1
|
Kunikane E, Orii Y, Inoue A, Inatani M. Patient Factors Influencing Intraocular Penetration of Brimonidine-Related Eye Drops in Adults: A Post Hoc Pooled Analysis. Ophthalmol Ther 2023; 12:3083-3098. [PMID: 37676633 PMCID: PMC10640521 DOI: 10.1007/s40123-023-00794-x] [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: 06/19/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION The factors related to the ocular penetration of drugs after the administration of eye drops in humans have not been examined in detail. Therefore, this study assessed the influence of patient factors on the intraocular penetration of eye drops. METHODS A pooled analysis was performed on the data of 42 participants from three studies to evaluate the ocular pharmacokinetics in humans after the topical application of brimonidine-related eye drops. The patients were scheduled for vitrectomy and received brimonidine-related eye drops (0.1% brimonidine tartrate ophthalmic solution, 0.1% brimonidine tartrate and 0.5% timolol fixed-combination ophthalmic solution, or 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination suspension) twice daily for 1 week. We analyzed the effects of patient factors (sex, the presence or absence of lens, age, corneal thickness, corneal endothelial cell density, tear secretion, eye axial length, height, weight and body mass index [BMI]) on brimonidine, timolol and brinzolamide concentrations in the aqueous and vitreous humor after topical application. RESULTS The drug concentrations in the aqueous and vitreous humor were not significantly different, regardless of sex or the presence or absence of lens. Age correlated positively with brimonidine (r = 0.3948, p = 0.012) and brinzolamide (r = 0.6809, p = 0.030) concentrations in the aqueous humor; the correlation with timolol showed a trend towards significance (r = 0.6425, p = 0.086). Corneal thickness, corneal endothelial cell density, tear secretion, eye axial length, height and BMI did not correlate with the drug concentrations in the aqueous or vitreous humor. Timolol concentration in the vitreous humor was negatively correlated with weight (r = - 0.8333, p = 0.010). CONCLUSION The findings of this study emphasize the necessity of considering individual differences in ocular pharmacokinetics during drug therapy (formulation design of the eye drops and dose regimen).
Collapse
Affiliation(s)
| | - Yusuke Orii
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akiko Inoue
- Senju Pharmaceutical Co., Ltd., Osaka, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| |
Collapse
|
2
|
Naageshwaran V, Bigonne H, Gum G, Malla S, Del Sol C, Bon C, Xu X, Vo A, Smith W, O'Reilly Beringhs A, Kozak D, Tan ML, Babiskin A, Urtti A, Del Amo EM, Ranta VP. Topical Pharmacokinetics of Brinzolamide Suspensions in Rabbits and Variability Analysis for Sample Size and Design Considerations. Int J Pharm 2023:123183. [PMID: 37369289 DOI: 10.1016/j.ijpharm.2023.123183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 06/29/2023]
Abstract
Identifying critical attributes for complex locally acting ophthalmic formulations and establishing in vitro-in vivo correlations can facilitate selection of appropriate thresholds for formulation changes that reflect lack of impact on in vivo performance. In this study the marketed antiglaucoma product Azopt® (1% brinzolamide suspension) and five other brinzolamide formulations varying in particle size distributions and apparent viscosities were topically administered in rabbits, and their ocular pharmacokinetics was determined in multiple ocular tissues. Statistical evaluation with ANOVA showed no significant differences between the formulations in the peak drug concentration (Cmax) in the aqueous humor and iris-ciliary body. As a post-hoc analysis, the within animal and total variability was determined for Cmax in the aqueous humor and iris-ciliary body. Based on the observed variability, we investigated the sample size needed for two types of study designs to observe statistically significant differences in Cmax. For the sample size calculations, assuming both 25% and 50% true differences in Cmax between two formulations, two study designs were compared: paired-eye dosing design (one formulation in one eye and another formulation in the other eye of the same animal at the same time) versus parallel-group design. The number of rabbits needed in the paired-eye dosing design are much lower than in the parallel-group design. For example, when the true difference in aqueous humor Cmax is 25%, nine rabbits are required in the paired-eye design versus seventy rabbits (35 per treatment) in the parallel-group design to observe a statistically significant difference with a power of 80%. Therefore, the proposed paired-eye dosing design is a viable option for the design of pharmacokinetic studies comparing ophthalmic products to determine the impact of formulation differences.
