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2.
Carbohydr Polym ; 337: 122188, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38710565

ABSTRACT

Growing plants in karst areas tends to be difficult due to the easy loss of water and soil. To enhance soil agglomeration, water retention, and soil fertility, this study developed a physically and chemically crosslinked hydrogel prepared from quaternary ammonium guar gum and humic acid. The results showed that non-covalent dynamic bonds between the two components delayed humic acid release into the soil, with a release rate of only 35 % after 240 h. The presence of four hydrophilic groups (quaternary ammonium, hydroxyl, carboxyl, and carbonyl) in the hydrogel more than doubled the soil's water retention capacity. The interaction between hydrogel and soil minerals (especially carbonate and silica) promoted hydrogel-soil and soil­carbonate adhesion, and the adhesion strength between soil particles was enhanced by 650 %. Moreover, compared with direct fertilization, this degradable hydrogel not only increased the germination rate (100 %) and growth status of mung beans but also reduced the negative effects of excessive fertilization on plant roots. The study provides an eco-friendly, low-cost, and intelligent system for soil improvement in karst areas. It further proves the considerable application potential of hydrogels in agriculture.


Subject(s)
Galactans , Humic Substances , Hydrogels , Mannans , Plant Gums , Quaternary Ammonium Compounds , Soil , Plant Gums/chemistry , Galactans/chemistry , Mannans/chemistry , Hydrogels/chemistry , Soil/chemistry , Quaternary Ammonium Compounds/chemistry , Fertilizers , Delayed-Action Preparations/chemistry , Germination/drug effects , Water/chemistry
3.
AAPS PharmSciTech ; 25(5): 94, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38710898

ABSTRACT

This study introduces and assesses the potential of a Luliconazole-loaded nanofiber (LUL-NF) patch, fabricated through electrospinning, for enhancing topical drug delivery. The primary objectives involve evaluating the nanofiber structure, characterizing physical properties, determining drug loading and release kinetics, assessing antifungal efficacy, and establishing the long-term stability of the NF patch. LUL-NF patches were fabricated via electrospinning and observed by SEM at approximately 200 nm dimensions. The comprehensive analysis included physical properties (thickness, folding endurance, swelling ratio, weight, moisture content, and drug loading) and UV analysis for drug quantification. In vitro studies explored sustained drug release kinetics, while microbiological assays evaluated antifungal efficacy against Candida albicans and Aspergillus Niger. Stability studies confirmed long-term viability. Comparative analysis with the pure drug, placebo NF patch, LUL-NF patch, and Lulifod gel was conducted using agar diffusion, revealing enhanced performance of the LUL-NF patch. SEM analysis revealed well-defined LUL-NF patches (0.80 mm thickness) with exceptional folding endurance (> 200 folds) and a favorable swelling ratio (12.66 ± 0.73%). The patches exhibited low moisture uptake (3.4 ± 0.09%) and a moisture content of 11.78 ± 0.54%. Drug loading in 1 cm2 section was 1.904 ± 0.086 mg, showing uniform distribution and sustained release kinetics in vitro. The LUL-NF patch demonstrated potent antifungal activity. Stability studies affirmed long-term stability, and comparative analysis highlighted increased inhibition compared to a pure drug, LUL-NF patch, and a commercial gel. The electrospun LUL-NF patch enhances topical drug delivery, promising extended therapy through single-release, one-time application, and innovative drug delivery strategies, supported by thorough analysis.


Subject(s)
Antifungal Agents , Aspergillus niger , Candida albicans , Drug Delivery Systems , Drug Liberation , Imidazoles , Nanofibers , Antifungal Agents/administration & dosage , Antifungal Agents/pharmacology , Antifungal Agents/chemistry , Nanofibers/chemistry , Candida albicans/drug effects , Aspergillus niger/drug effects , Drug Delivery Systems/methods , Imidazoles/chemistry , Imidazoles/administration & dosage , Imidazoles/pharmacology , Delayed-Action Preparations , Microbial Sensitivity Tests/methods , Drug Carriers/chemistry , Drug Stability
4.
AAPS PharmSciTech ; 25(5): 105, 2024 May 09.
Article in English | MEDLINE | ID: mdl-38724807

