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Park JS, Seo JH, Jeong MY, Yang IG, Kim JS, Kim JH, Ho MJ, Jin SG, Choi MK, Choi YS, Kang MJ. Carboxymethyl cellulose-based rotigotine nanocrystals-loaded hydrogel for increased transdermal delivery with alleviated skin irritation. Carbohydr Polym 2024; 338:122197. [PMID: 38763711 DOI: 10.1016/j.carbpol.2024.122197] [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: 01/11/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/21/2024]
Abstract
Transdermal rotigotine (RTG) therapy is prescribed to manage Parkinson's disease (Neupro® patch). However, its use is suffered from application site reactions. Herein, drug nanocrystalline suspension (NS)-loaded hydrogel (NS-HG) employing polysaccharides simultaneously as suspending agent and hydrogel matrix was constructed for transdermal delivery, with alleviated skin irritation. RTG-loaded NS-HG was prepared using a bead-milling technique, employing sodium carboxylmethyl cellulose (Na.CMC) as nano-suspending agent (molecular weight 90,000 g/mol) and hydrogel matrix (700,000 g/mol), respectively. NS-HG was embodied as follows: drug loading: ≤100 mg/mL; shape: rectangular crystalline; crystal size: <286.7 nm; zeta potential: -61 mV; viscosity: <2.16 Pa·s; and dissolution rate: >90 % within 15 min. Nuclear magnetic resonance analysis revealed that the anionic polymers bind to RTG nanocrystals via charge interaction, affording uniform dispersion in the matrix. Rodent transdermal absorption of RTG from NS-HG was comparable to that from microemulsions, and proportional to drug loading. Moreover, NS-HG was skin-friendly; erythema and epidermal swelling were absent after repeated application. Further, NS-HG was chemically stable; >95 % of the drug was preserved up to 4 weeks under long term (25 °C/RH60%), accelerated (40 °C/RH75%), and stress (50 °C) storage conditions. Therefore, this novel cellulose derivative-based nanoformulation presents a promising approach for effective transdermal RTG delivery with improved tolerability.
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Affiliation(s)
- Jun Soo Park
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Jae Hee Seo
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Min Young Jeong
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - In Gyu Yang
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Ji Seong Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Jin Hwan Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Myoung Jin Ho
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Sung Giu Jin
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Min Koo Choi
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea
| | - Yong Seok Choi
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea.
| | - Myung Joo Kang
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Republic of Korea.
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2
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Karnam S, Donthi MR, Jindal AB, Paul AT. Recent innovations in topical delivery for management of rheumatoid arthritis: A focus on combination drug delivery. Drug Discov Today 2024; 29:104071. [PMID: 38942070 DOI: 10.1016/j.drudis.2024.104071] [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: 04/23/2024] [Revised: 06/14/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
Rheumatoid arthritis (RA) is an immune-mediated disease that necessitates a thorough understanding of its intricate pathophysiological mechanism for precise and effective therapeutic targeting. The European League Against Rheumatism (EULAR) has established guidelines for RA treatment, endorsing monotherapy or combination therapy with corticosteroids and synthetic disease-modifying antirheumatic drugs (sDMARDs). This review delves into clinical trials and research outcomes related to combination drug delivery, with an emphasis on the role of natural products in combination with synthetic drugs. Given the significant adverse effects associated with systemic administration, topical delivery has emerged as an alternative avenue for effective management of RA.
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Affiliation(s)
- Sriravali Karnam
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan 333031, India
| | - Mahipal Reddy Donthi
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan 333031, India
| | - Anil B Jindal
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan 333031, India
| | - Atish T Paul
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan 333031, India.
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3
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Li M, Vora LK, Peng K, Sabri AHB, Qin N, Abbate M, Paredes AJ, McCarthy HO, Donnelly RF. Novel nano-in-micro fabrication technique of diclofenac nanoparticles loaded microneedle patches for localised and systemic drug delivery. BIOMATERIALS ADVANCES 2024; 161:213889. [PMID: 38781739 DOI: 10.1016/j.bioadv.2024.213889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Diclofenac, a nonsteroidal anti-inflammatory drug, is commonly prescribed for managing osteoarthritis, rheumatoid arthritis, and post-surgical pain. However, oral administration of diclofenac often leads to adverse effects. This study introduces an innovative nano-in-micro approach to create diclofenac nanoparticle-loaded microneedle patches aimed at localised, sustained pain relief, circumventing the drawbacks of oral delivery. The nanoparticles were produced via wet-milling, achieving an average size of 200 nm, and then incorporated into microneedle patches. These patches showed improved skin penetration in ex vivo tests using Franz-cell setups compared to traditional diclofenac formulations. In vivo tests on rats revealed that the nanoparticle-loaded microneedle patches allowed for quick drug uptake and prolonged release, maintaining drug levels in tissues for up to 72 h. With a systemic bioavailability of 57 %, these patches prove to be an effective means of transdermal drug delivery. This study highlights the potential of this novel microneedle delivery system in enhancing the treatment of chronic pain with reduced systemic side effects.
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Affiliation(s)
- Mingshan Li
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Lalitkumar K Vora
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom.
| | - Ke Peng
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Akmal H B Sabri
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Nuoya Qin
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Marco Abbate
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Alejandro J Paredes
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Helen O McCarthy
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom
| | - Ryan F Donnelly
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom.
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Yıldız MT, Osmaniye D, Saglik BN, Levent S, Kurnaz R, Ozkay Y, Kaplancıklı ZA. Synthesis, molecular dynamics simulation, and evaluation of biological activity of novel flurbiprofen and ibuprofen-like compounds. J Mol Recognit 2024:e3089. [PMID: 38894531 DOI: 10.1002/jmr.3089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 06/21/2024]
Abstract
The frequent use of anti-inflammatory drugs and the side effects of existing drugs keep the need for new compounds constant. For this purpose, flurbiprofen and ibuprofen-like compounds, which are frequently used anti-inflammatory compounds in this study, were synthesized and their structures were elucidated. Like ibuprofen and flurbiprofen, the compounds contain a residue of phenylacetic acid. On the other hand, it contains a secondary amine residue. Thus, it is planned to reduce the acidity, which is the biggest side effect of NSAI drugs, even a little bit. The estimated ADME parameters of the compounds were evaluated. Apart from internal use, local use of anti-inflammatory compounds is also very important. For this reason, the skin permeability values of the compounds were also calculated. And it has been found to be compatible with reference drugs. The COX enzyme inhibitory effects of the obtained compounds were tested by in vitro experiments. Compound 2a showed significant activity against COX-1 enzyme with an IC50 = 0.123 + 0.005 μM. The interaction of the compound with the enzyme active site was clarified by molecular dynamics studies.
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Affiliation(s)
- Mehmet Taha Yıldız
- Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Derya Osmaniye
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
- Central Analysis Laboratory, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
| | - Begum Nurpelin Saglik
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
- Central Analysis Laboratory, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
| | - Serkan Levent
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
- Central Analysis Laboratory, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
| | - Recep Kurnaz
- Acıbadem Hospital, Orthopedics and Traumatology Clinic, Eskişehir, Turkey
| | - Yusuf Ozkay
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
- Central Analysis Laboratory, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
| | - Zafer Asım Kaplancıklı
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Anadolu University, Eskişehir, Turkey
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Shetty A, Dubey A, Chrystle J, M M, John A, N A, Das P, Hebbar S. Fabrication and in vitro characterization of curcumin film-forming topical spray: An integrated approach for enhanced patient comfort and efficacy. F1000Res 2024; 13:138. [PMID: 38779313 PMCID: PMC11109671 DOI: 10.12688/f1000research.142860.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 05/25/2024] Open
Abstract
Background Curcumin, known for its anti-inflammatory properties, was selected for the developing consumer friendly film forming spray that offers precise delivery of curcumin and and improves patient adherence. Methods An optimized film-forming solution was prepared by dissolving curcumin (1%), Eudragit RLPO (5%), propylene glycol (1%), and camphor (0.5%) in ethanol: acetone (20:80) as the solvent. The solution was filled in a spray container which contained 70% solutions and 30% petroleum gas. In-vitro characterization was performed. Results Potential anti-inflammatory phytoconstituents were extracted from the PubChem database and prepared as ligands, along with receptor molecules (nsp10-nsp16), for molecular docking using Autodock Vina. The docking study showed the lowest binding energy of -8.2 kcal/mol indicates better binding affinities. The optimized formulation consisted of ethanol:acetone (20:80) as the solvent, Eudragit RLPO (5%) as the polymer, propylene glycol (1%) as the plasticizer, and camphor oil (0.5%) as the penetration enhancer. The optimized formulation exhibited pH of 5.8 ± 0.01, low viscosity, low film formation time (19.54 ± 0.78 sec), high drug content (8.243 ± 0.43 mg/mL), and extended ex vivo drug permeation (85.08 ± 0.09%) for nine hours. Consequently, the formulation was incorporated into a container using 30% liquefied petroleum gas, delivering 0.293 ± 0.08 mL per actuation, containing 1.53 ± 0.07 mg of the drug. The film-forming spray exhibited higher cumulative drug permeation (83.94 ± 0.34%) than the marketed cream formulation and pure drug solution after 9 h, with an enhancement ratio of 14. Notably, the film-forming spray exhibited no skin irritation and remained stable for over three months. Conclusions The developed curcumin film-forming system is promising as a carrier for wound management because of its convenient administration and transport attributes. Further in vivo studies are required to validate its efficacy in wound management.
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Affiliation(s)
- Amitha Shetty
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Akhilesh Dubey
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Jeshma Chrystle
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Manohar M
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Anish John
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Amitha N
- Department of Pharmaceutics, Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Deralakatte, Mangalore, Karnataka, 575018, India
| | - Paramita Das
- Department of Pharma chemistry, Krupanidhi College of Pharmacy, Bangaluru, Karnataka, 560035, India
| | - Srinivas Hebbar
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Bácskay I, Hosszú Z, Budai I, Ujhelyi Z, Fehér P, Kósa D, Haimhoffer Á, Pető Á. Formulation and Evaluation of Transdermal Patches Containing BGP-15. Pharmaceutics 2023; 16:36. [PMID: 38258047 PMCID: PMC10819821 DOI: 10.3390/pharmaceutics16010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
BGP-15 is an active ingredient with many advantages, e.g., beneficial cardiovascular and anti-inflammatory effects. The transdermal administration of BGP-15 has great potential, which has not been investigated yet, despite the fact that it is a non-invasive and safe form of treatment. The aim of our study was to formulate transdermal patches containing BGP-15 and optimize the production with the Box-Behnken design of experiment. The most optimal formulation was further combined with penetration enhancers to improve bioavailability of the active ingredient, and the in vitro drug release and in vitro permeation of BGP-15 from the patches were investigated. FTIR spectra of BGP-15, the formulations and the components were also studied. The most optimal formulation based on the tested parameters was dried for 24 h, with 67% polyvinyl alcohol (PVA) content and low ethanol content. The selected penetration enhancer excipients were not cytotoxic on HaCaT cells. The FTIR measurements and SEM photography proved the compatibility of the active substance and the vehicle; BGP-15 was present in the polymer matrix in dissolved form. The bioavailability of BGP-15 was most significantly enhanced by the combination of Transcutol and Labrasol. The in vitro permeation study confirmed that the formulated patches successfully enabled the transdermal administration of BGP-15.
