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Gupta AK, Eliasen AM, Andahazy W, Zhou F, Henson K, Chi V, Woods AK, Joseph SB, Kuhen KL, Wisler J, Ramachandruni H, Duffy J, Burrows JN, Vadas E, Slade A, Schultz PG, McNamara CW, Chatterjee AK. A Prodrug Strategy to Reposition Atovaquone as a Long-Acting Injectable for Malaria Chemoprotection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.08.579395. [PMID: 38979188 PMCID: PMC11230151 DOI: 10.1101/2024.02.08.579395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Recent malaria drug discovery approaches have been extensively focused on the development of oral, smallmolecule inhibitors for disease treatment whereas parenteral routes of administration have been avoided due to limitations in deploying a shelf-stable injectable even though it could be dosed less frequently. However, an updated target candidate profile from Medicines for Malaria Venture (MMV) and stakeholders have advocated for long-acting injectable chemopreventive agents as an important interventive tool to improve malaria prevention. Here, we present strategies for the development of a long-acting, intramuscular, injectable atovaquone prophylactic therapy. We have generated three prodrug approaches that are contrasted by their differential physiochemical properties and pharmacokinetic profiles: mCBK068, a docosahexaenoic acid ester of atovaquone formulated in sesame oil, mCKX352, a heptanoic acid ester of atovaquone formulated as a solution in sesame oil, and mCBE161, an acetic acid ester of atovaquone formulated as an aqueous suspension. As a result, from a single 20 mg/kg intramuscular injection, mCKX352 and mCBE161 maintain blood plasma exposure of atovaquone above the minimal efficacious concentration for >70 days and >30 days, respectively, in cynomolgus monkeys. The differences in plasma exposure are reflective of the prodrug strategy, which imparts altered chemical properties that ultimately influence aqueous solubility and depot release kinetics. On the strength of the pharmacokinetic and safety profiles, mCBE161 is being advanced as a first-in-class clinical candidate for first-in-human trials.
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Goudarzi F, Jajarmi V, Shojaee S, Mohebali M, Keshavarz H. Formulation and evaluation of atovaquone-loaded macrophage-derived exosomes against Toxoplasma gondii: in vitro and in vivo assessment. Microbiol Spectr 2024; 12:e0308023. [PMID: 38014940 PMCID: PMC10782982 DOI: 10.1128/spectrum.03080-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/03/2023] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE This study is the first of its kind that suggests exosomes as a nano-carrier loaded with atovaquone (ATQ), which could be considered as a new strategy for improving the effectiveness of ATQ against acute and chronic phases of Toxoplasma gondii.
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Affiliation(s)
- Fatemeh Goudarzi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Jajarmi
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeedeh Shojaee
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
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3
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Rocha B, de Morais LA, Viana MC, Carneiro G. Promising strategies for improving oral bioavailability of poor water-soluble drugs. Expert Opin Drug Discov 2023; 18:615-627. [PMID: 37157841 DOI: 10.1080/17460441.2023.2211801] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Oral administration of poorly water-soluble drugs (PWSDs) is generally related to low bioavailability, leading to high drug doses, multiple side effects, and low patient compliance. Thus, different strategies have been developed to increase drug solubility and dissolution in the gastrointestinal tract, opening new venues for these drugs. AREAS COVERED This review outlines the current challenges in PWSD formulation development and the strategies to overcome the oral barriers and increase their solubility and bioavailability. Conventional strategies include altering crystalline and molecular structures and modifying oral solid dosage forms. In contrast, novel strategies comprise micro- and nanostructured systems. Recent representative studies involving how these strategies have improved the oral bioavailability of PWSDs were also reviewed and reported. EXPERT OPINION New approaches to enhance PWSD bioavailability have sought to improve water solubility and dissolution rates, drug protection by overcoming biological barriers, and increased absorption. Still, only a handful of studies have focused on quantifying the increase in bioavailability. Improving the oral bioavailability of PWSDs remains an exciting unexplored field of research and has become an important issue for successfully developing pharmaceutical products.
