1
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Monteil M, M Sanchez-Ballester N, Devoisselle JM, Begu S, Soulairol I. Regulations on excipients used in 3D printing of pediatric oral forms. Int J Pharm 2024; 662:124402. [PMID: 38960343 DOI: 10.1016/j.ijpharm.2024.124402] [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: 05/27/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
A promising solution to customize oral drug formulations for the pediatric population has been found in the use of 3D printing, in particular Fused Deposition Modeling (FDM) and Semi-Solid Extrusion (SSE). Although formulation development is currently limited to research studies, the rapid advances in 3D printing warn of the need for regulation. Indeed, even if the developed formulations include pharmaceutical excipients used to produce traditional oral forms such as tablets, the quantities of excipients used must be adapted to the process. Therefore, the aim of this literature review is to provide a synthesis of the available safety data on excipients mainly used in extrusion-based 3D printing for the pediatric population. A total of 39 relevant articles were identified through two scientific databases (PubMed and Science Direct). Then, groups of the main excipients were listed including their general information (name, chemical structure and pharmaceutical use) and a synthesis of the available safety data extracted from several databases. Finally, the role of the excipients in 3D printing, the amount used in formulations and the oral dose administered per form are presented.
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Affiliation(s)
- M Monteil
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France
| | - N M Sanchez-Ballester
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France; Department of Pharmacy, Nîmes University Hospital, Nîmes, France
| | | | - S Begu
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
| | - I Soulairol
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France; Department of Pharmacy, Nîmes University Hospital, Nîmes, France.
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2
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Hauber B, Hand MV, Hancock BC, Zarrella J, Harding L, Ogden-Barker M, Antipas AS, Watt SJ. Patient Acceptability and Preferences for Solid Oral Dosage Form Drug Product Attributes: A Scoping Review. Patient Prefer Adherence 2024; 18:1281-1297. [PMID: 38919378 PMCID: PMC11197953 DOI: 10.2147/ppa.s443213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Background There is no consistent framework for patient-centric drug product design, despite the common understanding that drug product acceptability and preferences influence adherence and, therefore, drug product effectiveness. The aim of this review was to assess current understanding of patient acceptability and preferences for solid oral dosage form (SODF) drug product attributes, and the potential impact of these attributes on patient behaviors and outcomes. Patients and Methods A scoping review was conducted. Embase, Ovid MEDLINE®, and PubMed® were searched for full-text articles published between January 2013 and May 2023. Following screening and assessment against predefined inclusion criteria, data were analyzed thematically. Results Nineteen studies were included. Four overarching domains of drug product attributes were identified and summarized in a framework: appearance, swallowability, palatability, and handling. Each domain was informed by specific drug product attributes: texture, form, size, shape, color, marking, taste, mouthfeel, and smell. The most frequently studied domains were swallowability and appearance, while the most studied attributes were size, shape, and texture. Smell, marking, and mouthfeel were the least studied attributes. Texture intersected all domains, while form, shape, and size intersected appearance, swallowability, and handling. Swallowability and size appeared to be the key domain and attribute, respectively, to consider when designing drug products. Few studies explored the impact of drug product attributes on behaviors and outcomes. Conclusion While existing studies of drug product attributes have focused on appearance and swallowability, this review highlighted the importance of two less well-understood domains-palatability and handling-in understanding patients' acceptability and preferences for SODF drug products. The framework provides a tool to facilitate patient-centric design of drug products, organizing and categorizing physical drug product attributes into four overarching domains (appearance, swallowability, palatability, and handling), encouraging researchers to comprehensively assess the impact of drug product attributes on patient acceptability, preferences, and outcomes.
