Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region.
Department of Pharmacy, King's College London, 150 Stamford Street, London SE1 9NH, United Kingdom.
Int J Pharm. 2019 Apr 5;560:144-154. doi: 10.1016/j.ijpharm.2019.01.057. Epub 2019 Feb 4.
Systemic administration of antifungal agents for the treatment of pulmonary aspergillosis is limited by the poor lung deposition and severe adverse effects. In contrast, pulmonary delivery allows a higher amount of drug to be delivered directly to the infection site and therefore a lower dose is required. This study aimed to develop porous and inhalable voriconazole dry powder with good lung deposition by spray freeze drying (SFD), using tert-butyl alcohol (TBA) as a co-solvent. A three-factor two-level full factorial design approach was used to investigate the effect of total solute concentration, drug content and co-solvent composition on the aerosol performance of the SFD powder. In general, the SFD voriconazole powder exhibited porous and spherical structure, and displayed crystalline characteristics. The analysis of factorial design indicated that voriconazole content was the most significant variable that could influence the aerosol performance of the SFD powders. The formulations that contained a high voriconazole content (40% w/w) and high TBA concentration in the feed solution (70% v/v) displayed the highest fine particle fraction of over 40% in the Next Generation Impactor study in which the powder was dispersed with a Breezhaler® at 100 L/min. In addition, the fine particle dose of the SFD powder showed a faster dissolution rate when compared to the unformulated voriconazole. Intratracheal administration of SFD voriconazole powder to mice resulted in a substantially higher drug concentration in the lungs when comparing to the group that received an equivalent dose of liquid voriconazole formulation intravenously, while a clinically relevant plasma drug concentration was maintained for at least two hours. Overall, an inhalable voriconazole dry powder formulation exhibiting good aerosol property and lung deposition was developed with clinical translation potential.
全身用抗真菌药物治疗肺部曲霉菌病受到肺部沉积不良和严重不良反应的限制。相比之下,肺部给药可以将更多的药物直接递送到感染部位,因此需要的剂量更低。本研究旨在通过喷雾冷冻干燥(SFD)开发具有良好肺部沉积的多孔和可吸入伏立康唑干粉,使用叔丁醇(TBA)作为共溶剂。采用三因素两水平完全析因设计方法研究总溶质浓度、药物含量和共溶剂组成对 SFD 粉末气溶胶性能的影响。一般来说,SFD 伏立康唑粉末具有多孔和球形结构,并表现出结晶特性。析因设计分析表明,伏立康唑含量是影响 SFD 粉末气溶胶性能的最显著变量。制剂中含有高伏立康唑含量(40%w/w)和高进料溶液中 TBA 浓度(70%v/v)在下一代撞击器研究中显示出超过 40%的细颗粒分数,其中粉末在 100 L/min 下用 Breezhaler®分散。此外,与未配方的伏立康唑相比,SFD 粉末的细颗粒剂量显示出更快的溶解速率。与静脉注射接受等量伏立康唑溶液的液体伏立康唑制剂相比,肺部给药的 SFD 伏立康唑粉末可使肺部的药物浓度显著升高,而临床相关的血浆药物浓度至少维持两小时。总体而言,开发了一种具有良好气溶胶性质和肺部沉积的可吸入伏立康唑干粉制剂,具有临床转化潜力。