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Affiliation(s)
- Bruna Rocha
- Department of Pharmacy, Faculty of Biological and Health Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Letícia Aparecida de Morais
- Department of Pharmacy, Faculty of Biological and Health Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Mateus Costa Viana
- Department of Pharmacy, Faculty of Biological and Health Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Guilherme Carneiro
- Department of Pharmacy, Faculty of Biological and Health Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
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Elmehankar MS, Elhenawy AA, Aboukamar WA, Elzoheiry MA, Nabih N. Histopathological and ultrastructural assessment of atovaquone-proguanil hydrochloride combination in chronic murine toxoplasmosis. Ultrastruct Pathol 2021; 45:376-383. [PMID: 34595988 DOI: 10.1080/01913123.2021.1984349] [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: 10/20/2022]
Abstract
Over one billion people worldwide are expected to have Toxoplasma gondii infection with anonymous health problems. Available therapies are ineffective for persistent chronic toxoplasmosis. So, there is an imperative need for effective therapies to eliminate chronic tissue stage. In this study, we aimed to assess the effect of a drug combination of atovaquone and proguanil hydrochloride in the treatment of experimental chronic toxoplasmosis. Fifty Swiss Webster mice were used in the study. Forty mice were infected with Me49 type II cystogenic Toxoplasma gondii strain and allocated into four groups: infected untreated (vehicle-administered), infected and treated with cotrimoxazole (CTX) 370 mg/kg/day, infected and treated with atovaquone (ATV) 100 mg/kg/day, and infected and treated with atovaquone/proguanil (ATV/PROG) 50 mg/kg/day. An additional group of uninfected mice was used as an uninfected control group. Drug treatment was initiated 8 weeks post-infection and continued for two weeks. All mice were sacrificed 12 weeks post-infection. Parasitological and histopathological parameters were assessed. Toxoplasma gondii cysts recovered from brain tissue homogenates of both infected untreated and ATV/PROG-treated groups were examined by scanning electron microscopy. Combined ATV/PROG treatment demonstrated a significant reduction of Toxoplasma gondii cyst count in brain tissue (a reduction rate of 84.87%) compared to untreated group (P < .001). Brain tissues obtained from ATV/PROG treated group showed reduction of inflammatory infiltrate and marked attenuation and deformation of recovered Toxoplasma gondii cysts. We conclude that ATV/PROG drug combination could offer a potential drug therapy for Toxoplasma gondii chronic cystic stage.
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Affiliation(s)
- Manar S Elmehankar
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abeer A Elhenawy
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Wafaa A Aboukamar
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Manal A Elzoheiry
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nairmen Nabih
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Babadi D, Dadashzadeh S, Osouli M, Abbasian Z, Daryabari MS, Sadrai S, Haeri A. Biopharmaceutical and pharmacokinetic aspects of nanocarrier-mediated oral delivery of poorly soluble drugs. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Wang Y, Wang S, Xu Y, Wang P, Li S, Liu L, Liu M, Jin X. Etoposide Amorphous Nanopowder for Improved Oral Bioavailability: Formulation Development, Optimization, in vitro and in vivo Evaluation. Int J Nanomedicine 2020; 15:7601-7613. [PMID: 33116490 PMCID: PMC7549503 DOI: 10.2147/ijn.s265817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/03/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Etoposide refers to a derivative of podophyllotoxin, which plays an important role in the treatment of cancer due to its prominent anti-tumor effect. As a BCS IV drug, etoposide exhibits insufficient aqueous solubility and permeability, thereby limiting its oral absorption. To enhance the oral bioavailability of etoposide, this study developed an amorphous nanopowder. Methods Based on preliminary screening and experimental design, the stabilizer and preparation process of etoposide nanosuspension were explored. Subsequently, using a Box–Behnken design, the effects of independent factors (ultrasonication time, ratio of two phases and stabilizer concentration) on response variables (particle size and polydispersity index) were studied, and then the formulation was optimized. Finally, nanosuspension was further freeze dried with 1% of mannitol resulting in the formation of etoposide amorphous nanopowder. Results The optimized etoposide nanopowder showed as spherical particles with an average particle size and polydispersity index of 211.7 ± 10.4 nm and 0.125 ± 0.028. X-ray powder diffraction and differential scanning calorimetry confirmed the ETO in the nanopowder was amorphous. Compared with coarse powder and physical mixture, etoposide nanopowder achieved significantly enhanced saturated solubility and dissolution in various pH environments. The Cmax and AUC0–t of etoposide nanopowder after oral administration in rats were respectively 2.21 and 2.13 times higher than the crude etoposide suspension. Additionally, the Tmax value of nanopowder was 0.25 h, compared with 0.5 h of reference group. Discussion In the present study, the optimized amorphous nanopowder could significantly facilitate the dissolution and oral absorption of etoposide and might act as an effective delivery method to enhance its oral bioavailability.
