Dissertations / Theses on the topic 'Parenteral drug delivery'

The aim of this research was to formulate, characterise and assess the feasibility of a novel drug delivery system known as the in situ gelling matrix (ISGM) where a hydrophilic polymer is suspended in a non-aqueous solvent that converts into a gel when injected subcutaneously or intramuscularly thus giving a controlled release matrix for a drug. Although the concept has been patented with claims that this kind of drug delivery is achievable in theory for a wide variety of candidate substances, actual formulation studies for making a commercially viable product for this technology are completely lacking in practice. The research embodied in this thesis addresses this lack. Initial studies involved conducting a biocompatibility study using the HET-CAM (hens egg test - chorioallantoic membrane) test on a range of possible ingredients for the delivery system. The materials deemed biocompatible were then carried through to a screening process where the physical stability of the hydrophilic polymers in non-aqueous solvents was monitored. It was found that the hydrophilic polymers tested sedimented rapidly in the non-aqueous solvents indicating such a system was not physically stable. Consequently, density-inducing or viscosity-inducing agents were added to the non-aqueous solvents to retard the sedimentation rate. The addition of polycarbophil, a viscosity-inducing agent, clearly increased the viscosity of the system. However, undesirable formation of polycarbophil globules occurred during the manufacturing process, which caused batch-to-batch variations in the viscosity of the continuous phase. Various manufacturing methods were tested before arriving at the optimum procedure to prevent globule formation using a high speed dispersion tool. A final physical sedimentation analysis of candidate continuous phases and hydrophilic polymers was conducted for determining the ideal combination of ingredients to use in the system. These investigations finally led to the adoption of an optimum mix of components consisting of 10% (w/w) hydroxypropyl methylcellulose (HPMC) (the hydrophilic polymer) suspended in a continuous phase of propylene glycol (the non-aqueous solvent) containing 0.67% (w/w) polycarbophil (the viscosity inducing agent). Using this mix of components, the in situ gelling matrix system was then subjected to various characterisation studies including infrared (IR), differential scanning calorimetry (DSC), ultraviolet-visible (UV-Vis) spectrophotometry and redispersion studies. The chemical stability of the hydrophilic polymer and the continuous phase (the non-aqueous solvent and polycarbophil) was monitored and were found to be chemically stable over a 9 month period. The feasibility of the in situ gelling matrix technology as a controlled release device was assessed using the drug propranolol. In vitro drug release studies were conducted using a custom-built dissolution apparatus. The effect of various parameters such as the concentration of the hydrophilic gelling agent on the drug release rate was investigated. Increasing the concentration of the gelling agent in the formulation resulted in a slower rate of release. The drug release data were modelled using the Higuchi relationship and a power law relationship to compare the effects of the various parameters on the release rate Stability studies on the drug in the in situ gelling matrix system were carried out by storing samples in accelerated ageing conditions of 40 C / 75% relative humidity for 4 weeks. During this time, the samples were analysed each week by high performance liquid chromatography (HPLC). These demonstrated that no apparent drug degradation had occurred over the 4-week period. This indicates that the drug propranolol in the in situ gelling matrix system is stable under ambient conditions for at least 4 weeks. The results of this study demonstrated that the in situ gelling matrix technology is potentially viable as a drug delivery system and provide a practical methodology for the commercial development of such systems.

