Pharmacokinetics and pharmacodynamics of a pasireotide subcutaneous depot (CAM4071) and comparison with immediate and long-acting release pasireotide.

PURPOSE: To assess the pharmacokinetics, pharmacodynamics, safety and tolerability of subcutaneous depot CAM4071, a novel, ready-to-use pasireotide formulation. METHODS: This was a phase 1, randomised, open-label study in healthy volunteers. After a single 600 µg dose of pasireotide immediate release (IR), participants were randomised to one of eight groups to receive either a CAM4071 upper thigh (5, 10, 20, 40 or 80 mg) or buttock (20 mg) injection or multiple pasireotide IR 900 µg upper thigh injections twice daily or a single pasireotide long-acting release (LAR) 60 mg intramuscular buttock injection. RESULTS: Ninety-four participants were randomised. For all CAM4071 doses, initial pasireotide release was relatively rapid compared to pasireotide LAR and sustained over the 2-month observation period, with a slow decay in plasma concentrations. CAM4071 maximum plasma concentrations increased slightly greater than dose proportionally; area under the curve extrapolated to infinity increased approximately dose proportionally. Relative bioavailability of pasireotide for different doses of CAM4071 versus pasireotide IR 600 µg ranged from 0.752 (90% confidence interval [CI]: 0.58, 0.98) to 1.68 (1.32, 2.14), and versus pasireotide LAR: 0.517 (0.37, 0.72) to 1.15 (0.84, 1.58). CAM4071 doses >5 mg exhibited rapid initial reductions of insulin-like growth factor 1 (IGF-1) compared to pasireotide LAR. Maximum IGF-1 inhibition was greatest for CAM4071 80 mg. CAM4071 injections ≤40 mg were well tolerated and comparable with currently available pasireotide formulations. CONCLUSION: CAM4071 provided long-acting release of pasireotide over at least one month, with high bioavailability and onset and duration of IGF-1 suppression similar to pasireotide LAR. TRIAL REGISTRATION: EudraCT: 2014-003783-20.

Pharmacokinetic Evaluation of Once-Weekly and Once-Monthly Buprenorphine Subcutaneous Injection Depots (CAM2038) Versus Intravenous and Sublingual Buprenorphine in Healthy Volunteers Under Naltrexone Blockade: An Open-Label Phase 1 Study.

INTRODUCTION: CAM2038 q1w (once weekly) and q4w (once monthly) are investigational buprenorphine subcutaneous (SC) formulations based on FluidCrystal® injection depot technology. These two drug products are being developed for opioid dependence treatment, with a target for once-weekly and once-monthly SC dosing. The rationale for developing two products with different dosing frequencies is that treatment strategies/routines, and hence different treatment preferences, can vary between patients, different stages of opioid maintenance treatment, and countries. This study evaluated the pharmacokinetics and safety of buprenorphine and norbuprenorphine following administration of CAM2038 q1w or q4w versus active controls. METHODS: Healthy volunteers were randomized to five treatment groups. All received a single intravenous dose of buprenorphine 600 µg, followed post-washout by a single dose of CAM2038 q4w 96 mg, a single dose of CAM2038 q4w 192 mg, or sublingual buprenorphine 8, 16, or 24 mg daily for 7 days, followed post-washout by a single dose of CAM2038 q4w 64 or 128 mg or four repeated weekly doses of CAM2038 q1w 16 mg. All subjects received daily naltrexone. RESULTS: Eighty-seven subjects were randomized. Median buprenorphine t max after CAM2038 q4w was 4-10 h (24 h for CAM2038 q1w); mean terminal half-life was 19-25 days (5 days for CAM2038 q1w). CAM2038 q4w showed dose-proportional buprenorphine release, with similar exposure to repeat-dose CAM2038 q1w at comparable monthly dose level. Both CAM2038 formulations showed complete absolute bioavailability of buprenorphine and 5.7- to 7.7-fold greater buprenorphine bioavailability versus sublingual buprenorphine. CAM2038 q1w and q4w were well tolerated; subjects' acceptance was higher for CAM2038 than for sublingual buprenorphine 1 h post-dose. CONCLUSIONS: The pharmacokinetic profiles of CAM2038 q1w and q4w versus sublingual buprenorphine support expected treatment efficacy with once-weekly and once-monthly dosing, respectively. CAM2038 formulations were safe and showed good local tolerability. TRIAL REGISTRATION: ISRCTN24987553. FUNDING: Camurus AB.

