Influence of penetration enhancers on the blanching intensity of betamethasone 17-benzoate

Effect of Different Skin Penetration Promoters in Halobetasol Propionate Permeation and Retention in Human Skin

Halobetasol propionate (HB) is a potent synthetic corticosteroid used against inflammatory skin diseases, such as dermatitis, eczema, and psoriasis, among others. The aim of this study is to define how the presence of different skin penetration enhancers (nonane, menthone, limonene, azone, carene, decanol, linoleic acid and cetiol) affects the penetration and retention in skin of HB. To determine drug penetration through skin, 5% of each promoter was used in an ex vivo system with human skin on Franz cells. The results showed that the highest permeation occurs in the presence of menthone, followed by nonane. Permeation parameters were determined. The in vivo test was assessed, and the formulation containing HB-menthone presented better anti-inflammatory efficacy. These results are useful to generate a specific treatment according to each patient's needs, and the inflammatory characteristics of the disease.

The effect of cream and ointment bases on the steady state penetration of permeants through intact skin: the reciprocal of the onset time of a pharmacodynamic effect as parameter of response

To characterize cream or ointment bases for cosmetic or pharmaceutical purposes with regard to their effect on permeant penetration through intact healthy skin, the measurement of the pharmacodynamic response of a suitable model drug incorporated in these bases has been shown to be a promising approach. In general, it may be distinguished between thermodynamic vehicle effects owing to different permeant escaping tendencies from the vehicles and penetration-enhancing vehicle effects resulting from a change of the stratum corneum structure, which manifests itself in an increase of the permeant diffusion coefficient and/or its solubility in this barrier. As the latency time of onset of a pharmacodynamic effect, usually used as reciprocal value, represents a suitable response parameter under certain circumstances, this study was done to further evaluate this parameter with regard to the determination of relative bioavailability and penetration enhancement data obtained from simulated dose- and activity-response curves assuming infinite dose conditions, i.e. zero order penetration kinetics and considering varying lag times of drug penetration. The results indicate that bioavailability and enhancement factors may be determined accurately from the horizontal distance between dose- or activity-response curves of a standard and a test preparation as long as the curves are parallel to each other, as it is the case with uniform lag times of permeant penetration. Non-parallel curves observed with varying lag times indicate an influence of the vehicles on the permeant diffusion coefficient in the barrier. Enhancement factors from these curves may be obtained after determination of the lag times from the plateau region of the curves, subsequent subtraction of these values from the measured latency time data, and finally plotting of the reciprocal data as a function of the drug activity. Enhancement factors then correspond to the inverse logarithm of the horizontal distances between the resulting parallel curves.

Pharmacodynamics and dermatopharmacokinetics of betamethasone 17-valerate: assessment of topical bioavailability

BACKGROUND

The bioavailability of most topically delivered drugs is difficult to quantify, but is generally believed to be very low. With the exception of the vasoconstrictor assay for corticosteroids, no methodology to quantify the rate and extent of drug delivery to the skin has been validated. Recent research has examined the dermatopharmacokinetic (DPK) technique, which is based on stratum corneum (SC) tape-stripping.

OBJECTIVE

To compare the in vivo bioavailability of different topical formulations of betamethasone 17-valerate (BMV) using the vasoconstrictor assay and the DPK method.

METHODS

BMV was formulated in different vehicles and the drug concentration was adjusted to either (i) equal thermodynamic activity, or (ii) a range of values up to that corresponding to 80% of maximum thermodynamic activity. Vasoconstriction, an accepted and widely used method to determine bioavailability and bioequivalence of topical steroids, was quantified with a chromameter over 24 h post-removal of the formulation. Drug uptake into the SC was assessed by tape-stripping.

RESULTS

BMV at the same thermodynamic activity in different vehicles provoked similar skin blanching responses, while DPK profiles distinguished between the formulations. Further, skin blanching responses and drug uptake into the SC clearly depended upon the absolute BMV concentration applied. However, while the saturable nature of the pharmacodynamic response was clear, the tape-stripping method distinguished unequivocally between the different formulations and different concentrations.

CONCLUSIONS

The DPK approach offers a reliable metric with which to quantify transfer of drug from the vehicle to the SC, and may be useful for topical bioavailability and bioequivalence determinations.

Time of Erythema Onset after Application of Methyl Nicotinate Ointments as Response Parameter: Influence of Penetration Kinetics and Enhancing Agents

The time of erythema onset may be used as a response parameter for quantification of the cutaneous erythema response induced by methyl nicotinate. The vehicles light mineral oil (LMO; test) and medium chain triglycerides (MCT; standard) were compared with regard to the pharmacodynamic response. Moreover, the influence of penetration enhancers on the time of erythema onset was investigated under zero order penetration kinetics. The enhancers dimethyl sulfoxide, diethylene glycol monoethyl ether and three different glycerides in different concentrations were added to MCT as a standard vehicle. All preparations were applied to the forearms of volunteers under infinite dose conditions at different thermodynamic drug activity levels (0.2-3.2% of the saturation level) and different drug concentrations (0.051-0.816%), respectively. Different penetration kinetics do not influence data of erythema onset, as these data are comparable to those obtained under finite dose conditions (first order penetration kinetics). With regard to the penetration enhancers, a significantly enhanced penetration of methyl nicotinate could be observed only for diethylene glycol monoethyl ether and dimethyl sulfoxide. However, no significant difference between light mineral oil and MCT could be found with regard to penetration enhancement. The time of erythema onset is an easy and efficient parameter for quantification of the pharmacodynamic response caused by nicotinates.