ABSTRACT

The formulation of microspheres involves a complex manufacturing process with multiple steps. Identifying the appropriate process parameters to achieve the desired quality attributes poses a significant challenge. This study aims to optimize the critical process parameters (CPPs) involved in the preparation of naltrexone microspheres using a Quality by Design (QbD) methodology. Additionally, the research aims to assess the drug release profiles of these microspheres under both in vivo and in vitro conditions. Critical process parameters (CPPs) and critical quality attributes (CQAs) were identified, and a Box-Behnken design was utilized to delineate the design space, ensuring alignment with the desired Quality Target Product Profile (QTPP). The investigated CPPs comprised polymer concentration, aqueous phase ratio to organic phase ratio, and quench volume. The microspheres were fabricated using the oil-in-water emulsion solvent extraction technique. Analysis revealed that increased polymer concentration was correlated with decreased particle size, reduced quench volume resulted in decreased burst release, and a heightened aqueous phase ratio to organic phase ratio improved drug entrapment. Upon analyzing the results, an optimal formulation was determined. In conclusion, the study conducted in vivo drug release testing on both the commercially available innovator product and the optimized test product utilizing an animal model. The integration of in vitro dissolution data with in vivo assessments presents a holistic understanding of drug release dynamics. The QbD approach-based optimization of CPPs furnishes informed guidance for the development of generic pharmaceutical formulations.


Subject(s)
Chemistry, Pharmaceutical , Delayed-Action Preparations , Drug Delivery Systems , Drug Liberation , Microspheres , Naltrexone , Particle Size , Naltrexone/chemistry , Naltrexone/administration & dosage , Naltrexone/pharmacokinetics , Animals , Chemistry, Pharmaceutical/methods , Delayed-Action Preparations/chemistry , Drug Delivery Systems/methods , Polymers/chemistry , Emulsions/chemistry , Drug Compounding/methods , Solubility , Solvents/chemistry
5.
Pharmacoepidemiol Drug Saf ; 33(5): e5805, 2024 May.
Article in English | MEDLINE | ID: mdl-38720402

ABSTRACT

PURPOSE: In drug studies, research designs requiring no prior exposure to certain drug classes may restrict important populations. Since abuse-deterrent formulations (ADF) of opioids are routinely prescribed after other opioids, choice of study design, identification of appropriate comparators, and addressing confounding by "indication" are important considerations in ADF post-marketing studies. METHODS: In a retrospective cohort study using claims data (2006-2018) from a North Carolina private insurer [NC claims] and Merative MarketScan [MarketScan], we identified patients (18-64 years old) initiating ADF or non-ADF extended-release/long-acting (ER/LA) opioids. We compared patient characteristics and described opioid treatment history between treatment groups, classifying patients as traditional (no opioid claims during prior six-month washout period) or prevalent new users. RESULTS: We identified 8415 (NC claims) and 147 978 (MarketScan) ADF, and 10 114 (NC claims) and 232 028 (MarketScan) non-ADF ER/LA opioid initiators. Most had prior opioid exposure (ranging 64%-74%), and key clinical differences included higher prevalence of recent acute or chronic pain and surgery among patients initiating ADFs compared to non-ADF ER/LA initiators. Concurrent immediate-release opioid prescriptions at initiation were more common in prevalent new users than traditional new users. CONCLUSIONS: Careful consideration of the study design, comparator choice, and confounding by "indication" is crucial when examining ADF opioid use-related outcomes.


Subject(s)
Abuse-Deterrent Formulations , Analgesics, Opioid , Opioid-Related Disorders , Practice Patterns, Physicians' , Research Design , Humans , Analgesics, Opioid/administration & dosage , Retrospective Studies , Middle Aged , Male , Female , Adult , Opioid-Related Disorders/prevention & control , Opioid-Related Disorders/epidemiology , Practice Patterns, Physicians'/statistics & numerical data , Practice Patterns, Physicians'/standards , Young Adult , Adolescent , North Carolina/epidemiology , Delayed-Action Preparations , Cohort Studies , Drug Prescriptions/statistics & numerical data
6.
JAMA Netw Open ; 7(5): e249744, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38717773