Collapse
Affiliation(s)
- Vatsala Naageshwaran
- University of Eastern Finland, School of Pharmacy, Yliopistonranta 1, 70210 Kuopio, Finland; Pharmaron - 7901 Vickers Street, San Diego, CA 92111 and 436 Creamery Way, Exton, PA
| | - Hélène Bigonne
- University of Eastern Finland, School of Pharmacy, Yliopistonranta 1, 70210 Kuopio, Finland
| | - Glenwood Gum
- Pharmaron - 7901 Vickers Street, San Diego, CA 92111 and 436 Creamery Way, Exton, PA
| | - Spundana Malla
- Pharmaron - 7901 Vickers Street, San Diego, CA 92111 and 436 Creamery Way, Exton, PA
| | - Charity Del Sol
- Biostudy Solutions, LLC, 4008 Caesar Court, Wilmington, NC 28405
| | - Charles Bon
- Biostudy Solutions, LLC, 4008 Caesar Court, Wilmington, NC 28405
| | - Xiaoming Xu
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Anh Vo
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - William Smith
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Andre O'Reilly Beringhs
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Darby Kozak
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Ming-Liang Tan
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Andrew Babiskin
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Arto Urtti
- University of Eastern Finland, School of Pharmacy, Yliopistonranta 1, 70210 Kuopio, Finland; University of Helsinki, Faculty of Pharmacy, Viikinkaari 5 E, 00790 Helsinki, Finland
| | - Eva M Del Amo
- University of Eastern Finland, School of Pharmacy, Yliopistonranta 1, 70210 Kuopio, Finland.
| | - Veli-Pekka Ranta
- University of Eastern Finland, School of Pharmacy, Yliopistonranta 1, 70210 Kuopio, Finland
| |
Collapse
|
3
|
Palchunova K, Kaji Y, Fujita A, Oshika T. RNA-seq analysis of human trabecular endothelial cells after treatment with timolol maleate. Jpn J Ophthalmol 2023:10.1007/s10384-023-00998-5. [PMID: 37314597 DOI: 10.1007/s10384-023-00998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/26/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE Timolol maleate (timolol), a β-receptor blocker, reduces intraocular pressure by decreasing aqueous humor production. Timolol reportedly also protects ganglion cells, decreases aqueous humor outflow facility, and destroys the extracellular matrix in the trabecular meshwork. In this study, we investigated the effects of timolol on cultured human trabecular endothelial cells purchased from ScienCell using next-generation sequencing. STUDY DESIGN Experimental investigation. METHODS Total ribonucleic acid (RNA) was extracted after 24 h. More than 100 million RNAs in control and timolol-treated group were sequenced using a next-generation sequencer. The expression of 55,778 RNAs was analyzed. RESULTS A total of 2,105 genes were significantly upregulated and 2,125 genes were downregulated, after the addition of timolol. VGF nerve growth factor inducible (VGF) (388-fold) had the maximum increase in expression, followed by amphiregulin (333-fold), a member of the epidermal growth factor family. Moreover, the expression of extracellular matrix-degrading enzymes, matrix metalloproteinases (MMPs) 1, 2, 3, 10, 12, and 14, increased. CONCLUSION Timolol exerts various effects on human trabecular endothelial cells. The increase in MMP expression may contribute to the decrease in the aqueous humor outflow facility.
Collapse
Affiliation(s)
- Kseniya Palchunova
- Department of Ophthalmology, University of Tsukuba Majors in Medical Sciences, 1-1-1 Tennoudai Tsukuba, Ibaraki, 3058575, Japan
| | - Yuichi Kaji
- Department of Ophthalmology, University of Tsukuba Majors in Medical Sciences, 1-1-1 Tennoudai Tsukuba, Ibaraki, 3058575, Japan.