Percutaneous Penetration of Methyl Nicotinate from Ointments Using the Laser Doppler Technique: Bioequivalence and Enhancer Effects

Laser Doppler flowmetry (LDF) may be used to quantify erythema response as a result of an increased cutaneous microcirculation induced by methyl nicotinate (MN). Bioequivalence of a test and a standard preparation (vehicles: light mineral oil and medium chain triglycerides, respectively) was confirmed according to the pilot study of the FDA Guidance for Industry "Topical dermatologic corticosteroids: In Vivo bioequivalence" applying the staggered application and synchronized removal method for one defined concentration. Furthermore, the influence of penetration enhancers (5% w/w Dimethylsulfoxide (DMSO) and 10% w/w diethylene glycol monoethyl ether) on MN penetration was investigated. It was shown that DMSO and diethylene glycol monoethyl ether altered cutaneous microcirculation and thus MN penetration in comparison to the standard formulation. However, true penetration enhancement could only be proved with diethylene glycol monoethyl ether resulting from an improved drug solubility in the skin which was confirmed by attenuated total reflectance fourier transform infrared spectroscopy (ATR-FTIR). Increased MN penetration by DMSO was only caused by thermodynamic effects, i.e. a decreased drug solubility in the vehicle.

Pharmacokinetic analysis of the FDA guidance for industry--'Topical dermatologic corticosteroids: in vivo bioequivalence'

The FDA (Food and Drug Administration) Guidance for Industry 'Topical Dermatologic Corticosteroids: In vivo Bioequivalence' describes two methods for evaluation of cutaneously applied corticosteroid formulations by measurement of the skin blanching response with a chromameter. The experimental options are: staggered application with synchronized removal or synchronized application with staggered removal. From the resulting response vs. time profiles, the areas under the effect curves (AUECs) are calculated and plotted as a function of the exposure time period to obtain dose/response-like relationships. If these experimental procedures are analyzed pharmacokinetically applying the Bateman equation and Fick's First Law of diffusion, several critical factors may be determined that need to be considered in order to avoid misinterpretation of the data. If solution-type preparations are investigated, the applied formulation volume should be the same on all application sites. In the case of suspension-type preparations, the applied drug dose is not critical. Moreover, it is essential to guarantee zero order kinetics during the application time periods, which may only be achieved with suspension-type preparations or a sufficiently high volume of solution-type preparations. If all these critical factors are taken care of, bioavailability factors (solutions) and enhancement factors (suspensions) may be calculated as the quotient of the AUECs of test and reference formulations.

Do local anesthetics have an influence on the percutaneous penetration of a model corticosteroid? An in vivo study using the vasoconstrictor assay

Local anesthetics may exert nonspecific interactions with membrane components which can affect drug permeability. To investigate pharmacodynamically whether these membrane interactions lead to penetration enhancement of the coadministered model drug betamethasone-17-benzoate through human skin, the vasoconstrictor assay was used. Information on the penetration-enhancing properties of local anesthetic-containing vehicles compared to a plain standard were obtained from activity-response curves, where the enhancement factor was determined from the horizontal distance between the standard and a test in the linear range of the curves. The local anesthetics are able to enhance drug penetration through human skin to a different extent with lidocaine being the most efficient enhancer. An increase in the drug solubility and the diffusion coefficient in the stratum corneum due to membrane fluidization are possible mechanisms of action.

The maximum pharmacodynamic effect as a response parameter: pharmacokinetic considerations

In previous human in-vivo studies measuring the maximum pharmacodynamic response to characterize cutaneously applied ointment preparations, it was observed that differences between various formulations caused by penetration enhancement led to different enhancement factors depending on the method used for determination of these factors from activity-response curves. To clarify this discrepancy, pharmacokinetic simulations have been performed based on an open one-compartment model with either first- or zero-order drug penetration kinetics and first-order elimination kinetics. Under the assumption that the maximum pharmacodynamic response corresponds to the maximum effective drug concentration in the receptor compartment, which represents the difference between the maximum drug concentration and the threshold concentration, drug concentration vs time profiles and dose-response curves were simulated. In addition, maximum effective concentrations were calculated and plotted against the logarithm of the thermodynamic drug activity to obtain activity-response curves. Relative bioavailability and enhancement factors were determined either from the horizontal distance between the curves of a standard and a test preparation, or as the ratio of the maximum effective concentration of test and standard formulations. A significant difference between the first-order and the zero-order input kinetics with regard to the evaluation of bioavailability and drug penetration enhancement was shown. Under finite dose conditions, i.e. first-order input kinetics from solution-type preparations, a misestimation of the factors usually occurs. Only under infinite dose conditions, i.e. if large preparation volumes are applied to achieve zero-order input kinetics, is the determination of bioavailability and enhancement factors from dose- and activity-response curves accurate.