ABSTRACT

Importance: Injectable extended-release (XR)-naltrexone is an effective treatment option for opioid use disorder (OUD), but the need to withdraw patients from opioid treatment prior to initiation is a barrier to implementation. Objective: To compare the effectiveness of the standard procedure (SP) with the rapid procedure (RP) for XR-naltrexone initiation. Design, Setting, and Participants: The Surmounting Withdrawal to Initiate Fast Treatment with Naltrexone study was an optimized stepped-wedge cluster randomized trial conducted at 6 community-based inpatient addiction treatment units. Units using the SP were randomly assigned at 14-week intervals to implement the RP. Participants admitted with OUD received the procedure the unit was delivering at the time of their admission. Participant recruitment took place between March 16, 2021, and July 18, 2022. The last visit was September 21, 2022. Interventions: Standard procedure, based on the XR-naltrexone package insert (approximately 5-day buprenorphine taper followed by a 7- to 10-day opioid-free period and RP, defined as 1 day of buprenorphine at minimum necessary dose, 1 opioid-free day, and ascending low doses of oral naltrexone and adjunctive medications (eg, clonidine, clonazepam, antiemetics) for opioid withdrawal. Main Outcomes and Measures: Receipt of XR-naltrexone injection prior to inpatient discharge (primary outcome). Secondary outcomes included opioid withdrawal scores and targeted safety events and serious adverse events. All analyses were intention-to-treat. Results: A total of 415 participants with OUD were enrolled (mean [SD] age, 33.6 [8.48] years; 205 [49.4%] identified sex as male); 54 [13.0%] individuals identified as Black, 91 [21.9%] as Hispanic, 290 [69.9%] as White, and 22 [5.3%] as multiracial. Rates of successful initiation of XR-naltrexone among the RP group (141 of 225 [62.7%]) were noninferior to those of the SP group (68 of 190 [35.8%]) (odds ratio [OR], 3.60; 95% CI, 2.12-6.10). Withdrawal did not differ significantly between conditions (proportion of days with a moderate or greater maximum Clinical Opiate Withdrawal Scale score (>12) for RP vs SP: OR, 1.25; 95% CI, 0.62-2.50). Targeted safety events (RP: 12 [5.3%]; SP: 4 [2.1%]) and serious adverse events (RP: 15 [6.7%]; SP: 3 [1.6%]) were infrequent but occurred more often with RP than SP. Conclusions and Relevance: In this trial, the RP of XR-naltrexone initiation was noninferior to the standard approach and saved time, although it required more intensive medical management and safety monitoring. The results of this trial suggest that rapid initiation could make XR-naltrexone a more viable treatment for patients with OUD. Trial Registration: ClinicalTrials.gov Identifier: NCT04762537.


Subject(s)
Delayed-Action Preparations , Naltrexone , Narcotic Antagonists , Opioid-Related Disorders , Humans , Naltrexone/therapeutic use , Naltrexone/administration & dosage , Male , Female , Opioid-Related Disorders/drug therapy , Adult , Narcotic Antagonists/therapeutic use , Narcotic Antagonists/administration & dosage , Delayed-Action Preparations/therapeutic use , Middle Aged , Substance Withdrawal Syndrome/drug therapy , Treatment Outcome
7.
AAPS PharmSciTech ; 25(5): 118, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38806735

ABSTRACT

The use of in vitro-in vivo correlation (IVIVC) for extended release oral dosage forms is an important technique that can avoid potential clinical studies. IVIVC has been a topic of discussion over the past two decades since the inception of USFDA guidance. It has been routinely used for biowaivers, establishment of dissolution safe space and clinically relevant dissolution specifications, for supporting site transfers, scale-up and post approval changes. Although conventional or mathematical IVIVC is routinely used, other approach such as mechanistic IVIVC can be of attractive choice as it integrates all the physiological aspects. In the present study, we have performed comparative evaluation of mechanistic and conventional IVIVC for establishment of dissolution safe space using divalproex sodium and tofacitinib extended release formulations as case examples. Conventional IVIVC was established using Phoenix and mechanistic IVIVC was set up using Gastroplus physiologically based biopharmaceutics model (PBBM). Virtual dissolution profiles with varying release rates were constructed around target dissolution profile using Weibull function. After internal and external validation, the virtual dissolution profiles were integrated into mechanistic and conventional IVIVC and safe space was established by absolute error and T/R ratio's methods. The results suggest that mechanistic IVIVC yielded wider safe space as compared to conventional IVIVC. The results suggest that a mechanistic approach of establishing IVIVC may be a flexible approach as it integrates physiological aspects. These findings suggest that mechanistic IVIVC has wider potential as compared to conventional IVIVC to gain wider dissolution safe space and thus can avoid potential clinical studies.


Subject(s)
Chemistry, Pharmaceutical , Delayed-Action Preparations , Drug Liberation , Solubility , Chemistry, Pharmaceutical/methods , Administration, Oral , Piperidines/chemistry , Piperidines/administration & dosage , Pyrimidines/chemistry , Pyrimidines/administration & dosage , Pyrrolidines/chemistry , Biopharmaceutics/methods
8.
Ugeskr Laeger ; 186(20)2024 May 13.
Article in Danish | MEDLINE | ID: mdl-38808759

ABSTRACT

Long-acting injectable antipsychotics (LAI) is a frequently used treatment modality which has advantages over oral antipsychotics regarding hospitalization or relapse prevention. However, the pharmacokinetic properties of LAI greatly differ from oral antipsychotics. This necessitates an increased knowledge about LAI among clinicians, especially when commencing treatment, changing doses and discontinuing treatment. In this review, we summarize an array of clinically important characteristics of LAI and give a conceptual framework for understanding the pharmacokinetics of LAI.