Octreotide s.c. depot provides sustained octreotide bioavailability and similar IGF-1 suppression to octreotide LAR in healthy volunteers.

AIMS: The aim was to assess the pharmacokinetics, pharmacodynamics, safety and tolerability of octreotide subcutaneous (s.c.) depot, a novel octreotide formulation. METHODS: This was a phase I, randomized, open label study. After a single dose of octreotide immediate release (IR) 200 µg, subjects were randomized to one of eight groups to receive three monthly injections of octreotide s.c. depot A 10, 20 or 30 mg, B 30 mg, C 10, 20 or 30 mg or long acting octreotide (octreotide LAR) 30 mg. RESULTS: One hundred and twenty-two subjects were randomized. For all depot variants, onset of octreotide release was rapid and sustained for up to 4 weeks. The relative octreotide bioavailability of depot variants vs. octreotide IR ranged from 0.68 (90% confidence interval [CI] 0.61, 0.76) to 0.91 (90% CI 0.81, 1.02) and, vs. octreotide LAR, was approximately four- to five-fold greater: 3.97 (90% CI 3.35, 4.71) to 5.27 ng ml(-1) h (90% CI 4.43, 6.27). All depot variants showed relatively rapid initial reductions of insulin-like growth factor 1 (IGF-1) compared with octreotide LAR. A trend of octreotide dose dependence was also indicated from the plasma concentrations and suppression of IGF-1. Maximum inhibition of IGF-1 at steady-state was highest for depot B and C. All depot treatments were well tolerated. The most frequent adverse events were gastrointestinal related. CONCLUSIONS: Octreotide s.c. depot provides greater octreotide bioavailability with a more rapid onset and stronger suppression of IGF-1 than octreotide LAR in healthy volunteers.

Properties and effects of a novel liquid crystal nanoparticle formulation of docetaxel in a prostate cancer mouse model.

Treatment with docetaxel is the standard of care as first line chemotherapy in castration resistant prostate cancer. Due to serious side effects from the commercially available Taxotere formulation, we aimed to develop a safe and effective nanoparticle formulation of docetaxel. Liquid crystal nanoparticles (LCNPs), based on phosphatidyl choline, glycerol dioleate and polysorbate 80 dispersed in excess aqueous solution, were produced by simple procedures as carriers of docetaxel. Their effect on tumor growth in male SCID mice inoculated with PC-3 cells was compared to the effect of Taxotere and empty LCNP vehicle. Immunohistochemistry was performed to evaluate cell proliferation, angiogenesis and apoptosis in tumor tissue. Docetaxel and lipid excipients were dispersed into well-defined LCNP, stable during long-term storage. Mice subjected to LCNP/docetaxel formulation showed a better tumor regression than mice treated with Taxotere, with an indication of better tolerability. Immunohistochemical staining showed a decreased expression of Ki-67 in tumors from LCNP/docetaxel treated animals, especially in the cores of the tumors, suggesting better penetration/absorption compared to Taxotere. A new lipid-based nanoparticle formulation has been developed as carrier for docetaxel. Treatment effects in SCID mice indicate that this may be an interesting alternative to the current marketed formulation product.

Interactions of lipid-based liquid crystalline nanoparticles with model and cell membranes.

