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Lee DH, Lim S, Kwak SS, Kim J. Advancements in Skin-Mediated Drug Delivery: Mechanisms, Techniques, and Applications. Adv Healthc Mater 2024; 13:e2302375. [PMID: 38009520 DOI: 10.1002/adhm.202302375] [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: 07/25/2023] [Revised: 10/11/2023] [Indexed: 11/29/2023]
Abstract
Skin-mediated drug delivery methods currently are receiving significant attention as a promising approach for the enhanced delivery of drugs through the skin. Skin-mediated drug delivery offers the potential to overcome the limitations of traditional drug delivery methods, including oral administration and intravenous injection. The challenges associated with drug permeation through layers of skin, which act as a major barrier, are explored, and strategies to overcome these limitations are discussed in detail. This review categorizes skin-mediated drug delivery methods based on the means of increasing drug permeation, and it provides a comprehensive overview of the mechanisms and techniques associated with these methods. In addition, recent advancements in the application of skin-mediated drug delivery are presented. The review also outlines the limitations of ongoing research and suggests future perspectives of studies regarding the skin-mediated delivery of drugs.
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Affiliation(s)
- Dong Ha Lee
- Center for Bionics of Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
- Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sunyoung Lim
- Center for Bionics of Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Sung Soo Kwak
- Center for Bionics of Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Joohee Kim
- Center for Bionics of Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
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Imtiaz MS, Shoaib MH, Yousuf RI, Ali FR, Saleem MT, Khan MZ, Sikandar M. Formulation development and evaluation of drug-in-adhesive-type transdermal patch of metoclopramide HCl. Polym Bull (Berl) 2022. [DOI: 10.1007/s00289-021-03559-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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3
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Özen İ, Wang X. Biomedicine: electrospun nanofibrous hormonal therapies through skin/tissue—a review. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1985493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- İlhan Özen
- Textile Engineering Department, Erciyes University, Melikgazi, Kayseri, Turkey
| | - Xungai Wang
- Institute for Frontier Materials, Deakin University, Geelong, Australia
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Yang C, Li T. RETRACTED: Transdermal delivery of flurbiprofen from polyoxypropylene-polyoxyethylene block copolymer stabilized reduced graphene oxide to manage pain in spondylitis: In vitro and in vivo studies. Eur J Pharm Sci 2021; 165:105929. [PMID: 34256101 DOI: 10.1016/j.ejps.2021.105929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief. Significant similarities were noticed post-publication between this article and the article that was previously published by an apparently unrelated group of authors: Weifan Li, Guangqi Zhang and Xiaoxia Wei, Journal of Biomaterials Applications 35 (2021) 1034 https://doi.org/10.1177/0885328220988462. Moreover, the authors did not respond to the journal request to comment on these similarities and to provide the raw data, and the Editor-in-Chief decided to retract the article. One of the conditions of submission of a paper for publication is that authors declare explicitly that the paper has not been previously published and is not under consideration for publication elsewhere. As such this article represents an abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
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Affiliation(s)
- Chaoqun Yang
- Department of Spine Surgery, The Third hospital of Jinan, Gongyebei Road Wangsherenbei Street 1, Jinan City, Shandong Province 250132, China
| | - Tao Li
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Weiqi Road, Huaiyin District, Jinan, Shandong Province 250021, China.
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Machado BHB, Frame J, Zhang J, Najlah M. Comparative Study on the Outcome of Periorbital Wrinkles Treated with Laser-Assisted Delivery of Vitamin C or Vitamin C Plus Growth Factors: A Randomized, Double-blind, Clinical Trial. Aesthetic Plast Surg 2021; 45:1020-1032. [PMID: 33326047 PMCID: PMC8144134 DOI: 10.1007/s00266-020-02035-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/24/2020] [Indexed: 12/01/2022]
Abstract
Background Despite promising results, laser-assisted drug delivery (LADD) is not yet considered as standard therapies and published data rely mainly on laboratory tests, animal experiments or cadaver skin. Objectives This double-blind, prospective, randomized clinical trial investigates the impact in topical application of vitamin C and a cosmeceutical containing growth factors (GFs) on periorbital wrinkles primarily treated with laser skin resurfacing. Material and Methods In total, 149 female patients with periorbital wrinkles were consented and randomized into two study groups, R-C (receiving vitamin C only) and R-CGF (receiving vitamin C and a cosmeceutical containing growth factors). The statistical analysis evaluated the efficacy of each treatment regimen using software readouts provided by a three-dimensional stereophotogrammetry system prior to treatment and three months after the procedure. Results were compared to confirm if there was a significant change in the skin roughness and the average depth of the wrinkles between the two groups after treatment. Results There was a significant reduction in both skin roughness and average depth of the wrinkles in the group treated with vitamin C and growth factors (p <0.01) than those treated with LADD followed by topical application of vitamin C alone. There were no cutaneous reactions or adverse systemic reactions observed in this study related to LADD with vitamin C and GFs. Conclusion Controlled laser application might have a great potential to facilitate the absorption of exogenous macromolecules by the skin. Periorbital wrinkles were reduced in both groups, but LADD using vitamin C and GFs provided significantly better results. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Chen YS, Jiang X, Sun YY, Zhang SY, Li K, Chen WB, Liu YQ. Development and evaluation of 1-deoxynojirimycin sustained-release delivery system: In vitro and in vivo characterization studies. J Biomed Mater Res A 2021; 109:2294-2305. [PMID: 33942484 DOI: 10.1002/jbm.a.37213] [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] [Received: 01/29/2021] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 12/29/2022]
Abstract
We aimed to establish a 1-Deoxynojirimycin (DNJ) sustained-release delivery system to improve the hypoglycemic effect of DNJ. We used a transdermal diffusion meter in an in vitro orthogonal experiment to determine the optimal composition of the DNJ sustained-release transdermal system. Based on the in vitro analysis results, a sustained-release patch was prepared, and its pharmacokinetics and other properties were determined in vivo. The results showed that 30% hydroxypropyl methylcellulose (K100M ), 14% carboxymethyl cellulose sodium and 26% oleic acid-azone compound as the matrix material, drug excipient, and penetration enhancer, respectively, produced an optimal DNJ sustained-release delivery system. In vitro release tests showed that the system slowly released DNJ within 12 hr, conforming to the Higuchi equation. In vivo experiments showed that the prepared patch had good hypoglycemic activity and continuously released DNJ within 10 hr. In vivo pharmacokinetic study results showed that compared to conventional patches, the prepared patch exhibited significantly different maximum concentration (Cmax ), time to achieve Cmax (Tmax ), and area under the curve from 0 to time t (AUC[0-t] ) as well as improved pharmacokinetics. In conclusion, the prepared DNJ patch has high stability, a sustained-release effect, and relatively good pharmacokinetics and is a safe dosage form that does not cause skin irritation.