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Affiliation(s)
- Ildikó Bácskay
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - Zsolt Hosszú
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - István Budai
- Faculty of Engineering, University of Debrecen, Ótemető Utca 2-4, 4028 Debrecen, Hungary
| | - Zoltán Ujhelyi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - Pálma Fehér
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - Dóra Kósa
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - Ádám Haimhoffer
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
| | - Ágota Pető
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei körút 98, 4032 Debrecen, Hungary
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Kováčik A, Kopečná M, Hrdinová I, Opálka L, Boncheva Bettex M, Vávrová K. Time-Dependent Differences in the Effects of Oleic Acid and Oleyl Alcohol on the Human Skin Barrier. Mol Pharm 2023; 20:6237-6245. [PMID: 37950377 DOI: 10.1021/acs.molpharmaceut.3c00648] [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: 11/12/2023]
Abstract
Oleic acid and oleyl alcohol are commonly used permeation and penetration enhancers to facilitate topical drug delivery. Here, we aimed to better understand the mechanism of their enhancing effects in terms of their interactions with the human skin barrier using diclofenac diethylamine (DIC-DEA), a nonsteroidal anti-inflammatory drug for topical pain management. Oleic acid promoted DIC-DEA permeation through ex vivo human skin more rapidly than oleyl alcohol (both applied at 0.75%) due to fluidization of stratum corneum lipids as revealed by infrared spectroscopy. After 12 h, the effect of these enhancers on DIC-DEA permeation leveled off, fluidization was no longer evident, and skin permeabilization was mainly due to the formation of fluid enhancer-rich domains. Contrary to oleyl alcohol, oleic acid adversely affected two indicators of the skin barrier integrity, transepidermal water loss and skin electrical impedance. The content of oleyl alcohol in the stratum corneum was lower than that of oleic acid (even 12 h after the enhancers were removed from the skin surface), but it caused higher DIC-DEA retention in both epidermis and dermis compared to oleic acid. The effects of oleyl alcohol and oleic acid on DIC-DEA permeation and retention in the skin were similar after a single and repeated application (4 doses every 12 h). Thus, oleyl alcohol offers several advantages over oleic acid for topical drug delivery.
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Affiliation(s)
- Andrej Kováčik
- Skin Barrier Research Group, Charles University, Faculty of Pharmacy in Hradec Králové, Akademika Heyrovského 1203, 50005 Hradec Králové, Czech Republic
| | - Monika Kopečná
- Skin Barrier Research Group, Charles University, Faculty of Pharmacy in Hradec Králové, Akademika Heyrovského 1203, 50005 Hradec Králové, Czech Republic
| | - Iva Hrdinová
- Skin Barrier Research Group, Charles University, Faculty of Pharmacy in Hradec Králové, Akademika Heyrovského 1203, 50005 Hradec Králové, Czech Republic
| | - Lukáš Opálka
- Skin Barrier Research Group, Charles University, Faculty of Pharmacy in Hradec Králové, Akademika Heyrovského 1203, 50005 Hradec Králové, Czech Republic
| | | | - Kateřina Vávrová
- Skin Barrier Research Group, Charles University, Faculty of Pharmacy in Hradec Králové, Akademika Heyrovského 1203, 50005 Hradec Králové, Czech Republic
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8
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Maihöfner C, de Haas A, Sethi V, Shanga G, Wilcox TK, Csoke E, Fabrikant K. Patients' experience and utilization patterns of diclofenac gel in Germany: a real-world study with a prospective longitudinal survey and a retrospective analysis of pharmacy data. Curr Med Res Opin 2023; 39:1649-1661. [PMID: 37545357 DOI: 10.1080/03007995.2023.2243804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Describe and characterize treatment patterns, satisfaction, improvement in pain and functional impairment (health-related quality of life [HRQoL]) in users of over the counter (OTC) Voltaren gel diclofenac (VGD) 2.32% and 1.16% in a real-world setting. METHODS This observational real-world German study had prospective and retrospective components. The prospective data were collected from electronic surveys completed by adults who purchased VGD to treat their musculoskeletal pain at baseline and 4 and 12 weeks after baseline. Retrospective data were from a 12-month (March 2019 to February 2020) abstraction from dispensing software platforms used in select German pharmacies. RESULTS Surveys from 467 participants (mean age 60.8 years) were analyzed. Average pain severity at baseline was 6.0 on an 11-point Numeric Rating Scale (0 = no pain, 10 = worst possible pain), improving by 0.8 and 1.2 points at Weeks 4 and 12, respectively. Performance of functional activities (daily/physical/social activities and errands/chores) improved and the proportion of participants with at least moderate interference decreased at both follow-up timepoints. Retrospective analyses indicated that majority of patients receiving VGD (n = 95,085) were ≥65 years old (67.9%), had one dispensed tube (70.8%) and did not switch to another topical treatment (including other NSAIDs) (77.3%), and were co-prescribed at least one cardiovascular medication (74.3%). CONCLUSIONS This study provides the first real-world insights into OTC VGD use in Germany. The participants using VGD reported a decrease in pain severity and an improvement of HRQoL while under treatment, as well as resulting satisfaction with treatment. Patients infrequently switched to alternate topical therapies/NSAIDs.
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Affiliation(s)
- Christian Maihöfner
- Department of Neurology, General Fürth Hospital, University of Erlangen, Germany
| | - Anke de Haas
- Medical Affairs, Haleon (Formerly GSK Consumer Healthcare), Munich, Germany
| | - Vidhu Sethi
- Medical Affairs, Haleon, Singapore, Singapore
| | | | - Teresa K Wilcox
- Epidemiology and Scientific Affairs, Formerly of PPD, Part of Thermo Fisher Scientific, Bethesda, Maryland, USA
| | - Emese Csoke
- Medical Affairs, Formerly of GSK Consumer Healthcare, Basel, Switzerland
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9
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Belsey NA, Dexter A, Vorng JL, Tsikritsis D, Nikula CJ, Murta T, Tiddia MV, Zhang J, Gurdak E, Trindade GF, Gilmore IS, Page L, Roper CS, Guy RH, Bettex MB. Visualisation of drug distribution in skin using correlative optical spectroscopy and mass spectrometry imaging. J Control Release 2023; 364:79-89. [PMID: 37858627 DOI: 10.1016/j.jconrel.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
A correlative methodology for label-free chemical imaging of soft tissue has been developed, combining non-linear optical spectroscopies and mass spectrometry to achieve sub-micron spatial resolution and critically improved drug detection sensitivity. The approach was applied to visualise the kinetics of drug reservoir formation within human skin following in vitro topical treatment with a commercial diclofenac gel. Non-destructive optical spectroscopic techniques, namely stimulated Raman scattering, second harmonic generation and two photon fluorescence microscopies, were used to provide chemical and structural contrast. The same tissue sections were subsequently analysed by secondary ion mass spectrometry, which offered higher sensitivity for diclofenac detection throughout the epidermis and dermis. A method was developed to combine the optical and mass spectrometric datasets using image registration techniques. The label-free, high-resolution visualisation of tissue structure coupled with sensitive chemical detection offers a powerful method for drug biodistribution studies in the skin that impact directly on topical pharmaceutical product development.
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Affiliation(s)
- Natalie A Belsey
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK; School of Chemistry & Chemical Engineering, University of Surrey, Guildford GU2 7XH, UK.
| | - Alex Dexter
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Jean-Luc Vorng
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Dimitrios Tsikritsis
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Chelsea J Nikula
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Teresa Murta
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Maria-Vitalia Tiddia
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Junting Zhang
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Elzbieta Gurdak
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Gustavo F Trindade
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Ian S Gilmore
- Chemical & Biological Sciences Department, National Physical Laboratory, Teddington TW11 0LW, UK
| | - Leanne Page
- Charles River Laboratories Edinburgh Ltd, Tranent, East Lothian EH33 2NE, UK
| | - Clive S Roper
- Charles River Laboratories Edinburgh Ltd, Tranent, East Lothian EH33 2NE, UK; Roper Toxicology Consulting Limited, Edinburgh EH3 6AD, UK
| | - Richard H Guy
- Department of Life Sciences, University of Bath, BA2 7AY, UK
| | - Mila Boncheva Bettex
- Haleon CH SARL, Route de l'Etraz 2, Case postale 1279, 1260 Nyon 1, Switzerland.
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10
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Birngruber T, Vought K, Schwingenschuh S, Reisenegger P, Maibach H, Lissin D. Topical Delivery Systems Effectively Transport Analgesics to Areas of Localized Pain via Direct Diffusion. Pharmaceutics 2023; 15:2563. [PMID: 38004542 PMCID: PMC10674869 DOI: 10.3390/pharmaceutics15112563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Topical delivery systems (TDSs) enable the direct transport of analgesics into areas of localized pain and thus minimize the side effects of administration routes that rely on systemic drug distribution. For musculoskeletal pain, clinicians frequently prescribe topical products containing lidocaine or diclofenac. This study assessed whether drug delivery from a TDS into muscle tissue occurs mainly via direct diffusion or systemic transport. An investigational TDS containing 108 mg lidocaine (SP-103, 5.4% lidocaine), a commercially available TDS containing 36 mg lidocaine (ZTlido®, 1.8% lidocaine), and a topical pain relief gel (Pennsaid®, 2% diclofenac) were tested. Using open flow microperfusion (OFM), interstitial fluid from the dermis, subcutaneous adipose tissue (SAT), and muscle was continuously sampled to assess drug penetration in all tissue layers. Ex vivo and in vivo experiments showed a higher diffusive transport of lidocaine compared to diclofenac. The data showed a clear contribution of diffusive transport to lidocaine concentration, with SP-103 5.4% resulting in a significantly higher lidocaine concentration in muscle tissue than commercially available ZTlido® (p = 0.008). These results indicate that SP-103 5.4% is highly effective in delivering lidocaine into muscle tissue in areas of localized pain for the treatment of musculoskeletal pain disorders (e.g., lower back pain).
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Affiliation(s)
- Thomas Birngruber
- HEALTH—Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (P.R.)
| | - Kip Vought
- Scilex Holding Company, Palo Alto, CA 94303, USA;
| | - Simon Schwingenschuh
- HEALTH—Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (P.R.)
| | - Peter Reisenegger
- HEALTH—Institute for Biomedical Research and Technologies, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria; (S.S.); (P.R.)
| | - Howard Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA 94143, USA;
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Siritham A, Powcharoen W, Wanichsaithong P, Supanchart C. Analgesics effect of local diclofenac in third molar surgery: a randomized, controlled trial. Clin Oral Investig 2023; 27:6073-6080. [PMID: 37606721 DOI: 10.1007/s00784-023-05221-w] [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: 05/09/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effect of locally diclofenac application on postoperative pain, sequalae, and adverse effects following mandibular third molar (MTM) surgery. METHODS A randomized, crossover, double-blind, controlled trial was conducted in 20 patients who required surgical removal of bilateral symmetrical impacted MTM at two separate appointments. The 40 MTMs were randomly allocated to two groups. One side was assigned 0.1% w/v diclofenac sodium as the diclofenac group. The contralateral side was assigned phosphate-buffered saline (PBS) as the control group. Postoperative pain intensity was measured by visual analogue scale (VAS), where the time when the first pain emerged, the time to first rescue medication, pain at 6 and 24 h after surgery, and the total number of analgesics consumed were recorded. Postoperative swelling and trismus were assessed on postoperative days 2 and 7. The differences of continuous outcomes between two groups were analyzed by paired t-test or Wilcoxon signed-rank test. RESULTS VAS scores were significantly lower when the first pain emerged and 6 h after surgery in diclofenac group (p < 0.05). The onset of pain in the diclofenac group was significantly longer than in the control group (p < 0.05). Two patients reported mild nausea and dizziness in the diclofenac group. CONCLUSION This study demonstrates the analgesic effectiveness of 0.1% local application of diclofenac within 6 h postoperative with few side effects. CLINICAL RELEVANCE Locally diclofenac application is an alternative of postoperative analgesic in MTM surgery which provides pain-free periods within 6 h.
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Affiliation(s)
- Anya Siritham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Warit Powcharoen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Pinpinut Wanichsaithong
- Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Chayarop Supanchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand.
- Center of Excellence in Materials Science and Technology, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand.