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Affiliation(s)
- Yue Wang
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Shuhang Wang
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Yingju Xu
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Ping Wang
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Sukai Li
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Lu Liu
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Mengyan Liu
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
| | - Xiangqun Jin
- School of Pharmacy, Jilin University, Changchun, People's Republic of China
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Kakade P, Gite S, Patravale V. Development of Atovaquone Nanosuspension: Quality by Design Approach. Curr Drug Deliv 2020; 17:112-125. [DOI: 10.2174/1567201817666191227095019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/15/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022]
Abstract
Objective:
The present study reports the use of MicrofluidizerTM technology to form a stable
nanosuspension of atovaquone (ATQ) using quality by design (QbD) approach.
Methods:
The patient-centric quality target product profile and critical quality attributes (CQAs) were
identified. A Box-Behnken design was employed for the optimization of dependent variables, while
CQAs like particle size and PDI were evaluated as response variables. Effective optimization of ATQ
nanosuspension preparation using Microfluidizer processor as a novel green technology was achieved
using QbD approach.
Result:
The prepared nanosuspension had a mean particle size of 865 nm ± 5%, PDI of 0.261 ± 3%, and
zeta potential of -1.79 ± 5 mV. The characterization of the prepared nanosuspension by SEM, DSC, and
XRD revealed its nano-crystalline nature whereas FTIR spectroscopic analysis confirmed the absence
of any physicochemical interaction because of process parameters between the drug and excipients.
Conclusion:
In vitro dissolution studies of the nanosuspension using USP-IV exhibited a 100% cumulative
drug release over 90 minutes, which is significantly better than that of ATQ pure API. In vivo
pharmacokinetic studies revealed bioequivalence of ATQ nanosuspensions by Microfluidizer homogenization
process to the marketed formulation1.
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Affiliation(s)
- Pratik Kakade
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N.P. Marg, Matunga, Mumbai 400019, India
| | - Sandip Gite
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N.P. Marg, Matunga, Mumbai 400019, India
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N.P. Marg, Matunga, Mumbai 400019, India
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Kathpalia H, Juvekar S, Mohanraj K, Apsingekar M, Shidhaye S. Investigation of pre-clinical pharmacokinetic parameters of atovaquone nanosuspension prepared using a pH-based precipitation method and its pharmacodynamic properties in a novel artemisinin combination. J Glob Antimicrob Resist 2020; 22:248-256. [PMID: 32119990 DOI: 10.1016/j.jgar.2020.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Recently, a growing resistance to antimalarial drugs such as chloroquine, sulfadoxine-pyrimethamine, artemisinin derivatives and mefloquine has been observed. The pharmacokinetic limitation of the current therapy and multi-drug resistance has resulted in an urgent need to study the new antimalarial combinations with existing drugs. This study investigated the activity of a novel triple combination of atovaquone (nanosized)-proguanil-artesunate as an alternative artemisinin combination therapy. Atovaquone in this combination was formulated as a freeze-dried nanosuspension and its pharmacokinetic parameters were also evaluated. METHODS The suppressive and curative effect of atovaquone nanosuspension, proguanil, and artesunate were studied in a murine model. The in vivo pharmacokinetics of the newly developed atovaquone nanosuspension with particle size less than 200 nm was investigated. RESULTS Prophylactic efficacy of atovaquone nanosuspension alone at 1/80th the therapeutic dose was proven. In the curative test, atovaquone nanosuspension and proguanil at 1/10th the therapeutic dose was the minimum effective dose that resulted in complete cure of parasitaemia. As a triple combination, atovaquone nanosuspension in combination with proguanil at 1/80th the therapeutic dose of each and 1/5th the therapeutic dose of artesunate resulted in a complete cure. The in vivo pharmacokinetics of the nanosuspension showed a significant (three times) reduction in Tmax value and the area under the curve of the nanosuspension was 1.9 times greater as compared with the plain suspension. CONCLUSIONS The potential of the synergistic combination of atovaquone nanosuspension-proguanil-artesunate in curing the multi-drug resistant malarial infection at reduced doses of all three drugs could be a solution to pill burden observed with the current therapy.