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Affiliation(s)
- Yu-Si Chen
- College of Life Sciences, Nankai University, Tianjin, China
| | - Xue Jiang
- College of Life Sciences, Nankai University, Tianjin, China
| | - Yi-Yang Sun
- College of Life Sciences, Nankai University, Tianjin, China
| | - Sai-Ya Zhang
- College of Life Sciences, Nankai University, Tianjin, China
| | - Ke Li
- College of Life Sciences, Nankai University, Tianjin, China
| | - Wen-Bo Chen
- College of Life Sciences, Nankai University, Tianjin, China
| | - Yan-Qiang Liu
- College of Life Sciences, Nankai University, Tianjin, China
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Translabial drug delivery: potential and possibilities. Ther Deliv 2020; 11:673-676. [PMID: 32811339 DOI: 10.4155/tde-2020-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kováčik A, Kopečná M, Vávrová K. Permeation enhancers in transdermal drug delivery: benefits and limitations. Expert Opin Drug Deliv 2020; 17:145-155. [PMID: 31910342 DOI: 10.1080/17425247.2020.1713087] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction: Transdermal drug delivery has several clinical benefits over conventional routes of drug administration. To open the transdermal route for a wider range of drugs, including macromolecules, numerous physical and chemical techniques to overcome the natural low skin permeability have been developed.Areas covered: This review focuses on permeation enhancers (penetration enhancers, percutaneous absorption promoters or accelerants), which are chemicals that increase drug flux through the skin barrier. First, skin components, drug permeation pathways, and drug properties are introduced. Next, we discuss properties of enhancers, their various classifications, structure-activity relationships, mechanisms of action, reversibility and toxicity, biodegradable enhancers, and synergistic enhancer combinations.Expert opinion: Overcoming the remarkable skin barrier properties in an efficient, temporary and safe manner remains a challenge. High permeation-enhancing potency has long been perceived to be associated with toxicity and irritation potential of such compounds, which has limited their further development. In addition, the complexity of enhancer interactions with skin, formulation and drug, along with their vast chemical diversity hampered understanding of their mechanisms of action. The recent development in the field revealed highly potent yet safe enhancers or enhancer combinations, which suggest that enhancer-aided transdermal drug delivery has yet to reach its full potential.
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Affiliation(s)
- Andrej Kováčik
- Skin Barrier Research Group, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Monika Kopečná
- Skin Barrier Research Group, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Kateřina Vávrová
- Skin Barrier Research Group, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
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Pyo SM, Maibach HI. Skin Metabolism: Relevance of Skin Enzymes for Rational Drug Design. Skin Pharmacol Physiol 2019; 32:283-294. [PMID: 31357203 DOI: 10.1159/000501732] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 06/25/2019] [Indexed: 11/19/2022]
Abstract
Transdermal therapeutic systems (TTS) have numerous pharmacological benefits. Drug release, for example, is independent of whether a patient is in a fed or a fasted state, and lower doses can be given as gastrointestinal and hepatic first-pass metabolism is avoided. In addition, inter- and intrapatient variability is minimized as the release of the drug is mainly controlled by the system. This makes TTS interesting as alternative systems to the most common dosage form of oral tablets. The difficulty with the dermal administration route is transporting the drug through the skin, since the skin is an efficient barrier against foreign bodies. Various strategies have been reported in the literature of how drug penetration can be improved. Most of them, however, focus on overcoming the stratum corneum as the first (mechanical) skin barrier. However, penetration is much more complex, and the skin's barrier function does not only depend on the stratum corneum; what has been underestimated is the second (biological) skin barrier formed of enzymes. Compared to the stratum corneum, very little is known about these enzymes, e.g., which enzymes are present in the skin and where exactly they are localized. Hence, very few strategies can be found for how to bypass or even use the skin enzyme barrier for TTS development. This review article provides an overview of the skin enzymes considered to be relevant for the biotransformation of dermally applied drugs. Also, we discuss the use of dermal prodrugs and soft drugs and give the stereoselectivity of skin metabolism careful consideration. Finally, we provide suggestions on how to make use of the current knowledge about skin enzymes for rational TTS design.
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Affiliation(s)
- Sung Min Pyo
- Department of Biology, Chemistry, and Pharmacy, Freie Universität Berlin, Berlin, Germany,
| | - Howard I Maibach
- Department of Dermatology, University of California School of Medicine, San Francisco, California, USA
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10
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Transdermal patches: Design and current approaches to painless drug delivery. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2019; 69:197-215. [PMID: 31259729 DOI: 10.2478/acph-2019-0016] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 01/19/2023]
Abstract
Use of transdermal patches can evade many issues associated with oral drug delivery, such as first-pass hepatic metabolism, enzymatic digestion attack, drug hydrolysis and degradation in acidic media, drug fluctuations, and gastrointestinal irritation. This article reviews various transdermal patches available in the market, types, structural components, polymer role, and the required assessment tools. Although transdermal patches have medical applications for smoking cessation, pain relief, osteoporosis, contraception, motion sickness, angina pectoris, and cardiac disorders, advances in formulation development are ongoing to make transdermal patches capable of delivering more challenging drugs. Transdermal patches can be tailored and developed according to the physicochemical properties of active and inactive components, and applicability for long-term use. Therefore, a number of chemical approaches and physical techniques for transdermal patch development are under investigation.
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11
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Czajkowska-Kośnik A, Szekalska M, Winnicka K. Nanostructured lipid carriers: A potential use for skin drug delivery systems. Pharmacol Rep 2018; 71:156-166. [PMID: 30550996 DOI: 10.1016/j.pharep.2018.10.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/20/2018] [Accepted: 10/10/2018] [Indexed: 12/26/2022]
Abstract
Skin application of pharmaceutical products is one of the methods used for drug administration. The problem of limited drug penetration via topical application makes searching for safe drug carriers that will provide an expected therapeutic effect of utmost importance. Research into safe drug carriers began with liposome structures, paving the way for work with nanocarriers, which currently play a large role as drug vehicles. Nanostructured lipid carriers (NLC) consist of blended solid and liquid lipids (oils) dispersed in an aqueous solution containing a surfactant. These carriers have many advantages: good biocompatibility, low cytotoxicity, high drug content; they enhance a drug's stability and have many possibilities of application (oral, intravenous, pulmonary, ocular, dermal). The following article presents properties, methods of preparation and tests to assess the quality and toxicity of NLC. This analysis indicates the possibility of using NLC for dermal and transdermal drug application.
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Affiliation(s)
- Anna Czajkowska-Kośnik
- Department of Pharmaceutical Technology, Medical University of Bialystok, Białystok, Poland.
| | - Marta Szekalska
- Department of Pharmaceutical Technology, Medical University of Bialystok, Białystok, Poland
| | - Katarzyna Winnicka
- Department of Pharmaceutical Technology, Medical University of Bialystok, Białystok, Poland.