Poly(lactide-co-glycolide) [PLGA] is the most exploited biodegradable and biocompatible material in the pharmaceutical field for the preparation of long- acting parenteral formulations, despite there are limitations related to the PLGA itself or to the final product to face with. These mainly include the limited ability in encapsulating hydrophilic compounds, the physical and chemical instabilities in aqueous media, the detrimental effect of the sterilization methods and the drop off in the micro-environmental pH upon degradation. Hence, there is the need to find new strategies for their overcoming. This doctoral thesis aimed to exploit the functionalization of PLGA backbone with anti-oxidants (g-AA-PLGA) and a novel biodegradable material, containing polyesters segments in a multi-block poly(urethane) organization, to address the main limitations related to PLGA, with emphasis on nano-particulate drug delivery systems. PLGA grafted to caffeic acid (g-CA-PLGA) nanoparticles (NP) showed an improved uptake in endothelial cells (EC) and smooth muscle cells (SMC), the representative cell populations in the artery wall. Thus, they were worth of interest for the loading of fluvastatin in restenosis prevention. The proliferation inhibition of human SMC was not significantly affected after the encapsulation of fluvastatin within g-CA-PLGA NP, with the effective concentration being 4 mcM compared to the 1 mcM of free fluvastatin, suggesting a control of the polymer on the drug release. A higher dose was necessary in the case of EC, indicating the possibility to inhibit SMC proliferation while the healing of the endothelium is on-going. All these aspects highlight the suitability of this system in the prevention of restenosis, after the local delivery with the angioplasty balloon (Chapter 1). However, during the development of the formulation, the selection and optimization of the drying process is required, also with the aim to coat the angioplasty balloon with eluting-NP. In this context, a preliminary study was performed and the obtained results revealed that maltodextrins (MDX), an excipient widely used in the pharmaceutical industry, can be also advantageously used as drying auxiliary agent. Indeed, they permit an easily reconstitution of NP dispersion in aqueous media, independently of the selected drying technique, namely spray-drying or freeze-drying. The performances of such excipient were demonstrated in the case of both PLGA and g-CA-PLGA NP (Chapter 2). The multi-block poly(ester-urethane) DegraPol® displays biocompatibility and biodegradability and consequently it is already used for the preparation of medical devices by electrospinning. Conversely, the possibility to design long-acting parenteral formulations is unknown as well as the possibility to conferee a spherical shape with the desired particle size and a narrow distribution. The performed work demonstrated that the emulsion/solvent evaporation method was the optimal process, with the possibility to cover size range from nano- to micro-meters. Nevertheless, the dispersant medium should be carefully studied, given the tendency of the particles to form aggregates due to the almost neutral Z-potential of the material (Chapter 3). All together the collected results, along with the known stability to sterilization process (ionizing radiations for g-AA-PLGA and ethylene oxide for DegraPol®), demonstrated that both PLGA grafted to anti-oxidant and DegraPol® are suitable materials for preparing particulate drug delivery systems that can overcome some of the limitations associated to PLGA. As a general consideration, it should be underlined that formulation development cannot be disconnected from the regulatory framework. Particularly for long-acting parenteral formulations, the elaboration of an appropriate in vitro test to study the release of the drug is critical, given the complexity in the set-up of methods able to efficiently discriminate products that can have different in vivo behaviour (Chapter 4). In the case of PLGA microspheres intended to sustain the release of a drug after the intra-articular administration, a bio-relevant approach was followed in the attempt to evaluate their performance under healthy and disease states simulated conditions. Formulation parameters such as PLGA lactide/glycolide ratio and the amount of drug encapsulated should be carefully considered to properly optimize the formulation. Furthermore, proteins contained in the release medium simulating the disease condition affected the release behaviour of microspheres. This suggests that simple buffers (i.e., PBS at physiological pH) cannot correctly figure out the conditions occurring in vivo after the administration, much less the pathological situation (Chapter 5).

There has been a significant increase in the number of injectable pharmaceutical products over the last decade that have been incorporated into unique delivery systems such as pen injectors, auto-injectors, or pre-filled syringes. The advancement of these delivery systems and the paradigm shift towards administration of injectables in the out-of-hospital or home setting have introduced variables that can affect the bioavailability of injectable drugs and potential pharmacologic outcomes. An approach that allows for the qualitative and quantitative dispersion assessment of an injectable at the moment of tissue deposition coupled with an assessment of systemic exposure parameters could provide substantial information to researchers developing new injectable formulations and associated delivery systems. The overall goal of this research project was to develop an approach for investigating various injection dynamics, more specifically, dispersion dynamics associated with the administration of parenteral pharmaceutical products utilizing delivery technologies designed to deliver drug below the dermis. This was accomplished by first evaluating the safety and usability of computed tomography (CT) scanning as a novel radioimaging approach to assess qualitative and quantitative dispersion parameters in a cadaver study followed by a randomized, controlled, clinical study to assess CT tissue dispersion and the systemic exposure of iohexol, administered subcutaneously by two delivery systems in human volunteers. The primary finding of this work was the demonstration that CT scanning may be combined with a systemic exposure assessment to provide an effective paradigm for investigating dynamics of injectable delivery impacted by a variety of factors, including the choice of delivery system. In this study, iohexol delivered subcutaneously by an auto-injector resulted in notable qualitative and quantitative dispersion differences, including a higher rate of iohexol loss from the extravascular tissue, as well as differences in early plasma exposure as compared to a pre-filled syringe delivery system. The injections and CT scanning were well tolerated with adverse events limited to mild injection site reactions resolving without intervention. This research resulted in a novel local in-vivo(extravascular disappearance), systemic in-vivo(intravascular appearance) correlation approach that could be utilized to assess a wide variety of dynamics associated with injectable drug delivery below the dermis.

