Abstract
This investigation evaluated the feasibility of using subdermally implantable devices fabricated by nonconventional 3-dimensional printing technology for controlled delivery of ethinyl estradiol (EE2). In vitro release kinetics of EE2 and in vivo pharmacokinetics pharmacodynamics in ovariectomized New Zealand White rabbits were carried out to study 3 implant prototypes: implant I (single-channel EE2 distribution in polycaprolactone polymer core), implant II (homogeneous EE2 distribution in polycaprolactone polymer matrix), and implant III (concentration-gradient EE2 distribution in polycaprolactone and poly(dl-lactide-co-glycolide) (50∶50 matrix). EE2 was found to be released from all the implants in a nonlinear pattern with an order of implant III>implant II>implant I. The noncompartmental pharmacokinetic analysis of plasma EE2 profiles in rabbits indicated a significant difference (p>.05) in Cmax, tmax, and mean residence time between implant I and implants II and III, but no difference in the area under the plasma concentration time curves calculated by trapezoidal rule (AUC) among the implants. For pharmacodynamic studies, endogenous follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were observed to be suppressed following implantation of all implants, which demonstrated that a therapeutically effective dose of EE2 had been delivered. Furthermore, the noncompartmental analysis of plasma FSH and LH profiles in rabbits showed a significant difference (p<.05) in AUC and the mean residence time between implant III and implants I and II. A good in vivo/in vitro relationship was observed between daily amounts of EE2 released and plasma profiles of EE2 for all implants. This relationship suggests that plasma profiles of EE2 could be predicted from in vitro measurement of daily amount of EE2 released Therefore, performing in vitro drug release studies may aid in the development of an EE2 implant with the desired in vivo release rate.
Keywords: 3-dimensional printing, ethinyl estradiol, implant, pharmacokinetic, pharmacodynamic rabbit
Full Text
The Full Text of this article is available as a PDF (165.4 KB).
References
- 1.Balfour JA, Coukell AJ. Levonorgestrel subdermal implants. A review of contraceptive efficacy and acceptability. Drugs. 1998;55:861–887. doi: 10.2165/00003495-199855060-00019. [DOI] [PubMed] [Google Scholar]
- 2.Brouwers JR. Advanced and controlled drug delivery systems in clinical disease management. Pharm World Sci. 1996;18:153–162. doi: 10.1007/BF00820726. [DOI] [PubMed] [Google Scholar]
- 3.Kailasam S, Daneluzzi D, Gangadharam PR. Maintenance of therapeutically active levels of isoniazid for prolonged periods in rabbits after a single implant of biodegradable polymer. Tubercle Lung Dis. 1994;75:361–365. doi: 10.1016/0962-8479(94)90082-5. [DOI] [PubMed] [Google Scholar]
- 4.Allababidi S, Shah JC. Kinetics and mechanism of release from glyceryl monostearate-based implants: evaluation of release in a gel simulating in vivo implantation. J Pharm Sci. 1998;87:738–744. doi: 10.1021/js9703986. [DOI] [PubMed] [Google Scholar]
- 5.Ramchandani M, Robinson D. In vitro and in vivo release of ciprofloxacin from PLGA 50∶50 implants. J Control Rel. 1998;54:167–175. doi: 10.1016/S0168-3659(97)00113-2. [DOI] [PubMed] [Google Scholar]
- 6.Dang W, Daviau T, Brem H. Morphological characterization of polyanhydride biodegradable implant gliadel during in vitro and in vivo erosion using scanning electron microscopy. Pharm Res. 1996;13:683–691. doi: 10.1023/A:1016035229961. [DOI] [PubMed] [Google Scholar]
- 7.Wachol-Drewek Z, Pfeiffer M, Scholl E. Comparative investigation of drug delivery of collagen implants saturated in antibiotic solutions and a sponge containing gentamicin. Biomaterials. 1996;17:1733–1738. doi: 10.1016/0142-9612(96)87654-X. [DOI] [PubMed] [Google Scholar]