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Perlik V, Kulasekaran A, Coutinho G, Votava M, Cardot JM. Relationship between Pharmacokinetic Profile and Clinical Efficacy Data of Three Different Forms of Locally Applied Flurbiprofen in the Mouth/Throat. Pharmaceutics 2023; 15:1863. [PMID: 37514048 PMCID: PMC10385846 DOI: 10.3390/pharmaceutics15071863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to link pharmacokinetic (PK) data from different flurbiprofen preparations for the treatment of sore throat with published data to elucidate whether early efficacy is due to the local action of flurbiprofen or a systemic effect after absorption of the swallowed drug. Three comparative bioavailability studies conducted in healthy subjects provided data from flurbiprofen 8.75 mg formulations, including spray solution, spray gel, lozenges, and granules. A parallel interstudy comparison was made of PK parameters, including partial AUCs (pAUCs), using an ANOVA model with the calculation of 90% confidence intervals (CI) for the differences between least squares (LS) means for each of the test groups versus the respective reference groups. All three studies showed bioequivalence for the respective product comparisons. The interstudy comparison showed a slower rate of absorption for granules compared to spray solution (reference) based on Tmax, Cmax, and pAUCs for 1 h and 2 h. When AUC0.25h and AUC0.5h were considered, slower rates of absorption were also seen for lozenges and spray gel. The differences correlated with the reported time of onset of action, which is faster for the spray solution (20 min) compared to lozenges (26 min) and granules (30 min). These pAUCs provide useful data that allow for the discrimination between formulations. Moreover, the pAUC values represent <5% of the total AUC, suggesting that the early onset of pain relief is a response to immediate local absorption at the site of action rather than a systemic effect.
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Affiliation(s)
- Vit Perlik
- Institute of Pharmacology, First Faculty of Medicine, Charles University, Albertov 4, 12800 Prague, Czech Republic
| | | | - Graça Coutinho
- Reckitt Healthcare Limited, 103-105 Bath Road, Slough, Berkshire SL1 3UH, UK
| | - Martin Votava
- Cadore INV Scientific Consultant, Akademicka 1, 10800 Prague, Czech Republic
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Jyothi VGS, Veerabomma H, Kumar R, Khatri DK, Singh SB, Madan J. Meloxicam emulgel potently suppressed cartilage degradation in knee osteoarthritis: Optimization, formulation, industrial scalability and pharmacodynamic analysis. Colloids Surf B Biointerfaces 2023; 228:113399. [PMID: 37348266 DOI: 10.1016/j.colsurfb.2023.113399] [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: 03/18/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Meloxicam (MLX) is prescribed for the management of pain and inflammation allied with osteoarthritis (OA). However, MLX causes intestinal damage in long term administration. Hence, meloxicam loaded emulgel (MLX-emulgel) was optimized, formulated and examined under stringent parameters in monosodium-iodoacetate (MIA) induced knee OA in Wistar rats. METHODS AND RESULTS Nanoemulsion of MLX was fabricated by ultrasonication and microfluidization method with a droplet size of 66.81 ± 5.31-nm and zeta potential of -24.6 ± 0.72-mV. Further, MLX nanoemulsion was optimized with centrifugation, heating-cooling cycles and transmittance parameters in addition to scale-up feasibility with microfluidizer. Post optimization, MLX-nanoemulsion was tailored as emulgel with Carbopol Ultrez 10 NF and assessed for pH, rheology, textural properties, assay and stability features. The in-vitro release study revealed the Korsmeyer-Peppas release kinetics and ex-vivo skin permeation was improved by 6.71-folds. The skin distribution of MLX-emulgel evinced the transfollicular mode of permeation. In-vivo study indicated the protective action of MLX-emulegl expressed in terms of inflammatory cyctokines level, X-ray analysis of knee joints of rats, histopathology and OARSI (Osteoarthritis Research Society International) scoring. MLX-emulgel treated group displayed lower (P < 0.001) level of COX-2 intensity as compared to positive control group. However, it was comparable (P > 0.05) to the normal control group, MLX oral dispersion, i.v. solution and etoricoxib gel groups. MLX-emulgel showcased an alternative to the long term usage of analgesics for relieving the symptoms of knee OA. CONCLUSION MLX-emulgel may be a potential candidate for translating in to a clinically viable dosage form in the management of knee OA.
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Affiliation(s)
- Vaskuri Gs Sainaga Jyothi
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Harithasree Veerabomma
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Rahul Kumar
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Dharmendra Kumar Khatri
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Shashi Bala Singh
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Jitender Madan
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India.
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Alven S, Ubanako P, Adeyemi SA, Ndinteh DT, Choonara YE, Aderibigbe BA. Carboxymethyl cellulose/poloxamer gels enriched with essential oil and Ag nanoparticles: promising wound dressings. Ther Deliv 2023; 14:139-156. [PMID: 37125434 DOI: 10.4155/tde-2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Aim: Essential oils are promising antibacterial and wound-healing agents that should be explored for the design of wound dressings. Materials & methods: Topical gels prepared from a combination of carboxymethyl cellulose and poloxamer were incorporated with tea tree and lavender oil together with Ag nanoparticles. In vitro release, cytotoxicity, antibacterial, and wound healing studies were performed. Results: The gels displayed good spreadability with viscosity in the range of 210-1200 cP. The gels displayed promising antibacterial activity against selected Gram-positive and Gram-negative bacteria used in the study. The % cell viability of the gels was more than 90.83%. Conclusion: The topical gels displayed excellent wound closure in vitro revealing that they are potential wound dressings for bacteria-infected wounds.
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Affiliation(s)
- Sibusiso Alven
- Department of Chemistry University of Fort Hare, Alice Eastern Cape, 5700, South Africa
| | - Philemon Ubanako
- Department of Pharmacy & Pharmacology, Wits Advanced Drug Delivery Platform Research Unit, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samson A Adeyemi
- Department of Pharmacy & Pharmacology, Wits Advanced Drug Delivery Platform Research Unit, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Derek T Ndinteh
- Department of Applied Chemistry, University of Johannesburg, Doornfontein Campus, Johannesburg, 2028, South Africa
| | - Yahya E Choonara
- Department of Pharmacy & Pharmacology, Wits Advanced Drug Delivery Platform Research Unit, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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15
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Shi C, Ye Z, Shao Z, Fan B, Huang C, Zhang Y, Kuang X, Miao L, Wu X, Zhao R, Chen X, Zhang B, Tong R, Hu X, Fu Z, Lin J, Li X, Sun T, Liu G, Dai H, Guo C, Zhang B, Xu T, Wen A, Zuo X, Liu J, Chen X, Li H, Wang J, Luo M, Fan T, Qian Y, Li X, Qiu W, Lin X, Pang Y, Hou Y, Yao D, Kou W, Sun B, Hu C, Xia Y, Zhao M, Zhu C, Li Q, Zhang Y. Multidisciplinary Guidelines for the Rational Use of Topical Non-Steroidal Anti-Inflammatory Drugs for Musculoskeletal Pain (2022). J Clin Med 2023; 12:jcm12041544. [PMID: 36836078 PMCID: PMC9966446 DOI: 10.3390/jcm12041544] [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: 12/15/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
(1) Background: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the primary drugs for treating musculoskeletal pain. However, there are currently no evidence-based recommendations about drug selection, drug administration, drug interactions, and use in special populations or other pharmacology-related content of such medications. To this end, the Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. (2) Methods: The guidelines development process followed the World Health Organization guideline development handbook, the GRADE methodology, and the statement of Reporting Items for Practice Guidelines in Healthcare. The guideline panel used the Delphi method to identify six clinical questions to be addressed in the guidelines. An independent systematic review team conducted a systematic search and integration of evidence. (3) Results: Based on the balance between the benefits and harms of an intervention, the quality of the evidence, patient preferences and values, and resource utilization, the guideline panel developed 11 recommendations and nine expert consensuses on using topical NSAIDs to treat acute and chronic musculoskeletal pain. (4) Conclusions: Based on the effectiveness and overall safety of topical NSAIDs, we recommend patients with musculoskeletal pain use topical NSAIDs and suggest high-risk patients use topical NSAIDs, such as those with other diseases or receiving other concurrent treatments. The evidenced-based guidelines on topical NSAIDs for musculoskeletal pain incorporated a pharmacist perspective. The guidelines have the potential to facilitate the rational use of topical NSAIDs. The guideline panel will monitor the relevant evidence and update the recommendations accordingly.
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Affiliation(s)
- Chen Shi
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China
| | - Zhaoming Ye
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China
| | - Bifa Fan
- Department of Pain Management, China-Japan Friendship Hospital, Beijing 100029, China
| | - Cibo Huang
- Department of Rheumatology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen 518116, China
| | - Yuan Zhang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Xinying Kuang
- Global Health Nursing, St. Luke’s International University, Tokyo 104-0044, Japan
| | - Liyan Miao
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Xin’an Wu
- Department of Pharmacy, The First Hospital of Lanzhou University, Gansu 730000, China
| | - Rongsheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
| | - Xiao Chen
- Department of Pharmacy, The First Affiliated Hospital of Sun Yet-sen University, Guangzhou 510080, China
| | - Bikui Zhang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Rongsheng Tong
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu 610072, China
| | - Xin Hu
- Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing 100730, China
| | - Zhijian Fu
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Jianhao Lin
- Arthritis Clinic and Research Center, Peking University Peoples Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China
| | - Xiaomei Li
- Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Lujiang Str. 17, Hefei 230001, China
| | - Tiezheng Sun
- Arthritis Clinic and Research Center, Peking University Peoples Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China
| | - Guoqiang Liu
- Department of Clinical Pharmacy, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - Haibin Dai
- Department of Pharmacy, Second Affiliated Hospital of Zhejiang University School of Medicine, Research Center for Clinical Pharmacy, Zhejiang University, Hangzhou 310009, China
| | - Cheng Guo
- Department of Pharmacy, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Bo Zhang
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
| | - Ting Xu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Aidong Wen
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Xiaocong Zuo
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Jinmei Liu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China
| | - Xu Chen
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China
| | - Huibo Li
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
| | - Jing Wang
- Department of Pharmacy, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Min Luo
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tingting Fan
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yulan Qian
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Xiu’mao Li
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Wenjie Qiu
- Department of Rheumatology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen 518116, China
| | - Xiaowen Lin
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Yingchang Pang
- Arthritis Clinic and Research Center, Peking University Peoples Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China
| | - Yunfei Hou
- Arthritis Clinic and Research Center, Peking University Peoples Hospital, 11 Xizhimen South Street, Xicheng District, Beijing 100044, China
| | - Difei Yao
- Department of Pharmacy, Second Affiliated Hospital of Zhejiang University School of Medicine, Research Center for Clinical Pharmacy, Zhejiang University, Hangzhou 310009, China
| | - Wen Kou
- Department of Pharmacy, The First Hospital of Lanzhou University, Gansu 730000, China
| | - Bao Sun
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Can Hu
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Yanzhe Xia
- Department of Pharmacy, The First Affiliated Hospital of Sun Yet-sen University, Guangzhou 510080, China
| | - Ming Zhao
- Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing 100730, China
| | - Changyu Zhu
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu 610072, China
| | - Qian Li
- Department of Clinical Pharmacy, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - Yu Zhang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China
- Correspondence:
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Ataide JA, Coco JC, dos Santos ÉM, Beraldo-Araujo V, Silva JRA, de Castro KC, Lopes AM, Filipczak N, Yalamarty SSK, Torchilin VP, Mazzola PG. Co-Encapsulation of Drugs for Topical Application-A Review. Molecules 2023; 28:molecules28031449. [PMID: 36771111 PMCID: PMC9921006 DOI: 10.3390/molecules28031449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Achieving the best possible outcome for the therapy is the main goal of a medicine. Therefore, nanocarriers and co-delivery strategies were invented to meet this need, as they can benefit many diseases. This approach was applied specifically for cancer treatment, with some success. However, these strategies may benefit many other clinical issues. Skin is the largest and most exposed organ of the human body, with physiological and psychological properties. Due to its exposition and importance, it is not difficult to understand how many skin diseases may impact on patients' lives, representing an important burden for society. Thus, this review aims to summarize the state of the art in research concerning nanocarriers and co-delivery strategies for topical agents' applications targeting skin diseases. The challenge for the medicine of the future is to deliver the drug with spatial and temporal control. Therefore, the co-encapsulation of drugs and the appropriate form of administration for them are so important and remain as unmet needs.