L’objectif principal de ce travail de thèse est de développer une nouvelle formulation formant un dépôt in situ après administration parentérale pour la libération prolongée de principes actifs. Les systèmes à base de chitosane (CS) formant des hydrogels sous l’action de la chaleur corporelle ont été choisis parmi les différentes catégories de formulations injectables se solidifiant in situ pour la biocompatibilité et la biodégradabilité reconnue de ce polymère. Après une revue des différents systèmes thermo-gélifiants à base de CS et de leurs utilisations, nous nous sommes intéressés en détail aux mécanismes sur lesquels reposaient la formation des hydrogels de CS / agent gélifiant. Une étude rhéologique approfondie combinée à de la 31P-RMN a permis de mettre en évidence le rôle clé de la partie polyol de l’agent gélifiant dans cemécanisme. La troisième partie a été consacrée au développement d’un nouveau système associant le CS au glucose-1-phosphate (G1-P). Une étude des propriétés physico-chimiques et de la stabilité de ce système a mis en évidence sa gélification dans les conditions physiologiques et l’amélioration significative de sa stabilité à long terme par rapport au système standard CS / glycérophosphate. Des essais de tolérance locale souscutanée réalisés sur un modèle murin ont montré que le système est raisonnablement bien toléré. Enfin, la dernière partie, consacrée à l’étude de la libération in vitro de différents composés modèles, a démontré l’aptitude du réseau polymère de CS / G1-P à prolonger la libération des substances incorporées
The aim of this work was to develop a new parenteral in situ forming depot (ISFD) system for the controlled delivery of drugs. Chitosan (CS)-based systems that undergo sol / gel transition upon heating at physiological temperature were selected among the different categories of ISFDs due to their well-known biocompatibility and biodegradability. After an overall review of the recent progresses on standard CS-based ISFD systems, the synergistic mechanisms underlying the temperature-induced gelation of the CS / gelling agent systems were investigated through comprehensive rheological studies completed by 31P-NMR measurements. These investigations emphasized the key role of the polyol part of the gelling agent. The next step consisted in developing a new system combining CS and glucose-1-phosphate (G1-P). The physico-chemical characteristics and storage stability of this system were investigated. The results highlighted a sol / gel transition under physiological conditions and improved storage stability compared to the standard CS / glycerophosphate system. Local tolerability studies of the hydrogels in rats showed that the system was reasonably well tolerated. Finally, the last chapter, dedicated to the study of the in vitro release behavior of several model compounds, emphasized the ability of the polymeric CS / G1-P network to sustain the release of the incorporated substances

Future changes in the incidence and prevalence of OA are difficult to predict. As incidence and prevalence rise with increasing age, extending life expectancy will result in greater numbers with OA. Actually, usual therapeutic approaches are really restricted because of important side effects with long-term use. Therefore, there is a need to develop improved formulations which are well tolerated, biocompatible and biodegradable. Ideally, these new treatments should be able to deliver locally sufficient amount of anti-inflammatory or analgesic drugs into the site of arthritic inflammation while stabilizing or better restoring the mechanical integrity of the joint. In this way, the objective of this project is to develop slow-release gels that are sterile, injectable, characterized by viscoelastic properties and capable to sustain the in situ release of both hydrophilic and lipophilic drugs. The intraarticular delivery combined to sustained-release property should be interesting to reduce the number of injection required while prolonging the local drug activity over weeks. For that purpose, glycerol monooleate (GMO), also called “monolein” was selected for its capacity to form highly viscous crystalline phase structures upon contact with an aqueous fluid (e.g. synovial fluid).