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Affiliation(s)
| | - Mark V Hand
- Pfizer Ireland Pharmaceuticals, Ballintaggart, Cork, Ringaskiddy, Ireland
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3
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Kim YJ, Choi YR, Kang JH, Park YS, Kim DW, Park CW. Geometry-Driven Fabrication of Mini-Tablets via 3D Printing: Correlating Release Kinetics with Polyhedral Shapes. Pharmaceutics 2024; 16:783. [PMID: 38931904 PMCID: PMC11207496 DOI: 10.3390/pharmaceutics16060783] [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: 05/17/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this study was to fabricate mini-tablets of polyhedrons containing theophylline using a fused deposition modeling (FDM) 3D printer, and to evaluate the correlation between release kinetics models and their geometric shapes. The filaments containing theophylline, hydroxypropyl cellulose (HPC), and EUDRAGIT RS PO (EU) could be obtained with a consistent thickness through pre-drying before hot melt extrusion (HME). Mini-tablets of polyhedrons ranging from tetrahedron to icosahedron were 3D-printed using the same formulation of the filament, ensuring equal volumes. The release kinetics models derived from dissolution tests of the polyhedrons, along with calculations for various physical parameters (edge, SA: surface area, SA/W: surface area/weight, SA/V: surface area/volume), revealed that the correlation between the Higuchi model and the SA/V was the highest (R2 = 0.995). It was confirmed that using 3D- printing for the development of personalized or pediatric drug products allows for the adjustment of drug dosage by modifying the size or shape of the drug while maintaining or controlling the same release profile.
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Affiliation(s)
- Young-Jin Kim
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea; (Y.-J.K.); (Y.-R.C.)
| | - Yu-Rim Choi
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea; (Y.-J.K.); (Y.-R.C.)
| | - Ji-Hyun Kang
- School of Pharmacy, Institute of New Drug Development, and Respiratory Drug Development Research Institute, Jeonbuk National University, Jeonju 54896, Republic of Korea;
| | - Yun-Sang Park
- Research & Development Center, P2K Bio, Cheongju 28160, Republic of Korea;
| | - Dong-Wook Kim
- Collge of Pharmacy, Wonkwang University, Iksan 54538, Republic of Korea;
| | - Chun-Woong Park
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea; (Y.-J.K.); (Y.-R.C.)
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4
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Peng H, Han B, Tong T, Jin X, Peng Y, Guo M, Li B, Ding J, Kong Q, Wang Q. 3D printing processes in precise drug delivery for personalized medicine. Biofabrication 2024; 16:10.1088/1758-5090/ad3a14. [PMID: 38569493 PMCID: PMC11164598 DOI: 10.1088/1758-5090/ad3a14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/03/2024] [Indexed: 04/05/2024]
Abstract
With the advent of personalized medicine, the drug delivery system will be changed significantly. The development of personalized medicine needs the support of many technologies, among which three-dimensional printing (3DP) technology is a novel formulation-preparing process that creates 3D objects by depositing printing materials layer-by-layer based on the computer-aided design method. Compared with traditional pharmaceutical processes, 3DP produces complex drug combinations, personalized dosage, and flexible shape and structure of dosage forms (DFs) on demand. In the future, personalized 3DP drugs may supplement and even replace their traditional counterpart. We systematically introduce the applications of 3DP technologies in the pharmaceutical industry and summarize the virtues and shortcomings of each technique. The release behaviors and control mechanisms of the pharmaceutical DFs with desired structures are also analyzed. Finally, the benefits, challenges, and prospects of 3DP technology to the pharmaceutical industry are discussed.