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Affiliation(s)
- Janaína Artem Ataide
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
- Center for Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston, MA 02115, USA
| | - Julia Cedran Coco
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
| | - Érica Mendes dos Santos
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
| | - Viviane Beraldo-Araujo
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
| | | | | | - André Moreni Lopes
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
| | - Nina Filipczak
- Center for Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston, MA 02115, USA
| | | | - Vladimir P. Torchilin
- Center for Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston, MA 02115, USA
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-617-373-3206; Fax: +1-617-373-8886
| | - Priscila Gava Mazzola
- Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas 13083-871, SP, Brazil
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Kannan A, Sims N, Hold AJ, Jagadeesan K, Standerwick R, Barden R, Kasprzyk-Hordern B. The burden of city's pain treatment - A longitudinal one year study of two cities via wastewater-based epidemiology. WATER RESEARCH 2023; 229:119391. [PMID: 36462253 DOI: 10.1016/j.watres.2022.119391] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
This paper explores Wastewater-Based Epidemiology (WBE) as a tool enabling understanding of city's pain treatment in an intercity longitudinal study. An intensive 13-month monitoring programme was undertaken in two adjacent urban areas in South-West England: a small commuter town Keynsham and the city of Bath (>180 samples collected). The study has shown a great potential of using triangulated WBE and National health Service (NHS) prescription data in understanding pain treatment in two contrasting communities with strong apparent seasonal patterns of short pain medications vs chronic pain treatment as well as the type of treatment used (e.g. oral vs topical). Community-wide usage of Non-Steroidal Anti-inflammatory Drugs (NSAIDs) and paracetamol in the intercity study is population size and season driven with the highest usage recorded in winter months. This contrasts with other pain pharmaceuticals, especially those used for chronic pain, where no/limited seasonal usage was recorded. Unmetabolized NSAIDs are, to a large extent, directly disposed of into the sewerage system bypassing metabolism due to their topical application. This is particularly apparent in winter months with naproxen showing the highest seasonal variability. Pharma/met (ratio of pharmaceutical and its metabolite concentration) analysis allows for tracking topical (non-metabolic) application/down-the-drain disposal of pharmaceuticals with frequent instances of direct disposal of NSAIDs into the sewerage system observed. Normalisation of pharma markers to population size shows comparable estimates of pharma usage in the two cities confirming population as the main driver of pharma loads in wastewater. Variable application patterns of pain pharmaceuticals make back-calculation of intake more convoluted. Intake calculated using percentage excretion of parent NSAIDs will likely lead to overestimation, as it is assumed that NSAIDs are subject to extensive metabolism (this is not the case for topical applications). Intake calculated using percentage excretion of metabolites (or parent compound) as consumption markers leads to underestimation of NSAIDs usage due to contributions from topical application not being accounted for. Prescription data indicates cumulative internal and topical usage, but the data ignores large proportion of over-the-counter usage. Therefore, we have proposed a combined approach allowing for estimation of total usage including, and differentiating between, topical application and oral administration.
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Affiliation(s)
- Andrew Kannan
- Department of Chemistry, University of Bath, Bath BA2 7AY, United Kingdom
| | - Natalie Sims
- Department of Chemistry, University of Bath, Bath BA2 7AY, United Kingdom
| | - Angus J Hold
- Department of Chemistry, University of Bath, Bath BA2 7AY, United Kingdom
| | - Kishore Jagadeesan
- Department of Chemistry, University of Bath, Bath BA2 7AY, United Kingdom
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Tijani AO, Frempong D, Kaur J, Sergent S, Shaw K, Lessaint R, Al Shawi M, Verana G, Puri A. Dermaplaning for Transdermal Drug Permeation Enhancement: A Qualitative and Quantitative Assessment. AAPS PharmSciTech 2023; 24:54. [PMID: 36725790 DOI: 10.1208/s12249-023-02505-y] [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: 11/03/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
In this study, we sought to investigate the effect of dermaplaning, a popular cosmeceutical skin rejuvenation technique on the permeation of drugs. Baclofen and diclofenac were used as hydrophilic and hydrophobic model drugs, respectively. A specific area of skin was treated with 4 strokes of a dermaplane device. Interindividual variability was assessed by having multiple users operate the device for the study. Dermaplaned skin was histologically evaluated and characterized for resistance drop and the depletion of the stratum corneum (SC). The effect of dermaplaning on drug permeation was investigated via in vitro permeation studies. Histology studies depicted the removal of SC and some parts of viable epidermis by dermaplaning. A significant drop in electrical resistance post skin dermaplaning was observed for all treatment groups, signifying the depletion of barrier properties of SC (p < 0.05). Consequently, significant drug flux and permeation were observed over 24 h for the model drugs across dermaplaned skin. However, varied absorption profile was observed in vitro for both drugs across dermaplaned skin. Dermaplaning displayed a better suitability for significantly enhancing the permeation of the hydrophilic drug, baclofen. Evidence of variation in results post dermaplaning was observed amidst multiple users as well (p < 0.05).
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Affiliation(s)
- Akeemat O Tijani
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Dorcas Frempong
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Jagroop Kaur
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Sophia Sergent
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Kara Shaw
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Rebecca Lessaint
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Maryam Al Shawi
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Gabrielle Verana
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA
| | - Ashana Puri
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA.
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Yakusheva EV, Dukhanin AS, Iskra DA, Naumov AV, Runikhina NK, Strakhov MA. [Personalized patient-oriented approach to the treatment of musculoskeletal pain syndrome using over-the-counter medications. Resolution of the Expert Council (May 28, 2023)]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:134-138. [PMID: 37655423 DOI: 10.17116/jnevro2023123081134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Diseases of the musculoskeletal system in Russia affect 19.2 million people. Untimely diagnosis and inadequate therapy of pain syndrome negatively affect the daily functioning and quality of life of patients, and create significant socioeconomic problems. The most common variants of musculoskeletal pain (MSP) are osteoarthritis (OA) and low back pain (LBP). OA is seen in 57.6% of individuals over 65 years of age. It should be noted that chronic pain syndrome, rather than anatomical and degenerative changes detected by imaging studies, determines to a greater extent the quality of life of patients with OA and prognosis during the course of the disease. The global burden of disability associated with LBPD increased in all age groups between 1990 and 2019 and was highest in the 50-54 age group.
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Affiliation(s)
- E V Yakusheva
- Academy of Postgraduate Education of the Federal Research and Clinical Center, Moscow, Russia
| | - A S Dukhanin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - D A Iskra
- Saint-Petersburg State Pediatric Medical University, St-Petersburg, Russia
| | - A V Naumov
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Gerontological Research and Clinical Center, Moscow, Russia
| | - N K Runikhina
- Russian Gerontological Research and Clinical Center, Moscow, Russia
| | - M A Strakhov
- Pirogov Russian National Research Medical University, Moscow, Russia
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20
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Analysis of the therapeutic efficacy of meloxicam-loaded solid lipid nanoparticles topical gel in Wistar rats knee osteoarthritis. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Li LP, Jin YC, Fang L, Zhang C. Direct photolysis of diclofenac under simulated sunlight: Transformation pathway and biological concerns. CHEMOSPHERE 2022; 307:135775. [PMID: 35868525 DOI: 10.1016/j.chemosphere.2022.135775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/05/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Topical diclofenac gels are frequently applied on human skin and, consequently are exposed to sunlight during outdoor activities. The degradation of diclofenac (DCF) with sunlight exposure is known to occur but the detailed transformation characteristics and biological concerns have not been comprehensively investigated. In the present work, the transformation products during diclofenac photolysis were identified with the aid of ultra-performance liquid chromatography coupled with triple time-of-flight mass spectrometry (UPLC-TripleTOF). Biological concerns, including microtoxicity, genotoxicity, cytotoxicity and antiestrogenicity were examined with multiple in-vitro bioassays. Spearman correlation analysis was conducted to obtain further insight into the contributions of photolysis products to overall biological concerns. The results demonstrated that diclofenac was readily degraded under sunlight to form five main photolysis products via substitution, dechlorination, dehydroxylation, homodimerization and heterodimerization. Products P1, P2 and P5 were reported previously, while two dimer products (P3 and P4) are innovative products and have not been found in prior studies. A significant elevation in the microtoxicity was found during the photolysis of diclofenac, resulting mainly from the carbazole-containing photolysis products P2, P3, P4 and P5. Genotoxicity and antiestrogenicity declined along with the reduction of diclofenac, indicating that no photolysis products were genotoxic or anti-estrogenic. Modest cytotoxicity to the human skin epidermis cell line was observed and attributed to the formation of intermediate species. This outcome highlighted the biological concerns of diclofenac to human health when exposed to sunlight.
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Affiliation(s)
- Li-Ping Li
- Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai, 519087, China.
| | - Yan-Chao Jin
- College of Environmental Science and Engineering, Fujian Normal University, Fuzhou, 350007, China; Fujian Key Laboratory of Pollution Control & Resource Reuse, Fuzhou, 350007, China
| | - Le Fang
- Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai, 519087, China
| | - Cheng Zhang
- Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai, 519087, China
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22
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Accelerator mass spectrometry for quantification of micro- and therapeutic dose diclofenac in microdialysis samples. Bioanalysis 2022; 14:1111-1122. [PMID: 36165918 DOI: 10.4155/bio-2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Microdialysis sampling after drug microdosing may provide tissue pharmacokinetic data early in clinical drug development. However, low administered doses and small sample volumes pose an analytical challenge, particularly for highly protein-bound drugs. Materials & methods: Carbon-14 [14C]diclofenac was used as a model drug to assess the technical and analytical feasibility of in vivo microdialysis after microdose administration in an in vitro setup. Results: [14C]diclofenac dialysate concentrations were accurately quantified with accelerator MS. [14C]diclofenac dialysate recoveries were similar in the presence and absence of therapeutic diclofenac concentrations but were considerably decreased when albumin was added to the immersion solution, suggesting high protein binding. Conclusion: These results demonstrate the feasibility of combining microdosing and microdialysis to assess tissue pharmacokinetics.
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Formulation and Evaluation of the In Vitro Performance of Topical Dermatological Products Containing Diclofenac Sodium. Pharmaceutics 2022; 14:pharmaceutics14091892. [PMID: 36145640 PMCID: PMC9502351 DOI: 10.3390/pharmaceutics14091892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 02/05/2023] Open
Abstract
The selection of an appropriate vehicle in a semi-solid topical product is of utmost importance since the vehicle composition and microstructure can potentially cause changes in drug-vehicle or vehicle-skin interactions and affect drug release and subsequent permeation into and across skin. Hence, the aim of this study was to evaluate different semi-solid formulations containing diclofenac sodium for the physicochemical and structural performance of excipients used and various physiological factors governing permeation of drugs applied to skin. The formulations (emulsion, emulgel, gel, and ointment) were prepared using conventional excipients and were found to be homogenous and stable. Rheological analysis demonstrated characteristic shear-thinning and viscoelastic behavior of formulations. The mean release rate of the gel formulation (380.42 ± 3.05 µg/cm2/h0.5) was statistically higher compared to all other formulations. In vitro permeation using human skin showed a significantly greater extent of drug permeation and retention for the emulgel formulation (23.61 ± 1.03 µg/cm2 and 47.95 ± 2.47 µg/cm2, respectively). The results demonstrated that the different formulations influenced product performance due to their inherent properties. The findings of this study demonstrated that a comprehensive physicochemical and structural evaluation is required to optimize the in vitro performance for dermatological formulations depending on the intended therapeutic effect.