Subject(s)
Antipsychotic Agents , Delayed-Action Preparations , Humans , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/pharmacokinetics , Antipsychotic Agents/adverse effects , Injections , Injections, Intramuscular
9.
Food Res Int ; 187: 114423, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38763674

ABSTRACT

The ß-cyclodextrin and short-chain alkyl gallates (A-GAs), which are representative of phenolipids, such as butyl, propyl, ethyl, and methyl gallates, were chosen to form inclusion complexes by the use of the freeze-drying process. In the everted rat gut sac model, HPLC-UV analysis demonstrated that the released A-GAs from inclusion complexes were degraded to yield free gallic acid (GA) (sustained-release function 1). The small intestine membrane may be crossed by both the GA and the A-GAs. A-GAs may also undergo hydrolysis to provide GA (sustained-release function 2) following transmembrane transfer. Clearly, a helpful technique for the dual sustained-release of phenolic compounds is to produce ß-cyclodextrin inclusion complexes with short-chain phenolipids. This will increase the bioactivities of phenolic compounds and prolong their in vivo residence length. Moreover, changing the carbon-chain length of these ß-cyclodextrin inclusion complexes would readily modify the dual sustained-release behavior of the phenolic compounds. Thus, our work effectively established a theoretical foundation for the use of ß-cyclodextrin inclusion complexes containing short-chain phenolipids as new source of functional food components to provide the body with phenolic compounds more efficiently.


Subject(s)
Delayed-Action Preparations , Gallic Acid , Phenols , beta-Cyclodextrins , beta-Cyclodextrins/chemistry , Animals , Rats , Gallic Acid/chemistry , Male , Phenols/chemistry , Rats, Sprague-Dawley , Freeze Drying
10.
Pak J Pharm Sci ; 37(2): 385-397, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38767106

ABSTRACT

A drug-resin liquid delayed-release suspension of pantoprazole sodium (PAZ-Na) was prepared to improve the effectiveness, convenience and safety of peptic ulcer treatment in children, the elderly and patients with dysphagia. Pantoprazole sodium drug-resin complexes (PAZ-Na-DRC) were prepared using the bath method. The fluidized bed coating method is used to coat it and then add excipients to make a dry suspension prepared before use. The parameters of the in vitro release experimental conditions were optimized and the drug release curve showed delayed release. Rats were given commercial PAZ-Na enteric-coated pellet capsules and the PAZ-Na delayed release suspension via intragastric administration. The results showed that the Tmax of the PAZ-Na delayed release suspension was increased from 2h to 4h compared with the PAZ-Na enteric-coated pellet capsules. Similarly, the Cmax was reduced from 6.162µg/mL to 3.244µg/mL with the concentration-time curve is very gentle compared with the commercial drug capsules. After oral administration, the relative bioavailability of PAZ-Na delayed release suspension (AUC0-24 of 19.578 µg•h•mL-1) compared with the commercial drug (AUC0-24 of 17.388 µg•h•mL-1) was 112.67%. The findings showed that the PAZ-Na delayed release suspension for oral administration was successfully formulated with highly improved pharmacokinetic indices.


Subject(s)
Delayed-Action Preparations , Pantoprazole , Suspensions , Pantoprazole/pharmacokinetics , Pantoprazole/administration & dosage , Animals , Male , Rats , Drug Liberation , Biological Availability , Administration, Oral , Drug Compounding , Excipients/chemistry , Rats, Sprague-Dawley
11.
Pak J Pharm Sci ; 37(2): 405-416, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38767108

ABSTRACT

To develop a new kind of famotidine-resin microcapsule for gastric adhesion sustained release by screening out suitable excipients and designing reasonable prescriptions to improve patient drug activities to achieve the expected therapeutic effect. The famotidine drug resin was prepared using the water bath method with carbomer 934 used as coating material. Microcapsules were prepared using the emulsified solvent coating method and appropriate excipients were used to prepare famotidine sustained release suspension. Pharmacokinetics of the developed microcapsules were studied in the gastrointestinal tract of rats. The self-made sustained-release suspension of famotidine hydrochloride effectively reduced the blood concentration and prolonged the action time. The relative bioavailability of the self-made suspension of the famotidine hydrochloride to the commercially available famotidine hydrochloride was 146.44%, with an average retention time of about 5h longer, which indicated that the new suspension had acceptable adhesion properties. The findings showed that the newly developed famotidine-resin microcapsule increased the bioavailability of the drug with a significant sustained-release property.