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12
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Ganti SS, Nguyen HX, Murnane KS, Blough BE, Banga AK. Transdermal formulation of 4-benzylpiperidine for cocaine-use disorder. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2018.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Choi DH, Kim YS, Kim DD, Jeong SH. QbD based development and evaluation of topical microemulsion-based hydrogel against superficial fungal infections. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2018. [DOI: 10.1007/s40005-018-0386-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Design, Development, and Optimization of Dexibuprofen Microemulsion Based Transdermal Reservoir Patches for Controlled Drug Delivery. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4654958. [PMID: 29090219 PMCID: PMC5635477 DOI: 10.1155/2017/4654958] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 06/25/2017] [Accepted: 07/04/2017] [Indexed: 11/24/2022]
Abstract
The aim of the study was to develop a reservoir-type transdermal patch for a controlled delivery of dexibuprofen and to evaluate its in vivo anti-inflammatory activity in Albino Wistar rats. In order to develop these patches, six formulations of dexibuprofen microemulsion comprising ethyl oleate, Tween 80: PG (2 : 1), and water were prepared by simplex lattice design and characterized. The reservoir compartment was filled with these microemulsions and in vitro release and skin permeation were assessed. The optimized patch was obtained on the basis of the responses: Q24 and flux. The impact of drug loading, surface area, membrane thickness, adhesive, and agitation speed on drug release and permeation was also studied. The skin sensitivity reaction and in vivo anti-inflammatory activity of optimized patch were evaluated. Stability study at three different temperatures for three months was carried out. The result suggests that a membrane based patch with zero-order release rate, Q24 of 79.13 ± 3.08%, and maximum flux of 331.17 µg/cm2h can be obtained exhibiting suitable anti-inflammatory activity with no visible skin sensitivity reaction. The outcomes of stability study recommend storage of patches at 4°C having shelf-life of 6.14 months. The study demonstrates that the reservoir-type transdermal patch of dexibuprofen microemulsion has a potential of delivering drug across skin in controlled manner with required anti-inflammatory activity.
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Zelga PJ, Górnicz MM, Głuszkiewicz JM, Piasecka-Zelga J. Outcomes of acute dermal irritation and sensitisation tests on active dressings for chronic wounds: a comparative study. J Wound Care 2016; 25:722-729. [DOI: 10.12968/jowc.2016.25.12.722] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P. J. Zelga
- Medical University of Lodz, Department of General and Colorectal Surgery, Pl. Hallera 1, 91-647 Lodz, Poland
| | - M. M. Górnicz
- Institute of Occupational Medicine, Research Laboratory for Medicine and Veterinary Products in the GMP Head of Research Laboratory for Medicine and Veterinary Products
| | - J. M. Głuszkiewicz
- Institute of Occupational Medicine, Research Laboratory for Medicine and Veterinary Products in the GMP Head of Research Laboratory for Medicine and Veterinary Products
| | - J. Piasecka-Zelga
- Institute of Occupational Medicine, Research Laboratory for Medicine and Veterinary Products in the GMP Head of Research Laboratory for Medicine and Veterinary Products
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16
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Kovács G, Zelei T, Vokó Z. Comparison of efficacy and local tolerability of estradiol metered-dose transdermal spray to estradiol patch in a network meta-analysis. Climacteric 2016; 19:488-95. [PMID: 27593417 DOI: 10.1080/13697137.2016.1221919] [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: 10/21/2022]
Abstract
OBJECTIVES Transdermal hormone replacement therapy is preferred for menopausal vasomotor symptoms. Our purpose was to compare the efficacy and local tolerability of a patch and a metered-dose transdermal spray that have never been directly compared. METHOD The relative change in the number of hot flushes between baseline and week 12 was selected as an efficacy indicator and the frequency of local skin reactions as a tolerability indicator. A network meta-analysis was performed to compare efficacy. Application site tolerability was compared descriptively. RESULTS Overall 46 studies were identified. In the efficacy analysis, eight active treatment arms and a placebo arm were determined based on the estradiol daily dose (from 14 μg to 50 μg). All but one had a significantly higher effect on relative change in the number of hot flushes than did the placebo. We found no evidence for different efficacy of the patch and the metered-dose transdermal spray. The latter performed better in terms of local skin reactions. CONCLUSION The patch and the metered-dose transdermal spray seem to have the same efficacy on vasomotor symptoms in estradiol hormone replacement. The local tolerability of the metered-dose transdermal spray is favorable.
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Affiliation(s)
- G Kovács
- a Syreon Research Institute , Budapest , Hungary
| | - T Zelei
- a Syreon Research Institute , Budapest , Hungary
| | - Z Vokó
- a Syreon Research Institute , Budapest , Hungary ;,b Department of Health Policy and Health Economics, Faculty of Social Sciences , Eötvös Loránd University , Budapest , Hungary
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Preclinical safety of solid lipid nanoparticles and nanostructured lipid carriers: Current evidence from in vitro and in vivo evaluation. Eur J Pharm Biopharm 2016; 108:235-252. [PMID: 27519829 DOI: 10.1016/j.ejpb.2016.08.001] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 07/16/2016] [Accepted: 08/01/2016] [Indexed: 01/08/2023]
Abstract
Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) were designed as exceptionally safe colloidal carriers for the delivery of poorly soluble drugs. SLN/NLC have the particularity of being composed of excipientsalready approved for use in medicines for human use, which offers a great advantage over any other nanoparticulate system developed from novel materials. Despite this fact, any use of excipients in new route of administration or in new dosage form requires evidence of safety. After 25 years of research on SLN and NLC, enough evidence on their preclinical safety has been published. In the present work, published data on in vitro and in vivo compatibility of SLN/NLC have been surveyed, in order to provide evidence of high biocompatibility distinguished by intended administration route. We also identified critical factors and possible weak points in SLN/NLC formulations, such as the effect of surfactants on the cell viability in vitro, which should be considered for further development.
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18
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Salim N, Ahmad N, Musa SH, Hashim R, Tadros TF, Basri M. Nanoemulsion as a topical delivery system of antipsoriatic drugs. RSC Adv 2016. [DOI: 10.1039/c5ra14946k] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nanoemulsion as a potential enhancer for the treatment of psoriasis.
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Affiliation(s)
- Norazlinaliza Salim
- Department of Chemistry
- Faculty of Science
- University Putra Malaysia
- 43400 UPM Serdang
- Malaysia
| | - Noraini Ahmad
- Department of Chemistry
- Faculty of Science
- University of Malaya
- 50603 Kuala Lumpur
- Malaysia
| | - Siti Hajar Musa
- Department of Chemistry
- Faculty of Science
- University Putra Malaysia
- 43400 UPM Serdang
- Malaysia
| | - Rauzah Hashim
- Department of Chemistry
- Faculty of Science
- University of Malaya
- 50603 Kuala Lumpur
- Malaysia
| | | | - Mahiran Basri
- Department of Chemistry
- Faculty of Science
- University Putra Malaysia
- 43400 UPM Serdang
- Malaysia
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Pastore MN, Kalia YN, Horstmann M, Roberts MS. Transdermal patches: history, development and pharmacology. Br J Pharmacol 2015; 172:2179-209. [PMID: 25560046 PMCID: PMC4403087 DOI: 10.1111/bph.13059] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 12/24/2022] Open
Abstract
Transdermal patches are now widely used as cosmetic, topical and transdermal delivery systems. These patches represent a key outcome from the growth in skin science, technology and expertise developed through trial and error, clinical observation and evidence-based studies that date back to the first existing human records. This review begins with the earliest topical therapies and traces topical delivery to the present-day transdermal patches, describing along the way the initial trials, devices and drug delivery systems that underpin current transdermal patches and their actives. This is followed by consideration of the evolution in the various patch designs and their limitations as well as requirements for actives to be used for transdermal delivery. The properties of and issues associated with the use of currently marketed products, such as variability, safety and regulatory aspects, are then described. The review concludes by examining future prospects for transdermal patches and drug delivery systems, such as the combination of active delivery systems with patches, minimally invasive microneedle patches and cutaneous solutions, including metered-dose systems.