Lipid-based liquid crystalline nanoparticles (LCNPs) are interesting candidates for drug delivery applications, for instance as solubilizing or encapsulating carriers for intravenous (i.v.) drugs. Here it is important that the carriers are safe and tolerable and do not have, e.g. hemolytic activity. In the present study we have studied LCNP particles of different compositions with respect to their mixing behavior and membrane destabilizing effects in model and cell membrane systems. Different types of non-lamellar LCNPs were studied including cubic phase nanoparticles (Cubosome) based on glycerol monooleate (GMO), hexagonal phase nanoparticles (Hexosome) based on diglycerol monooleate (DGMO) and glycerol dioleate (GDO), sponge phase nanoparticles based on DGMO/GDO/polysorbate 80 (P80) and non-lamellar nanoparticles based on soy phosphatidylcholine (SPC)/GDO. Importantly, the LCNPs based on the long-chain monoacyl lipid, GMO, were shown to display a very fast and complete lipid mixing with model membranes composed of multilamellar SPC liposomes as assessed by a fluorescence energy transfer (FRET) assay. The result correlated well with pronounced hemolytic properties observed when the GMO-based LCNPs were mixed with rat whole blood. In sharp contrast, LCNPs based on mixtures of the long-chain diacyl lipids, SPC and GDO, were found to be practically inert towards both hemolysis in rat whole blood as well as lipid mixing with SPC model membranes. The LCNP dispersions based on a mixture of long-chain monoacyl and diacyl lipids, DGMO/GDO, displayed an intermediate behavior compared to the GMO and SPC/GDO-based systems with respect to both hemolysis and lipid mixing. It is concluded that GMO-based LCNPs are unsuitable for parenteral drug delivery applications (e.g. i.v. administration) while the SPC/GDO-based LCNPs exhibit good properties with limited lipid mixing and hemolytic activity. The correlation between results from lipid mixing or FRET experiments and the in vitro hemolysis data indicates that FRET assays can be one useful screening tool for parenteral drug delivery systems. It is argued that the hemolytic potential is correlated with chemical activity of the monomers in the mixtures.

Interaction between lamellar (vesicles) and nonlamellar lipid liquid-crystalline nanoparticles as studied by time-resolved small-angle X-ray diffraction.

The kinetics of structure change when dispersions of two different types of lipid-based liquid-crystalline phases, one lamellar and one reversed, are mixed has been investigated using synchrotron small-angle X-ray diffraction and ellipsometry. The systems studied were (i) cubic-phase nanoparticles (CPNPs) based on glycerol monooleate (GMO) stabilized with a nonionic block copolymer, Pluronic F-127; (ii) CPNPs based on phytantriol (PtOH) stabilized with D-alpha-Tocopheryl polyethylene glycol 1000 succinate (Vitamin E TPGS); and (iii) hexagonal-phase nanoparticles (HPNPs) based on a lipid mixture of diglycerol monooleate/glycerol dioleate, stabilized by Pluronic F-127. Time-resolved small-angle X-ray diffraction was used to track structural changes within nonlamellar nanoparticles when they interact with uni- and multilamellar vesicles of dioleoylphosphatidylcholine and dipalmitoylphatidylcholine. The results are very dependent on the type of nanoparticles under investigation. For GMO-based CPNPs, a strong interaction is observed on mixing with vesicular dispersions that leads to large changes in unit size dimensions as well as a later transition from cubic to lamellar structure. These results are in good agreement with previous studies on the interaction of GMO-based CPNPs with planar bilayers using neutron reflectivity, where the diffraction peak shifted with time upon mixing. The structural changes are much less prominent for the PtOH-based CPNPs and the HPNPs upon mixing with phospholipid vesicles. These results are correlated with those from measurement studying interactions between the liquid-crystalline nanoparticles and supported phospholipid bilayers by ellipsometry. Also, here the GMO-based CPNPs show more pronounced and rapid adsorption and interaction with the supported bilayer surface than do the other types of nonlamellar nanoparticles. The interaction also depends on the bilayer properties, where significantly slower lipid mixing is observed for a bilayer in the gel state compared to a bilayer in the liquid-crystalline phase. This study is not only relevant for drug-delivery applications but also shows the potential of synchrotron small-angle X-ray diffraction in studying time-dependent structural changes as a consequence of the interaction between different lipid self-assembled aggregates in complex systems.