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Affiliation(s)
- Harsha Kathpalia
- Department of Pharmaceutics, Vivekanand Education Society's College of Pharmacy, Affiliated to University of Mumbai, Mumbai, India
| | - Siddhesh Juvekar
- Department of Pharmaceutics, Vivekanand Education Society's College of Pharmacy, Affiliated to University of Mumbai, Mumbai, India
| | - Krishnapriya Mohanraj
- Department of Pharmaceutical Analysis, Bombay College of Pharmacy (Autonomous), Affiliated to University of Mumbai, Mumbai, India
| | - Mrunal Apsingekar
- Department of Pharmaceutical Analysis, Bombay College of Pharmacy (Autonomous), Affiliated to University of Mumbai, Mumbai, India
| | - Supriya Shidhaye
- Department of Pharmaceutics, Vivekanand Education Society's College of Pharmacy, Affiliated to University of Mumbai, Mumbai, India.
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Sustainable Dissolution Performance of a Carrier Tailored Electrospun. Pharm Res 2020; 37:28. [DOI: 10.1007/s11095-019-2734-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/12/2019] [Indexed: 01/15/2023]
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10
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Atovaquone oral bioavailability enhancement using electrospraying technology. Eur J Pharm Sci 2018; 111:195-204. [PMID: 28974387 DOI: 10.1016/j.ejps.2017.09.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/21/2017] [Accepted: 09/29/2017] [Indexed: 11/22/2022]
Abstract
Atovaquone in combination with proguanil hydrochloride, marketed as Malarone® tablets by GlaxoSmithKline (GSK), is prescribed for the treatment of malaria. High dose and poor bioavailability are the main hurdles associated with atovaquone oral therapy. The present study reports development of atovaquone nanoparticles, using in house designed and fabricated electrospraying equipment, and the assessment of bioavailability and therapeutic efficacy of the nanoparticles after oral administration. Solid nanoparticles of atovaquone were successfully produced by electrospraying and were characterized for particle size and flow properties. Differential Scanning Calorimetry, X-ray Diffraction, Fourier Transform Infrared Spectroscopy studies were also carried out. Atovaquone nanoparticles along with proguanil hydrochloride and a suitable wetting agent were filled in size 2 hard gelatin capsules. The formulation was compared with Malarone® tablets (GSK) and Mepron® suspension (GSK) in terms of in vitro release profile and in vivo pharmacokinetic studies. It showed 2.9-fold and 1.8-fold improved bioavailability in rats compared to Malarone® tablets and Mepron® suspension respectively. Therapeutic efficacy of the formulation was determined using modified Peter's 4-day suppressive tests and clinical simulation studies using Plasmodium berghei ANKA infected Swiss mice and compared to Malarone®. The developed formulation showed a 128-fold dose reduction in the modified Peter's 4-day suppressive tests and 32-fold dose reduction in clinical simulation studies. Given that only one capsule a day of developed formulation is required to be administered orally compared to 4 Malarone® tablets once a day and that too at a significantly reduced dose, this nanoparticle formulation will definitely reduce the side-effects of the treatment and is also likely to increase patient compliance.