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MESH Headings
- Administration, Cutaneous
- Animals
- Chemistry, Pharmaceutical/history
- Drug Carriers
- History, 15th Century
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- History, Ancient
- Humans
- Pharmaceutical Preparations/administration & dosage
- Pharmaceutical Preparations/chemistry
- Pharmaceutical Preparations/history
- Technology, Pharmaceutical/history
- Technology, Pharmaceutical/methods
- Transdermal Patch/history
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Affiliation(s)
- Michael N Pastore
- School of Pharmacy and Medical Sciences, University of South AustraliaAdelaide, SA, Australia
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of LausanneGeneva, Switzerland
| | - Michael Horstmann
- former Acino Pharma AG, now Independent Pharmacist (Transdermalpharma UG)Neuwied, Germany
| | - Michael S Roberts
- School of Pharmacy and Medical Sciences, University of South AustraliaAdelaide, SA, Australia
- Therapeutics Research Centre, School of Medicine, University of Queensland, Princess Alexandra HospitalBrisbane, Qld, Australia
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Marwah H, Garg T, Goyal AK, Rath G. Permeation enhancer strategies in transdermal drug delivery. Drug Deliv 2014; 23:564-78. [DOI: 10.3109/10717544.2014.935532] [Citation(s) in RCA: 254] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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21
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Lee EY, Chun MK, Chang JS, Choi HK. Development of matrix based transdermal delivery system for ketotifen. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2014. [DOI: 10.1007/s40005-014-0126-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Tan WS, Low WY, Ng CJ, Tan WK, Tong SF, Ho C, Khoo EM, Lee G, Lee BC, Lee V, Tan HM. Efficacy and safety of long-acting intramuscular testosterone undecanoate in aging men: a randomised controlled study. BJU Int 2013; 111:1130-40. [PMID: 23651425 DOI: 10.1111/bju.12037] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of long-acting i.m. testosterone undecanoate (TU) in Malaysian men with testosterone deficiency (TD). PATIENTS AND METHODS A total of 120 men, aged 40-70 years, with TD (serum total testosterone [TT] ≤ 12 nmol/L) were randomised to receive either i.m. TU (1000 mg) or placebo. In all, 58 and 56 men in the placebo and treatment arm, respectively, completed the study. Participants were seen six times in the 48-week period and the following data were collected: physical examination results, haemoglobin, haematocrit, TT, lipid profile, fasting blood glucose, sex hormone-binding globulin, liver function test, prostate- specific antigen (PSA) and adverse events. RESULTS The mean (sd) age of the participants was 53.4 (7.6) years. A significant increase in serum TT (P < 0.001), PSA (P = 0.010), haematocrit (P < 0.001), haemoglobin (P < 0.001) and total bilirubin (P = 0.001) were seen in the treatment arm over the 48-week period. Two men in the placebo arm and one man in the treatment arm developed myocardial infarction. Common adverse events observed in the treatment arm included itching/swelling/pain at the site of injection, flushing and acne. Overall, TU injections were well tolerated. CONCLUSIONS TU significantly increases serum testosterone in men with TD. PSA, haemoglobin and haematocrit were significantly elevated but were within clinically safe limits. There was no significant adverse reaction that led to the cessation of treatment.
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Affiliation(s)
- Wei Shen Tan
- Division of Surgery and Interventional Science, University College London, 74 Huntley St., London, UK.
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Zhu YL, Song GH, Liu DQ, Zhang X, Liu KF, Zang AH, Cheng Y, Cao GC, Liang J, Ma XZ, Ding X, Wang B, Li WL, Hu ZW, Feng G, Huang JJ, Zheng X, Jiao SC, Wu R, Ren J. Multicenter clinical study for evaluation of efficacy and safety of transdermal fentanyl matrix patch in treatment of moderate to severe cancer pain in 474 chinese cancer patients. Chin J Cancer Res 2013; 23:317-22. [PMID: 23359267 DOI: 10.1007/s11670-011-0317-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 08/26/2011] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Although a new matrix formulation fentanyl has been used throughout the world for cancer pain management, few data about its efficacy and clinical outcomes associated with its use in Chinese patients have been obtained. This study aimed to assess the efficacy and safety of the new system in Chinese patients with moderate to severe cancer pain. METHODS A total of 474 patients with moderate to severe cancer pain were enrolled in this study and were treated with the new transdermal fentanyl matrix patch (TDF) up to 2 weeks. All the patients were asked to record pain intensity, side effects, quality of life (QOL), adherence and global satisfaction. The initial dose of fentanyl was 25 μg/h titrated with opioid or according to National Comprehensive Cancer Network (NCCN) guidelines. Transdermal fentanyl was changed every three days. RESULTS After 2 weeks. The mean pain intensity of the 459 evaluated patients decreased significantly from 5.63±1.26 to 2.03±1.46 (P<0.0001). The total remission rate was 91.29%, of which moderate remission rate 53.16%, obvious remission rate 25.49% and complete remission rate 12.64%. The rate of adverse events was 33.75%, 18.78% of which were moderate and 3.80% were severe. The most frequent adverse events were constipation and nausea. No fatal events were observed. The quality of life was remarkably improved after the treatment (P<0.0001). CONCLUSION The new TDF is effective and safe in treating patients with moderate to severe cancer pain, and can significantly improve the quality of life.
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Affiliation(s)
- Yu-Lin Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Breast Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing 100142, China
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Hazeki N, Kobayashi K, Shinke H, Yamamoto M, Ohta M, Nishimura Y. Semipermeable membrane dressings can be used with the nicotine transdermal system and do not interfere with nicotine absorption. Intern Med 2013; 52:2743-8. [PMID: 24334578 DOI: 10.2169/internalmedicine.52.0423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Adverse skin reactions as a local side effect of nicotine patches sometimes interfere with smoking cessation therapy. We studied the effects of semipermeable membrane dressings (SMD) used under nicotine patches (NP) on nicotine absorption, as assessed according to the urinary cotinine levels, and skin symptoms. METHODS First, the urinary cotinine levels were compared in eight nonsmokers that applied NP over SMD and NP without SMD (Study 1). The urinary cotinine levels were measured using a highly sensitive competitive enzyme immunoassay. Second, 28 subjects undergoing NP therapy for diagnosed nicotine dependence were randomly assigned into two groups in a crossover design to receive NP over SMD and NP without SMD. The urinary cotinine levels and skin symptoms were compared between the two treatment groups. During the follow-up period of 48 weeks, the smoking cessation rate was evaluated (Study 2). RESULTS No statistical differences were observed in the urinary cotinine levels between the NP over SMD and NP without SMD groups. In Study 2, the skin symptoms improved with the use of SMD in 42.8% (6/14) of the patients and worsened in 28.5% (4/14) of the patients. No serious skin disorders were reported. The subjects followed in Study 2 exhibited smoking cessation rates of 92.8%, 78.5% and 64.2% at 12, 24 and 48 weeks, respectively. CONCLUSION The use of NP over SMD is a safe and effective alternative application to NP treatment for preventing the skin symptoms caused by NP without interfering with nicotine absorption.