A combined in vitro and in vivo study on the interactions between somatostatin and lipid-based liquid crystalline drug carriers and bilayers.

Somatostatin (SST) is a peptide hormone active in the regulation of the endocrine system via different somatostatin receptors subtypes. It inhibits the release of multiple secondary peptide hormones, affecting neurotransmission and cell proliferation. SST has a high therapeutic potential in the treatment of disease, such as acromegali, acute pancreatitis and gastroenteropathic endocrine tumors. However, its practical use is hampered by a short in vivo half-life of only a few minutes in man. For this reason more long-lived SST analogues, including octreotide and lanreotide, have been developed. Here we have used native SST as a model compound for a different approach of extending plasma half-lives of in vivo labile biomolecules. Through association of the peptide hormone with lipid-based liquid crystalline nanoparticle (LCNP) carriers, the terminal half-life of SST injected intravenously in rats is shown to be significantly extended from less than 10min to more than 1h. The effect on the in vivo circulation behavior depends on the mode of peptide association to the lipid particles and related physicochemical properties are discussed on the basis of in vitro light scattering, z-potential and adsorption measurements. It is concluded that application of the LCNP delivery system represents an interesting alternative to chemical modifications of in vivo sensitive therapeutically interesting peptides.

Structure of lyotropic self-assembled lipid nonlamellar liquid crystals and their nanoparticles in mixtures of phosphatidyl choline and alpha-tocopherol (vitamin E).

The structural/phase behaviour of self-assembled lyotropic liquid crystals formed in mixtures of a phospholipid and alpha-tocopherol (vitamin E) is presented.

Physicochemical and drug delivery aspects of lipid-based liquid crystalline nanoparticles: a case study of intravenously administered propofol.

Liquid crystalline nanoparticles (LCNP) formed through lipid self-assembly have a range of attractive properties as in vivo drug delivery carriers. In particular they offer: a wide solubilization spectrum, and consequently high drug payloads; effective encapsulation; stabilization and protection of sensitive drug substances. Here we present basic physicochemical features of non-lamellar LCNP systems with a focus on intravenous drug applications. This is exemplified by the formulation properties and in vivo behavior using the drug substance propofol; a well-known anesthetic agent currently used in clinical practice in the form of a stable emulsion. In order to appraise the drug delivery features of the LCNP system the current study was carried out with a marketed propofol emulsion product as reference. In this comparison the propofol-LCNP formulation shows several useful features including: higher drug-loading capacity, lower fat-load, excellent stability, modified pharmacokinetics, and an indication of increased effect duration.

"Sponge" nanoparticle dispersions in aqueous mixtures of diglycerol monooleate, glycerol dioleate, and polysorbate 80.

Lipid nanoparticles of nonlamellar lyotropic phases have a wide solubilizing and encapsulating spectrum for a range of substances thanks to their nanostructured interior featuring both lipophilic and hydrophilic domains. As a consequence, these systems have emerged as promising drug delivery systems in various pharmaceutical and diagnostic applications. Here we present the phase behavior and dispersion properties of a novel three-component lipid system composed of diglycerol monooleate (DGMO), glycerol dioleate (GDO), and polysorbate 80 (P80) which shows several advantageous features relating to drug delivery applications including: spontaneous dispersion formation with a narrow size distribution and tunable particle phase-structure. The obtained phase diagram shows the presence of lamellar (L(alpha)), hexagonal (H(2)), and reverse bicontinuous cubic (V(2)) liquid crystalline phases and an inverse micellar (L(2)) solution. A particularly interesting observation is the presence of a phase region where two liquid phases coexist, most likely the L(2) and L(3) ("sponge phase"). These two phase structures appear also to coexist in the submicron particles formed in the dilute water region, where the L(3) element appears to stabilize nanoparticles with inner L(2) structure. Increasing the fraction of the dispersing P80 component results in the growth of the more water rich L(3) "surface phase" at the expense of the size of the inner L(2) core.