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Affiliation(s)
- Haisheng Peng
- Department of Pharmacology, Medical College, University of Shaoxing, Shaoxing, People’s Republic of China
- These authors contributed equally
| | - Bo Han
- Department of Pharmacy, Daqing Branch, Harbin Medical University, Daqing, People’s Republic of China
- These authors contributed equally
| | - Tianjian Tong
- Department of Chemical and Biological Engineering, Iowa State University, Ames, IA 50011, United States of America
| | - Xin Jin
- Department of Pharmacology, Medical College, University of Shaoxing, Shaoxing, People’s Republic of China
| | - Yanbo Peng
- Department of Pharmaceutical Engineering, China Pharmaceutical University, 639 Longmian Rd, Nanjing 211198, People’s Republic of China
| | - Meitong Guo
- Department of Pharmacology, Medical College, University of Shaoxing, Shaoxing, People’s Republic of China
| | - Bian Li
- Department of Pharmacology, Medical College, University of Shaoxing, Shaoxing, People’s Republic of China
| | - Jiaxin Ding
- Department of Pharmacology, Medical College, University of Shaoxing, Shaoxing, People’s Republic of China
| | - Qingfei Kong
- Department of Neurobiology, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Neurobiology, Harbin, Heilongjiang 150086, People’s Republic of China
| | - Qun Wang
- Department of Chemical and Biological Engineering, Iowa State University, Ames, IA 50011, United States of America
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5
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Milliken RL, Quinten T, Andersen SK, Lamprou DA. Application of 3D printing in early phase development of pharmaceutical solid dosage forms. Int J Pharm 2024; 653:123902. [PMID: 38360287 DOI: 10.1016/j.ijpharm.2024.123902] [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: 12/21/2023] [Revised: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
Three-dimensional printing (3DP) is an emerging technology, offering the possibility for the development of dose-customized, effective, and safe solid oral dosage forms (SODFs). Although 3DP has great potential, it does come with certain limitations, and the traditional drug manufacturing platforms remain the industry standard. The consensus appears to be that 3DP technology is expected to benefit personalized medicine the most, but that it is unlikely to replace conventional manufacturing for mass production. The 3DP method, on the other hand, could prove well-suited for producing small batches as an adaptive manufacturing technique for enabling adaptive clinical trial design for early clinical studies. The purpose of this review is to discuss recent advancements in 3DP technologies for SODFs and to focus on the applications for SODFs in the early clinical development stages, including a discussion of current regulatory challenges and quality controls.
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Affiliation(s)
- Rachel L Milliken
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Thomas Quinten
- Janssen Pharmaceutica, Research & Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Sune K Andersen
- Janssen Pharmaceutica, Research & Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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6
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Kaba K, Purnell B, Liu Y, Royall PG, Alhnan MA. Computer numerical control (CNC) carving as an on-demand point-of-care manufacturing of solid dosage form: A digital alternative method for 3D printing. Int J Pharm 2023; 645:123390. [PMID: 37683980 DOI: 10.1016/j.ijpharm.2023.123390] [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: 05/24/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Computer numerical control (CNC) carving is a widely used method of industrial subtractive manufacturing of wood, plastics, and metal products. However, there have been no previous reports of applying this approach to manufacture medicines. In this work, the novel method of tablet production using CNC carving is introduced for the first time. This report provides a proof-of-concept for applying subtractive manufacturing as an alternative to formative (powder compression) and additive (3D printing) manufacturing for the on-demand production of solid dosage forms. This exemplar manufacturing approach was employed to produce patient-specific hydrocortisone (HC) tablets for the treatment of children with congenital adrenal hyperplasia. A specially made drug-polymer cast based on polyethene glycol (PEG 6,000) and hydroxypropyl cellulose was produced using thermal casting. The cast was used as a workpiece and digitally carved using a small-scale 3-dimensional (3D) CNC carving. To establish the ability of this new approach to provide an accurate dose of HC, four different sizes of CNC carved tablet were manufactured to achieve HC doses of 2.5, 5, 7.5 and 10 mg with a relative standard deviation of the tablet weight in the range of 3.69-4.79%. In addition, batches of 2.5 and 5 mg HC tablets met the British Pharmacopeia standards for weight uniformity. Thermal analysis and X-ray powder diffraction indicated that the model drug was in amorphous form. In addition, HPLC analysis indicated a level of purity of 96.5 ± 1.1% of HC. In addition, the process yielded mechanically strong cylindrical tablets with tensile strength ranging from 0.49 to 1.6 MPa and friability values of <1%, whilst maintaining an aesthetic look. In vitro, HC release from the CNC-carved tablets was slower with larger tablet sizes and higher binder contents. This is the first report on applying CNC carving in the pharmaceutical context of producing solid dosage forms. The work showed the potential of this technology as an alternative method for the on-demand manufacturing of patient-specific dosage forms.