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Pető Á, Kósa D, Haimhoffer Á, Nemes D, Fehér P, Ujhelyi Z, Vecsernyés M, Váradi J, Fenyvesi F, Frum A, Gligor FG, Vicaș LG, Marian E, Jurca T, Pallag A, Muresan ME, Tóth Z, Bácskay I. Topical Dosage Formulation of Lyophilized Philadelphus coronarius L. Leaf and Flower: Antimicrobial, Antioxidant and Anti-Inflammatory Assessment of the Plant. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27092652. [PMID: 35566001 PMCID: PMC9100982 DOI: 10.3390/molecules27092652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/12/2022]
Abstract
Philadelphus coronarius is a versatile plant and its use in folk medicine has a long tradition; however, scientifically, the medical utilization of the herb is a less explored research field. The aim of our study was to identify and determine the quantity of the bioactive compounds of both the leaf and the flower and prepare a lyophilized product of them, from which medical ointments were formulated, since the topical application of P. coronarius has also not been studied. In vitro drug release, texture analysis and biocompatibility experiments were carried out, as well as the investigation of microbiological, antioxidant and anti-inflammatory properties. According to our results the composition and the selected excipients of the ointments have a great impact on the drug release, texture and bioavailability of the preparation. During the microbiological testing, the P. coronarius leaf was effective against Escherichia coli and Staphylococcus aureus, but it did not significantly decrease IL-4 production when it was tested on HaCaT cells. P. coronarius is a promising herb, and its topical application in antimicrobial therapy can be a useful addition to modern medical therapy.
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Affiliation(s)
- Ágota Pető
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
| | - Dóra Kósa
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
| | - Ádám Haimhoffer
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
- Doctoral School of Pharmaceutical Sciences, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
| | - Dániel Nemes
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Pálma Fehér
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Zoltán Ujhelyi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Miklós Vecsernyés
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Judit Váradi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Ferenc Fenyvesi
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
| | - Adina Frum
- Faculty of Medicine, Lucian Blaga University Sibiu, Lucian Blaga Street, No 2A, H-550169 Sibiu, Romania; (A.F.); (F.G.G.)
| | - Felicia Gabriela Gligor
- Faculty of Medicine, Lucian Blaga University Sibiu, Lucian Blaga Street, No 2A, H-550169 Sibiu, Romania; (A.F.); (F.G.G.)
| | - Laura Grațiela Vicaș
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 Nicolae Jiga Street, H-410028 Oradea, Romania; (L.G.V.); (E.M.); (T.J.); (A.P.)
| | - Eleonora Marian
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 Nicolae Jiga Street, H-410028 Oradea, Romania; (L.G.V.); (E.M.); (T.J.); (A.P.)
| | - Tunde Jurca
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 Nicolae Jiga Street, H-410028 Oradea, Romania; (L.G.V.); (E.M.); (T.J.); (A.P.)
| | - Annamaria Pallag
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 Nicolae Jiga Street, H-410028 Oradea, Romania; (L.G.V.); (E.M.); (T.J.); (A.P.)
| | - Mariana Eugenia Muresan
- Department of Preclinical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, H-410068 Oradea, Romania;
| | - Zoltán Tóth
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary;
| | - Ildikó Bácskay
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary; (Á.P.); (D.K.); (Á.H.); (D.N.); (P.F.); (Z.U.); (M.V.); (J.V.); (F.F.)
- Institute of Healthcare Industry, University of Debrecen, Nagyerdei Körút 98, H-4032 Debrecen, Hungary
- Correspondence: ; Tel.: +36-52-411-717 (ext. 54034)
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Anti-Psoriasis Effect of Diclofenac and Celecoxib Using the Tail Model for Psoriasis. Pharmaceutics 2022; 14:pharmaceutics14040885. [PMID: 35456720 PMCID: PMC9025614 DOI: 10.3390/pharmaceutics14040885] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) showed effects in some hyperproliferative dermatologic pathologies. The aim of the study is the assessment of anti-psoriasis effect of diclofenac and celecoxib using a mice tail model. The topical application of substances on the proximal mice tails was performed for two weeks. The effects on the epidermal granular layer and mean epidermal thickness (excluding the stratum corneum) were evaluated using hematoxylin–eosin staining. Orthokeratosis degree and percentual drug activity were calculated. A positive control group treated with tretinoin and two negative controls (white soft paraffin and untreated mice) were used. Orthokeratosis degree significantly increased in all the NSAIDs groups (celecoxib 1%, 2% and diclofenac 1%, 2%) and in the tretinoin 0.05% group, versus negative controls. Celecoxib 1% and 2%, tretinoin 0.05% and white soft paraffin significantly increased mean epidermal thickness, versus untreated mice. The values obtained in the case of celecoxib 2% ointment regarding the orthokeratosis degree and percentual drug activity are providing premises for further investigations regarding this effect and the mechanisms of action involved. Celecoxib 2% had the greatest percentual drug activity and is a promising substance for the anti-psoriasis topical treatment. Along with the COX-2 inhibition, celecoxib might have an anti-psoriasis effect by other independent mechanisms.
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Silișteanu AE, Szakács J. Study on the effects of the use of therapeutic ultrasound in the treatment of osteoarticular diseases. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. The use of therapeutic ultrasounds is a method that proved its efficiency in articu-lar and periarticular pathology, in the subacute and chronic stages. The biological effects of the ultrasound use are determined by their interaction with the cellular structures whereas the re-sults depend on the used parameters. The purpose of the survey is to evaluate / identify the ef-fects of using ultrasounds in the treatment of musculoskeletal conditions (lumbar discopathy), knee osteoarthritis). Material and method. The survey was conducted on an outpatient basis in a period of 7 months and it is of the longitudinal type. It included 151 patients diagnosed with low back pain and knee osteoarthritis. The evaluated parameters were: pain, functional skills, articu-lar rigidity and the quality of life. Results. The effects of the use of ultrasounds is found in the decrease of pain, the stiffness of the joints and the contracture of the muscles, as shown by the re-sults of several surveys. Our survey proves that the use of ultrasounds decreases pain and in-creases the functional skills, it influences the physical function more obviously in patients with knee osteoarthritis, which is an aspect found in others surveys. Discussion. The use of a complex ultrasound treatment (in the pulsed way to avoid thermal effects) and kinesiotherapy enabled in our research the decrease of the pain and of the rigidity in the joints, the increase of the function-al skills and the quality of life, whereas these obtained results are in accordance with those of others surveys. Conclusions. The use of the therapeutic ultrasounds can have the following ef-fects: the decrease of the pain and of the joint rigidity, the improvement of the physical capacity for daily activities and the improvement of the quality of life. The use of low intensity ultra-sounds can determine biological effects with actions for a short period or for an average one.
Keywords: therapeutic ultrasound, treatment, osteoarticular diseases, quality of life
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Affiliation(s)
- Andrei-Emanuel Silișteanu
- 1 Master- Health Management- Lucian Blaga University, Faculty of Medicine, Sibiu 2 Faculty of Political, Administrative and Communication Sciences of Cluj-Napoca, Romania
| | - Juliánna Szakács
- 3 George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Faculty of Medicine, Department of Biophysics
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Zeng J, Xie TF, Huang T, Li F, Wang ZP, Feng LL. Preparation and In Vitro and In Vivo Evaluation of a Testosterone Film Forming Gel for the Treatment of Hypoactive Sexual Desire Disorder in Women. AAPS PharmSciTech 2022; 23:79. [PMID: 35212788 DOI: 10.1208/s12249-021-02201-9] [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: 08/26/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022] Open
Abstract
Hypoactive sexual desire disorder (HSDD) is one of the most common sexual complaints in women. Currently, there is an unmet need for a drug treatment for this disorder. The purpose of this study was to develop a testosterone (TS) film forming gel used for women to treat HSDD by measuring the tackiness, peel adhesion force, tensile strength, and elasticity of the formulation. Diethylene glycol monoethyl ether (Transcutol P), an efficient penetration enhancer, was added to the optimized formulation and the transdermal permeation characteristics in vitro were studied using Franz-diffusion cells. The quantitative determination of TS was performed by high-performance liquid chromatography (HPLC). After 24 h, Transcutol P at 3% had the largest cumulative amount of drug and enhancement ratio of TS of 75.14 μg/cm2 and 2.82, respectively. After the screening of film forming polymers and penetration enhancers, the optimal formulation was as follows: glycerol (1%, w/w); 12.5% sodium carboxymethylcellulose (CMC-Na) aqueous solution (0.5%, w/w); 2.5% Carbomer ethanol solution (0.5%, w/w); Transcutol P ethanol solution (3%, w/w) containing 0.5% TS; and 8% Poly vinyl alcohol (PVA) aqueous solution (30%, w/w). The optimized film forming gel had good uniformity and the release of TS in vitro was close to 100% within 24 h. In vivo studies showed the formulations had optimal area under blood drug concentration curve values in the order of 3% Transcutol P > 1% Transcutol P > 5% Transcutol P > control preparation. The formulation with 3% Transcutol P provided the highest permeation effect both in vitro and in vivo. The safety of this formulation was further evaluated with a skin irritation test. It could effectively improve the rabbit skin irritation observed with a marketed transdermal patch Androderm®. The present study provides a promising approach for the development of a novel TS film forming gel for the treatment of HSDD in women.
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Tavana B, Chen A. Determination of Drugs in Clinical Trials: Current Status and Outlook. SENSORS (BASEL, SWITZERLAND) 2022; 22:1592. [PMID: 35214505 PMCID: PMC8875021 DOI: 10.3390/s22041592] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/03/2022] [Accepted: 02/14/2022] [Indexed: 05/30/2023]
Abstract
All pharmaceutical drugs, vaccines, cosmetic products, and many medical breakthroughs must first be approved through clinical research and trials before advancing to standard practice or entering the marketplace. Clinical trials are sets of tests that are required to determine the safety and efficacy of pharmaceutical compounds, drugs, and treatments. There is one pre-phase and four main clinical phase requirements that every drug must pass to obtain final approval. Analytical techniques play a unique role in clinical trials for measuring the concentrations of pharmaceutical compounds in biological matrices and monitoring the conditions of patients (or volunteers) during various clinical phases. This review focuses on recent analytical methods that are employed to determine the concentrations of drugs and medications in biological matrices, including whole blood, plasma, urine, and breast milk. Four primary analytical techniques (extraction, spectroscopy, chromatography, and electrochemical) are discussed, and their advantages and limitations are assessed. Subsequent to a survey of evidence and results, it is clear that microelectromechanical system (MEMS) based electrochemical sensor and biosensor technologies exhibit several notable advantages over other analytical methods, and their future prospects are discussed.
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Affiliation(s)
| | - Aicheng Chen
- Electrochemical Technology Centre, Department of Chemistry, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada;
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29
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Cherukuri S, M T, Vuppalapati L. Formulation and optimization of novel dexibuprofen- Aloe vera deformable emulgels for enhanced anti-inflammatory activity. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Jorda A, Armogida M, Lackner E, Saikumar S, Sucharski F, Weber M, Zeitlinger M. Diclofenac in vitro microdialysis study comparing different experimental setups to improve quantitative recovery. Basic Clin Pharmacol Toxicol 2022; 130:468-480. [PMID: 35048557 PMCID: PMC9305941 DOI: 10.1111/bcpt.13709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
Several studies investigated diclofenac tissue concentrations using microdialysis (MD). However, thorough evaluations of the optimal MD set‐up for diclofenac are unavailable. Thus, this in vitro MD study aimed to compare different set‐ups to improve quantitative recovery of diclofenac. In forward and reverse in vitro MD experiments with diclofenac at two concentrations (1 and 100 ng/ml), the perfusion solutions physiological saline 0.9% (PS) and human albumin 1% (HSA) were compared using tissue probes (10‐mm membrane) and customized intravenous (iv) probes (30‐mm membrane). Using PS, the mean relative recovery of diclofenac at 1 ng/ml was 1.6% ± 0.04% and 3.12% ± 0.00% with the tissue probe and the iv probe, respectively. The respective mean relative recovery for diclofenac at 100 ng/ml was 0.02% ± 0.01% and 0.21% ± 0.11%. Using HSA, the mean relative recovery was 314% ± 25% (tissue probe) and 1064% ± 97% (iv probe) for diclofenac at 1 ng/ml and 444% ± 91% and 1415% ± 217% for diclofenac at 100 ng/ml. In reverse dialysis using PS, the mean relative loss of diclofenac was 99.2% ± 0.5% (tissue probe) and 95.8% ± 1.7% (iv probe). Using HSA, the mean relative loss was −4.4% ± 7.2% and 0.2% ± 7.5%, respectively. PS and HSA were not suitable perfusion solutions for quantification of absolute diclofenac concentrations. Despite methodological challenges, HSA may be used for comparative experiments or bioequivalence studies.