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Affiliation(s)
- Nobuko Hazeki
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Hospital, Japan
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Zhang H, Ho YF, Che CT, Lin ZX, Leung C, Chan LS. Topical herbal application as an adjuvant treatment for chronic kidney disease--a systematic review of randomized controlled clinical trials. J Adv Nurs 2012; 68:1679-91. [PMID: 22229543 DOI: 10.1111/j.1365-2648.2011.05925.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To report a systematic review to evaluate whether topical herbal medicine delays the progress of renal disease and improves its complications in people with chronic kidney disease. BACKGROUND Besides dialysis or renal transplantation, patients with chronic kidney disease, especially those with insufficient renal function, are in a great need of effective conservative treatment methods. Topical application of herbal medicine, a common treatment modality in China, has been found in some clinical studies to benefit the patients with chronic kidney disease. DATA SOURCES The English databases including CENTRAL (February 2010), Medline (1950 to February 2010), EMBASE (1980 to February 2010), and AMED (1985 to January 2010), and several Chinese databases covering the period of 1949 to February 2010 were searched for randomized controlled trials that compared external use of herbal medicine with no treatment, placebo, or conventional treatment for chronic kidney disease and its complications. REVIEW METHODS We undertook a systematic review and meta-analysis following Cochrane processes. RESULTS Twenty-three trials with a total of 1057 patients were included. Their results suggest that herbal paste and bathing or fuming treatment might have a beneficial effect in terms of delaying the progress of renal disease, improving kidney function, and ameliorating some kidney complications in patients with chronic kidney disease. However, the low quality and poor reporting practices of the studies covered led to no definitive conclusion. CONCLUSION Further larger and more rigorously designed clinical trials with proper outcome measures are needed to confirm the findings.
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Affiliation(s)
- Hongwei Zhang
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
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Conners W, Flinn K, Morgentaler A. Outcomes with the “V” Implantation Technique vs. Standard Technique for Testosterone Pellet Therapy. J Sex Med 2011; 8:3465-70. [DOI: 10.1111/j.1743-6109.2011.02441.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Namjoshi S, Benson HAE. Cyclic peptides as potential therapeutic agents for skin disorders. Biopolymers 2011; 94:673-80. [PMID: 20564043 DOI: 10.1002/bip.21476] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
There is an increasing understanding of the role of peptides in normal skin function and skin disease. With this knowledge, there is significant interest in the application of peptides as therapeutics in skin disease or as cosmeceuticals to enhance skin appearance. In particular, antimicrobial peptides and those involved in inflammatory processes provide options for the development of new therapeutic directions in chronic skin conditions such as psoriasis and dermatitis. To exploit their potential, it is essential that these peptides are delivered to their site of action in active form and in sufficient quantity to provide the desired effect. Many polymers permeate the skin poorly and are vulnerable to enzymatic degradation. Synthesis of cyclic peptide derivatives can substantially alter the physicochemical characteristics of the peptide with the potential to improve its skin permeation. In addition, cyclization can stabilize the peptide structure and thereby increase its stability. This review describes the role of cyclic peptides in the skin, examples of current cyclic peptide therapeutic products, and the potential for cyclic peptides as dermatological therapeutics and cosmeceuticals.
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Affiliation(s)
- Sarika Namjoshi
- Curtin Health Innovation Research Institute, School of Pharmacy, Curtin University, Perth, WA, Australia
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Abstract
INTRODUCTION Transdermal patch systems are an effective method of administering active ingredients through the skin, with considerable advantages over other drug delivery routes, for example, maintenance of constant plasma drug levels and avoidance of first-pass metabolism. However, repeated epicutaneous application may be associated with local skin reactions. AREAS COVERED This review addresses current issues regarding the effective/safe use of transdermal patch systems, and provides a critical analysis of the addition of 'skin-caring' ingredients to patch systems. Effective use of transdermal systems includes choosing an appropriate body area for application, maintaining regular skin care regimens before application and not replacing a patch in the same area (rotation) within 7 days. Another strategy, developed in an attempt to improve the tolerability of transdermal systems, is the addition of assumed 'skin-caring' ingredients (e.g., Aloe Vera) to patch systems. However, at present there is neither proof nor clinical evidence of any benefit. On the contrary, plant-derived ingredients might be associated with allergenic potential. EXPERT OPINION Transdermal systems are generally well tolerated; physicians must adequately inform patients of the most effective ways to use these formulations for maximum therapeutic benefit, while minimising local adverse events. Skin-caring agents, including Aloe Vera, cannot be recommended until well-controlled clinical trials with standardised extracts are available.
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Affiliation(s)
- Johannes Wohlrab
- Martin Luther University Halle-Wittenberg, Department of Dermatology and Venereology, Ernst-Kromayer-Str. 5, D 06097 Halle (Saale), Germany.
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Bharucha AE, Seide BM, Zinsmeister AR. The effects of clonidine on symptoms and anorectal sensorimotor function in women with faecal incontinence. Aliment Pharmacol Ther 2010; 32:681-8. [PMID: 20629973 PMCID: PMC2932810 DOI: 10.1111/j.1365-2036.2010.04391.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Women with faecal incontinence and rectal urgency have increased rectal stiffness and sensation. AIM To evaluate the effects of clonidine, an alpha(2) -adrenergic agonist, in faecal incontinence. METHODS In this open-label uncontrolled study, bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) were assessed before and during treatment with transdermal clonidine (0.2 mg daily, 4 weeks) in 12 women with urge-predominant faecal incontinence. RESULTS Clonidine reduced the frequency (17.8 +/- 3.1 before vs. 8.8 +/- 3.9 after, P = 0.03) and number of days with faecal incontinence (11.8 +/- 1.6 before vs. 6.1 +/- 1.8 after, P = 0.02), faecal incontinence symptom severity score (max = 13, 8.3 +/- 0.7 vs. 5.6 +/- 0.9, P < 0.01), and allowed patients to defer defecation for a longer duration (P = 0.03). Although overall effects on anorectal functions were not significant, the treatment-associated reduction in faecal incontinence episodes was associated with increased rectal compliance (r = -0.58, P < 0.05) and reduced rectal sensation. (r = -0.73, P = 0.007 vs. desire to defecate pressure threshold). CONCLUSIONS Clonidine improves symptoms in women with faecal incontinence; this improvement is associated with increased rectal compliance and reduced rectal sensitivity. A controlled study is necessary to confirm these observations.