- Matsumoto Eye Clinic, 2-25-2F Toride-i-center, Chuo-machi Toride, Ibaraki, 3020014, Japan.
| | - Akari Fujita
- Kagurazaka Eye Clinic, 115 Yarai-cho Shinjyuku, Tokyo, 1620805, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, University of Tsukuba Majors in Medical Sciences, 1-1-1 Tennoudai Tsukuba, Ibaraki, 3058575, Japan
| |
Collapse
|
4
|
Nassiri N, Mei F, Tokko H, Zeiter J, Syeda S, Kim C, Swendris R, Goyal A, Veld EI, Mas-Ramirez A, Rana SW, Juzych MS, Hughes BA. Consensual Ophthalmotonic Reaction Following Selective Laser Trabeculoplasty. J Curr Glaucoma Pract 2022; 16:36-40. [PMID: 36060042 PMCID: PMC9385382 DOI: 10.5005/jp-journals-10078-1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Nariman Nassiri
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
- Nariman Nassiri, Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States, Phone: +1 313-577-7615, e-mail:
| | - Frank Mei
- School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Hassan Tokko
- School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - John Zeiter
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Sarah Syeda
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Chaesik Kim
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Ronald Swendris
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Anju Goyal
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Elise In'T Veld
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Alma Mas-Ramirez
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Sonia W Rana
- Department of Ophthalmology, Lansing Ophthalmology Eye Care, East Lansing, Michigan, United States
| | - Mark S Juzych
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| | - Bret A Hughes
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States
| |
Collapse
|
5
|
Meshksar A, Hajizadeh M, Sharifipour F, Yazdani S, Pakravan M, Kheiri B. Intraocular Pressure Changes in the Contralateral Eye After Glaucoma Surgery. J Glaucoma 2021; 30:1074-1081. [PMID: 34628431 DOI: 10.1097/ijg.0000000000001950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022]
Abstract
PRCIS Glaucoma surgery in 1 eye can result in significant intraocular pressure (IOP) elevation in the fellow eye in a significant percentage of subjects. This effect is more pronounced following glaucoma drainage device implantation and in subjects developing postoperative hypotony in the first eye. PURPOSE The aim was to investigate the course and magnitude of IOP changes in contralateral eyes following glaucoma surgery. PATIENTS AND METHODS We studied 131 glaucoma patients undergoing surgery. IOP changes in fellow eyes and the number of glaucoma medications were recorded for 6 months. Both normal and glaucomatous fellow eyes were included. Patients on preoperative acetazolamide were analyzed separately. IOP change ≥4 mm Hg or 20% increase from baseline values was considered significant. RESULTS Baseline IOP in fellow eyes was 13.1±3.3 mm Hg which increased significantly at all-time points with a peak at 1 week (mean increase: 3.1±3.2 mm Hg) gradually decreasing up to 6 months (mean increase 0.9±2.1 mm Hg). The number of fellow eyes with clinically significant IOP elevation at 1 day, 1 week, and 1, 3. and 6 months was 47, 76, 47, 31, and 37 showing mean IOP rise of 4.5±2.3 (38.5%), 5.4±1.8 (48.5%), 4.8±1.6 (44.2%), 3.7±1.3 (36.5%), and 3.2±1.3 (32.6%) mm Hg, respectively. Medications were added to 18 fellow eyes (including 10 initially "normal" eyes) while 7 other fellow eyes required surgery.Significant IOP elevation in fellow eyes was associated with tube shunt surgery (P<0.008 at all-time points), a diagnosis of glaucoma following cataract surgery, IOP ≤5 mm Hg on the first postoperative day (P=0.002) and use of preoperative acetazolamide. CONCLUSION Glaucoma surgery was associated with IOP elevation in fellow eyes in a significant number of subjects and suggests that IOP in the unoperated eye should also be checked at postoperative visits.
Collapse
Affiliation(s)
- Aidin Meshksar
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
- Department of Ophthalmology and Poostchi Ophthalmology Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz
| | - Maryam Hajizadeh
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz
| | - Farideh Sharifipour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
- Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Yazdani
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
- Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Pakravan
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
- Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
| |
Collapse
|
6
|
Short B. Selected Aspects of Ocular Toxicity Studies With a Focus on High-Quality Pathology Reports: A Pathology/Toxicology Consultant's Perspective. Toxicol Pathol 2020; 49:673-699. [PMID: 32815474 DOI: 10.1177/0192623320946712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ocular toxicity studies are the bedrock of nonclinical ocular drug and drug-device development, and there has been an evolution in experience, technologies, and challenges to address that ensures safe clinical trials and marketing authorization. The expectations of a well-designed ocular toxicity study and the generation of a coherent, integrative ocular toxicology report and subreports are high, and this article provides a pathology/toxicology consultant's perspective on achieving that goal. The first objective is to cover selected aspects of study designs for ocular toxicity studies including considerations for contract research organization selection, minipig species selection, unilateral versus bilateral dosing, and in-life parameters based on fit-for-purpose study objectives. The main objective is a focus on a high-quality ocular pathology report that includes ocular histology procedures to meet regulatory expectations and a report narrative and tables that correlate microscopic findings with key ophthalmic findings and presents a clear interpretation of test article-, vehicle-, and procedure-related ocular and extraocular findings with identification of adversity and a pathology peer review. The last objective covers considerations for a high-quality ophthalmology report, which in concert with a high-quality pathology report, will pave the way for a best quality toxicology report for an ocular toxicity study.