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Affiliation(s)
- Anselm Jorda
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | - Edith Lackner
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | | | - Maria Weber
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Markus Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
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Walters R, Kasik J, Ettel C, Ortiz R. Evaluation of Sustained Acoustic Medicine for Treating Musculoskeletal Injuries in Military and Sports Medicine. Open Orthop J 2022; 16:e187432502211210. [PMID: 36694709 PMCID: PMC9869494 DOI: 10.2174/18743250-v16-e221130-2022-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Musculoskeletal injuries are common in collegiate, professional, and military personnel and require expedited recovery to reduce lost work time. Sustained acoustic medicine (SAM) provides continuous long-duration ultrasound at 3MHz and 132mW/cm2. The treatment is frequently prescribed to treat acute and chronic soft tissue injuries and reduce pain. The objective of this study was to evaluate the efficacy of SAM treatment for musculoskeletal injuries and accelerated recovery. Methods An 18-question electronic survey and panel discussion were conducted on Athletic Trainers (ATs) using SAM treatment in professional, collegiate, and military sports medicine. The survey included both qualitative and quantitative questions. In addition, a panel discussion discussed SAM effectiveness with expert ATs. Power calculation of sampling and statistical evaluation of data was utilized to generalize the results. Results Survey respondents (n=97) and panelists (n=142) included ATs from all National Athletic Trainers Association districts. SAM was primarily used for musculoskeletal injuries (83.9%, p<0.001) with a focus on healing tendons and ligaments (87.3%, p<0.001). SAM treatment was also used on joints (44.8%), large muscle groups (43.7%), and bone (41.4%). SAM provided clinical improvement in under 2 weeks (68.9%, p<0.001) and a 50% reduction in pain medication (63%, p<0.001). In addition, patients were highly receptive to treatment (87.3%, p<0.001), and ATs had a high level of confidence for improved function and returned to work after 30-days of SAM use (81.2%, p<0.001). Conclusion SAM is an effective, safe, easy-to-use, noninvasive, comfortable, and versatile therapeutic for healing musculoskeletal injuries.
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Affiliation(s)
- Rod Walters
- NATA Hall of Fame, Walters Inc. Consultants in Sports Medicine, Columbia, SC, USA
| | - John Kasik
- Atheltic Training and Sports Medicine, University of South Carolina, Columbia, SC, USA
| | - Cassie Ettel
- Atheltic Training, Jacksonville Jaguars, Jacksonville, FL, USA
| | - Ralph Ortiz
- Cayuga Medical Center, Medical Pain Consultants, Dryden, NY, USA,Address correspondence to this author at the Cayuga Medical Center, Medical Pain Consultants, Dryden, NY, USA; Tel: 6078449979;
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Shavlovskaya OA, Bokova IA, Shavlovskiy NI. The possibilities of using topical nonsteroidal anti-inflammatory drugs in the complex pain syndrome therapy of musculoskeletal system diseases. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.11.201145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diseases of the peripheral joints (osteoarthritis OA) and the spine are the most common pathology among other chronic conditions. One of the most common diseases characterized by degenerative periarticular changes with various clinical manifestations is periarthritis. Unlike OA, periarthritis is characterized by a discrepancy between active and passive movements, increased pain during strictly defined movements, the absence of joint swelling or local swelling in the projection of the affected tendon. As the basic therapy of OA (step 1), it is recommended to prescribe locally nonsteroidal anti-inflammatory drugs (NSAIDs), as drugs with less systemic adverse effects. Local NSAIDs have a sufficient analgesic effect in knee joints OA. Among topical NSAIDs for reducing pain in knee joints OA and periarticular tissues, diclofenac gel (Voltaren Emulgel 2%) is approved for use, the effectiveness of which has been demonstrated in many studies. To achieve maximum effect, the gel is applied according to the instructions for use of the drug: 2 ml on the anterior, posterior and lateral surfaces of the knee 2 times a day (every 12 hours) for 4 weeks.
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Espinoza LC, Sosa L, Granda PC, Bozal N, Díaz-Garrido N, Chulca-Torres B, Calpena AC. Development of a Topical Amphotericin B and Bursera graveolens Essential Oil-Loaded Gel for the Treatment of Dermal Candidiasis. Pharmaceuticals (Basel) 2021; 14:ph14101033. [PMID: 34681257 PMCID: PMC8538170 DOI: 10.3390/ph14101033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 01/02/2023] Open
Abstract
The higher molecular weight and low solubility of amphotericin B (AmB) hinders its topical administration. The aim of this study was to incorporate Bursera graveolens essential oil into an AmB topical gel (AmB + BGEO gel) in order to promote the diffusion of the drug through the skin in the treatment of cutaneous candidiasis. AmB + BGEO gel formulation was determined using a factorial experiment. Physical and chemical parameters, stability, in vitro release profile and ex vivo permeation in human skin were evaluated. In vitro antimicrobial activity was studied using strains of C. albicans, C. glabrata and C. parapsilosis. The tolerability was evaluated using in vitro and in vivo models. AmB + BGEO gel presented appropriate characteristics for topical administration, including pH of 5.85, pseudoplastic behavior, optimal extensibility, as well as high stability and acceptable tolerability. In vitro release studies showed that the formulation releases the drug following a Boltzmann sigmoidal model. Finally, AmB + BGEO gel exhibited higher amount of drug retained inside the skin and lower Minimum Inhibitory Concentration than a formulation sans essential oil. Therefore, these results suggest that the incorporation of B. graveolens essential oil in the formulation could be used as strategy to promote a local effect in the treatment of cutaneous candidiasis.
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Affiliation(s)
- Lupe Carolina Espinoza
- Departamento de Química, Universidad Técnica Particular de Loja, Loja 1101608, Ecuador; (L.C.E.); (B.C.-T.)
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain;
| | - Lilian Sosa
- Faculty of Chemical Sciences and Pharmacy, National Autonomous University of Honduras (UNAH), Tegucigalpa 11101, Honduras;
| | - Paulo C. Granda
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain;
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Nuria Bozal
- Department of Biology, Healthcare and the Environment, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain;
| | - Natalia Díaz-Garrido
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain;
- Institute of Biomedicine of the University of Barcelona-Sant Joan de Déu Research Institute (IBUB-IRSJD), 08028 Barcelona, Spain
| | - Brenda Chulca-Torres
- Departamento de Química, Universidad Técnica Particular de Loja, Loja 1101608, Ecuador; (L.C.E.); (B.C.-T.)
| | - Ana Cristina Calpena
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain;
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Correspondence:
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McMonnies CW. Transdermal anti-inflammatory therapy for aqueous deficiency. Ophthalmic Physiol Opt 2021; 41:1267-1272. [PMID: 34605579 DOI: 10.1111/opo.12891] [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: 11/24/2020] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Lacrimal gland inflammation has been identified as an important limitation on aqueous production and associated dry eye disease. Ocular surface inflammation in dry eye disease can be a downstream response to reduced quantities of warmer hyperosmotic aqueous being delivered from an inflamed lacrimal gland with high concentrations of inflammatory mediators. This review examines evidence which shows how topical applications of anti-inflammatory drugs have very limited access to the lacrimal gland and an associated limited capacity to increase aqueous flow by reducing inflammation in the main lacrimal gland. RECENT FINDINGS Using cyclosporine as an exemplar immunomodulatory drug, this review examines problems associated with the topical administration of all anti-inflammatory drugs in the treatment of dry eye disease. SUMMARY Limited access to the lacrimal gland for topical applications and their very short on-eye residence times are compared with the therapeutic potential of prolonged therapeutic episodes that could be achieved with transdermal applications of a drug to the skin at the site of the lacrimal gland. Poor access to the lacrimal gland for topically administered drugs is a major barrier to the treatment of aqueous deficiency. While topical inflammatory drug access to the ocular surface is direct, poor access to the lacrimal gland is partly due to drop placement being downstream to the flow of aqueous (Eye Vis 2020;7:1; Eye Vis 2019;6:1). This barrier is much greater according to the degree that reflex tear flow is stimulated by irritation associated with adverse drop temperature, and/or pH and/or tonicity for example.
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Affiliation(s)
- Charles W McMonnies
- Faculty of Medicine and Health, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Comparison of the Efficacy and Safety of Ketoprofen Plaster and Diclofenac Plaster for Osteoarthritis-Related Knee Pain: A Multicenter, Randomized, Active-Controlled, Open-Label, Parallel-Group, Phase III Clinical Trial. Clin Ther 2021; 43:1720-1734. [PMID: 34479761 DOI: 10.1016/j.clinthera.2021.08.002] [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: 05/25/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the efficacy and safety of ketoprofen plasters and diclofenac plasters after 3 weeks of administration in patients with osteoarthritis-related knee pain. METHODS This multicenter, randomized, active-controlled, open-label, parallel-group, noninferiority phase III study randomized 236 adults with osteoarthritis-related knee pain for 3 weeks with ketoprofen plaster 30 mg twice daily (n = 118) or diclofenac plaster 15 mg once daily (n = 118). The primary efficacy end point was the mean change from baseline to week 3 in the mean knee pain intensity score during walking, as measured by a 100-mm visual analog scale with a predefined noninferiority margin of 10.0 mm. Secondary end points included changes in knee pain intensity score during walking (weeks 1 and 2) and at rest (weeks 1, 2, and 3), Knee Injury and Osteoarthritis Outcome Score, Patient Global Impression of Improvement scale assessments, and frequency of rescue medication use after 2 and 3 weeks of treatment. FINDINGS A total of 223 patients (115 in the ketoprofen group and 108 in the diclofenac group) were included in the per-protocol analysis. After 3 weeks of treatment, the least squares mean change from baseline in knee pain intensity scores during walking was -35.9 (95% CI, -39.7 to -32.2) in the ketoprofen group and -31.7 (95% CI, -35.5 to -27.9) in the diclofenac group, with noninferiority found (least squares mean difference, -4.2; 95% CI, -9.6 to 1.1). Ketoprofen significantly (P < 0.05) reduced the pain intensity score at rest after 2 and 3 weeks of treatment compared with diclofenac. No statistically significant difference was found between the groups in terms of changes in pain intensity score during walking at weeks 1, 2, and 3. The mean Patient Global Impression of Improvement score was statistically significant (P < 0.001) in favor of ketoprofen after 2 and 3 weeks of treatment. In addition, the Knee Injury and Osteoarthritis Outcome Score improved in both groups, and no statistically significant difference was found between the groups in terms of frequency of rescue medication use. The overall adverse event profile of the groups was similar, and no difference was found in skin reaction rates between the 2 groups. IMPLICATIONS Ketoprofen plasters can be effectively and safely administered to patients with osteoarthritis-related knee pain.