Self-assembled lipid superstructures: beyond vesicles and liposomes.

A unique set of nanoparticle dispersions of self-assembled lipid mesophases with distinctive reversed cubic, hexagonal, and sponge phase structures has been prepared by use of original lipid combinations and a simple, generally applicable and scalable method. All key properties, particle size distributions, shape, phase structure, and stability, are controlled predictably and reproducibly. The results suggest the cross-disciplinary use of nonlamellar particle structures in science and technology as, for instance, biomimetics, in vivo drug delivery vehicles for diagnostic and therapeutic agents, protein crystallization matrices, and soft nanoporous materials.

Aqueous phase behavior and dispersed nanoparticles of diglycerol monooleate/glycerol dioleate mixtures.

The first part of this study concerns the aqueous phase behavior of mixtures of diglycerol monooleate (DGMO) and glycerol dioleate (GDO) examined by X-ray diffraction (XRD). The ternary phase diagram displays a multitude of liquid crystalline phases (polymorphism). With increasing GDO content the following phase sequence was observed: lamellar (L(alpha)); two reversed bicontinuous cubic phases (Q(230) and Q(224)); reversed hexagonal (H(II)); the reversed micellar (L(2)) phase. The second part deals with the preparation and characterization of aqueous dispersions of the reversed hexagonal phase in the presence of the nonionic triblock copolymer Pluronic F127. Submicrometer-sized monocrystalline H(II) phase particles were obtained, as evidenced by cryo-transmission electron microscopy (cryo-TEM), laser diffraction, and XRD, by use of a simple and reproducible preparation method including a heat-treatment step. Moreover, the particle size distributions of the H(II) phase nanoparticle dispersions were narrow as determined by laser diffraction measurements. Using XRD, we show that the polymeric stabilizer is depleted from the core of the hexagonal particles and preferentially located at the surface. It is concluded that the preferential distribution of stabilizing agents at particle surfaces is a prerequisite for the formation of structurally well-defined and kinetically stable H(II) phase particles (Hexosome).

Cubic phase nanoparticles (Cubosome): principles for controlling size, structure, and stability.

Methods and compositions for producing lipid-based cubic phase nanoparticles were first discovered in the 1990s. Since then a number of studies have been presented, but little is known about how to control key properties such as particle size, morphology, and stability of cubic phase dispersions. In the present work we give examples of how these properties can be tuned by composition and processing conditions. Importantly we show that stable particle dispersions with consistent size and structure can be produced by a simple processing scheme comprising a homogenization and heat treatment step.

Cubic phases and cubic phase dispersions in a phospholipid-based system.

A cubic liquid crystalline phase forming system based on the phospholipid dioleoylphosphatidylethanolamine (DOPE) which is fortified with small amounts of PEGylated (poly(ethylene) glycol) glycerol monooleate (PEG(660)-GMO) is characterized. The cubic phase formed by the DOPE/PEG(660)-GMO/water system coexists with water in the dilute part of the phase diagram and can be fragmented into colloidal size particles with retained cubic phase structure.

Phase behavior of DOPE/TritonX100 (reduced) in dilute aqueous solution: aggregate structure and pH-dependence.

The phase behavior of dilute mixtures of dioleoylphosphatidylethanolamine (DOPE) and reduced TritonX100 (TX100(r)) has been investigated at pH 7.4 and 10. Using simple turbidity measurements and optical observations, together with cryo-transmission electron microscopy (cryo-TEM), we estimate the phase boundaries. We show that at both pH 7.4 and 10, a very large amount of surfactant is needed for the onset of micelle formation (X(TX100(r)) approximately 0.60-0.70) as well as for a complete solubilization of DOPE into mixed micelles (X(TX100(r)) > 0.94). We find that the micelles that are formed at high TX100(r) concentrations are of spherical shape. Increasing the pH from 7.4 to 10 has a comparably small effect on the transition from a lamellar (Lalpha) to a micellar (L1) phase. However, the reversed hexagonal phase (H(II)) that is present at low surfactant content at pH 7.4 is absent at pH 10. This is due to the partial negative charge of DOPE at pH 10. We determine the fraction of charged DOPE (alpha = 0.34) at pH 10 in a 150 mM NaCl buffer using zeta-potential (zeta-potential) measurements in combination with a Poisson-Boltzmann (PB) model. The intrinsic pK(a) of the primary amino group of DOPE, in a pure DOPE membrane, is estimated to 9.15 +/- 0.2.