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Affiliation(s)
- Kazim Kaba
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London SE1 9NH, United Kingdom
| | - Bryn Purnell
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London SE1 9NH, United Kingdom
| | - Yujing Liu
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London SE1 9NH, United Kingdom
| | - Paul G Royall
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London SE1 9NH, United Kingdom
| | - Mohamed A Alhnan
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King's College London, London SE1 9NH, United Kingdom.
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7
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Junqueira LA, Raposo FJ, Vitral GSF, Tabriz AG, Douroumis D, Raposo NRB, Brandão MAF. Three-Dimensionally Printed Vaginal Rings: Perceptions of Women and Gynecologists in a Cross-Sectional Survey. Pharmaceutics 2023; 15:2302. [PMID: 37765271 PMCID: PMC10537249 DOI: 10.3390/pharmaceutics15092302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Three-dimensional printing technologies can be implemented for the fabrication of personalized vaginal rings (VRs) as an alternative approach to traditional manufacturing. Although several studies have demonstrated the potential of additive manufacturing, there is a lack of knowledge concerning the opinions of patients and clinicians. This study aimed to investigate the perception of women and gynecologists regarding VRs with personalized shapes. The devices were printed with different designs (traditional, "Y", "M", and flat circle) by Fused Deposition Modeling for a cross-sectional survey with 155 participants. Their anticipated opinion was assessed through a questionnaire after a visual/tactile analysis of the VRs. The findings revealed that most women would feel comfortable using some of the 3D-printed VR designs and demonstrated good acceptability for the traditional and two innovative designs. However, women presented multiple preferences when the actual geometry was assessed, which directly related to their age, previous use of the vaginal route, and perception of comfort. In turn, gynecologists favored prescribing traditional and flat circle designs. Overall, although there was a difference in the perception between women and gynecologists, they had a positive opinion of the 3D-printed VRs. Finally, the personalized VRs could lead to an increase in therapeutic adherence, by meeting women's preferences.
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Affiliation(s)
- Laura Andrade Junqueira
- Center for Research and Innovation in Health Sciences, Department of Pharmaceutical Science, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (L.A.J.); (F.J.R.); (M.A.F.B.)
| | - Francisco José Raposo
- Center for Research and Innovation in Health Sciences, Department of Pharmaceutical Science, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (L.A.J.); (F.J.R.); (M.A.F.B.)
| | - Geraldo Sérgio Farinazzo Vitral
- Woman Health Investigation Group, Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil;
| | - Atabak Ghanizadeh Tabriz
- Centre for Innovation and Process Engineering Research, University of Greenwich, Chatham Maritime, Chatham ME4 4TB, UK; (A.G.T.); (D.D.)
| | - Dennis Douroumis
- Centre for Innovation and Process Engineering Research, University of Greenwich, Chatham Maritime, Chatham ME4 4TB, UK; (A.G.T.); (D.D.)
| | - Nádia Rezende Barbosa Raposo
- Center for Research and Innovation in Health Sciences, Department of Pharmaceutical Science, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (L.A.J.); (F.J.R.); (M.A.F.B.)
| | - Marcos Antônio Fernandes Brandão
- Center for Research and Innovation in Health Sciences, Department of Pharmaceutical Science, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; (L.A.J.); (F.J.R.); (M.A.F.B.)
