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Li F, Ye X, Li M, Nie Q, Wang H, Zhang G, Dong L, Wang C, Wu L, Liu H, Wang L, Peng C, Zhang J. Enhanced ophthalmic bioavailability and stability of atropine sulfate via sustained release particles using polystyrene sulfonate resin. Int J Pharm 2024; 660:124294. [PMID: 38823467 DOI: 10.1016/j.ijpharm.2024.124294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/17/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
Atropine sulfate (ATS) eye drops at low concentrations constitute a limited selection for myopia treatment, with challenges such as low ophthalmic bioavailability and inadequate stability. This study proposes a novel strategy by synthesizing ophthalmic sodium polystyrene sulfonate resin (SPSR) characterized by a spherical shape and uniform size for cationic exchange with ATS. The formulation of ATS@SPSR suspension eye drops incorporates xanthan gum and hydroxypropyl methylcellulose (HPMC) as suspending agents. In vitro studies demonstrated that ATS@SPSR suspension eye drops exhibited sustained release characteristics, and tropic acid, its degradation product, remained undetected for 30 days at 40 °C. The ATS levels in the tear fluids and aqueous humor of New Zealand rabbits indicated a significant increase in mean residence time (MRT) and area under the drug concentration-time curve (AUC0-12h) for ATS@SPSR suspension eye drops compared to conventional ATS eye drops. Moreover, safety assessment confirmed the non-irritating nature of ATS@SPSR suspension eye drops in rabbit eyes. In conclusion, the cation-responsive sustained-release ATS@SPSR suspension eye drops enhanced the bioavailability and stability of ATS, offering a promising avenue for myopia treatment.
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Affiliation(s)
- Falan Li
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Xinyue Ye
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Mingwei Li
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Qin Nie
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Huihui Wang
- Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Guoqing Zhang
- Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Liyun Dong
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Caifen Wang
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Li Wu
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Hongfei Liu
- Jiangsu University, Zhenjiang 212000, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China.
| | - Lifeng Wang
- Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China.
| | - Can Peng
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Jiwen Zhang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China.
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Richdale K, Skidmore KV, Tomiyama ES, Bullimore MA. Compounded 0.01% Atropine-What's in the Bottle? Eye Contact Lens 2023; 49:219-223. [PMID: 37022143 PMCID: PMC10194055 DOI: 10.1097/icl.0000000000000990] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To describe the labeling, packaging practices, and characteristics of compounded 0.01% ophthalmic atropine. METHODS A convenience sample of parents of children who had previously been prescribed low-concentration atropine for myopia management were randomized to obtain 0.01% atropine ophthalmic solution from one of nine compounding pharmacies. The products were analyzed for various important quality attributes. The main outcomes were labeling practices, concentration of atropine and degradant product tropic acid, pH, osmolarity, viscosity, and excipients in 0.01% atropine samples obtained from nine US compounding pharmacies. RESULTS Twenty-four samples from nine pharmacies were analyzed. The median bottle size was 10 mL (range 3.5-15 mL), and eight of nine pharmacies used clear plastic bottles. Storage recommendations varied and were evenly split between refrigeration (33%), room temperature (33%), and cool, dark, dry location (33%). Beyond use dates ranged from 7 to 175 days (median, 91 days). Median pH of samples was 7.1 (range, 5.5-7.8). Median measured concentration relative to the prescribed concentration was 93.3% (70.4%-104.1%). One quarter of samples were under the 90% minimum target concentration of 0.01%. CONCLUSIONS An inconsistent and wide variety of formulation and labeling practices exist for compounding 0.01% atropine prescribed to slow pediatric myopia progression.
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Affiliation(s)
- Kathryn Richdale
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Kelsea V. Skidmore
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Erin S. Tomiyama
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Mark A. Bullimore
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
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Fu Y, Luo Y, Chen X, Tong Y, Zhu Y, Yang L. Atropine-eluting silicone contact lenses for myopia control. J Biomater Appl 2023; 37:1724-1735. [PMID: 37083186 DOI: 10.1177/08853282231166858] [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: 04/22/2023]
Abstract
Myopia, also known as nearsightedness, is one of the prime reasons for vision impairment worldwide. Atropine in topical ophthalmic solutions (e.g., 0.01% atropine sulfate eye drops) is the primary medical treatment for controlling myopia, especially for pseudomyopia or true myopia in rapid progress. However, aqueous atropine solution is unstable and easily breaks down to tropic acid, which will result in vision blur. Drug-eluting contact lenses (CLs) have been explored as a potentially superior alternative to effectively control the drug release and improve the drug efficacy. In this work, an atropine-eluting contact lens was developed by encapsulating an atropine implant in a silicon-based contact lens, towards functioning in vision correction and controlling myopia. The safety and effectiveness of this atropine-eluting contact lens were verified with rabbit and guinea pig models. The results showed that the lenses reduced the side effects like mydriasis and no other adverse events were observed in rabbit eyes. More importantly, atropine-loaded lenses could effectively delay the progress of form-deprivation myopia with guinea pig eyes as the model. Thus, we concluded that atropine-eluting CLs prepared by implantation technology may be an option for the treatment of myopia.