In the first step of this work, it was decided to develop and characterize hydro-lipidic gels based on the use of monolein and hyaluronic acid in order to provide in vitro sustained release of hydrophilic drugs such as clonidine and lipophilic drugs such as betamethasone. Initially, a compatibility study was performed on the main ingredients selected in order to check that there were not physico-chemical incompatibilities, which could be deleterious regarding to their stability in formulation. Then, the development of hydro-lipidic gels was initiated by considering on the first hand the solubility of each ingredient and on the other hand the syringeability, the rheological properties and the in vitro dissolution profiles obtained for the developed formulations. The objective of this preformulation program was to identify potential candidates that presented suitable syringeability while being able to sustain the release of drugs over weeks and being characterized by interesting viscoelastic properties for the long-term management of osteoarthritis. Moreover, several methods of quantification and characterization were developed in order to allow the physico-chemical properties (rheology, syringeability, water uptake, stability and dissolution profiles) of the developed formulations to be studied.

Results of the compatibility study showed that the concomitant use of monolein, hyaluronic acid and clonidine/betamethasone is not contraindicated. Next, the preformulation program allowed many injectable drug delivery systems to be prepared. However, the carrier that best meets our needs was composed of 10,0 % (wt/wt) absolute ethanol ;15,0 % propylene glycol (wt/wt) ;15,0 % (wt/wt) water ;55,0 % (wt/wt) de monolein ;5,0 % (wt/wt) purified soybean oil ;0,03 % (wt/wt) α-tocophérol and 7,5 mg/g sodium hyaluronate (1.9 MDa). This carrier assured suitable syringeability and rheological properties. Indeed, it presented marked pseudoplastic flow behavior that allowed relatively fast injection through a narrow needle, followed by an increase in viscosity upon contact with aqueous fluids to obtain an in vitro sustained release of hydrophilic and lipophilic drugs over a few weeks. As a consequence, it was assumed that this carrier should be able to jellify in situ upon contact with physiological fluid such as synovial fluid. Then, according to EMA recommendations, a fast and easy manufacturing process that could be applied in a cleanroom at industrial scale was validated in our Laboratory. Finally, according to these promising results obtained in vitro, a stability study was performed on the carrier alone and containing clonidine or betamethasone according to ICH recommendations described for products intended for storage in a refrigerator. In that purpose, several parameters such as the quantification of drugs, the pH, the molecular weight of hyaluronic acid, the dissolution profiles of drugs and the rheological properties of the formulations were recorded depending on time and conditions of storage. This stability study showed clearly the importance to adjust the pH value of the formulation. Indeed, it was demonstrated that a pH value of 6.5, adjusted with diluted NaOH, allowed the stability of the formulation to be significantly improved. During this first step of this project, our Laboratory initiated two new collaborations. On the first hand, collaboration with the Laboratory of Professor Siepmann (University of Lille 2 – Faculty of Pharmacy) was started for their expertise on mathematical modeling. On the other hand, collaboration with the Laboratory of Professor Jerôme (ULg – Faculty of sciences) was started for their expertise on macromolecular chemistry and more particularly on rheological properties.

In the second step of this work, it was decided to evaluate in vitro the safety and the efficiency of the developed carrier and formulations containing clonidine or betamethasone. In this way, it was suggested to test selected drugs and potential candidates formulations on equine polymorphonuclear leukocytes (PMN) by measuring the production of reactive oxygen species (ROS) by PMNs stimulated or not with phorbol 12-myristate 13-acetate (PMA). For that purpose, our Laboratory initiated a new collaboration with the Laboratory of Professor Serteyn (ULg – Faculty of veterinary) for their expertise on equine PMNs and quantification of (ROS) produced in particular in inflammatory diseases.