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8
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McCloskey AP, Bracken L, Vasey N, Ehtezazi T. 3D printing - an alternative strategy for pediatric medicines. Expert Rev Clin Pharmacol 2023; 16:613-616. [PMID: 37408478 DOI: 10.1080/17512433.2023.2233416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/03/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Alice P McCloskey
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University
| | - Louise Bracken
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust Liverpool
| | - Nicola Vasey
- The Great North Children's Hospital Newcastle-Upon-Tyne
| | - Touraj Ehtezazi
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University
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9
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Yang TL, Stogiannari M, Janeczko S, Khoshan M, Lin Y, Isreb A, Habashy R, Giebułtowic J, Peak M, Alhnan MA. Towards Point-of-Care Manufacturing and Analysis of Immediate-Release 3D Printed Hydrocortisone Tablets for The Treatment of Congenital Adrenal Hyperplasia. Int J Pharm 2023:123072. [PMID: 37230368 DOI: 10.1016/j.ijpharm.2023.123072] [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: 01/30/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
Hydrocortisone (HC) is the preferred drug in children with congenital adrenal hyperplasia due to its lower potency as well as fewer reports of side effects. Fused deposition modelling (FDM) 3D printing holds the potential to produce low-cost personalised doses for children at the point of care. However, the compatibility of the thermal process to produce immediate-release bespoke tablets for this thermally labile active is yet to be established. This work aims to develop immediate-release HC tablets using FDM 3D printing and assess drug contents as a critical quality attribute (CQA) using a compact, low-cost near-infrared (NIR) spectroscopy as a process analytical technology (PAT). The FDM 3D printing temperature (140 °C) and drug concentration in the filament (10%-15% w/w) were critical parameters to meet the compendial criteria for drug contents and impurities. Using a compact low-cost NIR spectral device over a wavelength of 900-1700 nm, the drug contents of 3D printed tablets were assessed. Partial least squares (PLS) regression was used to develop individual calibration models to detect HC content in 3D printed tablets of lower drug contents, small caplet design, and relatively complex formula. The models demonstrated the ability to predict HC concentrations over a wide concentration range (0-15% w/w), which was confirmed by HPLC as a reference method. Ultimately, the capability of the NIR model had preceding dose verification performance on HC tablets, with linearity (R2 = 0.981) and accuracy (RMSECV = 0.46%). In the future, the integration of 3DP technology with non-destructive PAT techniques will accelerate the adoption of on-demand, individualised dosing in a clinical setting.
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Affiliation(s)
- Tzuyi L Yang
- Centre for Pharmaceutical Medicine, Institute of Pharmaceutical Science, Kings College, London, UK
| | - Melpomeni Stogiannari
- Centre for Pharmaceutical Medicine, Institute of Pharmaceutical Science, Kings College, London, UK
| | - Sylwia Janeczko
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Marva Khoshan
- Centre for Pharmaceutical Medicine, Institute of Pharmaceutical Science, Kings College, London, UK
| | - Yueyuan Lin
- Centre for Pharmaceutical Medicine, Institute of Pharmaceutical Science, Kings College, London, UK
| | - Abdullah Isreb
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Joanna Giebułtowic
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Matthew Peak
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP
| | - Mohamed A Alhnan
- Centre for Pharmaceutical Medicine, Institute of Pharmaceutical Science, Kings College, London, UK
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10
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Englezos K, Wang L, Tan ECK, Kang L. 3D printing for personalised medicines: implications for policy and practice. Int J Pharm 2023; 635:122785. [PMID: 36849040 DOI: 10.1016/j.ijpharm.2023.122785] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
The current healthcare dynamic has shifted from one-size-fits-all to patient-centred care, with our increased understanding of pharmacokinetics and pharmacogenomics demanding a switch to more individualised therapies. As the pharmaceutical industry remains yet to succumb to the push of a technological paradigm shift, pharmacists lack the means to provide completely personalised medicine (PM) to their patients in a safe, affordable, and widely accessible manner. As additive manufacturing technology has already established its strength in producing pharmaceutical formulations, it is necessary to next consider methods by which this technology can create PM accessible from pharmacies. In this article, we reviewed the limitations of current pharmaceutical manufacturing methods for PMs, three-dimensional (3D) printing techniques that are most beneficial for PMs, implications of bringing this technology into pharmacy practice, and implications for policy surrounding 3D printing techniques in the manufacturing of PMs.
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Affiliation(s)
- Klaudia Englezos
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Lingxin Wang
- Pharmacy Department, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
| | - Edwin C K Tan
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Lifeng Kang
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia.
