1
|
Md S, Kotta S. Advanced drug delivery technologies for postmenopausal effects. J Control Release 2024; 373:426-446. [PMID: 39038543 DOI: 10.1016/j.jconrel.2024.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
Postmenopause is the 12-month absence of menstrual periods, characterized by decreased estrogen and progesterone levels, leading to physical and psychological alterations such as hot flashes, mood swings, sleep disruptions, and skin changes. Present postmenopausal treatments include hormone replacement therapy, non-hormonal drugs, lifestyle modifications, vaginal estrogen therapy, bone health treatments, and alternative therapies. Advanced drug delivery systems (ADDSs) are essential in managing postmenopausal effects (PMEs), offering targeted and controlled delivery to alleviate symptoms and improve overall health. This review emphasizes such ADDSs for addressing PMEs. Emerging trends such as artificial ovaries are also reviewed. Additionally, the prospects of technologies such as additive manufacturing (3D and 4D printing) and artificial intelligence in further tailoring therapeutic strategies against PMEs are provided.
Collapse
Affiliation(s)
- Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sabna Kotta
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
| |
Collapse
|
2
|
Thapa R, Pandey P, Parat MO, Gurung S, Parekh HS. Phase transforming in situ gels for sustained and controlled transmucosal drug delivery via the intravaginal route. Int J Pharm 2024; 655:124054. [PMID: 38548071 DOI: 10.1016/j.ijpharm.2024.124054] [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: 02/14/2024] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Abstract
Direct, reliable, controlled, and sustained drug delivery to female reproductive tract (FRT) remains elusive, with conventional dosage forms falling way short of the mark, leading to premature leakage, erratic drug delivery, and loss of compliance. Historically, the intravaginal route remains underserved by the pharmaceutical sector. To comprehensively address this, we turned our focus to phase-transforming sol-gels, using poloxamers, a thermosensitive polymer and, doxycycline (as hyclate salt, DOXH) as our model agent given its potential use in sexually transmitted infections (STIs). We further enhanced mucoadhesiveness through screening of differing viscosity grade hydroxypropyl methyl celluloses (HPMCs). The optimised sol-gels remained gelled at body temperature (<37 °C) and were prepared in buffer aligned to vaginal cavity pH and osmolality. Lead formulations were progressed based on their ability to retain key rheological properties, and acidic pH in the presence of simulated vaginal fluid (SVF). From a shelf-life perspective, DOXH stability, gelation temperature (Tsol-gel), and pH to three months (2-8 °C) was attained. In summary, the meticulously engineered, phase-transforming sol-gels provided sustained mucoretention despite dilution by vaginal fluid, paving the way for localised antimicrobial drug delivery at concentrations that potentially far exceed the minimum inhibitory concentration (MIC) for target STI-causing bacteria of the FRT.
Collapse
Affiliation(s)
- Ritu Thapa
- School of Pharamcy, The University of Queensland, 20 Cornwall St, Woollongabba, QLD 4102, Australia
| | - Preeti Pandey
- School of Pharamcy, The University of Queensland, 20 Cornwall St, Woollongabba, QLD 4102, Australia.
| | - Marie-Odile Parat
- School of Pharamcy, The University of Queensland, 20 Cornwall St, Woollongabba, QLD 4102, Australia
| | - Shila Gurung
- School of Health and Allied Sciences, Pokhara University, Pokhara-30, Kaski 33700, Nepal
| | - Harendra S Parekh
- School of Pharamcy, The University of Queensland, 20 Cornwall St, Woollongabba, QLD 4102, Australia.
| |
Collapse
|
3
|
Garg A, Agrawal R, Singh Chauhan C, Deshmukh R. In-situ gel: A smart carrier for drug delivery. Int J Pharm 2024; 652:123819. [PMID: 38242256 DOI: 10.1016/j.ijpharm.2024.123819] [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: 11/03/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
In-situ gel technology is a promising drug delivery strategy that undergoes a 'sol to gel' transition upon administration, providing controlled and prolonged drug release. These gels are composed of cross-linked 3D networks of polymers, with hydrogels being a specific type of absorbing water while retaining their shape. Gelation can be triggered by various stimuli, such as temperature, pH, ions, and light. They offer several advantages like improved patient compliance, extended drug residence time, localized drug delivery, etc, but also have some disadvantages like drug degradation and limited mechanical strength. In-situ gel falls into three categories: temperature-sensitive, ion-sensitive, and pH-sensitive, but multi-responsive gels that respond to multiple stimuli have better drug release characteristics. The mechanism of in-situ gel formation involves physical and chemical mechanisms. There are various applications of in-situ gel, like ocular drug delivery, nose-to-brain delivery, etc. In this review, we have discussed the types, and mechanisms of in-situ gel & use of in-situ gel in the treatment of different diseases through various routes like buccal, vaginal, ocular, nasal, etc., along with its use in targeted drug delivery.