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Prabhu P, Suryavanshi S, Pathak S, Patra A, Sharma S, Patravale V. Nanostructured lipid carriers of artemether-lumefantrine combination for intravenous therapy of cerebral malaria. Int J Pharm 2016; 513:504-517. [PMID: 27596113 DOI: 10.1016/j.ijpharm.2016.09.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/28/2016] [Accepted: 09/02/2016] [Indexed: 12/14/2022]
Abstract
Patients with cerebral malaria (CM) are unable to take oral medication due to impaired consciousness and vomiting thus necessitating parenteral therapy. Quinine, artemether, and artesunate which are currently used for parenteral malaria therapy have their own drawbacks. The World Health Organization (WHO) has now banned monotherapy and recommends artemisinin-based combination therapy for malaria treatment. However, presently there is no intravenous formulation available for combination therapy of malaria. Artemether-Lumefantrine (ARM-LFN) is a WHO approved combination for oral malaria therapy. However, the low aqueous solubility of ARM and LFN hinders their intravenous delivery. The objective of this study was to formulate ARM-LFN nanostructured lipid carriers (NLC) for intravenous therapy of CM. ARM-LFN NLC were prepared by microemulsion template technique and characterized for size, drug content, entrapment efficiency, drug release, crystallinity, morphology, amenability to autoclaving, compatibility with infusion fluids, stability, antimalarial efficacy in mice, and toxicity in rats. The ARM-LFN NLC showed sustained drug release, amenability to autoclaving, compatibility with infusion fluids, good stability, complete parasite clearance and reversal of CM symptoms with 100% survival in Plasmodium berghei-infected mice, and safety in rats. The biocompatible ARM-LFN NLC fabricated by an industrially feasible technique offer a promising solution for intravenous therapy of CM.
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Affiliation(s)
- Priyanka Prabhu
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N.P. Marg, Matunga, Mumbai 400019, Maharashtra, India
| | - Shital Suryavanshi
- Department of Biological Sciences, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, Maharashtra, India
| | - Sulabha Pathak
- Department of Biological Sciences, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, Maharashtra, India
| | - Aditya Patra
- Department of Biological Sciences, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, Maharashtra, India
| | - Shobhona Sharma
- Department of Biological Sciences, Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, Maharashtra, India
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N.P. Marg, Matunga, Mumbai 400019, Maharashtra, India.
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Artemetherlumefantrine nanostructured lipid carriers for oral malaria therapy: Enhanced efficacy at reduced dose and dosing frequency. Int J Pharm 2016; 511:473-487. [DOI: 10.1016/j.ijpharm.2016.07.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 11/20/2022]
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13
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Calderón MM, Penzak SR, Pau AK, Kumar P, McManus M, Alfaro RM, Kovacs JA. Efavirenz but Not Atazanavir/Ritonavir Significantly Reduces Atovaquone Concentrations in HIV-Infected Subjects. Clin Infect Dis 2016; 62:1036-1042. [PMID: 26797214 PMCID: PMC4803107 DOI: 10.1093/cid/ciw028] [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: 11/16/2015] [Accepted: 01/13/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The current study was conducted to determine if efavirenz (EFV) or atazanavir/ritonavir (ATV/r)-based combination antiretroviral therapy (cART) impacted