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German C, Chen Z, Przekwas A, Walenga R, Babiskin A, Zhao L, Fan J, Tan ML. Computational Model of In Vivo Corneal Pharmacokinetics and Pharmacodynamics of Topically Administered Ophthalmic Drug Products. Pharm Res 2023; 40:961-975. [PMID: 36959411 DOI: 10.1007/s11095-023-03480-6] [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: 09/29/2022] [Accepted: 02/09/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION Although the eye is directly accessible on the surface of the human body, drug delivery can be extremely challenging due to the presence of multiple protective barriers in eye tissues. Researchers have developed complex formulation strategies to overcome these barriers to ophthalmic drug delivery. Current development strategies rely heavily on in vitro experiments and animal testing to predict human pharmacokinetics (PK) and pharmacodynamics (PD). OBJECTIVE The primary objective of the study was to develop a high-fidelity PK/PD model of the anterior eye for topical application of ophthalmic drug products. METHODS Here, we present a physiologically-based in silico approach to predicting PK and PD in rabbits after topical administration of ophthalmic products. A first-principles based approach was used to describe timolol dissolution, transport, and distribution, including consideration of ionized transport, following topical instillation of a timolol suspension. RESULTS Using literature transport and response parameters, the computational model described well the concentration-time and response-time profiles in rabbit. Comparison of validated rabbit model results and extrapolated human model results demonstrate observable differences in the distribution of timolol at multiple time points. CONCLUSION This modeling framework provides a tool for model-based prediction of PK in eye tissues and PD after topical ophthalmic drug administration to the eyes.
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Affiliation(s)
- Carrie German
- CFD Research Corporation, Computational Biology Division, 6820 Moquin Dr NW, Huntsville, AL, 35806, USA.
| | - Zhijian Chen
- CFD Research Corporation, Computational Biology Division, 6820 Moquin Dr NW, Huntsville, AL, 35806, USA
| | - Andrzej Przekwas
- CFD Research Corporation, Computational Biology Division, 6820 Moquin Dr NW, Huntsville, AL, 35806, USA
| | - Ross Walenga
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Andrew Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Liang Zhao
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Jianghong Fan
- Division of Pharmacometrics, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Ming-Liang Tan
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
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Kleinbeck S, Schäper M, Pacharra M, Lehmann ML, Golka K, Blaszkewicz M, Brüning T, van Thriel C. A short-term inhalation study to assess the reversibility of sensory irritation in human volunteers. Arch Toxicol 2020; 94:1687-1701. [PMID: 32185413 PMCID: PMC7261732 DOI: 10.1007/s00204-020-02703-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/09/2020] [Indexed: 01/22/2023]
Abstract
Sensory irritation is an acute adverse effect caused by chemicals that stimulate chemoreceptors of the upper respiratory tract or the mucous membranes of the outer eye. The avoidance of this end point is of uttermost importance in regulatory toxicology. In this study, repeated exposures to ethyl acrylate were analyzed to investigate possible carryover effects from day to day for different markers of sensory irritation. Thirty healthy subjects were exposed for 4 h on five subsequent days to ethyl acrylate at concentrations permitted by the German occupational exposure limit at the time of study. Ratings of eye irritation as well as eye blinking frequencies indicate the elicitation of sensory irritation. These markers of sensory irritation showed a distinct time course on every single day. However, cumulative carryover effects could not be identified across the week for any marker. The rhinological and biochemical markers could not reveal hints for more pronounced sensory irritation. Neither increased markers of neurogenic inflammation nor markers of immune response could be identified. Furthermore, the performance on neurobehavioral tests was not affected by ethyl acrylate and despite the strong odor of ethyl acrylate the participants improved their performances from day to day. While the affected physiological marker, the increased eye blinking frequency stays roughly on the same level across the week, subjective markers like perception of eye irritation decrease slightly from day to day though the temporal pattern of, i.e., eye irritation perception stays the same on each day. A hypothetical model of eye irritation time course derived from PK/PD modeling of the rabbit eye could explain the within-day time course of eye irritation ratings repeatedly found in this study more precisely.
