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Ponnusamy C, Ayarivan P, Selvamuthu P, Natesan S. Age-Related Macular Degeneration - Therapies and Their Delivery. Curr Drug Deliv 2024; 21:683-696. [PMID: 37165500 DOI: 10.2174/1567201820666230510100742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/15/2022] [Accepted: 01/05/2023] [Indexed: 05/12/2023]
Abstract
Age-related macular degeneration (ARMD) is a degenerative ocular disease that is the most important cause of irreversible vision loss in old-aged people in developed countries. Around fifty percent of vision impairments in developed countries are due to ARMD. It is a multifaceted disease that is associated with both genetic and environmental risk factors. The most important treatments option for ARMD includes laser photocoagulation, photodynamic therapy (PDT), Anti-VEGF Injections, and combination therapies. In this review, we also propose that topical ocular drug delivery with nanocarriers has more attention for the treatment of ARMD. The nanocarriers were specially designed for enhanced corneal residential time, prolonged drug release and action, and minimizing the frequency of administrations. Different types of nanocarriers were developed for the topical ocular delivery system, such as nanomicelles, nanoemulsions, nanosuspensions, liposomes, and polymeric nanoparticles. These topical ocular nanocarriers were administered topically, and they can fix the hydrophobic substances, increase solubility and improve the bioavailability of an administered drug. Hence the topical ocular delivery systems with nanocarriers provide a safe and effective therapeutic strategy and promising tool for the treatment of posterior segment ocular diseases ARMD.
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Affiliation(s)
- Chandrasekar Ponnusamy
- Department of Pharmaceutical Technology, University College of Engineering, Bharathidasan Institute of Technology Campus, Anna University, Tiruchirappalli-620024, Tamil Nadu, India
| | - Puratchikody Ayarivan
- Drug Discovery and Development Research Group, Department of Pharmaceutical Technology, University College of Engineering, Bharathidasan Institute of Technology Campus, Anna University, Tiruchirappalli-620024, Tamil Nadu, India
| | - Preethi Selvamuthu
- Department of Pharmaceutical Technology, University College of Engineering, Bharathidasan Institute of Technology Campus, Anna University, Tiruchirappalli-620024, Tamil Nadu, India
| | - Subramanian Natesan
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER)-Kolkata, ChunilalBhawan, Kolkata-700054, West Bengal, India
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Esteban-Pérez S, Andrés-Guerrero V, López-Cano JJ, Molina-Martínez I, Herrero-Vanrell R, Bravo-Osuna I. Gelatin Nanoparticles-HPMC Hybrid System for Effective Ocular Topical Administration of Antihypertensive Agents. Pharmaceutics 2020; 12:E306. [PMID: 32231033 PMCID: PMC7238113 DOI: 10.3390/pharmaceutics12040306] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
The increment in ocular drug bioavailability after topical administration is one of the main challenges in pharmaceutical technology. For several years, different strategies based on nanotechnology, hydrogels or implants have been evaluated. Nowadays, the tolerance of ophthalmic preparations has become a critical issue and it is essential to the use of well tolerated excipients. In the present work, we have explored the potential of gelatin nanoparticles (GNPs) loaded with timolol maleate (TM), a beta-adrenergic blocker widely used in the clinic for glaucoma treatment and a hybrid system of TM-GNPs included in a hydroxypropyl methylcellulose (HPMC) viscous solution. The TM- loaded nanoparticles (mean particle size of 193 ± 20 nm and drug loading of 0.291 ± 0.019 mg TM/mg GNPs) were well tolerated both in vitro (human corneal cells) and in vivo. The in vivo efficacy studies performed in normotensive rabbits demonstrated that these gelatin nanoparticles were able to achieve the same hypotensive effect as a marketed formulation (0.5% TM) containing a 5-fold lower concentration of the drug. When comparing commercial and TM-GNPs formulations with the same TM dose, nanoparticles generated an increased efficacy with a significant (p < 0.05) reduction of intraocular pressure (IOP) (from 21% to 30%) and an augmentation of 1.7-fold in the area under the curve (AUC)(0-12h). On the other hand, the combination of timolol-loaded nanoparticles (TM 0.1%) and the viscous polymer HPMC 0.3%, statistically improved the IOP reduction up to 30% (4.65 mmHg) accompanied by a faster time of maximum effect (tmax = 1 h). Furthermore, the hypotensive effect was extended for four additional hours, reaching a pharmacological activity that lasted 12 h after a single instillation of this combination, and leading to an AUC(0-12h) 2.5-fold higher than the one observed for the marketed formulation. According to the data presented in this work, the use of hybrid systems that combine well tolerated gelatin nanoparticles and a viscous agent could be a promising alternative in the management of high intraocular pressure in glaucoma.