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Affiliation(s)
- A. E. Bharucha
- Division of Gastroenterology and Hepatology, Department of Medicine
| | - B. M. Seide
- Division of Gastroenterology and Hepatology, Department of Medicine
| | - A. R. Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
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Paudel KS, Milewski M, Swadley CL, Brogden NK, Ghosh P, Stinchcomb AL. Challenges and opportunities in dermal/transdermal delivery. Ther Deliv 2010; 1:109-31. [PMID: 21132122 PMCID: PMC2995530 DOI: 10.4155/tde.10.16] [Citation(s) in RCA: 325] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Transdermal drug delivery is an exciting and challenging area. There are numerous transdermal delivery systems currently available on the market. However, the transdermal market still remains limited to a narrow range of drugs. Further advances in transdermal delivery depend on the ability to overcome the challenges faced regarding the permeation and skin irritation of the drug molecules. Emergence of novel techniques for skin permeation enhancement and development of methods to lessen skin irritation would widen the transdermal market for hydrophilic compounds, macromolecules and conventional drugs for new therapeutic indications. As evident from the ongoing clinical trials of a wide variety of drugs for various clinical conditions, there is a great future for transdermal delivery of drugs.
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Affiliation(s)
- Kalpana S Paudel
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Mikolaj Milewski
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Courtney L Swadley
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Nicole K Brogden
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Priyanka Ghosh
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Audra L Stinchcomb
- College of Pharmacy, University of Kentucky, Lexington, KY 40536-0200, USA
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Cummings JL, Farlow MR, Meng X, Tekin S, Olin JT. Rivastigmine Transdermal Patch Skin Tolerability. Clin Drug Investig 2010; 30:41-9. [DOI: 10.2165/11531270-000000000-00000] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Brown MR, Denman R, Platts D. Analgesic patches and defibrillators: a cautionary tale. Europace 2009; 11:1552-3. [DOI: 10.1093/europace/eup261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ale I, Lachapelle JM, Maibach HI. Skin tolerability associated with transdermal drug delivery systems: an overview. Adv Ther 2009; 26:920-35. [PMID: 19967501 DOI: 10.1007/s12325-009-0075-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Indexed: 01/18/2023]
Abstract
As transdermal patches become more widely prescribed, it is important that clinicians understand: (a) the common causes of skin reactions with these medications; (b) how to minimize these reactions; and (c) how to manage the signs and symptoms. Here we review published data for skin reactions with patch medications approved within the past decade. Overall, the most common application site signs and symptoms appear to be localized redness (erythema) or itching, sometimes accompanied by swelling (edema). Typically, these are mild to moderate in severity, transient in nature, and occur in 20% to 50% of patients. Most are localized to the area of application, and resolve spontaneously within several days following patch removal. Discontinuations due to these types of event are infrequent, ranging from 1.7% to 6.8% in the 6-month trials reviewed here. Based on expert opinion, the majority of these skin reactions would be a form of irritant contact dermatitis, with infrequent cases of allergic contact dermatitis. These types of reactions usually cause minimal pain or discomfort to the patient, and are unlikely to be of medical concern. Signs and symptoms of irritant contact dermatitis may be minimized by rotation of the application site, careful removal of the patch, and appropriate use of moisturizers and topical corticosteroids. In conclusion, the potential advantages of transdermal patches usually outweigh any additional skin issues; however, further research into treatment and management strategies is required.
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Affiliation(s)
- Iris Ale
- Department of Dermatology, University of Uruguay, Montevideo, Uruguay
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Frei A, Andersen S, Hole P, Jensen NH. A One Year Health Economic Model Comparing Transdermal Fentanyl with Sustained-Release Morphine in the Treatment of Chronic Noncancer Pain. J Pain Palliat Care Pharmacother 2009; 17:5-26. [PMID: 14649386 DOI: 10.1080/j354v17n02_02] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A Markov model was constructed to simulate the resource use and health outcomes of one year of treatment comparing the fentanyl transdermal therapeutic system (fentanyl-TTS) with oral sustained-release (SR) morphine in outpatients with noncancer pain in Denmark. Effectiveness was assessed in terms of days of good pain control and days on initial treatment. Costs included those of baseline pain management, including breakthrough pain; co-medication costs; and control of adverse events. Fentanyl-TTS was more effective than SR-morphine in achieving good pain control (99 vs. 64 days, respectively) and the incremental cost-effectiveness of fentanyl-TTS was US dollars 10.26 per extra day of good pain control. Patients treated with fentanyl-TTS remained considerably longer on initial treatment compared with those treated with SR-morphine (166 days vs. 117 days, respectively). The results of this study suggest that fentanyl-TTS is a competitive therapeutic and economic choice for the treatment of chronic noncancer pain.
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35
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Winblad B, Machado JC. Use of rivastigmine transdermal patch in the treatment of Alzheimer's disease. Expert Opin Drug Deliv 2008; 5:1377-86. [DOI: 10.1517/17425240802542690] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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36
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Brown MB, Martin GP, Jones SA, Akomeah FK. Dermal and Transdermal Drug Delivery Systems: Current and Future Prospects. Drug Deliv 2008; 13:175-87. [PMID: 16556569 DOI: 10.1080/10717540500455975] [Citation(s) in RCA: 356] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The protective function of human skin imposes physicochemical limitations to the type of permeant that can traverse the barrier. For a drug to be delivered passively via the skin it needs to have adequate lipophilicity and also a molecular weight <500 Da. These requirements have limited the number of commercially available products based on transdermal or dermal delivery. Various strategies have emerged over recent years to optimize delivery and these can be categorized into passive and active methods. The passive approach entails the optimization of formulation or drug carrying vehicle to increase skin permeability. Passive methods, however do not greatly improve the permeation of drugs with molecular weights >500 Da. In contrast active methods that normally involve physical or mechanical methods of enhancing delivery have been shown to be generally superior. Improved delivery has been shown for drugs of differing lipophilicity and molecular weight including proteins, peptides, and oligonucletides using electrical methods (iontophoresis, electroporation), mechanical (abrasion, ablation, perforation), and other energy-related techniques such as ultrasound and needless injection. However, for these novel delivery methods to succeed and compete with those already on the market, the prime issues that require consideration include device design and safety, efficacy, ease of handling, and cost-effectiveness. This article provides a detailed review of the next generation of active delivery technologies.
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Affiliation(s)
- Marc B Brown
- Pharmaceutical Sciences Research Division, King's College London and MedPharm Ltd., London, United Kingdom.