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Affiliation(s)
- Stefan Kleinbeck
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany.
| | - Michael Schäper
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany
| | - Marlene Pacharra
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany.,MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Marie Louise Lehmann
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany.,Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Klaus Golka
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany
| | - Meinolf Blaszkewicz
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany
| | - Thomas Brüning
- Research Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle de la Camp-Platz 1, 44789, Bochum, Germany
| | - Christoph van Thriel
- Leibniz Research Center for Working Environment and Human Factors, TU Dortmund University, Ardeystr. 67, 44139, Dortmund, Germany
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Gillmann K, Bravetti GE, Niegowski LJ, Mansouri K. Using sensors to estimate intraocular pressure: a review of intraocular pressure telemetry in clinical practice. EXPERT REVIEW OF OPHTHALMOLOGY 2019. [DOI: 10.1080/17469899.2019.1681264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
| | | | | | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA
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Joussen AM, Wolf S, Kaiser PK, Boyer D, Schmelter T, Sandbrink R, Zeitz O, Deeg G, Richter A, Zimmermann T, Hoechel J, Buetehorn U, Schmitt W, Stemper B, Boettger MK. The Developing Regorafenib Eye drops for neovascular Age-related Macular degeneration (DREAM) study: an open-label phase II trial. Br J Clin Pharmacol 2018; 85:347-355. [PMID: 30341774 DOI: 10.1111/bcp.13794] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 10/02/2018] [Accepted: 10/12/2018] [Indexed: 01/09/2023] Open
Abstract
AIMS This programme investigated topical regorafenib, a multikinase inhibitor, in patients with neovascular age-related macular degeneration (nAMD). METHODS Topical regorafenib was investigated in an open-label, phase IIa/b study in which patients with choroidal neovascularization (CNV) secondary to nAMD received regorafenib (25 μl, 30 mg ml-1 ) three times a day for 12 weeks. The primary endpoint of the phase II/a/b study was mean change in best-corrected visual acuity (BCVA) from baseline to weeks 4 and 12. RESULTS In nAMD patients (N = 51), mean changes in BCVA were +1.2 [90% confidence interval (CI) -0.61, 2.97] and -2.4 (90% CI -4.18, -0.54) letters at weeks 4 and 12, respectively. Ocular treatment-emergent adverse events (TEAEs) (study eye) were reported in 21 patients by week 12. There was one serious ocular TEAE (visual acuity reduced) that was not drug related. Twenty patients required rescue (intravitreal ranibizumab). CONCLUSIONS The programme was terminated after phase IIa ended because efficacy was lower than with current nAMD treatments. According to elaborate post hoc analyses, the most likely reason was insufficient exposure in the target compartment (back of the eye).
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Affiliation(s)
- Antonia M Joussen
- Department of Ophthalmology, Charité - University Medicine Berlin, Berlin, Germany
| | - Sebastian Wolf
- Bern Photographic Reading Center and Department of Ophthalmology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | | | - David Boyer
- Retina-Vitreous Associates Medical Group, Beverly Hills, CA, USA.,USC/Keck School of Medicine, Los Angeles, CA, USA
| | | | - Rupert Sandbrink
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany.,Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany
| | - Oliver Zeitz
- Department of Ophthalmology, Charité - University Medicine Berlin, Berlin, Germany.,Bayer AG, Division Pharma, Berlin and Wuppertal, Germany
| | - Gesa Deeg
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany
| | - Annett Richter
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany
| | | | | | - Ulf Buetehorn
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany
| | - Walter Schmitt
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany
| | - Brigitte Stemper
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany.,Department of Neurology, University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael K Boettger
- Bayer AG, Division Pharma, Berlin and Wuppertal, Germany.,Department of Sports Medicine, Bergische Universität, Wuppertal, Germany
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Lavik E, Kuehn MH, Shoffstall AJ, Atkins K, Dumitrescu AV, Kwon YH. Sustained Delivery of Timolol Maleate for Over 90 Days by Subconjunctival Injection. J Ocul Pharmacol Ther 2016; 32:642-649. [PMID: 27835065 PMCID: PMC5165680 DOI: 10.1089/jop.2016.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/03/2016] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Medical treatment of glaucoma relies on intraocular pressure (IOP)-lowering medications, typically administered daily by the patient. While these medications are effective when applied correctly, patient adherence is a major obstacle in glaucoma treatment. We have developed a sustained-release formulation of timolol maleate that can be injected subconjunctivally to avoid patient noncompliance. METHODS A biodegradable microsphere formulation for timolol maleate was injected subconjunctivally in normal rabbits. We measured timolol levels in tears, aqueous humor, vitreous humor, and serum of study rabbits. Furthermore, IOP profiles were recorded longitudinally. Tissue compatibility and side effects were evaluated using histochemistry. RESULTS The microsphere formulation led to measureable amounts of timolol in the aqueous humor and the tear film for up to 90 days. Timolol was not detectable in the serum at any time. A significant reduction of IOP was observed in treated eyes. Clinically, the subconjunctival administration of the microspheres was well tolerated with no signs of inflammation or infection. The absence of local inflammation was confirmed by histology. CONCLUSIONS A single subconjunctival administration of timolol microspheres achieved delivery and IOP reduction in rabbits for up to 90 days without local or systemic inflammation or toxicity. This approach has the potential to improve the management of glaucoma in patient populations, who are challenged to adhere to a regimen of daily eye drops.