This in vitro study has shown that no pro-inflammatory effect appeared by incubating carrier with unstimulated PMNs in comparison with the control assay. However, the production of ROS was quickly and considerably decreased when stimulated cells were placed in contact with carrier regardless on the incorporation of clonidine or betamethasone. This observation demonstrated that developed carrier provided a strong antioxidant effect, certainly by trapping the ROS produced. These results were very promising because that antioxidant effect of carrier could inhibit oxidative damages and might consequently potentiate the prevention of inflammatory conditions. Concerning the clonidine and betamethasone, only the last one provided significant inhibition of the ROS activity.

Finally, by considering the very promising results obtained with the in vitro study on PMNs, an in vivo study on rabbits, which seemed to be the most appropriate small animal model for this kind of intraarticular formulations, was performed to evaluate the toxicity and the efficiency of the developed carrier and formulation containing betamethasone. Therefore, our Laboratory started collaboration with the unit of research in osteo-articular pathologies (UROC) of Pr. Henrotin (ULg) for their expertise in animal models, in particular rabbits with osteoarticular pathologies such as osteoarthritis. For this purpose, this in vivo study was outsourced by TNO (Delft, Holland) and was designed as follow: (i) 0.9 % saline buffered (n=8); (ii) carrier (n=8); (iii) formulation containing betamethasone (n=8); (iv) Durolane® (n=8) a marketed product of HA. Surprisingly, it seemed that the control group (saline buffered) presented macroscopical and histological scores that were globally low according to literature. As a consequence, it was difficult to conclude about the efficiency of the developed treatments by considering only this pilot study. However, it is important to note that it seemed that the expected viscoelastic protection of the carrier to prevent the degradation of articular cartilage was not optimal regardless on the incorporation of betamethasone. Nevertheless, the histological analyses of synovial membranes from each treated groups demonstrated that there was no pro-inflammatory reaction. This meant that all formulations tested were well tolerated despite of the apparition of lumps (in 37.5 % of treated rabbits) that are probably due to both the high volume injected (900 µL) and an excessive and unexpected in situ water uptake of developed formulations based on GMO. However, this lack of rejection of the developed carrier could be very important since it allowed new perspectives to be considered. For example, other articular disorders could be targeted by incorporating drugs, for which in situ sustained release or mechanical protection could be beneficial.

Our laboratory is member of a collaborative project "JOINT-AIC" from BioWin and is supported by a grant from the Walloon Region. The development of analytical methods, the evaluation of physico-chemical properties and finally the preparation of sterile batches of formulations based on GMO intended for in vitro and in vivo studies were performed in the Laboratory of Galenic and Biopharmacy of the Faculty of Pharmacy of ULB./L’arthrose est une pathologie dont la prévalence et le coût ne font qu’augmenter dans notre société vieillissante. Les moyens thérapeutiques actuels étant fort limités suite à de sérieux effets secondaires à long terme, il existe réellement un besoin médical important de développer de nouveaux traitements locaux qui soient bien tolérés, biocompatibles et biodégradables. Idéalement, ceux-ci devraient être actifs au niveau du processus inflammatoire ou de la douleur tout en étant capable de stabiliser, voire de restaurer, l’intégrité mécanique de l’articulation.

Dans cette optique, l’objectif de ce projet a été de développer des systèmes hydrolipidiques stériles, injectables et viscoélastiques qui soient capables de prolonger in situ la libération de principes actifs hydrophiles et lipophiles. Cette caractéristique devait permettre de réduire le nombre d’injections nécessaires dans le cadre du traitement symptomatique de l’arthrose et de maintenir l’effet des composés sur un minimum de quatre à six semaines. Cette étude entre dans le cadre du projet JOINT-AIC entièrement financé par le programme BioWin de la Région Wallonne. Le développement, la validation des méthodes analytiques, l’évaluation des propriétés physico-chimiques ainsi que la préparation stérile des lots de formulation destinés aux tests in vitro et in vivo ont été réalisés au sein du Laboratoire de Galénique et Biopharmacie de la Faculté de Pharmacie de l’ULB.