steady-state atovaquone plasma concentrations in human immunodeficiency virus (HIV)-infected patients receiving treatment doses of atovaquone. METHODS Thirty HIV-infected volunteers were recruited, 10 taking no cART and 10 each taking cART that included EFV or ATV/r. Subjects were randomly assigned to atovaquone 750 mg twice daily (BID) for 14 days followed by atovaquone 1500 mg BID for 14 days, or vice-versa, with a washout period in between. On day 14 of each phase, blood was sampled for pharmacokinetic studies, and the area under the concentration-time curve (AUCτ) and average concentration (C avg) were calculated and compared using an unpaired t test. RESULTS Twenty-nine subjects completed both dosing cohorts. Subjects receiving EFV-based cART had 47% and 44% lower atovaquone AUCτ than subjects not receiving cART at atovaquone doses of 750 mg BID and 1500 mg BID, respectively (P≤ .01). Only 5 of 10 subjects receiving EFV-based cART plus atovaquone 750 mg BID had an atovaquone C avg>15 µg/mL, which has previously been associated with successful treatment of Pneumocystis jirovecipneumonia. AUCτ and Cavg did not significantly differ for concurrent ATV/r for 750 mg BID or 1500 mg BID when compared to the group not receiving cART. Nine of 10 subjects not receiving cART, 8 of 10 subjects receiving ATV/r, and 2 of 10 subjects receiving EFV in combination with atovaquone 750 mg BID achieved an atovaquone C avg>18.5 µg/mL, a concentration that has previously been associated with successful treatment of Toxoplasmaencephalitis (TE). CONCLUSIONS These data suggest that the currently recommended dose of atovaquone 750 mg BID for treatment of mild to moderate PCP may not be adequate in patients receiving concurrent EFV. Furthermore, doses lower than the currently recommended dose of 1500 mg BID may achieve plasma concentrations adequate to treat TE in HIV-infected patients not receiving EFV. CLINICAL TRIALS REGISTRATION NCT01479361.
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Affiliation(s)
- Mónica M Calderón
- Pharmacy Department, National Institutes of Health (NIH) Clinical Center, Bethesda
- Leidos Biomedical Research, Inc, National Cancer Institute at Frederick
| | - Scott R Penzak
- Pharmacy Department, National Institutes of Health (NIH) Clinical Center, Bethesda
| | - Alice K Pau
- National Institute of Allergy and Infectious Diseases, NIH
| | - Parag Kumar
- Pharmacy Department, National Institutes of Health (NIH) Clinical Center, Bethesda
| | - Maryellen McManus
- Leidos Biomedical Research, Inc, National Cancer Institute at Frederick
| | - Raul M Alfaro
- Pharmacy Department, National Institutes of Health (NIH) Clinical Center, Bethesda
| | - Joseph A Kovacs
- Critical Care Medicine Department, NIH Clinical Center, Bethesda, Maryland
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14
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Mechanistic investigation of biopharmaceutic and pharmacokinetic characteristics of surface engineering of satranidazole nanocrystals. Eur J Pharm Biopharm 2016; 100:109-18. [DOI: 10.1016/j.ejpb.2015.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 12/14/2022]
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15
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Beg S, Raza K, Kumar R, Chadha R, Katare OP, Singh B. Improved intestinal lymphatic drug targeting via phospholipid complex-loaded nanolipospheres of rosuvastatin calcium. RSC Adv 2016. [DOI: 10.1039/c5ra24278a] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The present work describes the systematic development and characterization of nanolipospheres (NLPs) loaded with phospholipid complex of rosuvastatin for enhanced oral drug absorption trough lymphatic pathways.