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Development of a novel nanoemulgel formulation containing cumin essential oil as skin permeation enhancer. Drug Deliv Transl Res 2021; 12:1455-1465. [PMID: 34275091 PMCID: PMC9061677 DOI: 10.1007/s13346-021-01025-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
Essential oils have been proposed as promising non-toxic transdermal permeation enhancers. Their use is limited because of their low water solubility. The use of nanotechnology-based strategies is one of the ways to overcome this limitation. This study aimed to explore the transdermal permeation enhancing capability of cumin essential oil in nanoemulgel systems containing diclofenac sodium. Cumin essential oil nanoemulsion was produced by high-pressure homogenization technique. The formulation was optimized by changing HLB values in a range of 9.65–16.7 using different surfactant mixtures, namely, Tween 20, Tween 80, and Span 80. Preparations were characterized by polydispersity index, droplet size, and zeta potential. Nanoemulsion with concentrations of 2 and 4% essential oil was incorporated into 0.75% Carbopol gel matrix to make nanoemulgel formulation, and its permeation enhancing effect was performed through Franz diffusion cells. Antinociceptive activities of the formulations were measured in thermal (tail-flick) and chemical (formalin) models of nociception in mice. Characterization exhibited that at HLB value of 9.65, the smallest particle size (82.20 ± 5.82 nm) was formed. By increasing the essential oil percentage in the nanoemulgel from 1 to 2%, the permeation of diclofenac increased from 28.39 ± 1.23 to 34.75 ± 1.07 µg/cm2 at 24 h. The value of permeation from the simple gel (21.18 ± 2.51 µg/cm2) and the marketed product (22.97 ± 1.92 µg/cm2) was lower than the formulations containing essential oil. Nanoemulgel of diclofenac containing essential oil showed stronger antinociceptive effects in formalin and tail-flick tests than simple diclofenac gel and marketed formulation. In conclusion, the study proved that nanoemulgel formulation containing cumin essential oil could be considered as a promising skin enhancer to enhance the therapeutic effect of drugs.
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Pennick G, Robinson-Miller A, Cush I. Topical NSAIDs for acute local pain relief: in vitro characterization of drug delivery profiles into and through human skin. Drug Dev Ind Pharm 2021; 47:908-918. [PMID: 34109888 DOI: 10.1080/03639045.2021.1935996] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The efficacy of topical nonsteroidal anti-inflammatory drugs (NSAIDs) relates not only to the individual NSAID used but also to differences in formulation design. The aim of this study was to investigate the fundamental differences in ibuprofen and diclofenac drug delivery vehicles, specifically gels and plasters, compared to a recently launched 200 mg ibuprofen medicated plaster and characterize the resulting dermatologic-pharmacokinetic profiles into and through ex vivo human skin layers. METHODS In vitro skin permeation testing over 24 h and sacrificial timepoint penetration experiments (at 1, 4, 8, 12, and 24 h) were conducted using an automated flow-through diffusion cell system. The amount of drug delivered to the epidermis, dermis, and receptor solution (representing deeper tissue) was determined by liquid chromatography-tandem mass spectrometry. Skin protein binding of ibuprofen and diclofenac was investigated by spiking skin homogenate with increasing concentrations of each drug and determining the fraction unbound. RESULTS Differences were observed in the amount of drug recovered at sacrificial timepoints and rate at which drug was delivered to the target site between plaster and gel formulations of ibuprofen and diclofenac and between plaster formulations of the same drug (ibuprofen). While the amount of drug quantified at sacrificial timepoints did not necessarily determine in vivo flux rates, differences in drug distribution within the skin layers indicated where drug reservoirs were formed. CONCLUSIONS These findings highlight the importance of intelligent formulation design in determining NSAID delivery through skin layers. Further work is required to quantify drug delivery into deeper tissues and the resultant local anti-inflammatory effects.
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Kikuchi S, Togo K, Ebata N, Fujii K, Yonemoto N, Abraham L, Katsuno T. A Retrospective Database Study of Gastrointestinal Events and Medical Costs Associated with Nonsteroidal Anti-Inflammatory Drugs in Japanese Patients of Working Age with Osteoarthritis and Chronic Low Back Pain. PAIN MEDICINE 2021; 22:1029-1038. [PMID: 33585939 DOI: 10.1093/pm/pnaa421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT The real-world burden of gastrointestinal (GI) events associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in Japanese patients with osteoarthritis (OA) and/or chronic low back pain (CLBP) remains unreported. OBJECTIVE To assess the incidence and economic burden of NSAID-induced GI events by using data from large-scale real-world databases. METHODS We used the Japanese Medical Data Center database to retrospectively evaluate anonymized claims data of medical insurance beneficiaries employed by middle- to large-size Japanese companies who were prescribed NSAIDs for OA and/or CLBP between 2009 and 2018. RESULTS Overall, 180,371 patients were included in the analysis, of whom 32.9% had OA, 53.8% had CLBP, and 13.4% had both OA and CLBP. NSAIDs were administered as first-line analgesics to 161,152 (89.3%) of the patients in the sample, in oral form to 90.3% and as topical patches to 80.4%. A total of 65.1% used combined oral/topical patches. Of the 21.0% of patients consistently using NSAIDs (percentage of days supplied ≥70%), 54.5% received patches. A total of 51.5% patients used NSAIDs for >1 to ≤6 months. The incidence of GI events was 9.97 per 10,000 person-years (95% confidence interval: 8.92-11.03). The risk of developing GI events was high in elderly patients and patients with comorbidities and remained similar for patients receiving oral vs. topical NSAIDs. Longer treatment duration and consistent NSAID use increased the risk of GI events. The cost (median [interquartile range]) of medications (n = 327) was US$ 80.70 ($14.10, $201.40), that of hospitalization (n = 33) was US$ 2,035.50 ($1,517.80, $2,431.90), and that of endoscopic surgery (n = 52) was US$ 418.20 ($418.20, $418.20). CONCLUSION NSAID-associated GI toxicity imposes a significant health and economic burden on patients with OA and/or CLBP, irrespective of whether oral or topical NSAIDs are used.
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Affiliation(s)
- Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan
| | | | | | | | | | | | - Takayuki Katsuno
- Department of Nephrology and Rheumatology, Aichi Medical University, Aichi, Japan
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Veloso C, Cardoso C, Vitorino C. Topical Fixed-Dose Combinations: A Way of Progress for Pain Management? J Pharm Sci 2021; 110:3345-3361. [PMID: 34102201 DOI: 10.1016/j.xphs.2021.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/17/2022]
Abstract
Pain, a severe public health problem, can affect patient quality of life when inadequately controlled. Considering that pain pathophysiological mechanisms are complex, combining active pharmaceutical ingredients (APIs) with multiple and synergistic mechanisms of action represents a potentially more effective therapeutic approach than conventional monotherapy treatments. In turn, topical drug delivery has clear advantages over other routes of administration, such as high levels of efficacy, better safety profile and great patient compliance. In this context, the combination of two or more APIs in a single dosage form - fixed-dose combination product (FDC) - for topical administration may represent a promising therapeutic option in the field of pain management. Considering the above mentioned, the purpose of this manuscript is to address an overview of some general aspects regarding pain management and FDCs, as well as the regulatory environment that has to be taken into consideration during their development. Special emphasis will be given to fixed-dose combinations for topical administration with analgesic and/or anti-inflammatory activity. Market drivers of the topical FDC currently approved are ultimately pointed out, and new opportunities in pain management highlighted.
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Affiliation(s)
- Cláudia Veloso
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; Coimbra Chemistry Center, Department of Chemistry, University of Coimbra, Rua Larga, 3004-535 Coimbra, Portugal
| | - Catarina Cardoso
- Laboratórios Basi, Parque Industrial Manuel Lourenço Ferreira, lote 15, 3450-232 Mortágua, Portugal
| | - Carla Vitorino
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; Coimbra Chemistry Center, Department of Chemistry, University of Coimbra, Rua Larga, 3004-535 Coimbra, Portugal; Center for Neurosciences and Cell Biology (CNC), University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st floor, 3004-504 Coimbra, Portugal.
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PLGA based film forming systems for superficial fungal infections treatment. Eur J Pharm Sci 2021; 163:105855. [PMID: 33872699 DOI: 10.1016/j.ejps.2021.105855] [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] [Received: 01/18/2021] [Revised: 03/30/2021] [Accepted: 04/14/2021] [Indexed: 12/18/2022]
Abstract
As proven in clinical trials, superficial fungal infections can be effectively treated by single topical application of terbinafine hydrochloride (Ter-HCl) in a film forming system (FFS). Poly(lactic-co-glycolic acid) (PLGA) derivatives, originally synthesized with intention to get carriers with optimized properties for drug delivery, and multifunctional plasticizers - ethyl pyruvate, methyl salicylate, or triacetin - were used for formulation of Ter-HCl loaded FFSs. After spraying, a biodegradable, transparent, adhesive, and occlusive thin layer is formed on the skin, representing drug depot. In situ formed films were characterized by thermal, structural, viscoelastic, and antifungal properties as well as drug release and skin penetration. DSC and SEM showed fully amorphous films with Ter-HCl dissolved in PLGA in high concentration (up to 15%). FFSs are viscoelastic fluids with viscosity which can be easily adjusted by the type of plasticizer used and its concentration. The formulations showed excellent bioadhesion properties, thus ensuring persistence on the skin. In situ film based on branched PLGA/A plasticized with 10% of ethyl pyruvate allowed prolonged release of Ter-HCl by linear kinetics for the first 6 days with a total time of almost 14 days. During ex vivo human skin penetration experiment, Ter-HCl was found to be located only in its target layer, the epidermis. According to our results, plasticized branched PLGA derivatives loaded by Ter-HCl are suitable for the development of FFSs for superficial fungal infections treatment.
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Oliveira LB, Geller M, Cunha KS, Santos A, Bernacchi A, Rubenstein AE, Takirambudde S, Mezitis S, de Almeida Ito Brum C, Darrigo LG, Ribeiro MG. Clinical assessment of the use of topical liquid diclofenac following laser microporation of cutaneous neurofibromas in individuals with neurofibromatosis type 1. Heliyon 2021; 7:e06518. [PMID: 33817379 PMCID: PMC8010391 DOI: 10.1016/j.heliyon.2021.e06518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/16/2020] [Accepted: 03/11/2021] [Indexed: 11/03/2022] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with a prevalence of 1:3000 births and a wide variety of clinical manifestations. Cutaneous neurofibromas (cNF) are among the most common visible manifestations of NF1 and present a major clinical burden for patients. NF1 patients with cNF often report decreased quality of life, emotional well-being and physical comfort. Developing effective medical therapies for cNF has been identified as a priority for the majority of adults with NF1. Methods The study was an open, controlled and prospective proof-of-concept clinical trial. The topical treatment consisted of two steps: cNF microporation using a laser device followed by topical application of one drop of diclofenac 25 mg/mL on the surface of the cNF (T neurofibroma = treatment) or physiological saline (C neurofibroma = control) and reapplied twice daily for 3 days. Neurofibroma assessments included visual and dermatoscopy observations noting color and presence of necrosis, presence of flaccidity, measurements in two dimensions, photographs, and histopathology after excision. The primary efficacy variable was the presence of tissue necrosis. The primary safety variable was the occurrence of treatment-related adverse events. Results Six patients were included in the study. The treatment resulted in transitory topical changes (healing of the microporation grid with formation of scintillating tissue layer, hyperemia and desquamation), with no statistically significant variation in the dimensions of the T and C neurofibromas in relation to pretreatment measurements. There was no necrosis in the T or C neurofibromas. In the histopathological analysis, there was no significant difference in the distribution of chronic (lymphocytic) inflammatory infiltrate in the papillary reticular dermis (subepithelial), type of infiltrate (diffuse, perivascular, or both), presence of fibrosis, and presence of atrophy among the T and C neurofibromas. No adverse events attributable to the use of diclofenac were reported during the treatment period. Conclusions Treatment did not result in significant alterations in terms of presence of tissue necrosis, size, or histopathological features in the T neurofibromas or in comparison to the C neurofibromas. Topical diclofenac with laser microporation was well-tolerated, with no adverse events attributable to diclofenac reported. Whether these observations are due to minimal systemic and neurofibroma exposure remain to be explored in dosage studies with larger patient groups. Trial registration ClinicalTrials.gov (NCT03090971) retrospectively registered March 27, 2017.