Subject(s)
Biological Availability , Delayed-Action Preparations , Famotidine , Famotidine/pharmacokinetics , Famotidine/administration & dosage , Famotidine/chemistry , Famotidine/pharmacology , Animals , Rats , Male , Excipients/chemistry , Suspensions , Capsules , Drug Liberation , Acrylic Resins/chemistry , Histamine H2 Antagonists/pharmacokinetics , Histamine H2 Antagonists/administration & dosage , Histamine H2 Antagonists/pharmacology , Histamine H2 Antagonists/chemistry , Adhesiveness , Drug Compounding , Acrylates
12.
J Biomed Mater Res B Appl Biomater ; 112(6): e35418, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38786546

ABSTRACT

The method of synthesis of unmodified and organo-modified silica hydrogels and their composites with orotic acid as a model drug was developed. The hydrogels had a pH of 6.5-7.8. The particulate nature and highly porous structures of the hydrogel materials were revealed using scanning electron and optical microscopy methods. The content of aqueous phase in the hydrogels was 99% or more. In order to evaluate the possibility of their application as a basis for development of novel soft drug formulations and cosmetic compositions, rheological properties of the hydrogels and in vitro release kinetics of the drug were studied. The effects of synthesis conditions (increasing concentration of catalyst of silica sol formation, drug loading) and the silica matrix modification with various organic groups on the indicated properties were investigated. It was found that all synthesized hydrogels exhibited pseudoplasticity, thixotropy and controlled release of the drug, which are important for their potential application. However, in general, the indicated effects led to worsening the properties of the hydrogel materials in comparison with the unmodified silica hydrogels.


Subject(s)
Hydrogels , Rheology , Silicon Dioxide , Hydrogels/chemistry , Silicon Dioxide/chemistry , Kinetics , Drug Liberation , Delayed-Action Preparations/chemistry , Delayed-Action Preparations/pharmacokinetics
13.
Sci Rep ; 14(1): 11573, 2024 05 21.
Article in English | MEDLINE | ID: mdl-38773172

ABSTRACT

GSK2838232 (GSK8232) is a second-generation maturation inhibitor (MI) developed for the treatment of HIV with excellent broad-spectrum virological profiles. The compound has demonstrated promising clinical results as an orally administered agent. Additionally, the compound's physical and pharmacological properties present opportunities for exploitation as long-acting parenteral formulations. Despite unique design constraints including solubility and dose of GSK8232, we report on three effective tunable drug delivery strategies: active pharmaceutical ingredient (API) suspensions, ionic liquids, and subdermal implants. Promising sustained drug release profiles were achieved in rats with each approach. Additionally, we were able to tune drug release rates through a combination of passive and active strategies, broadening applicability of these formulation approaches beyond GSK8232. Taken together, this report is an important first step to advance long-acting formulation development for critical HIV medicines that do not fit the traditional profile of suitable long-acting candidates.


Subject(s)
Drug Liberation , Animals , Rats , Hydrophobic and Hydrophilic Interactions , Delayed-Action Preparations , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/chemistry , Anti-HIV Agents/pharmacology , Anti-HIV Agents/pharmacokinetics , Drug Delivery Systems/methods , Ionic Liquids/chemistry , Rats, Sprague-Dawley , Male , Solubility , HIV Infections/drug therapy , Anti-Retroviral Agents/administration & dosage , Anti-Retroviral Agents/chemistry
14.
Am J Ther ; 31(3): e219-e228, 2024.
Article in English | MEDLINE | ID: mdl-38691662

