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利培酮微球给药作为联合治疗的替代方案。

Microsphere delivery of Risperidone as an alternative to combination therapy.

作者信息

D'Souza Susan, Faraj Jabar, DeLuca Patrick

机构信息

University of Kentucky College of Pharmacy, Lexington, USA.

出版信息

Eur J Pharm Biopharm. 2013 Nov;85(3 Pt A):631-9. doi: 10.1016/j.ejpb.2013.07.012. Epub 2013 Jul 24.

Abstract

The purpose of this study was to develop a parenteral delivery system of Risperidone that would provide initial and extended drug release and thereby avoid the need for co-administration of oral tablets. Key formulation parameters utilized to achieve desired therapeutic levels in vivo were particle size and drug loading. Three poly (D,L-lactide-co-glycolide) (PLGA) microsphere formulations (Formulations A, B, and C) that encapsulated Risperidone were prepared by varying particle size (19-49 μm) and drug loading parameters (31-37%) but with a uniform bulk density (0.66-0.69)g/cc and internal porosity, utilizing the solvent extraction/evaporation method. The microspheres were characterized for drug content by HPLC, particle size by laser diffractometry, surface morphology by scanning electron microscopy (SEM), and in vivo drug release. In vivo studies were performed in male Sprague-Dawley rats, and levels of the active moiety (Risperidone and its metabolite, 9-hydroxyrisperidone) were assessed. In vivo release profiles from the three microsphere formulations were dependent on particle size and drug loading. The smaller sized microspheres (Formulation A) exhibited a large initial burst and a shorter duration of action, while the larger particles exhibited a smaller initial burst (Formulations B and C) but released drug for a much longer period in vivo. Extended duration of drug release was ascribed to higher drug content in the microspheres. A biweekly simulation of multiple dosing revealed that Formulation C, the selected formulation, with a high load and large particle size would provide adequate initial and maintenance levels of the active moiety (Risperidone and its metabolite, 9-hydroxyrisperidone). A comparison of biweekly dosing in vivo of Formulation C with the marketed product showed that at steady state, though average concentrations for both preparations were similar, the time taken to achieve steady state was much faster for Formulation C. The delay in attaining steady state with Risperdal Consta® was attributed to the 3 week latency in drug release from the microspheres and was in accordance with previous studies indicating a good corroboration with clinical findings. Calculated cumulative AUC (area under the curve) levels for Formulation C were similar to the Risperdal Consta®, though there were marked differences in AUC levels at the early time points. Comparison of Risperidal Consta® and Formulation C by multiple dosing in vivo experiments revealed that the marketed preparation demonstrated a substantial delay in providing an initial loading dose, continuous circulating levels, and attainment of steady state; all of which were observed rapidly with Formulation C. Findings from the current study strongly suggest that a microsphere dosage form of Risperidone can be formulated with an optimum particle size and drug loading to provide an initial bolus followed by maintenance levels, thereby eliminating combination therapy and improving patient compliance.

摘要

本研究的目的是开发一种利培酮的肠胃外给药系统,该系统能够实现药物的初始释放和延长释放,从而避免同时服用口服片剂的必要性。为在体内达到所需治疗水平而采用的关键制剂参数是粒径和载药量。通过改变粒径(19 - 49μm)和载药量参数(31 - 37%),但保持均匀的堆积密度(0.66 - 0.69)g/cc和内部孔隙率,利用溶剂萃取/蒸发法制备了三种包裹利培酮的聚(D,L - 丙交酯 - 乙交酯)(PLGA)微球制剂(制剂A、B和C)。通过高效液相色谱法测定微球的药物含量,用激光衍射法测定粒径,用扫描电子显微镜(SEM)观察表面形态,并进行体内药物释放研究。在雄性Sprague - Dawley大鼠中进行体内研究,并评估活性成分(利培酮及其代谢物9 - 羟基利培酮)的水平。三种微球制剂的体内释放曲线取决于粒径和载药量。较小粒径的微球(制剂A)表现出较大的初始突释和较短的作用持续时间,而较大粒径的微球(制剂B和C)初始突释较小,但在体内释放药物的时间更长。药物释放时间的延长归因于微球中较高的药物含量。每两周进行一次多次给药模拟显示,选定的制剂C,具有高载药量和大粒径,将能提供活性成分(利培酮及其代谢物9 - 羟基利培酮)足够的初始和维持水平。将制剂C在体内每两周给药一次与市售产品进行比较,结果表明在稳态时,虽然两种制剂的平均浓度相似,但制剂C达到稳态所需的时间要快得多。使用利培酮长效注射剂(Risperdal Consta®)达到稳态的延迟归因于微球药物释放的3周潜伏期,这与先前的研究一致,表明与临床结果有良好的相关性。制剂C计算得出的累积曲线下面积(AUC)水平与利培酮长效注射剂相似,尽管在早期时间点AUC水平存在显著差异。通过体内多次给药实验对利培酮长效注射剂和制剂C进行比较,结果表明市售制剂在提供初始负荷剂量、持续循环水平和达到稳态方面有显著延迟;而制剂C能迅速观察到所有这些情况。本研究结果强烈表明,可以将利培酮微球剂型制成具有最佳粒径和载药量的制剂,以提供初始推注剂量,随后维持一定水平,从而消除联合治疗并提高患者依从性。

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