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Kaestli LZ, Wasilewski-Rasca AF, Bonnabry P, Vogt-Ferrier N. Use of Transdermal Drug Formulations in the Elderly. Drugs Aging 2008; 25:269-80. [DOI: 10.2165/00002512-200825040-00001] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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38
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Brown MB, Traynor MJ, Martin GP, Akomeah FK. Transdermal drug delivery systems: skin perturbation devices. Methods Mol Biol 2008; 437:119-139. [PMID: 18369965 DOI: 10.1007/978-1-59745-210-6_5] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Human skin serves a protective function by imposing physicochemical limitations to the type of permeant that can traverse the barrier. For a drug to be delivered passively via the skin it needs to have a suitable lipophilicity and a molecular weight < 500 Da. The number of commercially available products based on transdermal or dermal delivery has been limited by these requirements. In recent years various passive and active strategies have emerged to optimize delivery. The passive approach entails the optimization of formulation or drug carrying vehicle to increase skin permeability. However, passive methods do not greatly improve the permeation of drugs with molecular weights >500 Da. In contrast, active methods, normally involving physical or mechanical methods of enhancing delivery, have been shown to be generally superior. The delivery of drugs of differing lipophilicity and molecular weight, including proteins, peptides and oligonucletides, has been shown to be improved by active methods such as iontophoresis, electroporation, mechanical perturbation and other energy-related techniques such as ultrasound and needleless injection. This chapter details one practical example of an active skin abrasion device to demonstrate the success of such active methods. The in vitro permeation of acyclovir through human epidermal membrane using a rotating brush abrasion device was compared with acyclovir delivery using iontophoresis. It was found that application of brush treatment for 10 s at a pressure of 300 N m(-2) was comparable to 10 min of iontophoresis. The observed enhancement of permeability observed using the rotating brush was a result of disruption of the cells of the stratum corneum, causing a reduction of the barrier function of the skin. However, for these novel delivery methods to succeed and compete with those already on the market, the prime issues that require consideration include device design and safety, efficacy, ease of handling, and cost-effectiveness. This chapter provides a detailed review of the next generation of active delivery technologies.
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Affiliation(s)
- Marc B Brown
- School of Pharmacy, University of Hertfordshire, College Lane Campus, Hatfield, Herts., UK
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Transdermal Buprenorphine Patches Applied in a 4-Day Regimen Versus a 3-Day Regimen: A Single-Site, Phase III, Randomized, Open-Label, Crossover Comparison. Clin Ther 2007; 29:1591-606. [DOI: 10.1016/j.clinthera.2007.08.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2007] [Indexed: 01/22/2023]
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Abstract
The recent recognition of the magnitude of cardiovascular risk of both nonselective nonsteroidal anti-inflammatory drugs and COX-2 selective inhibitors, in addition to the persistent concerns about the use of opioids, has brought increased attention to nonsystemic, topical analgesics. These agents have a favorable safety profile and there is increasing evidence indicating their efficacy for a variety of pain disorders. The use of topical analgesics in the treatment of the most prevalent musculoskeletal pain syndromes is described, with a focus on mechanisms for drug delivery and clinical trials data.
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Affiliation(s)
- Steven P Stanos
- Chronic Pain Care Center, Rehabilitation Institute of Chicago, and Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60610, USA.
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Zhu QG, Hu JH, Liu JY, Lu SW, Liu YX, Wang J. Stereoselective Characteristics and Mechanisms of Epidermal Carboxylesterase Metabolism Observed in HaCaT Keratinocytes. Biol Pharm Bull 2007; 30:532-6. [PMID: 17329851 DOI: 10.1248/bpb.30.532] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is increasing evidence that epidermal carboxylesterase may be involved in the stereoselective hydrolysis of prodrugs in percutaneous absorption. The present study was designed to evaluate the stereoselective characteristics and mechanisms of ketoprofen ethyl ester hydrolysis by epidermal carboxylesterase expressed in HaCaT keratinocytes. Ketoprofen ethyl ester was mainly hydrolyzed to R-ketoprofen by carboxylesterase of human HaCaT keratinocytes. Human carboxylesterase-1 (hCE-1) and human carboxylesterase-2 (hCE-2) were intensively detected in L02 hepatocytes, hCE-2 was also intensively detected in HaCaT keratinocytes, but hCE-1 was not detected in HaCaT keratinocytes. hCE-2 is thus an abundant carboxylesterase in HaCaT keratinocytes which may be responsible for stereoselective hydrolysis of ketoprofen ethyl ester.
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Affiliation(s)
- Quan-Gang Zhu
- Department of Pharmacy, Changhai Hospital, Second Military Medical University, 174 Chang-Hai Road, Shanghai 200433, PR China.
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Irie S, Tsukikawa H, Nabeshima T, Usami M, Karino T, Komatsu S, Akasaki M. Skin tests of a novel nicotine patch, PHK-301p, in healthy male volunteers: phase I, placebo-controlled study. J Pharmacol Sci 2006; 102:72-6. [PMID: 16960422 DOI: 10.1254/jphs.fp0060422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Major local adverse reactions in the nicotine patches are skin reactions. To assess the skin reaction of PHK-301p, a newly developed nicotine patch, we conducted a phase I study that consisted of 2 parts: a skin irritation test (48-h closed patch test) and a photosensitivity test (24-h closed patch test + Ultraviolet A irradiation). Twenty healthy men were treated with PHK-301p and placebo. Both preparations were punched out to a circle of 6-mm diameter and were applied simultaneously to each participant. Skin irritation and photosensitivity were assessed by a physician who was kept unaware of the treatment. In the skin irritation test, moderate and mild erythemas were observed in each participant 72 h after application (24 h after removal) for PHK-301p. Mild erythema was observed in one participant 49 h after application (1 h after removal) for placebo. The skin irritation index, which was calculated based on the skin reactions of participants, was 7.5 for PHK-301p and 2.5 for placebo. In the photosensitivity test, one participant had mild erythema (+/-) approximately 25 and 72 h after application of PHK-301p. No solar urticaria was observed. From these results, we concluded that PHK-301p is an acceptable product as a nicotine patch.
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Affiliation(s)
- Shin Irie
- Kyushu Clinical Pharmacology Research Clinic, Japan.
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Abstract
Nitrates are very effective antianginal and anti-ischaemic agents. Provision of a long nitrate-free interval or low plasma nitrate levels prior to the morning dose prevents the loss of clinical efficacy by preventing the development of tolerance. However, side effects during nitrate therapy are common. Headache is the most common side effect of nitrates; often dose-related and reported by up to 82% of patients in placebo-controlled trials. Nearly 10% of patients are unable to tolerate nitrates due to disabling headaches or dizziness. In others, headaches are mild-to-moderate in severity and either resolve or diminish in intensity with continued nitrate therapy. Nitrate-induced hypotension is common, but often asymptomatic. In rare instances, nitrate-induced hypotension is severe and accompanied by marked slowing of the heart rate and syncope. Use of nitrates in patients who experience syncope after administration of nitrates is contraindicated. Nitrates rarely cause coronary steal and myocardial ischaemia. Nitrate rebound may occur and patients may experience nocturnal anginal episodes during intermittent therapy with nitroglycerin patches. Administration of nitrates is contraindicated with concomitant use of phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction, as combination therapy may lead to profound hypotension and even death. There are disturbing observational reports in the literature that continuous, prolonged use of nitrates may lead to increased mortality and recurrent myocardial infarctions. Large, randomised, placebo-controlled studies are needed to confirm or refute these reports; until then, the use of nitrates to treat angina is here to stay.