Collapse
Affiliation(s)
- Akash Garg
- Bhupal Noble's University, New Shiv Nagar, Central Area, Udaipur, Rajasthan 313001, India.
| | - Rutvi Agrawal
- Bhupal Noble's University, New Shiv Nagar, Central Area, Udaipur, Rajasthan 313001, India
| | - Chetan Singh Chauhan
- Bhupal Noble's University, New Shiv Nagar, Central Area, Udaipur, Rajasthan 313001, India
| | - Rohitas Deshmukh
- Institute of Pharmaceutical Research, GLA University, Mathura, India
| |
Collapse
|
4
|
Abdelgader A, Govender M, Kumar P, Choonara YE. Intravaginal Drug Delivery Systems to Treat the Genitourinary Syndrome of Menopause: Towards the Design of Safe and Efficacious Estrogen-loaded Prototypes. J Pharm Sci 2023; 112:1566-1585. [PMID: 36868359 DOI: 10.1016/j.xphs.2023.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
Estrogens locally delivered to the vagina by tablets, capsules, rings, pessaries, and creams are the most common and highly recommended platforms to treat the genitourinary syndrome of menopause (GSM). Estradiol, an essential estrogen, is routinely administered alone, or in combination with progestins, to effectively alleviate the symptoms associated with moderate to severe menopause when non-pharmacological interventions are not indicated. Since the risk and side effects of estradiol use depends on the administered amount and duration of use, the lowest effective dose of estradiol is recommended when long-term treatment is required. Although there is a wealth of data and literature comparing vaginally administered estrogen-containing products, there is a lack of information revealing the effect of the delivery system used and formulation constituent's attributes on the efficacy, safety, and patient acceptability of these dosage forms. This review therefore aims to classify and compare various designs of commercially available and non-commercial vaginal 17β-estradiol formulations and analyze their performance in terms of systemic absorption, efficacy, safety, and patient satisfaction and acceptance. The vaginal estrogenic platforms included in this review are the currently marketed and investigational 17β-estradiol tablets, softgel capsules, creams, and rings for the treatment of GSM, based on their different design specifications, estradiol loads, and materials used in their preparation. Additionally, the mechanisms of the effects of estradiol on GSM have been discussed, as well as their potential impact on treatment efficacy and patient compliance.
Collapse
Affiliation(s)
- Ahmed Abdelgader
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Mershen Govender
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Pradeep Kumar
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Yahya E Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa.
| |
Collapse
|
5
|
Patel R, Yadav BK, Patel G. Progresses in Nano-Enabled Platforms for the Treatment of Vaginal Disorders. RECENT PATENTS ON NANOTECHNOLOGY 2023; 17:208-227. [PMID: 35762539 DOI: 10.2174/1872210516666220628150447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The most common vaginal disorders are within the uterus. According to the latest statistics, vaginal disorders occur in 50% to 60% of females. Although curative treatments rely on surgical therapy, still first-line treatment is a non invasive drug. Conventional therapies are available in the oral and parenteral route, leading to nonspecific targeting, which can cause dose-related side effects. Vaginal disorders are localized uterine disorders in which intrauterine delivery via the vaginal site is deemed the preferable route to mitigate clinical drug delivery limitations. OBJECTIVE This study emphasizes the progress of site-specific and controlled delivery of therapeutics in the treatment of vaginal disorders and systemic adverse effects as well as the therapeutic efficacy. METHODS Related research reports and patents associated with topics are collected, utilized, and summarized the key findings. RESULTS The comprehensive literature study and patents like (US 9393216 B2), (JP6672370B2), and (WO2018041268A1) indicated that nanocarriers are effective above traditional treatments and have some significant efficacy with novelty. CONCLUSION Nowadays, site-specific and controlled delivery of therapeutics for the treatment of vaginal disorders is essential to prevent systemic adverse effects and therapeutic efficacy would be more effective. Nanocarriers have therefore been used to bypass the problems associated with traditional delivery systems for the vaginal disorder.
Collapse
Affiliation(s)
- Riya Patel
- Department of Pharmaceutics, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat 388421, India
| | - Bindu Kumari Yadav
- Department of Pharmaceutics, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat 388421, India
| | - Gayatri Patel
- Department of Pharmaceutics, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat 388421, India
| |
Collapse
|
6
|
Development and Evaluation of a Thermosensitive In Situ Gel Formulation for Intravaginal Delivery of Lactobacillus gasseri. Pharmaceutics 2022; 14:pharmaceutics14091934. [PMID: 36145685 PMCID: PMC9501376 DOI: 10.3390/pharmaceutics14091934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/20/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
In situ administration of vaginal probiotics has been proposed as an effective prevention strategy against gynecological diseases caused by microecological disorders. In this study, a thermosensitive in situ gel formulation was prepared for intravaginal delivery of Lactobacillus gasseri(L. gasseri). The optimized formulation was characterized for the rheological properties, in vitro release properties, and microencapsulation efficiency. The mixtures of poloxamer 407 (26.0% w/w) and 188 (9.0% w/w) produced an increase in gelation extent at 37 °C after dilution in simulated vaginal fluid (SVF). The presence of a low concentration of hyaluronic acid (HA, 0.3% w/w) improved the mucoadhesive properties and the capability to gel at 37 °C. Additionally, the viability of L. gasseri encapsulated with alginate or via co-extrusion technique with fructooligosaccharide (FOS, 0.5% w/w) was maintained at 11 log CFU/mL for eight weeks at 4 °C. In conclusion, the evaluation of the in situ thermosensitive gel formulation was shown to be efficacious for intravaginal delivery of L. gasseri with suitable textural and rheological properties.
Collapse
|