Au cours de ce projet, il a donc fallu dans un premier temps développer et caractériser des formulations hydrolipidiques à base de monoléine et d’acide hyaluronique permettant une libération in vitro prolongée de principes actifs tels que la clonidine (hydrophile) et le dipropionate de bétaméthasone (lipophile). Une étude de compatibilité a ainsi été préalablement réalisée afin de s’assurer qu’aucun des constituants principaux de la formulation ne présentaient d’incompatibilité physico-chimique qui pourrait être délétère vis-à-vis de leur stabilité en formulation. Ensuite, le développement de préparations hydro-lipidiques a été initié en tenant compte, d’une part de la solubilité des différents composants et, d’autre part de l’injectabilité, des propriétés rhéologiques et des profils de libération de la clonidine obtenus à partir des gels développés. Cette étude visait à obtenir une composition de référence qui soit à la fois injectable et capable de libérer un principe actif hydrophile sur plusieurs jours, voire plusieurs semaines, tout en possédant des propriétés rhéologiques intéressantes dans le cadre d’une viscosupplémentation articulaire. Enfin, un protocole de fabrication en milieu aseptique a été développé et plusieurs méthodes pour étudier les propriétés physico-chimiques des gels développés telles que la rhéologie, l’injectabilité, l’indice de gonflement, la stabilité et les profils de libérations ont été mises en place.

Les résultats ont montré qu’aucune incompatibilité ne semblait exister entre les trois composés majeurs de notre préparation, la monoléine, l’acide hyaluronique et la clonidine. Le développement des formulations nous a ensuite permis d’obtenir de nouveaux systèmes hydrolipidiques stériles et injectables à délivrance prolongée. Le véhicule qui remplissait au mieux nos objectifs était composé de 10,0% (m/m) d’éthanol ;de 15,0% de propylène glycol (m/m) ;de 15,0% (m/m) d’eau ;de 55,0% (m/m) de monoléine ;5,0% (m/m) d’huile de soja purifiée ;0,03% (m/m) d’α-tocophérol, de 7,5 mg/g d’HA et son pH était ajusté à 6,5 avec du NaOH 1N. Ce véhicule a montré un intérêt réel dans le cadre du développement de préparations biodégradables et biocompatibles pour le traitement de pathologies articulaires.En effet, cette composition présentait un écoulement de type pseudoplastique et des propriétés rhéologiques qui lui procuraient une bonne injectabilité. De plus, cette formulation a démontré in vitro une excellente capacité à gélifier au contact de fluides aqueux et à ralentir efficacement sur plusieurs semaines la libération des différents principes actifs incorporés (clonidine et dipropionate de bétaméthasone). Nous pouvions, dès lors, envisager que celle-ci serait capable de gélifier in situ au contact d’un fluide physiologique tel que le liquide synovial. Ensuite, suivant les recommandations de l’EMA, nous avons décidé d’utiliser l’association d’une filtration stérilisante et d’une préparation en milieu aseptique pour obtenir des formulations qui répondaient aux exigences en matière de préparation parentérale. C’est ainsi qu’un protocole de fabrication stérile de nos gels a été développé par nos soins en vue d’une éventuelle mise à l’échelle industrielle. Enfin, une étude de stabilité sur une année, suivant les normes ICH décrites pour des formulations destinées à être conservées au frigo, a été réalisée sur différents véhicules développés et contenant soit la clonidine, soit le dipropionate de bétaméthasone. Dans cette optique, plusieurs paramètres, tels que le dosage en principe actif, l’évolution du pH et du poids moléculaire de HA, le profil de libération ainsi que la rhéologie des formulations ont été évalués au cours du temps aux différentes conditions de conservation testées. Cette étude a permis de démontrer toute l’importance d’ajuster le pH de la préparation pour prévenir l’hydrolyse de l’HA, et cela indépendamment de l’incorporation de principe actif. Ainsi, il a pu être montré que l’ajustement du pH du véhicule à 6,5 à partir de NaOH dilué permettait d’améliorer considérablement la stabilité de la formulation puisqu’aucune modification significative de ses différents paramètres physico-chimiques et teneurs n’a été observée après un an de conservation à 5 et à 25 °C (60% HR) mais également après six mois à 30 °C (65% HR). Au cours de cette première partie, deux collaborations ont été initiées, l’une avec le Laboratoire du Prof. Siepmann de l’Université de Lille 2 et l’autre avec le Prof. Jerôme de l’Université de Liège. Avec l’aide du Prof. Siepmann, il a été possible de mettre au point un modèle mathématique pour caractériser les profils de libération des principes actifs à partir des différents véhicules développés. Le Prof. Jerôme a, quant à elle, mis à notre disposition un rhéomètre qui a permis d’approfondir nos connaissances sur les propriétés rhéologiques et viscoélastiques des formulations.