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11
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O'Donovan A, Duncan JC, Li KY, Del-Nevo L, Gill A, Peak M, Alhnan MA. The Use of Special-Order Products in England between 2012-2020: An Insight into The Need for Point-of-Care Manufacturing. Int J Pharm 2023; 637:122801. [PMID: 36878418 DOI: 10.1016/j.ijpharm.2023.122801] [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: 10/31/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
Point-of-care manufacturing such as 3D printing has recently received significant attention from regulatory bodies and the pharmaceutical industry. However, little information is available on the quantity of the most prescribed patient-specific items, their dosage form, and why they were required to be dispensed. In England, 'Specials' are unlicensed medicines formulated to meet the requirements of a specific prescription, prescribed if no suitable licensed alternative exists. This work aims to quantify and examine trends in the prescribing of 'Specials' in England during 2012-2020, using the NHS Business Services Authority (NHSBSA) database. Quarterly prescription data from NHSBSA for the top 500 'Specials' by quantity from 2012-2020 were compiled yearly. The changes in net ingredient cost, the number of items, British National Formulary (BNF) drug category, dosage form, and a potential reason for requiring a 'Special' were identified. In addition, the cost-per-unit was calculated for each category. The total spending on 'Specials' decreased by 62% from £109.2M in 2012 to £41.4M in 2020, primarily due to a 55.1% reduction in the number of 'Specials' items issued. The most frequently prescribed dosage form type of 'Special' was oral dosage forms (59.6% of all items in 2020) particularly oral liquids. The most common reason for prescribing a 'Special' was an inappropriate dosage form (74% of all 'Specials' in 2020). The total number of items dropped over the 8 years as commonly prescribed 'Specials' such as melatonin and cholecalciferol became licensed. In conclusion, the total spending on 'Specials' dropped from 2012-2020 primarily due to a reduction in the number of 'Specials' items issued and pricing change in the Drug tariff. Based on the current demand for 'special order' products, these findings are instrumental for formulation scientists to identify 'Special' formulations to design the next generation of extemporaneous medicine to be produced at the point of care.
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Affiliation(s)
- Anna O'Donovan
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Kings College, London, SE1 9NH
| | - Jennifer C Duncan
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP
| | - Kuan-Yin Li
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Kings College, London, SE1 9NH
| | - Lucy Del-Nevo
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Kings College, London, SE1 9NH
| | - Andrea Gill
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP
| | - Matthew Peak
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP
| | - Mohamed A Alhnan
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Sciences, Kings College, London, SE1 9NH.
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12
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Lyousoufi M, Lafeber I, Kweekel D, de Winter BCM, Swen JJ, Le Brun PPH, Bijleveld-Olierook ECM, van Gelder T, Guchelaar HJ, Moes DJAR, Schimmel KJM. Development and Bioequivalence of 3D-Printed Medication at the Point-of-Care: Bridging the Gap Toward Personalized Medicine. Clin Pharmacol Ther 2023; 113:1125-1131. [PMID: 36762628 DOI: 10.1002/cpt.2870] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Personalized medicine is currently hampered by the lack of flexible drug formulations. Especially for pediatric patients, manual compounding of personalized drug formulations by pharmacists is required. Three-Dimensional (3D) printing of medicines, which enables small-scale manufacturing at the point-of-care, can fulfill this unmet clinical need. This study investigates the feasibility of developing a 3D-printed tablet formulation at the point-of-care which complies to quality requirements for clinical practice, including bioequivalence. Development, manufacturing, and quality control of the 3D-printed tablets was performed at the manufacturing facility and laboratory of the department of Clinical Pharmacy and Toxicology at Leiden University Medical Center. Sildenafil was used as a model drug for the tablet formulation. Along with the 3D-printed tablets a randomized, an open-label, 2-period, crossover, single-dose clinical trial to assess bioequivalence was performed in healthy adults. Bioequivalence was established if areas under the plasma concentration curve from administration to the time of the last quantifiable concentration (AUC0-t ) and maximum plasma concentration (Cmax ) ratios were within the limits of 80.00-125.00%. The manufacturing process provided reproducible 3D-printed tablets that adhered to quality control requirements and were consequently used in the clinical trial. The clinical trial was conducted in 12 healthy volunteers. The 90% confidence intervals (CIs) of both AUC0-t and Cmax ratios were within bioequivalence limits (AUC0-t 90% CI: 87.28-104.14; Cmax 90% CI: 80.23-109.58). For the first time, we demonstrate the development of a 3D-printed tablet formulation at the point-of-care that is bioequivalent to its marketed originator. The 3D printing of personalized formulations is a disruptive technology for compounding, bridging the gap toward personalized medicine.
