs. A subsequent partial least square algorithm was applied to verify the dose, where a coefficient of determination of 0.96, 0.99 and 0.98 was obtained for ODFs of paracetamol, caffeine, and theophylline, respectively. Therefore, it was concluded that the combination of 3D printing, NIR and ML can result in a rapid production and verification of ODFs. Additionally, a machine vision tool was used to automate the in vitro testing. These collective digital technologies demonstrate the potential to automate the ODF workflow.
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Affiliation(s)
| | | | | | | | - Abdul W. Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK (M.E.); (N.D.); (S.G.)
| | - Mine Orlu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK (M.E.); (N.D.); (S.G.)
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de Oliveira RS, Fantaus SS, Guillot AJ, Melero A, Beck RCR. 3D-Printed Products for Topical Skin Applications: From Personalized Dressings to Drug Delivery. Pharmaceutics 2021; 13:1946. [PMID: 34834360 PMCID: PMC8625283 DOI: 10.3390/pharmaceutics13111946] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/13/2021] [Accepted: 11/14/2021] [Indexed: 01/05/2023] Open
Abstract
3D printing has been widely used for the personalization of therapies and on-demand production of complex pharmaceutical forms. Recently, 3D printing has been explored as a tool for the development of topical dosage forms and wound dressings. Thus, this review aims to present advances related to the use of 3D printing for the development of pharmaceutical and biomedical products for topical skin applications, covering plain dressing and products for the delivery of active ingredients to the skin. Based on the data acquired, the important growth in the number of publications over the last years confirms its interest. The semisolid extrusion technique has been the most reported one, probably because it allows the use of a broad range of polymers, creating the most diverse therapeutic approaches. 3D printing has been an excellent field for customizing dressings, according to individual needs. Studies discussed here imply the use of metals, nanoparticles, drugs, natural compounds and proteins and peptides for the treatment of wound healing, acne, pain relief, and anti-wrinkle, among others. The confluence of 3D printing and topical applications has undeniable advantages, and we would like to encourage the research groups to explore this field to improve the patient's life quality, adherence and treatment efficacy.
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Affiliation(s)
- Rafaela Santos de Oliveira
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752, Porto Alegre 90610-000, Brazil;
| | - Stephani Silva Fantaus
- Departamento de Produção e Controle de Medicamentos, Universidade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752, Porto Alegre 90610-000, Brazil;
| | - Antonio José Guillot
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estelles SN, 46100 Burjassot, Spain;
| | - Ana Melero
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estelles SN, 46100 Burjassot, Spain;
| | - Ruy Carlos Ruver Beck
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752, Porto Alegre 90610-000, Brazil;
- Departamento de Produção e Controle de Medicamentos, Universidade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752, Porto Alegre 90610-000, Brazil;
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