Ensuite, la seconde partie de notre travail a consisté à évaluer la tolérance, ainsi que l’efficacité des principes actifs sélectionnés et des formulations développées, à travers un modèle in vitro de cellules de l’inflammation (neutrophiles équins). Cette étude avait pour objectif d’évaluer deux aspects importants de la formulation :d’une part vérifier l’absence de réaction pro-inflammatoire qui pourrait être in vivo destructrice vis-à-vis du véhicule ainsi que des tissus environnants, et d’autre part vérifier l’effet anti-inflammatoire propre à la clonidine et au dipropionate de bétaméthasone seuls et en formulation. Cette étude a été réalisée avec la collaboration du Laboratoire du Prof. Serteyn de l’Université de Liège.Cette étude in vitro a démontré que les cellules restaient viables au moins pendant quatre heures lorsqu’elles étaient exposées à la matrice épurée de ses solvants. Ensuite, de manière surprenante, il a même pu être démontré que le véhicule permettait à la fois de prévenir et de réduire significativement la production des espèces réactives de l’oxygène (ROS) par les neutrophiles équins lorsque ceux-ci étaient stimulés au phorbol 12-myristate 13-acetate (PMA). Cette propriété peut être d’un grand intérêt dans le cadre de la prise en charge de l’arthrose car cette activité antioxydante pourrait permettre d’inhiber les dommages oxydatifs générés par les ROS et ainsi prévenir les dommages liés au développement du processus inflammatoire et qui peut, à long terme, s’avérer délétère pour les tissus environnants tels que le cartilage. Cette propriété du véhicule semble trouver son origine dans la monoléine qui, de par sa composition en alpha-tocophérol (200 ppm), présente également une activité antioxydante vis-à-vis des ROS. Toutefois, une action synergique liée à l’HA, à l’huile de soja ou à l’alpha-tocophérol incorporés aux formulations, n’est pas à exclure. Enfin, parmi les deux principes actifs sélectionnés, seul le dipropionate de bétaméthasone a montré une inhibition significative de la production des ROS.

Enfin, en tenant compte des résultats obtenus sur cellules, une étude in vivo pilote a été réalisée sur base d’un modèle de lapins. Cette étude visait à vérifier la tolérance ainsi que l’efficacité en prophylaxie de l’arthrose du véhicule développé ainsi que de la formulation contenant le dipropionate de bétaméthasone. Dans ce but, quatre groupes d’animaux (n=8) ont été constitués pour chacun des traitements testés :(i) groupe témoin :0,9 % tampon salin pH 7,4 ;(ii) véhicule à base de GMO développé; (iii) véhicule contenant du dipropionate de bétaméthasone ;(iv) groupe référence :Durolane®. Cette étude a été réalisée avec l’aide du Laboratoire du Prof. Henrotin de l’Université de Liège. L’hébergement des animaux ainsi que les actes chirurgicaux ont, quant à eux, été sous-traités par TNO (Delft, Pays-Bas).