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Affiliation(s)
- Lisa Brauer Oliveira
- Postgraduate Program in Clinical Medicine, Universidade Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro, Brazil
| | - Mauro Geller
- Medical Genetics Service, Instituto de Puericultura e Pediatria Martagão Gesteira Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Department of Immunology and Microbiology, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Clinical Immunology, Instituto de Pós-Graduação Médica Carlos Chagas - Rio de Janeiro, Brazil
| | - Karin Soares Cunha
- Postgraduate Program in Pathology, Universidade Federal Fluminense (UFF) Medical School, Niterói, Brazil.,Pathology Department, Faculdade de Medicina - Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Alessandra Santos
- Postgraduate Program in Clinical Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Allan Bernacchi
- Department of Plastic Surgery, Serviço Prof. Pitanguy, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Allan E Rubenstein
- Department of Neurology and Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Sanyu Takirambudde
- Department of Pediatrics, New York University Langone Medical Center, New York, NY, USA
| | - Spyros Mezitis
- Department of Endocrinology/Clinical Medicine, Weill Medical College of Cornell University, New York, NY, USA.,New York Presbyterian Hospital/Cornell Medicine, Lenox Hill Hospital/Northwell Health, New York, NY, USA
| | | | - Luiz Guilherme Darrigo
- Bone Marrow Transplant Unit, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcia Gonçalves Ribeiro
- Department of Pediatrics, Federal University of Rio de Janeiro Medical School (UFRJ), Rio de Janeiro, Brazil.,Medical Genetics Service, Instituto de Puericultura e Pediatria Martagão Gesteira, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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43
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Tenoxicam loaded hyalcubosomes for osteoarthritis. Int J Pharm 2021; 601:120483. [PMID: 33737098 DOI: 10.1016/j.ijpharm.2021.120483] [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: 11/11/2020] [Revised: 02/24/2021] [Accepted: 03/08/2021] [Indexed: 12/25/2022]
Abstract
The main aim is to develop transcutaneous tenoxicam (TNX) loaded vesicles to control osteoarthritis (OA) without common side effects. Different vesicles were prepared by the emulsification technique, where poloxamer and glyceryl monooleate used for cubosomes. Then, hyalcubosomes were prepared by adding sodium hyaluronate to cubosomes components. Different characterization techniques were used. The selected formulations were tested using an ex-vivo permeation study to evaluate the ability to penetrate and retained in skin layers. Also, in-vitro cell studies using human skin fibroblasts were evaluated the safety of the formulation. The anti-inflammatory efficiency was tested using an in-vivo carrageenan-induced rat paw edema model. Finally, the efficiency to control OA symptoms was tested on three patients with a medical history of knee OA. Results confirmed the successful development of spherical cubosomes with particle size <250 nm, -14.5 mV, high entrapment efficiency percentage (>90%). Moreover, the addition of sodium hyaluronate to selected cubosomes improved viscosity and spreadability. Permeation study confirmed drug penetration and deposition. Cell studies proved the safety of the selected formulation. The animal model showed high anti-inflammatory activity. Finally, the preliminary clinical study demonstrates the potential efficacy and safety of the formulation in controlling OA symptoms over 8 weeks of therapy.
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Abouhussein DM. Enhanced transdermal permeation of BCS class IV aprepitant using binary ethosome: Optimization, characterization and ex vivo permeation. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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45
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Transdermal Permeation and Skin Retention of Diclofenac and Etofenamate/Flufenamic Acid From Over-the-Counter Pain Relief Products. J Pharm Sci 2021; 110:2517-2523. [PMID: 33508308 DOI: 10.1016/j.xphs.2021.01.022] [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: 11/06/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 11/22/2022]
Abstract
Topical pain relief products differ in the type of drug, concentration, and formulation. All these factors influence the drug transit through the skin barrier, and its eventual retention in the skin as a reservoir for subsequent release. In addition, the drug potency can be different, which is important for the product efficacy. We studied here ex vivo human skin permeation and retention of five over-the-counter NSAID gels containing 2.32% diclofenac (DIC) and 5-10% etofenamate (ETF). The potency of the permeated/retained drug amounts were compared using a composite parameter, the Index of Relative Topical Anti-inflammatory Activity (IRTAA), which is calculated as the product of the skin permeation/retention and the drug relative potency. The IRTAAs of the DIC gel were 94-667-fold higher and 72-208-fold higher for transdermal delivery and skin retention, respectively, than IRTAAs of the ETF gels. These superior IRTAAs indicate that DIC delivered by this topical formulation would achieve a higher bioactivity and would form a potent drug reservoir relevant for its subsequent long-lasting release.
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46
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Fayet M, Hagen M. Pain characteristics and biomarkers in treatment approaches for osteoarthritis pain. Pain Manag 2021; 11:59-73. [DOI: 10.2217/pmt-2020-0055] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Osteoarthritis (OA) is a progressive disease and OA pain intensity is related to ongoing pathophysiological changes. However, OA pain is complex and multimodal; its characteristics, including severity, localization and the stimuli that elicit it, can change as the disease progresses and differ greatly among patients. Understanding mechanisms underlying specific pain characteristics may help guide clinicians in choosing appropriate treatments, targeting treatments to those patients most likely to benefit. Associations have been demonstrated between biomarkers and some characteristics of OA pain, and to processes linked to the shift in pain characteristics over the course of OA. This article examines how understanding OA pain characteristics and their relation to the disease process could inform treatment choice when applying well-established treatment guidelines.
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Affiliation(s)
- Marina Fayet
- GSK Consumer Healthcare S.A., Route de l'Etraz 2, 1260, Nyon, Switzerland
| | - Martina Hagen
- GSK Consumer Healthcare S.A., Route de l'Etraz 2, 1260, Nyon, Switzerland
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47
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Alginate-pluronic topical gels loaded with thymol, norfloxacin and ZnO nanoparticles as potential wound dressings. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101960] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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48
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Lee YS, Jeon SH, Ham HJ, Lee HP, Song MJ, Hong JT. Improved Anti-Inflammatory Effects of Liposomal Astaxanthin on a Phthalic Anhydride-Induced Atopic Dermatitis Model. Front Immunol 2020; 11:565285. [PMID: 33335525 PMCID: PMC7736086 DOI: 10.3389/fimmu.2020.565285] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/04/2020] [Indexed: 11/13/2022] Open
Abstract
Previously, we found that astaxanthin (AST) elicited an anti-inflammatory response in an experimental atopic dermatitis (AD) model. However, the use of AST was limited because of low bioavailability and solubility. We hypothesized that liposome formulation of AST could improve this. In this study, we compared the anti-inflammatory and anti-dermatotic effects of liposomal AST (L-AST) and free AST. We evaluated the effect of L-AST on a phthalic anhydride (PA)-induced animal model of AD by analyzing morphological and histopathological changes. We measured the mRNA levels of AD-related cytokines in skin tissue and immunoglobulin E concentrations in the serum. Oxidative stress and transcriptional activities of signal transducer and activator of transcription 3 (STAT3) and nuclear factor (NF)-κB were analyzed via western blotting and enzyme-linked immunosorbent assay. PA-induced dermatitis severity, epidermal thickening, and infiltration of mast cells in skin tissues were ameliorated by L-AST treatment. L-AST suppressed AD-related inflammatory mediators and the inflammation markers, inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 in PA-induced skin conditions. Oxidative stress and expression of antioxidant proteins, glutathione peroxidase-1 (GPx-1) and heme oxygenase-1 (HO-1), were recovered by L-AST treatment in skin tissues from PA-induced mice. L-AST treatment reduced transcriptional activity of STAT3 and NF-κB in PA-induced skin tissues. Our results indicate that L-AST could be more effective than free AST for AD therapy.
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Affiliation(s)
- Yong Sun Lee
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Seong Hee Jeon
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Hyeon Joo Ham
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Hee Pom Lee
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Min Jong Song
- Department of Obstetrics and Gynecology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jin Tae Hong
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Chungbuk, South Korea
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49
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Persson MSM, Stocks J, Sarmanova A, Fernandes G, Walsh DA, Doherty M, Zhang W. Individual responses to topical ibuprofen gel or capsaicin cream for painful knee osteoarthritis: a series of n-of-1 trials. Rheumatology (Oxford) 2020; 60:2231-2237. [DOI: 10.1093/rheumatology/keaa561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/31/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
To determine individual responses to ibuprofen gel or capsaicin cream for painful, radiographic knee OA using a series of n-of-1 trials.
Methods
Twenty-two participants were allocated 5% ibuprofen gel (A) and 0.025% capsaicin cream (B) in random sequence (AB or BA). Patients underwent up to 3 treatment cycles, each comprising one treatment for 4 weeks, an individualized washout period (maximum 4 weeks), then the other treatment for 4 weeks. Differential (ibuprofen or capsaicin) response was defined when change-from-baseline pain intensity scores (0–10 NRS) differed by ≥1 between treatments in ≥2 cycles within a participant.
Results
A total of 104 treatment periods were aggregated. Mean pain reduction was 1.2 (95% CI: 0.5, 1.8) on ibuprofen and 1.6 (95% CI: 0.9, 2.4) on capsaicin (P = 0.221). Of 22 participants, 4 (18%) had a greater response to ibuprofen, 9 (41%) to capsaicin, 4 (18%) had similar responses, and 5 (23%) were undetermined.
Conclusion
Irrespective of equal efficacy overall, 59% of people displayed a greater response to one treatment over the other. Patients who do not benefit from one type of topical treatment should be offered to try another, which may be more effective. N-of-1 trials are useful to identify individual response to treatment.
Clinical trial registration
https://clinicaltrials.gov, NCT03146689
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Affiliation(s)
- Monica S M Persson
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Joanne Stocks
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Aliya Sarmanova
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Gwen Fernandes
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - David A Walsh
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Michael Doherty
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Weiya Zhang
- Pain Centre Versus Arthritis, Academic Rheumatology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
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50
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Pradal J. Comparison of Skin Permeation and Putative Anti-Inflammatory Activity of Commercially Available Topical Products Containing Ibuprofen and Diclofenac. J Pain Res 2020; 13:2805-2814. [PMID: 33177865 PMCID: PMC7650811 DOI: 10.2147/jpr.s262390] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The therapeutic effect of topical nonsteroidal anti-inflammatory drugs (NSAIDs) depends on the drug’s ability to penetrate and permeate the skin and subsequently inhibit cyclo-oxygenase (COX) isoforms responsible for pain and inflammation. Most commercially available topical NSAID formulations are clinically effective, but direct comparisons of anti-inflammatory activity including both skin absorption and inhibitory potency are lacking. This study examined the skin absorption of representative commercially available topical diclofenac- and ibuprofen-based formulations along with published potency values to determine formulations with superior anti-inflammatory activity. Materials and Methods Cumulative absorption and flux profiles of 12 commercially available topical NSAIDs (6 diclofenac-based and 6 ibuprofen-based) were evaluated in vitro using human skin in static Franz diffusion cells. Each formulation was applied as a single dose. In vitro permeation parameters and published COX-2 inhibition values were used to calculate a modified index of topical anti-inflammatory activity (mITAA). Results All diclofenac and ibuprofen formulations permeated human skin in vitro. The rate and degree of absorption differed between diclofenac and ibuprofen formulations and between formulations of the same drug. NSAID concentration within a product was not solely responsible for the permeation flux or degree of absorption. Ibuprofen formulations permeated the skin more rapidly and to a greater degree than diclofenac, but calculated mITAAs were higher for diclofenac. Conclusion Diclofenac exhibited superior anti-inflammatory activity as measured by the index. Differences beyond drug concentration, including excipients, drug salt form, and dosage form, contribute to differences in absorption and thus in anti-inflammatory activity. Both absorption and COX-2 inhibition potency are important for anti-inflammatory activity, but their priority depends upon the products being compared—with the same NSAID, absorption determines superiority; with different NSAIDs, superiority is determined by the balance between absorption and COX-2 potency. These findings should be considered when selecting a topical NSAID for treating patient pain and inflammation.
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Affiliation(s)
- Julie Pradal
- GlaxoSmithKline Consumer Healthcare S.A, Nyon 1260, Switzerland
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