Collapse
Affiliation(s)
- Brian Short
- Brian Short Consulting, LLC, Laguna Beach, CA, USA
| |
Collapse
|
7
|
Gonzalez-De la Rosa A, Navarro-Partida J, Altamirano-Vallejo JC, Jauregui-Garcia GD, Acosta-Gonzalez R, Ibanez-Hernandez MA, Mora-Gonzalez GF, Armendáriz-Borunda J, Santos A. Novel Triamcinolone Acetonide-Loaded Liposomal Topical Formulation Improves Contrast Sensitivity Outcome After Femtosecond Laser-Assisted Cataract Surgery. J Ocul Pharmacol Ther 2019; 35:512-521. [PMID: 31486694 PMCID: PMC6839423 DOI: 10.1089/jop.2019.0032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: To assess visual results, macular modifications, and the incidence of clinically significant macular edema (CSME) in patients using a topical triamcinolone acetonide-loaded liposomal formulation (TA-LF) after femtosecond laser-assisted cataract surgery (FLACS). Methods: Fifty-six eyes after FLACS were selected. Twenty-eight eyes in the combined therapy group (P + N) were treated with prednisolone 1% and nepafenac 0.1% for 21 days postoperatively, whereas 28 eyes in the TA-LF group received a liposomal formulation containing 2 mg/mL of TA (0.2%) for the same period of time. Follow-up visits at 1 day, 6 weeks, and 12 weeks after surgery consisted of visual acuity, contrast sensitivity (CS), central foveal thickness (CFT), total macular volume (TMV) measurements, and the detection of CSME. Results: CS improved in the TA-LF group (basal value: 1.087 ± 0.339 vs. 1.276 ± 0.147 at week 12, P = 0.0346), whereas in the P + N group, CS was not different from the baseline (basal value: 1.130 ± 0.331 vs. 1.274 ± 0.133 at week 12, P = 0.1276). There were similar increases in postoperative CFT and TMV in both groups. CFT and TMV significantly correlate with CS only in the TA-LF group. The r2 for CFT and CS was 0.1963 (P = 0.0206), whereas the r2 for TMV and CS was 0.3615 (P = 0.0007) at 12 weeks. No difference was observed in the incidence of CSME between the groups. Conclusion: TA-LF is associated with better CS outcomes compared to combined therapy after FLACS.
Collapse
Affiliation(s)
- Alejandro Gonzalez-De la Rosa
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Jose Navarro-Partida
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Juan Carlos Altamirano-Vallejo
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Gerardo Daniel Jauregui-Garcia
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | | | | | | | - Juan Armendáriz-Borunda
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Instituto de Biología Molecular y Terapia Génica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Arturo Santos
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| |
Collapse
|
8
|
Samy KE, Cao Y, Kim J, Konichi da Silva NR, Phone A, Bloomer MM, Bhisitkul RB, Desai TA. Co-Delivery of Timolol and Brimonidine with a Polymer Thin-Film Intraocular Device. J Ocul Pharmacol Ther 2019; 35:124-131. [PMID: 30615539 PMCID: PMC6450452 DOI: 10.1089/jop.2018.0096] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/08/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE We developed a polycaprolactone (PCL) co-delivery implant that achieves zero-order release of 2 ocular hypotensive agents, timolol maleate and brimonidine tartrate. We also demonstrate intraocular pressure (IOP)-lowering effects of the implant for 3 months in vivo. METHODS Two PCL thin-film compartments were attached to form a V-shaped co-delivery device using film thicknesses of ∼40 and 20 μm for timolol and brimonidine compartments, respectively. In vitro release kinetics were measured in pH- and temperature-controlled fluid chambers. Empty or drug-loaded devices were implanted intracamerally in normotensive rabbits for up to 13 weeks with weekly measurements of IOP. For ocular concentrations, rabbits were euthanized at 4, 8, or 13 weeks, aqueous fluid was collected, and ocular tissues were dissected. Drug concentrations were measured by liquid chromatography-tandem mass spectrometry. RESULTS In vitro studies show zero-order release kinetics for both timolol (1.75 μg/day) and brimonidine (0.48 μg/day) for up to 60 days. In rabbit eyes, the device achieved an average aqueous fluid concentration of 98.1 ± 68.3 ng/mL for timolol and 5.5 ± 3.6 ng/mL for brimonidine. Over 13 weeks, the drug-loaded co-delivery device resulted in a statistically significant cumulative reduction in IOP compared to untreated eyes (P < 0.05) and empty-device eyes (P < 0.05). CONCLUSIONS The co-delivery device demonstrated a zero-order release profile in vitro for 2 hypotensive agents over 60 days. In vivo, the device led to significant cumulative IOP reduction of 3.4 ± 1.6 mmHg over 13 weeks. Acceptable ocular tolerance was seen, and systemic drug levels were unmeasurable.