De manière étonnante, il s’est avéré que le groupe contrôle présentait des scores macroscopique et histologique globalement peu élevés par rapport à ce qui est rapporté dans la littérature. Compte tenu de cette observation, il est difficile de se prononcer, sur base uniquement de cette étude, sur l’efficacité des différents traitements testés. Toutefois, il faut reconnaître que l’effet protecteur attendu pour le véhicule vis-à-vis de la dégradation du cartilage ne semble pas optimal et cela indépendamment de l’incorporation de dipropionate de bétaméthasone. Par ailleurs, l’étude des membranes synoviales a permis de démontrer qu’il n’y avait aucune différence significative en termes d’inflammation et de structure entre le groupe contrôle et les différents groupes traités. Ce qui signifie qu’aucun rejet n’a été observé vis-à-vis des formulations et que celles-ci ont, par conséquent, été bien tolérées malgré la formation de masses liées probablement au volume important injecté (900 µL) et au gonflement in situ du produit chez 37,5 % des lapins. Cette observation est importante puisqu’elle permet d’envisager de nouvelles perspectives telles que l’incorporation d’autres principes actifs pouvant éventuellement viser d’autres pathologies articulaires et pour lesquels une libération prolongée ou une protection mécanique du principe actif in situ serait bénéfique.

Doctorat en Sciences biomédicales et pharmaceutiques
info:eu-repo/semantics/nonPublished

Pharmaceutical Sciences
Ph.D.
Diabetes is a leading cause of death and disability in the United States. Diabetes requires a lifetime medical treatment. Some diabetes drugs could be taken orally, while others require daily injection or inhalation to maximize bioavailability and minimize toxicity. Parenteral delivery is a group of delivery routes which bypass human gastrointestinal track. Among all the parenteral methods, we chose subcutaneous implant based on its fast act and high patient compliance. When using subcutaneous implant, drug release needs to be strictly controlled. There are three major groups of controlled release methods. Solvent controlled system is already used as osmotic implant. Matrix controlled system is used in Zoladex® implant to treat cancer. Membrane controlled systems is widely used in coating tablets, but not that popular as an implant. Based on the research reported by previous scientists, we decided to build a hybrid system using both matrix and membrane control to delivery human insulin and other small molecule drugs. Subcutaneous environment is different from human GI track. It has less tolerance for external materials so many polymers cannot be used. From the FDA safe excipient database, we selected albumin as our primary polymer and gelatin as secondary choice. In our preliminary insulin diffusion study, we successfully found that insulin mixed with albumin provided a slower diffusion rate compared with control. In addition, we added zinc chloride, a metal salt that can precipitate albumin. The insulin diffusion rate is further reduced. The preliminary study proved that matrix control using albumin is definitely feasible and we might add zinc chloride as another factor. In order to fabricate an implant with appropriate size, we use lyophilisation technology to produce uniformly mixed matrix. Apart from albumin and human insulin, we added sucrose as protectant and plasticizer. The fine powder after freeze-dry was pressed as a form of tablet. The tablets were sealed in Falcon® cell culture insert. Cell culture insert provide a cylinder shape and 0.3 cm2 surface area for drug release. Insulin release study provided a zero order kinetics from prototypes with zinc chloride or 0.4 micron pore size membrane. Caffeine was used as a model drug to investigate the releasing mechanism. Three pore size membranes (0.4, 3 and 8 micron) were tested with same formulation. While 0.4 micron prototypes provided the slowest release, 3 micron ones surprisingly released caffeine faster than 8 micron implants. We calculated the porosity with pore size and concluded that the percentage of open area on a membrane is the key point to control caffeine release. 0.4 micron membranes were used for future research. We increased the percentage of albumin in our excipient, and achieved a slower caffeine release. However, the zero order release could only last for 3 days. After we replaced sucrose with gelatin, a 5 day zero order release of caffeine was achieved. With all the results, we proposed our “Three Phase” drug release mechanism controlled by both membrane and matrix. Seven other small molecule drugs were tested using our prototype. Cloudy suspension was observed with slightly soluble drugs. We updated our “Three Phase” drug release mechanism with the influence of drug solubility. Data shows that releasing rate with same formulation and membrane follows the solubility in pH 7.4. This result proves that our prototype might be used for different drugs based on their solubility. Finally, with all the information of our prototype, we decided to build a “smart insulin implant” with dose adjustment. We proposed an electrical controlled implant with different porosity membranes. Solenoid was used as the mechanical arm to control membrane porosity. 3-D printing technology was used to produce the first real prototype of our implant. Finally, insulin implant with clinically effective insulin release rate was achieved.
Temple University--Theses