Liposomes, disks, and spherical micelles: aggregate structure in mixtures of gel phase phosphatidylcholines and poly(ethylene glycol)-phospholipids.

Poly(ethylene glycol) (PEG) decorated lipid bilayers are widely used in biomembrane and pharmaceutical research. The success of PEG-lipid stabilized liposomes in drug delivery is one of the key factors for the interest in these polymer/lipid systems. From a more fundamental point of view, it is essential to understand the effect of the surface grafted polymers on the physical-chemical properties of the lipid bilayer. Herein we have used cryo-transmission electron microscopy and dynamic light scattering to characterize the aggregate structure and phase behavior of mixtures of PEG-lipids and distearoylphosphatidylcholine or dipalmitoylphosphatidylcholine. The PEG-lipids contain PEG of molecular weight 2000 or 5000. We show that the transition from a dispersed lamellar phase (liposomes) to a micellar phase consisting of small spherical micelles occurs via the formation of small discoidal micelles. The onset of disk formation already takes place at low PEG-lipid concentrations (<5 mol %) and the size of the disks decreases as more PEG-lipid is added to the lipid mixture. We show that the results from cryo-transmission electron microscopy correlate well with those obtained from dynamic light scattering and that the disks are well described by an ideal disk model. Increasing the temperature, from 25 degrees C to above the gel-to-liquid crystalline phase transition temperature for the respective lipid mixtures, has a relatively small effect on the aggregate structure.

Sugar-based gemini surfactant with a vesicle-to-micelle transition at acidic pH and a reversible vesicle flocculation near neutral pH.

A sugar-based (reduced glucose) gemini surfactant forms vesicles in dilute aqueous solution near neutral pH. At lower pH, there is a vesicle-to-micelle transition within a narrow pH region (pH 6.0-5.6). The vesicles are transformed into large cylindrical micelles that in turn are transformed into small globular micelles at even lower pH. In the vesicular pH region, the vesicles are positively charged at pH < 7 and exhibit a good colloidal stability. However, close to pH 7, the vesicles become unstable and rapidly flocculate and eventually sediment out from the solution. We find that the flocculation correlates with low vesicle zeta-potentials and the behavior is thus well predicted by the classical DLVO theory of colloidal stability. Surprisingly, we find that the vesicles are easily redispersed by increasing the pH to above pH 7.5. We show that this is due to a vesicle surface charge reversal resulting in negatively charged vesicles at pH > 7.1. Adsorption, or binding, of hydroxide ions to the vesicular surface is likely the cause for the charge reversal, and a hydroxide ion binding constant is calculated using a Poisson-Boltzmann model.

Development of EGF-conjugated liposomes for targeted delivery of boronated DNA-binding agents.

Liposomes are of interest as drug delivery tools for therapy of cancer and infectious diseases. We investigated conjugation of epidermal growth factor, EGF, to liposomes using the micelle-transfer method. EGF was conjugated to the distal end of PEG-DSPE lipid molecules in a micellar solution and the EGF-PEG-DSPE lipids were then transferred to preformed liposomes, either empty or containing the DNA-binding compound, water soluble acridine, WSA. We found that the optimal transfer conditions were a 1-h incubation at 60 degrees C. The final conjugate, (125)I-EGF-liposome-WSA, contained approximately 5 mol % PEG, 10-15 EGF molecules at the liposome surface, and 10(4) to 10(5) encapsulated WSA molecules could be loaded. The conjugate was shown to have EGF-receptor-specific cellular binding in cultured human glioma cells.