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Affiliation(s)
- Erin Lavik
- Department of Chemical, Biochemical, and Environmental Engineering, University of Maryland-Baltimore County, Baltimore, Maryland
| | - Markus H. Kuehn
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
- Iowa City Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa
| | - Andrew J. Shoffstall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Kristyn Atkins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Alina V. Dumitrescu
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
| | - Young H. Kwon
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
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Isobe T, Kasai T, Kawai H. Ocular Penetration and Pharmacokinetics of Ripasudil Following Topical Administration to Rabbits. J Ocul Pharmacol Ther 2016; 32:405-14. [PMID: 27463221 DOI: 10.1089/jop.2016.0028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE We evaluated the ocular pharmacokinetics of ripasudil (K-115), a selective Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor, following topical administration to rabbits. METHODS We determined the ocular distribution of [(14)C]ripasudil by whole-head autoradiography and the radioactivity of each ocular tissue after single and multiple instillation of [(14)C]ripasudil to pigmented rabbits. We also measured the aqueous humor concentrations after concomitant instillation of ripasudil and a combination agent (0.005% latanoprost and 0.5% timolol) to pigmented rabbits as well as the tear fluid concentrations after instillation into rabbits, dogs, and monkeys using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Membrane permeability was evaluated using an in vitro parallel artificial membrane permeability assay system and Ussing chamber with rabbit cornea and conjunctiva. RESULTS [(14)C]Ripasudil was rapidly absorbed into the cornea and distributed throughout the eye after topical instillation. The melanin-containing ocular tissues, such as the iris-ciliary body and retina-choroid, showed much higher concentrations of radioactivity than the other nonpigmented tissues. Concomitant instillation showed minor effects on the aqueous humor concentrations of each compound in rabbits. Membrane permeability of ripasudil was higher than other glaucoma drugs in vitro and ex vivo. The aqueous humor concentrations of ripasudil in rabbits were higher than those in dogs and monkeys in the early period after instillation and associated with tear turnover rate. CONCLUSIONS These results indicate favorable intraocular penetration characteristics of ripasudil following topical administration.
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Affiliation(s)
- Tomoyuki Isobe
- 1 Tokyo New Drug Research Laboratories, Kowa Co., Ltd. , Tokyo, Japan .,2 Department of Pharmaceutics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama , Toyama, Japan
| | - Taku Kasai
- 1 Tokyo New Drug Research Laboratories, Kowa Co., Ltd. , Tokyo, Japan
| | - Hiroyuki Kawai
- 1 Tokyo New Drug Research Laboratories, Kowa Co., Ltd. , Tokyo, Japan
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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
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Sakanaka K, Kawazu K, Tomonari M, Kitahara T, Nakashima M, Nishida K, Nakamura J, Sasaki H, Higuchi S. Ocular pharmacokinetic/pharmacodynamic modeling for multiple anti-glaucoma drugs. Biol Pharm Bull 2008; 31:1590-5. [PMID: 18670094 DOI: 10.1248/bpb.31.1590] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have constructed a new ocular pharmacokinetic pharmacodynamic (PK/PD) model for anti-glaucoma drugs to describe ocular hypotensive effects on intraocular pressure (IOP) after instillation of a combination of an alpha(1)-adrenergic antagonist, bunazosin, and a beta-adrenergic antagonist, timolol, into rabbits. This model was constructed by the combination of two ocular PK/PD models for bunazosin and timolol by including aqueous humor dynamics based on both action mechanisms. We also verified the reliability of this model by confirming the drug concentrations in aqueous humor and ocular hypotensive effects after instillation of the drug combination. The aqueous humor concentrations of timolol and bunazosin were determined by an HPLC, and ocular hypotensive effect-time profiles were measured using a telemetry system, which was able to record automatically detailed effects. The combined model could simulate the aqueous humor concentrations of both drugs and the additive IOP-lowering effect after instillation of the combination using the MULTI (RUNGE) program and PK/PD parameters which were obtained from ocular hypotensive effects after instillation of bunazosin alone or timolol alone. The theoretical concentration curves of both drugs in the aqueous humor and the theoretical ocular hypotensive effect curves almost agreed with both the observed concentrations and ocular hypotensive effects after instillation of the drug combination. These results indicate the reliability and usefulness of PK/PD modeling considering aqueous humor dynamics to predict IOP in multidrug therapy. This is the first study to develop a PK/PD model for multidrug therapy for the eye.
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