- 8.Allababidi S, Shah JC. Efficacy and pharmacokinetics and site-specific cefazolin delivery using biodegradable implants in the prevention of post-operative wound infections. Pharm Res. 1998;15:325–333. doi: 10.1023/A:1011939323560. [DOI] [PubMed] [Google Scholar]
- 9.Makarainen L, van Beek A, Tuomivaara L, Asplund B, Coelingh Bennink H. Ovarian function during the use of a single contraceptive implant: Implanon compared with Norplant. Fertil Steril. 1998;69:714–721. doi: 10.1016/S0015-0282(98)00015-6. [DOI] [PubMed] [Google Scholar]
- 10.Sivin I, Lahteenmaki P, Mishell DR, et al. First week drug concentrations in women with levonorgestrel rod or Norplant capsule implants. Contraception. 1997;56:317–321. doi: 10.1016/S0010-7824(97)00153-4. [DOI] [PubMed] [Google Scholar]
- 11.Klijn JG, van Geel B, de Jong FH, Sandow J, Krauss B. The relation between pharmacokinetics and endocrine effects of buserelin implants in patients with mastalgia. Clin Endocrinol (Oxford). 1991;34:253–258. doi: 10.1111/j.1365-2265.1991.tb03763.x. [DOI] [PubMed] [Google Scholar]
- 12.Yoburn BC, Cohen AH, Inturrisi CE. Pharmacokinetics and pharmacodynamics of subcutaneous naltrexone pellets in the rat. J Pharmacol Exp Ther. 1986;237:126–130. [PubMed] [Google Scholar]
- 13.Yoburn BC, Chen J, Huang T, Inturrisi CE. Pharmacokinetics and pharmacodynamics of subcutaneous morphine pellets in the rat. J Pharmacol Exp Ther. 1985;235:282–286. [PubMed] [Google Scholar]
- 14.Chien YW. Novel Drug Delivery Systems. 2nd ed. New York, NY: Marcel Dekker, Inc.; 1992. pp. 443–458. [Google Scholar]
- 15.Chien YW. Polymer-controlled drug delivery systems: science and engineering. In: Gebelein CG, Carraher CE, editors. Polymeric Materials in Medication. New York, NY: Plenum Press; 1985. pp. 27–46. [Google Scholar]
- 16.Cima MJ, Sachs EM, Fan T, et al, inventors: Three-dimensional printing techniques. US patent 5 387 380. 1995.
- 17.Sachs EM, Haggerty JS, Cima MJ, Williams PA Three-dimensional printing techniques. US patent 5 340 656. 1994.
- 18.Sachs EM, Haggerty JS, Cima MJ. Williams PA Three-dimensional printing techniques. US patent 5 204 055. 1993.
- 19.Monkhouse D. TheriForm™: a new process for preparing prescriptive dosage forms. Presented at 39th Annual International Industrial Pharmaceutical Research Conference; June 2–5, 1997; Merrimac, WI.
- 20.Wu BM, Borland SW, Giordano RA, Cima LG, Sachs EM, Cima MJ. Solid free-form fabrication of drug delivery devices. J Control Rel. 1996;40:77–87. doi: 10.1016/0168-3659(95)00173-5. [DOI] [Google Scholar]
- 21.Physicians' Desk Reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:3347–3348.
- 22.Pau KY, Orstead KM, Hess DL, Spies HG. Feedback effects of ovarian steroids on the hypothalamic-hypophyseal axis in the rabbit. Biol Reprod. 1986;35:1009–1023. doi: 10.1095/biolreprod35.4.1009. [DOI] [PubMed] [Google Scholar]
- 23.Orstead KM, Hess DL, Spies HG. Pulsatile patterns of gonadotropins and ovarian steroids during estrus and pseudopregnancy in the rabbit. Biol Reprod. 1988;38:733–743. doi: 10.1095/biolreprod38.4.733. [DOI] [PubMed] [Google Scholar]
- 24.PCNONLIN User Guide. 4th ed. Lexington. KY: Statistical Consultants, Inc: 1992.
- 25.Peyman GA, Yang D, Khoobehi B, Rahimy MH, Chin SY. In vitro evaluation of polymeric matrix and porous biodegradable reservoir devices for slow-release drug delivery. Ophthalmic Surg Lasers. 1996;27:384–391. [PubMed] [Google Scholar]
- 26.Zhou T, Lewis H, Foster RE, Schwendeman SP. Development of a multiple-drug delivery implant for intraocular management of proliferative vitreoretinopathy. J Control Rel. 1998;55:281–295. doi: 10.1016/S0168-3659(98)00061-3. [DOI] [PubMed] [Google Scholar]