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Affiliation(s)
- Sarwar Beg
- University Institute of Pharmaceutical Sciences
- UGC-Centre of Advance Studies
- Panjab University
- Chandigarh
- India 160 014
| | - Kaisar Raza
- Department of Pharmacy
- School of Chemical Sciences and Pharmacy
- Central University of Rajasthan
- Ajmer
- India 305 817
| | - Rajendra Kumar
- UGC-Centre of Excellence in Applications of Nanomaterials
- Nanoparticles and Nanocomposites (Biomedical Sciences)
- Panjab University
- Chandigarh
- India 160 014
| | - Renu Chadha
- University Institute of Pharmaceutical Sciences
- UGC-Centre of Advance Studies
- Panjab University
- Chandigarh
- India 160 014
| | - O. P. Katare
- University Institute of Pharmaceutical Sciences
- UGC-Centre of Advance Studies
- Panjab University
- Chandigarh
- India 160 014
| | - Bhupinder Singh
- University Institute of Pharmaceutical Sciences
- UGC-Centre of Advance Studies
- Panjab University
- Chandigarh
- India 160 014
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Melariri P, Kalombo L, Nkuna P, Dube A, Hayeshi R, Ogutu B, Gibhard L, deKock C, Smith P, Wiesner L, Swai H. Oral lipid-based nanoformulation of tafenoquine enhanced bioavailability and blood stage antimalarial efficacy and led to a reduction in human red blood cell loss in mice. Int J Nanomedicine 2015; 10:1493-503. [PMID: 25759576 PMCID: PMC4346002 DOI: 10.2147/ijn.s76317] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Tafenoquine (TQ), a new synthetic analog of primaquine, has relatively poor bioavailability and associated toxicity in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. A microemulsion formulation of TQ (MTQ) with sizes <20 nm improved the solubility of TQ and enhanced the oral bioavailability from 55% to 99% in healthy mice (area under the curve 0 to infinity: 11,368±1,232 and 23,842±872 min·μmol/L) for reference TQ and MTQ, respectively. Average parasitemia in Plasmodium berghei-infected mice was four- to tenfold lower in the MTQ-treated group. In vitro antiplasmodial activities against chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum indicated no change in half maximal inhibitory concentration, suggesting that the microemulsion did not affect the inherent activity of TQ. In a humanized mouse model of G6PD deficiency, we observed reduction in toxicity of TQ as delivered by MTQ at low but efficacious concentrations of TQ. We hereby report an enhancement in the solubility, bioavailibility, and efficacy of TQ against blood stages of Plasmodium parasites without a corresponding increase in toxicity.
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Affiliation(s)
- Paula Melariri
- Polymers and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Port Elizabeth, South Africa
| | - Lonji Kalombo
- Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Patric Nkuna
- Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Admire Dube
- Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa ; School of Pharmacy, University of the Western Cape, Bellville, South Africa
| | - Rose Hayeshi
- Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Benhards Ogutu
- Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya ; Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Liezl Gibhard
- Division of Pharmacology, University of Cape Town Medical School, Groote Schuur Hospital, Cape Town, South Africa
| | - Carmen deKock
- Division of Pharmacology, University of Cape Town Medical School, Groote Schuur Hospital, Cape Town, South Africa
| | - Peter Smith
- Division of Pharmacology, University of Cape Town Medical School, Groote Schuur Hospital, Cape Town, South Africa
| | - Lubbe Wiesner
- Division of Pharmacology, University of Cape Town Medical School, Groote Schuur Hospital, Cape Town, South Africa
| | - Hulda Swai
- Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa
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Pawar VK, Singh Y, Meher JG, Gupta S, Chourasia MK. Engineered nanocrystal technology: in-vivo fate, targeting and applications in drug delivery. J Control Release 2014; 183:51-66. [PMID: 24667572 DOI: 10.1016/j.jconrel.2014.03.030] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/17/2014] [Indexed: 12/17/2022]
Abstract
Formulation of nanocrystals is a robust approach which can improve delivery of poorly water soluble drugs, a challenge pharmaceutical industry has been facing since long. Large scale production of nanocrystals is done by techniques like precipitation, media milling and, high pressure homogenization. Application of appropriate stabilizers along with drying accords long term stability and commercial viability to nanocrystals. These can be administered through oral, parenteral, pulmonary, dermal and ocular routes showing their high therapeutic applicability. They serve to target drug molecules in specific regions through size manipulation and surface modification. This review dwells upon the in-vivo fate and varying applications in addition to the facets of drug nanocrystals stated above.
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Affiliation(s)
- Vivek K Pawar
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, India
| | - Yuvraj Singh
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, India
| | - Jaya Gopal Meher
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, India
| | - Siddharth Gupta
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, India
| | - Manish K Chourasia
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP, India.
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