Collapse
Affiliation(s)
- Karen E. Samy
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California
| | - Yiqi Cao
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California
| | - Jean Kim
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California
| | | | - Audrey Phone
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Michele M. Bloomer
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Robert B. Bhisitkul
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Tejal A. Desai
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California
| |
Collapse
|
9
|
Rao HL, Senthil S, Garudadri CS. Contralateral intraocular pressure lowering effect of prostaglandin analogues. Indian J Ophthalmol 2015; 62:575-9. [PMID: 24881604 PMCID: PMC4065508 DOI: 10.4103/0301-4738.129783] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Though the use of prostaglandin analogues (PGA) for reduction of intraocular pressure (IOP) has shown a marked increase, studies evaluating the contralateral effects of PGA are limited. Aims: To evaluate if PGA treatment in one eye has an effect on the IOP of the untreated fellow eye. Design: Retrospective study. Materials and Methods: Thirty patients of open-angle glaucoma with no previous antiglaucoma treatment underwent 24-hour diurnal IOP phasing. They subsequently were started on a uniocular trial with PGA, and had office diurnal IOP measurements 6 weeks later. Twenty-four hour diurnal consisted of 8 IOP readings over 24 hours and office diurnal consisted of 4 IOP readings between 8 AM and 6 PM at 3 hourly intervals. Statistical Analysis: IOPs of the fellow eye during the office diurnal were compared with IOPs at similar time points during the 24-hour diurnal using paired t-tests. Results: Mean (± standard deviation) IOP in the treated eye reduced (P < 0.001) from 17.17 ± 3.2 mm Hg at baseline to 13.7 ± 2.4 mm Hg at 6 weeks, while that in the untreated eye reduced from 16.4 ± 3.1 mm Hg to 14.8 ± 2.7 mm Hg (P = 0.01). The decrease in IOP in the untreated fellow eye was statistically significant at 8 AM (2.7 mm Hg, P = 0.003) and 11 AM (2.3 mm Hg, P = 0.01) but not so at 2 PM (1.2 mm Hg, P = 0.10) and 5 PM (0.9 mm Hg, P = 0.19). The amount of IOP reduction in the untreated eye was significantly associated with the magnitude of IOP reduction in the treated eye (β = 0.69, P = 0.008). Conclusion: Uniocular PGA treatment tends to reduce the IOP of the untreated fellow eye.
