1
|
Breithaupt MH, Krohmer E, Taylor L, Koerner E, Hoppe-Tichy T, Burhenne J, Foerster KI, Dachtler M, Huber G, Venkatesh R, Eggenreich K, Czock D, Mikus G, Blank A, Haefeli WE. Oral bioavailability of microdoses and therapeutic doses of midazolam as a 2-dimensionally printed orodispersible film in healthy volunteers. Eur J Clin Pharmacol 2022; 78:1965-1972. [PMID: 36258053 DOI: 10.1007/s00228-022-03406-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The use of two-dimensional (2D) printing technologies of drugs on orodispersible films (ODF) can promote dose individualization and facilitate drug delivery in vulnerable patients, including children. We investigated midazolam pharmacokinetics after the administration of 2D-printed ODF. METHODS Midazolam doses of 0.03 and 3 mg were printed on an ODF using a 2D drug printer. We investigated the bioavailability of the two midazolam doses with ODF swallowed immediately (ODF-IS) or delayed after 2 min (ODF-DS) by comparing their pharmacokinetics with intravenous and oral midazolam solution in 12 healthy volunteers. RESULTS The relative bioavailability of ODF-IS 0.03 mg was 102% (90% confidence interval: 89.4-116) compared to oral solution and for 3 mg 101% (86.8-116). Cmax of ODF-IS 0.03 mg was 95.5% (83.2-110) compared to oral solution and 94.3% (78.2-114) after 3 mg. Absolute bioavailability of ODF-IS 0.03 mg was 24.9% (21.2-29.2) and for 3 mg 28.1% (23.4-33.8) (oral solution: 0.03 mg: 24.4% (22.0-27.1); 3 mg: 28.0% (25.0-31.2)). Absolute bioavailability of ODF-DS was significantly larger than for ODF-IS (0.03 mg: 61.4%; 3 mg: 44.1%; both p < 0.0001). CONCLUSION This trial demonstrates the tolerability and unchanged bioavailability of midazolam printed on ODF over a 100-fold dose range, proving the suitability of ODF for dose individualization. Midazolam ODF-IS AUC0-∞ in both doses was bioequivalent to the administration of an oral solution. However, Cmax of the therapeutic dose of ODF-IS missed bioequivalence by a clinically not relevant extent. Prolonged mucosal exposure increased bioavailability. (Trial Registration EudraCT: 2020-003984-24, August 10, 2020).
Collapse
Affiliation(s)
- Mareile H Breithaupt
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Evelyn Krohmer
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Lenka Taylor
- Hospital Pharmacy, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120, Heidelberg, Germany
| | - Eva Koerner
- Hospital Pharmacy, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120, Heidelberg, Germany
| | - Torsten Hoppe-Tichy
- Hospital Pharmacy, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120, Heidelberg, Germany
| | - Juergen Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Kathrin I Foerster
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Markus Dachtler
- Gen-Plus GmbH & Co KG, Staffelseestrasse 6, 81379, Munich, Germany
| | - Gerald Huber
- DiHeSys, DiHeSys Digital Health Systems GmbH, Marie-Curie-Str. 19, 73529, Schwäbisch Gmünd, Germany
| | - Rakesh Venkatesh
- DiHeSys, DiHeSys Digital Health Systems GmbH, Marie-Curie-Str. 19, 73529, Schwäbisch Gmünd, Germany
| | - Karin Eggenreich
- Gen-Plus GmbH & Co KG, Staffelseestrasse 6, 81379, Munich, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Antje Blank
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| |
Collapse
|
2
|
Dantas RO, Nascimento WV. Brazilian manuscripts published in the Dysphagia journal. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212320821] [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
ABSTRACT Objective: to survey the Brazilian participation in original and review articles published in the Dysphagia journal. Methods: original and review articles in volumes 1 to 35, quantifying all those developed in Brazil, the diseases researched, the places where the investigations were conducted, and the number of citations they received, were analyzed. The categorical variables are presented in relative and absolute frequencies. Literature Review: a total of 35 Brazilian manuscripts were published. The most researched disease was Parkinson’s, followed by Chagas disease, stroke, and the physiology of swallowing. The highest number of publications was carried out at the Universidade de São Paulo, campus at Ribeirão Preto, SP, and the Universidade Federal de São Paulo, capital city. Between 2001 and 2010, 14 manuscripts were published (3.7% of the journal), and between 2011 and 2020, 20 were published (2.9% of the journal). By 2019, the manuscripts had received 481 citations - 17 citations per article between 1998 and 2009, and 14, between 2010 and 2019. Conclusion: Brazilian manuscripts are regularly published in the Dysphagia journal and have a scientific impact. However, there has not been a progressive increase in the number of published articles.
Collapse
|