ABSTRACT

BACKGROUND: Patients with schizophrenia often face challenges related to cognitive function, affecting their daily functioning and overall quality of life. The choice of antipsychotic treatment may play a crucial role in determining cognitive outcomes. STUDY QUESTION: Our study aimed to investigate whether there was a difference in cognitive ability between the patients with schizophrenia receiving oral antipsychotics (OAP) versus long-acting injectable antipsychotics (LAI-APs). STUDY DESIGN: We conducted a cross-sectional study using analytical methods between January 1, 2020, and January 1, 2022. Participants were divided into 2 groups: patients undergoing treatment with OAP and patients undergoing treatment with LAI-AP. All participants underwent version A of Brief Assessment of Cognition in Schizophrenia (BACS). MEASURES AND OUTCOMES: The primary objective was to compare cognitive function in patients with schizophrenia treated with LAI antipsychotics versus OAP using BACS. Primary outcome measures include overall BACS score, with secondary measures focusing on specific cognitive domains. This study contributes to the understanding of the cognitive effects of different antipsychotic formulations in schizophrenia treatment. RESULTS: Although there was a slightly higher intelligence quotient in the LAI-AP group (102.2 vs. 101.32, P = 0.5401), it was not statistically significant. Olanzapine was the most commonly prescribed antipsychotic, with 48% of patients in the LAI-AP group and 40% in the OAP group. The LAI-AP group outperformed in all BACS evaluations. The most notable difference was in the token motor task (57.78 ± 17.03 vs. 50.04 ± 18.82, P = 0.0335), while the Tower of London test showed the smallest difference (17.26 ± 2.61 vs. 15.48 ± 3.47, P = 0.0046). Regression analysis revealed no significant variance in intelligence quotient scores; however, a significant discrepancy in BACS scores was evident, favoring the LAI treatment for better cognitive outcomes. CONCLUSIONS: The use of long-acting antipsychotic treatment in individuals with schizophrenia offers promising advantages in preserving cognitive function.


Subject(s)
Antipsychotic Agents , Cognition , Delayed-Action Preparations , Schizophrenia , Humans , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/therapeutic use , Schizophrenia/drug therapy , Male , Female , Cross-Sectional Studies , Adult , Administration, Oral , Cognition/drug effects , Middle Aged , Injections , Schizophrenic Psychology , Quality of Life , Olanzapine/administration & dosage , Olanzapine/therapeutic use
15.
Transpl Int ; 37: 11571, 2024.
Article in English | MEDLINE | ID: mdl-38694490

ABSTRACT

Once-daily extended-release tacrolimus (LCPT) exhibits increased bioavailability versus immediate-release (IR-TAC) and prolonged release (PR-TAC) tacrolimus. Improvements in tremor were previously reported in a limited number of kidney transplant patients who switched to LCPT. We conducted a non-interventional, non-randomized, uncontrolled, longitudinal, prospective, multicenter study to assess the impact of switching to LCPT on tremor and quality of life (QoL) in a larger population of stable kidney transplant patients. The primary endpoint was change in The Essential Tremor Rating Assessment Scale (TETRAS) score; secondary endpoints included 12-item Short Form Survey (SF-12) scores, tacrolimus trough concentrations, neurologic symptoms, and safety assessments. Subgroup analyses were conducted to assess change in TETRAS score and tacrolimus trough concentration/dose (C0/D) ratio by prior tacrolimus formulation and tacrolimus metabolizer status. Among 221 patients, the mean decrease of TETRAS score after switch to LCPT was statistically significant (p < 0.0001 vs. baseline). There was no statistically significant difference in change in TETRAS score after switch to LCPT between patients who had received IR-TAC and those who had received PR-TAC before switch, or between fast and slow metabolizers of tacrolimus. The overall increase of C0/D ratio post-switch to LCPT was statistically significant (p < 0.0001) and from baseline to either M1 or M3 (both p < 0.0001) in the mITT population and in all subgroups. In the fast metabolizers group, the C0/D ratio crossed over the threshold of 1.05 ng/mL/mg after the switch to LCPT. Other neurologic symptoms tended to improve, and the SF-12 mental component summary score improved significantly. No new safety concerns were evident. In this observational study, all patients had a significant improvement of tremor, QoL and C0/D ratio post-switch to LCPT irrespective of the previous tacrolimus formulation administered (IR-TAC or PR-TAC) and irrespective from their metabolism status (fast or slow metabolizers).


Subject(s)
Delayed-Action Preparations , Immunosuppressive Agents , Kidney Transplantation , Quality of Life , Tacrolimus , Humans , Tacrolimus/administration & dosage , Tacrolimus/pharmacokinetics , Female , Male , Middle Aged , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/pharmacokinetics , Prospective Studies , Adult , Aged , Tremor/drug therapy , Drug Administration Schedule , Longitudinal Studies , Transplant Recipients
16.
J Clin Psychiatry ; 85(2)2024 May 01.
Article in English | MEDLINE | ID: mdl-38696112