Collapse
Affiliation(s)
- Harsha L Rao
- VST Glaucoma Center; Center for Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Andhra Pradesh, India
| | | | | |
Collapse
|
10
|
Park HS, Choi CY, Bae JH, Kim JM. The Effect of Fixed Combination of Brinzolamide 1% and Timolol 0.5% in Normal-Tension Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.7.1056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Han Seok Park
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Fulgêncio GDO, Viana FAB, Ribeiro RR, Yoshida MI, Faraco AG, Cunha-Júnior ADS. New Mucoadhesive Chitosan Film for Ophthalmic Drug Delivery of Timolol Maleate: In Vivo Evaluation. J Ocul Pharmacol Ther 2012; 28:350-8. [DOI: 10.1089/jop.2011.0174] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gustavo de Oliveira Fulgêncio
- Department of Ophthalmology, School of Veterinary Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fernando Antônio Bretas Viana
- Department of Ophthalmology, School of Veterinary Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Raul Rio Ribeiro
- Center for Agricultural, Environmental, and Biological Sciences, Federal University of Recôncavo of Bahia, Cruz das Almas, Brazil
| | - Maria Irene Yoshida
- Department of Chemistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - André Gomes Faraco
- School of Pharmacy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | |
Collapse
|
12
|
Roy K, Mondal KK, Ray B, Chakraborty S, Biswas S, Baral BK. Effect of dacryocystorhinostomy on systemic adverse effects of topical timolol maleate. Indian J Ophthalmol 2012; 60:105-7. [PMID: 22446904 PMCID: PMC3339068 DOI: 10.4103/0301-4738.94050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: To evaluate whether transformation of the naso-lacrimal passage as happens after dacryocystorhinostomy (DCR) operation has any effect on the systemic adverse effects of topically administered timolol maleate. Materials and Methods: Fifty otherwise healthy adult patients without any prior history of cardiac or pulmonary problems scheduled for elective DCR surgery received a drop of timolol maleate 0.5% on the healthy eye. This eye served as a control. Six weeks after successful DCR surgery, the operated eye received the same medication. Parameters compared included intraocular pressure (IOP), pulse rate, blood pressure and forced expiratory volume in the first second (FEV1) findings. Observations: Post DCR patients showed an increased incidence of reduced pulse rate and FEV1. Conclusion: Timolol maleate ophthalmic preparation should be used with caution in post-DCR patients.
Collapse
|
13
|
Si EC, Bowman LM, Hosseini K. Pharmacokinetic Comparisons of Bromfenac in DuraSite and Xibrom. J Ocul Pharmacol Ther 2011; 27:61-6. [DOI: 10.1089/jop.2010.0103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Erwin C. Si
- Department of Preclinical Research, InSite Vision, Alameda, California
| | - Lyle M. Bowman
- Department of Development, InSite Vision, Alameda, California
| | - Kamran Hosseini
- Department of Preclinical Research, InSite Vision, Alameda, California
- Clinical Operations and Medical Affairs, InSite Vision, Alameda, California
| |
Collapse
|
14
|
Volotinen M, Mäenpää J, Kautiainen H, Tolonen A, Uusitalo J, Ropo A, Vapaatalo H, Aine E. Ophthalmic timolol in a hydrogel vehicle leads to minor inter-individual variation in timolol concentration in aqueous humor. Eur J Pharm Sci 2008; 36:292-6. [PMID: 19013521 DOI: 10.1016/j.ejps.2008.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 08/21/2008] [Accepted: 10/14/2008] [Indexed: 11/26/2022]
Abstract
Ophthalmic timolol has been used for decades in the treatment of glaucoma and ocular hypertension, traditionally in aqueous 0.5% eye drops. Recently a timolol 0.1% hydrogel has been developed to improve systemic safety. The aim of the present study was to compare aqueous humor timolol concentrations after administration of 0.1% hydrogel and aqueous 0.5% timolol in patients scheduled for a cataract operation. The concentration in the aqueous humor was 210+/-175 ng/ml (mean+/-S.D.) 2h after administration of timolol 0.1% hydrogel and 538+/-304 ng/ml after aqueous 0.5% timolol. In the aqueous 0.5% timolol group more patients had unnecessarily high concentrations of timolol in the aqueous humor. beta(1)-receptors and beta(2)-receptors were practically 100% occupied after administration of both products. The hydrogel proved to be an excellent formulation in giving smaller inter-individual variation in penetration of timolol into the aqueous humor. Only a weak correlation was seen between corneal thickness and the aqueous humor concentration of timolol in the aqeuous 0.5% timolol group. In conclusion, in contrast to the conventional aqueous 0.5% timolol, 0.1% timolol hydrogel caused only slight inter-individual variation in timolol concentration in the aqueous humor.