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Affiliation(s)
- Yan Fu
- Affiliated Hospital of Medical School Ningbo University, Ningbo, China
- School of medicine, Ningbo University, Ningbo, China
| | - Yang Luo
- Affiliated Hospital of Medical School Ningbo University, Ningbo, China
- School of medicine, Ningbo University, Ningbo, China
| | - Xi Chen
- Affiliated Hospital of Medical School Ningbo University, Ningbo, China
| | - Yao Tong
- Affiliated Hospital of Medical School Ningbo University, Ningbo, China
- School of medicine, Ningbo University, Ningbo, China
| | - Yabin Zhu
- School of medicine, Ningbo University, Ningbo, China
| | - Lu Yang
- Affiliated Hospital of Medical School Ningbo University, Ningbo, China
- School of medicine, Ningbo University, Ningbo, China
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García Del Valle I, Alvarez-Lorenzo C. Atropine in topical formulations for the management of anterior and posterior segment ocular diseases. Expert Opin Drug Deliv 2021; 18:1245-1260. [PMID: 33787441 DOI: 10.1080/17425247.2021.1909568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Atropine is an old-known drug which is gaining increasing attention due to the myriad of therapeutic effects it may trigger on eye structures. Nevertheless, novel applications may require more adequate topical formulations. AREAS COVERED This review aims to gather the existing knowledge about atropine and its clinical applications in the ophthalmological field when administered topically. Atropine ocular pharmacokinetics is paid a special attention, including recent evidences of the capability of the drug to access to the posterior segment. Ocular bioavailability and systemic bioavailability are counterbalanced. Finally, limitations of traditional dosage forms and potential advantages of under investigation delivery systems are analyzed. EXPERT OPINION Mydriasis and cyclopegia have been widely exploited for eye examination, management of anterior segment diseases, and more recently as antidotes of chemical weapons. Improved knowledge on drug receptors and related pathways explains atropine repositioning as an outstanding tool to prevent myopia. The ease with which atropine penetrates ocular tissues is a double edged sword, that is, while it ensures therapeutic levels in the posterior segment, the unspecific distribution causes a wide variety of untoward effects. The design of formulations that can selectively deliver atropine to the target tissue for each specific application is an urgent unmet need.
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Affiliation(s)
- Ines García Del Valle
- Departamento De Farmacología, Farmacia Y Tecnología Farmacéutica, I+D FarmaGroup, Facultad De Farmacia and Health Research Institute of Santiago De Compostela (IDIS), Universidade De Santiago De Compostela, Santiago De Compostela, Spain
| | - Carmen Alvarez-Lorenzo
- Departamento De Farmacología, Farmacia Y Tecnología Farmacéutica, I+D FarmaGroup, Facultad De Farmacia and Health Research Institute of Santiago De Compostela (IDIS), Universidade De Santiago De Compostela, Santiago De Compostela, Spain
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Jones L, Drobe B, González-Méijome JM, Gray L, Kratzer T, Newman S, Nichols JJ, Ohlendorf A, Ramdass S, Santodomingo-Rubido J, Schmid KL, Tan D, Tan KO, Vera-Diaz FA, Wong YL, Gifford KL, Resnikoff S. IMI - Industry Guidelines and Ethical Considerations for Myopia Control Report. Invest Ophthalmol Vis Sci 2019; 60:M161-M183. [PMID: 30817831 DOI: 10.1167/iovs.18-25963] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To discuss guidelines and ethical considerations associated with the development and prescription of treatments intended for myopia control (MC). Methods Critical review of published papers and guidance documents was undertaken, with a view to carefully considering the ethical standards associated with the investigation, development, registration, marketing, prescription, and use of MC treatments. Results The roles and responsibilities of regulatory bodies, manufacturers, academics, eye care practitioners, and patients in the use of MC treatments are explored. Particular attention is given to the ethical considerations for deciding whether to implement a MC strategy and how to implement this within a clinical trial or practice setting. Finally, the responsibilities in marketing, support, and education required to transfer required knowledge and skills to eye care practitioners and academics are discussed. Conclusions Undertaking MC treatment in minors creates an ethical challenge for a wide variety of stakeholders. Regulatory bodies, manufacturers, academics, and clinicians all share an ethical responsibility to ensure that the products used for MC are safe and efficacious and that patients understand the benefits and potential risks of such products. This International Myopia Institute report highlights these ethical challenges and provides stakeholders with recommendations and guidelines in the development, financial support, prescribing, and advertising of such treatments.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Björn Drobe
- Essilor Research and Development, Vision Sciences AMERA, Center of Innovation and Technology AMERA, Singapore, Singapore
| | - José Manuel González-Méijome
- Clinical & Experimental Optometry Research Lab, Center of Physics (Optometry), School of Science, University of Minho, Braga, Portugal
| | - Lyle Gray
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Timo Kratzer
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Jason J Nichols
- University of Alabama at Birmingham, School of Optometry, Birmingham, Alabama, United States
| | - Arne Ohlendorf
- Carl Zeiss Vision International GmbH, Aalen, Germany.,Institute for Ophthalmic Research, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Stephanie Ramdass
- Vision Research Institute, Michigan College of Optometry, Ferris State University, Big Rapids, Michigan, United States
| | | | - Katrina L Schmid
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Donald Tan
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Kah-Ooi Tan
- Brien Holden Vision Institute, and School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Yee-Ling Wong
- Essilor Research and Development, Vision Sciences AMERA, Center of Innovation and Technology AMERA, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Kate L Gifford
- Private Practice and School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, and School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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