ABSTRACT

Introduction: This study aimed to assess the association between long-acting injectable (LAI) antipsychotic prescription and the risk of psychiatric hospitalization in patients with treatment-resistant schizophrenia (TRS) receiving clozapine.Methods: In this retrospective cohort study at a single tertiary psychiatric center, we analyzed rehospitalization hazard ratios (HRs) in refractory schizophrenia patients, classified by DSM-IV-TR and DSM-5 criteria. We examined various psychotropic regimens-clozapine with or without other oral antipsychotics (OAPs) or LAI antipsychotics. Subgroups were stratified by daily clozapine dosage and previous admissions.Results: A total of 719 patients were included in the study. Analyses were conducted on all the patients over 3- month, 6-month, and 1-year periods. Patients treated with a combination of clozapine and LAI antipsychotics (CLO + LAI) had a significantly higher number of previous hospitalizations (P = .003), and a higher daily dose of clozapine (P < .001) was found in the CLO + OAP group than in the CLO (monotherapy) group and the CLO + LAI group. Patients treated with LAI antipsychotic comedication had significantly lower HRs for rehospitalization in 1 year among 3 studied groups. Moreover, the protective effects of LAI antipsychotics were observed in all the subgroups stratified by daily clozapine dosage and number of previous admissions to represent disease severity.Conclusion: The combination of clozapine and LAI antipsychotics was associated with a significantly lower risk of rehospitalization compared to both the combination of clozapine and OAPs and clozapine monotherapy. The use of LAI antipsychotics should be considered to prevent rehospitalization in patients with TRS who are already being treated with clozapine.


Subject(s)
Antipsychotic Agents , Clozapine , Delayed-Action Preparations , Drug Therapy, Combination , Patient Readmission , Schizophrenia, Treatment-Resistant , Humans , Clozapine/administration & dosage , Antipsychotic Agents/administration & dosage , Male , Female , Retrospective Studies , Adult , Patient Readmission/statistics & numerical data , Middle Aged , Schizophrenia, Treatment-Resistant/drug therapy , Injections , Schizophrenia/drug therapy
17.
Food Res Int ; 183: 114223, 2024 May.
Article in English | MEDLINE | ID: mdl-38760142

ABSTRACT

This study investigates the potential of κ-carrageenan hydrogel beads as a delivery system for curcumin, a bioactive compound with various health benefits. Hydrogel beads were prepared using the extrusion technique with a hypodermic needle. The encapsulation efficiency of curcumin in the κ-carrageenan hydrogel beads was found to be 74.61 ± 3.2 %. FTIR spectroscopy analysis revealed shifts in absorption peaks, indicating possible hydrogen bonding and/or ionic interactions between the polymer and salt. An increase in the melting point of curcumin, by 25 °C, in curcumin- κ-carrageenan beads suggests the heat protection offered by the carrageenan chains to curcumin molecules. The in vitro release of curcumin from the beads suggests a sustained and pH-dependent release nature. The release kinetics follow the first order and the Korsmeyer-Peppas model. The outcome offers value-added delivery systems of bioactive compounds toward developing novel food and pharmaceutical applications.


Subject(s)
Carrageenan , Curcumin , Delayed-Action Preparations , Dietary Supplements , Hydrogels , Curcumin/chemistry , Carrageenan/chemistry , Hydrogels/chemistry , Spectroscopy, Fourier Transform Infrared , Hydrogen-Ion Concentration , Drug Liberation , Drug Delivery Systems , Kinetics , Colloids/chemistry , Drug Carriers/chemistry
18.
Otol Neurotol ; 45(5): 564-571, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38728560

ABSTRACT

OBJECTIVE: To investigate the safety and feasibility of precise delivery of a long-acting gel formulation containing 6% dexamethasone (SPT-2101) to the round window membrane for the treatment of Menière's disease. STUDY DESIGN: Prospective, unblinded, cohort study. SETTING: Tertiary care neurotology clinic. PATIENTS: Adults 18 to 85 years with a diagnosis of unilateral definite Menière's disease per Barany society criteria. INTERVENTIONS: A single injection of a long-acting gel formulation under direct visualization into the round window niche. MAIN OUTCOME MEASURES: Procedure success rate, adverse events, and vertigo control. Vertigo control was measured with definitive vertigo days (DVDs), defined as any day with a vertigo attack lasting 20 minutes or longer. RESULTS: Ten subjects with unilateral Menière's disease were enrolled. Precise placement of SPT-2101 at the round window was achieved in all subjects with in-office microendoscopy. Adverse events included one tympanic membrane perforation, which healed spontaneously after the study, and two instances of otitis media, which resolved with antibiotics. The average number of DVDs was 7.6 during the baseline month, decreasing to 3.3 by month 1, 3.7 by month 2, and 1.9 by month 3. Seventy percent of subjects had zero DVDs during the third month after treatment. CONCLUSIONS: SPT-2101 delivery to the round window is safe and feasible, and controlled trials are warranted to formally assess efficacy.