Collapse
Affiliation(s)
- Marjo Volotinen
- Institute of Biomedicine, Pharmacology, University of Helsinki, Helsinki, Finland; Santen Oy, Tampere, Finland
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Sigurdsson HH, Konráethsdóttir F, Loftsson T, Stefánsson E. Topical and systemic absorption in delivery of dexamethasone to the anterior and posterior segments of the eye. ACTA ACUST UNITED AC 2007; 85:598-602. [PMID: 17645424 DOI: 10.1111/j.1600-0420.2007.00885.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aimed to: (1) determine the relative efficiencies of topical and systemic absorption of drugs delivered by eyedrops to the anterior and posterior segments of the eye; (2) establish whether dexamethasone-cyclodextrin eyedrops deliver significant levels of drug to the retina and vitreous in the rabbit eye, and (3) compare systemic absorption following topical application to the eye versus intranasal or intravenous delivery. METHODS In order to distinguish between topical and systemic absorption in the eye, we applied 0.5% dexamethasone-cyclodextrin eyedrops to one (study) eye of rabbits and not to the contralateral (control) eye. Drug levels were measured in each eye. The study eye showed the result of the combination of topical and systemic absorption, whereas the control eye showed the result of systemic absorption only. Systemic absorption was also examined after intranasal and intravenous administration of the same dose of dexamethasone. RESULTS In the aqueous humour dexamethasone levels were 170 +/- 76 ng/g (mean +/- standard deviation) in the study eye and 6 +/- 2 ng/g in the control eye. Similar ratios were seen in the iris and ciliary body. In the retina the dexamethasone level was 33 +/- 7 ng/g in the study eye and 14 +/- 3 ng/g in the control eye. Similar ratios were seen in the vitreous humour. Systemic absorption was similar from ocular, intranasal and intravenous administration. CONCLUSIONS Absorption after topical application dominates in the anterior segment. Topical absorption also plays a significant role in delivering dexamethasone to the posterior segment of the rabbit eye. In medication administered to the retina, 40% of the drug reaches the retina via the systemic route and 60% via topical penetration. Dexamethasone-cyclodextrin eyedrops deliver a significant amount of drug to the rabbit retina.
Collapse
|
16
|
Tan AY, LeVatte TL, Archibald ML, Tremblay F, Kelly MEM, Chauhan BC. Timolol concentrations in rat ocular tissues and plasma after topical and intraperitoneal dosing. J Glaucoma 2002; 11:134-42. [PMID: 11912361 DOI: 10.1097/00061198-200204000-00009] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Topical beta-blockers, such as timolol, have been used extensively in the medical treatment of glaucoma to lower intraocular pressure (IOP). Recently, these drugs have been shown to have effects on the retinal and optic nerve circulation as well as potential neuroprotective properties. In the current study, the concentration of timolol attained in the cornea, iris-ciliary body, retina, vitreous, and plasma was measured after topical or intraperitoneal administration in rats to determine the relative contributions of each route to intraocular timolol concentrations. MATERIALS AND METHODS One group of rats received one drop of commercially available 0.5% timolol in the right eye and two drops in the left eye for 3 to 12 days. Another group of rats received one drop of 0.5% timolol in one eye only and concentrations were studied in the ocular tissues at 15, 30, 60, 120, and 240 minutes after instillation. The final group of rats received a single intraperitoneal injection of timolol ranging in concentration from 5 to 75 mg/kg after which tissue and plasma concentrations were measured 30 minutes after injection. All tissue and plasma concentrations were measured by high performance liquid chromatography. RESULTS Rats that received topical timolol daily for 3 to 12 consecutive days accumulated timolol concentrations of 2.3 to 4.4 microg/g in cornea, 198 to 326 microg/g in iris, 0.05 to 0.11 microg/ml in vitreous, and 0.17 to 0.77 microg/g in retina. In rats that received a single drop of timolol in one eye, the tissue concentrations were higher in the treated eye than in the untreated eye in all cases except for vitreous. In these experiments, timolol levels in plasma were either low or not detectable. Increasing timolol doses administered intraperitoneally resulted in corresponding increased tissue and plasma concentrations. CONCLUSIONS Absorption of drug into the systemic circulation plays a significant role in delivering timolol to the retina and vitreous in addition to a local ocular route. A clear dose-response relationship exists in all ocular tissues studied after an intraperitoneal dose of timolol. High doses of timolol were required to achieve measurable concentrations of drug in the ocular tissues via our high performance liquid chromatography assay suggesting that a significant hepatic first-pass effect may be involved after an intraperitoneal injection of timolol.