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Affiliation(s)
- Sergio Esteban-Pérez
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - Vanessa Andrés-Guerrero
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - José Javier López-Cano
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - Irene Molina-Martínez
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - Rocio Herrero-Vanrell
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - Irene Bravo-Osuna
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (S.E.-P.); (V.A.-G.); (J.J.L.-C.); (I.M.-M.); (R.H.-V.)
- Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC) San Carlos Clinical Hospital, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Calle Profesor Martín Lagos, s/n, 28040 Madrid, Spain
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Quiroz-Mercado H, Ivri E, Gonzalez-Salinas R, Kourtis IC, Gilbert J, Pérez-Vázquez JF, Blumenkranz M, Jiménez-Román J, Marcellino G. Clinical Evaluation of a Novel Electromechanical Topical Ocular Drug Delivery System: Two Phase 1 Proof of Concept Studies. Clin Ophthalmol 2020; 14:139-147. [PMID: 32021079 PMCID: PMC6980856 DOI: 10.2147/opth.s221749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/29/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Self-administration of topical ophthalmic therapies remains challenging for many patients as errors due to improper technique are common. The aim of the current studies was to evaluate a novel electromechanical topical ocular drug delivery device designed to facilitate precise dosing and accurate delivery with substantially lower drug exposure than conventional eye drops. PATIENTS AND METHODS Two randomized Phase 1 studies were performed to evaluate the efficacy and safety of a single dose of a topical ophthalmic solution administered as a ~9 μL microfluid stream via the test device compared with a ~30-40 μL drop delivered via conventional dropper in healthy subjects (Trial 1) and glaucoma patients (Trial 2). In Trial 1, a 1% tropicamide/2.5% phenylephrine solution was administered via the test device in one eye and by conventional dropper in the contralateral eye. Pupil dilation was measured at 30 min intervals post-instillation and subject comfort was assessed using a visual analogue scale (range, 0-100). In Trial 2, patients were randomized to receive latanoprost 0.005% via the test device or conventional dropper. Intraocular pressure was measured at baseline and 4-8 hrs post-instillation. RESULTS In Trial 1 (N=20), mean (SD) pupil diameter 30 mins post-instillation increased by 3.4 (0.9) and 3.5 (1.0) mm in the test and control eyes, respectively. The mean comfort score was 81.7 for the test device versus 57.3 for conventional dropper delivery. In Trial 2 (N=18), the mean change in intraocular pressure following administration of latanoprost was -5.0 (1.8) and -4.3 (3.3) mm Hg in the test and control groups, respectively. No serious adverse events were observed in either study. CONCLUSION Administration of a single dose of topical ophthalmic therapy via an electromechanical drug delivery device resulted in comparable effects on pupil dilation and intraocular pressure with lower drug exposure and increased patient comfort compared with conventional dropper delivery.
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Affiliation(s)
- Hugo Quiroz-Mercado
- Association to Prevent Blindness, Hospital Sanchez-Bulnes, Mexico City, Mexico
| | - Ehud Ivri
- Kedalion Therapeutics Inc., Menlo Park, CA, USA
| | | | | | | | | | | | - Jesús Jiménez-Román
- Association to Prevent Blindness, Hospital Sanchez-Bulnes, Mexico City, Mexico
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