Subject(s)
Dexamethasone , Meniere Disease , Round Window, Ear , Humans , Meniere Disease/drug therapy , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Middle Aged , Male , Female , Aged , Adult , Treatment Outcome , Prospective Studies , Aged, 80 and over , Delayed-Action Preparations , Cohort Studies , Vertigo/drug therapy , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Gels , Young Adult
19.
Pak J Pharm Sci ; 37(1): 107-113, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38741406

ABSTRACT

Entecavir, an effective anti-hepatitis B drug with low resistance rate, was designed as sustained-release micro spheres in our previous study. Here, we aimed to reveal the drug-release mechanism by observing the drug distribution and degradation behavior of poly (lactic-co-glycolic acid) and to investigate the pharmacodynamics of entecavir micro spheres. Raman spectroscopy was used to analyze the distribution of active pharmaceutical ingredients in the micro spheres. The results showed that there was little entecavir near the micro sphere surface. With increasing micro sphere depth, the drug distribution gradually increased and larger-size entecavir crystals were mainly distributed near the spherical center. The degradation behavior of poly (lactic-co-glycolic acid) was investigated using gel permeation chromatography. Changes in poly (lactic-co-glycolic acid) molecular weights during micro sphere degradation revealed that dissolution dominated the release process, which proved our previous research results. Pharmacodynamics studies on transgenic mice indicated that the anti-hepatitis B virus replication effect was maintained for 42 days after a single injection of entecavir micro spheres, similar to the effect of daily oral administration of entecavir tablets for 28 days. The entecavir micro spheres prepared in this study had a good anti-hepatitis B virus replication effect and it is expected to be used in anti hepatitis B virus treatment against hepatitis B virus.


Subject(s)
Antiviral Agents , Guanine , Hepatitis B virus , Polylactic Acid-Polyglycolic Acid Copolymer , Guanine/pharmacology , Guanine/analogs & derivatives , Guanine/pharmacokinetics , Animals , Antiviral Agents/pharmacology , Antiviral Agents/pharmacokinetics , Polylactic Acid-Polyglycolic Acid Copolymer/chemistry , Hepatitis B virus/drug effects , Drug Liberation , Mice, Transgenic , Mice , Virus Replication/drug effects , Microspheres , Delayed-Action Preparations , Hepatitis B/drug therapy , Particle Size , Polyglycolic Acid/chemistry , Spectrum Analysis, Raman , Lactic Acid
20.
Pharmacol Res Perspect ; 12(3): e1205, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38764237

ABSTRACT

This study aimed to examine the effect of acute exogenous melatonin administration on salivary cortisol and alpha-amylase (sCort and sAA) as representatives of the HPA axis and the sympathetic nervous system, respectively. A single-dose prolonged-release melatonin (2 mg) or a placebo tablet was given to healthy volunteers (n = 64) at 20:00 h in a crossover design. The saliva was collected at six time points (20:00, 21:00, awakening, 30 min after awakening, 10:00, and 12:00 h) and was measured for sCort, sAA, and salivary melatonin (sMT) levels. Pulse rates and sleep parameters were also collected. Melatonin was effective in improving sleep onset latency by 7:04 min (p = .037) and increasing total sleep time by 24 min (p = .006). Participants with poor baseline sleep quality responded more strongly to melatonin than participants with normal baseline sleep quality as they reported more satisfaction in having adequate sleep (p = .017). Melatonin administration resulted in higher sCort levels at awakening time point (p = .023) and a tendency of lower sAA levels but these were not significant. Melatonin ingestion at 20:00 h resulted in a marked increase in sMT levels at 21:00 h and remained higher than baseline up to at least 10:00 h (p < .001). Melatonin increases sCort levels at certain time point with a tendency to lower sAA levels. These opposing effects of melatonin suggested a complex interplay between melatonin and these biomarkers. Also, the results confirmed the positive acute effect of a single-dose melatonin on sleep quality.


Subject(s)
Cross-Over Studies , Hydrocortisone , Melatonin , Saliva , Humans , Melatonin/administration & dosage , Melatonin/pharmacology , Saliva/chemistry , Saliva/metabolism , Hydrocortisone/metabolism , Male , Adult , Female , Young Adult , alpha-Amylases/metabolism , Sleep/drug effects , Sleep Quality , Double-Blind Method , Healthy Volunteers , Hypothalamo-Hypophyseal System/drug effects , Hypothalamo-Hypophyseal System/metabolism , Pituitary-Adrenal System/drug effects , Pituitary-Adrenal System/metabolism , Delayed-Action Preparations
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