Collapse
Affiliation(s)
- Alexander Y Tan
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | |
Collapse
|
17
|
Piltz J, Gross R, Shin DH, Beiser JA, Dorr DA, Kass MA, Gordon MO. Contralateral effect of topical beta-adrenergic antagonists in initial one-eyed trials in the ocular hypertension treatment study. Am J Ophthalmol 2000; 130:441-53. [PMID: 11024416 DOI: 10.1016/s0002-9394(00)00527-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the magnitude of the contralateral effect of topically administered beta-blockers on intraocular pressure. METHODS The Ocular Hypertension Treatment Study enrolled 1,636 subjects. Of these, 817 subjects were randomized to receive topical ocular hypotensive medication and 819 subjects were randomized to close observation (i.e., no topical medication). We compared the intraocular pressure of the contralateral eye of subjects at the baseline visit and after an initial one-eyed therapeutic trial of topical beta-blockers. We examined differences between baseline and follow-up intraocular pressure in untreated eyes of subjects randomized to close observation. RESULTS The mean reduction in intraocular pressure in the beta-blocker-treated eyes was -5.9 +/- 3. 4 mm Hg (-22% +/- 12%; Student t test, P <.0001). In the contralateral eyes, mean intraocular pressure reduction was -1.5 +/- 3.0 mm Hg (-5.8% +/- 12%; P <.0001). Of the contralateral eyes, 35% showed a reduction of 3 mm Hg or more, and 10% showed a reduction of 6 mm Hg or more. The contralateral effect of the relatively selective beta-blocker betaxolol did not differ from that of any of the nonselective beta-blockers. Factors associated with the magnitude of the contralateral effect were the degree of intraocular pressure reduction in the treated eye and baseline intraocular pressure of the contralateral eye. In the close observation group, no significant reduction in intraocular pressure was noted between the baseline and follow-up visit. CONCLUSIONS The contralateral effect is important in clinical practice and in clinical trials when the hypotensive effect of a topical beta-blocker is evaluated by means of a one-eyed therapeutic trial.
Collapse
Affiliation(s)
- J Piltz
- Department of Ophthalmology, Scheie Eye Institute/University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | |
Collapse
|
18
|
Ohtori R, Sato H, Fukuda S, Ueda T, Koide R, Kanda Y, Kiuchi Y, Oguchi K. Pharmacokinetics of topical beta-adrenergic antagonists in rabbit aqueous humor evaluated with the microdialysis method. Exp Eye Res 1998; 66:487-94. [PMID: 9593641 DOI: 10.1006/exer.1997.0448] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The microdialysis method was used to evaluate the pharmacokinetics of the beta-adrenergic antagonists carteolol and timolol and the new ophthalmic solution WP-934 in rabbit aqueous humor, following instillation. A probe with a microdialysis membrane (length, 5 mm; diameter, 0.2 mm) was implanted in the anterior chamber of the pigmented rabbit and perfused with Ringer's solution. Twenty microliters of 0.5% timolol maleate (0.5% Timoptol(R)), 2% carteolol hydrochloride (2% Mikelan(R)), or a novel preparation of 0.5% timolol maleate (WP-934) that gels after instillation were then instilled. The concentrations of these drugs in dialysates were measured using high-performance liquid chromatography and an electrochemical detection system. In vitro relative recovery of the membrane with timolol and carteolol was approximately 17.5% and 21. 6%, respectively. Timolol and carteolol levels in aqueous humor increased rapidly after instillation of Timoptol and Mikelan and reached maximal levels (Cmax) within 60 minutes. The Cmax of carteolol (4.25 microg ml-1) was lower than that of timolol (5.52 microg ml-1), suggesting that the corneal permeability of timolol is higher than that of carteolol. After instillation of WP-934, the Cmax of timolol (12.32 microg ml-1) was 2.2-fold higher than that after instillation of Timoptol. However, t1/2 values of beta-adrenergic antagonists after instillation of the three preparations were not significantly different. These data suggest that the microdialysis technique is useful for continuous monitoring of aqueous levels of beta-blockers and for analysis of their pharmacokinetic parameters while requiring much fewer animals than conventional sampling with paracentesis.
Collapse
Affiliation(s)
- R Ohtori
- Department of Ophthalmology, Showa University School of Medicine, 1-5-8 Hatanodai, Tokyo, Shinagawa-ku, 142-0064, Japan
| | | | | | | | | | | | | | | |
Collapse
|