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Affiliation(s)
- Udho Thadani
- University of Oklahoma Health Sciences, Cardiovascular Section, Department of Medicine, 920 Stanton L. Young Blvd, WP3120, Oklahoma City, OK 73104, Oklahoma, USA.
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Nitti VW, Sanders S, Staskin DR, Dmochowski RR, Sand PK, MacDiarmid S, Maibach HI. Transdermal delivery of drugs for urologic applications: Basic principles and applications. Urology 2006; 67:657-64. [PMID: 16618554 DOI: 10.1016/j.urology.2005.11.039] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Revised: 10/25/2005] [Accepted: 11/15/2005] [Indexed: 11/22/2022]
Affiliation(s)
- Victor W Nitti
- New York University School of Medicine, New York, New York 10016, USA.
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Dmochowski RR, Nitti V, Staskin D, Luber K, Appell R, Davila GW. Transdermal oxybutynin in the treatment of adults with overactive bladder: combined results of two randomized clinical trials. World J Urol 2005; 23:263-70. [PMID: 16151816 DOI: 10.1007/s00345-005-0012-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Accepted: 05/16/2005] [Indexed: 10/25/2022] Open
Abstract
The safety and efficacy of oxybutynin transdermal delivery system (oxybutynin-TDS) versus placebo in adults with urge and mixed urinary incontinence was investigated using combined results from double-blind stages of 2 phase 3 clinical trials. Study 1: placebo-controlled, parallel-group comparison of 3 oxybutynin-TDS doses in 12-week double-blind and open-label periods, followed by a 28-week open-label extension. Study 2 was a 12-week randomized, double-blind, placebo-controlled comparison of oxybutynin-TDS versus long-acting tolterodine and placebo, followed by a 52-week open-label extension. Efficacy analysis included 241 patients receiving oxybutynin-TDS, 244 receiving placebo. Most participants were Caucasian women (92%). Approximately 60% received prior anticholinergic therapy. Primary outcome was determined by changes from baseline to end of treatment in frequency of incontinence episodes, frequency of urination, and void volume. Oxybutynin-TDS was significantly more effective than placebo in reducing median daily incontinence episodes (-3.0 vs placebo -2.0; P=.00004) and daily urinary frequency (-2.0 vs -1.0; P=.0023), and in increasing void volume (25 mL vs 5.5 mL; P<.00001). Overall rates of anticholinergic adverse events (AEs) were 12.8% for oxybutynin-TDS and 11.0% for placebo (P=0.5421). The most common systemic anticholinergic AEs were dry mouth (7.0% for oxybutynin-TDS vs 5.3% for placebo) and constipation (2.1% vs 2.0%). Application site erythema occurred in 7.0% of participants who received oxybutynin-TDS (3.7% discontinuation rate); pruritus occurred in 16.1% (3.3% discontinuation rate). Transdermal oxybutynin was shown to be efficacious, with a proven safety profile. It may be utilized for patients with overactive bladder as a treatment option that could enhance compliance.
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Affiliation(s)
- Roger R Dmochowski
- Department of Urologic Surgery, Vanderbilt University, Nashville, TN 37235, USA.
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47
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Abstract
The adverse effects of tobacco on the skin are well known but the role of nicotine is more controversial. Nicotinic receptors are expressed in the skin, on keratinocytes, fibroblasts and blood vessels. Nicotine induces vasoconstriction associated with local hyperaemia. It inhibits inflammation through effects on central and peripheral nervous system and through direct effect on immune cells. It delays wound healing and accelerates skin aging. The role of nicotine on skin diseases remains unclear. Therapeutic effects of nicotine could be possible and this a new stimulating field of research.
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Affiliation(s)
- Laurent Misery
- Laboratory of Cutaneous Neurobiology, Department of Dermatology, University Hospital, Brest, France.
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48
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Dmochowski RR, Sand PK, Zinner NR, Gittelman MC, Davila GW, Sanders SW. Comparative efficacy and safety of transdermal oxybutynin and oral tolterodine versus placebo in previously treated patients with urge and mixed urinary incontinence. Urology 2003; 62:237-42. [PMID: 12893326 DOI: 10.1016/s0090-4295(03)00356-x] [Citation(s) in RCA: 225] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To compare the efficacy and safety of an oxybutynin transdermal delivery system (OXY-TDS) and oral, long-acting tolterodine (TOL-LA) with placebo in previously treated patients with urge or mixed urinary incontinence. METHODS After withdrawal of their current antimuscarinic therapy, 361 adult patients were randomized to 12 weeks of double-blind, double-dummy treatment with twice weekly OXY-TDS 3.9 mg/day, daily TOL-LA 4 mg, or placebo. Evaluations included change from baseline in patient urinary diary symptoms, incontinence-specific quality of life, and safety. RESULTS OXY-TDS 3.9 mg/day and TOL-LA 4 mg/day significantly reduced the number of daily incontinence episodes (median change -3 OXY-TDS and -3 TOL-LA versus -2 placebo; P <0.05), increased the average void volume (median change 24 and 29 mL versus 5.5 mL, P <0.01), and improved quality of life (incontinence impact questionnaire [IIQ] total score, P <0.05; Urogenital Distress Inventory Irritative Symptom subscale, P <0.05) compared with placebo. The most common adverse event for OXY-TDS was localized application site pruritus (14% versus 4% placebo) accompanied by a low incidence of systemic side effects (eg, dry mouth 4.1%). Anticholinergic adverse events occurred with greatest frequency during TOL-LA treatment (dry mouth 7.3% versus 1.7% placebo, P <0.05). CONCLUSIONS OXY-TDS and TOL-LA are effective and comparable treatments for patients with urge and mixed incontinence. OXY-TDS improves systemic safety with regard to anticholinergic side effects. Local skin irritation occurs in some OXY-TDS patients.
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Abstract
The management of pain is complex having to take into consideration patient specific characteristics. Drug therapy should be individualized and managed based on numerous factors. The opioid of first choice for the treatment of cancer pain is morphine, according to the European Association for Palliative Care (2000). Transdermally administered fentanyl is one alternative to oral morphine in the treatment of cancer pain. The transdermal systems are designed to deliver fentanyl at a constant rate for periods of 72 hours. Patches with a delivery rate of 25, 50, 75 and 100 ?g/h are available. Treatment with transdermal fentanyl is safe and acceptable to many cancer patients. Significantly more patients expressed a preference for transdermal fentanyl than for sustained release oral morphine. The global score of adverse effects was significantly lower in patients receiving transdermal fentanyl than in those receiving sustained release oral morphine. The transdermal fentanyl patch is as effective as oral opioids in relieving cancer related pain, with a safety and side effect profile equal to or better than that of oral opioids.
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