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Affiliation(s)
- Maryam Lyousoufi
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Iris Lafeber
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dinemarie Kweekel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda C M de Winter
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jesse J Swen
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul P H Le Brun
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Teun van Gelder
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dirk Jan A R Moes
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Kirsten J M Schimmel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
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13
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Wang N, Shi H, Yang S. 3D printed oral solid dosage form: Modified release and improved solubility. J Control Release 2022; 351:407-431. [PMID: 36122897 DOI: 10.1016/j.jconrel.2022.09.023] [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: 06/12/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
Oral solid dosage form is currently the most common used form of drug. 3D Printing, also known as additive manufacturing (AM), can quickly print customized and individualized oral solid dosage form on demand. Compared with the traditional tablet manufacturing process, 3D Printing has many advantages. By rationally selecting the formulation composition and cleverly designing the printing structure, 3D printing can improve the solubility of the drug and achieve precise modify of the drug release. 3D printed oral solid dosage form, however, still has problems such as limitations in formulation selection. And the selection process of the formulation lacks scientificity and standardization. Structural design of some 3D printing approaches is relatively scarce. This article reviews the formulation selection and structure design of 3D printed oral solid dosage form, providing more ideas for achieving modified drug release and solubility improvement of 3D printed oral solid dosage form through more scientific and extensive formulation selection and more sophisticated structural design.
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Affiliation(s)
- Ning Wang
- Department of Plastic Surgery, The First Hospital of China Medical University, 110001 Shenyang, Liaoning Province, PR China
| | - Huixin Shi
- Department of Plastic Surgery, The First Hospital of China Medical University, 110001 Shenyang, Liaoning Province, PR China
| | - Shude Yang
- Department of Plastic Surgery, The First Hospital of China Medical University, 110001 Shenyang, Liaoning Province, PR China; Liaoning Provincial Key Laboratory of Oral Diseases, School of Stomatology and Department of Oral Pathology, School of Stomatology, China Medical University, 110001 Shenyang, Liaoning Province, PR China.
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14
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The Advent of a New Era in Digital Healthcare: A Role for 3D Printing Technologies in Drug Manufacturing? Pharmaceutics 2022; 14:pharmaceutics14030609. [PMID: 35335984 PMCID: PMC8952205 DOI: 10.3390/pharmaceutics14030609] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/24/2022] Open
Abstract
The technological revolution has physically affected all manufacturing domains, at the gateway of the fourth industrial revolution. Three-dimensional (3D) printing has already shown its potential in this new reality, exhibiting remarkable applications in the production of drug delivery systems. As part of this concept, personalization of the dosage form by means of individualized drug dose or improved formulation functionalities has concentrated global research efforts. Beyond the manufacturing level, significant parameters must be considered to promote the real-time manufacturing of pharmaceutical products in distributed areas. The majority of current research activities is focused on formulating 3D-printed drug delivery systems while showcasing different scenarios of installing 3D printers in patients' houses, hospitals, and community pharmacies, as well as in pharmaceutical industries. Such research presents an array of parameters that must be considered to integrate 3D printing in a future healthcare system, with special focus on regulatory issues, drug shortages, quality assurance of the product, and acceptability of these scenarios by healthcare professionals and public parties. The objective of this review is to critically present the spectrum of possible scenarios of 3D printing implementation in future healthcare and to discuss the inevitable issues that must be addressed.
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